NurseClick A GRADUATE'S JOURNEY ACKNOWLEDING OUR COMMUNITY NURSES ANZAC DAY
Reflections of a reluctant cancer nurse
IN THIS EDITION
IN FOCUS @ACN
In the news
Australian College of Nursing update
A graduate's journey
Adjunct Professor Kylie Ward FACN, ACN CEO
EVENTS @ACN Acknowledging our community nurses
IN FOCUS @ACN
CNMO SERIES @ACN
Goodbye paper hello digital
Leading nurses forward
IN FOCUS @ACN
Showing the way for others
Reflections of a reluctant cancer nurse
National health support service now available
Adjunct Professor Kylie Ward FACN, CEO of ACN
Welcome to the April edition of NurseClick. As the pre-eminent and national leader of the nursing profession, it is important that we celebrate and acknowledge the invaluable contribution nurses make to the health and wellbeing of our society. In this edition of NurseClick, we feature a number of insightful articles that recognise the work, commitment and care provided by Australian nurses in all settings and at all stages of their career. Community and primary health care nurses are integral to ensuring optimal health outcomes for all people across their lifespan. In our highly informative feature article, Acknowledging our community nurses, we recognise all the nurses who work tirelessly to deliver high quality health care to individuals and communities across the country. The vital role nurses play in health service delivery at every stage of a patient’s journey is further explored in our article, Celebrate International Nurses Day with ACN. This engaging piece encourages readers to get involved in our upcoming National Nurses Breakfast and join us in celebrating the many nurses who lead the development and delivery of strong health systems locally, nationally and globally. Adjunct Associate Professor Lydia Dennett MACN is one such nurse who is driving change across the Australian health care system. In our ongoing CNMO feature series, we recognise
Lydia’s strong commitment to ensuring the continuing education and professional development of nurses and midwives across the country. A highly educated and skilled nursing workforce is essential to ensuring the timely delivery of evidence-based care in complex health environments. This month, our fabulous nurse educator Trish Lowe MACN offers insights on care auditing as a non-punitive means to overcome barriers to timely nursing care in her regular column, Vital Signs. Compassion and empathy for our patients and their loved ones are also essential components of nursing care. In an uplifting profile piece, Reflections of a reluctant cancer nurse, another of our wonderful nurse educators, Musette Healey MACN, describes her emotional journey as a young graduate nurse working in a paediatric oncology ward. At ACN, we support Australian nurses throughout every stage of their nursing journey – from the moment they begin to think about joining our profession, right through to retirement. In this edition of NurseClick, we encourage all current, aspiring and future nurse leaders to explore the diverse career pathways available within this dynamic profession at our Nursing and Health Expos.
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© Australian College of Nursing 2017 The opinions expressed within are the authors’ and not necessarily those of ACN or the editor. No part of this publication can be reproduced without permission from ACN. Information is correct at time of print. All files marked ‘Stock photo’ or credited to iStock are representative only and do not depict the actual subjects and events described in the articles. Cover image: iStock ACN publishes The Hive, NurseClick and the ACN Weekly eNewsletter.
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In the news national Educational program on chronic obstructive pulmonary disease
Excess salt hidden in bread There are concerns many Australians are consuming risky levels of salt just by eating bread. A study by The George Institute of Global Health has found two slices of the food staple can contain more than a third of the daily recommended salt intake.
Promise in rheumatoid arthritis treatments
Spider venom 'protects' brain from stroke
A new class of drugs is offering promise for Australians living with rheumatoid arthritis. However, it's essential that the progressive and often painful immune disease is detected early, say a group of Australian experts.
The deadly venom of Australia's Darling Downs funnel-web spider may one day be used to treat stroke patients.
Elderly females taking statins should be aware of diabetes risk Elderly women taking statins should regularly monitor for increased blood glucose, researchers have said. This warning was prompted by research that linked the cholesterol-lowering drugs with an increased risk of developing diabetes among elderly women. Read more
NPS MedicineWise has announcedÂ thatÂ it is launching a new educational program on chronic obstructive pulmonary disease (COPD) for practice nurses, GPs and pharmacists.
Simple test could replace invasive biopsies for people with blood cancer A husband and wife research team at the Peter MacCallum Cancer Centre have developed a simple blood test that could eliminate the need for invasive and costly bone marrow and lymph node biopsies for people with blood cancers. The liquid biopsy is a blood test that looks at minor fragments of DNA emitted from cancer cells into the blood stream, called circulating tumour DNA. Read more
The program focuses on diagnosis of COPD and assessment of severity. Read more
Six most common chronic health conditions
Researchers at the University of Queensland and Monash University have discovered a protein found in the DNA of the spider's venom that can protect the brain from damage in the crucial hours after a stroke.
New research has revealed the six most common chronic health conditions affecting Australians. Hypertension, osteoarthritis, hyperlipidaemia, depression, anxiety, and asthma are the most prevalent chronic health conditions amongst the Australian population.
Self-repairing heart tissue breakthrough Queensland researchers have used stem cells to create a beating human heart muscle, as well as heart tissue that is able to repair itself. Doctors James Hudson and Enzo Porello from the University of Queensland worked with German researchers to create the samples in a laboratory, and will use them to study cardiac biology and diseases. Read more
New concussion eye test could be 'holy grail' for sports medicine An eye-test has been developed at the Australian National University that may be able to detect symptoms of concussion, simply by measuring the pupil's response to light. If proven to work, it has the potential to dramatically change the way concussion is tested, putting people at risk out of harm's way. Read more
In the news world Can sweat patches revolutionise diabetes?
B vitamins may protect against air pollution B vitamins may offer some protection against the impacts of air pollution, a small study suggests. Researchers in the US found that high doses of these supplements may completely offset the damage caused by very fine matter.
New app can test for Zika virus Researchers have developed a smartphonecontrolled, battery-operated diagnostic device that weighs under a pound, costs as little as $100 and can detect Zika virus, dengue and chikungunya within 30 minutes. Read more
New method predicts who will respond to lithium therapy
A blood test for a protein called highsensitivity troponin T, which is released into the bloodstream when injury to the heart occurs, can identify patients with heart damage after non-cardiac surgery whose lives could potentially be saved with timely treatment. Read more
For roughly one-third of people diagnosed with bipolar disorder, lithium is a miracle drug, effectively treating both their mania and depression. However, once someone is diagnosed, it can take up to a year to learn whether that person will be among the 30% who respond to lithium or the 70% who do not. Now, a team of international scientists may have found a quicker way to predict, with 92% accuracy, whether an individual with bipolar disorder will be a lithium responder. Read more
The team – in South Korea – showed the sensor was accurate and think it could eventually help patients with diabetes. Read more
Bad hangovers may be hereditary, study finds People with a family history of alcoholism are already known to be at a greater risk of developing a drinking problem, but new research led by researchers at Keele University have found they are also more likely to hold onto the painful memory of hangovers. Read more
Blood test can detect heart damage after non-cardiac surgery
Scientists have developed a sensor that can monitor blood sugar levels by analysing sweaty skin. But rather than a gym-soaked t-shirt, it needs just one millionth of a litre of sweat to do the testing.
'Healthiest hearts in the world' found The healthiest hearts in the world have been found in the Tsimane people in the forests of Bolivia, say researchers. Barely any Tsimane people have signs of clogged up arteries – even well into old age – a study in The Lancet showed. Read more
Huge advance in fighting world's biggest killer An innovative new drug can prevent heart attacks and strokes by cutting bad cholesterol to unprecedented levels, new research has found. The results of the large international trial on 27,000 patients means the drug could soon be used by millions. Read more
New research looks into sperm swimming techniques How an individual sperm swims, against all the odds, through fluid to reach the fallopian tubes has been revealed — and it's all about rhythm. Researchers from the UK and Japan found that the head and tail movements of sperm made patterns similar to the fields that form around magnets. And these help to propel sperm towards the female egg. Read more
Australian College of Nursing update
The Star, Sydney
Nurses and vaccination advice
Advanced Diploma of Nursing
ACN Policy Summit a success!
In a recent media release, ACN remind the nursing profession of how highly Australians respect their advice and of their obligation to provide unbiased clinical evidence to enable patients to make their own informed decision.
As the pre-eminent and national leader of the nursing profession, ACN is committed to supporting the vital role that ENs play in delivering high quality nursing care. Keeping in line with this commitment, we are excited to announce that we will now be offering an Advanced Diploma of Nursing (HLT64115).
ACN held its inaugural Policy Summit in Canberra on Friday 21 April.
“Nurses are viewed as the most ethical and honest profession in Australia, and we are very proud of the trust the community has in us,” said ACN CEO Adjunct Professor Kylie Ward FACN. “We must ensure we do not damage this reputation by providing anything but the most clinically up-to-date information to our patients.” Adjunct Professor Ward’s comments followed recent public debate around vaccination. “ACN has adopted the Australian Nursing and Midwifery Federation (ANMF) Policy: Vaccination and Immunisation for Nurses and Midwives,” explained Adjunct Professor Ward. “Immunisation is a key factor in protecting Australians from disease and preventing the spread of disease.”
This course is for ENs who wish to further develop their knowledge and skills as leaders in their chosen specialty areas of practice – including acute care, critical care, and perioperative nursing. Aged care and mental health units will commence in 2018. This course consists of three core units followed by seven electives per specialisation pathway. Students seeking RPL for recent and relevant nursing study and experience must apply prior to course commencement. If you are an EN who has found your area of passion and want to extend your knowledge and skills in that speciality, then this course is for you! Please visit our website for more information.
The Summit provided a platform for informative discussion and debate amongst nursing leaders and consumers relating to workforce issues, endof-life care, chronic disease and policy leadership. ACN was honoured that the Chief Executive Officer of the International Council of Nurses, Dr Frances Hughes, took part in this highly important event. It was also a privilege to have the Assistant Minister for Health, The Hon Dr David Gillespie MP, ACT Minister for Health, Ms Meegan Fitzharris MLA, our President Professor Christine Duffield FACN and many highly esteemed nursing experts participate in this important event. The Summit was a perfect opportunity to work collaboratively with consumers to develop the national nursing policy agenda. We received considerable media attention and publicity surrounding this event. Moving forward, ACN will take the policy priorities identified at the Summit and work to see them communicated at every level of the Australian health care system.
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A Graduate's Journey â€œDown Lewis Carrollâ€™s rabbit hole I tumbled!â€? By Andrew Dean MACN
I have read with interest various articles of graduates telling of their journey from student to nurse over the past couple of years and have felt my story not as exciting or worthy of telling. However, at a recent ACN social event I was reminded how diverse the nursing profession is and that perhaps my experiences can help others and reassure them that their dream of nursing can be a reality.
Why nursing? It seems the inevitable question asked of a forty-something man who gave up a career as an IT consultant to become a nurse. This is both an easy question to answer and a complex one. On one hand, it was a career that I investigated in my late teens and found fitted my attitudes to people and life. My eldest sister was at that time a nurse in a regional hospital, so I was aware of the nature of nursing. In another time and place, I would have
gone to university (at that time the transitioning from hospital-training to university was almost complete) and completed my nursing degree. However, at the time I could not afford to go to university and to be honest at 18, was not secure enough in my own skin or mature enough to contemplate the attitude towards me as a male nurse (I lived in a very small country town with very conservative attitudes) (Kulakac et al, 2015). So twenty-something odd years down the path of life, after a career as an engineer, SCUBA instructor, working in air traffic control and as an IT consultant, I was in a position to return to university to complete a Master of Nursing Practice.
What I found was at once a source of excitement, wonder, and despair! There is something very fulfilling and privileged about looking after another human being who is sick and injured. The responsibility feels like a great weight on your shoulders but there is also a sense of great satisfaction from helping them in their hour of need. I wanted to make a difference in the world and nursing gave me that opportunity. Unfortunately, like most other
Almost three years have passed since I graduated from university as a nurse. Those years have seen me through a graduate year and to a position as a nurse in charge in aged care. I also work as an acting Clinical Services Manager and Director of Nursing when required.
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students and graduates I found the real world is something other than utopian (Suresh, 2009). During my first training placement in an acute ward of a major hospital, I encountered such systematic bullying that I thought I was back working as an apprentice engineer in my youth when hazing was the de rigueur. Surprisingly, the bullying was more directed at my female colleagues than me. I did however encounter social isolation from staff to such an extent that I learnt most of my practical basic nursing skills from trial and error on the ward as some of my buddy nurses rarely said more than 10 words to me in a shift. At one point, a senior manager told me I was too emotional to be a nurse after I had queried why a particular procedure was the way it was. While I encountered good nurses and role models, they were not the majority during this placement. I wondered whether my dream of becoming a nurse was worth it to work in such an environment. In fact, I took six months off to rest an injury and contemplate whether it was all worth it. Fortunately, the dream was stronger than the doubts! I subsequently found out on other placements that the culture of a ward seemed very dependent on its management and some were as bad as my first placement and some were fantastic. It was during this time that I really noticed the hierarchical nature of nursing. Nurses appeared to be sorted by experience rather than skill, rosters were not an even playing field and seemed to depend on whether you were liked or not. It also seemed that ideas from ‘junior’ nurses were not encouraged and that reaching a management position was out of reach despite your skills. I learnt that the nursing student is the lowest of the low and keeping one’s head down and not asking questions was the easiest way to succeed (Kelly and Ahern, 2009). In my opinion the above is a good example of how our historical hierarchical nursing structures still haunt us in the twenty first century. These
structures allow bullying behaviour to exist disguised as management and efficient practice. Graduates and students in other professional organisations are considered to be the next wave of talent and sort after; behaviour such as I endured has no place in today’s world. As a manager, I have always encouraged my staff to look after graduates and students and provide feedback to them. It was in my and my company’s interest to see which ones showed promise and to provide assistance to others that needed it. I graduated from my Master’s degree with a very high grade-point average, I state this not in hubris but to illustrate that I didn’t scrape through my placements or course work and that bullying can occur to anyone at any time. Post-graduation I received an offer for a graduate position with a major metropolitan hospital and, unexpectedly, a graduate position within aged care. The Master of Nursing Practice had not exposed me to aged care but the graduate position promised a fast track to management, which seemed the way to make change happen. I had seen in hospital wards that there appeared no way into management except from years of nursing experience. I decided on the aged care position and accidentally found my niche. It is my opinion that we focus far too much on ‘experience’. The old theory of 10,000 hours of practice to master a skill is often quoted but nearly always misquoted, indeed current research suggests that practice has little as 1% influence on mastery of a skill (Macnamara et al, 2014, Gladwell, 2008). Why then is it the case that our nursing awards are based so much on experience rather than skills and aptitude? (Humpries et al, 2014). Experience does not magically endow upon an individual management and leadership skills. Experience is just one aspect of a nurse’s ability and should be treated as such.
“The Australian College of Nursing has given me access to like-minded professionals and opportunities and much of what I plan to do would be impossible without them.” I started the management/graduate program and I found that while good, the program was designed for nurses without any management experience. Again, here I found bullying in the form of constant unwarranted criticism. Criticism is a useful learning tool but only if it is constructive and comes with techniques to improve. I had an entire career leading and managing people and projects, to my frustration this seemed not to be acknowledged in my new profession. I was only considered a graduate nurse and just had to endure. What I did discover was a nursing role that was unlike the hospital experience in my training. I was often responsible for up to 150 patients (called residents in aged care), these varied in acuteness from relatively independent to residents with endstage dementia and palliation. Depending on the model of care, medication was either dispensed by me or delegated to enrolled nurses and personal care workers (carers/assistants in nursing). I took my management and leadership skills, and developed a team based on my enrolled nurses. It is often the enrolled nurses who form the back bone of aged care. In short, I thrived! I love my work and consider it a privilege to care for the elderly. Along with my carers and other nurses, we become a surrogate family and we care for them right up to the end. Despite the fantastic work of aged care staff, I find the system very poor with many systemic faults, too many for this article. The deficits in our aged care system and lack of transparency in it have given me the drive to change it. I was always taught that criticism is easy but
finding a solution is infinitely harder. I am presently designing a management model which will allow managers in aged care to predict impacts on resident care from changes to most variables within an aged care facility. While primarily designed to help verify my ultimate goal, that is, to design and implement a much more human centred care model, I hope it will enable us as a profession to lobby for better conditions for residents and staff. While my journey thus far has been brief, my drive and reasons for becoming a nurse have never wavered, the Australian College of Nursing has given me access to like-minded professionals and opportunities and much of what I plan to do would be impossible without them. I would say for all of the current and future nursing students and graduates, the most important thing is to hold onto your dreams and hopes and not fall victim to apathy and despair as you are the vanguard for change that nursing will need into the future.
References Gladwell, M 2008, Outliers: The Story of Success, New York, Little, Brown and Company Humpries, T., Fitzpatrick, L. & Abmar, D 2014, Homestyle Aged Care Services, ANMF and HSU, Enterprise Agreement 2014, In: COMMISSION, F. W. (ed.). Kelly, J. & Ahern, K. 2009, 'Preparing nurses for practice: a phenomenological study of the new graduate in Australia', 'Journal of Clinical Nursing', 18, 910-918 Kulakac, O., Arslan, I, Sucu Dag, G & O'lynn, C 2015, 'Faculty experiences with rapid integration of male nursing students within a patriarchal societal context' Nurse Education Today, 35, 1075-1079 Macnamara, B. N., Hambrick, D. Z. & Oswald F. L 2014, 'Deliberate Practice and Performance in Music, Games, Sports, Education, and Professions', Psychological Science, 25, 1608-1618 Suresh, P 2009, Stress and stressors in the clinical environment: A comparative study of fourth-year student nurses and newly qualified general nurses in Ireland, M.Sc., Dublin City University (Ireland)
Acknowledging our community nurses Western Victoria PHN Primary Health Care Nurse Excellence Awards The role of community and primary health care nurses is integral to ensuring optimal health outcomes for all people across their lifespan. Community and primary health care nursing applies a social model of health care that addresses the health needs of individuals and communities while considering the social, economic and environmental factors impacting their health. When most people think of nurses, they picture a traditional hospital setting. However, community and primary health care nurses work in a wide variety of non-traditional settings. These settings can include prisons, schools, medical centres, sexual health clinics, aged care facilities, rehabilitations clinics, and outreach services. Community and primary health care nursing covers a very broad number of roles and also includes nurses that work in rural and remote
areas. These nurses are sometimes the only health professional a community has access to. They are responsible for health promotion and education, illness prevention, treatment and care of the sick. Community nurses often work in roles that go unnoticed in the wider community. However, the care that they provide alleviates the pressure on the hospital system and supports the shifting of care from the acute to the primary health care sector. The Western Victoria Primary Health Network’s (PHN) Primary Health Care Nurse Excellence Awards aims to raise awareness of the contribution of nurses in the primary care sector and acknowledge the significant role they play in driving quality improvements. The awards recognise nurses practicing in the Western Victoria Region who have demonstrated an
outstanding contribution to the health and wellbeing of their patients by undertaking a quality improvement activity within their practice. Nominations are now open for the awards. Visit the Western Victoria PHN website for more information. COMMUNITY AND PRIMARY HEALTH CARE NURSING WEEK 2017 Community and Primary Health Care Nursing Week is an annual ACN initiative that aims to educate the health care community, government officials and the wider community about the important contribution community and primary health care nurses provide to our health care system. Each year, there are a range of activities that ACN encourages nurses and the broader community to become involved in during Community and Primary Health Care Nursing Week.
“Community and primary health care nurses work in a wide variety of nontraditional settings”
More details about this year’s campaign will be released shortly. To read our 2016 Community and Primary Health Care Nursing Week eBook and find out more about last year’s celebrations, please visit www. acn.edu.au/community-and-primaryhealth-care-nursing-week-2016.
Goodbye paper hello digital Donâ€™t forget that Collegian is now an e-journal! Collegian: The Australian Journal of Nursing official journal of ACN. Collegian aims to reflect the broad interests of nurses and the nursing profession, within an Australian and international health context. The journal publishes articles on professional, policy and practice issues. It is ranked in ISI with an impact factor of 1.122. Since 2016, Collegian has been available as an e-journal to Members and Fellows of ACN. Current and previous editions can all be accessed for free by members and by separate subscription to others. Free access to all editions of Collegian is a key ACN member benefit. The second edition of Collegian for 2017, Volume 24 issue 2, is now available online. Included as a snapshot is an extract from an intriguing research piece published in this issue.
Australian nursing studentsâ€™ experience of bullying and/or harassment during clinical placement By Lea M. Budden, Melanie Birks, Robyn Cant, Tracy Bagley and Tanya Park Bullying and harassment in nursing are unacceptable behaviours in the workplace. There is a large body of evidence relating this problem, however little of it focuses on the experiences of nursing students. This prospective cross-sectional survey investigated Australian undergraduate nursing studentsâ€™ (N = 888) experiences of bullying and/or harassment during clinical placement. Half (50.1%) of the students indicated they had experienced this behaviour in the previous 12 months. Younger students were more likely to be bullied/harassed than older students (p = 0.05). Participants identified perpetrators of bullying/harassment as registered nurses (56.6%), patients (37.4%), enrolled nurse's (36.4%), clinical facilitators (25.9%), preceptors (24.6%), nurse managers (22.8%) and other student nurses (11.8%).
The majority of students reported that the experience of being bullied/harassed made them feel anxious (71.5%) and depressed (53.6%). Almost a third of students (32.8%) indicated that these experiences negatively affected the standard of care they provided to patients with many (46.9%) reconsidering nursing as their intended career. In the face of workforce attrition in nursing, the findings of this study have implications for education providers, clinical institutions and the profession at large.
If you would like to read the rest of this research piece, please visit www.acn.edu. au/publications to find out how to access current and previous issues of Collegian.
Practice, Scholarship and Research is the
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Unfinished care and consumer outcomes By Trish Lowe MACN Nurses are obliged to deliver care that is evidence-based and timely. The Registered Nurse Standards for Practice (Nursing and Midwifery Board of Australia (NMBA) 2016, p. 1) state that Trish Lowe MACN ‘registered nurse (RN) practice is personcentred and evidence-based’, while the Code of ethics for nurses (NMBA 2013, p. 1) outlines that ‘the nursing profession has a commitment to respect, promote, protect and uphold the fundamental rights of people who are both the recipients and providers of nursing and health care’. The Code of professional conduct for nurses (NMBA 2013, p. 1) implores nurses to ‘respect the dignity, culture, ethnicity, values and beliefs of people receiving care and treatment’ and to ‘inform the community of the standards of professional conduct it can expect nurses in Australia to uphold’. Australians hold nurses in high regard, with surveyed populations consistently rating nurses as the most ethical and honest profession (Roy Morgan Research 2016). However, not-withstanding this, features of the health care landscape, such as poor skill mix and rapid throughput, can
impact on the nurse’s ability to deliver essential and timely care, leading to consumer complaints and sub-optimal outcomes. Care auditing is one method used to identify deficient care in order to inform the change management strategies required to enhance workforce satisfaction and improve consumer experiences. MISSCARE (Kalisch & Williams 2009) is one example of a validated tool utilised to capture ‘unfinished’ care, in order to more closely identify the predictive factors. Any examination of data pertaining to ‘unfinished care’ and consumer complaints must be conducted through a lens which acknowledges the human condition. Nurses are employed in dynamic workplaces and subjected to uncontrollable variables. That being said, in their 2015–2016 Annual Report, the Healthcare Complaints Commission (HCC) noted that consumer complaints against health professionals in general are rising, with the three most common complaint categories relating to treatment (42.3%), communication (17.2%) and professional conduct (14.9%) (NSW Government 2016, p. 4, 16 & 22). Unfinished nursing care – that which is missed, rationed or left undone – is evident worldwide and emerging as a growing health care concern (Jones et al. 2015, p. 1122). Blackman et al. (2015, p. 47)
state that unfinished care prevalent in acute and aged care settings is attributed to limited human and material resources, and responsible for care ‘rationalisation’ or ‘prioritisation’. Prioritisation strategies leave patients feeling vulnerable with unmet ‘educational, emotional, and psychological needs’ (Jones et al 205, p. 1122). The MISSCARE survey developed and validated by Kalisch and Williams (2009) collects data pertaining to ‘missed’ nursing care and the reasons cited for this. Patient ambulation, rapid response to call bells, monitoring fluid balance and the provision of mouth care, second hourly turns, and regular analgesia have been identified as commonly missed elements of care (Blackman et al. 2015). Shift type, nursing resource allocation, ineffective communication and workload intensity are cited as reasons why care is missed (Maloney, Fencl & Hardin 2015, p. 234). It is essential that all factors influencing consumer satisfaction, skill mix, staff turnover and absenteeism are systematically examined, so that workforce building continues and consumer outcomes are optimised. Care auditing is one of the non-punitive means by which any barrier interfering with the delivery of timely nursing care is captured, so that quality improvements can continue.
References: Blackman, I, Henderson, J, Willis, E, Hamilton, P, Toffoli, L, Verrall, C, Abery, E & Harvey, C 2015, ‘Factors influencing why nursing care is missed’, Journal of Clinical Nursing, vol. 24, pp. 47-56 Maloney, S, Fencl, JL & Hardin, SR 2015, ‘Is Nursing Care Missed? A Comparative Study of Three North Carolina Hospitals’, MEDSURG Nursing, vol. 24, no. 4, pp. 229-235 NSW Government 2016, HealthCare Complaints Commission Annual Report 2015–16, viewed 8 January 2017, <http://www.hccc.nsw.gov.au/Publications/Annualreports/Default> Jones, TL, Hamilton, P & Murry, N 2015, ‘Unfinished nursing care, missed care, and implicitly rationed care: State of the science review’, International Journal of Nursing Studies, vol. 52, no. 6, pp. 1121-1137 Kalisch, B & Williams, R 2009, ‘Development and psychometric testing of a tool to measure missed nursing care’, The Journal of Nursing Administration, vol. 39, no. 5, pp. 211-219 Nursing and Midwifery Board of Australia (NMBA) 2016, Registered Nurse Standards for Practice, NMBA, Canberra Nursing and Midwifery Board of Australia (NMBA) 2013, Code of Ethics for nurses, NMBA, Canberra Nursing and Midwifery Board of Australia (NMBA) 2013, Code of Professional Conduct for Nurses, NMBA, Canberra Roy Morgan Research 2016, Roy Morgan Image of Professions Survey 2016: Nurses still most highly regarded – followed by Doctors, Pharmacists & Engineers, Roy Morgan Research Ltd., Melbourne, viewed 17 March 2017, <http://www.roymorgan. com/findings/6797-image-of-professions-2016-201605110031>
Discover exciting new opportunities Attend the ACN Nursing and Health Expos As the pre-eminent and national leader of the nursing profession, ACN is here with you for your whole nursing journey. We encourage and support nurses in all settings and at every stage of their career to pursue their leadership and career goals. A career in nursing and health offers lifelong learning, critical thinking, a broad array of vocational opportunities and the chance to contribute to the health of our communities.
Our Expos have a strong reputation for connecting visitors with a range of organisations, including hospitals, health care services, educational institutions and specialty nursing groups. With a broad selection of exhibitors from across the country, there are a wealth of products and services on show for visitors to find out more about the diverse career pathways available within the nursing and health professions.
Whether you are just starting out or looking to progress your career, ACN’s Nursing and Health Expos offer a broad scope of exciting opportunities for aspiring and current nursing and health care professionals.
At our Nursing and Health Expos, we also have complimentary educational seminars lead by prominent industry professionals running throughout the day. These seminars are a great opportunity for visitors to gain practical take-home advice and skills.
“ACN’s Nursing and Health Expos offer a broad scope of exciting opportunities for aspiring and current nursing and health care professionals.”
ACN NURSING & HEALTH EXPO 2017
Upcoming Expos We have just held a Nursing and Health Expo in Melbourne on Saturday 29 April. The Melbourne Expo was a massive success, with more than 6,000 current and aspiring nurses in attendance. ACN will be holding it's next Expo in Perth on Sunday 18 June. If you are a nurse, currently studying nursing or considering a career in the nursing or health professions, then we encourage you to come along! Visit www.acn.edu.au/expos for more information.
FREE ENTRY Sunday 18 June 2017 8:30am – 1:30pm Perth Convention & Exhibition Centre
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Leading nurses forward Get to know Ms Lydia Dennett MACN, Chief Nursing and Midwifery Officer for South Australia In every state and territory across the country, our Chief Nurse and Midwifery Officers (CNMO’s) provide a vital professional link between the Department of Health, and the Australian nursing and midwifery community. Our CNMOs play a key role in developing a collaborative and strategic approach to nursing and midwifery at a state and national level. They provide leadership, advice, information and guidance on all issues related to nursing and midwifery. ACN is publishing a series of articles about our CNMOs throughout the next few editions of NurseClick. This edition, we are profiling Adjunct Associate Professor Lydia Dennett MACN, Chief Nurse and Midwifery Officer for South Australia, whose experience and expertise as a nurse leader has seen her achieve remarkable outcomes while in this role.
Adjunct Associate Professor Lydia Dennett MACN, Chief Nurse and Midwifery Officer for South Australia Adjunct Associate Professor Dennett was appointed to the role of Chief Nurse and Midwifery Officer for SA Health in December 2011. Lydia trained as an intensive care nurse before immigrating to Australia from London. She has extensive experience within both private and public health sectors, and has previously spent a number of years working in Victoria at Alfred Health, The Royal Children’s Hospital, Melbourne Private Hospital and Western Health as a clinician, and for the last 15 years, in senior management and executive roles.
In her current role as the Chief Nurse and Midwifery Officer for SA Health, Lydia has the responsibility of providing professional leadership, as well as providing advice and direction on a diverse range of nursing and midwifery issues, including workforce planning, development and reform, recruitment and retention, best practice initiatives, research and policy development. In line with this is the requirement to influence and represent the nursing and midwifery professions to continue to enhance the quality of care delivered to consumers, and to ensure that practice is contemporary and evidence-based.
• The design and implementation of the Caring with Kindness Professional Practice Framework. The values and behaviours depicted within the framework were created by nurses and midwives and are highlighted as an exemplar on the website of the Office for the Public Sector. This framework will also be profiled at the upcoming International Council of Nurses Congress in Barcelona
Lydia has a strong commitment to ensuring continuing education and professional development of nurses and midwives. She is a member of a number of different committees, steering groups and working parties, including the Ministerial Advisory Committees, and is the current elected Chair of the Australian and New Zealand Council of Chief Nursing and Midwifery Officers.
• The recent design and development of a nurse endoscopist model of care which will provide for the introduction of nurse endoscopists in South Australia
Examples of initiatives led by Lydia and her team within the Nursing and Midwifery Office in SA Health include: • The development of the Nursing and Midwifery Strategic Framework, recently transitioned to the Strategic Commitment 2016–2018, which provides the key strategic priorities and objectives for the nursing and midwifery professions within SA Health
• The development of a comprehensive policy to support access by privately practicing midwives to public sector maternity services for the provision of a private midwifery model of care
• The creation of a Professional Leadership Network for nurses and midwives within SA Health which has supported the implementation of a structured mentorship program. Lydia holds a Masters Degree in Business of Management and is an Adjunct Associate Professor with the University of South Australia. She has also been a surveyor for the Australian Council on Healthcare Standards since 2005. Lydia is a valued member of ACN who delivered an exceptional keynote address at the 2016 National Nursing Forum on the power of teamwork. ACN looks forward to continuing to work collaboratively with Lydia in 2017.
ACN O-week Instagram competition To celebrate the start of the new University and TAFE year we ran an exciting Instagram competition. We asked undergraduate nursing students to tell us why they are excited to become nurses and received some fabulous responses!
We are excited to share the five winning posts with you. To see the other entries check out #acnoweek on Instagram.
Showing the way for others Meet one of our exceptional Puggy Hunter Memorial Scholarship recipients, Naizel Enosa By Kristen Connell
A strong Indigenous health workforce has a key role in improving outcomes for Aboriginal and Torres Strait Islander peoples, according to the Prime Minister’s latest Closing the Gap report. One young man has personally taken up this challenge and is obtaining his nursing qualifications in order to provide health care in his community. Naizel Enosa is in his final year of a Bachelor of Nursing degree at Deakin University in Geelong. Naizel is one of our Puggy Hunter Memorial Scholarship recipients. He believes educating Aboriginal and Torres Strait Islander high school students about the supports available, such as the Puggy Hunter Memorial Scholarship, is key to encouraging others to pursue careers as health professionals. As part of its Closing the Gap goals, the Australian Government funds four Indigenous-specific health professional organisations to assist in growing the Aboriginal and Torres Strait Islander health workforce and support culturally appropriate health services for Aboriginal and Torres Strait Islander peoples. Activities provided by these organisations range from mentoring programs, professional development opportunities, leadership programs and networking opportunities for Aboriginal and Torres Strait Islander health professionals and students. These organisations also provide cultural safety programs for health professionals working in mainstream
services and the Aboriginal community controlled health sector. The Puggy Hunter Memorial Scholarship, which ACN helps administer, aims to encourage and assist Aboriginal and Torres Strait Islander undergraduate students in health-related disciplines to complete their studies and join the health workforce.
The community’s nurse has to be able to deal with all types of illness or injury, and coordinate transfers in critical situations.” Once working as a remote nurse, Naizel will have to liaise with doctors from the closest hospital and the Royal Flying Doctors to provide emergency care until a patient can be transported.
Winning a Puggy Hunter Memorial Scholarship has helped Naizel pursue a career dream that came to him during his high-school years.
“A nurse working somewhere like Badu Island will get excellent experience in all manners of health care,” Mr Enosa said.
While at St Teresa's Abergowrie College, Naizel enrolled in a new course the school had recently begun offering: the Certificate II in Indigenous Primary Health Care.
With limited access to equipment and facilities, it will be important to be able to improvise and rely on our skills and knowledge to deal with the variety of issues we will confront.”
“Before that I had different career aspirations but this course inspired an interest in Indigenous health,”
Naizel also recommends nurses seek out a post in an Indigenous community for other reasons.
Mr Enosa explained. A particular driver was watching the First Australians program during this course. “This video made me realise there was a real need for Indigenous nurses, particularly male Indigenous nurses.” Undertaking his tertiary studies has not lessened Naizel’s passion. He is exploring options to do a graduate year in a remote area, such as Alice Springs, before returning to his home on Badu Island in the Torres Strait to provide health services to his community as a registered nurse. “A registered nurse can be the central health care provider in a remote community such as mine,” Mr Enosa said.
Include Badu for example, the atmosphere is wonderful, you will be warmly welcomed and within a week feel like you’ve always been part of the community – and of course the fishing is great.” It is in the field of men’s health that Naizel believes he will make the greatest contribution. English is Naizel’s third language, he is fluent in both his mother’s and father’s traditional language. “Aboriginal and Torres Strait Islander men are more reticent than most to seek health care when they need it,” Mr Enosa explained. “As a result, Aboriginal and Torres Strait Islander women tend to have a longer life expectancy.
“When we are talking men’s business, I will be able to discuss in their language the need for men to come and see me as a health care professional and hopefully remove some of the hurdles that prevent men from getting help.” Naizel hopes to see the number of Indigenous health care practitioners increase in the future. “It would be valuable for young Aboriginal and Torres Strait Islander men and women to be more aware of the opportunities,” he said. “Before I learned of the Puggy Hunter Memorial Scholarship, I didn’t know how I could turn my dream of becoming a nurse into reality. “I think a lot of high-school students can’t see what is out there to help them undertake further study in a field they are interested in. “My own personal experience is that there is financial, social and personal support on offer for those who want to go to university. It would be good to see more information provided in schools to let young Aboriginal and Torres Strait Islander men and women know what is available.”
Celebrate International Nurses Day with ACN! Do you have plans for International Nurses Day this year? Register your workplace, university or community centre as an ACN National Nurses Breakfast host and you will receive a free hosting kit full of exciting materials to help you celebrate and decorate your venue. The ACN National Nurses Breakfast is the perfect opportunity to come together with friends and colleagues to celebrate International Nurses Day and the invaluable contribution nurses make to the health of our society. Last year, 241 registered breakfasts were held across Australia with over 9,000 people taking part in the celebrations. The theme for International Nurses Day this year is Nurses: A Voice to Lead, Achieving the Sustainable Development Goals. As pre-eminent and national leader of the nursing profession, ACN provides a voice for Australian nurses and advocates on behalf of our membership at a local, state and national level. Therefore, we are excited to embrace this theme and celebrate International Nurses Day with you all this May! Visit www.acn.edu.au/breakfast to find out more about our National Nurses Breakfast and to register your event today. Make sure you also share photos of your celebration with us on social media using the hastag #ACNBREAKFAST
IN FOCUS @ACN
Honouring the fallen Observed on 25 April each year, Anzac Day marks the anniversary of the first major military action fought by Australian and New Zealand forces during WWI. Australians recognise 25 April as a day of national remembrance. It is a day to acknowledge and honour all those who have served our country during war, armed conflict and peacekeeping operations. It is a day where the nation pauses to pay our respects to the fallen and reflect on the sacrifices made by those before us. Following Anzac Day, ACN would like to thank all of the nurses, in our past and present, who have served in honour of our profession. Lest we forget your courage, service and sacrifice.
ACN Centenary Commemorative Trilogy ACN is proud to partner with Dr Ruth Rae FACN in a commemorative publication of The History of Australian Nurses in the First World War: An ACN Centenary Commemorative Trilogy (the Trilogy). The Trilogy details the important contribution of Australian nurses who served in WWI and highlights the valuable service Australian nurses provided, to not only the servicemen, but to the ongoing professionalism of civilian and military nursing in this country. The Trilogy features: • Book one – From Narromine to the Nile (2nd edition) • Book two – Scarlet Poppies (3rd edition) • Book three – Veiled Lives (3rd edition) • ACN First World War Nursing Nominal Roll
Visit www.acn.edu.au/commemorative_ trilogy for more information and to purchase The Trilogy today!
Commemorative coin The Royal Australian Mint has released a commemorative coin in honour of Australian service nurses. The limited edition coin can be purchased via the Royal Australian Mint eShop. As an ACN member you are eligible to receive free shipping (a saving of $10) on your purchase until the end of May. To take up this offer simply call 1300 652 020 and state you are a member of ACN.
Is your organisation an ACN Affiliate? A number of leading organisations across the country have positioned themselves as employers of choice by gaining ACN Affiliate status. The ACN Affiliate program is tiered into Platinum, Gold, Silver and Bronze, allowing all organisations, from large to small not-for-profits, to invest in, and give back to, their nursing staff or members. ACN Affiliates receive access to a large number of practical tools to enhance productivity and morale.
Depending on the Affiliation level, benefits include a customised Executive Leadership Development Day, a complimentary ACN membership and National Nursing Forum registrations to reward high performing staff members, as well as discounts on ACN membership, education and events allowing all employees to benefit. All ACN General members that are part of an Affiliate organisation are eligible to receive the discounted Affiliate membership rate â€“ a saving of over $70 per year!
If your organisation is listed as an Affiliate on our website get in touch with us via email@example.com or 1800 061 660 and we will adjust your rate accordingly. If not, we would love to invite your organisation to join our ACN Affiliation community! You can share our Affiliation brochure with your organisation to demonstrate the value of this exceptional opportunity.
If you have any questions regarding ACN Affiliation please feel free to reach out to: ACN Affiliation Specialist Helen Stamatiou via firstname.lastname@example.org or 02 6215 8314.
Reflections of a reluctant cancer nurse Musette Healey MACN
I remember vividly the dread and trepidation I felt when I accepted a position on a paediatric oncology ward. You see, oncology was an area I said Musette Healey MACN, I would never work in. At the end of my new graduate program I was thinking about what I wanted to do next; I have always loved kids, so I thought I would try and get a job as a paediatric nurse. I applied for a position in a major tertiary hospital and was told the only ward with vacancies was the oncology ward – I remember thinking; oh crap! At this point, I became quite indecisive (which is very unlike me). My heart was saying; take the job you really want to work with kids. But
my head was saying; it’s cancer, it will be really sad, you won’t be able to do it. I turned to the ever present oracle of information and advice – my mum! I was young and on reflection incredibly innocent and naïve. I really had no idea what I had got myself in for but I was working in a major paediatric hospital – that was something. I remember the first patient that died after I started, he was a young teenage boy with beautiful blonde hair. I had only looked after him a couple of times and only been on the ward for a few weeks. He was in one of the single rooms and it was an evening shift. I remember standing at the nurses’ station watching the nurse who had been caring for him come out of the room and inform us that he had passed away. It felt like time stood still, I didn’t know how to react. I wanted to curl up in a ball and cry for this young man and his family but I had other patients who needed my care.
“I wanted to curl up in a ball and cry for this young man and his family but I had other patients who needed my care.”
I am not sure how I got through that shift, but I did. I think I expected this to be a very frequent occurrence but in reality, it wasn’t. Most patients had treatment, eventually got well and went home. The reality was that most days were filled with observations, taking bloods, giving medications, putting up IV fluids, dodging kids as they screamed up the corridor dragging their IV pole on their way to reserve the PlayStation, writing notes, giving chemotherapy, cleaning up the mess that comes with the nausea from chemotherapy, madly scrambling to get antibiotics started on the patient who has just spiked a temperature of 39 degrees and has no neutrophils, supporting parents who are struggling to accept the diagnosis, treatment and side effects, and comforting parents who fear losing their child and are trying to juggle the needs of the rest of the family, while they feel like their world is crumbling. I would often go home exhausted both physically and emotionally. I must have looked quite a sight talking to myself and crying in
the car on the way home. I would lie in bed at night and wonder if the child I had just left who had no platelets would still be there in the morning or if I had given the 10:00pm antibiotics. I would ache for the family who were going to be told the next morning that their two year old girl had leukemia or the 15 year old boy who was frustrated and angry that he couldn’t spend time with his friends and be a normal teenager. There were some great moments as well. The days where you were able to find five minutes to sit and play a game of UNO with a 10 year old girl, while you waited for her chemotherapy to finish or when you said goodbye to a family as they walked out of the ward because treatment was finally over. Watching the smile on a three year old, as he realised the Wiggles had come to visit or decorating the ward ready for a party day. I learnt so much about life and myself from these children and their families. What was once an area I said I never wanted to work in, has become something so precious to me and I wouldn’t change it for the world.
ADVANCED DIPLOMA OF NURSING FOUR SPECIALITY STREAMS AVAILABLE Advancing nurse leadership www.acn.edu.au
Nurse & Midwife Support:
National health support service now available Nurses and midwives now have 24/7 confidential health support via phone and online, after Nurse & Midwife Support launched at the Melbourne Town Hall on Wednesday 8 March. Nurse & Midwife Support provides confidential and professional advice for nurses and midwives on a wide range of health issues, including mental health, addiction, illness or injury, and workplace stress. Nurses and midwives, as well as students of nursing and midwifery, can speak to a specialist counselor anonymously on 1800 667 877, or access health information and referral tools at www.nmsupport.org.au.
can continue to provide safe care to the public,’ Associate Professor Cusack said.
support nurses and midwives with health issues.
Nurse & Midwife Support also offers information and advice for employers, educators and those wanting to help a colleague or friend.
“Early action is the key to ensure that nurses and midwives are supported to receive the treatment they need, so that matters don’t end up with the NMBA,” she said.
Adjunct Professor Debra Thoms FACN (DLF), Commonwealth Chief Nursing and Midwifery Officer, officially opened the new service and urged all health agencies, professional organisations, employers and regulators to work together to better identify and
If you would like confidential, professional advice on a health issue or how to support someone with a health issue, you can call Nurse & Midwife Support anonymously on 1800 667 877 or you can visit the website www.nmsupport.org.au.
The health support service is a Nursing and Midwifery Board of Australia (NMBA) initiative but is run independently by Turning Point, a leading provider of health support services. Nurse & Midwife Support is independent of the NMBA and the Australian Health Practitioner Regulation Agency (AHPRA). NMBA Chair Lynette Cusack RN spoke at the launch of the new service, which she said would make an important contribution to all Australians receiving safe, quality care. ‘Nurses and midwives make up the largest group of health practitioners in Australia – over 380 000 – and there is strong research supporting the provision of health support to these professions so that they
Anthony Denham, Program Director, Turning Point, Adjunct Professor Debra Thoms FACN (DLF), Commonwealth Chief Nursing and Midwifery Officer, and Lynette Cusack, NMBA Chair, open Nurse & Midwife Support
NurseClick is the Australian College of Nursing's monthly e-zine focusing on topical articles.