ACN National Nursing Breakfast a success!
IN THIS EDITION
IN FOCUS @ACN
In the news
Australian College of Nursing update
A day in the life of an emergency nurse
IN FOCUS @ACN
CNMO SERIES @ACN
Advancing nurse leadership
Adjunct Professor Kylie Ward FACN, ACN CEO
IN FOCUS @ACN
The practice of mindfulness
ACN National Nurses Breakfast a success!
IN FOCUS @ACN
Reflections of a neonatal nurse
World No Tabacco Day
ACN Policy Summit
Registration renewal 2017
Adjunct Professor Kylie Ward FACN, CEO of ACN
Welcome to the May edition of NurseClick. It has been an extremely eventful few months for the Australian College of Nursing (ACN), as we continued to advance nurse leadership and drive transformational change throughout the Australian health care system. Bringing together leaders in nursing, health and government from across the country and around the world, ACN’s inaugural Policy Summit was a fantastic opportunity to work collaboratively with consumers to develop our national nursing policy agenda. Held in Canberra on Friday 21 April, the Summit provided a platform for informative discussion and debate relating to end-of-life care, chronic disease, policy leadership and nursing workforce. Keeping in line with our commitment to support the development of a highly skilled nursing workforce, ACN provided current, aspiring and future nurse leaders with an opportunity to kick-start and progress their careers at our Melbourne Nursing & Health Expo this April. The Expo was a great success, with more than 6,000 visitors exploring the exciting career opportunities available within this dynamic and diverse profession. The ACN National Nurses Breakfast on International Nurses Day was another highlight for our profession and organisation this month. With more than 240 events held across the country, this nation-wide celebration was the
perfect opportunity to acknowledge the invaluable contribution nurses make to the development and delivery of strong health systems locally, nationally and globally. International Nurses Day is an important reminder of the vital role nurses play in health service delivery at every stage of a patient’s journey. In NurseClick this month, one of our wonderful nurse educators Trish Lowe MACN perfectly outlines the privileged position nurses hold during some of the most challenging moments of their patients’ lives in her insightful piece, Reflections of a neonatal nurse. The valuable learning experiences that can come from challenging work environments is a concept further explored by one of our exceptional members, Rachel Wardrop MACN, in her uplifting feature article, A day in the life of an emergency nurse. Reflecting on her early experiences working in a busy emergency department, Rachel beautifully describes defining moments that shaped her career in this highly rewarding profession. Acting Chief Nursing and Midwifery Officer, Heather Keighley MACN, is an inspiring nurse leader who has made a significant contribution to the nursing profession. In our ongoing CNMO feature series this month, we congratulate Heather on her many achievements and celebrate her distinguished career. I hope you enjoy this inspiring read!
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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: Steve Keough Photography ACN publishes The Hive, NurseClick and the ACN Weekly eNewsletter.
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In the news national 6,000 to be saved from rare cervical cancer
More than 6,000 cases of a rare, hard-to-detect type of cervical cancer will be averted by 2040 as a result of vaccination and screening, according to new research.
Link between obesity and failed epidurals
Two-thirds of kids outgrow food allergies
One in five truck drivers experience mental health issues
Losing weight before falling pregnant may save mums-to-be a world of pain during labour.
Nearly two thirds of children with a food allergy will have outgrown it by the age of four, Australian research has found.
One in five truck drivers have experienced mental health issues, according to the Transport Workers' Union.
Australian research shows that as a woman's body mass index increases the likelihood of an epidural failing also increases. As the prevalence of obesity rises in Australia, the successful administration of an epidural is a growing concern for anaesthetists.
But the prevalence of food allergies among Australian children is still remarkably high compared to other countries.
According to a recent survey, 918 truck drivers out of more than 4,000 said they had suffered from mental illness.
Antimicrobial resistance, occupational health and safety, and workplace violence The International Council of Nurses has released three new position statements on antimicrobial resistance, occupational health and safety, and workplace violence. Read more
Risk of heart attack increases after flu The risk of having a heart attack increases in the seven days after a serious respiratory infection, Australian researchers have found. Previous research has suggested a bout of the flu, pneumonia or bronchitis could trigger a heart attack but a study published in in the Internal Medicine Journal has confirmed the association. Read more
Testosterone could be key to creating more targeted asthma treatments The male sex hormone testosterone could be the key to understanding why asthma affects women and men differently, medical researchers say. The researchers said testosterone could block the production of an immune cell, and that could lead to more targeted asthma treatments. Read more
An Australian study by Cancer Council NSW has estimated the combined impact of HPV vaccination and HPV-based cervical screening on the future burden of adenocarcinoma. Read more
Death no incentive for lung infection vax Potential death is not enough to make three quarters of Australian adults vaccinate against pneumococcal pneumonia, a survey reveals. This research suggests efforts to raise public awareness of the seriousness of the infection are failing. Read more
2017 Australian Federal Budget On Tuesday 9 May, ACN representatives attended the Australian Government 2017-18 Budget briefing by the Hon Greg Hunt MP, Minister for Health, Minister for Sport. Following the briefing, ACN compiled an overview of the health announcements in the Federal Budget. Read more
In the news world Baby brain scans reveal trillions of neural connections
UK scientists have released the first batch of ground-breaking medical scans that reveal step-by-step how the human brain develops in babies.
Plant chemicals provide hope for alternative contraceptives
Better than BMI: more accurate way to determine adolescent obesity
Road accidents biggest global killer of teenagers
Two compounds normally found in wild plants could make good alternatives to emergency contraceptives.
Researchers have found a new, more accurate way to determine if adolescents are overweight.
Road traffic injuries are the biggest killer of teenagers globally, data released by the World Health Organization reveals.
Chemicals from dandelion roots and the â€˜thunder god vineâ€™ plant have long been used in traditional medicines. Now, Californian researchers have found they can also block fertilisation.
A new study published in the Journal of the American Medical Association Pediatrics shows that tri-ponderal mass index estimates body fat more accurately than the traditional body mass index in adolescents. Read more
In 2015, road injuries were to blame for about one in 10 of adolescent deaths. Most of the road fatalities involved males between the ages of 10 and 19. Read more
Every year, 100,000 women die from massive bleeding in the moments after giving birth. But an international study in The Lancet, suggests that tranexamic acid could cut that by a third. Read more
HIV life expectancy 'near normal' thanks to new drugs Young people on the latest HIV drugs now have a near-normal life expectancy because of improvements in treatments, a study in The Lancet suggests. 20 year olds who started antiretroviral therapy in 2010 are projected to live 10 years longer than those first using it in 1996, the study found. Read more
New drug could stop Postpartum haemorrhaging
The detailed MRI scans could also improve understanding of conditions, such as autism and cerebral palsy.
'Exciting' blood test could spot cancer a year early
Air pollution: 'heart disease link found'
Researchers have spotted cancer coming back up to a year before normal scans in an exciting new discovery.
Extremely small particles of pollution have the potential to evade the lungs' protective filter system and end up deep in the body, scientists suggest.
The UK team were able to scour blood samples for signs of cancer, while it was just a tiny cluster of cells invisible to X-ray or CT scans. Read more
Researchers speculate the particles could then build up in blood vessels and raise the risk of heart disease. Read more
Where you live may impact how much you drink Neighbourhoods with greater poverty and disorganisation may play a greater role in problem drinking than the availability of bars and stores that sell hard liquor, a University of Washington-led study has found. Read more
Australian College of Nursing update
Prostate cancer specialist nurses receive further support
Depression a chronic problem for Australia
Further funding support announced by the Commonwealth Government for prostate cancer nurses is welcome news for patients and their families.
On World Health Day last month, ACN called for increased support to provide additional training to all nurses in identifying people at risk of depression or suffering from a depressive disorder.
“ACN welcomes the continued support for prostate cancer specialist nurses announced by the Hon Greg Hunt MP, Minister for Health, today,” said ACN CEO Adjunct Professor Kylie Ward FACN.
“Our profession has highly-trained mental health nurses, but with the prevalence of depression and chronic disease in Australia, all nurses are likely to be caring for people with depression or at risk of depression and have a vital role in early intervention,” said ACN CEO Adjunct Professor Kylie Ward FACN.
“Prostate cancer nurses provide vital information, care and support for men and their families. “These specialist nurses coordinate and provide continuity of care for patients as they navigate their cancer journey. “Nurses provide essential care to cancer patients right through from diagnosis to the recovery stage. "Continuing funding for prostate cancer nurses in urban and regional locations around Australia improves health outcomes for men directly affected and indirectly to their families and the wider community.”
According to the World Health Organization, depression is the leading cause of disability worldwide, and is a major contributor to the overall global burden of disease. In any one year, around one million Australians have depression. Research shows that physical illness is one of the strongest risk factors for depression. “The Australian College of Nursing would like to see nurses receive more ongoing and intensive training in recognising the symptoms of depression,” Adjunct Professor Ward said. “Nurses can help ensure depression is no longer underdiagnosed and undertreated.”
ACN online shop now open! We are excited to announce that the ACN online shop is now open for business! Our e-shop has an impressive range of products, merchandise and accessories available for nurses and the broader health community. From our stylish green silk ties to our handy little nurses’ pouches – there is something for everyone at the ACN online shop. Amongst our collection, we have a wide range of enlightening books that will take you back in time and inform you about the history of our profession, including the ACN’s Centenary Commemorative Trilogy Limited Edition Box Set. Whether you are looking for a new book to snuggle up with this Autumn or would like to give a thoughtful gift to a nursing peer, you are sure to find something suitable at the ACN online shop. Click here to check out our e-shop and browse our diverse selection today. Happy shopping!
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ADVICE AND TAKES 15 MINS TO READ
IN FOCUS @ACN
By Rachel Wardrop MACN RN, BN, MN Hons
My first shift in the emergency department brought with it a myriad of emotions; excitement, panic and utter dread amongst the top 10. This was one particular case which set into motion a series of events for my career progression. I had just graduated from my graduate year as a casual pool nurse, working in various specialities such as medical, surgical, palliative, stroke, orthopaedics and respiratory wards. As a new nurse with what I
felt was a broad understanding of the nursing field, I felt that a transition into the emergency department would be smooth. What I quickly learnt was that I was incredibly wrong. As I commenced my morning shift, I was responsible for four patient bays. Luckily for me, all four were empty. Harnessing my free time, I tried to re-stock and keep my hands busy. The first case brought in by the ambulance was allocated to me. A 32 year old woman was experiencing mild abdominal cramping with some spotting; she was just over four months pregnant. Receiving handover, I completed my patientâ€™s observations and standard blood work. Not familiar with the area of maternity, I felt myself become nervous; what do I ask her exactly? As I had no children of my own, I wasnâ€™t sure how to empathise with the patient at this point, so my aim was to stay on top of her observations and provide her with anything she needed. As we waited for her blood work and review from the doctor, the patient had stated that her blood
A day in the life of an
In an ever-changing health care climate, governed by increasing patient acuity and fiscal restraints, the emergency nurse stands at the forefront, with the expectation to deliver a high level of nursing care (Howstein & Sandy, 2012). In order to deliver such care, the emergency nurse must undergo an assortment of resilience-based experiences, have the capability to prioritise care, de-escalate potential conflict and respond effectively to a variety of situations. This case study follows one emergency nurse through a shift in the emergency department via the use of reflective enquiry.
IN FOCUS @ACN
loss was getting worse. I informed the doctor and completed another set of observations which demonstrated a hemodynamically stable patient. The patient grew nervous as she previously had two miscarriages and wanted to go to the bathroom. As her husband followed, I changed her sheets and attempted to make the environment as comfortable as possible for my patient. Minutes later a nurse from another section of the department ran up to me yelling, “Someone’s having a baby in the bathroom!” A wave of dread spread over me; that couldn’t possibly be my patient could it? As I ran to the bathroom, multiple thoughts raced through my head. How would I deal with this? What is the protocol? Am I in trouble for not going with her?
Upon reflection, I believe this moment was one that defined my career. It has been the only time in my career that I have ever felt so useless. Despite my experience in multiple clinical areas, this was one situation in which I felt I had no control. At this moment I learnt that as nurses, we cannot control everything. Since the event, I have been involved in many situations which resulted in both the arrival of new life and the loss of new life. In every situation I remember this particular patient, and understand the fragility of life and the importance of doing all I can do within my scope as a registered nurse. We intervene to the best of our ability as nurses, but life at times has other plans for our patients as much as we may wish otherwise.
Arriving at the bathroom, I saw my patient on the floor crying as she had miscarried. I remember staring blankly at the patient and feeling faint; I froze. Luckily, a very experienced shift manager came to my rescue and assisted me. I helped my patient back to bed where she received an emergency exam by the doctor. I walked out of the room and into the ambulance bay and cried. I felt out of control and I felt lost. I had no idea how I could have prevented this. My shift manager explained the mechanics behind this type of event and during my shift, my patient was discharged. She thanked me for my support but I could see the loss in her eyes.
Now as an early career academic, I teach students ‘best practice’ but what we fail to teach is that we cannot control every situation. I believe in being transparent with my students and hope that from this event, they too can learn that ‘best practice’ and the role of the nurse involves more than just paperwork, it involves understanding that patient situations differ. Too often we teach from a textbook and forget that each patient is unique, with their own history and yet to be written future. Nothing is permanent and yet everything is possible.
“We intervene to the best of our ability as nurses, but life at times has other plans for our patients as much as we may wish otherwise.”
Howenstein, J.S. & Sandy, L. 2012, "Case Management and the Expanded Role of the Emergency Nurse", Journal of Emergency Nursing, vol. 38, no. 5, pp. 454-459.
IN FOCUS @ACN
The practice of
mindfulness Managing burnout and stress in clinical environments
By Kerrie Otto de Grancy, Evolve Yourself Institute, Co Founder and Co CEO
Are you going to be a burnout statistic? What are you doing to manage your stress and anxiety? How much thought and action have you put into your self-care? Nursing is a high stress, high demand and high risk vocation when it comes to sustainability, retention, illness and burnout. Nurses need self-care practices and tools to allow their specific demands to be dealt with in ease. Does it have to be complicated? NO. What if one solution was to simply become more...mindful. Mindfulness is attention to an action without judgement; your attention to an experience with all senses. It is being in the moment and opening your mind to what is in front of you, no matter what it is. Mindfulness is allowing the mind to rant, but not paying attention to what it has to say.
â€œMindfulness can be used in nurses daily lives, the workplace, and in assisting patientsâ€? However, just like you have rehearsed so well to listening to your mind rant, it does take some practice to change this. The good news is that once you are there, you will have the ability to embrace the fundamentals of being human, goodness, compassion, joy and happiness (Giovanni, n/d). The practice of mindfulness has been scientifically proven to develop thickening of grey matter, which develops self-awareness, self-regulation, connection and compassion (Hozel et al, 2011). The growth in these abilities leads to improved competencies in communication, emotional intelligence (EQ), team play and leaderships skills - supporting collaborative and growth mindsets.
One-third of Australian nurses are considering leaving the profession as a result of stress and burnout (Monash University, 2016).
IN FOCUS @ACN
“Work-related stress has increased, and is a growing challenge for health care workers, managers, organisations and the community generally." There are four core elements to EQ: 1. Self-awareness: The ability to recognise your own emotions for what they are and understand their origins. Self-awareness means knowing your strengths and limitations. 2. Self-management: The ability to delay gratification, balance your needs with those of others, take initiative and to pull back on impulsivity. Self-management means being able to cope with change and to stay committed. 3. Social awareness: The ability to be attuned to other people's emotions and concerns, as well as being able to notice and adapt to social cues. Being socially aware means being able to see the power dynamics at play within any group or in an organisational context. 4. Relationship management: The ability to get along well with others, manage conflict, inspire and influence people, and to communicate clearly.
Life as a nurse can be very stressful. We know stress affects our health and increases the likelihood of reacting to situations, rather than responding to them. Many nurses are living with constant stress and anxiety; worrying about their patients, relationships, work schedules, home schedules and the endless to-do lists. Where and how can you create time for more? You don’t have to. Mindfulness is about less doing and more being. One popular form of mindfulness is meditation. Meditation practices support being mindful. There are many forms of meditation, some of the most commonly known are: guided, mantra, visual, breath count, silence, walking, mindful and tree gazing. MRI scans show that meditation decreases activity in the brain regions associated with stress. A reduction in levels of the stress hormone, cortisol, in the brain allows for a responsive state, rather than a reactive state (Eco Institute, n/d). With a regular meditation practice, stress and anxiety can be reduced. In addition to a reduction in stress, there are other health benefits, including stronger immune systems. The University of Wisconsin School of Medicine researchers found that meditation lessons the effects of colds (Tsabary, 2010) – something every nurse and health practitioner would welcome… especially during the lead up to winter!
If you’re new to the concept of mindfulness, I invite you to be curious, explore and play. Start with just 5–10 minutes of meditation a day, before your shift, in the car after school drop off, before gym class, on the bus, in the park, before bed or on your tea break – grab a headset and your phone, and do a quick guided meditation. It is a tool for anytime, anywhere and for anyone. Guided meditation is a great kick-starter. Try one of my favourite 10-minute meditations below: Right now, take a moment and ...CLOSE YOUR EYES Feel the breeze in your hair. Keep your eyes closed. Squeeze your body – every part, even your eyelids.
“Unmanaged stress is known to have a detrimental effect on staff wellbeing, with increased absenteeism, staff turnover, and reduced performance, all of which affect working relationships, staff-to-staff and nurse-to-patient interactions.” References Eco Institute n/d, How Meditation Boosts Melatonin, Serotonin, GABA, DHEA, Endorphins, Growth Hormone, & More, accessed 28 April 2017, <http://eocinstitute. org/meditation/dhea_gaba_cortisol_hgh_melatonin_serotonin_endorphins/> Giovanni n/d, Scientific benefits of meditation – 76 things you might be missing out on, accessed 28 April 2017, <http://liveanddare.com/benefits-of-meditation-2/>
Relax and take 10 slow, mindful breaths through your nose and out your mouth.
Holzel, Britta K, Carmody James, Vangel Mark, Congleton Christine, Yerrasetti Sita M, Gard Tim, Lazar Sara W 2011, ‘Mindfulness practice leads to increases in regional brain gray matter density’, Psychiatry Res, 191(1)
Notice your abdomen rise and fall. Notice your breath.
Monash University 2016, Findings from the national survey on workplace climate and wellbeing, accessed 28 April 2017, < https://business.monash.edu/__data/ assets/pdf_file/0004/624127/What-Nurses-And-Midwives-Want-Findings-from-theNational-Survey-on-Workplace-Climate-and-Well-being-2016.pdf>
Notice the breeze on your skin and in your hair.
Tsabary Shefali 2010, The Conscious Parent, Namaste Publishing Inc,
Smile. YOU JUST MEDITATED
Mindfulness is one of the world’s fastest growing health and wellness spaces. It’s use in business, trauma, sport, education and illness (just to name a few) are accumulating and the power of the practice is being heard.
EYI facilitates an ACN accredited online program How fit is your brain? SOS for Nurses and a practical workshop for nurses. EYI education delivers practical tools and strategies to develop self-awareness, emotional intelligence and manage stress and anxiety. Visit the EYI website for more information.
The evidence is in the experience.
ACN National Nurses Breakfast a success! ACN would like to sincerely thank all those who got involved in the 2017 ACN National Nurses Breakfast this year. It was so wonderful to celebrate the invaluable contribution nurses make to the health of our society with you all! 242 breakfasts were held across the country with over 9500 individuals taking part. ACN held breakfast celebrations in both our Canberra and Sydney offices as a part of this national event. It was great to see so many groups involved and sharing their celebrations on social media. We hope you enjoyed spending International Nurses Day with your colleagues and friends!
IN FOCUS @ACN
The creation of a virtual doctor’s office
Clear communication could mean the difference between life and death. However, what’s a health professional to do when some conditions are too complex to explain or if a patient simply fails to understand? Medical professionals learn a specific language in school that they understand and communicate in, but do not know how to translate this into plain English to communicate to patients. Dr Kim Chilman-Blair was a pediatrics doctor in New Zealand when she developed a series of comic book storyboards for children to explain in simple terms their conditions and how to handle them. She discovered that parents were using these comic books more than children, so she decided to remove the superhero and make the comic books for everyone. This birthed Medicine X. Medicine X removes the confusion and hopelessness patients feel when they are confronted with complex conditions by appealing to one of the most basic human forms of communication: storytelling. “Stanford University did a study that showed that people are 22 times more likely to have a behavior change, if you explain to them what they should do in a story,” Dr Kim Chilman-Blair said.
“This is because you are much more impassioned with the main character and what’s going on.” Through the creation of a virtual doctor’s office, Medicine X is able to provide patients with a greater understanding of their medical conditions through the display of animated holograms and virtual doctors using plain English. They explain disease, pathology and physical symptoms. Dr Kim Chilman-Blair's father was saved by her own creation. Using the prostate cancer app, her father discovered he had symptoms related to prostate cancer. A quick visit to the doctor revealed he had aggressive prostate cancer. However, because of the app, he caught it in time and a made a full recovery. Medicine X uses real life patient’s stories and nursing expertise to create each free app. Dr Kim Chilman-Blair advised that nurses are invaluable to the creation of each app, as they provide insight into how patients understand and how a patient would respond to the app. Currently nurses are heavy users of their Type 2 diabetes app, as it is a notoriously difficult disease to manage for a patient. Other apps include, advanced prostate cancer, and even Parkinson’s. If you would like to participate in their next app creation or see what other free apps are available, please visit their website. Editor's note: Medicine X is not endorsed by the Australian College of Nursing.
By Samuel Eaton, Acting ACN Partnership Manager
CNMO SERIES @ACN
Advancing nurse leadership Get to know Ms Heather Keighley MACN, Acting Chief Nursing and Midwifery Officer for the Northern Territory
Our CNMO’s 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 CNMO’s throughout the next few editions of NurseClick. This edition, we are profiling, Ms Heather Keighley MACN, Acting Chief Nursing and Midwifery Officer for the Northern Territory, whose experience and expertise as a nurse leader has seen her achieve remarkable outcomes while in this role.
“As an ACN Key Contact, Heather aims to work with members to promote opportunities to network, share experiences and raise the profile of rural and remote nurses.” Ms Heather Keighley, Acting Chief Nursing and Midwifery Officer, RN, RM, M Intl Health Mgmt, MACN Heather has worked as a nurse and midwife in the Northern Territory since 1975, with a brief period in Queensland and another working in Qatar as an English teacher for 12 months. Over her time in the NT, Heather has worked in acute, community, public health and remote practices in Alice Springs, Tennant Creek, Nhulunbuy, Darwin and in remote Indigenous communities. Heather has a strong history working in multi-disciplinary teams. Her most recent appointment in August 2014 prior to joining the Office of the Chief Nursing and Midwifery Officer as a Senior Nursing and Midwifery Advisor in 2016, was Director of Nursing and Midwifery for Top End Health Service Primary Health Care. In this role, Heather was responsible for overseeing the professional development and performance of nurses and midwives during the transition into the health service, amalgamation of community health, remote and prison health, and strategic planning as
a member of the Top End Health Service primary health care leadership team. As the Director of Nursing and Midwifery, she also provided policy advice and oversight for medication management in remote health clinics. As the Acting Chief Nursing and Midwifery Officer, Heather leads the team in the NT Department of Health’s Office of the Chief Nursing and Midwifery Officer. This role requires Heather to represent the NT’s nursing and midwifery profession, locally, nationally and internationally, advocating for continuous support and improvement in the NT’s health care service delivery. Heather’s portfolio also includes models of care, remote area workforce and professional organisation liaison and nursing agency agreements. Heather is a highly valued member of ACN who delivered an exceptional keynote address at the 2016 National Nursing Forum on the power of opportunity and nursing in the NT. Last year, Heather also took on the role of Key Contact for our Rural and Remote Nursing and Midwifery Community of Interest (COI) and NT North Region.
SOURCE: NT HEALTH
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.
As an ACN Key Contact, Heather aims to work with members to promote opportunities to network, share experiences and raise the profile of rural and remote nurses. ACN would like to thank Heather for her significant contribution to both our organisation and profession. We look forward to continuing to work alongside her in 2017.
Reflections of a neonatal nurse By the time our options for work experience were circulated in ‘fourth form’, I knew that of the four presented – hairdressing, secretarial work, teaching and nursing – nursing was the one for me. Many older friends and family members were already either practicing or retired from the profession and my head was full of colourful and somewhat romantic stories, which detailed their experiences, patients and ‘dashing’ lives as young nurses busily socialising between shifts in Sydney or Newcastle.
I can’t recall a time in my life, when I didn’t want to be a nurse. Actually, that’s not technically true, as for a short time as a nine year old, I did have illusions of entering the convent. My aunt is a nun in the order of St. Joseph’s and I was a very pious young girl, who found the incense and iconography appealing as a counterpoint to my upbringing on a wheat, sheep and cattle farm. That was before I discovered boys. Suffice to say – I didn’t pursue that idea!
It was 1982; these were heady days! My Preliminary Training Course (PTC) group came together in support of each other, as we acquired the requisite skills to embark on our nursing careers. For many of us, this was our first
Trish Lowe MACN
As many members of my matriculating class opted to settle in our rural hometown, marry their childhood sweethearts, work the land or take up a trade, I was one of only a few to interview for student nursing positions and make plans to move away. My mother escorted me on many trips to Armidale, Lismore, Newcastle and Sydney for interviews before giving me permission to accept a position at what was once The Coast Hospital (by then Prince Henry) in Sydney’s Little Bay.
"But when I had my own children, I found myself surrounded by friends in similar situations and saw the incredible work that midwives do first hand; I knew that was my calling.”
experience of living away from home and like so many generations before us, we ‘burnt the candle at both ends’; going out until the wee small hours before rushing home, showering and heading off to work. From memory, it was about two months before the novelty of living in Sydney wore off, allowing us to catch up on some much needed sleep! After graduation, a grand affair at the University of New South Wales, where we wore for the first time, our traditional v-shaped ‘Sister’s veils’, I worked in Prince Henry’s Adult Intensive Care Unit. Whilst situated in a gorgeous setting on acres of seaside land, the wards were largely ‘Nightingale’ wards, built side-by-side in response to the smallpox epidemic of 1881. Therefore, the logistics of transporting critically ill ventilated patients toand-fro, were immense and required considerable coordination. The infrastructure had not kept pace with technological advancements and we battled to provide 20th century care in a 19th century environment. Initially, I resisted the trend towards seeking ‘triple certification’ (general, midwifery, child and family health) which was in the pre-tertiary era; one of the few ways to advance your nursing career and seek greater remuneration. At that age, I was not even remotely interested in those specialty areas. But when I had my own children, I found myself
surrounded by friends in similar situations and saw the incredible work that midwives do first hand; I knew that was my calling. By this stage it was 1998. Hospitals now bore no resemblance to those in which I had earned my stripes, technological advancement was apparent and tertiary education the norm. Because midwives do such a wonderful job of shielding women and their partners from the busyness, stress, trauma and at times tragedy, occurring outside their room, I was shocked to embark on my prac year and have the metaphorical ‘scales fall from my eyes’. The years that I worked as a midwife, often with three women in labour at once or on the postnatal unit with up to eight women and their babies to care for, were extraordinarily busy but immensely rewarding. Even now, many of my childrens’ friends are becoming aware of the fact that I was their midwife – a fact that causes great hilarity, as I look up at these tall, gorgeous 18 year olds! A large part of my role was going to theatre to ‘catch’ the babies being born by caesarean section. On many occasions, those babies were born in quite compromised states, either due to distress in-utero, the result of cord compression or malpresentation. On these occasions, skilled resuscitation was necessary. Often, I was the only person available to initiate the resuscitation
until additional backup arrived! For that reason and because multiple births and prematurity were becoming more commonplace, I felt that my midwifery practice would be enhanced by more specific neonatal intensive care experience. And so by 2006 – some 20 years after I had initially qualified – I came full circle, arriving once again in an intensive care environment. Because of the nurse/patient ratios in place, we experienced the luxury of being able to focus on one or two babies at a time. This allowed us to get to know our tiny patients and their families extremely well. This became both a blessing and a curse. We celebrated many milestones – reaching 1kg, weaning off ventilation, the first breast feed, the first 100 days! So many times, we would see babies who had an incredibly rough births stabilise quickly and go on to grow up with no long term effects from their premature entry into the world. I take great delight in watching ‘ex-prems’ – often born 16 weeks early and weighing just 400gms – growing up in my community – strong, healthy and surrounded by family and friends. But conversely – and these were always the saddest and most difficult cases to process – babies would do well initially, and then crash. Or worse, families would arrive grief stricken because their gorgeous term infant, the one they already had the nursery painted, tiny clothes and grandma sitting by the phone for, had inexplicably experienced a traumatic birth and died despite our best efforts. So why do we do it? Why do nurses and midwives persist despite the strenuous nature of our work and the enormous emotional and physical toll it takes? Because for me at least, there was never another option.
ADVANCED DIPLOMA OF NURSING FOUR SPECIALITY STREAMS AVAILABLE Advancing nurse leadership www.acn.edu.au
ACN NURSING & HEALTH EXPO MELBOURNE
On Saturday 19 April, over 6,000 eager visitors converged on the Melbourne Convention and Exhibition Centre for the ACN Nursing & Health Expo.
The crowd was buzzing with energy as current, aspriring and future nurse leaders connected with exhibitors who were on hand to offer valuable advice and provide information about upcoming education and employment opportunities. Visitors also attended complimentary seminars that were held throughout the day covering topics such as CV and interview skills, transition to practice and nursing abroad. The seminars provided attendees with practical up-to-date information to assist them in furthering their career. ACN would like to thank our Members and Fellows who volunteered their time to assist onsite at the Expo –
your support and expertise helped us make the day a success. Don’t forget to save the date for our next ACN Nursing & Health Expo which will be held at the Perth Convention and Exhibition Centre on Sunday 18 June. Doors will be open from 8.30am to 1.30pm and, as always, there will be a great range of exhibitors and seminars on offer. ACN would like to thank the Department of Health and Human Services Victoria for their support of the Melbourne Expo.
KEY CONTACTS @ACN
Leading in nurse informatics ACN recognises the importance of providing members with targeted networking and engagement opportunities. Our Regions and Communities of Interest (COI) provide unique opportunities to connect with members who are located in your region or share your area of practice. They are memberled and a crucial repository of high-level, active discussion about specific health and aged care topics. Each Region and COI is led by a Key Contact, who acts as the liaison between their special interest group and ACN. Our Key Contacts are highly skilled professionals who are passionate about raising the profile of local and national health concerns.
ACN NURSING & HEALTH EXPO
Welcome to our new Deputy Key Contact! Last year, ACN introduced a new Nurse Informatics COI to our suite of specialty groups. During this time, we were so pleased to have Adjunct Associate Professor Naomi Dobroff MACN come on as our Key Contact for this new COI.
Sunday 18 June 2017 8:30am - 1:30pm Perth Convention & Exhibition Centre
ACN is thrilled to announce the appointment of Aaron Jones MACN as Deputy Key Contact of our Nurse Informatics COI. Aaron is the Chief Nursing Information Officer (CNIO) for Sydney Local Health District (SLHD) and the first CNIO appointed in New South Wales. He has been in this position for 12 months and has worked within the NSW Health sector for 24 years. Prior to his current role, Aaron was the SLHD Nurse Manager for Clinical Informatics – which was another first for NSW. He has an extensive nursing background, having worked in a wide variety of clinical settings including intensive care, emergency, cardiology and surgical oncology. Aaron has a passion for nursing informatics and truly believes that we need to advocate for nursing and midwifery at all levels to ensure that our practice and patient care remains a priority. He has a keen interest in data analytics and leveraging the data that is currently being captured in our Electronic Medical
ACN's Centenary Commemorative Trilogy Limited Edition Boxed Set Nurse Informatics COI Deputy Key Contact Aaron Jones MACN
Record program (eMR) and using it to inform nursing and midwifery practice. Aaron believes that we are at a turning point and our roles will only continue to grow and evolve, and he is truly excited to be a part of the change that is occurring within health in such an influencing role. Welcome Aaron!
“Aaron has a passion for nursing informatics and truly believes that we need to advocate for nursing and midwifery at all levels to ensure that our practice and patient care remains a priority”
IN FOCUS @ACN
World No Tobacco Day Get ready for plain packaging World No Tobacco Day was first developed by the member states of the World Health Organization (WHO) in 1987 (WHO, 2017). 30 years on and World No Tobacco Day continues to be celebrated by health care professionals and organisations around the globe. Over the years, this annual campaign has provided a platform for WHO to highlight the health risks associated with tobacco use and encourage governments to adopt effective policies to reduce the incidence of smoking on a world scale (WHO, 2017). Each year, WHO selects a theme for the day in an effort to create a more unified global message behind the campaign. The theme of this year’s World No Tobacco Day is Get ready for plain packaging. This theme aims to highlight global efforts to control misleading advertising and promotion of tobacco products.
What is plain packaging? Plain packaging of tobacco products restricts the use of logos, colours, brand images and promotional information on packaging other than brand and product names displayed in a standard colour and font style (WHO 2013). Plain packaging aims to reduce the attractiveness and appeal of tobacco products, increase the noticeability and effectiveness of mandated health warnings, and reduce the ability of retail packaging to mislead consumers about the harms of smoking (WHO 2013).
Australia’s story In 2011, smoking was the leading risk factor contributing to death and disease in Australia (Australian Institute of Health and Welfare (AIHW), 2016). In December the following year, Australia became the first country to fully implement plain
packaging for tobacco products (WHO, 2013). Since then, all tobacco products must be sold in standardised drab, dark brown packaging with large graphic health warnings (WHO 2013). The Tobacco Plain Packaging Act 2011 and the Tobacco Plain Packaging Regulations 2011 set out the requirements for plain packaging in Australia (Department of Health, 2017). The objectives of these new implementations were to improve public health by discouraging people from using tobacco products, discouraging relapse of tobacco use and reducing exposure to tobacco smoke (Department of Health, 2017). While the full effect of tobacco plain packaging is expected to be realised over time, early available evidence indicates that the measure is already beginning to achieve its public health objectives and is expected to continue to do so into the future (Department of Health, 2017).
Between December 2012 and September 2015, there was an additional 0.55 percentage point fall in smoking prevalence among those aged 14 and above attributable to the packaging changes, according to Australia’s post-implementation review. This equates to more than 108,000 people quitting, not relapsing or not starting to smoke during that period. References Australian Institute of Health and Welfare (AIHW) 2016, Australia’s health 2016 Tobacco smoking, accessed 27 March 2017, <http://www.aihw.gov.au/WorkArea/ DownloadAsset.aspx?id=60129556763> Department of Health 2017, Evaluation of Tobacco Plain Packaging in Australia, accessed 27 March 2017, <http://www.health.gov.au/internet/main/publishing.nsf/ content/tobacco-plain-packaging-evaluation> World Health Organisation (WHO) 2013, Reducing the appeal of smoking – first experiences with Australia’s plain tobacco packaging law, accessed 27 March 2017, <http://www.who.int/features/2013/australia_tobacco_packaging/en/> World Health Organisation (WHO) 2017, World No Tobacco Day, accessed 27 March 2017, <http://www.who.int/tobacco/wntd/previous/en/>
ACN Policy Summit
Informing our strategic nursing policy agenda
Stefan Wythes, ACN Policy Research Assistant
ACN held its inaugural Policy Summit in Canberra on Friday 21 April. Bringing together expert Fellows, Members, consumers and government, the Summit provided a platform for informative discussion and debate relating to end-of-life care, chronic disease, policy leadership and nursing workforce. The Summit was an enormous success and valuable opportunity to inform our strategic nursing policy agenda. At ACN, policy is at the core of our activities and we aim to deliver empirical-based nursing perspectives on a wide range of issues. As the pre-eminent and national leader of the nursing profession, we work collaboratively and in full consultation with stakeholders to function as an informed leader and partner in nursing and health policy discussions. The Summit was opened by the Hon Dr David Gillespie MP, Assistant Minister for Health,
and Meegan Fitzharris MLA, ACT Minister for Health, participated in the final panel discussion. Dr Frances Hughes, the Chief Executive Officer of the International Council of Nurses, also attended and addressed the Summit. Dr Hughes provided a summation of the day and encouraged all nurses to get more involved in policy discussions locally, nationally and internationally. It was an honour to have leaders in nursing, health and government from across the country and around the world participate in our inaugural Policy Summit.
SUMMIT OBJECTIVES • To demonstrate our commitment to improving health outcomes through advancing nursing policy leadership; • To increase engagement with expert Fellows and Members to develop our policy agenda; • To increase consumer participation and engagement in ACN policy; • To increase awareness of key policy issues; • To strengthen the consumer voice in health policy; • To identify key stakeholders in key policy areas;
• To provide guidance on how to progress policy; and • To consolidate ACNs role in nursing policy leadership. The day centred on four key policy issues that are of local, national and international significance: 1. Ensuring a vibrant and sustainable nursing workforce 2. End of life care: promoting dignity and choice 3. Chronic disease: improved coordination of care 4. The complexities of policy leadership
“Each and every nurse has a voice that can be used to make a difference.”
Key points relating to each of the key policy issues explored during the Summit include: Ensuring a vibrant and sustainable nursing workforce • That elements for nurse workforce sustainability include well-supported professional development and workplace environments, person-centred care, shared decision-making, multi-disciplinary teams, evidence-based care, performance evaluation and recognition, and professional satisfaction.
ACN ENL's Emily Wardell MACN, Andrew Dean MACN, Tammie Breneger MACN and Samantha Petric MACN.
• That there is an alignment of expectations for nurse education preparation and 'work readiness' between education providers and service providers. • That to better prepare early career nurses for the workforce, there is a need to reduce demarcation of nursing education between education and service providers.
Mr Andrew Dean MACN, ICN CEO Dr Frances Hughes, Professor Glenn Gardner FACN and Dr May El Haddad MACN.
• That role proliferation has led to nurse workforce underutilisation and can be a barrier to nurses working to their full scope of practice. • That nurses do not recognise their inherent power, unique knowledge and skills-base. End of life care: promoting dignity and choice ACN CEO Adjunct Professor Kylie Ward FACN, Assistant Minister for Health, The Hon David Gillespie MP, and ACN President Professor Christine Duffield FACN.
ACN CEO Adjunct Professor Kylie Ward FACN and ICN CEO Dr Frances Hughes.
• That people must be afforded dignity and choice at end-of-life. • That physician assisted dying and palliative care are separate issues. • That addressing accessibility and affordability of home-based palliative care is a nursing priority.
ACT Health Minister, Meegan Fitzharris MLP, ACN President Professor Christine Duffield FACN, ICN CEO Dr Frances Hughes, Health Care Consumers Association Executive Director Ms Darlene Cox and Professor Jill White AM FACN.
• That foundations for promoting quality end-of-life care should include testing practice assumptions to inform policy development.
Chronic disease: improved coordination of care • That the value and impact of nurse-led care coordination for preventative health, and positive economic and health outcomes must form part of the nursing narrative. • That systems integration through health informatics is critical for the delivery of coordinated care. • That nurse-led models of care must be promoted to support health system capacity and capability to provide coordinated, cost effective and quality chronic disease care to meet increasing demands. The complexities of policy leadership • That nursing influence in policy domains can be strengthened through coalition, understanding processes, demonstrating a broad view of health issues rather than self-interest matters and strengthening the consumer voice. It is important to identify evidence, political opportunities and to provide quality briefs to decision-makers. • That nursing must consider how it contributes to policy discourse by identifying its “anchor points” within the system. For example, when commenting on policy consider how issues link to systems pillars such as the national health standards, health care charters, key strategies etc. Each and every nurse has a voice that can be used to make a difference. At ACN, we empower nurses to become leaders and use their voice to influence others in order to achieve collective objectives. Moving forward, ACN will examine the issues raised and feedback received from the Summit to help guide our current and future work priorities. The next Policy Summit is planned for April 2018.
Registration renewal 2017 Reminder to be familiar with new registration standards The Nursing and Midwifery Board of Australia (NMBA) would like to remind nurses and midwives to renew their registration by 31 May 2017. Renewing online is quick and easy, with 98.1% of nurses and midwives renewing their registration online last year. If you are due to renew your registration as a nurse or midwife, please remember that you need to meet the obligations of new registration standards which took effect last year.
New registration requirements in effect NMBA Chair, Associate Professor Lynette Cusack RN, reminded nurses and midwives to carefully read the requirements for renewal of registration. “Revised registration standards and standards for practice for nurses and midwives took effect on 1 June 2016 and 1 January 2017 respectively,” Associate Professor Cusack said. “The NMBA visited workplaces in every state and territory in 2016 to explain the changes in person, but if you missed out on attending a session we’ve made a vodcast of the presentation, which you can view on our website.”
Extra step when renewing this year Renewal for nurses and midwives includes an extra step this year. When completing your renewal, you will be asked to check that your qualification(s) and the date you were first registered in Australia are recorded correctly on the online national register of practitioners. “We are including this as part of online renewal to make it easy for you to confirm and update these details if required,” Associate Professor Cusack said. “By checking this information you will be helping us to maintain the integrity of the national register, which helps to protect the public” For further information about the Register detail check, please refer to the NMBA website.
How to renew registration Nurses and midwives should look out for emails from the Australian Health Practitioner Regulation Agency (AHPRA), reminding them to renew their registration with the NMBA.
“The renewal reminder emails are a one-stop shop for access to online renewal and to resources explaining the renewal process or how to reset your password,” Associate Professor Cusack said. “Online renewal is the quickest and easiest way to renew your registration and is explained in our short video for nurses and midwives.” If you do not receive a reminder email, please check that your contact details held by AHPRA are up to date. Go to ‘login’ at the top of the AHPRA or NMBA website homepages, enter your User ID and password to access the secure portal and choose to update your contact details. If you do not renew your registration by 31 May, or within the following one-month late period, your registration will lapse. Your name will be removed from the national Register of Nurses and Midwives and you will not be able to practice without making a new application for registration.
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