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NurseClick Artificial intelligence MILITARY NURSING REFUGEE NURSES OF AUSTRALIA REDUCING PRESSURE INJURIES

NOVEMBER 2017


IN THIS EDITION

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WELCOME

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SNAPSHOT

IN FOCUS @ACN

IN FOCUS @ACN

In the news

A personal reflection

Artificial intelligence

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EDUCATION @ACN

IN FOCUS @ACN

IN FOCUS @ACN

IN FOCUS @ACN

Behind our Graduate Certificates

Military nursing

Refugee Nurses of Australia

Reducing pressure injuries

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Adjunct Professor Kylie Ward FACN, ACN CEO

EVENTS @ACN 2030 and Beyond

IN FOCUS @ACN How one student group became a catalyst for change

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LEADERSHIP @ACN

NMBA UPDATE

Play as an educational tool

New codes of conduct for nurses and midwives


WELCOME

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Publishing details

Hello!

Adjunct Professor Kylie Ward FACN, CEO of ACN

Welcome to the November edition of NurseClick.

I am always inspired by stories of nurse leaders across all professional levels who have carved out a career path based upon personal integrity and a passion for improving health care experiences. This edition of NurseClick highlights a range of exceptional nurses – individuals and groups – who have taken a leap of faith to pursue principles they strongly stand for. These qualities of genuine compassion and a willingness to embrace innovation are key ingredients for creating great nurse leaders. Patrick McCrohan outlines a case study of how one particular hospital turned a worrying problem of an over-incidence of pressure injuries into an innovative model of care, resulting in positive patient outcomes. This example of nurse leadership from within an organisation should be an approach we all aspire to. In order to remain relevant and effective, health care needs to adapt and improve utilising the available resources and technology. Emily Wardell MACN (ENL) explains how artificial intelligence technologies are being used to reduce loneliness in aged care facilities, even though there is some public concern about the disconnect that may occur by reducing human connections. Once again, nurses are leading the way.

Lieutenant Anthony Russell MACN provides a glimpse into his world in his article entitled Military nursing: A Navy nurse’s journey, which details the challenges and triumphs of his military nursing career, including providing humanitarian aid in post-cyclone Fiji and taking up a management posting in Darwin. If this type of high-paced nursing and lifestyle entices you, join our Military Nursing Community Of Interest for news, networking and information on this topic. Vanessa Tilbrook MACN has followed her passion for people and initiated unique methods of educating patients, families, students and peers through play and simulation scenarios. In an enlightening Q&A, Vanessa describes the ways that meaningful connections and person-centred care have been beneficial in her varied roles within nursing, midwifery and health education. In this edition, you will also hear from our own inspiring nurse educator Trish Lowe MACN, who you may recognise from her regular NurseClick column, Vital Signs. This month, however, we profile Trish in her capacity as coordinator of our Graduate Certificate in Neonatal Care. Look out for more of these behind-the-scenes profiles of clinical experts and students in editions to come. Stay safe as we lead into the holiday season, and I hope you enjoy the read!

Publisher Australian College of Nursing Editors Sally Coen Olivia Congdon Karen Watts Design Nina Vesala Emma Butz Enquiries publications@acn.edu.au Advertising partnerships@acn.edu.au

© 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 or ThinkStock are representative only and do not depict the actual subjects and events described in the articles. Cover image: Thinkstock ACN publishes The Hive, NurseClick and the ACN Weekly eNewsletter.

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In the news national

Social media fuelling anxiety and perinatal depression for new mums, experts warn

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One in 10 five-year-olds show signs of developing mental illness: study finds One in 10 five-year-olds in NSW show early warning signs of developing mental illness later in life, according to a new study that provides a ready-made blueprint for detecting at-risk children. Read more

Millions of Australians are getting sunburnt on weekends

Children consuming too much salt: study

Researchers discover how to unblock arteries with maths

New mums are bombarded with social media images of the 'perfect family' and it's leading to increased anxiety and perinatal depression, experts are warning.

There are fears Australians have become complacent about sun protection, with new research revealing 2.7 million adults are getting sunburnt on weekends because many aren't slipping on a shirt.

There are concerns the common diet of Australian children is setting them up for poor heart health after a study found two thirds consume too much salt and don't get enough potassium.

Researchers have combined mathematical modelling, supercomputing and laser imaging technology to assess the severity of artery blockages.

Research by the national perinatal depression helpline PANDA has also found more than half of mums with the illness are waiting at least a month to seek help, and one in 10 callers to the service are at serious risk of self-harm or suicide.

The latest Cancer Council National Sun Protection Survey shows that overall the proportion of adults wearing clothing to protect themselves from the sun has decreased from 19%–17% in the last three years.

Read more

Read more

Breakthrough in battle against sepsis

Health professionals overworked, go beyond job description

Australian researchers have discovered a molecule that could be used to treat sepsis, potentially saving millions of lives each year.

Australia’s health and aged care workers consistently go above and beyond their job description – to the point of even providing financial guidance – a new report has found.

Sepsis occurs when the body’s immune response to an infection starts to damage its own tissues and organs. It causes between six and nine million deaths worldwide each year. Read more

The recent report found that almost half of Australia’s 960,000 aged care and health professionals were over the age of 55 and in danger of being overworked. Read more

A study of more than 650 Victorian primary school-aged children, found that sodium levels in their urine were about twice that of potassium. Read more

The University of Melbourne researchers have discovered a way to unblock arteries without having to insert a physical separate pressure wire to assess blood pressure loss around a blockage. Read more

Antibiotic-resistant STI mycoplasma genitalium may soon be as great a health risk as chlamydia A sexually transmitted disease that may be infecting up to 700,000 Australians without them knowing is becoming so resistant to treatment it may soon become as great a health risk as chlamydia, doctors have warned. Mycoplasma genitalium is developing resistance to antibiotics at what health professionals say is an alarming rate. Read more

New app makes UV rays visible to the eye A new app that makes UV rays visible to the human eye has been launched to help people protect their skin from sunburn this summer. The SunSmart app developed at Deakin University, uses augmented reality technology and real time data from the bureau of meteorology to provide a visual image of hidden UV and alert users when it's at dangerous levels. Read more


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In the news world Stick-on patch could help peanut allergy sufferers

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A stick-on patch could help cure life-threatening peanut allergies, new research has found.

Dog ownership lowers early death risk, study finds

Cleaning the house can help elderly women live longer

Giving birth on due date 'less risky' for older mums

Dog owners have a lower risk of death from cardiovascular disease or other causes, a study of 3.4 million Swedes has found.

In a study of women age 65 and older, just 30 minutes a day of light exercise – like running errands and cleaning the house – was linked to a lower risk of death.

Stillbirth and newborn death risk could be reduced by offering more pregnant women the chance to give birth on their due date, experts believe.

Read more

New research suggests bringing forward induction to 40 weeks' gestation may be a safer option for mothers and babies.

The team analysed national registries for people aged 40 to 80, and compared them to dog ownership registers. Read more

Revolutionary ‘single injection’ treatment could help back pain sufferers Liver test to aid paracetamol overdose treatment People who overdose on paracetamol could be helped by a blood test that shows immediately if they are going to suffer liver damage. Researchers in Edinburgh and Liverpool said the test would help health care professionals identify which patients arriving in hospital need more intensive treatment. Read more

There's hope for millions of Australians who suffer from back pain, with scientists discovering a revolutionary treatment that could fix the problem with a single injection. Australian scientists have discovered that stem cell technology may assist the one in six Aussies who experience the debilitating condition. Read more

Read more

The Viaskin Peanut Patch, which looks like a round Band-Aid, contains a small amount of peanut protein that goes into the skin and is absorbed by specialised immune cells in the superficial layer. Read more

Computer brain training cuts dementia risk Computerised brain-training focused on mental quickness can reduce the risk of dementia among older adults by a third, a study has shown. The ACTIVE Study accessed 2,802 healthy older adults for 10 years – as they aged from an average of 74 to 84 years. Read more

Sleep deprivation affects sleep similarly to alcohol Sleep deprivation disrupts brain cell communication in much the same way as alcohol, research has shown. Exhausted neurons respond more slowly than usual and take longer to transmit weaker signals, a study found. Read more

People with diabetes often struggle with emotional or mental health issues Three in five people living with diabetes currently struggle with emotional or mental health issues, a large-scale international survey has found. The survey asked 8,500 people of different ages, ethnicities and backgrounds from across the UK to share their experiences of living with diabetes today. Read more


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Australian College of Nursing update

Nurses welcome vote for equality Earlier this month, ACN welcomed the result of the Australian Marriage Law Postal Survey showing that the overwhelming majority of Australians support marriage equality. Of the nearly eight out of 10 eligible Australians who expressed their view, 61.6% responded Yes and all states and territories recorded a majority Yes response. “ACN strongly supports equality for all. It is a fundamental human right and we condemn any kind of discrimination, be it on the basis of race, religion, ethnicity, sexual orientation, gender or disability,” said ACN CEO Adjunct Professor Kylie Ward FACN. “Nurses have a long history of caring for people where others have been either unable or unwilling and we absolutely believe that equality is a critical component of health,” said Adjunct Professor Ward. Read our media release.

Nurses applaud recognition of climate and health ACN applauds the recent announcement by one of Australia's biggest health insurers, Medibank, to reduce its exposure to carbon intensive assets and invest $25 million in green bonds for carbon reducing and environmentally responsible projects. In a statement to the Australian Stock Exchange explaining why it would transition to low-carbon investments in its international portfolio within the next year, Medibank acknowledged that the health of the environment has an impact on the health of the community. Air pollution is now clearly recognised as an important global risk factor for disease, ranking fifth on the global ranking of risk factors for total deaths from all causes for all ages and sexes in 2015. “The health and well-being of people, indeed their survival, depends fundamentally, on a healthy environment: clean atmosphere and water, fertile soils, pollution free oceans and biological diversity,” explained ACN CEO Adjunct Professor Kylie Ward FACN. Read more.

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Cover doesn’t always mean protection. Find out more

Four ACN Policy Chapters launched ACN recently launched four new Policy Chapters in recognition of the constantly changing landscape of the provision of patient care and services within the Australian health and aged care system. The aim of our new Policy Chapters is to provide opportunities for nursing leaders and experts to inform change and guide future directions through collaboration. The intent is to influence government and policy makers relating to reform required now and into the future. Each Policy Chapter will facilitate face-to-face and virtual meetings throughout the year. These will be determined by the Chapter Chair and Deputy Chair in consultation with ACN and be specific to the priority of the Policy Chapter. This may consist of forums, workshops and projects. The first planned meeting of Policy Chapter participants will be at our Policy Summit in Canberra on 20 April 2018. Our four new Policy Chapters are: • Workforce • Chronic Disease Sustainability • End of Life Care. • Healthy Ageing Read more.

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A personal reflection Novice nurse takes on the ICN Congress Ariela Rother MACN (ENL)

After completing my graduate program and attending the National Nursing Forum in 2016, I was inspired to expand my knowledge and perspective of nursing on a global scale. The International Council of Nurses (ICN) Congress in Barcelona was the perfect opportunity to do this. When I was thinking about how to reflect on my experiences at the ICN Congress, I found it challenging to try to explain all the emotions that I experienced. I will try my best to share my experiences in this article and hopefully, other novice nurses will gain the confidence to attend the 2019 ICN Congress in Singapore. Before the conference even began, I couldn't contain my excitement and nerves. I couldn't even believe that a girl from South East Queensland, Australia, would have an opportunity like this. But standing under the ICN Barcelona sign, I knew that I had found where I belong. It was evident that the 8,000 nurses, from all over the world, had a shared mission to learn, inspire, lead and aspire to become better nurses for their communities.

Although at times the number of people and all the different sessions and talks felt overwhelming, I tried to remain grounded and find like-minded people to discuss and explore different concepts of nursing – which was so rewarding. On the first day, the opening ceremony at the Palau Sant Jordi exceeded my expectations beyond anything I imagined. It felt like I was at the "nursing Olympics", where everyone waved in joy to see organisations from all over the world come together to represent their countries and achievements. The Spanish Congress knows how to put on amazing entertainment – from magic shows and live music to dancing and art. The entertainment really set the energy for the rest of the conference. Being in the opening session in the plenary room, where ICN welcomed all the wonderful nurses to the congress, was an incredible feeling. All I wanted to do was listen to everyone's stories about advancements in nursing leadership from across the globe.


IN FOCUS @ACN

I went into the congress with the aim to expand my knowledge of the nursing profession by meeting and learning about different practices from around the world. Although most of the nurses at the conference were presenting or had a poster, it was good for me to just be amongst all of the people, listen to talks about the many different areas of nursing that are driving positive change and witness the incredible leadership showed by the nurses there.

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96% of nurses surveyed agree UpToDate® helps them improve patient care*

It would be too much to try to describe the four days of amazing sessions – varying from leadership, clinical practices, policy and representation, nursing ratios and health care reform. Going to all the different sessions, learning about different health care systems and hearing how nurses are making an incredible difference in the lives of their patients, was inspirational. It was so energising to see so many passionate nurses wanting to make change happen and be at the forefront of health care reform. From seeing how nurses can have such significant roles in climate change to rural and remote practice, it definitely provided me with a different perspective on what it means to be a nurse in Australia. I hope my experiences at the congress will encourage all novice nurses to take on the 2019 ICN Congress in Singapore. It is an incredible opportunity to expand your knowledge and professional development. I definitely came out of the conference inspired and enthusiastic to make change happen. If any novice or early career nurses would like to ask me about the ICN 2017 experience, feel free to contact me through ACN. EDITOR’S NOTE ACN is the Australian member of ICN, creating an important link between Australian nurses and the global nursing community. Through this role, ACN represents Australian nurses in the development and reform of international nursing policy, and promotes the nursing profession across the globe.

Access current, comprehensive clinical content UpToDate is an evidence-based, physician-authored resource which is used by nearly 80% of Australia’s acute hospitals and is a resource that nurses trust to practice evidence-based nursing. Nurses report that using UpToDate: • Increases clinical knowledge • Improves patient safety • Promotes continuity of care • Saves time • Minimises drug risks • Promotes shared decisionmarking with patients

Download our evidence-based nursing starter kit to find out more. https://go.wolterskluwer.com /ACN-EBM-Nursing.html * UpToDate Surveys, survey respondents who are in the nursing profession. August 2011 to July 2012, N=2,895


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Artificial intelligence Reducing isolation for elderly clients in the community Emily Wardell MACN (ENL)

Social isolation is a key risk factor for ill health amongst older people (Aged and Community Services Australia, 2015; World Health Organisation (WHO, 2010). In an essay, Franklin and Tranter (2011) discuss direct links between Emily Wardell MACN loneliness, and physical and mental illness, noting that lonely elderly people are twice as likely as other elderly people to be admitted to nursing homes. With an increase in the ageing population, and a greater demand on aged care facilities, there is increased economic and social pressure to enable older people to stay in their homes for as long as possible. The use of technology has been widely used in nursing and home care for several decades (Schlachta-Fairchild et al., 2010). With developments in artificial intelligence (AI) and machine learning across industries, it is imperative the health care sector further adopts the use of AI. Some of the drivers are predicted nursing workforce shortage and the increased geographical spread of consumers of health care.

Telehealth, the distribution of health and health-related services via electronic information, is one method being used increasingly by health care organisations to improve access to and increase delivery of cost effective health care (State of Victoria, 2015). Rural patients can dial into outpatient appointments via videoconference thus avoiding lengthy travel and delays (Bala, 2017). Bolton Clarke (previously known as the Royal District Nursing Service) nurses have been conducting medicationmonitoring visits via videoconference to clients in their homes for several years (Bolton Clarke, 2017). This is an example of transition from in-home care to remote monitoring with the use of technology. Telehealth has led the concept of in-home monitoring using AI. In-home monitoring is not new. Services such as community nursing visits and personal alarms, worn as pendants around the neck, which can be pressed in emergencies have been usual practice for at least two decades. They are not without limitations. The personal alarm service relies on the user remembering to wear the pendant at all times and many elderly clients living at home may be unable to do so. Some clients perceive the alarms as visually unappealing and their operation has been described as giving a poor user experience.


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“There is increased economic and social pressure to enable older people to stay in their homes for as long as possible. The challenge is for technology to be 'hidden', non-invasive and preventative, as well as supporting elderly people to stay safely at home, socially connected. In response to this, several Australian organisations have introduced the idea of in-home monitoring using AI to monitor behaviour, as well as combat loneliness. In comparison with reliance on nursing visits or personal alarms, AI can provide around-the-clock monitoring and has the potential to predict falls and functional decline. Conpago© and Umps Health have technologies that build upon the personal alarm concept. They use technology to monitor patterns of use in electrical appliances such as the kettle, refrigerator and lighting. Conpago© will initiate a glowing light on the family member’s device, giving a signal to the consumer and the carer/ family member that the situation is usual. The technologies aim to decrease isolation by fostering relationships and increasing communication (Conpago, 2017). Umps Health also recognises patterns of activity in the use of electrical devices, identifying behaviour that is abnormal, and thus sends a notification to a family member (Umps Health, 2017). SofiHub, a product of Unisono Pty Ltd, differentially uses sensors located in rooms around the home to monitor activity and feed this information back to a central hub. It is also

used for reminders such as medication, hydration and anniversaries, which are linked to a calendar (SofiHub, 2017). The SofiHub technology learns what normal is for the person regarding their movements in the house and alerts someone if there is a deviation from normal. The Commonwealth Scientific and Industrial Research Organisation (CSIRO) have also conducted a trial of in-home sensors in a NSW study that aims to keep people in their homes for longer, increase quality of life and reduce the burden on the health care system (CSIRO, 2017). These technologies are just some of the products currently undergoing testing and trailing among users across Australia working towards reliable and efficient systems. Interestingly SofiHub’s first trials revealed that users liked the voice messages and looked forward to receiving them. The device gave the impression that they were being cared for and 'someone' knew their routine. The findings resulted in a reduction of loneliness; however, another study is needed to directly measure this (Curumsing et al., 2017). The next trial is currently being conducted in partnership with Bolton Clarke in the northern suburbs of Melbourne, with SofiHub being used in client homes for a fourweek period. With the Australian health care sector facing a nursing shortage and an increase of people aged >85 years over the next 30 years, it is imperative

that innovative approaches using AI are adopted (Health Workforce Australia, 2014). They might address these workforce shortages, to some extent, by decreasing the need for home personal nursing visits. The projected benefit from AI to those who wish to remain at home longer and in familiar environments are equally important. They may keep costs down, give carers the comfort of knowing their persons are happy and safe. Ultimately, AI may reduce isolation and increase connectedness.

References Aged and Community Services Australia, 2015, ‘Social Isolation and Loneliness Amongst Older Australians’. <https://www.acsa.asn.au/getattachment/ Publications-Submissions/Social-Isolation-and-Loneliness/1015-Social-Isolationand-Loneliness-Paper.pdf.aspx?lang=en-AU> Bala, A., 2017, ‘How Technology is Changing Nursing: The Impact of Telehealth’ – Medscape. Bolton Clarke, 2017, ‘Bolton Clarke’, Queensland, viewed 21 October 2017. <https://www.boltonclarke.com.au/> Conpago, 2017, ‘Conpago Bringing Families Together’- Viewed 21 October 2017, <http://conpago.com.au/ > Curumsing, M, K., Fernando, N., Abdelrazek, M., Vasa, R., & Mouzakis, K., (YEAR) ‘Smart homes can help to alleviate loneliness among senior citizens.’ Deakin University Industry Report. Franklin, A. & Tranter, B., 2011, ‘AHURI Essay. Housing, Loneliness and Health’, Australian Housing and Urban Research Institute, Melbourne, VIC. Health Workforce Australia, 2014, ‘Australia’s Future Health Workforce – Nurse Detailed’, https://www.health.gov.au/internet/main/publishing.nsf/ Content/34AA7E6FDB8C16AACA257D9500112F25/$File/AFHW%20-%20 Nurses%20detailed%20report.pdf Schlachta-Fairchild, L., Varghese, S.B., Deickman, A., & Castelli, D., 2010. ‘Telehealth, Telenursing, and Advanced Practice Nurses.’ The Journal for Nurse Practitioners 6, 98-106. SofiHub, 2017, ‘SofiHub’, Melbourne, viewed 21 October 2017, <https://sofihub.com/> State of Victoria 2015, ‘Critical success factors: how to establish a successful telehealth service.’ <http://www.health.vic.gov.au/telehealth> Umps Health, 2017, ‘Umps Health’, Melbourne, viewed 21 October 2017, <https://www.umpshealth.com/> Commonwealth Scientific and Industrial Research Organisation, 2015-2017, ‘CSIRO’, viewed 21 October 2017, <https://www.csiro.au/en/Research/BF/Areas/ Digital-health/Improving-access/Smarter-safer-homes> WHO, 2017, ‘World Health Organisation’, Denmark, viewed 21 October 2017, <http://www.euro.who.int/en/health-topics/Life-stages/healthy-ageing/data-andstatistics/risk-factors-of-ill-health-among-older-people>

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EDUCATION @ACN

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Behind our Graduate Certificates Meet Trish Lowe MACN ACN offers a number of graduate certificate courses, enabling nursing professionals to gain the qualifications they need to specialise in their particular passions and skillsets within the health care industry. Our graduate certificate courses are designed, developed and delivered by dynamic industry experts, educators and academics with advanced clinical, health and aged care experience in complex environments. ACN will be profiling our educators, students and relevant clinical experts throughout the next few editions of NurseClick. In this edition, we are excited to profile the talented educator who coordinates our Graduate Certificate in Neonatal Care, Trish Lowe MACN…

Tell us a little about yourself and your background in your specialty My name is Trish Lowe MACN. I have been a registered nurse since 1985 and a registered midwife since 2001. In 2006, I pursued neonatal care as a clinical specialty. I commenced at the Australian College of Nursing in February 2013 and have coordinated the Graduate Certificate in Neonatal Care – alongside Leanne Sheppard – since then. Give us a short snapshot of your course This course provides nurses and midwives with the requisite knowledge, skills and attributes to deliver evidence-based, individualised care to compromised neonates and their families. Students are selected on merit, but must be working in an appropriate clinical area to qualify for admission. This is to facilitate the enrolment of students who have insights and experiences in this specialty area, access to clinical support, and opportunities to reflect on their growth as a neonatal practitioner throughout the program. Students have the opportunity to expand upon their pre-existing theoretical and practical knowledge by pursuing either a neonatal special care or neonatal intensive care stream.

How is your course structured? The Graduate Certificate in Neonatal Care is developed according to the Australian Quality Framework – Level 8 (i.e. Bachelor’s Honours/Graduate Certificate/Graduate Diploma level). The course comprises of four 150-hour units of study, each delivered online over four 10-week terms. The subjects offered are: Applied Neonatal Physiology, Assessment of Growth and Development, Professional Issues in Neonatal Care and one elective subject (Neonatal Special Care, Neonatal Care in the Perinatal Environment or Neonatal Care of the High Risk Neonate). Do you think there is such a thing as a typical student in your course? The only commonality evident within this student cohort is a commitment to neonatal care and desire to optimise health outcomes for neonates and their families. Students commence with a wide range of clinical experience, and work in many clinical settings across Australia – from very large tertiary referral centres to small, rural, maternity units. Why study the Graduate Certificate in Neonatal Care with ACN? The course content is informed by current evidence and regular stakeholder engagement. The course

coordinator and tutors are clinical experts, and are actively involved in relevant professional bodies such as The Australian College of Neonatal Nurses (ACNN). This enables students to be provided with an informed and contemporary perspective, throughout their learning experience. What are the career pathways for nurses in the neonatal specialty with this Graduate Certificate in Neonatal Care? All nurses and midwives working in neonatal specialty areas will benefit from the knowledge gained throughout this course. Students will enhance their information literacy, become accustomed to meeting deadlines and build professional networks. Many will utilise their postgraduate qualification to advance their career and assume advanced practice roles. Clinical nurse/midwifery specialist, clinical nurse/midwifery educator, nurse/midwifery educator or associate lecturer, are some of the many career paths, which may become available to graduates, upon completion. Further information, including the units offered and key dates, can be found on our website www.acn.edu.au/postgraduate


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Military nursing A Navy nurses journey Lieutenant Anthony Russell MACN

27 July 2014 – the date that my nursing career entered an exciting new chapter.

Lieutenant Anthony Russell MACN

This was the date I enlisted into the Royal Australian Navy as a fulltime uniformed navy nurse.

I thought I knew what I had gotten myself in to. I was well prepared for my officer selection board, so I thought I knew everything to expect.

How wrong I was. I flew to Sydney with 77 other new enlisted officers, where we boarded a bus to HMAS Creswell in the picturesque South Coast of NSW to undertake our initial military training. At the time it was challenging to adjust to military life; being away from family and friends, and generally being put outside of your comfort zone for 22 weeks.

On completion of my initial training, I was posted to Sydney to work as a part of the Maritime Operational Health Unit (MOHU) – the sea-faring health unit for the Navy. I was tasked with working as an emergency nurse and responsible for providing expert advice on the development of the emergency department on board our biggest ships, HMAS Canberra and Adelaide.

Looking back, I had the best 22 weeks of my life and I have made some of the closest friends. I developed as a person; becoming much more independent and a free thinker. It was not all sunshine and lollypops; it was emotionally and physically challenging, but so rewarding in the end, culminating into the proudest day of my life, graduation.

MOHU was a fantastic posting. I was working clinically 24 hours a week at a busy tertiary trauma centre in Sydney and also doing clinical administration at MOHU. I was on short notice to go to sea – and to sea we went. I had the opportunity to serve on many platforms in Canberra, Adelaide, Choules and Armidale Class Patrol Boats. I would spend between five to seven months at sea a year.

Sea life is great! The daily routine generally starts with early morning physical training, run by a qualified instructor. Breakfast, cooked by the chefs, and then onto treating whatever comes through the doors! We then have booked appointments with the medical officer. We have to be prepared for anything. There are high-risk activities happening, such as helicopter and small boat operations, not to mention the general risks of being in a maritime environment. In our down time, we have whole department training – mass casualty simulation, crash on deck and man overboard training, to name a few. We also have time to study and binge watch TV series! Finally, we have port visits…they are always fun!


IN FOCUS @ACN

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The Army is now recruiting Nursing Officers

“Joining the Navy has been the highlight of my career.” During the MOHU posting, I was extremely proud to be a part of the team to provide humanitarian aid to Fiji following the devastating tropical cyclone Winston. Providing humanitarian aid was one of my many motivating factors to join the Navy. Being able to provide aid to a country experiencing such devastation, was the most rewarding experience. Between all the grief and loss, there was much joy in having Australians there to lend a hand. I will always look favourably on my five weeks on OP FIJI ASSIST 16. At the end of 2016, I had finished my two years at MOHU and it was time for my posting. I was given the opportunity to stay in Sydney or go to Darwin. I weighed up the options and decided that I’d never be given the chance to go to Darwin again. So off to Darwin I went. The Navy was continuing to challenge me. This time, I was going to be the Senior Nursing Officer/ Health Centre Manager at the busy Larrakeyah Health Centre. This was really my first taste of middle management in the Navy.

I am responsible for the service delivery of health services to Australian Defence Force personal posted to Larrakeyah Barracks/HMAS Coonawarra. The health centre is small but very efficient – with approximately 160 medical appointments a week, on top of the unknown number of walk-in patients. I manage a diverse team of doctors, nurses, physiotherapists, pharmacists, psychologists and rehab consultants – which is all very challenging to say the least. I believe a good correlation to civilian practice would be a nurse manager role. Like most management jobs, there is an administration burden but it isn’t so bad, as I can further maintain my clinical skills by treating patients (in a primary health care sense) and working clinically at a busy trauma centre once a week. Have I mentioned the training opportunities the Navy has given me? Not only are there a wide range of health-related courses but we also receive training in areas such as, military law, discipline officer training, advanced combat

survivability, weapons training, advanced leadership and management, and not to mention, subsidised postgraduate training. I’m currently completing a Masters of Public Health and Masters of Health Management. Joining the Navy has been the highlight of my career. It has provided me with opportunities that I could never dream of in a civilian health care setting. I have developed my management and leadership skills, and am now a confident leader and manager. I have not been in the Navy long but I am looking forward to many more challenging opportunities in the future! If you are interested in joining the defence force, drop me a line or come join the ACN Military Nursing Community of Interest to see what we are all about. We are always looking for motivated, experienced nurses in perioperative nursing (Scrub/Scout), ICU and ED to name a few!

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’.

Call 13 19 01 or visit defencejobs.gov.au /Army

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Refugee Nurses of Australia First National Forum Chairperson of the RNA, Lindy Marlow

The Refugee Nurses of Australia (RNA) held their first National Forum on Friday 13 October in Liverpool, NSW. Over 60 delegates from across Australia attended the Forum, which was the first face-to-face meeting of the general membership. Chairperson of the RNA, Lindy Marlow from Victoria greeted delegates at the Forum. Launched in October 2016 at the ACN National Nursing Forum, the RNA aims to give a professional voice to nurses working in refugee health, and for those nurses with an interest in the health of refugees and those seeking asylum.

The Forum was also an appropriate venue to launch the RNA website: refugeenursesaustralia.org The Forum provided an opportunity to explore and discuss the different models of refugee health care that are in operation across Australia, and hear from the Department of Social Services about the potential impacts of the new Humanitarian Settlement Program contract arrangements on existing health service models. Delegates also heard from Sam Furneaux about the progress of the National Refugee Health Guidelines website. This important iniaitive (with funding

from the Commonwealth Government) will give clinicians across Australia access to contemporary, evidence-based guidelines to increase consistency in patient management, and decrease unnecessary testing, duplication of services, and out-of-date clinical practices. The afternoon of the Forum was dedicated to brainstorming and constructing the RNA Refugee nurse competency framework. This is an important focus of the RNA, and will assist in professional development, skill acquisition, and a recognised knowledge base for practice. Sam Furneaux


IN FOCUS @ACN

Professor Elizabeth Halcomb FACN

In recognition of the primary health environment of many refugee health services, the RNA were delighted to invite Professor Elizabeth Halcomb FACN to lead the discussions. Professor Elizabeth Halcomb is the inaugural Professor of Primary Health Care Nursing at the University of Wollongong, Australia. She is an experienced academic nurse leader who is committed to developing researchers in both academia and the clinical setting. Professor Halcomb leads a strong research program in primary care nursing, with particular emphasis on nursing in general practice, chronic disease and nursing workforce issues.

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Nyari Garakshe, Irene Simonda and Jenn McCleod

She has recently developed the professional practice standards for nurses in Australian general practice in conjunction with the ANMF. The competency framework was an excellent opportunity for delegates to compare and discuss their particular models of care, and network with colleagues as they 'unpacked' their day-to-day refugee nursing roles. The day included lots of networking opportunities, great food, and generated discussion, ideas and future options.

“Launched at the ACN National Nursing Forum, the RNA aims to give a professional voice to nurses working in refugee health.”

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IN FOCUS @ACN

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Reducing pressure injuries

By Patrick McCrohan

Pressure injury: the words every nurse unit manager dreads to hear. Pressure injuries are now classified in the top three clinical risks of most inpatients in general medical and surgical wards throughout Australia. Pressure injuries are described as a localised injury to the skin and/or underlying tissue, usually over a bony prominence, as a result of pressure, or pressure in combination with shear (Varga, 2015, p. 26). Pressure injuries are not a new phenomenon; they have been documented for thousands of years. The ancient Egyptians even used honey as one of their various remedies for pressure injuries. There have been many strange and

mysterious treatments used over the years in the management of pressure injuries including mouldy bread, meat, animal and plant extracts, copper sulphate, zinc oxide and alum have been used in the past (Agrawal & Chauhan 2012, p. 244). As clinicians, we know what pressure injuries do; we know the burden it places on the patient, staff, and the health system. However, this problem has been around for thousands of years and there is still no quick and easy solution. No matter how much money and education the health care system throws at this issue it seems to never go away. In fact, with the culture of incident reporting becoming more embedded in health, the actual enormity of the problem is only starting to become evident. So, what can we as nurse unit managers do about it? Unfortunately, extra staff and resources

do not fall within most budgets. In fact, nurse unit managers are under increasing pressure to fall within budget while caring for an ageing population with increasing co-morbidities. What we do have however, is the power to innovate and encourage the staff to take ownership of these issues. Accountability: a word that can be found in copious amounts of not just health care organisations but also within the values and mission statements of many other sectors. But what does it actually mean? One of Victoriaâ&#x20AC;&#x2122;s largest health care providers makes reference to accountability in their values as follows: â&#x20AC;&#x153;We will be responsible for care, patient outcomes, and the consequences of our actions.â&#x20AC;? So how does this translate to pressure injuries? Who is accountable for the pressure injury

Innovation from within

developed by the patient whilst in the care of the health provider? In a word, everyone! Everyone involved in the care of this patient from the bedside nurse to the CEO and Board of the hospital are responsible and should therefore be accountable for the pressure injury developed by the patient. With the shift away from solitary nursing to team nursing, there is a real danger that nurses will lose that sense of responsibility for their patient's care. As nurse unit managers, it is important that we ensure that patient care and the accountability that goes with patient care is not lost within the team model. We need to promote a culture of ownership of our issues and involve nursing staff in the development of ideas and solutions for dealing with problems identified, such as pressure injury prevention.


IN FOCUS @ACN

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“To minimise resistance to change, it is vital we link the change to improving patient outcomes.”

At Eastern Health, one of Melbourne’s largest metropolitan public health services, it was evident that pressure injuries had become a major organisational-wide problem. Incidences of pressure injuries were at an all-time high, especially in the general medicine and continuing care programmes. Between the four months of May through to August, there were 14 incidences of pressure injuries acquired in care recorded on the General Medicine Ward 1. With no apparent cause for the spike in incidences, the ward decided to take it upon themselves to improve results with ideas from within. With no extra funding for air mattresses, the ward had to utilise all available resources. With no room to move with nursing ratios and an increasingly heavy workload, the nurse unit manager and the health assistant in nursing (HAN) decided to come together and develop a strategy that they hoped would see an improvement in pressure injury incidence.

Every morning at the start of a shift the HAN would liaise with the nurse in charge of the ward to identify the patients that had been identified as at high risk of pressure injury or at high risk of developing worsening pressure injuries. Having identified these patients, the HAN would incorporate frequent turning and pressure area care for these patients in conjunction with the nursing teams throughout the shift. What started as a new concept became part of the HAN’s standard daily work. In the four months following the introduction of this strategy, there has been only two incidences of pressure injuries acquired in care. This is without any extra resources or funding. Through awareness and the development of a pressure injury prevention portfolio team lead by the nursing staff themselves, the ward began to build a culture of accountability and responsibility for pressure injuries. Goals were set to try and

get through the entire month without having a pressure injury acquired whilst in care. When this was achieved, the goal became two months pressure injury free. The ward measured themselves against other wards with similar cohorts of patients. This competition gave the staff a sense of satisfaction that they were providing the highest level of care to their patients. When a pressure injury was discovered there was a genuine disappointment by all the staff on the ward. Changing culture and practice within health care is notoriously difficult. One of the most dangerous phrases in health care is, “because we’ve always done it this way”. To minimise resistance to change, it is vital we link the change to improving patient outcomes. Empowering nurses to drive change and innovate from within will reduce resistance and provide the best chance of successful implementation. With a little hard work and dedication, the ward managed to turn its weakness into one of its greatest strengths.

References

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CONTACT ACN MEMBERSHIP TO SPREAD THE CHEER

Agrawal, K., & Chauhan, N, 2012, Pressure Ulcers: Back to basics, Indian Journal of plastic Surgery, Vol 45, No. 2, pp 244-254 Varga, M, 2015, Prioritizing Pressure Ulcer Prevention, Alberta RN, Vol 71, No. 1, pp 26-27

1800 061 660 membership@acn.edu.au


EVENTS @ACN

2030 and Beyond The Future of Nursing Regulation

Bringing together leaders from across our profession and country, the National Regulation Seminar and Dinner was held on Wednesday 15 November at the Rydges Hotel in Melbourne. This inaugural, sell-out event was cohosted by ACN and the Nursing and Midwifery Board of Australia (NMBA). The theme for the seminar was: 2030 and Beyond: The Future of Nursing Regulation. The United States National Council of State Boards of Nursing (NCSBN) Chief Executive Officer Dr David Benton gave a dynamic keynote presentation on this important topic. Mr Benton was joined by the NMBA Chair, Associate Professor Lynette Cusack MACN, ACN President Professor Christine Duffield FACN and Australian Health Practitioner Regulation Agency (AHPRA) Chief Executive Officer Martin Fletcher for a panel discussion. This event provided all those in attendance with an opportunity to have their say on nursing regulation and enjoy networking with passionate nurse leaders working across our health care system.

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IN FOCUS @ACN

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How one student group became a catalyst for change From “I am just a student” to “we made change happen” By Suzanne Lee Volejnikova-Wenger MACN ENL

Students at most universities liken their adult learning to a contract between the university and themselves, as in a business model. Nursing and midwifery Suzanne Lee Volejnikova-Wenger students are no MACN ENL different and often think that problems need to be solved by the provider they are paying for their degree. When confronted by the idea that they can be part of the solution, the comment most heard is, “I am just a student.” Students with such a passive mindset often become disengaged with their learning. When they encounter obstacles in their learning journey, few are resilient enough to overcome these obstacles and either change programs, universities or completely discontinue their undergraduate nursing or midwifery degree. Student retention and attrition is a current high-priority issue for universities and faculties,

with a significant nursing shortage predicted in the near future (Kukkonen, Suhonen & Salminen, 2016; Mooring, 2016). Different interventions to lower attrition rates are discussed and evaluated, with outcomes indicating that factors leading to students discontinuing their nursing program are too complex for a singular intervention (Fontaine, 2014; Harris, Rosenberg & O’Rourke, 2014). Overall, half of all nursing students considered leaving their undergraduate degree, but tangible support by peers and academics helped them overcome this low point (Walker et al., 2016). A sense


IN FOCUS @ACN

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“Students with such a passive mindset often become disengaged with their learning.” of belonging and the feeling of sharing the journey through peer support, was also a major factor in student retention (Cameron, 2011; Grobecker, 2015: O’Keeffe, 2013). Jeffereys (2014), in her book, Nursing Student Retention, argues, that caring learning communities are fundamental to student satisfaction and graduate outcomes. Three years ago, nursing and midwifery students at a regional university were invited by their peers to engage with a student group, which focussed on building relationships with the faculty and academics, provided a platform to promote the nursing and midwifery professions and encouraged students to strive for academic excellence. The handful of these new students, who decided that they wanted to be proactive, own their own learning and provide peer support, went about to expand the nursing and midwifery student group into a catalyst of change. Through peer support, they looked for ways to change the culture of perceived passiveness they saw around them. To continue and expand on the connection with the faculty and academics, the student group committee formalised their intentions in a mission, vision and values document, which was approved by the Head of School and supported by granting funds for the various activities of the group. The first phase was to foster a sense of belonging for nursing and midwifery students by creating a physical place to meet, with a big notice board, a banner and where new students knew they could find a friendly face from their program cohort. Other initiatives implemented by the nursing and midwifery

student group included: individual welcome packs (which also contained ACN material) on orientation day, twice-weekly drop in sessions with library and academic skills support, pre-placement and exam information sessions, colloquial Australian and nursing jargon sessions for international students, secure Facebook page with currently over 1,000 members, supported nursing lab sessions and much more. Through committee members also serving on the Student Representative Council, bigger issues such as lack of student placements, parking fees at the new learning centre and food subsidies were addressed, with positive outcomes. Smaller issues, such as advocacy for individual students, liaising with academics concerning some course complications and referrals to the university counselling service were all part of this grassroots peer support. Here are some student comments on how the student group changed their learning journey: “For me, being part of the student group was a way of being proactive in my decision to attend university as a mature aged student, providing the opportunity to go beyond simply attending classes and handing in assignments. It allowed me to interact with likeminded students and staff members, access nursing events and create a network of supportive friends. In more general terms, I believe that the success of the nursing and midwifery student group is reflective of the relationship it has developed with both students and staff. Listening to students concerns and presenting them to the university in a structured and mature manner has allowed cohort-wide changes

to occur (e.g. uniform changes). The student group has also been an important source of information in times of confusion and heightened stress. On a smaller scale, but equally if not more important, the student group has provided a point of contact for students looking to connect with others. At times, it is the simple actions, such as a coffee and chat at one of the drop-ins, that can really make a difference in a student’s university experience, and to me this is where the student group is really successful.” “Before I knew about the student group, I was lonely and I considered that I was the only person who had to go through this rough journey by myself. Since I met the student group, I have seen great encouragement from the cohort group and empathy towards each other – which became my source of power to endure the hectic semesters. As an international student, I truly appreciate the great support and understanding of cultural diversity in terms of settling into new environments. Thanks to the student group, my experience in studying in Australia is full of fun and achievements.” “I felt the nursing and midwifery student group strengthened my support networks on both a personal and academic level. Personally, through meeting other nursing and midwifery students on the same journey in which I could share my concerns, thoughts, ideas and celebrate our achievements. Academically, as the nursing and midwifery student group organised affiliations with academic advisors and nursing and midwifery lecturers who could come along to drop in sessions and support my learning and academic achievements. Drop in sessions organised by the student group were a safe place in which I felt supported personally and academically. I further felt the student group purposefully strengthened the nursing and midwifery cohort as the group was always actively participating in extracurricular events that supported new and

upcoming students such as a ‘welcome morning tea’ for nursing and midwifery students and O-week tours and activities. I feel as though support from the student perspective is important throughout a nursing and midwifery degree for it is a challenging but rewarding degree.” The student leaders, who grew this nursing and midwifery student group, are now graduating and are experiencing the difficulty of securing a graduate position in a health care system oversaturated with novice nurses. Moving on from a student perspective, the next big issue is being a collective voice for nursing and midwifery graduates and starting the conversation with education providers, employers and professional organisations, such as ACN. The creation of a new nursing and midwifery alumni network is the continuation and next level for these fresh graduates. Caring 2 Connect is the aim and motto of this peer-support group for novice and experienced nurses and midwives. Watch this space, because, “we can make change happen.” References Cameron, J., Roxburgh, M., Taylor, J. & Lauder, W., 2011, ‘An integrative literature review of student retention in programmes of nursing and midwifery education: why do students stay?’, Journal of Clinical Nursing, vol. 20, no. 9-10, pp. 13721382 Fontaine, K., 2014, ‘Effects of a retention intervention program for associate degree nursing students’, Nursing Education Perspectives, vol. 35, no. 2, pp. 94-99 Grobecker, P.A., 2015, ‘A sense of belonging and perceived stress among baccalaureate nursing student in clinical placements’, Nurse Education Today, vol. 30, pp. 178-183 Harris, R.C., Rosenberg, L. & O’Rourke, M.E.G. 2014, ‘Addressing the challenges of nursing student attrition’, Journal of Nursing Education, vol. 53, no. 1, pp. 31-37. Jeffreys, M.R., 2013, Nursing and Student Retention – Understanding the Process and Making a Difference, Springer Publishing Company, New York, USA Kukkonen, P., Suhonen, R. & Salminen, L., 2016, ‘Discontinued students in nursing education – Who and why?’, Nurse Education in Practice, vol.17, pp. 67-73 Mooring, Q.E., 2016, ‘Recruitment, advising, and retention programs – Challenges and solutions to the international problem of poor nursing student retention: A narrative literature review’, Nurse Education Today, vol. 40, pp. 204-208 O’Keeffe, P., 2013, ‘A sense of belonging: Improving student retention’, College Student Journal’, vo. 47, no. 4, pp. 605-613 Walker, S., Ross, D., Anastasi, J., Gray-Ganter, G. & Tennent, R., 2016, ‘Indicators of undergraduate nursing student’s satisfaction with their learning journey: An integrative review’, Nurse Education Today, vol. 43, pp. 40-48


LEADERSHIP @ACN

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Play as an educational tool Q&A with Vanessa Tilbrook MACN Vanessa Tilbrook MACN is a dynamic nurse entrepreneur who incorporates play and fun into nursing and education.

Could you provide a quick overview of your career to date?

They essentially became ‘little people’ with their own authentic case history.

realistic and felt that they could obtain the knowledge easily.

I’ve been nursing for over 30 years. Chiefly, my focus has been in paediatrics, paediatrics ICU and recently, maternity, with a focus on complex care.

The whole concept is a framework called Pup-Ed, which was created by Professor Kerry Reid-Searl at Central Queensland University. She was my research supervisor. My Masters project involved looking at the experiences of educators and the experiences of paediatric nurses using the puppets within their practice.

What are you passionate about?

I’ve just finished my Masters, where I looked at puppet simulation in health care as a form of education. That’s where I’ve really been sitting for the last 10 years – in education. The focus has been on using play as a way to engage the learner. What did your Masters project involve? For the puppet simulation project, I used two-handed glove puppets that were about 65cm long – about the size of a two-year-old.

I found that there are a few benefits. Within the paediatric population they facilitate the development of a therapeutic relationship, aided in the reduction of fear, increased compliance and engagement with families. And within the education environment, students were more engaged, and found the simulations to be more

Education, play and making it fun. I’ve created my own educational learning tool, which is called Open the VALT (Visually Authentic Learning Tool). So essentially, it involves a shoebox with laminated walls to represent a clinical environment. I use dolls, bikes, cars – whatever I need to replicate a scenario. For example, a car crash or a woman giving birth – and inside the lid is an ISBARR (Identify, Situation, Background, Assessment and Recommendation) scenario that the learners work through as a group.

I use this instead of written scenarios, this allows the group to interact with it and, for example, determine blood loss. I used that at postgraduate and undergraduate level, and they all have a laugh. And they all get involved. It just facilitates discussion. Sometimes they already know it, but they just need something to neutralise that environment, have a little bit of a laugh and then start the conversation. I thinking teaching should be fun. Sitting in a classroom and being talked at isn’t always the way to learn. As nurses – we’re very practical people – we provide care and we do a lot of education for the families and people that we care for, so I just think that we should make learning a little more tactile.


LEADERSHIP @ACN

A lot of simulation is really expensive, and it’s not very transportable. But we can have fun – simulation is role play. We still all play games, we do sport, we learn through play and I don’t think we stop learning through playing and doing. It’s about being able to laugh at ourselves and have self-compassion. Did you always see yourself working in the health care industry? Absolutely. If I’d had my time again to go back, I’d be in the same place now. Only one thing that might have distracted me is kindy teaching – or occupational therapy, where I’d get to play games with people all the time. I love cutting and pasting! (I’m great at dressings…) Do you think nursing and midwifery leadership is important? And why? Absolutely. Within a multidisciplinary team, I think nurses and midwives have a role in formal education. We’re with people all the time; we’re educating not only the women, families and patients that we are looking after, we’re actually educating the new staff that are coming through – and the doctors as well. I think that consumers look to us for leadership, whether you’ve got a management role or not. It doesn’t matter whether you’re a level one, level two, three or five; we are all leaders. It’s about how we conduct ourselves when we’re caring for someone; showing empathy and care. That’s what they’ll take away – and it’s what our colleagues and peers will see. So I think that we are all leaders. I think that it’s important that we show that we are a united front and that we show that we know what we’re doing, we are capable and we’re confident moving forward. We all have the opportunity to show and demonstrate this to others, through being professional, ethical and caring. Caring is an art –

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and to some people it doesn’t come naturally. We all have different strengths, and we should show them. If we are showing our strengths at work, then we are really leading our profession.

“If we are showing our strengths at work, then we are really leading our profession.”

Is there a certain person/people who have a resounding impact on you? Education is my thing. So if I think back to the people who have influenced me, I don’t think it is just one person. The people who have had the biggest impact on me are the ones who have said, “No, you can do better.” They have made me try harder. The person who tells you that you’re awesome all the time, isn’t actually going to help you because you stop trying. And the person who says, “Yeah this is good, but you can do better,” frustrates you, but they make you more determined to try harder and you achieve more. So there are multiple people that I could name, but won’t because it will be discrediting the value of others. But there have been a least five women and a couple of guys who have made me try harder by saying, “Nah, you can do better,” in a nice, constructive way.

cast of a thousand people in the room with a job to do, that she still felt like this was going to be one of the most exciting days of her life, and enjoy meeting her baby. So I was trying to have some fun and made it a little more focused on her. The next day when I rang her to check how she was she said, “Thank you for making me feel like a person. Like a real person who was special, instead of just a fat chick.” So I will always take that with me. That sometimes, as nurses, we say, “Oh yeah, the diabetic in bed five,” and “The guy with hypertension in bed six,” and we forget that they are actually a person. We need to make sure there is that element of caring and making the person feel like they are special. That experience stood out to me: we need to do this every time.

What has been a notable learning experience during your career?

What are your hopes for the nursing profession in the future? And how do you think this can be achieved?

This happened (when I was working in maternity) about five years ago. I was looking after this beautiful woman who had a very high BMI. So there were all these potential risks for her delivery.

Everything is changing in nursing. It seems to be more of a conveyor belt – budgets are changing, acuity’s changing, patients are coming in with a lot more co-morbidities.

We became very focused on the mode of delivery and where we were going to do it. The care became very focused on the management of the disease and the complications. Even though we wanted to make it a safe environment, it was actually about caring for a potential complication and not for a woman. So I just started to focus on her, on her experience and making her care more woman-centred; trying to make sure that, with a

So I think that nursing will hopefully not become a business. If we can still move forward and maintain that element of caring, and seeing the person behind the disease; caring for the person with the disease, instead of the disease. I know we say, “partnering with consumers”, but I think we really need to break it down to see what that actually looks like at that caring level.

I think that the nurses on the floor need to really truly be valued, because that’s where they are changing lives – not necessarily up the ladder. So I think really encouraging those girls and guys to give them the support to keep doing what they are doing is really important. To me, that’s what nursing should be about, that direct care. It’s great that we have all these national and state policies around changing health, but at the end of the day, there still has to be someone providing that care. So I really hope that between all of those initiatives, moving forward, that supporting those level ones, twos and threes that are there caring for people is still the key priority. What advice do have for nurses who may want to go down your path of being a nurse entrepreneur? Back yourself. I’ve found that the hardest thing in nursing and midwifery is that we’re taught to look after other people, and that’s our priority. And when it comes to having a good idea and sharing it, it’s actually really hard to work out how to do that. So you’ve got to just stop, back yourself and keep knocking on doors and finding a pathway forward. Work out where you want to go, and then find the right staircase. It might take a few attempts, you’ll get a few empty doors, but just keep going. If you’re really passionate about it and you want to make a difference and change things, then just back yourself and keep going. The squeaky wheel will eventually get heard.


NMBA UPDATE

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Code of conduct for nurses domain three: act with professional integrity The Nursing and Midwifery Board of Australia (NMBA) has published the new Code of conduct for nurses (the code), which takes effect for all nurses in Australia on 1 March 2018. Nurses need to understand and apply the NMBA code to their practice, even if their employer also has a code of conduct. The new code is grouped into four domains of conduct: • practise legally • practise safely, effectively and collaboratively • act with professional integrity, and • promote health and wellbeing. The third domain in the new Code of conduct for nurses is “act with professional integrity” and is underpinned by three principles and value statements: • Professional behaviour: Nurses embody integrity, honesty, respect and compassion. • T  eaching, supervising and assessing: Nurses commit to teaching, supervising and assessing

students and other nurses, in order to develop the nursing workforce across all contexts of practice. •  Research in health: Nurses recognise the vital role of research to inform quality health care and policy development, conduct research ethically and support the decision-making of people who participate in research. The principle of “professional behaviour” gives guidance for nurses around a number of important areas, including: • professional boundaries, to ensure nurses and the person receiving care and their nominated partners, family and friends, engage safely and effectively in professional relationships, including where care involves personal contact and/or emotional intimacy • to ensure honesty and transparency when advertising, representing yourself professionally, and when conducting legal, insurance and other assessments

• how to manage conflicts of interest, including issues related to financial arrangements and gifts, to ensure transparency and trust. The “teaching, supervising and assessing” principle sets out the expectations for nurses in relation to creating opportunities for nurses and nursing students to learn, and also expectations around performing honest, objective and fair assessments of colleagues and students. The final principle of the “act with professional integrity” domain is “research in health.” This principle outlines the additional responsibilities of nurses involved in the design, organisation, undertaking or reporting of health research. The NMBA encourages nurses to get to know their new code before it takes effect next year. Please view the Code of conduct for nurses in full on the NMBA website.

NurseClick November 2017  

NurseClick is the Australian College of Nursing's monthly e-zine focusing on topical articles.

NurseClick November 2017  

NurseClick is the Australian College of Nursing's monthly e-zine focusing on topical articles.