The Lamp November 2010

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lamp the

magazine of the NSW Nurses’ Association

volume 67 no.10 November 2010

Print Post Approved: PP241437/00033

NSW GOVT SAYS

NO

TO NURSES IT’S TIME TO ACT

Bu mp F er R sti EE ck er ins ide


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ABOUT THE LAMP

C O N T E N T S

Contacts NSW NURSES’ ASSOCIATION For all membership enquiries and assistance, including Lamp subscriptions and change of address, contact our Sydney office.

Cover story Bu mp

lamp the

magazine of the NSW Nurses’ Association

er FR sti EE ck er ins ide

NSW Govt says NO to nurses It’s time to act 14 12 14 15 16 18 20 22

volume 67 no.10 November 2010

Keneally Government says No to nurses NSWNA claim vs Government response FAQs on nurse-to-patient ratios Action will escalate if Government won’t listen Closing beds won ratios in Victoria How the Victorians won ratios Our TV ads aim to win community support

NSW GOVT SAYS

Print Post Approved: PP241437/00033

NO

Cover

TO NURSES IT’S TIME TO ACT

Jila Talebi-Ardestani, RN; and Cuc Tran, RN, with NSWNA General Secretary Brett Holmes at Bankstown Hospital. Photography by Shane Rozario.

News in brief 8 8 8 8 9 9 9 10 10 10 10

Government announces $425 million for health training Raising awareness of pressure ulcer prevention WA doctors condemn home birth advice on Health Department website Aged care scholarships available HIV/AIDS body calls for investment in prevention programs World Aids Day reminder for nurses to be informed about HIV Australasian Contact Tracing Manual launched NZ nurses reject GST on healthy food Violent workplace encounters put nurses at risk of musculoskeletal pain Anti-bullying advice line available Nurses need more training in handling patients who self-harm Average age of nurses increases Breast check iPhone app launched Australians working fewer hours in the office

Occupational Health and Safety 28 OHS win at Bathurst Base 31 Sharps injuries – a major OHS hazard

Fighting fit nurses 38 Fitness can be fun

NSWNA matters 40 NSWNA Branch News

Obituary 44 Libby King: A ray of sunshine that touched many

Regular columns 5

Editorial by Brett Holmes Your letters to The Lamp Ask Judith Nurses online Nursing research online At the movies Books Our nursing crossword Diary dates

11 What’s on

6 33 34 36 42 45 47 49

Aged care

Competition

11 11 11

NSWNA education program

24 Bupa nurses win fair agreement 26 Nurses thrilled with Riviera agreement

13 Win a trip to Melba House in Katoomba

Special offers 42 Win 25 double passes to Made in Dagenham and Gasland, and 10 double passes to Wild Target

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SYDNEY OFFICE 43 Australia Street Camperdown NSW 2050 PO Box 40 Camperdown NSW 1450 (all correspondence) T 8595 1234 (metro) 1300 367 962 (non-metro) F 9550 3667 E gensec@nswnurses.asn.au W www.nswnurses.asn.au HUNTER OFFICE 120 Tudor Street Hamilton NSW 2303 ILLAWARRA OFFICE L1, 63 Market Street Wollongong NSW 2500 NSWNA COMMUNICATIONS MANAGER Noel Hester T 8595 2153 NSWNA COMMUNICATIONS ASSISTANT Megan Williams T 8595 2159 For all Lamp editorial enquiries, letters and diary dates: Editorial Enquiries T 8595 1234 E lamp@nswnurses.asn.au M PO Box 40 Camperdown NSW 1450 THE LAMP PRODUCED BY Sirius Communications T 9560 1223 W www.siriuscommunications.com.au PRESS RELEASES Send your press releases to: T 9550 3667 E gensec@nswnurses.asn.au THE LAMP EDITORIAL COMMITTEE Brett Holmes, NSWNA General Secretary Judith Kiejda, NSWNA Assistant General Secretary Coral Levett, NSWNA President John Lyons, Baradine MPS Roz Norman, Tamworth Base Hospital Elsie May Henson, Barraba Multi Purpose Service Peg Hibbert, Hornsby & Ku-Ring-Gai Hospital Michelle Cashman, Long Jetty Continuing Care Richard Noort, Justice Health ADVERTISING Patricia Purcell T 8595 2139 or 0416 259 845 F 9550 3667 E ppurcell@nswnurses.asn.au RECORDS AND INFORMATION CENTRE – LIBRARY To find old articles in The Lamp, or to borrow from the NSWNA library’s nursing and health collection, contact: Jeannette Bromfield, RIC Coordinator T 8595 2175 E gensec@nswnurses.asn.au THE LAMP ISSN: 0047-3936 General disclaimer The Lamp is the official magazine of the NSWNA. Views expressed in articles are contributors’ own and not necessarily those of the NSWNA. Statements of fact are believed to be true, but no legal responsibility is accepted for them. All material appearing in The Lamp is covered by copyright and may not be reproduced without prior written permission. The NSWNA takes no responsibility for the advertising appearing herein and it does not necessarily endorse any products advertised. Privacy Privacy statement: The NSWNA collects personal information from members in order to perform our role of representing their industrial and professional interests. We place great emphasis on maintaining and enhancing the privacy and security of your personal information. Personal information is protected under law and can only be released to someone else where the law requires or where you give permission. If you have concerns about your personal information please contact the NSWNA office. If you are still not satisfied that your privacy is being maintained you can contact the Privacy Commission. Subscriptions Free to all Association members. Professional members can subscribe to the magazine at a reduced rate of $50. Individuals $73, Institutions $120, Overseas $130.


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& Havnce to a cha

e u t x o u l H a a L i r g Shan

Start paying your NSWNA fees by Direct Debit for the chance to win a two-night stay in one of Sydney’s top five-star hotels, the Shangri-La Hotel, Sydney. The Direct Debit prize includes two nights’ accommodation in a Horizon Deluxe Grand Harbour View Room with Horizon club privileges, breakfast on the Horizon Club Floor or option of a full hot breakfast on Level 1 of the hotel. Afternoon tea, evening drinks and Canapes on the Horizon Club Floor are also included, as well as two rescue release treatments in CHI, The Spa to treat and relieve muscle tension in the troubled areas of your body. Situated in the historic Rocks district within easy walking distance of the city’s main shopping and commercial districts, with breathtaking views of Sydney Harbour, the deluxe five-star Shangri-La Hotel, Sydney, offers the city’s largest guest rooms, all with water views. The Shangri-La Hotel, Sydney, offers a wide selection of dining options and Australia’s first CHI, The Spa.

Here’s how you can win

2Cancel your payroll deductions and start paying your fees

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2Convince your colleagues to convert from payroll deductions

to direct debit, and you and each of your colleagues who switch to direct debit will go into the lucky draw and/or

2Sign up a new member using the direct debit method of paying

their fees, and you and the new member will go into the lucky draw.

Direct debit is not only the easiest and most convenient way to pay your membership, but switching over could win you a luxury holiday! Don’t risk your membership lapsing from changing workplaces. With direct debit you are always protected on the job. Membership Application forms or Direct Debit forms can be downloaded from our website www.nswnurses.asn.au 4 THE LAMP NOVEMBER 2010

Alternatively call the NSWNA on 8595 1234 (metro area) or 1300 367 962 (non-metro area) for more information.


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E D I T O R I A L BY BRETT HOLMES GENERAL SECRETARY

It’s time to take on the State Government g Nurses want ratios and the public thinks they already exist. The main obstacle is a Government afraid to make the necessary bold move to save our health system. It is time to take it on. The future of our public health system and nursing depends on it.

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urses have been patient and reason able. Our Memorandum of Understanding expired four months ago and we have constructively engaged in extensive talks with NSW Health for months. Our claim is not a greedy grab based on wishful thinking. It has been arrived at after years of careful consideration and analysis of the problems of the health system and how they can be rectified. In our opinion mandatory nurse-to-patient ratios are a key starting point in reforming the NSW public health system. Politicians, the media and the public easily fall into the trap of believing that if more money is put into capital works and the creation of beds, the system’s problems will be solved. This is understandable. Clinicians know from long personal experience that without enough experienced staff with the right skills the creation of extra beds will not solve the problems. It seems the key arguments against ratios are the cost and the assertion that there just aren’t enough experienced nurses out there.

Nurses are there and will return if conditions improve The most recent Australian Institute of Health and Welfare (AIHW) figures show that the number of RNs ‘not looking for work’ in NSW was 11,000 compared to 3,000 in Victoria. We believe the reason for this difference is the existence of ratios in Victoria, which make the profession more attractive to work in. NSW has 52% of all nurses nationally who are registered but not looking for work in nursing. There are over 7,000 nurses out there who could

The Victorian experience is instructive, too, when it comes to the cost of funding ratios. Victoria has funded ratios for 10 years without negatively impacting on the State’s finances. If Victoria can afford it, so can NSW. This year the Federal Government committed to pump an extra $7 billion into public health. The money is there. What is lacking is political will and the right set of priorities.

The responsible thing to do now is act

The future of our public health system and nursing is in the balance.The responsible thing to do now the Government refuses to move is to take action. be back in the system but don’t want to be. This is an indictment on the current conditions of work for NSW nurses. Also, there are many graduate nurses who haven’t been able to get employment in public hospitals. In 2010, 2,749 students are expected to graduate but NSW Health is only offering 1,700 positions in the public health system. Considering the dire situation of our public hospitals and the importance of RNs in delivering safe patient care this is scandalous. In Victoria, experienced nurses returned to the profession in their droves once ratios were introduced – 2,650 within the first year.

The most powerful argument for ratios is that they will deliver safer patient care and this drives our determination to achieve them. As The Lamp goes to print, the State Government’s position is a categorical No to ratios. We will continue to meet NSW Health and advance what we believe is a compelling case for the introduction of mandatory nurse-to-patient ratios. This is the responsible approach we have shown all along. But the Government’s position is unlikely to change without action on our part. Over the next month, we will be asking you to stand together as we apply pressure in support of our claim. It will be difficult and will require determination on our part. Every nurse in the public health system will need to play a part. I urge you to talk to your colleagues and convince them that we all need to act together. The future of our public health system and nursing is in the balance. The responsible thing to do now the Government refuses to move is to take action in the interests of patient care. It’s time to take on the State Government.n THE LAMP NOVEMBER 2010 5


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L E T T E R S

LETTER of the month Fran James

Stop criticising EENs I would like to respond to some negative comments about EENs in the September issue of The Lamp. I am an EEN and have been nursing longer than many RNs have been alive, as have many of my EEN colleagues, near and far. I have worked in theatre, ED, ICU, acute surgical wards, and now medical. We are quite capable of accurate documentation, holistic patient care, and detecting early deteriorating signs in our patients. We are also capable of communicating these signs to our RNs and doctors. We can speak for ourselves. At my workplace, like most workplaces, we are quite often working with new grad RNs and nursing students to guide and impart our considerable knowledge to their learning process. I have mentored many students over the years. When an RN rings in sick we also get casual RNs – some quite senior – to replace them. All I can say is that some of these casuals are ‘extremely casual’. In these cases, more often than not, it is the EEN working with them that has to be hyper-vigilant for any patient condition changes. Like many workplaces, when regular staff, both RNs and EENs, are on the shift the morale is high. Perhaps some of our big-city RNs need to spend some time in rural areas to see what it is like in the real world. Fran James, EEN, Medical Ward, Belmont Hospital

Every letter published receives a 6 month weekend subscription to the Herald, valued at over $114! Subscribe to the Herald today to save 41% off the newsstand price and enjoy the convenience of the paper delivered to your home each morning. Visit www.subscribe. smh.com.au/lamp for more details.

We need a Charter for agency nurses I am writing to support the letter published in The Lamp in July 2010 titled ‘More Respect and Consideration for Agency Nurses’ by Elisabeth Connell and would like to propose that the NSWNA endorse a Charter of Rights and Responsibilities for Agency Nurses. Some suggested provisions: 1. All agency nurses are entitled to be treated with courtesy and respect. All agency nurses will treat staff that they work with, with courtesy and respect. 2. Agency nurses are entitled to a brief period of familiarisation with a ward or unit. Basic information on the expectations of the management of that ward or unit shall be conveyed either verbally or in writing at the commencement of the shift. Throughout the shift, all reasonable requests for further information will be answered with courtesy and respect. Agency nurses will ask the ward or unit staff for further information with courtesy and respect. 3. No agency nurse shall be subject to bullying or unreasonable treatment. No agency nurse shall bully or treat staff that they work with unreasonably. 4. The work of agency nurses shall be judged by the same benchmarks as those used for the staff of that ward or unit. 5. Agency nurses are entitled to breaks as specified in the relevant Nurses Award or Agreement, as are the ward or unit staff.

THE TROUBLE WITH TUESDAYS You may be finding it hard to talk to our information officers on Tuesdays. This is because Tuesday is the one day of the week when all our staff are in the office for staff and team meetings. These meetings are essential for information distribution and planning activities. If at all possible, please don’t ring on this day

6 THE LAMP NOVEMBER 2010

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If there are questions about the work of an agency nurse, those questions will, in the first instance, be raised with the agency nurse directly, before approaches are made toward more senior management. If there is a complaint made about an agency nurse, the agency nurse is entitled to be informed of that complaint by the ward or unit in order that they may reply. Having worked as an agency nurse and having listened to my students’ concerns about their treatment as agency nurses in the workplace, I think it is time the NSWNA helped agency nurses deal with the difficulties they face in the workplace, and maybe a Charter is one way that could be done. Jenny Haines, RN, tutor in Law and Ethics, UTS Jenny Haines won the prize for this month’s letter of the month, a $50 Coles Myer voucher.

The letter judged the best each month will be awarded a $50 Coles Myer voucher, courtesy of Medicraft HillRom. For details on the range of hospital beds, trolleys, mattress & care solutions, please visit www.medicrafthill-rom.com or call (02) 9569 0255

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as there can be considerable delays. But if you need urgent assistance, you will get it. Our information department receives approximately 900 calls per week, and the phones are ringing hot from 8.30am to 5pm. NSWNA Information Officers are available until 7pm. We are working hard to meet your needs and thank you for your patience. Call 8595 1234 (metro) or 1300 367 962 (non-metro).


NSW Health needs to stop passing the buck Harry Truman famously had a sign on his desk declaring that ‘The buck stops here’, now synonymous with management hierarchy. However, in the management of NSW Health it would seem that this is a foreign concept and that the ‘buck’ is spun round and returned to sender. In the rural hospital where I work, we will soon have to manage a six-day period without a doctor on call, not because we could not find one willing to work, but because area management would not agree to pay for them. Now this may appear to be good economics when the system is strapped for cash, but not when you consider the following facts: Our ED averages 500 presentations per month, over 60 admissions per month and an average of three ambulances per shift; On COSOPS, (operating without an on-call doctor) we assess patients on presentation, and then refer to our supporting tertiary hospital. If review by a doctor is required, we send the patient by ambulance to that hospital. This is a mandatory aspect of the Medicare charter, as anyone who presents to an ED is entitled to be seen by a doctor. Each trip costs $1,250-$1,500 and because the patient is sent by a nurse – we cannot claim the occasion of service – our hospital has to bear the cost. The patient suffers the inconvenience of having to go a long way from home, when perhaps they could have been treated in our ED, or admitted and nursed locally. We also miss out on extra funding from private patients who are encouraged to use their health insurance. So, for the cost of a Chief Medical Officer (CMO) for six days at $120,000 we could be potentially spending $18,000 on unnecessary ambulance trips, unquantifiable lost inpatient revenue, $500/day lost PP revenue, and unquantifiable stress for patients and staff. Our area management’s answer to pay for the CMO is ‘take it out of the nursing budget’. This is a ludicrous suggestion given our skeleton staffing and they know this. So, if the accepted management hierarchy states ‘The buck stops here’ and we are given the buck back, perhaps it is time to give management back to

hospitals, so good management and plain common sense will prevail. We will also be able to fulfil our mandate to the Medicare Charter. I suggest the first cost saving will be the cost of a manager, who is unwilling and unable to accept ‘the buck’. Mary Smeaton, RN

CPD disappointment Today we need to keep our skills updated. I have been nursing over 35 years under national registration. Nurses now have to keep a professional portfolio to show continuing professional development (CPD), so when the Royal College of Nursing was running a CPD portfolio workshop, I filled out the form and gave it to my NUM. Prior to commencement of the course, I rang the college as I had not heard confirmation. I was informed they had not received the paperwork. I rang my NUM, who told me she had sent it to the next department to be approved. I was to fill in another form. I rang the college again to enquire about the next workshop and the cost. The cost was $113. St George Hospital cannot afford $113 for an

Thank you for sponsoring Balmain Hospital celebration Thanks for being one of the sponsors for Balmain Hospital’s 125th anniversary celebration raffle on 13 August 2010. I have been a member of the NSWNA for over 25 years and I was fortunate to receive first prize in the raffle, which was four nights at the Eaglereach Wilderness Resort near Vacy, NSW.

employee who is now permanent part time only 10 hours a week. Is it the cost? Is it that I do not work enough hours? I just thought I will pay it myself so there would be fewer hassles and problems. Am I so worthless? It is a sad time for nursing; our morale is low and our workload is increasing. How sad nursing has become. Has top management forgotten us? I also feel extremely sorry for our NUM Diana Petrovski, who fills out our forms and is so helpful to me in so many ways. This is the first time I have ever written about a subject, but I did feel let down. Christine Prasad, EEN, St George Public Hospital

Got something to say? Send your letters to: Editorial Enquiries email lamp@nswnurses.asn.au fax 9550 3667 mail PO Box 40 Camperdown NSW 1450 Please include a photograph along with your name, address, phone and membership number. Letters may be edited for clarity and space.

My family and I had a very nice time and got to do yabby catching, kayaking, fishing, tennis, swimming, feeding wild kangaroos and wildlife spotting (there were lots of eagles there). The view of Barrington Tops from our cabin was beautiful. We hope to return for a relaxing getaway again some time. Thanks to all at the NSWNA. Angela Conte, CNS, Balmain Hospital THE LAMP NOVEMBER 2010 7


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N E W S I INN BBRRI IEEFF

GOVERNMENT

ANNOUNCES $425 MILLION

FOR HEALTH

TRAINING he Prime Minister Julia Gillard and the Minister for Health Nicola Roxon last month announced funding for the clinical training of up to 12,000 more medical, nursing and allied health professional students. Twenty-two health and medical professions will benefit in remote, regional and metropolitan Australia including nurses, midwives, doctors, physiotherapists, dieticians, dentists and Aboriginal health workers. The funds are to support the undergraduate clinical training requirements for a 9.1% increase in the number of health professional students over the next three years. This amounts to 1.2 million additional training days annually – an increase of 23.4% compared to the 2009 baseline – in 448 projects across 41 universities and over 700 clinical training providers. Ms Roxon said places had been allocated by Health Workforce Australia (HWA), the new national body established by the Government to address health workforce shortages in a strategic way. HWA have conducted the firstever nationwide workforce planning process to establish where these grants are most needed In its future work HWA will undertake a comprehensive set of profession- and specialty-specific training plans for graduating nurses and medical officers. It is also working on the issue of clinical placements for overseas students. Ms Roxon said $425 million had been allocated for the new training places over the next three years, of which $139 million would be delivered in 2011.

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8 THE LAMP NOVEMBER 2010

Raising awareness of pressure ulcer prevention The NSW State Coroner, Magistrate Mary Jerram, has asked the NSWNA to promote awareness among its members to educate staff, patients and primary carers of the best practice in pressure ulcer prevention. The request came as Her Honour handed down her finding after an inquest into the death of an immobile disabled woman, Kate Therese Bugmy in Broken Hill, from streptococcal sepsis resulting from skin ulceration and complications of cerebral palsy. ‘It is important that all nurses, both in public and private sectors, are aware that NSW Health provides policies and clinical practice guidelines that are considered best practice and are readily available on their website www.health. nsw.gov.au/policies,’ said NSWNA Assistant General Secretary Judith Kiejda. ‘Nurses who work in remote areas and small clinics are often confronted with patients who are immobile and need advice for pressure care. People in those places often ask for advice about what to do with their elderly mother, for example. It’s important that nurses know they have those resources available to them online, even though their local facility may not have such resources.’ Her Honour drew particular attention to the following best practice resources: Clinical Practices – Pressure Ulcer Prevention Policy (a NSW Health Policy Directive – document number PD2005_257), available at www.health.nsw.gov.au/ policies; and Taking the Pressure Off (Wound Care Association of NSW Guidelines, 2008), available at www.wcansw.com.au.

WA doctors condemn home birth advice on Health Department website Doctors in WA have condemned what they regard as the Health Department’s promotion of home births on its website, saying it has biased information and fails to acknowledge the risks to women and their babies, according to The West Australian.

Dr Louise Farrell, the former WA head of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, and the Australian Medical Association, called for the information to be changed or a link to the Community Midwifery Program (CMP) removed, the newspaper reported. The CMP is a publicly-funded service for low-risk women who wish to give birth at home. Despite the department releasing findings of an independent review of home birth last year that found it was generally safe if well supported, doctors insist home births are riskier than hospital ones. AMA WA President Dave Mountain accused the department of using ‘unbalanced’ and ‘biased’ language to promote home births. But chief medical officer Simon Towler told The West Australian the department recognised some women wanted a home birth and referred them to the CMP. He said the recent review found a planned home birth with a qualified practitioner was a safe alternative for women at low risk of complications, but added that the site would be changed to include references to the review and the RANZCOG policy on home birth.

Aged care scholarships available Nurses are encouraged to take advantage of government funding to train in aged care. The Federal Minister for Mental Health and Aged Care, Mark Butler, announced the release of funding for aged care nursing scholarships last month. ‘Successful applicants will be able to undertake studies relating to aged care, including continuing education courses, postgraduate studies and courses leading to a Nurse Practitioner qualification,’ said NSWNA General Secretary Brett Holmes. The funding for the scholarships has come about as a result of the Because we care campaign and solid lobbying by the NSWNA in conjunction with the ANF Branches and Federal office. ‘I urge you to take up these hardwon opportunities,’ said Brett. Applications close for 2010 on 4 November. For more information, visit http://rcna.org.au/scholarships/ agedcarecpd


© Cameron Miller

HIV/AIDS BODY

CALLS FOR INVESTMENT IN PREVENTION

PROGRAMS IV infections will not start declining until prevention investment is increased, according to national HIV/ AIDS body – the Australian Federation of AIDS Organisations (AFAO).

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‘We should be aiming to drive the infection rate down.’ It described the increased HIV diagnoses in 2009 as ‘disappointing’ and called for increased investment in prevention programs by both State and Territory Governments, and the Federal Government. The Annual Surveillance Report on Bloodborne Viruses and Sexually Transmitted Infections for calendar year 2009, released last month, reported 1,050 new diagnoses of HIV infection in 2009, compared with 1,001 in 2008 and 1,048 in 2007. ‘These figures indicate a plateau over the past three years and it is clear we will not start driving HIV infection rates down unless governments at both state and national levels increase their investments in prevention programs,’ said AFAO Executive Director Don Baxter. ‘We are operating at the minimum level of investment to maintain HIV infections at this unacceptable rate – but we should be aiming to drive the infection rate down.’ Mr Baxter also warned that the evidence indicating increasing rates of injecting drug use in many Aboriginal communities also threatens a significant increase in HIV infections over the next five years unless effective, community-led prevention programs are put in place.

World AIDS Day reminder for nurses to be informed about HIV Nurses are encouraged to wear a red ribbon on World AIDS Day and to keep up to date with information about HIV, transmission, privacy and effective universal precautions to make health care more comfortable for patients and themselves. World AIDS Day is observed on 1 December in over 120 countries worldwide to raise awareness in the community about HIV and AIDS, including the need for support and understanding for people living with HIV, and the need for education and prevention initiatives. There are more than 17,000 people living with HIV in Australia, most of whom are working full or part time and leading fulfilling and productive working lives. Many are employed in health and allied health services. Information and awareness training about HIV is available, with details available on Positive Life NSW’s World AIDS Day website. Positive Life NSW is a non-profit community organisation that works to promote a positive image of people living with and affected by HIV with the aim of eliminating prejudice, isolation, stigmatisation and discrimination. Visit www.worldaidsdaynsw.org for more information on World AIDS Day and how to buy a red ribbon.

Australasian Contact Tracing Manual launched The fourth edition of the Australasian Contact Tracing Manual was launched at the 2010 Sexual Health Conference last month. Produced by the Australasian Society for HIV Medicine (ASHM), the manual is a national resource available to health care workers for the contact tracing – or partner notification – of sexually transmissible infections, viral hepatitis and HIV-related tuberculosis. The need for a revised version was initiated by ASHM in response to recent research suggesting both health-care providers and patients diagnosed with STIs would like more guidance and resources to assist them with partner notification. The manual includes a range of patient handouts, sample referral letters for partners, and resources for health-care professionals to provide to both patients and partners of patients. The Australasian Contact Tracing Manual is funded by the Department of Health and Ageing and is distributed free throughout Australia. It is available as a hard copy handbook and now in a searchable webbased format at www.ashm.org.au/ctm. It can also be ordered online or downloaded at www.ashm.org.au/resources THE LAMP NOVEMBER 2010 9


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N E W S I INN BBRRI IEEFF

NZ NURSES

Violent workplace encounters put nurses at risk of musculoskeletal pain

he New Zealand Nurses Organisation (NZNO) has passed a remit to support the removal of GST from healthy food. ‘One of NZNO’s strategic aims is to oppose injustice and inequality wherever it impacts on the health and well-being of New Zealanders. Removing GST from healthy food would certainly be a step in the right direction to achieving this goal,’ said Rosemary Minto, Chair of NZNO College of Primary Health Care Nurses.

Nursing home workers who are routinely exposed to violent encounters with either the residents they care for or visitors to the nursing home face a three times greater risk for developing painful musculoskeletal conditions, according to a study. Dr Helena Miranda, of the Finnish Institute of Occupational Health in Helsinki, led a team that surveyed 920 employees working at 12 different nursing homes that were owned by a single company, located in Maryland and Maine in the US. The study authors found that nearly half the workers had been attacked in some manner by a patient or a patient’s visitor at least one time during the three months prior to being surveyed. A quarter of the workers said they had been repeatedly attacked in that timeframe. The risk for attack appeared to be greater among younger and newer staff, the researchers observed. Overall, the more a person was attacked, the greater likelihood that he or she went on to develop musculoskeletal pain, according to the report, which is published in the 28 September online edition of the journal Occupational & Environmental Medicine. Widespread pain across the lower back, shoulders, hands and knees was three times more common among those who had been attacked three or more times in the prior three months, the researchers noted. ‘Musculoskeletal disorders are a leading reason for sick leave and permanent disability in most occupations, particularly health care,’ the authors said. ‘Good workplace safety in nursing homes is likely to protect against this and many other adverse effects of violence.’

REJECT GST ON HEALTHY FOOD

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‘If GST was removed from healthy food it would be one less barrier to accessing healthy food.’ According to NZNO, studies show that the availability of food and access to it is presenting a growing health problem for New Zealanders during the current global financial crisis, particularly for those on low incomes. ‘Low-income earners pay a higher proportion of their income in GST than high-income earners. If GST was removed from healthy food it would be one less barrier to accessing healthy food,’ said Ms Minto. ‘If GST is removed from healthy food, nurses and health care workers would expect to see fewer cases of obesity. We would also hope to see people who suffer from from diabetes better able to manage their condition. Gains in health mean less spending on health, so I see the removal of GST on food as a win-win situation for patients, the health system and Government.’ 10 THE LAMP NOVEMBER 2010

Anti-bullying advice line available Are you being bullied at work, or know someone who is? The NSWNA would like to remind members that an Anti-Bullying Advice Line (ABAL) is available to NSW

Health and Health Support Services (HSS) staff, Monday to Friday 7.00am to 6.00pm. ABAL offers free, statewide telephone advice on the process for managing bullying complaints and what you can do to stop the bullying behaviour. The telephone number is 1300 416 088. A brochure with more information on ABAL, including details of what does or does not constitute workplace bullying, is available on the NSW Health and HSS intranets.

Nurses need more training in handling patients who self-harm Healthcare professionals are not receiving the appropriate training and support they need to help people who self-harm and this can result in negative attitudes and inadequate levels of care, an international review has found. Staff nurse Jo McHale and lecturer Anne Felton, both mental health specialists from the University of Nottingham, UK, studied 19 papers from the UK, Australia, Sweden and Ireland, dating from 1998 to 2009 and covering the views of 1,300 nurses, other healthcare professionals and service users. These included all aspects of self-harm, from patients who cut themselves to those that try to commit suicide. McHale and Felton found that the lack of professional education on selfharm for healthcare staff was the main cause of negative attitudes. Where special education programs did exist, they fostered more positive attitudes and improved quality of care, because staff had a better understanding of why patients self-harm. The researchers also discovered that lack of support left nurses feeling they were failing in their duty of care towards patients who self-harmed and that fear of litigation affected their confidence. ‘The gap between what health professionals saw as their role and what they were expected to do in practice also influenced negative attitudes,’ said Jo McHale. The study is published in the October 2010 issue of the Journal of Psychiatric and Mental Health Nursing.


Average age of nurses increases The number of nurses aged 50 and over has increased, as has the average age of nurses, according to a new Government report. The Nursing and Midwifery Labour Force 2008 report from the Australian Institute of Health & Welfare (AIHW), released last month, found that between 2004 and 2008, the proportion of nurses aged 50 years and over rose from 29% to 35%, while the average age of nurses also increased, from 43.3 years to 44.1. The report also showed that nursing continues to be a female-dominated profession, with women making up 90.6% of nurses in 2008. ‘The number of male nurses increased only slightly, from 8.7% in 2004 to 9.4% in 2008,’ said David Braddock, from the AIHW’s Labour Force Unit.

Breast check iPhone app launched A new iPhone application to help women remember to check themselves for signs of breast cancer has been launched by UK charity Breakthrough Breast Cancer. The aim of the app – iBreastCheck – is to raise awareness of the disease. The app has three main features: Touch Look Check – video and images

of Breakthrough Breast Cancer’s breast awareness information explaining what women need to look out for when checking themselves for anything unusual; The Risk Report – an interactive quiz that enables women to enter details about themselves to assess their own risk of breast cancer, based on family history, lifestyle and environmental factors; and iBreastCheck alert – an optional reminder system to enable women to set a personalised alert at a time and date convenient for them to check their breasts. The iBreastCheck app is free to download from iTunes and the iBreastCheck.com website.

Australians working fewer hours in the office There’s no doubt that nurses are working longer hours, but as a nation, Australian workers are spending fewer hours in the workplace than they did 10 years ago, according to a report by Bankwest. Its Working Times report shows fulltime workers put in an average 41.4 hours a week over the past year to August 2010, compared with 42.7 hours a week a decade ago – representing a 1.3 hour decrease in hours worked over the decade. The research found that small business owners worked the longest hours in Australia (50.7 hours), while government employees in the public sector worked fewer hours than other Australians (36.8 hours). Gen Y bucked the trend, working fewer hours than any other age group, at an age when traditionally Australians worked longer hours in a bid to try and establish their careers, which had some effect on the figures. Bankwest’s analysis of labour force data found the major employment trend over the past decade has been a shift into part-time from full-time work. Now, 30% of workers are employed part-time, compared to 27% a decade ago. The average hours worked by parttimers has increased by 0.9 hours per week over the past decade from 16.1 to 17.0 hours per week, while the average hours of all workers – both full-time and parttime – has fallen by 1.5 hours per week over the past decade from 35.6 hours in August 2000 to 34.1 hours currently.

s Legal & Professional Issues for Nurses and Midwives 5 November, Port Macquarie, ½ day 26 November, Newcastle, ½ day Topics covered include the Nurses and Midwives Act 1991, potential liability, importance of documentation, role of disciplinary tribunals including the NMB, writing statements. Members $39 • Non-members $85 s Review & Implementation of Guidelines & Policies 12 November, Camperdown, 1 day Seminar is suitable for all nurses. Members $85 • Non-members $170 s Drug and Alcohol Nurses Forum 19 November, Camperdown, 1 day Seminar is suitable for all nurses. Members $30 • Non-members $50

TO REGISTER or for more information go to www.nswnurses.asn.au or ring Carolyn Kulling on 1300 367 962

ANF FEDERAL OFFICE

FINANCIAL

REPORT The Australian Nursing Federation Federal Office Financial Report for the year ended 30 June 2010 is now available at www.anf.org.au Members without internet access may obtain a hard copy of the report by applying in writing to: Federal Finance Officer Australian Nursing Federation Level 1, 365 Queen Street Melbourne Victoria 3000

CORRECTION In last month’s issue of The Lamp, we ran a story on a study about nursing students failing to spot deteriorating patients (page 11), in which it was stated the study appeared in the October 2010 issue of the Journal of Clinical Nursing. It appears in the August 2010 issue. THE LAMP NOVEMBER 2010 11


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Keneally Government says NO to nurses g NSW Government has presented an unacceptable offer, rejecting nurse ratios and the majority of our pay and conditions claim.

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he NSW Government has categorically rejected the majority of our pay and conditions claim, despite the greatly increased flow of money into the NSW health system from Canberra, the evident crisis in our health system due to the lack of experienced nurses and the success of the Victorian ratios model. After months of waiting and extensive negotiations with the NSWNA, we have a response from NSW Health and the NSW Government regarding our pay and conditions claim. The Government has offered pay rises of 3.9%, 3% and 2.5% per year over three years, contingent on offsets. These offsets include the removal of the stocking and sock allowance and nurses injured at work giving up their right to use sick leave to top up workers’ compensation entitlements after six months. The Keneally Government has also delivered a categorical NO to your ratios and skill mix claim. NSWNA General Secretary Brett Holmes says the Government’s offer is disappointing and short-sighted and he flagged a vigorous campaign in pursuit of our principal claims. ‘We are particularly disappointed with the categorical rejection of ratios

and clinically appropriate skills mix levels. They have also chosen to attack the shoe and stocking allowance and make-up pay for injured nurses and midwives,’ he said. ‘We will not step aside from our responsibility to act to ensure our hospitals are safe and we will step up our campaign to win public support for ratios.’ A TV and radio advertising campaign to educate the public about the NSWNA campaign for mandated nurse-to-patient ratios began as The Lamp went to print.

Nurses and public agree that ratios and proper skill mix are the way forward The Government’s intransigent position on ratios and skill mix stands in stark contrast to the views of nurses and the public. Research by the NSWNA has found nurses and the general public support mandatory ratios in NSW hospitals. Nurses think ratios will provide a safer environment for staff and patients and would attract and retain more nurses in the system. Crucially, nurses think this is a pivotal time for addressing staffing ratios and skill mix because nurses believe strongly that the system is in crisis and the status quo is unsustainable. For nurses, ratios are easily the most important component of our claim. The public understands that ratios

WHAT HAPPENS NEXT AND WHAT YOU CAN DO c Continuing talks between the NSWNA and NSW Health are scheduled in November. c A full report on the progress of these talks will be presented to NSWNA Committee of Delegates meeting on 16 November. 12 THE LAMP NOVEMBER 2010

c Tell your Branch delegates what you think of this offer so they can bring your views to the delegates’ meeting. c Delegates will then report back to members after the Committee of Delegates meeting.

‘We will only win by garnering the support of the public and showing the Government we mean business.’ NSWNA General Secretary Brett Holmes

are a key starting point to the reform of the NSW public health system and are surprised that ratios aren’t already in place.

We’ll only win this through pressure Brett Holmes says now that the Government has laid its cards on the table nurses and midwives need to take stock of what is required to win better conditions for patients and nurses in our hospitals. ‘We will only win by garnering the


C O M P E T I T I O N

THE GOVERNMENT’S RESPONSE The offer does not include ratios and the pay increases have strings attached. NSWNA has not agreed to this offer. Talks are continuing in November.

1. From July 2010: 3.9% increase The Government’s wages policy states that any increases above 2.5% pa must be funded by individual departments. The 1.4% above the Treasury-funded 2.5% pa is offered ‘to recognise nurse/midwifery contribution to co-operation with various initiatives: better demand management through MAUs, COMPACs and CAPACs, improved hospital-acquired infection control and clinical handover procedures, Take the Lead NUMs project, and implementing the new [forthcoming statewide] rostering system’. [Not the Hunter/New England Balanced Rostering system.] [The Department informs NSWNA that this software will be a tool for NUMs to develop rosters to meet their particular unit’s needs within the Award requirements and allowing individual preferences.]

2. From July 2011: 3% increase, but strings attached The 0.5% of this increase that is above the Treasuryfunded 2.5% pa is conditional on continued co-operation with efficiency and productivity initiatives and: 1) removing all sock and stocking allowances; and 2) removing existing top-up payments for injured nurses’ workers’ compensation.

3. From July 2012: 2.5% increase NSW Health is also offering discussions for a possible 0.5% additional increase, but any extra would have strings attached. The Department states that negotiations for this would need to be held ‘over the longer term’. The Association has not agreed to this offer. Tell your NSWNA Branch delegates what you think so they can bring your feedback to the Committee of Delegates meeting on 16 November.

Win a trip to Melba House in Katoomba

‫ﱼﱻ‬ ‫ﱾﱽﱼﱻ‬ Melba House is a weatherboard home e bui built around1905. It has stunning patterned plaster ceilings and carved woo woodwork throughout. Located in the heart of Katoomba in the Blue Mountains, ins, it’s an easy 20-minute walk to Echo Point to view the famous Three Sisters.

The Lamp is offering one lucky reader the chance to win a Melba House Blue Mountains Indulgence Package, which includes: c Two nights’ accommodation in a deluxe spa/open wood fireplace suite (Monday-Thursday) c Four-course gourmet breakfast served in your suite each morning c Afternoon tea on arrival and home-made cake available 24/7 c Bowl of fresh fruit daily with a jar of home-made cookies and decanter of port to enjoy during your stay c Bottle of bubbly‚ with strawberries hand-dipped in chocolate c Three-course meal at The Rooster, an award-winning French restaurant including coffee and champagne cocktail (to book, call 4782 1206 or go to www.jamisonhouse.com/french_restaurant.shtml). PLUS A Pampering Package that includes 1.5hrs of absolute bliss at Spa Sublime for each person. Be deliciously spoilt as they revitalise and rejuvenate all your senses. Unwind with an aromatherapy massage and relaxing vitamin-packed facial while your feet receive an exfoliating mask and massage of their own. These treatments are enjoyed by both men and women. Prize is worth $1,080 per couple.

support of the public and showing the Government we mean business. ‘For some months now many of our members have been active in this campaign – distributing leaflets to the public, lobbying MPs, talking to colleagues in the workplace. ‘Now we need all nurses to step up to the plate. Over the next month there will be opportunities for all nurses to join in this campaign as the NSWNA organises actions to apply the pressure. I would urge all nurses to stand with their colleagues as we send a message to the Government that we put patient safety before everything,’ said Brett.n

For other Indulgence Package options visit the Melba House website at www.melbahouse.com/indulgence. To book contact Sue Handley on (02) 4782 4141 or email stay@melbahouse.com. 10% discount for two or more night stays at Melba House (excludes Midweek Special and Indulgence Package). Contact Spa Sublime on 4782 3113 or go to www.spasublime.com.au. Mention The Lamp competition and get a 10% discount. To enter, simply write your name, address and membership number on the back of an envelope and send it to: Melba House Indulgence Package competition PO Box 40, Camperdown, NSW 1450. Please note: only one entry per member will be accepted. THE LAMP NOVEMBER 2010 13 Competition closes 30 November 2010


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NSWNA claim vs Government response g The following table outlines the NSW Government’s position (as The Lamp goes to print) on individual components of the NSWNA pay and conditions claim.

WHAT NURSES AND MIDWIVES ARE CLAIMING NSW GOVERNMENT’S RESPONSE* 5% pay and pay-related allowances increase per year – no strings attached.

3-year Award with strings attached to some pay increases. See box on page 13.

Mandated minimum staffing ratios with a skill mix consideration.

NO

CNE for every 30 nurses/midwives.

NO

Replace absences with ‘like with like’ nurse classification.

NO

Award to include fair rostering principles.

NO

1% extra employer-provided superannuation per year ie. 13% by 2013.

NO

Meal allowance to be paid for overtime before, as well as after a rostered shift.

NO

Return 100% of salary packaging savings to nurses, not just 50%.

NO

Clearer rules for In Charge of Shift payment.

Under discussion

Reinstate Higher Grade Duty payment for every shift (not only for 5+).

NO

Improved study leave to match Queensland nurses: three days per annum for conferences plus allowances; plus leave and course costs for tertiary study.

NO

ENs graduating as RNs should start at RN Year 2.

NO

Continuing Education Allowance for CNCs who achieve a qualification higher than the minimum required for their role.

NO

Union delegates to have paid leave for NSWNA Committee of Delegates meetings.

NO

Award to say that rotating shift nurses should be free from night duty immediately before starting leave and on the first shift back from leave.

NO

Increase paid maternity/adoption leave to 26 weeks and paternity leave to four weeks.

NO

Improve Award lactation break provisions for breastfeeding mothers.

Under discussion

Management should not unreasonably refuse nurses’ requests for 12-hour shifts on a unit.

Under discussion

Experienced RNs/RMs IRC case for higher pay rates.

NO

Better insurance for NETS (Newborn & Paediatric Emergency Transport Services)/Air Ambulance nurses.

Under investigation

*As at end October 2010.

14 THE LAMP NOVEMBER 2010


FAQs on nurse-to-patient ratios g Got questions about our campaign for mandated nurse-to-patient ratios and skill mix? Check out our Frequently Asked Questions for the answers. How has the ratio claim been determined? Our claim for nurse-to-patient ratios is tailored to the nursing requirements of patients in a number of specialties: medical, surgical, emergency, palliative care, rehabilitation, inpatient mental health, critical care, community health and community mental health, and operating theatres. The claim was developed after extensive research conducted by the NSWNA. The NSWNA engaged leading nurse workforce and industrial relations academics to conduct empirical research on what is the current status of staffing numbers and skill mix. We also spoke with expert clinicians (NUMs and some CNCs) from each of the nursing specialties we had decided to develop ratios models for. We also carried out a literature review and examined the Victorian experience, where ratios have been in place for more than a decade. The resulting draft claim was then discussed by NSWNA members in over 55 meetings across NSW and then endorsed by NSWNA Branch vote.

How do we ensure skill mix and that we have enough senior nurses to supervise new grads? The recommended skill mix levels in the claim are based on academic literature that suggests a high RN level delivers superior patient outcomes against nursing-sensitive indicators. The introduction of nurse-to-patient ratios would ensure a mandated level of RNs on every shift. The claim also includes specific additional requirements to ensure a skill mix. This includes an increased number of CNEs across the State. The CNE role is critical in supporting the development of all nurses and new grads.

What will the skill mix mean for ENs/EENs? Enrolled Nurses play a very important role

in the delivery of health care. The claim is not intended to disadvantage any nurse, and ratios will result in more funded nursing positions across the state. The announcement this month that more beds are being opened in 2011/2012 confirms that more ENs will be needed. While NSW Health is trying to reduce the number of ENs by changing to pre-employment education, the Association is securing a place for all nurses, now and into the future.

What’s happening with Birthrate Plus for midwives? The NSWNA is still waiting for a final offer from NSW Health to implement the trial permanently.

Where will the extra nurses come from? There are a lot of new graduate nurses who haven’t been able to get jobs in public hospitals. For example, in 2010 2,749 RNs are expected to graduate, but NSW Health is only offering 1,700 positions in the public health system (NSW Health, Nursing and Midwifery Branch 2010). Experienced nurses will also return to the workforce once mandated ratios are in place. Nurses will return to the public health system if the conditions are right. This was proven in Victoria where experienced nurses returned to the workforce once ratios were introduced. 2,650 nurses returned to the workforce within the first year that ratios were introduced in Victoria in 2000/2001.

Where will the money come from to fund ratios and can we afford it? Funding must be provided for ratios to ensure safe patient care in NSW. Victoria has a similar health system to NSW and it had a similar staffing crisis to that being experienced in NSW. In 2001, the Victorian Government acknowledged it had a major staffing crisis, with safe patient care in jeopardy, and prioritised

introducing nurse ratios as a solution. It allocated the necessary resources for the adoption of nurse ratios. Ten years later, the cost of introducing ratios has not crippled the health system in Victoria. In fact, according to many indicators, Victoria now has the most efficient health system in Australia. In September 2010, the Victorian Health Minister Daniel Andrews told Parliament that: ‘Victoria’s public hospitals have recorded a combined financial surplus for the sixth successive year.’ If Victoria can afford ratios, then so can NSW.

How long will the claim take to finalise? The Award will be finalised when the Government makes an offer that NSWNA Branches decide is acceptable. We can accelerate the process by participating in activities to put pressure on the Government to listen to nurses and deliver ratios.

Are ratios and better skill mix really achievable? Yes. But don’t expect that the Government will fund ratios just because the Association has asked. We will need to work together to inform the community and convince the Government that safe patient care is important and that mandated nurse-to-patient ratios are the answer.

What can I do to help win ratios? Attend local Branch meetings – keep up to date with the campaign and local activities. Set up or join an existing Workplace Campaign Committee (WCC) to organise events to publicise the campaign. A full report on the outcomes of these talks will be presented to NSWNA Committee of Delegates meeting on 16 November. Tell your Branch delegates what you think of this offer so they can bring your views to the delegates’ meeting. Delegates will then report back to members after their meeting.n THE LAMP NOVEMBER 2010 15


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Nurses say

Action will escalate if Government won’t listen g NSWNA branches have unanimously voted to endorse the mandated nurse-to-patient ratios claim, and our research indicates that members are prepared to escalate action to show their support and pressure the Government to deliver safer patient care. The Lamp spoke with four members about the importance of ratios and taking action to win this crucial component of our claim.

MORE TIME TO GIVE PATIENTS PROPER CARE

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uc Tran, RN, says winning nurse-to-patient ratios is very important to members at Bankstown Hospital Branch. ‘We need more time to give patients proper care. We don’t have enough time now. Other nurses feel the same way. ‘We would all welcome a pay rise but ratios are more important. I would rather go home after my shift happy, knowing my patients have been cared for properly. And patients are happy because they have received the proper care. ‘I’m prepared to take action to fight for ratios. We’ll wear our campaign t-shirts and I’ve already distributed community leaflets in my block.’ 16 THE LAMP NOVEMBER 2010

WE’RE ALL PREPARED TO TAKE ACTION

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urse-to-patient ratios will mean more time to look after all aspects of patients’ care, says Jila Talebi-Ardestani, RN at Bankstown Hospital. ‘Nurse ratios would mean we’d be able to do our jobs properly and provide complete patient care. ‘For me, ratios are more important than a pay rise. I put myself in patients’ shoes – they are suffering because we don’t have enough time to provide all aspects of patient care. Nurses are so busy they haven’t got time to talk and listen properly. ‘Bankstown Hospital Branch is ready to take action. We’ve all distributed leaflets, and we’re thinking about more action.’


IF GOVERNMENT WON’T LISTEN, WE’RE PREPARED TO FIGHT

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ebra Smith, NSWNA Councillor, works as a NUM in the preassessment unit at Auburn Hospital. ‘Nurse-to-patients ratios are really important in planning elective surgery. We need to know there is proper staffing and skill mix from the start of the pre-assessment process right through the patient journey until the patient is safely discharged home into the care of their family/friends. With mandated ratios, we would be able to adequately plan the number of patients coming through the system and know there will be adequate

staffing to care for them. We try to do this now but because there are no mandated ratios, and if sick leave occurs, the post -operative wards can be very busy. ‘At the moment, we have to cut elective surgery lists because there is not enough staffing. ‘The Reasonable Workloads Clause hasn’t worked. We don’t have the tools to ensure we have the right staffing and skill mix; we’re running by the seat of our pants. ‘With nurse-to-patient ratios we know exactly what staffing is needed for safe practice. It’s there in black and white.

‘Ratios would mean there is light at the end of the tunnel of constant shortages. With ratios, if the staff aren’t available, beds are closed – and this is mandated. We may still need to cut elective surgery but we know the correct formulas and skill mix to ensure safe patient care. At present, we are constantly crisis managing. If you think each day before you go in to work that you are going to be crisis managing, you don’t feel very enthusiastic about coming to work. The Victorian experience shows us that nurses did flow back into the public system because they knew that the wards were adequately staffed, thus alleviating the stress on their colleagues trying so hard to manage. Work became a pleasant place because Victorian nurses can provide the safe care that you’re educated to give. ‘It’s not acceptable that the Government can offer a pay rise but say “no” to ratios. For me personally, I would happily forgo a payrise, just give us ratios. But I understand nurses need a pay rise to keep up with the costs of living. ‘Achieving mandated nurse ratios is the most important thing in my 30 years of nursing. ‘Over the past month, the Branch has been taking action to show how important this is. We’ve all “done our blocks”. We’ve distributed thousands of brochures, we’ve even had our kids distributing them. The support of the community is important. ‘And we are prepared to take more serious action.’

NOT ACCEPTABLE GOVERNMENT HAS REJECTED RATIOS AND SKILL MIX CLAIM

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endy Goodman, NUM at John Hunter Hospital and NSWNA Councillor, says it is not acceptable that the Government has offered a pay rise but rejected our claim for nurse-to-patient ratios.‘At the moment, we have to cut elective surgery lists because there is not enough staffing. ‘Mandated nurse ratios are essential. The current staffing model is not working; we’re unable to deliver the standard of care we should be providing. We’re working with staffing levels that are four to five years old.

‘The only way to ensure safe patient care is to have mandated nurse ratios. We need a system that ensures we have the right number of nurses, in the right place, with the right skills. ‘A pay rise is just not enough. Extra money is nice but it’s not just about money. We’re here first for our patients. ‘Members at John Hunter share this view. ‘The John Hunter Hospital Branch is prepared to take action to put pressure on Government. Members are passionate that ratios are the right course to take.’n

THE LAMP NOVEMBER 2010 17


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Closing beds won ratios in Victoria g Strong action by nurses, especially closing beds, was an important component of the Victorian nurses’ campaign to win mandated nurse-to-patient ratios.

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ulie Jones, an Associate Nurse Unit Manager at Ballarat Base Hospital, is a veteran of the Victorian nurses’ campaign for nurse-to-patient ratios. An ANF Victoria Delegate since 1993, she sees mandated nurseto-patient ratios as necessary for quality patient care. Julie says winning ratios was hard fought and could not have been achieved without action by nurses. Over the years Victorian nurses have honed the tactic of closing beds and Julie says this was a key to their historic ratios win. ‘In Victoria we were actually closing beds in the ’90s to a certain degree, but more determinedly since 2000 when we brought in the nurseto-patient ratios. Since then, we’ve had two more Enterprise Agreements and both times the Government wanted to either reduce or remove the ratios. Each time we went into discussion with the Government it was pretty much a foregone conclusion that at some time we would have to close beds to focus the Government’s attention on meaningful discussion,’ she said. ‘Closing beds is not something nurses take lightly and to proceed was an indication of the importance Victorian nurses give to nurse-to-patient ratios. ‘When we first started this type of action the prospect of closing beds was daunting and members had to be convinced. The nursing fraternity usually baulks at disruption to patients, but closing beds was the only means 18 THE LAMP NOVEMBER 2010

‘Closing beds is not something nurses take lightly and to proceed was an indication of the importance Victorian nurses give to nurseto-patient ratios.’ Julie Jones, Associate Nurse Unit Manager at Ballarat Base Hospital.

of getting mandated nurse-to-patient ratios. Surprisingly, we found that most hospital managements were reasonably co-operative,’ she said. ‘Patient safety is paramount and patients requiring emergency admission can’t be turned away. Bed closures are primarily obtained by cutting elective admissions from operating lists. Our aim was for one in four beds closed. ‘As they were vacated, beds to be closed were not remade and a notice, like “Closed to save the health care system”, was put on the end of the bed. Full bed closures might not happen for several days as you wait for discharges, but once the momentum starts, it happens.’ Another Victorian nurse, Pauline North, agrees that bed closures were pivotal in putting pressure on the Government.


‘When you close beds it makes such a difference to patient flow, and to hospital KPIs. The public are very supportive of the nurses; the backlash is against the Government not against the nurses. Once you start closing beds and it affects the patient flow through the hospital it takes no time for the Government to go to the negotiating table,’ she said. Pauline says now ratios are in place it would be very difficult to return to the old ways. ‘Working without ratios now would be very hard. I think mandated minimum nurse-to-patient ratios are attractive to nurses because they can give better care, and better quality of care. Nurses will want to come and work; people will return to work and stay in the workforce longer.’n

‘The public are very supportive of the nurses; the backlash is against the Government not against the nurses.’ Pauline North

THE LAMP NOVEMBER 2010 19

Jason South/FairfaxPhotos

‘Closed to save the health system’: Victorian nurses closed one in four beds to focus the Victorian Government’s attention.


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How the Victorians One ‘Operational Bed’ in four was closed on every ward/unit in each public hospital after members voted to do so. ‘Operational Beds’ meant beds that were open the day before the resolution was passed. Beds closed or not regularly used prior to that date remained closed. These bed closures included aged care, radiology departments and cardiac catheter laboratories.

Exemptions from closures applied to ED, oncology patients, palliative care patients, haemodialysis patients, terminations of pregnancy and labour/neonatal wards, paediatric wards/beds with respect to paediatric patients only, ante and post natal wards with respect to maternity patients only, ICU, CCU and HDU, the Royal Children’s Hospital cancer centres.

An additional three operational beds per ward/unit were closed and reserved for emergency admissions, determined by clinical need. No patient was denied emergency care.

Operating Suite/Theatre Nurses closed one-in-four booked sessions or its equivalent in each Operating Suite/Theatre including endoscopy and day surgery. As far as possible, the ‘closed’ sessions were spread across a range of clinical specialties.

20 THE LAMP NOVEMBER 2010


won ratios Nurses only undertook nursing duties. They did not carry out nonnursing duties.

All ward/unit rosters were maintained including leave replacement or there was an increase in the number of operational beds closed so as to ensure safe patient care and appropriate workloads.

One-in-four new referrals to outpatient clinics, post acute care, hospital in the home and district nursing services were refused. One-in-four Review Spots/appointments were refused. Radiology nurses did not accept one-infour elective bookings. Exemptions to referrals, reviews and radiology elective bookings applied to the exempted areas.

When beds were closed nurses always stated that they were ‘on duty, here to work, and acting to ensure the delivery of safe patient care’.

THE LAMP NOVEMBER 2010 21


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‘When I moved to Victoria … I was very happy to discover they have a one-nurse-to-four-patients ratio. Unfortunately, we don’t have this safety requirement in NSW. ’

Our TV ads aim to win community support ‘If Victoria can do it, why can’t NSW?’

22 THE LAMP NOVEMBER 2010


Victorian public hospitals have mandatory nurse staffing levels. NSW hospitals don’t. g The NSWNA has stepped up our campaign for mandated nurse-to-patient ratios with a TV and radio advertising campaign that has just hit the airwaves. The ads star Claire Brunton (left), a nurse who worked in NSW hospitals for 11 years and moved to work in Victoria, talking about the benefits of ratios there and the need to have them in NSW.

For safe patient care, NSW hospitals need a mandatory ratio of 1 nurse to 4 patients.

Send a message to the Government. Register your support at one2four.com.au. THE LAMP NOVEMBER 2010 23


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Bupa nurses win fair g After rejecting a substandard agreement in July, members at the aged care employer have finally secured a good outcome.

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urses working at Bupa’s 21 aged care facilities in NSW are celebrating their first Enterprise Agreement with their employer. This Agreement contains a 3.5% pay rise per year for three years and reinstates conditions that nurses lost when they transitioned from the old NAPSA award to the Modern Award. Regained conditions include the nurses’ picnic day, 250% for working on public holidays and bigger uniform and laundry allowances. It also improves some conditions. For example, staff are now able to purchase additional annual leave and cash out part of their annual leave. It was a hard fight to secure a fair

agreement. In July members voted ‘no’ to an agreement proposed by Bupa because it contained a very low pay offer – it averaged just 2.6% per year for four years. ‘After the offer was rejected, Bupa reverted to the Modern Award conditions. This included taking away in-charge and on-call allowances and significantly reducing the laundry and clothing allowances to the rates in the Modern Award,’ said NSWNA Assistant General Secretary Judith Kiejda.

‘Being a part of the Union made people realise they can have a say and make a difference.’ Bupa aged care nurse

A sustained campaign by the Association, which included advertisements in metropolitan newspapers, forced the aged care employer to re-enter negotiations and finally agree to deliver fair wages and conditions to its hard-working staff. ‘We went back into negotiations after the “no” vote and ended up with a good outcome – comparable with what is

KEY BENEFITS OF THE AGREEMENT c Pay increases of 3.5% per year for three years. c Uniform and laundry allowances reinstated from 1 September 2010 at the rate staff were receiving before they were reduced in July 2010. c Longstanding conditions that are not in the Nurses’ Award restored, including the picnic day public holiday; 250% payment for work performed on a public holiday (or 150% payment and an additional day’s annual leave); and on-call and in-charge allowances. c Allowances to be adjusted by the relevant CPI figure or by 3.5% in each year of the agreement. 24 THE LAMP NOVEMBER 2010

happening elsewhere,’ said Judith. ‘This is a good example of why it’s important not to accept an unsatisfactory agreement from your employer. It proves that it’s worth sticking to your guns. The NSWNA negotiated hard on members’ behalf and came out with a solid, positive outcome.’ On 27 September, 98% of nurses who voted on the new agreement voted ‘yes’. A member – who we have chosen not to name due to Bupa’s policy of prohibiting staff from speaking to the

c Five weeks’ annual leave for shift workers (pro-rata for parttimers). A shift worker is defined as anyone who works outside 6am-6pm Monday to Friday. Four weeks’ annual leave for other staff. c Increase in loading paid to casual staff. The loading will increase from 18.3% to 19.67% in July 2010, 21% in July 2011, 22.33% in July 2012 and to 23.67% in July 2013. c Part-timers can request a review of their contracted hours and casuals can ask for their jobs to be made permanent. c Staff can purchase additional annual leave and cash out part of their annual leave entitlement.

media without written consent – told The Lamp that having a local NSWNA Branch was the key to giving members at that facility a voice. ‘People weren’t aware they could have a say. They were unhappy with what was happening so joining the Union and participating in the local Branch helped them to band together,’ the member said. ‘We were very upset when Bupa made the low pay offer in July because we felt we weren’t valued. That’s demoralising because we all love our jobs and our residents, and to think we weren’t valued or appreciated was depressing and disappointing.’ Becoming active in the local Branch empowered members into believing they could create change. ‘We had teleconferences with the other Branches to keep us up-to-date with what was happening and keep us connected across all facilities. We were consulted and able to have our say,’ the member said. The member urged other nurses who may find themselves in a similar situation to reject unsatisfactory Enterprise Agreements, and fight for fair pay and conditions. ‘If you’re in the Union, you have the numbers and that’s very important. Employers won’t listen to one person.


agreement ‘This is a good example of why it’s important not to accept an unsatisfactory agreement from your employer. The NSWNA negotiated hard on members’ behalf and came out with a solid, positive outcome.’ NSWNA Assistant General Secretary Judith Kiejda

One person raising an issue is perceived to be a nuisance but if it’s coming from the Union, employers are more inclined to listen. ‘Don’t give up and accept a substandard agreement. You’re selling

yourself out and for what? We do a really good job and to be able to deliver care feeling that we do count is very important. I feel proud we have helped to negotiate a fair agreement for Bupa nurses.’n

NSWNA Assistant General Secretary Judith Kiejda.

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THE LAMP NOVEMBER 2010 25


s

A G E D C A R E

Nurses thrilled with Riviera agreement g After an initial bumpy start, negotiations between the NSWNA and Riviera proceeded smoothly to deliver a high-quality Enterprise Agreement.

N

urses at Riveria’s 14 aged care facilities are celebrating their first Enterprise Agreement, which sees them retain all their conditions under the previous NAPSA award, as well as some extra improvements. In addition to a 4% increase to wages and allowances in the first pay period in October 2010 and a further 3% increase in October 2011, the two-year agreement

includes an optional conversion to permanent employment for long-term casuals, a process to address workload issues, and a top-up to full pay on top of the Federal scheme minimum payment for the first 10 weeks of parental leave. Other wins, which are rare in aged care agreements, include an AiN duty allowance (a higher rate for shifts where an AiN is required to administer medications); consultation on significant change, which must occur prior to a

Staff are delighted with the new agreement. decision being made; and a provision that guarantees nurses will receive their ordinary pay if they are suspended while an investigation into an allegation of serious and wilful misconduct happens. NSWNA Assistant General Secretary Judith Kiejda hailed the new agreement:

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‘There are some significant wins in this agreement for nurses at Riviera, including an AiN duty allowance and a process for managing workloads,’ said Judith. After several years of trying to get Riviera to bargain, the for-profit aged care provider agreed to come to the table in December last year. The first meeting was in January 2010 and continued for the next nine months as both parties worked to reach agreement. ‘The NSWNA is pleased to finally be in a position where we can recommend a great agreement to our members,’ said Judith Kiejda. ‘The first agreement is often the most difficult to achieve and we congratulate our members for fighting for a set of pay and conditions that demonstrates their work is valued.

We hope that other for-profit aged care employers that have not yet started bargaining with their staff will follow Riviera’s lead.’ Sharon Harvey, AiN and Branch Secretary at Wyong Aged Care Home, said staff are delighted with the new agreement. ‘They’ve got big grins on their faces!’ she told The Lamp. ‘Our main issue was workloads. During the bargaining process we gave examples of unreasonable workloads and the ratios we had and how we didn’t think they were fair. We gave examples of nurses who had to work too many hours or where we were short-staffed.’ These real-life stories resulted in Riviera agreeing to the workloads clause. ‘It was frustrating at the beginning

KEY BENEFITS OF THE AGREEMENT c 4% increase to wages and allowances in the first pay period in October 2010 and a further 3% increase in October 2011, with agreement length of two years. c Maintenance of all allowances under the NAPSA. c Five weeks’ annual leave for all nurses and an extra week for those who work outside the hours of 6.00am to 6.00pm Monday to Friday. c Casual loading increases to 21% backdated to July 2010, 22% in July 2011 and 23% in July 2012. c Optional conversion to permanent for long-term casuals. c Higher grade duties payable after two days or more. c Public holidays paid at 250%. c Process to fix workload issues. c AiN duty allowance: a higher rate for shifts where an AiN is required to dispense medications.

c Optional cashing out of accrued annual leave. c Increased long service leave for staff with over 15 years’ service. c Optional cash-out of accrued sick leave. c Top-up to full pay on top of the Federal scheme minimum payment for the first 10 weeks of parental leave. c Consultation on significant change to occur prior to a definite decision being made. c Dispute procedure that provides an independent umpire to decide the outcome if agreement cannot be reached. c Provision that guarantees nurses will receive their ordinary pay if they are suspended while an investigation into an allegation of serious and wilful misconduct occurs.

‘Our main issue was workloads. It was frustrating at the beginning but we worked through it and came out successful at the end.’ Sharon Harvey, AiN, Wyong Aged Care Home

but we worked through it and came out successful at the end,’ said Sharon. ‘It was a long, hard road of negotiating initially, but once it got going it was a smooth process.’ To nurses who still do not have an Enterprise Agreement, Sharon offers the following advice: ‘Get on to the NSWNA and get an agreement. You should not be without an agreement. Make sure you join the Association. I’m proud to be a member. If I had my way I’d have every nurse in Australia become a member. You can’t do without the Union.’ As The Lamp went to press a 97% ‘in favour’ vote was announced.n THE LAMP NOVEMBER 2010 27


s

OCCUPATIONAL HEALTH AND SAFETY

OHS win at Bathurst Base

‘It was very claustrophobic – a bit like cabin fever.’ Helen Gotch, NUM, Chifley Clinic.

g Staff at a poorly designed methadone clinic are pleased with the unit’s refurbishment.

A

fter two years of working in claustrophobic conditions with a sea of OHS problems, staff at the Chifley Clinic at Bathurst Base Hospital are celebrating the refurbishment of the methadone unit. The new design features a soundproofed waiting room, better security measures, suitable admin space, its own toilet and a kitchenette. Originally the methadone clinic was one of a number of badly-designed areas in the hospital. ‘There were no work areas for staff, and inadequate storage,’ the unit’s NUM Helen Gotch told The Lamp. ‘To do case management you had to leave the unit and go out and use a room in mental health. 28 THE LAMP NOVEMBER 2010

The acoustics were terrible. People dosing could hear conversations from clients in the waiting room and vice versa. And clients had a clear view into the dosing rooms, giving them too much visual access to staff, the drug safes and paperwork.’ Staff had to leave the unit, go through the mental health’s reception area and into another part of the hospital to use the toilet, and were physically at risk in the hallway outside the waiting room. ‘There were four doors opening into this miniscule corridor, so if any of them opened and you were in the hallway, the likelihood was you’d be smacked in the head by the doors,’ said Helen. After a visit to the unit by the NSWNA’s OHS officer, who identified it as ‘one of the worst workplaces from an OHS perspective’, Greater Western Area Health Service (GWAHS) carried out its own risk management assessment and agreed there were problems. ‘It was very claustrophobic – a bit like cabin fever – and there was no good work flow,’ said Helen. ‘If we wanted

to have a team meeting or when we did clinical reviews with our prescriber we had to leave the unit area and go into mental health, so we had to physically move our dosing carts into another area. It was stressful and frustrating.’ GWAHS agreed to a redesign of the unit and to implement interim risk measures, which included installing peepholes in the doors leading out on to the hallway so staff could check there was no one coming before opening them. According to Helen, staff were consulted on the new design ‘100 per cent’ and are pleased with the result. ‘The client waiting room has been soundproofed so clients dosing can’t hear conversations coming from the waiting room and vice versa. The big glass window that allowed clients to see into the dosing room has been removed,’ she explained. ‘By doing that we were able to put the safes against that wall, which has enlarged the space for staff in the dosing room. ‘We’ve been given a room that was originally for community mental


health and that is now my office, and the case managers and admin staff have a workspace too. We can have our team meetings and clinical reviews in the unit now.’ The creation of a small kitchenette has boosted staff morale, Helen added. ‘Because we open at 6.30am and staff don’t stop for a break until around 11.30am they can now at least easily access tea and coffee and this is great for morale. We also now have our own toilet in the unit for staff only.’ Helen praised both the Union and the hospital’s drug and alcohol management team for their support, which ultimately led to a safer and much more comfortable working environment for staff. ‘Once everyone got together and determined what the needs were, things moved along quite well,’ she said. ‘Staff are very much looking forward to working in the new space.’ As The Lamp went to press, the refurbishment was due to be completed.n

Pictured left to right: Melody Cole and Kath Cheney are delighted with their new RN/Case Managers office, which was non-existent before the refurbishment.

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ARE YOUR WORKMATES OR FRIENDS MEMBERS OF THE NSWNA? Why not ask them and if they aren’t, sign them up. Like you, they need the security of belonging to a strong and dynamic union. Not only will you be building your union by signing up a new member, you and a friend could win this fabulous holiday on Lord Howe Island. The more members you sign up, the more chances you have to win! The prize* includes a seven-nights’ stay with meals at Pinetrees Lodge, return flights for two on Qantaslink from Sydney, airport transfers on Lord Howe Island, and some activities.

30 THE LAMP NOVEMBER 2010 *

Conditions apply.

Experience the natural beauty and tranquility of world-heritage-listed Lord Howe Island. Enjoy great food, good accommodation and outstanding hospitality at the historic Pinetrees Lodge. Pinetrees Lodge is situated on one of the prime aspects of Lord Howe Island as it has unsurpassed access to the lagoon. Cycling, reading, birdwatching, scuba diving, surfing, swimming and bush climbing – it’s up to you! And if you believe your cardiac health is up to it you can always attempt the challenging climb up Mt Gower. We have been told that this climb is worth every strenuous step as the views from the top are incredible.

So, if you are up for this sort of holiday where you will enjoy uncomplicated days, crystal clear waters and uncrowded and unspoilt beaches, make sure you ask the nurses and midwives you work with if they are members of the NSWNA!

HURRY! Call the Association now for a recruitment kit and recruitment incentive scheme details. Ph: 8595 1234 (metropolitan area) or 1300 367 962 (non metropolitan area) or go to www.nswnurses.asn.au DRA

WN 3 0 JU N E 2011


s

OCCUPATIONAL HEALTH AND SAFETY

Sharps injuries – a major OHS hazard g Study shows more sharps injuries occur in remote areas, and many are caused because nurses recap needles.

R

esults from a major collaborative study into Sharps Including Needlestick (SIN) injury suggest that remote area nurses are more likely to sustain a sharps injury than their metropolitan colleagues, and indicate that one third of nurses continue to recap needles after drawing up medication. The study was conducted by researchers from the University of Newcastle and the NSWNA following evidence that nursing is the occupation at highest risk of SIN injuries. Over 1,300 NSWNA members participated in the study (giving a response rate of 17%) and results show that needlestick injury remains a significant OHS issue for nurses, especially in rural and remote areas. While the generalisability of the findings is limited, it is nevertheless clinically relevant. ‘The reported 12-month period prevalence of SIN injury was 6.5%, with a significantly higher rate of 16.4% in remote areas,’ said Newcastle University academics and coauthors of the study Dr Ashley Kable and Maya Guest. Some clinical areas, including the Emergency Department and operating theatres, appeared to have a higher risk for SIN injury (up to 12%).

Of the 84 respondents who experienced SIN injuries, 86% reported the injury at their workplace and 35% believed they were at risk of contracting a blood-borne disease. The main reasons for reporting SIN injury were the fear of acquiring hepatitis B, C, and HIV, the need to have the workplace assessed for risk, and the desire to be informed about blood test results. Only 39% of nurses reported that SIN injury data were routinely provided to staff. The study further found that only 32% of nurses attended sharps training when it was offered. Many of the results from the study were encouraging, however, with the majority of nurses reporting practices that are consistent with NSW Health policy directives. Compliance with hepatitis B vaccinations was reported by 95% of nurses, 90% reported the use of point-of-use sharps containers and 95% stated a preference for Safety Engineered Devices (SEDs), with 55% of nurses active in the selection and evaluation processes of the SEDs in their workplaces. ‘These results are good, but there is room for improvement. Of most concern is the finding that 33% of our members continue to recap after drawing up medications, and that 5% recap after administering medications or obtaining blood samples. Given that these results go against long-established infection control policies and procedures it is important to find out why some nurses continue to recap. The study recommends initiatives to address the issue,’ said study project manager and NSWNA Professional Officer Mary McLeod.

THE STATISTICS The study shows that: c 6.5% of nurses surveyed in NSW reported experiencing SIN injuries in the previous 12 months with 16.4% reported in remote areas. c 33% of nurses surveyed recap after drawing up medications. c 5% of nurses surveyed recap after administering medications or obtaining blood samples. c 86% of nurses surveyed officially reported SIN injuries. c 73% of nurses surveyed reported that SIN incidents are managed according to NSW Health policy. c 95% of nurses surveyed prefer the use of Safety Engineered Devices (SEDs). c 90% of nurses surveyed use point-of-use sharps containers.

‘Another finding that deserves further study is the higher prevalence of SIN injury in remote area nursing. We need to assess the causes of this disparity: Is there a lack of safety engineered devices or disposal equipment? Do remote area nurses undertake work in the field more often? Are there gaps in training, or could it be related to culture? Further research into this anomaly may assist in the development of future prevention strategies,’ said Mary.n The study report is available on the NSWNA’s website and the results are published in the CSIROs Health Care Infection journal. This research was funded under the WorkCover NSW WorkCover Assist Program. The research conclusions are those of the authors and any views expressed are not necessarily those of WorkCover NSW. THE LAMP NOVEMBER 2010 31


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s

Q & A

ASK

JUDITH

WHEN IT COMES TO YOUR RIGHTS AND ENTITLEMENTS AT WORK, NSWNA ASSISTANT GENERAL SECRETARY JUDITH KIEJDA HAS THE ANSWERS.

When do public holidays fall? I am the NUM of a medical ward in a public hospital, and I am responsible for preparing the rosters. Could you advise me of the gazetted public holidays over the Christmas/New Year period for 2010/2011, and also for the remainder of 2011?

The public holidays over the Christmas/ New Year period are: c Christmas Day 2010: Saturday 25 December c Boxing Day 2010: Monday, 27 December c Additional public holiday: Tuesday 28 December. In addition, public health system employees are entitled to an extra public holiday during the Christmas/New Year period each year that is in lieu of the August Bank Holiday. The agreed day for 2010 (agreed between the Department of Health and the NSWNA) for public sector nurses is Friday, 31 December 2010. The staff rostered to work on that day will be entitled to public holiday rates. Gazetted public holidays for 2011 are as follows: c New Year’s day 2011: Saturday, 1 January, and Monday, 3 January (additional public holiday) c Australia Day 2011: Wednesday, 26 January c Good Friday: Friday, 22 April c Easter Saturday: Saturday, 23 April c Easter Monday: Tuesday, 26 April (substituted public holiday for Easter Monday) c Anzac Day: Monday, 25 April c Queen’s Birthday: Monday, 13 June

c c

c

Labour Day: Monday, 3 October Christmas Day: Monday, 26 December (transferred public holiday for Christmas Day) Boxing Day: Tuesday, 27 December.

What disputes does the Workers’ Compensation Committee handle? I have been told that the Workers’ Compensation Commission (WCC) handles disputes about Workers’ Compensation matters. What types of disputes does it handle and how will the NSWNA assist me?

The WCC handles disputes about denied claims, weekly compensation payments, management of return to work such as suitable duties, medical and related expenses, permanent impairment/pain and suffering, death of a worker, and payment for damages to personal property. If you are experiencing any problems with any of these issues, contact the NSWNA and we will refer you to our solicitor who will consider whether to lodge a dispute in the WCC.

Do I have to be on-call on my days off? I’m an RN working in a busy public hospital. Due to staffing issues, I am often asked to be on-call during my days off. I know there is a higher allowance when I am on-call at these times but I don’t feel I can relax when I am asked to be on-call. Are they allowed to roster on-call in this way?

Management does not have free reign to be able to roster staff on-call during

their days off. Clause 4, sub-clause (xvii) provides the following clarification: ‘(b) Except as hereafter provided, no employee shall be required to remain on call whilst on a rostered day off or from the completion of the employees’ shift on the day preceding a rostered day off. (c) Paragraph (b) shall not apply where in extreme circumstances (which shall be agreed between the employer and the Head Office of the Association) it is necessary for a public hospital or public health organisation in order to ensure the provision of services, to place staff on call on rostered days off.’

Should I be paid at CNS or NUM rate while on leave? I am a CNS working in a public hospital and have been acting as a NUM for 11 months. I plan to have annual leave and I have been advised by payroll that I will only be paid at the CNS rate while I am on leave and not at the NUM rate. Is this correct?

If you take your annual leave after a period of six months acting in the highergrade position you are entitled to be paid at the higher NUM rate while you are on annual leave. Previously, an employee was required to be acting in the higher grade position for a period of 12 months before being paid higher grade while on leave; however, this was changed in the Public Health System Nurses and Midwives (State) Award effective 1 July 2008. Clause 24 subclause ii states that a person who has been acting in a vacant position for a period of six months or longer is deemed to be appointed to the position until such time as a permanent appointment is made to the position or the position is no longer required.n

THE LAMP NOVEMBER 2010 33


s

N U R S E S O N L I N E

What’s hot on Nurse Uncut g We investigate workers’ compensation and workplace injury, the big wide world of professional development, and student midwives left hanging after imposed training changes, and don’t forget to check out Nurse Uncut (http://nurseuncut.com.au) for details on our latest contest!

HOT TOPICS CONTEST: Win a two-night stay at Peppers Anchorage, Port Stephens www.nurseuncut. com.au/nurseuncut-contesttime-win-aseasideweekend-escape

Would you like to get away from the hustle and bustle of the hospital and escape for a relaxing seaside weekend at Peppers Anchorage, Port Stephens? Then enter our latest contest ‘Chattiest Nurse Uncutter’! Our most talkative nurse will win the fantastic

prize – a two-night stay at the Peppers Anchorage, Port Stephens, with deluxe Anchorage room with full water views, and hot and cold breakfast. Nestled between rugged bushes and built in the style of a cosy fishing village, Peppers Anchorage is a boutique resort offering luxury seaside accommodation in the beautiful NSW region of Nelson Bay, Port Stephens. Check out all the details of how to enter at Nurse Uncut.

Our investigation into ‘Workers’ Compensation and Workplace Injury’ www.nurseuncut.com.au/ourinvestigation-into-workplace-injuryand-workers-compensation-part-2

Since introducing our series we’ve been inundated with comments from readers sharing their experiences. Elizabeth was injured when the office chair she was sitting on in the nurses’ office ripped apart at the star-based leg, causing her to fall and land with a twisted back and left leg and wedged between the desk and back of the chair, unable to move. Little did she know that little fall started a workplace compensation nightmare that is still going on three years later ... Do you have a story to tell us? If so, share your views at Nurse Uncut.

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34 THE LAMP NOVEMBER 2010


The big wide world of professional development www.nurseuncut. com.au/the-bigwide-world-ofprofessionaldevelopment

Gordon tells us about the time and energy he put into completing a Certificate IV in Workplace Training & Assessment a few years ago. Often abbreviated to Cert IV WTA, this is a training and workplace assessing course. It provides you with the ‘basic’ skills you need to teach others in an adult learning environment, and then how to assess those vocational skills passed onto trainees or students.

Concern over midwifery changes www.nurse uncut.com. au/midwiferychanges-left-ushanging

One of our readers, Susan, a third year Bachelor of Nursing student at the University of Newcastle, was disappointed at the cancellation of its postgraduate Diploma of Midwifery. Susan also raised concerns about the change in NSW Health barring third-year students from

WHAT NURSES ARE TALKING ABOUT? Number of aged care workers decreases www.nurseuncut.com.au/component/option,com_ccboard/Itemid,24/forum,12/ topic,143/view,postlist

Aged care nurses are a dying breed with a large number of nurses in their late forties and fifties. Retirement of many will further shrink the ageing workforce that exists in all areas of nursing but most especially aged care. I am an aged care nurse and advocate for aged care nurses; however, each day there are fewer nurses and more care workers in this industry. As a union that supports nurses, I feel we are losing the battle with declining numbers of members in this industry.

Tell us your views on the Nurse Uncut forums!

applying for student midwife positions. Check out the full story at Nurse Uncut. Since Susan shared her plight, we asked the University of Newcastle to

respond to her concern. Read what the University had to say here: www.nurseuncut.com.au/concernover-midwifery-changesn

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THE LAMP NOVEMBER 2010 35


s

NURSING RESEARCH ONLINE

Research hub g The Australian Journal of Advanced Nursing continues to provide a vehicle for nurses to publish original research and scholarly papers about all areas of nursing. Papers develop, enhance, or critique nursing knowledge. All nurses have access to this excellent journal at www.ajan.com.au Reasons for entering and leaving nursing: an Australian regional study Robert Eley, University of Southern Queensland; Diann Eley, University of Queensland; Cath Rogers-Clark, University of Southern Queensland.

The objective of this research was to compare and contrast the reasons that nurses and nursing students provide for entering and leaving nursing. Among the nurses, Robert Eley 88.4% were female and 37% 50 years of age or older. Almost half (45.3%) of the nursing students were 30 years of age or older and 44.1% of all students were working as nursing assistants or enrolled Diann Eley nurses while studying. Of these working students, 32.5% had been nursing in excess of five years. Self-interest, vocation and altruism were identified by both students and nurses as the main reasons Cath Rogers-Clark for entering nursing. Respondents above and below 30 years of age gave the same reasons for entering nursing. Choice of factors for considering leaving nursing differed between groups and ages. Compared to students, nurses were most likely to cite disillusionment with nursing. Students under 30 years of age indicated pursuit of another career and starting a family to be the major factors while older students offered disillusionment with nursing and health concerns. The authors conclude that retention strategies may need to differ for the age of nurse. However, recruitment needs to be 36 THE LAMP NOVEMBER 2010

informed by the altruistic and vocational reasons why nurses and nursing students are drawn to nursing rather than focusing on perceived generational differences. www.ajan.com.au/Vol28/ 28-1_Eley.pdf

Casualisation in the nursing workforce – the need to make it work

Susanne Becker

Susanne Becker, University of South Australia; Prof. Helen McCutcheon, University of South Australia; Prof. Desley Hegney, National University of Singapore.

The aim of this paper is to highlight some of the challenges faced by the nursing profession in response to increased casualisation of its workforce and why the presence of casualisation Prof. Helen needs to be viewed in a McCutcheon positive light. The care-giving responsibilities of a predominantly female workforce and the ageing of the nursing workforce worldwide means some nurses Prof. Desley Hegney are choosing or need to work as casual employees in order to remain in the workforce. Historically, casuals have been viewed in a negative light, particularly in discussions around commitment and continuity of care. Without a change in attitude towards nurses who work as casuals, a significant portion of the nursing workforce may be lost. An ageing nursing workforce, coupled

with a worldwide shortage of nurses, means that employers need to ensure options are available to accommodate nurses requiring flexible rosters in order to encourage recruitment and retention. Policies are needed to ensure that all staff, regardless of their contribution in hours, feel valued and supported and are able to contribute to their profession. Maintaining a portion of the workforce in a flexible form will allow increased staffing options and ensure that sufficient experienced staff are available in order to maintain quality patient care and outcomes. www.ajan.com.au/Vol28/28-1_ Becker.pdf

Nurse practitioners are well placed to lead in the effective management of delirium

Dianne Burge

Wendy Kent

Jacqui Verdon

Deanne Burge, Northeast Health; Wendy Kent, Northeast Health; Jacqui Verdon, Northeast Health; Stephen Voogt, Northeast Health; Helen M. Haines, The University of Melbourne.

This article seeks to acknowledge the detrimental impact that delirium continues to have on an individual and at the system level in an Australian acute inpatient setting and highlight the potential role that Nurse Practitioners can play in evidencebased prevention and management. Despite extensive literature and national policy-driven initiatives


delirium continues to be a neglected iatrogenic condition for elderly people. A local investigation by Nurse Practitioner candidates in an acute care hospital setting highlights the Stephen Voogt poor recognition of the problem. Delirium management must be a key part of the scope of practice for the gerontological Nurse Practitioner. Recognition and management of delirium is Helen M. Haines problematic. Leadership and continuity of care using evidencebased prevention strategies; accurate diagnosis and treatment are important aspects of the gerontology of Nurse Practitioners’ (GNP) scope of practice. www.ajan.com.au/Vol28/28-1_ Burge.pdf

Nursing education: reducing reality shock for graduate Indigenous nurses – it’s all about time Allison Hinton, Palmerston Health Precinct, Northern Territory; Dr. Sharon Chirgwin, Batchelor Institute of Indigenous Tertiary Education, Northern Territory.

Since the decision to transfer nurse education to tertiary institutions in 1984, there have been many follow-up inquiries to assess if the issues around training, including the inadequate preparation for the stresses of work, had in fact been addressed. This paper aims to highlight a range of specific strategies explored and implemented during the delivery of a Bachelor of Nursing program in an attempt to improve the retention of Indigenous nursing students and to generate a more enhanced educational preparation for future nursing students. Ten years after the transition from hospital-based to tertiary sector training, the 1994 National Review of Nurse Education

in the Higher Education Sector, (presented by Reid et al), acknowledged that the undergraduate curriculum was constrained by the time demands required to cover clinical education and nursing subjects. The committee suggested that the (then) changing health care environment, and in particular the health care of Indigenous Australians, would necessitate an increase in time allocation in some schools of nursing. Lack of time should never be an excuse for failing to address student needs, such as the broadest possible exposure to, and repeated practice of, key clinical skills. A nursing curriculum focused on incorporating maximum clinical practice hours both on and off campus; limiting the time between translating theory into practice; implementing intensive theory delivery and developing a hospital-based mentoring program provides solutions to reducing much of the reality shock experienced by new graduate nurses.n www.ajan.com.au/Vol28/28-1_ Hinton.pdf

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mebank.com.au THE LAMP NOVEMBER 2010 37


s

F I G H T I N G

F I T N U R S E S

Photo credit: Gaetane Potard

n u f e b n a c Fitness Stephanie Quigley has learned to do an impressive set of tricks during her trapeze lessons.

HIGH FLYER

E

ach week for around two hours, Stephanie Quigley, RN at Sydney Children’s Hospital, flies through the air on a trapeze, throwing in a somersault or two, before being caught on the other side by her wrists. And she loves every moment of it. ‘I love the adrenaline rush because you’re high up and it can get quite fast,’ she says. ‘It takes your mind off things and is a good escape.’ Stephanie did her first class at Sydney Trapeze School in St Peters a year ago and was immediately hooked. In just 12 months she’s learned a series of tricks and is now considered to be at intermediate standard. But while flying trapeze is a great way to build up strength and fitness, it isn’t Stephanie’s main reason for going. ‘I don’t like fitness,’ she confesses. ‘I hate the gym. Because trapeze is fun you’re not thinking about an exercise, you are just having fun and flying through the air. One of my best friends goes with me but we have met heaps of people there and now we are doing a performance class. It’s the same 10 people 38 THE LAMP NOVEMBER 2010

each week for 10 weeks and we put on a show at the studio for family and friends.’ If you think flying through the air on a trapeze sounds daunting, or an activity only for fit young people, think again. ‘You don’t need to have a certain level of fitness when you start – they start you on simpler things,’ says Stephanie. ‘There is an old man of 73 who goes. It’s very mixed in age and gender – you have to be over four and that’s it.

‘I hate the gym. Because trapeze is fun you’re not thinking about an exercise, you are just having fun.’ Stephanie Quigley ‘There’s an older woman who came to class and if you’re not as flexible it’s harder to do it as quickly as someone who is flexible. It took this woman seven weeks of one lesson a week to get the trick but she loved it that much that she didn’t care and she got better each week.’ Not only do you not have to be fit or flexible to start with, flying trapeze can

actually help some health problems – as Stephanie’s friend found out. ‘One of my friends who goes has scoliosis and she found she’s not going to the chiropractor anymore because the gravity of hanging from your hands is stretching out your back, and her back has really benefited from it,’ says Stephanie. And despite her not being into fitness, Stephanie has noticed a distinct improvement in her wellbeing since doing trapeze. ‘I haven’t been sick lately – no coughs and colds.’ So enthralled was she by the adrenaline rush of flying through the air at high speed that Stephanie decided it was only fair to share the fun, so she organised a local ward day out to the studio. ‘About10 or 11 of us went along, including two doctors. They really enjoyed it. In fact, the two doctors have started going regularly. We had a lot of fun and everyone had the giggles. When it’s your first time and you’re up that high, you make funny noises – people squeal; everyone does funny things when they’re up there. You get to see colleagues out of context and having fun!’

www.sydneytrapezeschool.com


e are you with dread, ther lls fi m gy e th to g in e– g If jogging or go creative and enjoyabl e ar at th e ap sh in many ways to keep overed. ildren’s Hospital disc Ch ey dn Sy m fro es as two nurs

CAPOIERA: Mixing sport and culture Frances Usherwood, CNS at Sydney Children’s Hospital, took up Capoiera in March this year. ‘Capoiera is a Brazilian martial art,’ she explains. ‘It’s generally non-contact and more like a dance. It came from the African slaves brought to Brazil by the Portuguese. They had to mainly use their feet as their hands were tied. Then it became illegal to practise it until the 1920s, so to hide it the slaves turned it into a dance. They still trained and learned to perform the lethal martial art but presented it as a folk dance.’ Frances attends the Capoiera Aruanda school, which runs classes in Broadway and Coogee, three times a week where she is taught by Contra Mestre Borracha. In just a few months she’s seen her fitness and flexibility improve. ‘There’s lots of acrobatics involved like back flips and cartwheels, which really develops your strength as well as giving you a cardiac workout,’ she says. ‘Doing shift work, it’s really good to have something you can do that makes you feel much healthier.’

In addition to the fitness aspect, being part of the Capoiera community is an important factor for Frances and motivates her to attend classes regularly. ‘As a sport it’s culturally rich and you really become part of a community – in just a few months I know everyone and feel very connected. It’s also a lot of fun. Part of the training is you learn how to play the music and sing the songs. People are getting into zumba and I think it’s for the same reason – there’s music and dancing, and you get better quickly at it.’

Frances Usherwood (left) and her colleague Dr Anna Fisher practising Capoiera.

so I found it quite hard to maintain balance and be motivated to exercise,’ she admits. Finding an activity that is fun is the best motivator, she advises. ‘I started doing just one Capoiera class a week then did more and more. The most important thing for me was finding something I really enjoyed and that I could become involved in from more than just an exercise element. ‘I went along with my partner, who’d done Capoiera for five years, and

‘The most important thing for me was finding something I really enjoyed and that I could become involved in from more than just an exercise element.’ Frances Usherwood Frances enjoys exercising her body and keeping fit – she rides her bike to work and eats healthy food – but it wasn’t always the case. ‘When I first started nursing I got overwhelmed by having a career and working full time, which is exhausting,

that was good. Involving other people is fun – I took a couple of colleagues along and they had a great time. There’s also a couple of other nurses in my class. It’s so nice to be part of the Capoiera community.’n

www.capoeiraaruanda.com/au/ THE LAMP NOVEMBER 2010 39


s

N S W N A M A T T E R S

NSWNA Branch News

gear up for Cam g NSWNA members

paign 2010.

Members at RPA got busy handing out campaign leaflets to their co-workers. ‘As a NUM, having ratios in place would be very useful. We need to have something to ensure consistency,’ said Nathan MacDonald (pictured above right getting leaflets from NSWNA Organiser Margaret Burgess). RN Jacquie Myers (above left) agreed. ‘I’m right behind ratios. It makes it better for nurses in the frontline,’ she said. Dorothy Florimo (left), EEN, a recently appointed Campaign 2010 rep for Ward 6 in Gosford Hospital, took her role seriously and recruited six new members to the NSWNA in one day. ‘I tell would-be members, being in a union is like having insurance – you might not need it all the time, but they’re there when you need them,’ she said. She is pictured with one of her new recruits, Diana Sotiriou, AiN.

Nurses from Gosford Hospital’s Medical Ward made sure their colleagues were informed about Campaign 2010. Left to right: Aminta Spare, Ashley Cameron, Michelle Forbes and Kelly Cook. 40 THE LAMP NOVEMBER 2010


Members from Liverpool Hospital got a chance to meet with Paul Lynch, MLA, Member for Liverpool, Minister for Industrial Relations, Minister for Commerce, Minister for Energy, Minister for Public Sector Reform, and Minister for Aboriginal Affairs. ‘We talked about ratios and highlighted to him how that would be an improvement to patient care, which he was very receptive to hearing about,’ said Maureen McIlwrath, RN. Left to right: Michelle Nicholson, RN; Belinda Hubbard, NUM and Maureen McIlwrath, RN.

From left to right: Nurses from Bathurst and Orange Base Hospitals Kath Hamilton, Helen Price, Lyn Sloane, Luke Marks and Katrina Lee enjoyed speaking with the Prime Minister at the 26th Annual Light on the Hill dinner.

A ‘significant win’ was the result of industrial action at Bathurst Base Hospital where nurses fought for and won a budget increase for staffing in the ED. ‘When we received no response from management after a resolution at Branch level was passed, we moved to industrial action and management signed off on the budget increase overnight,’ said Cath O’Neill, EEN and Branch Secretary. Pictured left to right: Ingrid Burnett, Tatiana Muller, Alex Koehn, Cath O’Neill, Lyn Sloane, Trish Comisky and Kath Hamilton.

THE LAMP NOVEMBER 2010 41


s

A T

T H E

M O V I E S

Made in Dagenham g An uplifting tale of women at the Ford motor group lobbying for equal pay in England during the 1960s.

T

he film opens to the sound of Desmond Decker’s ‘The Israelites’, with images of the female workforce of the Ford motor group in the UK cycling to work in the ’60s. The film stars Sally Hawkins as Rita O’Grady, a married woman with two children working as a machinist, who is encouraged by her union rep (Bob Hoskins) to take what started as a local plea for equal pay for equal work all the way to the Employment Secretary, Barbara Castle (Miranda Richardson). It may sound a little dry, but this is a very warm and uplifting film with enough measure of domestic crisis – Rita’s husband adapting to his hitherto submissive wife developing into a voice for her co-workers and the friendship that starts to develop between Rita and the very intelligent trophy wife (Rosamund Pike) of a Ford executive – to appeal and maintain the entertainment. Numbering fewer than 190 of the total employment force of over 54,000, this group of women successfully lobbied for a move towards equal pay for women, ultimately resulting in the passing of the Equal Pay Act 1970. I loved this film with its sub-plots,

Wild Target

Review by Pam Stahel, Registered Midwife, Hornsby Hospital

which are integral to the story, and which help to expand the characters. There are some very amusing vignettes of 1960s England along with some more poignant reminders of a society still emerging from the Second World War – in particular the struggling relationship between one of the women and her war hero husband. The cast are well chosen, with the scenes changing seamlessly from one scenario to the next. The script is well written with some lines that I wish I had thought of myself when having conversations similar to those on film! It will grace my DVD rack when it is available.n Only at the movies from 28 October www.MadeInDagenham.com.au

GIVEAWAYS FOR NSWNA MEMBERS The Lamp has 25 double passes to Made in Dagenham and Gasland, and 10 double passes to Wild Target. To enter, email lamp@ nswnurses.asn.au with your film preference, name, membership number, address and contact number. First entries win!

Review by Meg Collins, RN, RPA Hospital.

g A clever British comedy about an assassin, a beautiful kleptomaniac and a nervous young man.

B

ritain’s Jonathon Lynn directs this wonderfully funny film. Lynn’s previous work includes the cocreation and writing of the BBC’s highly-successful television series Yes Prime Minister and Yes Minister. Wild Target centres on middle-aged Victor Maynard (Bill Nighy), a borderline obsessive/compulsive assassin. He is 42 THE LAMP NOVEMBER 2010

lethally efficient and renowned for his slick, cold approach to murder. He is a great credit to his family, all of whom have been assassins. His mother is concerned about him on one level, though, and speculates that he may be ‘homosexual’. Maynard’s world is turned upside down when he encounters Rose (Emily Blunt), a professional thief, who happens

to be very beautiful, sexually manipulative and has a passion for art. Maynard is unable to function as he had done so previously – much to the disgust of his mother. Sent to kill Rose, he finds himself unable to do so and evolves into her bodyguard. This worries his mother and angers Maynard’s employer considerably, to the point where he seeks his revenge on him.


Our reviewers and tipsters receive a delightful ABC Classics CD for uplifting enjoyment! Gifts so good, you won’t want to give them away. There is an ABC Shop near you. For locations visit abcshop.com.au or call 1300 360 111. Ask about our rewards program.

Review by Charlotte Rogers, RN, RPA.

Gasland g A deeply-moving film about the contamination of American water by large corporations.

A

s nurses, we are well aware of the importance of clean water for human, plant and animal health. In this film, George Bush’s administration is implicated in 2005 in exempting the natural gas industry in 34 states of the US from most of America’s environmental regulations including the Safe Drinking Water Act. This led to an upsurge in gas production with dire consequences. Attempts to rescind this exemption are ongoing. Josh Fox, the filmmaker, reveals how great quantities of unidentified poisonous

chemicals and water are acquired by the new cheaper methods of extraction (hydraulic fracturing). This method is seen to result in pollution of the surface water and air over vast areas of rural America. He travels through 10 states interviewing rural families about the effects of this ‘fracking’. Attracted by the offer of hard cash, farmers have opened their gates to gas exploration on their land. The ‘clean burning’ promised by the PR campaign has actually delivered permanent contamination of water courses, ongoing air pollution, sick families, sick animals and sick land. It has also spoilt the beauty of

the land with thousands of towers, roads and seeping storage areas. The farmers have no redress and must prove their case individually against powerful companies. Without this film, the general public would have remained unaware of the extreme effect this form of drilling is having on the land far from the cities. Now, when New York water supply is threatened, a moratorium is being sought. This film is a deeply moving experience. You see ordinary people fighting large corporations that have all the answers, short of environmental justice. Gas companies can only provide a temporary energy fix anyway and you are left wondering whatever happened to consideration of the future. Can the short-term economic contribution of gas be at the expense of an agriculture that provides for the needs of many future generations? Surely not. Australia is in the same position as America just at an earlier stage. Many rural groups today in all Australian states are struggling to preserve their land. Watch for this film. For more information, visit http://gaslandthemovie.com.n Gasland opens on 18 November.

Along the way, during one of their many altercations, Maynard acquires an ‘apprentice’, Tony (Rupert Grint), a young, very nervous man, who learns the lifestyle of an assassin with a lot of emotional support and encouragement. The screenplay is not perfect; there is some incongruence in the characters’ behaviour. Generally speaking, it has been written very well. It is not the intellectualised comedy of the Yes Minister TV series, but it is the perfect film to go and see when you want to laugh, after a hard week at the hospital. It is suitable for both men and women. All violence is offscreen and the soundtrack is great.n Wild Target opens on 11 November. THE LAMP NOVEMBER 2010 43


s

O B I T U A R Y

A ray of sunshine that touched many LIBBY KING • 13 December 1946 – 1 March 2010

L

ibby started her nursing life in 1964 with four years’ training at the Royal Children’s Hospital Camperdown and the Royal Prince Alfred Hospital. She did a stint of agency nursing before having a break to have her three much loved children. She came back to nursing in 1976 at Dorrigo Hospital working in Accident and Emergency. A short stay at Macksville Hospital followed before she moved to Port Macquarie where she met the love of her life, Geoff, and they forged a great life together. In Port Macquarie Libby worked at Hampsen’s Pathology, a private medical practice, Port Macquarie Private Hospital for 10 years, and then on to the Base Hospital for several years. Wherever she worked, people were drawn to her. Doctors, nurses, wards men, cleaners, and patients – young and old – all felt the sense of confidence, safety and love she exuded. Her vitality and love of life was contagious and made everyone feel special. Suffering fools poorly, especially the ever-present nursing hierarchy, Libby was fiercely loyal to her friends. Working a shift with her was always an adventure – one where your scope of vocabulary would expand greatly! Against all rules she would put on a theatre gown like a

coat over her uniform and put flowers in her hair that she stole from the gardens. Libby also championed good nurse morale and fitness. On quiet nights she would organise running races around the corridors to keep the night staff awake and energised. Punters club on Saturday mornings often took precedent over work, but ever mindful of patient care, they were included too. Saturday mornings were also for old-time singing. ‘Sweet Violet’ comes to mind and everyone had to join in loudly. Our special Lunch-a-Lot Club, so named by another missing angel, was a time to catch up with old nursing friends and tell stories only nurses would laugh at – normal people would be horrified! The best lunches were always at Libby and Geoff’s, where she indulged her third love – after Geoff and her family, and nursing – the art of cooking, and it showed! Libby and Geoff worked hard to bring their two families together, plus many grandchildren. With a love of the wide-open spaces, they built many lovely homes and memories including the tranquil-set property ‘Ellangee’. Here, Libby set out making it a true place to call home, losing herself in her widespread gardens and large bridged fishpond at her front door. Libby fell ill in late 2009 and died suddenly after what was thought to be a

successful surgery in the autumn of 2010. It is the greatest loss to family and friends as part of our hearts went with her, but also a great loss to the nursing world. We can be happy, at least, in the knowledge that a little piece of sunshine still resides in everyone she touched. Compassion and common sense Love and laughter Humour and a sense of fun Expertise and an inner light Dedication and lots of loyalty …and just a smidgen of wickedness! Roll these all into one and her name is … Libby King!n By dear friends and work colleagues, Kaye Clark and Susan Peace

ALL REGISTERED NURSES

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s

B O O K S

Book me Basic Nursing

(7th ed.) By Patricia A. Potter, Anne Griffin Perry, Patricia Stockert and Amy Hall, Mosby (available through Elsevier Australia), RRP *$124.00 : ISBN 9780323058919 Basic Nursing has a visually-appealing design and direct, easy-to-read style, making it perfect for beginning nursing students. It addresses all the essential nursing principles, concepts, and skills needed, and consistently follows the 5-step nursing process framework with a strong focus on critical thinking that provides a solid base for clinicals.

Pharmacology for Health Professionals (2nd ed.)

General Practice Nursing

By Susan Fickertt Wilson and Jean Foret Giddens, Mosby Elsevier (available through Elsevier Australia), RRP *$130.00 : ISBN 9780323053228 Health Assessment for Nursing Practice is a textbook for nursing students on health assessment that includes a discussion on ethnic and cultural issues, sleep and nutritional assessment, and assessment of the adult by body system, with a special section on assessment across the lifespan. Discussion of evaluating infants, children and older adults is new to this edition and the CD contains student lab guides, printable physical exam and assessment forms, exam skills checklists, audio of heart and

By Lynne Walker, Elizabeth Patterson, William Wong and Doris Young, McGraw-Hill, RRP *$100:00 : ISBN 9780070276949 General Practice Nursing is the first Australian textbook written specifically for practice nurses, a milestone in the development of practice nursing as a specialty. This textbook offers practice nurses information on a range of clinical and professional topics in a concise, easyto-read format. Its aim is to reinforce and expand the knowledge of those currently working in this area, and hopefully inspire them to become leaders in the field while igniting interest generally.

By Bronwen Bryant and Kathleen Knights, Mosby (available through Elsevier Australia), RRP *$120.00 : ISBN 9780729537872 Pharmacology for Health Professionals text provides a comprehensive introduction to pharmacology principles and concepts and has a strong focus on therapeutics. It includes local generic drug names, availability and clinical uses, plus local aspects of scheduling, drug legislation and ethical issues.

Health Assessment for Nursing Practice (4th ed.)

WHERE TO GET THIS MONTH’S NEW RELEASES These books are all available on order through the publisher or your local bookshop. Members of the NSWNA can borrow any of these books and more from our Records and Information Centre. For borrowing information, contact Jeannette Bromfield, 8595 2175, jbromfield@nswnurses.asn.au or Cathy Matias, 8595 2121, cmatias@ nswnurses.asn.au Reviews by NSWNA librarian, Jeannette Bromfield.

PUBLISHERS’ WEBSITES c Elsevier Australia: http://shop.elsevier.com.au c Mosby: www.us.elsevierhealth.com c John Hopkins University press: www.press.jhu.edu c McGraw-Hill: www.mcgraw-hill.com.au c Footprint Books: www.footprint.com.au

Disclaimer: Some of the items featured in Book Me are based on information received and have not been independently reviewed.

NEW REFERENCE BOOK

Diversity and Women’s Health Edited by Sue Rosser, John Hopkins University Press (available through Footprint Books), RRP* $35.00 : ISBN 9780801892806 Diversity and Women’s Health presents cuttingedge research on women’s health from a feminist perspective. Essays in this text highlight the lack of equality in diagnosis and treatment among women because of their race, ethnicity, sexual orientation, disability, and age. Some articles focus on the range of medical problems that affect women, while others take a women’s studies approach. lung sounds, critical thinking exercises, and other exercises and activities.

Promoting Health: A Primary Care Approach (4th ed.) By Lyn Talbot and Glenda Verrinder, Churchill Livingstone (available through Elsevier Australia), RRP *$84.00 : ISBN 9780729539241 Promoting Health: A Primary Care Approach provides material for public health educators and practitioners, in a number of professions, who are increasingly being required to address the challenges emerging from the inter-related impacts of the social and environmental factors impacting on health in an era of globalisation. This edition examines the social, environmental, cultural and psychological determinants of health and illness, and the role that primary health care and the new public health movement have in addressing health inequalities.n *Price in Australian dollars at time of printing THE LAMP NOVEMBER 2010 45


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Test your knowledge in this month’s nursing crossword. 1

2

3

4

5

6

7

8

9 10 11 12 13

14 15

16

17 18 19

20

21 22

23

24 25

26

27

28

29

s

ACROSS

1. 6. 9. 10.

Failure of nerve force, weakening (10) The collective head bone (5) Intracranial pressure (1.1.1) Inability to distinguish blue and yellow (10) Resembling a socket (7) The watery eye (8) Multiple epiphysial dysplasia (1.1.1) Containing blood vessels (8) A scar (8) Excessively overweight (5) The crustlike surface of a healing skin lesion (4) A horn (5)

11. 12. 13. 15. 17. 18. 19. 21.

30

23. Breast bone (7) 24. Glue, gluelike (4) 26. Small dome-shaped first molar teeth occurring in congenital syphilis (10) 27. Inwardly (5) 28 A thin cushion of resilient or absorbent material to absorb fluid (3) 29 A person who is habituated to a substance or practice (6) 30. A substance composed of a mixture of two or more metals (5)

s

DOWN

1. Ulceration of the bowel (12) 2. A widespread outbreak of an infectious disease (8)

3. Capability of living (8) 4. Pulley-shaped (12) 5. Sodium salt used to stain and identify protozoa (11) 6. Removal of the spleen (11) 7. The joining of two or more bodies (5) 8. An electrical conductor carrying current between organ and electronic device (4) 14. Any surgical incision into the lumen of an artery (11) 16. Splenic (6) 20. Glandlike; glandular (7) 22. A deficiency of red blood cells (6) 24. Relating to cheek (5) 25. Relating to urine (4) 26. A representation of a region or structure (3) Solution page 49 THE LAMP NOVEMBER 2010 47


Master of Medicine and Master of Science in Medicine (Psychotherapy) course 20010 – 2011 University of Sydney

The University of Sydney, through the Department of Psychological Medicine, Westmead/Cumberland Campus, is offering a 3-year part-time course of training in psychodynamic psychotherapy, leading to a Master of Science in Medicine (Psychotherapy) or Master of Medicine (Psychotherapy) degree. The program is being made available to both medical graduates and non-medical graduates in the health sciences. This course provides a unique opportunity to students to gain in-depth training in psychodynamic psychotherapy and an academic qualification that is recognised by major professional psychotherapy organisations in Australia. Intensive supervision of the candidates' own psychotherapeutic work forms the major component of the course work. Lectures, seminars and supervision take place on Thursday mornings. A treatise is required at the end of the course for completion of the degree. The course is open to Psychiatrists, Psychiatrists in Training, Medical Practitioners, Psychologists, Social Workers, Mental Health Nurses and allied practitioners with a basic degree in the health sciences, who have clinical experience working in the Mental Health field and who are professionally registered with professional indemnity allowing them to practice in NSW. The number of places in the course is limited. x

Course Fee: $5,160.00 per semester (approx.) Applications Close Definitely on 10th December 2010 Interviews to be advised Inquiries and application forms can be obtained from:

Dr A. Korner / Dr L McLean, Tel 9840 3335 Fax: 9840 3572 Email: michelle.phillips@swahs.health.nsw.gov.au Website: http://sites.google.com/site/conversationalmodel/

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NSWNA Branch Officials’ & Activists’ Training Program 2010

DIARY DATES

’Negotiation and Advocacy Part 1’ Wednesday 17 November.

Conferences, seminars, meetings SYDNEY, HUNTER & ILLAWARRA Wound Care Association of NSW Conference & 1 Day Workshop 5-6 Nov, Merimbula RSL. Contact: 0428 922 679 or www.wcansw.com.au 2010 Alliance Building Institutes 6 & 13 Nov (2-days), 9am-5pm, LHMU Auditorium, 187 Thomas St, Haymarket. No cost for partner organisations. Please bring $10/day for catered lunch Contact: Chantelle Ogilvie, 0439 584 221, chantelle.ogilvie@sydneycatholic.org, or Cherie Brandon, 0425214628, cbrandon@ lhmu.org.au, www.s.eventarc.com/event/ view/969/entry/sydney-alliance-2-dayalliance-building-institute Ausmed Conference • ‘Psych Nursing Assesment Skills’: 11-12 Nov, Quality Hotel Cambridge, Surry Hills. • ‘Acute Care Update’: 15-16 Nov, Quality Hotel Cambridge, Surry Hills. • ’The Nurses Role in Grief & Loss Counselling’ 2-day Seminar: 2 & 3 Dec, Quality Hotel Cambridge, Surry Hills. • ‘Guidance for Infection Control’ for Nurses: 6 Dec, Quality Hotel Cambridge. • ‘Dealing With Difficult Situations With Relatives’ 2-day Seminar: 16 & 17 Dec, Quality Hotel Cambridge, Surry Hills. • ‘Safety at Work – Dealing with Highly Unpredictable Situations & Behaviours’ for nurses and allied health workers: 9-10 December, UTS. Cost: $451. • ‘The Management of Persistent Pain – incl. Advanced Cancer Pain’ 2-day seminar: 3 & 4 March 2011, Quality Hotel Cambridge, Surry Hills. • ‘Trauma & Emergency Nursing Skills’ 2-day seminar: 28 & 29 April 2011, Quality Hotel Cambridge, Surry Hills. Contact: (03) 9375 7311 or www.ausmed.com.au

All About Kids, Organ and Tissue Donation in Paediatrics 29 Nov, The Children’s Hospital Westmead Contact: Karen Joy, 9382 4872 or Karen. joy@sesiahs.health.nsw.gov.au Sydney West Wound Interest Group Meeting 30 Nov, 5-6pm, Our Lady of Consolation, Rooty Hill. Contact: Jill_Sparks@wsahs. nsw.gov.au, 8887 4484, 0414 192 691 World Aids Day Dinner 1 December, 6.30pm red carpet arrivals, 7.30-10.30pm event, The Randwick Pavilion, Royal Randwick Racecourse Contact and tickets: www. worldaidsdaydinner.com.au. NSW Agency for Clinical Innovation Aged Health Network ‘Caring for the Confused Older Person’ 3 Dec, 8am-4.30pm, Liverpool Hospital Auditorium. Contact: Rachna Garg, 9887 5728 or rgarg@nsccahs.health.nsw.gov.au Nurses Christian Fellowship Conf. 6 Dec, 6pm, BBQ - Balls Head Waverton Contact: Jane, 9449 4868 Change Champions’ Masterclass: Radical Health Care Reform under a Minority Government. Facilitated by Pippa Bagnall 7 December, Parramatta Contact: info@changechampions.com.au, 9692 0533, www.changechampions.com.au INTERSTATE AND OVERSEAS The Change Champions seminar Best Care, Best Place: Designing and Improving Patient Flow 11-12 Nov, Hilton Hotel, Adelaide, SA. Early bird discount registrations ends 28 Oct. Contact: www.changechampions. com.au/seminar/best-care-best-placedesigning-and-improving-patient-flow_82 2nd Annual Art of Good Health & Wellbeing International Arts & Health Conf. 16-19 November, Sidney Myer Asia Centre, University Melbourne, VIC.

Contact: info@artsandhealth.org or www. artsandhealth.org

’Negotiation and Advocacy Part 2’ Wednesday 17 November.

43rd Australian Association of Gerontology National Conference 17-19 Nov, Hotel Grand Chancellor, Hobart. Contact: Jayne Hindle, Susan Contempree, Amy McIntosh, (02) 6650 9800, aag@eastcoastconferences.com. au, www.eastcoastconferences.com.

Venue: NSWNA Camperdown.

3rd Annual HITH Australasia Scientific Conference ‘The Highway to Health’ 18-19 November, The Hilton on the Park, Melbourne, VIC. Contact: Janis Coconis, Janis.Coconis@ sesiahs.health.nsw.gov.au or www.archi. net.au/events/upcoming/hith2010 M&K Update – Clinical training Courses in UK for Nurses & Allied Health Professionals: The Future Role of Support Workers and Assistant Practitioners 19 November, Manchester Contact: www.mkupdate.co.uk for a complete listing of dates and venues. The Frontiers of Pain: Australian Pain Society 31st Annual Scientific Meeting 12-16 June 2011, Darwin Convention Ctr Contact: aps2011@dcconferences.com.au, (02) 9954 4400, www.dcconferences. com.au/aps2011

Reunions St Joseph’s Hosp. Auburn, Feb’78 PTS 27 November, TDD, Sydney. Contact: Shirley, 0438 631 225, shirms1@ yahoo.com.au/ Vince, vcarroll@tpg.com.au

lamp magazine of the NSW Nurses’

volume 64 no.8 September

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volume 64 no.3 April

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For The Lamp advertising enquiries contact: Lamp_September07_1.55.indd

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Print Post Approved: PP241437/00033

Patricia Purcell Tel: (02) 8595 2139 • 0416 259 845 Email: ppurcell@nswnurses.asn.au

St Vincent’s Hospital, Darlinghurst, March 1978 PTS, 30 Year Reunion March 2011. Contact: Patsy Sullivan, psu34047@bigpond.net.au/ Maria Hulme (née Honner), hulme@internode.on.net

NSWNA Events Education Dates: • Legal and Professional Issues for Nurses & Midwives: 5 Nov, Panthers Club Port Macquarie & 26 Nov, Panthers Club Newcastle. • Review & Implementation of Guidelines & Policies: 12 Nov, Sydney TBD. • Drug & Alcohol Nurses Forum: 19 November, Sydney TBD. Contact: Carolyn Kulling, 8295 1234/ 1300 367 962, www.nswnurses.asn. au/topics/2761.html

Crossword solution

Armidale & New England Hospital, 30 Year Reunion – Light Green Group

Association

2007

Seeking interest. Contact: Brian Rapley, 6366 3242 or open1@iprimus.com.au

30 Year Reunion – General Nursing RPAH March 1980 PCB Seeking interest for a reunion in Nov. Contact: Denise Borwick (McComb), 0414 692 105, dborwick@bigpond.net. au or Facebook: Royal Prince Alfred Hospital March 1980 PCB Group.

Diary Dates the

Contact and registration: Lyn Stevens at NSWNA on (02) 8595 1234 (metro), 1300 376 962 (rural), or visit diary dates at www.nswnurses.asn.au

GIVING NURSES

A VOICE

Diary Dates is a free service for members. Please send diary date details, in the same format used here – event, date, venue, contact details, via email, fax and the web before the 5th of the month prior, for example: 5th of May for June Lamp. Send information to: Editorial Enquiries Email: lamp@nswnurses.asn.au Fax: 9550 3667 PO Box 40, Camperdown NSW 1450 Please double-check all information sent is correct. The Lamp cannot guarantee that the issue will always be mailed in time for the listed event.

Due to high demands on the page, some dates too close to publication or too far in the future may be cut. Only Diary Dates with an advised date and contact person will be published. Special Interest Groups Special Interest Groups is now part of Diary Dates. If you are a special interest group, you now must send information about your event as above. Diary Dates are also on the web – www.nswnurses.asn.au/events

Send us your snaps If you’re having a reunion, send us some photos and any information from the night, and we’ll try to publish them. THE LAMP NOVEMBER 2010 49

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Nurses see it all. Now they can tell it all. WRITE IT. SHOOT IT. SEND IT.

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