NurseClick AUG U S T 2 0 16
Australian Nursing Workforce: A Snap Shot 2015
The value of interning: Nursing professional in global health
National Networking Roadshow connects nurses across country
Wearable devices and their community health potential
In this edition
Adjunct Professor Kylie Ward FACN, CEO of ACN
In the news
Australian Nursing Workforce: A Snap Shot 2015
NATIONAL NURSING FORUM
26–28 October 2016
THE POWER OF NOW Melbourne Park Function Centre
In focus @ACN
In focus @ACN
National Networking Roadshow connects nurses across the country
The value of interning: Nursing professionals in global health
Recognising and combating moral distress
The National Nursing Forum preliminary program now available
For more details and to secure your#NNF2016 place visit www.acn.edu.au/nnf2016
In focus @ACN
Wearable devices and the potential for community health improvement
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Welcome Adjunct Professor Kylie Ward FACN, CEO of ACN
Welcome to the August edition of NurseClick. It was an absolute pleasure to engage with nurse leaders and emerging nurse leaders from across Australia who attended the Australian College of Nursing’s recent National Networking Roadshow cocktail functions for our Members, Fellows and VIP guests. The energy and passion for our profession and organisation was inspiring in every state and territory. ACN will continue to create opportunities at a local, regional and national level for our valued Members and Fellows to engage with each other, as well as key health and political stakeholders. The recently released Nursing and Midwifery Workforce 2015 report from the Australian Institute of Health and Welfare has highlighted the need for further government strategy and initiatives to address an ageing nursing workforce, the increasing demand for nurses and graduate transition issues. In this month’s policy article, the ACN team have analysed these projections from the report and discuss possible solutions to ensure a strong nursing workforce for the future. Early career nurse and inspiring ACN member, Ely Taylor MACN, has kindly shared her World Health Organization interning experience with us in the hope of encouraging other nurses to take up this amazing opportunity to expand their skillset and understanding of public health. As leaders and providers of care in many different settings, nurses are well-placed to inform health initiatives and an internship such as this offers an incredible opportunity to gain insight into national and global health policy development.
Almost every nurse has been faced with a morally distressing situation at some point in the career, most on a daily or weekly basis. In this month’s Vital Signs, ACN Nurse Educator Trish Lowe MACN discusses the often toxic effects of moral distress and how healthy work environments and authentic leadership can go a long way to relieving these repercussions. As relatively new players in the rapidly advancing world of health technology, the impact of wearable health devices on individuals, communities and the health workforce is still being explored. The technology has the potential to inform patient care, enhance consumer engagement and promote shared decision making. In her report about a recent symposium on Wearable Health Technologies, Dr Ruth De Souza MACN explores whether wearable technologies can realise these benefits or whether they exacerbate disparities for structurally and culturally marginalised communities, in particular, people from culturally and linguistically diverse backgrounds. I am delighted to be able to share these insightful articles in our publications. It’s just one of the many ways our members and their colleagues make meaningful contributions to the ACN community. If you are interested in sharing your knowledge and experiences, I encourage you to submit an article. I hope you enjoy the issue. Adjunct Professor Kylie Ward FACN Chief Executive Officer
Publishing details Publisher Australian College of Nursing Editors Karina Piddington Sally Coen Wendy Hooke
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Design Nina Vesala Emma Butz Enquiries t 02 6283 3400 firstname.lastname@example.org Advertise with ACN Send your enquiries to email@example.com © Australian College of Nursing 2016 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 ‘file photo’ or credited to iStock are representative only and do not depict the actual subjects and events described in the articles.
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In the news Nat ional Complex genetic secrets of cancer risk uncovered Pioneering work by Australian researchers has uncovered the complex genetic secrets of a rare type of cancer that predominantly strikes the young. The discoveries transform the medical profession's understanding of sarcoma and have immediate implications for patients' treatment, says the Garvan Institute’s Professor David Thomas, who led the study. Read more
Flat head fears put babies at risk: study
New approach to suicide prevention in NSW
Parents worried about their newborn baby developing a flat head are potentially putting their child at risk of sudden death, a new study has found. Australian researchers have found parents are ignoring the Sudden Infant Death Syndrome (SIDS) guidelines and are using pillows and dangerous sleeping positions to prevent plagiocephaly, also known as flat head syndrome.
A new integrated approach to suicide prevention combining school education programs, advanced training for psychologists and crisis teams is being implemented across NSW, with other states to follow soon. It's hoped the LifeSpan model will reduce suicide deaths by at least 20 per cent and attempts by 30 per cent. Read more
New software simplifies dysphagia diagnose A new analysis software that simplifies dysphagia diagnoses will speed up results and eliminate the need for x-rays. AIMplot Collaborative Software was developed by researchers from Flinders University in South Australia to give clinicians the ability to accurately assess patient swallowing at the bedside. Read more
Bed numbers rising more in private hospitals than in public hospitals In 2014–15, there were 1,322 hospitals in Australia—698 public and 624 private hospitals, according to reports released by the Australian Institute of Health and Welfare (AIHW). “In the five years to 2014–15, the number of public hospital beds increased by an average of 1.1% each year to 60,300 and private hospital beds increased by an average of 2.9% to almost 32,000,” said AIHW spokesperson Jenny Hargreaves. Read more
Aboriginal patients have different experience of hospital, especially in country A report on Aboriginal people's perceptions of the NSW hospital system showed a gulf between their experiences and those of non-Aboriginal people in several key measures, which were more pronounced in rural hospitals. Aboriginal patients were particularly lukewarm on the quality of their communications with clinical staff, whether they had enough privacy when discussing their treatment and whether appropriate arrangements were made for their discharge. Read more
Cholesterol boosts progression of aggressive cancers, study suggests An Australian-first study by Queensland researchers has revealed how fats, including cholesterol, increase the progression of aggressive cancers. The study focussed on how fats work to regulate cell function but at the same time create proteins that are elevated in more aggressive cancers. Read more
Qld black lung cases continue to grow Another three Queensland miners have been diagnosed with black lung disease, according to the CFMEU. The union says one of the victims was a retired miner who died in July, but Queensland's Department of Natural Resources and Mines is yet to publicly confirm the cases. The state government has so far confirmed 11 cases of the disease but the CFMEU says it knows of more than 30 people who have contracted the disease. Read more
THE ARMY IS NOW RECRUITING NURSING OFFICERS A career as an Army Nursing Officer offers variety and challenges in employment and travel not always available in the normal hospital environment. You will gain experience and skills that will equip you for advancement in the Army, and will also be in high demand in your profession. You’ll also enjoy great benefits like free medical and dental, world class training, subsidised accommodation, excellent salary packages, work/life balance and unique experiences. To find out more about becoming a Nursing Officer search ‘Army Nurse’.
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International Council of Nurses publishes new TB guidelines for nurses The International Council of Nurses (ICN) has released updated TB Guidelines for Nurses Working in the Care and Control of Tuberculosis and Multidrug-Resistant Tuberculosis. These guidelines are intended to help nurses in their important role of detecting Tuberculosis (TB) cases, providing care and managing TB treatment. Read more
‘Game-changing’ asthma pill reduces severe symptoms in patients, study finds A new drug could significantly reduce the symptoms of asthma in patients, according to researchers. The pill, called Fevipiprant, has been described as a “a game changer for future treatment of asthma”. It was found to decrease the symptoms of asthma, improve lung function, reduce inflammation and repair the lining of airways. Read more
Researchers propose new treatment to prevent kidney stones
Women who had appendectomy have greater chance of getting pregnant
Researchers have found evidence that a natural fruit extract is capable of dissolving calcium oxalate crystals, the most common component of human kidney stones. This finding could lead to the first advance in the treatment of calcium oxalate stones in 30 years.
Women needing their appendix removed should not fear it will reduce their chances of falling pregnant, say UK researchers. A new 15-year British study has surprisingly found that women who had their tonsils or appendix removed when they were young are more likely to get pregnant.
Study shows scarred and inflamed ovary may cause infertility
Zika linked to baby joint deformities
Scientists in the US have found the ovarian stroma – the environment in which the eggs grow in – of older mice look completely different to those of young mice. It's hoped this new understanding of how ageing effects the ovary will lead to new treatments to preserve fertility and help young women with polycystic ovary syndrome. Read more
One drug is 'new hope' for three killer infections One drug can treat three deadly and neglected infections – Chagas disease, leishmaniasis and sleeping sickness – animal studies show. It has been described as a "new hope" for tackling the parasitic infections which affect millions of people in the poorest parts of the world. The discovery, reported in the journal Nature, was made by testing three million compounds.
Zika infection during pregnancy may cause limb joint deformities in the baby, experts now fear. Brazilian researchers from Recife, the city at the centre of the Zika epidemic, describe seven suspect cases in the journal The BMJ. The virus is already known to cause a serious baby brain defect. Read more
Researchers devise method for bone marrow transplants without using chemotherapy Blood stem cell transplantation, widely known as bone marrow transplantation, is a powerful technique that potentially can provide a lifelong cure for a variety of diseases. But the procedure is so toxic that it is currently used to treat only the most critical cases. Now, researchers at the Stanford University School of Medicine have come up with a way of conducting the therapy that, in mice, dramatically lowers its toxicity.
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MAKING EDUCATION EASY FOR NURSES www.researchreview.com.au
Read the latest in nursing research and practice in ACN’s digital journal, Collegian. Access to the peer-reviewed publication is free for all ACN Members via the My ACN member portal, members.acn. edu.au
Aus tr alian C ollege of Nur sing update Become an ACN Career Coach
GET SOCIAL WITH ACN
The Australian College of Nursing (ACN) is seeking expressions of interest from Members and Fellows who would like to support undergraduate RN and EN students by providing a minimum of two one-hour career coaching sessions every year. This new initiative will be made available as part of ACN’s revamped undergraduate student membership due to launch soon. Click here to learn more about this exciting opportunity and to find out how to submit an expression of interest. Applications for the first round of career coaching sessions will close on Wednesday 31 August.
Facilitate an ACN CPD Short Course ACN is delighted to offer our Members and Fellows an opportunity to assist in facilitating the smooth operations of our CPD short courses that occur across the country. In exchange for your support a complimentary registration to take part in the program is included. This valuable opportunity allows ACN Members and Fellows to participate in quality face-toface education programs free of charge and contribute to the ACN member community, as well as showing your support and commitment to continuous learning in the nursing profession. If you are interested in this role be quick to secure your registration, as there is only one place per short course available! Information on upcoming short courses can be found on our website. Please read our facilitation guidelines for more information.
ACN condemns mistreatment of youth detainees in NT
RNs needed to protect safety of aged care residents
ACN is appalled by the recent Four Corners exposé of the Don Dale Youth Detention Centre in Darwin which showed the shocking mistreatment of children in juvenile detention. The use of tear gas, physical violence and solitary confinement are sickening occurrences that should never happen in Australia.
ACN recently announced the publication of its position statement on The role of registered nurses in residential aged care facilities that unambiguously supports the requirement for registered nurses (RNs) to be present within residential aged care facilities (RACFs) at all times.
ACN is pleased to hear of the establishment of a Royal Commission. ACN hopes to see answers and solutions in a timely fashion in response to this deplorable treatment. Children incarcerated in Australia remain at risk and deserve immediate access to care. Read the full media release
The new position statement outlines ACN’s expectation that regulation of RACFs should at a minimum mandate a requirement that an RN be on-site and available at all times to promote the safety and well-being of residents. ACN’s statement recognises that there is a need to ensure that RACFs can support the growing pattern of frailty and dependence amongst residential aged care populations. Read the full media release
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Australian Nursing Work force: A Snap Shot 2015 By Stefan Wythes and Liza Edwards MACN
The Australian Institute of Health and Welfare (AIHW) has recently released Nursing and midwifery workforce 2015, a report outlining the current characteristics of Australiaâ€™s nursing and midwifery workforce (Australian Institute of Health and Welfare 2016). The report reveals that the number of nurses and midwives registered in Australia increased from 330,680 in 2011 to 360,008 in 2015, an increase of 8.9%. Of these, 307,104 registered nurses (RNs) were currently employed, with the remaining registrants not in paid employment or on extended leave. A total of 8,930 registrants were actively seeking employment, down from 9,110 in 2014. The report also highlighted that in 2015, there were more nurses and midwives in the 50 and over age group employed throughout the workforce than any other age group (39.0%), slightly less than the previous year (39.4%), but higher than in 2011 (38.3%).
Workforce innovations and current initiatives In 2014, future nurse workforce planning projections showed that the medium to long-term demand for nurses across Australiaâ€™s health care system will significantly exceed supply (Health Workforce Australia 2014). Long-term projections predict a nursing workforce shortfall of approximately 85,000 nurses by 2025 increasing to 123, 000 by 2030 primarily due to population health trends, including rising rates of chronic disease, an ageing nurse
workforce and inadequate retention rates (Health Workforce Australia 2014). These workforce predictions are warning decisionmakers that Australia’s nursing workforce will not have the numbers to sustain the health system into the future, so there is a clear need to address the balance between workforce supply and demand. In contrast, in the current environment, it is reported that many nurses graduating from preregistration courses in Australia are struggling to gain employment in today’s highly competitive employment market (Christopher et al. 2015). While many health services across the country offer structured programs to support graduate nurses’ transition into practice, these opportunities are limited within both the public and private sectors and do not correlate with the numbers of nurses graduating each year (Health Workforce Australia 2014). While it is not mandatory for graduate nurses to enter the workforce through these programs, those unable to secure such a position can become caught in a cycle of seeking employment without experience in a system that does not provide appropriate transition supports (Peters & Jackson 2013). There is evidence that work to address this issue has commenced in some jurisdictions, however, a system wide solution is only possible if this work is a key priority shared not only by all governments, but also the tertiary education sector, professional groups and providers across the health system. It is crucial that solutions are found to ease current ‘bottle necks’ and increase employment opportunities for new graduates to ensure the system is able to retain and grow them as professionals, augmenting our system to face future shortages and meet the ever increasing demand for service delivery. While it is critical that the health workforce is enabled by adequate numbers of graduates, it is equally
important that this occurs in line with the workforce needs of health systems across jurisdictions. In this era of health reform, it is critical that strategic health workforce planning becomes a national priority as it is crucial in developing the future resilience of Australia’s health system.
Graduate nursing initiatives The Queensland Government committed to employing 4000 nurse graduates as part of its 2015 election pledge (Queensland Government 2016a). $110 million has been dedicated to increasing numbers of nursing staff state-wide, including supporting up to 1,000 additional nurse graduates to enter Queensland’s Hospital and Health Services every year for four years (Queensland Government 2016a). As a result, every nurse who graduated from a Queensland University in 2015 was offered a position in Queensland Health and since February 2015, more than 2000 graduate nurses have been employed across the State (Queensland Government 2016a). These nurses have joined more than 36,000 nurses employed across Queensland Health (Queensland Government 2016a). This initiative to increase the number of graduate nurses employed across Queensland Health Services comes after years of decline. For example, at one Queensland hospital there were 203 nursing graduates employed in 2007, however, this had reduced to 88 per annum by 2013 (Henderson et al. 2015). Tasmania’s graduate nurses also continue to struggle to find employment. It is claimed that in 2015, there were “approximately 300 graduating [nurses] and only around 120 positions funded across the public sector” resulting in just 40% of nursing graduates being able to find employment (Shannon 2015).
“In this era of health reform, it is critical that strategic health workforce planning becomes a national priority as it is crucial in developing the future resilience of Australia’s health system.” Despite the reported oversupply of nurse graduates, the Tasmanian branch of the Australian Nursing and Midwifery Federation (ANMF) has predicted a shortfall of nearly 400 nurses in the aged and community care sectors by 2020 in Tasmania (Fromberg 2015). The ANMF won a government tender to train 20 extra enrolled nurses, however they remain concerned that the large number of retiring nurses across the State will lead to significant shortfalls in the next five to 10 years (Fromberg 2015). The Tasmanian Government has committed to funding increased numbers of nurses with 80 new full time positions across the Tasmanian Health Service implemented since July 2015. As is the case across the health system, ACN encourages the Tasmanian Government to ensure nurses are provided with appropriate transitional supports as they move into new jobs. The Australian Government has provided funding to the Australian Primary Health Care Nurses Association to develop a Transition to Practice Pilot Program over three years (2015-2018) to support both newly graduated and experienced nurses to transition into primary health care as a career option. (Australian Primary Health Care Nurses Association, n.d). The Transition to Practice Program aims to improve workforce development, sustainability and retention through the development of an accessible, partly
structured, and flexible program to increase the skills, knowledge, competence and confidence of nurses transitioning to work in the primary health care settings.
Further workforce initiatives From July 2016 Queensland introduced nurseto-patient ratios across the State. According to Queensland Health, these ratios provide increased benefits for patients, nursing staff and the health system more broadly, with patients spending less time in hospital and inpatient mortality reduced when increased numbers of registered nurses are available to care for patients (Queensland Health 2016). The Queensland Government has endorsed minimum nurse-to-patient ratios of one nurse to every four patients for a morning and afternoon shift (1:4) and one nurse for every seven patients for a night shift (1:7) in acute medical and surgical wards and in prescribed wards and facilities in the State’s public health services (Queensland Health 2016). The nurse-to-patient ratios will be enforced in acute medical wards in 28 hospitals and surgical wards in 24 hospitals, covering approximately 80% of the acute wards in Queensland public hospitals. Queensland Health, as part of its Nursing Guarantee policy, also introduced a new nurse navigator model of care (Queensland Health 2015). The 400 nurse navigator positions are undertaken by nurses
Policy @ACN with expert clinical knowledge and an in-depth understanding of the health system, whose focus is to support patients with complex health care needs across the entire health care journey. In the 2016-17 Queensland Budget an additional 68 nurse navigators are funded on top of the 50 nurse navigators employed in 2015-16 (Queensland Government 2016b). According to Queensland Health, the service provided by nurse navigators complements other care coordination services by developing partnerships across sectors and providers, ensuring a system-wide, integrated approach to health service delivery. Effective and efficient use of resources in the delivery of services leads to reduced costs, especially for people with multiple health and social needs, and significant productivity gains across the broader health system (Queensland Health 2015).
Budget initiatives Recent State and Territory budgets handed down in the ACT, QLD and NSW have seen increasing investment in health. In the ACT, for example, the government announced an investment of $139 million for 91 new nurses, 22 new doctors and 34 new allied health professionals as part of a total investment of $1.6 billion in health services for Canberra (ACT Government 2016). In Queensland the health budget increased to $15.274 billion for the 2016-17 period with the majority of the funding directed towards the State’s 16 hospital and health services (Queensland Government 2016b). In June 2016 the NSW Government announced that 900 extra nurses, doctors, allied health professionals and hospital support staff would be provided within the $22 billion health care budget (NSW Government 2016). $375 million has been outlaid for increases in hospital activity including 79,000 more emergency department attendances and 4,500 more elective surgery patients (NSW Government 2016).
Recruiting and retaining a skilled nursing workforce in rural and remote areas of Australia is an ongoing challenge for many governments. This has resulted in some governments investing in incentives to attract a new skilled nurse workforce to these communities. Queensland Health has been offering incentives and benefits to nurses willing to relocate to areas of need in rural and remote areas. These include bonus payments, professional development allowance, free or subsidised accommodation and payment of relocation costs (Queensland Health 2014). Similarly, the Northern Territory Primary Health Network (PHN) offers free recruitment services and grants through the Rural Health Professionals Programme (RHPP) and the New to the Territory Grant (NT Grant) (PHN Northern Territory 2016). These grant programs offer financial assistance to eligible health professions to assist with relocation costs and ongoing professional development. Initiatives to boost the nursing workforce, particularly in the area of nurse graduate employment are well received, however, there remains a clear need for a coordinated, collaborative and national strategy to address future nursing workforce issues as individual or state and territory-based solutions will only have a limited impact. The nursing profession in Australia needs to be supported and developed as a highly mobile and responsive health workforce by future initiatives that address a spectrum of issues that include appropriately facilitating supply and demand, supporting transition from graduation to employment, improving retention rates and addressing the issue of an ageing workforce. References ACT Government 2016, $1.6 Billion Investment in Health Services for Canberra, media release, ACT Government, viewed 17 June 2016, < http://apps.treasury.act.gov.au/budget/budget-2016-2017/mediareleases/$1.6-billion-investment-in-health-services>. Australian Institute of Health and Welfare 2016, Nursing and midwifery workforce 2015, viewed 22 June 2016 < http://www.aihw.gov.au/ workforce/nursing-and-midwifery/>.
Australian Primary Health Care Nurses Association APNA, APNA Transition to Practice, viewed 12 August 2016 <http://www.apna.asn. au/lib/pdf/NiPHC/TPPP/EOI%20Guidelines.pdf>. Christopher, S.A., Chiarella, E.M. & Waters, D. 2015, ‘Can Generation Y nurses supply areas of shortage? New graduate challenges in today's job market', Australian Journal of Advanced Nursing, vol. 33, no. 2, pp. 35-44. Fromberg, A. 2015, Tasmanian Government to spend $200,000 to stem nursing skill shortage, ABC News, Australian Broadcasting Corporation, viewed 1 July 2016, < http://www.abc.net.au/ news/2015-04-08/tasmanian-government-to-spend-242002c000-tostem-nursing-skil/6379124>. Health Workforce Australia 2014, Australia’s Future Health Workforce – Nurses Overview Report, Department of Health, Canberra, viewed 9 August 2016, < https://www.health.gov.au/internet/main/publishing. nsf/Content/34AA7E6FDB8C16AACA257D9500 112F25/$File/AFHW%20-%20Nurses%20overview%20report.pdf>. Henderson, A., Ossenberg, C. & Tyler, S. 2015, ‘What matters to graduates: An evaluation of structural clinical support for newly graduated nurses’, Nurse Education in Practice, vol. 15, no. 3, pp. 225-31. NSW Government 2016, Record $22 billion health budget boosts frontline care, media release, 21 June, NSW Government, viewed 21 June 2016, <http://www.health.nsw.gov.au/news/ Documents/21062016_01.pdf>. Peters, K. & Jackson, D.E. 2013, ‘New graduate nursing unemployment: A threat to the future health care workforce’, Contemporary Nurse, vol. 44, no. 2, pp. 130-32. Primary Health Network Northern Territory 2016, Nursing and Allied Health Professionals, viewed 23 June 2016 <http://www.ntphn.org. au/working-nt/nursing-and-allied-health-professionals>. Queensland Government 2016a, Record nurse graduate intake in Gold Coast hospitals, Media Statements, Minister for Health and Minister for Ambulance Services The Honourable Cameron Dick, the Queensland Cabinet and Ministerial Directory, viewed 16 June 2016, <http://statements.qld.gov.au/Statement/2016/5/16/record-nursegraduate-intake-in-gold-coast-hospitals>. Queensland Government 2016b, Queensland Health budget puts patients first, media release, 14 June, Queensland Government, viewed 17 June 2016, < https://s3-ap-southeast-2.amazonaws.com/ s3-media-budget/pdfs/media/Dick-+Queensland+Health+budget+pu ts+patients+first.pdf>. Queensland Health 2014, Remote area nurses, viewed 22 June 2016 < https://www.health.qld.gov.au/employment/rural-remote/practise/ nurses/default.asp>. Queensland Health 2015, Nurse navigators, information sheet, October 2015, Queensland Health, viewed 17 June 2016, < https:// www.health.qld.gov.au/nmoq/documents/nninfosheet.pdf>. Queensland Health 2016, Nurse-to-patient ratios – Questions and Answers, Office of the Chief Nursing and Midwifery Officer, Queensland Health, viewed 1 July 2016, < https://www.health.qld.gov. au/nmoq/documents/ratiosqa.pdf>. Shannon L 2015, Tasmania's graduate nurses struggling to find work, Nursing and Midwifery Federation survey finds, ABC News, viewed 22 June 2016 < http://www.abc.net.au/news/2015-06-08/more-thanhalf-tasmania27s-graduate-nurses-can-not-find-work3/6529366>.
EDUCATION: The key to career progression With 15 postgraduate certificates and 80 units to choose from, what will you study? READ MORE
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ACN’s National Net working Roadshow connects nurses across the countr y The Australian College of Nursing (ACN) recently hosted networking cocktail functions for ACN Members and VIP guests across the country as part of its National Networking Roadshow. ACN was honoured to have members of parliament and nursing leaders in attendance at each of the functions, which were held in Perth, Canberra, Sydney, Melbourne, Hobart, Adelaide, Darwin, Brisbane and Cairns. These events were an excellent opportunity for ACN to engage in discussion with nurse leaders and emerging nurse leaders across Australia from the public, private, aged care and primary health care sectors and to facilitate the opportunity for these exceptional nurse leaders to engage with politicians.
ACN CEO Adjunct Professor Kylie Ward FACN, Annabel Digance MP and Elizabeth Burton FACN (DLF) – Adelaide
India Talbot, Lisa Twine, ACN CEO Adjunct Professor Kylie Ward FACN, Karen Farrell and Jane Dyer – Cairns
The cocktail functions focused on three key themes: • The power of nursing as a collective voice • The top three priorities for the future of nursing • The top three priorities our Members and Fellows want to see from ACN These were the first of many networking events ACN plans to host throughout every state and territory in the near future.
Visit www.acn.edu.au for more information and view photos from the events on our Facebook page, www.facebook.com/ acnursing
ACN CEO Adjunct Professor Kylie Ward FACN, Doctor Lesley Potter MACN and Ruth Zionzee ACN FACN (DLF) – Sydney
ACN CEO Adjunct Professor Kylie Ward FACN, Associate Professor Suzanne Belton, Libby Webb FACN and Dr Beverley Turnbull FACN – Darwin
ACN CEO Adjunct Professor Kylie Ward FACN, Gracie Patten, Amanda Quayle, Carolyn Salter MACN and Rebecca White MP, Shadow Minister for Health – Hobart
Susan De Vries FACN and Doctor Lesley Williams FACN – Brisbane
Tracy Kidd MACN, Sharan Ermel MACN and Dianna Burr MACN – Melbourne
Louise Botha MACN, Kirsty Cummin MACN, Rowena King MACN and Michelle Lambert MACN – Canberra
In focus @ACN
The value of interning: Bringing nursing professionals into global health By Ely Taylor MACN
Going from nursing in a busy metropolitan hospital to being part of the high-level global bureaucracy at the World Health Organization (WHO) headquarters in Geneva was always going to be a bit of a shock. From February to May this year I was an intern with the WHO Global Coordination Mechanism for the Prevention and Control of Noncommunicable Diseases (GCM/NCD). This unit focuses on uniting existing initiatives to address the rise of cardiovascular diseases, respiratory diseases, diabetes and cancer, primarily through increased awareness of the four major risk factors of smoking, physical inactivity, unhealthy diet and excessive alcohol use. Although the day-to-day work was miles away from what I was used to on the floor, my grounding in nursing prepared me in a way that gave me an acute awareness of the care and prevention of these issues. I was reminded that the skills that we learn as nurses are invaluable and transferable to many different settings and not just between nursing specialty areas. Nurses have a critical role to play in the development of policy, advocacy activities and even navigating the often challenging political environment within which high-level health decisions are made. Who better than nurses to actually share first-hand experiences of people living with diseases and impart their understanding and knowledge of how people can be influenced and their behaviour changed? Despite this, I met very few nurses sharing their knowledge and expertise at this global level. We, as nurses have a unique insight both into the way that
Are you an RMIT Nursing alumnus? Ely Taylor at the United Nations Office in Geneva
primary and secondary prevention programs can be implemented at the consumer level and in the development of policies at a national and global level. The head of the GCM/NCD Secretariat, Dr Bente Mikkelsen, has highlighted this time and again by reiterating that nurses are the people who are at the coalface of many of these issues and also have the ability to directly drive change. The insight provided by nurses is critical at all levels of the health system as it is the nursing profession that will ultimately need to implement many of these policies. As an early career nurse and keen public health professional, an internship opened up my world to the possibilities for nurses to be at the forefront of national and global health policy development. An internship is an investment in your professional
development and offers many opportunities to deepen and broaden your skills, experience and understanding of the system that we all work in. Anyone can apply for an internship. Members of the Australian College of Nursing can apply to intern with the International Council of Nurses in Geneva, visit www.icn.ch/news/internship/. Also see www.who.int/employment/internship/en/ for WHO internships in Geneva and at all of the regional and country offices.
The Australian College of Nursing is the Australian Member of the International Council of Nurses.
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Recognising and combating moral distress By Trish Lowe MACN
Moral distress has been defined by Fourie (2015), as the “psychological response to morally challenging situations such as moral constraint, moral conflict, or both”. Nurses frequently encounter morally distressing situations. Examples include, providing treatments with limited patient benefit, Trish Lowe MACN or those which do not reflect patient preferences, working in unhealthy environments with limited organisational support, or feeling powerless to alter an outcome. The unfortunate, but related consequences – burnout, absenteeism, anger and frustration – have toxic effects which contribute to overall attrition rates. A team of nurse academics from the University of California, sought to quantify the impact of moral distress and develop a model to address and manage the effects (Pavlish, So, Brown-Saltzman & Wong 2016). The SUPPORT model’s acronym instructs users to; See it-Seek it out, Understand it, Pay attention, Promote receptive environments, Open opportunities for dialogue, Reflect-Revise and Transform the environment. The objective of providing healthy work environments, can be further enhanced by the demonstration of authentic leadership.
“Authentic leadership is a positive, honest and ethical style, which values input from all stakeholders." Authentic leadership is a positive, honest and ethical style, which values input from all stakeholders. Team members are supported with open communication, collaboration, appropriate staffing, timely recognition and talent development. Eleanor Roosevelt could have been describing authentic leadership, when she suggested, “To handle yourself, use your head; to handle others, use your heart.” While exposure to morally distressing situations is somewhat unavoidable, for a variety of reasons, the impact can be ameliorated by combining the fundamentals of a model such as SUPPORT, with the benefits of an authentic leadership style.
References: Fourie, C 2015, ‘Moral distress and moral conflict in clinical ethics’, Bioethics, vol. 29, no. 2, pp. 91-97 Pavlish, C, So, L, Brown-Saltzman, K & Wong, J 2016, ‘An evidence based model for leaders addressing moral distress’, The Journal of Nursing Administration, vol. 46, no. 6, pp. 313-320.
THE NATIONAL NURSING FORUM THE POWER OF NOW
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26â€“28 October 2016 Major partner
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Preliminary program now available! The Australian College of Nursing is very pleased to announce that the preliminary program for the National Nursing Forum is now available! The program includes an exciting line-up of speakers, as well as fascinating seminars and information sessions that will explore the most vital issues nurses are currently facing and the creative ways in which we are leading reform to positively influence patient outcomes. Join us in celebrating the passion, innovation and energy across all generations of nursing at ACN's signature event! Click here to secure an early bird registration and to access more information about the Forum.
THE NATIONAL NURSING FORUM
26â€“28 October 2016
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View the program online
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For more details and to secure your#NNF2016 place visit www.acn.edu.au/nnf2016
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In focus @ACN
Wearable devices and the potential for community health improvement By Ruth DeSouza MACN
“Wearable technology“, “wearable devices“ and “wearables” all refer to electronic technologies or computers that are incorporated into items of clothing and accessories which can comfortably be worn on the body. These wearable devices can perform many of the same computing tasks as mobile phones and laptop computers, however, in some cases, wearable technology can outperform these hand-held devices through their integration into bodily movements and functions through inbuilt sensory and scanning features, for example. Wearables include smart watches, fitness trackers, head mounted displays, smart clothing and jewellery. There are also more invasive varieties including implanted devices such as microchips or even smart tattoos, insulin pumps, or for contraception. The purpose of wearable technology is to create constant, seamless and hands-free access to electronics and computers. Wearables are all about data. Thanks to recent advancements in sensors, we’re able to collect more information about ourselves than ever and use that data to make health care personal and tailored to our needs. Traditionally, qualitative health research and much clinical interaction relies on self-reporting by consumers, which is then interpreted by researchers and published for incorporation into practice by health practitioners. Along the way, much important information is “lost in translation”. New consumer health care technologies are brokering a shared informational interface between caregivers, clinicians, communities and researchers, allowing practitioners to access richer and more detailed empirical data
on health consumer activity and their participation in health-seeking activities. Consumer health technologies offer potential for care to be more equitable and patient-centred. The technological promise also brings concerns, including the impact on the patient-provider relationship and the appropriate use and validation of technologies. Technologies are also developed with particular service-users in mind and rarely designed with the participation of people from structurally and culturally marginalised communities. In turn, the impacts of these technologies on health service education, planning and policy are far reaching. It is important that technology is not demographically blind. From a public health and community health perspective, it must not reinforce the structural inequalities that exist between those who have access to health and those who haven’t. The Centre for Culture, Ethnicity and Health, in partnership with the University of Melbourne’s Research Unit in Public Cultures and the Better Health Channel, recently organised a seminar and stakeholder consultation in Melbourne on 28 July 2016 with the aim of shaping a research agenda on wearable health technologies and culturally and linguistically diverse (CALD) communities. Typically, wearables have been marketed toward the 'wealthy worried and well' demographic and the purpose of the seminar was to discuss both the generic issues that emerging wearable technologies present, as well as the unique issues for people from diverse backgrounds. The three-hour event brought together clinicians, academics, developers, community organisations and policymakers to consider the future issues with these technologies.
A recent Seminar and Stakeholder Consultation held in Melbourne explored the opportunities and issues surrounding Wearable Health Technologies and CALD Communities. Photo: Jared Kuvent
The first speaker was University of Melbourne researcher and lecturer Suneel Jethani who expressed scepticism about what wearable health technologies may deliver for health, particularly for CALD communities. Suneel explored the growth of wearable health technologies through the notion of the pharmakon, the notion that every medicine is also poison, with the devices having capacity to be both beneficial and harmful. Janette Gogler, a Nurse Informatician from Melbourne's Eastern Health, described a randomised control trial of emerging technologies for remote patients with chronic heart failure and chronic
obstructive pulmonary disease (COPD). In this trial patients took a number of their own physiological measurements, including electrocardiography (ECG) monitoring, blood pressure and spirometry. While the trial led many patients to feel more in control of their health through a better understanding of their physiology, there were also challenges, including having to manage their expectations of the technology, where patients who became suddenly unwell were upset that the system had not given them forewarning, even though the issues were outside the scope of the devices. Janette also raised the issue of research excluding speakers of additional languages.
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ACN has launched new member benefits
Breakout groups at the seminar and stakeholder consultation. Photo: Jared Kuvent
â€œTechnologies are developed with particular service-users in mind and rarely designed with the participation of people from structurally and culturally marginalised communities.â€? The final speaker was Deloitte Digital partner Sean McClowry, who noted that the uptake of wearable health technologies has been slower to reach 'digital disruption' compared to the smart phones, but saw the likelihood of exponential growth through a new model of care. Sean raised questions about the unprecedented nature of data: how to make it high quality and its analysis meaningful. The session by the three panellists was followed by two youth respondents and a question and answer session and then breakout groups which developed further questions and issues for an emerging research program.
In the stakeholder consultation a number of critical themes emerged from many participants: the need to carefully manage privacy; the lack of accuracy of much consumer information; certification of apps; Western models of individual health hard-wired into the platform; the potential of peer support from new technologies; challenges for existing workforces and roles; and the potential of research to stigmatise as well as assist CALD communities. What was agreed was that consumer health technologies were only going to continue to grow and that no part of the health system would be undisrupted by the changes ahead, both intimidating and exciting!
MY ACN A new online portal where members can access all of their details, benefits and services. Members can update their profile and preferences, and specify the publications they wish to receive.
1, 2, 3 CPD COURSES FOR FREE
DISCOUNTS ON ALL ACN COURSES
Members can now access three free CPD courses each registration year (1 June to 31 May).
Members and Fellows can now receive a 10% discount on full fees for all ACN Courses.
Visit www.acn.edu.au for more information or contact ACN Membership on 1800 061 660 or email@example.com
Community & Primary Health Care Nursing Week
Nurses where you need them 19–25 SEPTEMBER 2016
Community and Primary Health Care Nursing (CPHCN) makes an important contribution to health care, however, its current and potential contribution is not well recognised by politicians, the nursing professions, the broader health care community and the general public. Raising the awareness of CPHCN supports the shifting of care from the acute to the primary health care sector.
There are a number of ways you can get involved in Community and Primary Health Care Nursing Week.
Nurses lead and provide care in many community-based health services across the country, striving to improve equity of access for the hardest to reach communities and promoting the integration of health care delivered by a range of services.
If you have an interest in sharing a story that describes a time ‘when’ nursing care you received has impacted on your health and wellbeing or when your nursing care has improved the lives of individuals and/or communities, then we encourage you to please submit your story.
With thanks to the support of our official sponsors
ACN is seeking contributions to the Community and Primary Health Care: Nurses where you need them 2016 eBook, a collection of stories from and about community and primary health care nurses. This year, we’re asking contributors to focus on ‘when’ community and primary health nursing care is provided. The ‘when’ may refer to a life phase, such as prenatal, early childhood, adolescence, ageing or dying, or a point in time when nurses care for individuals, such as when there are drug and alcohol issues, settling as a refugee, transitioning home after hospitalisation, during incarceration and a myriad of other times.
Register your event with ACN before the 2nd of September and we will send you a Community and Primary Health Care Nursing Week host pack. SUBMIT A STORY
REGISTER AN EVENT TO SHOW YOUR APPRECIATION
Read the 2015 eBook
Aus tr alia’s only locally manuf ac tured Q I V now TG A approved A recent media release by Seqirus, a CSL Limited company, revealed that Australia’s only locally manufactured, quadrivalent seasonal influenza vaccine (QIV) received Therapeutic Goods Administration (TGA) approval on July 15, 2016. Afluria Quad, Seqirus’ four-strain, inactivated seasonal influenza vaccine, is indicated for people aged 18 years and older. The new quadrivalent vaccine will replace the company’s trivalent vaccine (TIV), Fluvax for the 2017 flu season. Manufactured by the world’s second largest influenza business in Parkville, Melbourne, with operations spanning more than 20 countries, Afluria Quad will be supplied locally and exported globally.
Historical CSL influenza vaccine production.
Dr Lorna Meldrum, Vice President, Commercial Operations, Asia Pacific says Seqirus is thrilled to be adding Afluria Quad to its product portfolio comprising seasonal, pre-pandemic and pandemic influenza vaccines. “We are excited about the addition of Afluria Quad to our extensive pipeline of influenza products. Afluria Quad will be available in Australia for the 2017 influenza season,” said Dr Meldrum. About influenza and vaccination • Influenza is a highly contagious respiratory illness that can cause severe illness and lifethreatening complications, including pneumonia and bronchitis, which often require hospitalisation (Immunise Australia 2016). • Influenza results in around 18,000 hospitalisations per annum (Newall et al. 2007) and more than 100,000 Australians had laboratory confirmed influenza in 2015 (Department of Health 2016).
Seqirus has been manufacturing influenza vaccine for 70 years.
However, estimates suggest this figure is an under-representation of national flu cases (NHMRC 2013).
immunity to be strengthened before the start of the flu season (Immunise Australia 2016). References
• Influenza occurs all year round, with the disease typically peaking during the winter months (Department of Health 2016).
Department of Health 2016, National Notifiable Diseases Surveillance System, Department of Health, Canberra, viewed July 2016 <http://www9.health.gov.au/cda/ source/rpt_3.cfm>.
• Annual influenza vaccination is the best way to prevent flu (NHMRC 2013). Influenza vaccination is recommended early in autumn to allow time for
Newall, A., Scuffham, P. & Hodgkinson, B. 2007, Economic report into the cost of influenza to the Australian Health System, viewed July 2016 <http://www.isg.org.au/ assets/assets/isg-cost-influenza-report-30-2007.pdf>.
Immunise Australia 2016, ‘About Immunisation: Influenza’, Immunise Australia Program, Department of Health, Canberra, viewed July 2016 <http://www.immunise. health.gov.au/internet/immunise/publishing.nsf/Content/immunise-influenza>.
NHMRC 2013, The Australian Immunisation handbook, 10th Edition, National Health and Medical Research Council, Canberra.
The Australian College of Nursing offers an Immunisation course for Registered Nurses (RNs) and NSW Midwifes. This course is based on the National Guidelines for Immunisation Education for RNs. It is designed for RNs and NSW midwives working in health care areas where administration of vaccinations is part of their role or those who want to enhance their career opportunities. This course is accredited in the Australian Capital Territory, New South Wales, Victoria, Tasmania and South Australia. You can still obtain qualifications as a Nurse Immuniser this year. ACN has limited places available in courses held in September until December. Please visit our website for more information.
T hanks for renewing your regis tr ation The Nursing and Midwifery Board of Australia (NMBA) would like to thank the nurses and midwives who have renewed their registration for another year. Of the more than 370,000 registrants due to renew their registration by 31 May, 94 per cent of nurses and midwives renewed on time this year – 98.1 per cent of those renewed online.
Figure 1: The registered nurse standards for practice
The NMBA would also like to acknowledge the contribution to the professions that retiring nurses and midwives have made throughout their careers.
Registered nurse (RN) standards for practice The new Registered nurse standards for practice (RN standards) came into effect on 1 June 2016 and replace the Registered nurses competency standards. The RN standards are used in a number of ways including: • development of nursing curricula by education providers • assessment of students and new graduates • assessment of nurses educated overseas seeking to work in Australia, and • assessment of RNs returning to work after breaks in service. It is important that RNs are familiar with these standards and use them in practice. The Registered nurse standards for practice are high level and principle-based, which is quite different from the previous competency standards. The RN standards were developed through project phases that included literature and evidence reviews, gap analysis, two rounds of consultation and two rounds of observations of RN practice. Consumer interviews were also conducted. In total, close to 10,000 stakeholders were engaged in the development of the RN standards.
The standards: • comprise seven standards that are interconnected • are founded on person-centred and evidencedbased practice • are for all RNs across all areas of practice, and • are designed to be read in conjunction with NMBA standards, codes and guidelines. You can find the RN standards on the Professional Codes & Guidelines sections of www.nursingmidwiferyboard.gov.au.
NMBA information forums As part of its engagement with nurses and midwives on the revised registration standards, standards for practice and guidelines, the NMBA is continuing to hold information forums across Australia. The NMBA recently held two successful forums in Brisbane and Gold Coast, which for the first time were available to multiple venues simultaneously via videoconferencing.
Almost 200 nurses and midwives attended in person at Royal Brisbane and Women’s Hospital on 5 July, with an additional 11 health service sites joining via videoconference. Around 120 nurses and midwives were in attendance at Gold Coast University Hospital on 6 July, with six sites joining via videoconference. So far this year the NMBA has spoken in person to over 1600 nurses and midwives at the forums, visiting cities and towns including Sydney, Dubbo, Darwin, Bunbury, Perth and many more. Thank you to the nurses and midwives who have participated in one of the NMBA forums. More information forums are scheduled for 2016 and nurses and midwives will receive an email invitation if a forum is held near their place of work. The NMBA looks forward to meeting more of you! For registration enquiries please call 1300 419 495 (within Australia) or +61 3 9275 9009 (overseas callers).
NurseClick is the Australian College of Nursing's monthly e-zine focusing on topical articles...