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Issue 11 03/06/13 fortnightly

Theatre & Critical Care Feature Improving resilience in OR nursing Forensic mental health staff trial aims to assist EDs Dietitians call for aged care malnutrition screening Nurses say no to violence


Work and play in beautiful Western Australia Live in a booming economy and reap the rewards! Have the sun and sea right on your doorstep Western Australia is home to plenty of extraordinary experiences, the likes of which can only be found right here. WA boasts the largest collection of wildflowers on the planet, some of the whitest beaches in the country and one of only a few places world-wide where you can swim with the ocean’s largest fish.

TR7 Health is leading the way in Health recruitment with quality, excellence and professionalism. We have developed strong and positive relationships within the industry and actively work to place hundreds of qualified nurses and healthcare professionals into hospitals and aged care facilities throughout Western Australia. Send us your resume today or for career/ market advice and information on living and working in Western Australia contact our specialist consultants today! PH: (08) 9218 1431 Email:pallan@tr7.com.au or visit us online at www.tr7.com.au www.ncah.com.au

We have current vacancies for Uˆ`܈Ûià U/…i>ÌÀiÊEÊ,iVœÛiÀÞÊ ÕÀÃià U}i`Ê >ÀiÊ ÕÀÃiÃÊ>˜`Ê>˜>}iÀà Ui˜Ì>Êi>Ì…Ê ÕÀÃià U-«iVˆ>ˆÃÌÊ ÕÀÃià Ui`ˆV>Ê>˜`Ê-ÕÀ}ˆV>Ê ÕÀÃià U Ê ÕÀÃià Uˆi`Êi>Ì…Ê Professionals


To see what we can offer you as a member of the Epworth team, please contact: Oncology

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22/05/13 10:21 AM Nursing Careers Allied Health - Issue 11 | Page 3


www.ncah.com.au )SSUEp*UNE We hope you enjoy perusing the range of opportunities included in Issue11, 2013.

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If you are interested in pursuing any of these opportunities, please contact the advertiser directly via the contact details provided. If you have any queries about our publication or if you would like to receive our publication, please email us at careers@ncah.com.au

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Total Audited Print and Digital Distribution: 28,090 The NCAH Magazine is the most widely distributed national nursing and allied health publication in Australia For all advertising and production enquiries please contact us on +61 (0) 3 9271 8700, email careers@ncah.com.au or visit www.ncah.com.au If you would like to change your mailing address, or be included on our distribution, please email careers@ncah.com.au

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Published by Seabreeze Communications Pty Ltd Trading as NCAH. ABN 29 071 328 053. Š 2013 Seabreeze Communications Pty Ltd. All rights reserved. No part of this publication may be copied or reproduced by any means without the prior written permission of the publisher. Compliance with the Trade Practices Act 1974 of advertisements contained in this publication is the responsibility of those who submit the advertisement for publication.

Oxford Aunts Care Pulse Staffing Quick and Easy Finance South West Healthcare TR7 Health University of New England

Next Publication: Mental Health feature Publication Date: Monday 17th June 2013 Colour Artwork Deadline: Tuesday 11th June 2013 Mono Artwork Deadline: Wednesday 12th June 2013

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NURSE UNIT MANAGER OPERATING SUITE An exciting opportunity exists for a dynamic, highly motivated experienced Registered Nurse to join our progressive middle management team. This exciting opportunity is seen as pivotal to the strategic direction and growth of the organisation’s Operating Suite services. We offer: s !MODERNFRIENDLYENVIRONMENTTHATENCOURAGESGROWTHAND professional development. s 3UPPORTOF ANDCOMPLIANCEWITH BESTPRACTICEGUIDELINES s &REEONSITEPARKING s 'ENEROUS3ALARY0ACKAGING s !CTIVEPARTICIPATIONINTHELEADERSHIPANDMANAGEMENTTEAM

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What I like about OUM is that I can continue to work part time and continue my studies in medicine. The ability to combine my studies with the cases I was seeing in the hospital really enhanced my education.    



Page 8 | www.ncah.com.au

RN to MBBS

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Nursing Careers Allied Health - Issue 11 | Page 9


PBS becomes a bitter pill for Medicines Australia by Karen Keast The Federal Government and Medicines Australia are at odds over the Pharmaceutical Benefits Scheme (PBS). Medicines Australia, which represents pharmaceutical companies, says patients are missing out on new medicines because the process of listing them on the PBS is too difficult. The organisation is calling on both sides of politics to fix deficiencies in the PBS system, claiming Australian patients are unable to access medicines, including melanoma and Pompe’s disease treatments already available overseas. Medicines Australia has also released a report on the impact of the 2010 PBS reforms, claiming the number of new medicines listed on the PBS in 2011-12 was the lowest in 20 years. In its Impact of Further PBS Reforms study, it found reforms to the PBS will deliver up to $18 billion in savings - which are not resulting in the funding of new medicines on the PBS. “That’s very alarming because it means many patients who need new treatments aren’t getting access to them,” Medicines Australia chief executive Dr Brendan Shaw said. “Consumers expect better than that. Australia should be a country that can afford new medicines for patients.” Health Minister Tanya Plibersek said the government’s own report, Trends In and Drivers of Pharmaceutical Benefits Scheme Expenditure, co-authored by Medicines Australia, found spending on the PBS increased by $500 million a year, reaching $8.9 billion in 2010-11, while 780 new listings and indications for existing PBS medicines have been added since 2007. “This new report confirms growth in PBS spending is lower than forecast, as taxpayers Page 10 | www.ncah.com.au

reap the benefits of 2010 legislation which is bringing government subsidies for medicines into line with prices pharmacists pay their suppliers, saving $2 billion over the forward estimates,” she said. “In its report last week, Medicines Australia chose to only identify drugs recommended for listing on the PBS for the first time, completely ignoring 85 new indications for treatment listed by the government in 2011-12.” Ms Plibersek said the ageing population and increased incidence of chronic disease were also putting upward pressure on PBS spending. Meanwhile, the Pharmacy Guild of Australia has welcomed the Medicines Australia report, and said its savings are likely to be understated because the report doesn’t consider the increasing number of prescriptions pharmacies dispense as private prescriptions, which reduces the costs to the government and consumers. “The report provides a further demonstration that price disclosure is achieving its desired objective of ensuring that the PBS is sustainable and provides value-for-money for taxpayers and consumers,” Pharmacy Guild executive director David Quilty said. “However, it is important that the very large savings from price disclosure do not undermine the viability of industry participants, including community pharmacy.” The Medicines Australia report coupled with Federal Budget expenditure downgrades indicate the need for increased dispensing remuneration in the next Community Pharmacy Agreement to offset the major impact of price disclosure, The Guild stated.


iPod the key to recovery for trauma patients? by Karen Keast A world first trial in Melbourne will see children and young adults recovering from trauma and severe injuries fitted with iPods to record their movements after leaving hospital. Patients from The Royal Childrenâ&#x20AC;&#x2122;s Hospital will wear the devices to randomly record their conversations, and monitor their activities, responses and interactions with others, with a view to enabling the healthcare professionals caring for them to effectively assess their recovery. The study is being undertaken by Dr Eva Alisic of Monash Injury Research Institute, a department of Melbourneâ&#x20AC;&#x2122;s Monash University established to prevent injury and save lives. It is being rolled out in collaboration with The Royal Childrenâ&#x20AC;&#x2122;s Hospital and the University of Arizona, and is designed to allow trauma doctors and psychologists to determine how children are coping by talking about their injuries. The trial will see the day to day lives of 100 victims aged three to 16 monitored in 30 second bites, which will be recorded an average of every five minutes. One 16-year-old patient who almost lost her life after being pinned under a four wheel drive, resulting in a broken leg, shattered pelvis and possible spinal and head trauma, reportedly said she felt reassured by the iPod while coming to terms with her ordeal and resulting injuries. Dr Alisic said the initiative would help provide an understanding of how much time patients were spending with family, to what extent they were talking about the trauma or incident and whether this was being conveyed in a positive or negative way.

CRITICAL CARE EDUCATION SERVICES Pty. Ltd. A.C.N. 078 182 975. A.B.N. 70 078 182 975. Email: info@criticalcare.edu.au Website: www.criticalcare.edu.au The â&#x20AC;&#x153;ALERTâ&#x20AC;? COURSE (TM) Acute Life-threatening Emergencies, Recognition & Treatment. Sydney: 12th & 13th July 2013. Perth: 26th & 27th July 2013. Brisbane: 13th & 14th Sept 2013. Adelaide: 26th & 27th September 2013. Newcastle: 29th & 30th Nov 2013. ANAESTHESIA & POST ANAESTHESIA CARE NURSING SEMINAR  Melbourne: 21st & 22nd June 2013. Brisbane: 19th & 20th July 2013. Perth: 6th & 7th September 2013. Sydney: 22nd & 23rd November 2013. Writing an article

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BASIC LIFE SUPPORT & ADVANCED Australian Family Physician (AFP) is a peer reviewed journal publis CARDIAC LIFE SUPPORT monthly by The Royal Australian College of General Practitioners Our readership includes grassroots general practitioners, general Melbourne: 25th & 26th October 2013. registrars, international medical graduates, primary care academi Sydney: 1st & 2nd November 2013.specialist physicians and medical students.

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For the full article visit NCAH.com.au Nursing Careers Allied Health - Issue 11 | Page 11

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Nurses central to treatment of sepsis in critical care by Karen Keast The role played by critical care nurses in early recognition of sepsis and timely, protocol-driven interventions has been highlighted by new international guidelines. Dr. Ruth Kleinpell and Dr. Christa Schorr presented on the implications of the guidelines at the American Association of Critical-Care Nurses (AACN) 2013 National Teaching Institute and Critical Care Exposition on 21 May. â&#x20AC;&#x153;Critical care nurses play an important role in identifying patients with sepsis and these guidelines reinforce certain management areas that nurses directly oversee,â&#x20AC;? Dr Kleinpell, PhD, RN, from Rush University, in Chicago, Illinois, told online journal articles aggregator Medscape Medical News. Part of the Surviving Sepsis Campaign, the new guidelines suggest the key management steps nurses must take within three hours of severe sepsis and six hours of initial signs and symptoms of septic shock. These differ from guidelines published in 2008 suggesting that nurses had a six hour and a 24 hour window to carry out protocol-defined steps. Under the new guidelines, within three hours of severe sepsis, nurses must complete a number of steps including:t .FBTVSFMBDUBUFMFWFM

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Page 12 | www.ncah.com.au

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American Association of Critical-Care Nurses Critical Care Exposition: Abstract C75M479.


ASSOCIATE UNIT MANAGER - ANAESTHETICS OPERATING THEATRE An opportunity exists for a highly motivated, skilled nurse to be part of a dynamic team in undertaking the full time role of Associate Unit Manager in Anaesthetics of the Operating Theatre at South West Health Care. This is an exciting leadership role within our busy Operating Suite. The successful applicant will have well developed competency and analytical skills in the clinical field and the ability to communicate and manage effectively at all levels. Warrnambool Campus

Ryot Street, Warrnambool 3280 of clinical standards The AUM is responsible for the promotion and maintenance www.southwesthealthcare.com.au in the Operating Theatre â&#x20AC;&#x201C; Anaesthetics to ensure the delivery of quality patient 2010 Regional Health Service of the Year care, cost effective management of service delivery and contributes to the overall management of the unit and deputises for the Nurse Unit Manager when required.

A position description and further details can be found at our website under Careers. For specific enquiries regarding the role, please contact Tony Kelly (Perioperative Services Manager) on (03) 5564 4131 or email tkelly@swh.net.au The successful applicant will be required to consent to and undergo a Police Record Check. Applications are to be submitted online via our website only under Careers and need to include: an application letter, full personal particulars, qualifications and experience; together with the names of three (3) referees by Friday 14 June 2013. Other documents you feel are relevant may also be attached: however this is limited to 5 documents and there is also a size limitation of no greater than 2 Mega Bytes. Note: If you experience any difficulties with this website or completing the application process, please send an email to: humanresources@swh.net.au Please note this address is for enquiries only and application cannot be submitted via this email. Warrnambool Campus Ryot Street, Warrnambool 3280 www.southwesthealthcare.com.au 2010 Regional Health Service of the Year

Nursing Careers Allied Health - Issue 11 | Page 13


Improving resilience in OR nursing by Karen Keast Resilience. It’s often described as the power within. But what forges resilience and how do you improve resilience in the demanding clinical environment of OR nursing? According to one researcher, the answer may lie in five main qualities.

the patient outcome. Nurses have to look after themselves.”

Dr Brigid Gillespie worked as a theatre nurse for 16 years.

Dr Gillespie says those stress factors have also impacted on the OR specialty, where nurses are continually challenged on a daily basis to provide safe and competent patient care.

She loved working in the operating room – with its unique set of factors that set it apart from every other field of nursing. “I just loved the challenge - every day was different in the OR,” she says. “There was a lot of routine but there were also a lot of challenges, you have got to think on your feet particularly when you have got trauma. “That’s probably why there’s a certain type of nurse who likes that environment.” In her time in the OR, Dr Gillespie watched nurses come and go, and was particularly intrigued by the nurses who “stuck it out”. “I wanted to figure out what it was about the nurses who did stick it out that I worked with,” she says. “They worked there for 30 or 40 years and would never work anywhere else.” Dr Gillespie eventually followed her curiosity into nursing research, and she is now a Senior Research Fellow at Griffith University’s NHMRC Centre for Research Excellence in Nursing (NCREN). In her research, Dr Gillespie has studied resilience; which is recognised as a vital attribute for nurses in demanding and volatile clinical environments such as ORs. “If nurses are not resilient themselves, it is hard for them to care for their patients,” she says. “In the worst case scenario, it can impact on Page 14 | www.ncah.com.au

Economic rationalism, increased workloads, changes in nursing education and the ageing of the nursing workforce have all contributed to greater levels of nursing stress.

And if nurses are unable to manage the contextual stressors associated with the OR, she says they are at greater risk of being unable to cope and as a result may leave the profession. Dr Gillespie studied a range of qualities and also how personal characteristics, including age, nursing experience and education contribute to resilience in OR nursing. More than 700 nurses were surveyed, who worked across public and private sector OR departments in rural and urban regions across all Australian states and territories, who were also members of the Australian College of Operating Room Nurses. Dr Gillespie’s research identified five qualities that contribute to resilience in OR nurses – hope, self-efficacy, coping, control and competence. And it found age, nursing experience, education and years of employment did not influence resilience in OR nurses. Dr Gillespie says while there are likely to be other contributing qualities that remain unexplained, she says hope and self-efficacy were found to be the main contributors to resilience – affecting how nurses perform in the OR environment. “For OR nurses, it’s building up their competence and building your self-efficacy, building your clinical skills, that way you are able to move


across more specialties – orthopaedics, vascular, eyes, ENT, cardiac – you are going to feel more confident in your ability to do your job.” Dr Gillespie wants to see strategies implemented that promote the five behaviours in a bid to retain nurses in the OR specialty, from educational programs that improve knowledge and skills to stress management programs centred on teaching coping strategies. Importantly, Dr Gillespie says nurses can also improve their resilience in the OR through selfcare and reflective practice. “I think, if we know from experience that there are certain situations at work that make you feel inadequate and uneasy and you know you don’t cope as well…it’s about reflecting on your practice and being aware of your own limitations,” she says. “I think it’s being in touch and knowing the things that trigger anxiety in an individual in a work situation – and it’s about finding a mentor. “Whether you are a newly graduated nurse or a seasoned nurse, even having someone to talk

to and to debrief - what you did, what you can improve on, it helps to build self-efficacy, the way you cope and your competence.” Dr Gillespie says nurses should also tap into employee assistance programs, from counselling services to exercise programs. “Look after yourself first and have some insight into the things that make you feel stressed in the workplace and how can you deal with that,” she says. “Know what works for you - it’s different for everyone.” Dr Gillespie says while more research is needed in the field the findings are a good starting point for improving nursing retention in the OR specialty. “One of the main things is nursing retention,” she says. “We are churning young graduates out now from universities all around Australia and we hope they will be able to get a job. “Jobs are getting scarce, even in nursing. For those that do get jobs, we want them to stay in nursing, we don’t want them to burn out.” Nursing Careers Allied Health - Issue 11 | Page 15


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Nursing Careers Allied Health - Issue 11 | Page 17


Forensic mental health staff trial aims to assist EDs by Karen Keast South Australia will trial a plan to employ forensic mental health staff to better manage people in the state’s court system, in a move designed to alleviate demand on public hospital emergency departments. The 12-month pilot project, which has been based on the introduction of Court Liaison Services in many states across Australia, and in New Zealand and the United Kingdom, will begin in July. The Australian Nursing and Midwifery Federation SA branch applauded the move but raised concerns about a severe lack of forensic mental health beds to meet demand. ANMF SA branch secretary Adj Associate Professor Elizabeth Dabars said if no forensic mental health beds were available, forensic mental health patients will still have to be housed in EDs. Adj Assoc Professor Dabars said it was unacceptable to leave forensic consumers in EDs when they do not require health care or for periods of more than four hours. “We are aware of instances of these consumers being accommodated in the emergency department for up to eight days,” she said. “It is not appropriate to accommodate them in a busy emergency department, and it is unreasonable for other patients attending

Page 18 | www.ncah.com.au

the emergency department with a medical emergency or condition requiring assessment and treatment.” Under the trial, two forensic mental health staff will provide advice to the courts on the appropriate assessment, treatment and management of forensic mental health consumers. The role will include providing advice about the relationship between mental illness, crime and violence, and the staff will also act as a liaison between the consultant and the courts, the Corrections Department, police and other agencies. Health Minister Jack Snelling, who announced the initiative, said the number of people using mental impairment as a defence has risen from 92 people in 2006 to 278. “This has resulted in an increase in the court directing people to a specialist forensic bed or to a secure hospital ED bed, which puts additional pressure on our public health system,” he said. “Not all of the people who are directed to a forensic bed under this section of the (Criminal Law Consolidation) Act require a forensic or secure bed. “Under the pilot, experienced staff will be able to work with the courts to refer those people to other, more appropriate mental health treatment services and support.”


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Nurses answer the call of telephone triage by Karen Keast Sabrina Ellis is a triage nurse but she can’t actually see her patients. Instead, the Victorian-based nurse is one of the 300 nurses providing vital assistance over the phone through her work for a 24-hour health advice phone line. “I am a triage nurse at the front desk at the emergency department but imagine a big curtain between me and the patient,” she says.

At the service, nurses are available day and night to speak to callers with any health concerns or queries. Nurses provide information to assist with their condition at home or refer people to a local face-to-face primary health service or in an emergency they transfer them to Triple Zero. The service enables people to access immediate clinical advice and source specific and clinically accurate health information for an issue that may not need a medical consultation.

“It’s exactly the same service, the same

The Victorian telephone advice line made

questions and the same things I am going to

headlines

be determining but I just can’t see the patient.

suffered a brain haemorrhage after playing a

“When you are looking at them face to face you

Melbourne concert.

can make that decision and assessment but

The Seekers star’s manager called Nurse on

this is definitely relying on what the patients are

Call before rushing the singer and musician to

telling you rather than what you are seeing.

an emergency department.

“It’s trying to get a mental picture of the

Concerns about colds, fevers, coughs, vomiting

situation.”

through to chest pains and complications

The former emergency department nurse is one of a growing number of nurses leaving behind the clinical environment to work for government-provided telephone advice lines. In Victoria, the service is called Nurse on Call but the phone advice service is also provided across New South Wales, the ACT, Northern Territory,

South

Australia,

Tasmania

and

Western Australia under healthdirect Australia.

recently

when

Judith

Durham

from surgery are all part of the work, with the telephone advice service fielding calls about newborns through to those about older residents. For Sabrina, a nurse of 10 years, who has been working for Nurse on Call for two years, the opportunity for flexible shift work suited her family’s needs. Sabrina, who has worked in emergency departments in the United Kingdom, as well

To work for the telephone nurse triage service,

as at Dandenong Hospital and the Monash

registered nurses must have unconditional

Medical Centre, says being able to select Friday,

registration with AHPRA and three years’ full-

Saturday and Sunday night shifts enabled her

time equivalent experience and evidence of

husband to take care of their two-year-old child

recency.

while she worked.

Page 20 | www.ncah.com.au


What’s more, Sabrina can choose to field the constant calls, on average between 35 to 50 calls in a shift, either from her home office or from a work office. “It really works very well for our family. Flexible hours just don’t exist for the average nurse in a hospital setting and working from home is a massive bonus,” she says. “There’s no commuting, no travel time or cost.” Sabrina says the advice line’s nurses are able to communicate with each other through instant messenger during shifts, and she can access the office for support and to meet with team leaders. And she says there is also room for career progression, with telephone advice lines also employing the equivalent of clinical nurse specialists and nurse educators. “I am loving it. I don’t have any plans to go anywhere at all,” she says. Nursing Careers Allied Health - Issue 11 | Page 21


Nurses say no to violence by Karen Keast Nurse ‘Jackie’ has been threatened by patients, who have also threatened to hunt down her family.

“If this was happening at Spring Street or any other workplace something would be urgently done about it.”

Jackie has become the face of the new Australian Nursing Federation Victorian branch campaign calling on the State Government to enforce its $21 million pre-election promise to make hospitals safer.

The ‘Say No to Violence’ campaign calls on the government to implement the 39 recommendations outlined by the Drugs and Crime Prevention Committee’s Inquiry into Violence and Security Arrangements in Victorian Hospitals.

With being punched, hit, pushed, kicked, bitten or threatened with a weapon while caring for patients all common occurrences in emergency departments and wards, Victorian nurses and midwives fed up with these incidents of workplace violence are taking a stand. There have been two dozen reported attacks on nurses in the past four months in Victoria, and the union expects the tally is actually much higher, with many attacks often going unreported. ANF Vic branch secretary Lisa Fitzpatrick said the health system was continuing to accept the unacceptable. “Regional and metropolitan nurses and midwives more often than not are left to fend for themselves, sometimes in extremely dangerous situations, they feel abandoned by those with the power to stop the violence and they feel betrayed when they are reprimanded for responding to the situation by calling for security or calling the police,” she said in a statement. “When nothing happens when a nurse is hit by a relative because his mother’s wait in emergency is too long, when a midwife is threatened by the former partner of a mother who has just given birth, when a nurse is chastised for calling the police when a patient with a severe head injury threatens to throw a heavy metal canister at her, when a nurse is grabbed by the throat of a dying patient with a brain tumour - they believe our politicians don’t care. Page 22 | www.ncah.com.au

The recommendations include implementing standardised Code Grey (unarmed threat or aggressive behaviour that threatens injury) and Code Black (armed threat using a weapon or where there is a serious threat) response. It also calls for the establishment of an aggression management reference group to coordinate and implement policies and procedures to manage aggressive incidents, and adequate security measures, including response by staff trained in the prevention and management of violence and aggression, in all high-risk departments. The measures include annual education and training for nurses to prevent and manage violence and bullying with additional specific training for staff working in high-risk areas, and dedicated around-the-clock security personnel in all major emergency departments. The union placed open letters in Victoria’s major metropolitan newspapers and asked for the public to rally to support nurses and midwives by signing a new online petition. The union is also encouraging nurses and midwives to formally report all incidents of violence and aggression and to seek the advice and support of the ANF, which has an online form making it easier for nurses and midwives to report incidents.


Nursing Careers Allied Health www.ncah.com.au

Please contribute to the discussion about violence against nurses in the workplace by completing the

Violence at work survey Go to www.ncahSURVEY.com The survey should take no more than 5 minutes to complete.

Nursing Careers Allied Health - Issue 11 | Page 23


Home nursing – a new career horizon by Karen Keast Home nursing is dusting off its oldfashioned image to showcase itself as a diverse, modern career that embraces cutting-edge technology and offers a wealth of job opportunities. Home nursing is proving to be a new career frontier for nurses. Home nursing, where health care is provided in the home environment, has come of age – not only providing nurses with a varied, challenging and rewarding career but one which is also focused on the future to meet increasing demands. Australia’s population is rapidly ageing. Government statistics forecast the number of Australians aged over 65 is set to double to almost seven million people in the next 30 years. With a public health system already under stress, the government has turned its focus to a raft of health reforms, including more home care packages, aimed at keeping people living in their homes for longer. And that’s where community nurses such as Kirsty LeGassick and Kosta Michalopoulos come in. Kirsty, 38, was working as an EN in a Victorian hospital and studying to become an RN at university when she knew she needed a change of scenery.

“I thought - that’s definitely for me, working out on the road in people’s homes,” she says. Fast-forward two years, and Kirsty now works three days a week as a grade two district nurse for RDNS, which employs more than 1200 registered nurses. Kirsty covers a large geographical area within the Yarra Ranges and visits between 10 and 15 people in a shift, with time allocated for travel. Her clients range from people with dementia needing assistance with their medicine to people who have suffered strokes, people with wounds, those recovering from surgery and those with cancer. “Home nursing is providing holistic care to a person in their home with a goal of keeping them in the home and working with them as a team,” she says. “It’s diverse. A lot of people think when you do RDNS it’s just wound care but it’s not, we do everything. “I love that you might be going there for one thing and you then can really make a difference to a person’s life by picking up on other things – they might need help with a wound or you realise they are not having much support with meals so you can help them out by referring them to Meals on Wheels. “It’s not just one part of nursing, it’s holistic and that’s what I really love.”

The mother-of-two routinely came across patients who accessed Australia’s largest provider of home nursing services, the Royal District Nursing Service (RDNS).

Kirsty’s car is her office. She carries her computer and phone with her in what is mostly an autonomous role but where she can tap into RDNS support when required.

Kirsty also visited a nursing and health expo where she spoke with RDNS nurses and spent her final university placement at the RDNS Knox site, when she realised she had found her new calling – to home nursing.

She says working on a variety of sites also poses its own challenges, from “not always having everything at your fingertips” to occupational, health and safety issues ranging from clients’ dogs to slippery surfaces.

Page 24 | www.ncah.com.au


The move towards virtual nursing not only eliminates the need for RDNS nurses to travel, requiring less time on the road, it also provides nurses with additional time to care for more clients.

“I think people are afraid they are going to come to community nursing and not use their skills,” she says. “I think it’s the opposite – you have got to use your skills more and you are working in an everchanging environment and nothing is ever going to be the same twice. “You have really got to think quick on your feet.” The home environment can also pose challenges for the patient, which Kirsty can assess and address. “Every environment is different and challenging. I have one client who chooses to live with no electricity and water in his house and he’s 90,” she says. “I love going there. He has so many wonderful stories. You can really build up great relationships with your clients and just learn so much about people. “You really see what they are like in their own home and you get a full picture.” As home nursing faces an ever-increasing demand, the sector is also embracing and even pioneering cutting-edge technology. RDNS has been trialling an innovative telehealth project aimed at connecting clients with nurses at its customer service centre at Camberwell, for medication management. Clients use a remote broadband monitoring system, featuring a purpose-built hand-held device with a large video conferencing touch screen.

Home nursing also offers a variety of career opportunities, enabling nurses to specialise in areas such as wound management, Diabetes, palliative care, medication administration, selfmanagement and dementia. Kosta is another district nurse who loves home nursing. The 35-year-old was a surgical nurse in Greece who moved to Australia in 2002. When his qualification wasn’t recognised in Australia, he worked as a carer in a nursing home and also studied full-time before deciding to venture into home nursing with RDNS almost two years ago. “Because I had been working in aged care in nursing homes, I realised the importance of being able to keep the client home as long as possible,” he says. “I wanted to work in community nursing and make a difference that way.” Kosta says he thrives on being able to build long-term, professional relationships with clients and their families. “You are able to see the difference you make in the clients’ lives and you work around the clients’ needs with a holistic approach,” he says. “I really love working with the veterans; we have lots of veterans that we look after, and we have discussions about the war – it’s amazing, the stories people have.” Kosta says home nursing does have its challenges. For the full article visit NCAH.com.au Nursing Careers Allied Health - Issue 11 | Page 25


Dietitians call for aged care malnutrition screening by Karen Keast A Canberra dietitian wants mandatory malnutrition screening introduced for aged care residents after her research found one in five ACT aged care residents are malnourished. Jane Kellett, an APD and lecturer in Nutrition and Dietetics at the University of Canberra, assessed 100 people living across five residential aged care facilities last year and found 22 per cent were moderately or severely malnourished. Ms Kellett, who presented her research at the recent Dietitians Association of Australia’s National Conference in Canberra, said malnutrition screening was a quick, simple and validated tool that could catch malnutrition in its early stages and prevent malnutrition in people at risk. “People think it (malnutrition) is a part of ageing but it’s not. It’s a separate thing and it’s not a part of ageing,” she said. “Older adults are nutritionally vulnerable and we need to make sure there’s early recognition.” Ms Kellett said while the nation focused on overweight and obesity issues there had been little attention paid to malnutrition, which is rife across all states of Australia. She said there is ample research on malnutrition in hospitals but there was little data to prove malnutrition was occurring in aged care facilities. With government statistics forecasting the number of Australians aged over 65 is set to double to almost 7 million people in the next 30 years, Ms Kellett said it was more important than ever to address the debilitating health condition placing strain on our hospital system. “We know that when people are malnourished they are more likely to be hospitalised and have longer recovery times,” she said. Page 26 | www.ncah.com.au

“It would be a really cost-effective measure to implement mandatory screening.” Ms Kellett said residents found to be at risk or malnourished could then be referred to an APD who could provide a nutrition assessment and implement an appropriate strategy to reverse or treat the condition. “It’s really simple to fix,” she said. “It would be great if we could have mandatory malnutrition screening as part of national aged care standards. “Older adults are nutritionally vulnerable and we need to make sure there’s early recognition.” DAA CEO Claire Hewat said with more than 230,000 Australians now in permanent residential aged care it was vital the government act now. “If the government is serious about the health and well-being of our older generation – and keeping money in taxpayer wallets, a national program for screening, assessing and treating this preventable health problem is a must,” she said.


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Nursing Careers Allied Health - Issue 11 | Page 27


New Zealand pharmacist jailed by Karen Keast An Auckland pharmacist has been jailed for selling unapproved prescription medicines for the treatment of male sexual dysfunction. Fadi Iskander, 32, was convicted in a hearing at the Auckland District Court and sentenced to four months and two weeks in prison for breaching the Medicines Act 1981. Iskander was convicted on 47 of the 49 charges laid by the Ministry of Health in relation to offences which took place before June 2010, when Iskander was advertising and selling products online which were manufactured without approval. The products contained erectile dysfunction medicines Vardenafil or Phentolamine, which were represented as herbal despite containing prescription medicines as active ingredients. He was also found to have possessed medicines at two addresses without a reasonable excuse. In a statement, the Ministry of Health said Iskander was conducting the website business separately to a pharmacy which went into receivership in February 2010, and the Pharmacy Council has since suspended Iskander’s pharmacy practising certificate.

Page 28 | www.ncah.com.au

Iskander was convicted on 20 charges of selling a new medicine without the consent of the Minister of Health, 15 charges relating to the storage and possession of prescription medicines without reasonable excuse and three charges of having medicines not in a proper container. He was also convicted on three charges of advertising new medicines without the consent of the Minister of Health, three charges of packing or labelling a medicine without a licence, two charges of selling medicines with misleading labelling and one charge of manufacturing a medicine without a licence. The Ministry said the supply of unapproved prescription medicines outside the regulatory system put the health of the public at risk. “Prescription medicines were made available to the public unsupervised by a doctor with no consideration as to their safety and suitability for the consumer,” the Ministry stated. “Prescription medicines are potent substances used for treating patients with conditions that require thorough and effective diagnosis by a medical professional.” The products sold went under various versions of the trade name Exotic.


Global platform for nurse leadership by Karen Keast Nurse leadership was firmly in the spotlight at the International Council of Nurses’ (ICN) 25th Quadrennial Congress recently held in Australia. About 5000 nurses from across the globe converged on Melbourne for the May 18-23 event where the development of nurse leaders was showcased as being integral to enhancing the nursing profession and health care the world over. And the leadership torch of the ICN, which oversees the federation of more than 130 national nurses associations and represents more than 13 million nurses across the globe, was passed from outgoing president and Australia’s own chief nurse Dr Rosemary Bryant to newly announced president, Canadian Judith Shamain. Leadership was one of the common threads throughout the congress, which focused on the theme ‘equity and access to healthcare’, with the event inspiring nurse leaders to think beyond their boundaries to issues of gender equity and the global epidemic of non-communicable diseases. The Australian College of Nursing and Australian Nursing Federation hosted the congress, last held in Australia more than 50 years ago, providing a global platform for Australian and international nursing leaders to gain access to nursing innovation, new nursing roles and cutting edge research. ACN executive manager member relations Kathleen McLaughlin said the college was proud to have worked with the ICN to host the event. “Protecting and promoting health is an international endeavour, and nursing must continue to have a strong and visible role,” she said. “Australian College of Nursing, in conjunction with ICN, is committed to supporting nurses demonstrate their contributions to the health of individuals, families and communities.

International nursing delegates with the Australian College of Nursing Koala and Kangaroo

“All of those present at the congress know how important nurses are to providing health access to the most disadvantaged.” ANF federal secretary Lee Thomas said the event was an opportunity to share the benefits of advances in nursing methodology and new technology while also highlighting areas of concern. “The ICN conference provides a great opportunity to raise and discuss the issues and challenges faced by Australia’s nursing workforce and show why nurses must be at the centre (of) the delivery of safe patient care across the country’s health and aged care sectors.” Highlights of the event included the Virginia Henderson lecture by Anne Rafferty, the Florence Nightingale luncheon which raised $20,000 for the Girl Child Education Fund, which supports the orphaned daughters of nurses in four countries in sub-Saharan Africa, and the presentation of nursing’s most prestigious international award, the Christiane Reimann prize, which was awarded to Danish nurse and former ICN president Kirsten Stallknecht. South Korea will host the ICN’s next congress in Seoul from June 19-23, 2015, and Barcelona has been announced as the site for the 2017 congress. Photo credit: Keren Nicholson, Australian College of Nursing.

Nursing Careers Allied Health - Issue 11 | Page 29


Page 30 | www.ncah.com.au


Nursing Careers Allied Health - Issue 11


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Ncah issue 11 2013