Issue 13 02/07/12 fortnightly
Midwifery Feature Midwives push for home-birthing choice, by Karen Keast Cameron cares for paediatric nursing Tasmanian nurses fly interstate for work Physiotherapist thrives on working with older people
Visited by more nurses, midwives and AHPs than any other health website
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Midwifery Opportunities within Sydney Local Health District SLHD provides maternity services at two hospitals within the central Sydney Metropolitan area. Canterbury Hospital births 1800 babies each year and offers care to women with low to moderate risk pregnancies. Services include midwifery group practice (caseload), Antenatal Clinics, Delivery Ward, Postnatal Inpatient ward and midwifery home visiting. RPA has over 5000 births each year and offers both a low risk service for local families and high risk services which manage complex pregnancies by referral locally and from across the state. Midwifery opportunities at RPA include working in Antenatal, Delivery, Postnatal and Neonatal Intensive Care Areas – either as a specialty placement or as a supported rotation across a number of specialty areas. Limited opportunities are also currently available within our Fertility Unit providing services to couples requiring assisted reproduction services. RPA has midwifery led models of care including a well-established Birth Centre and developing midwifery group practice model. If you are looking for short term or long term opportunities to build your skills, share your passion for woman-centred care and work with a dynamic team centrally located in Australia’s premier city call Karen Redrup, Clinical Manager, Women’s Health Neonatology and Paediatrics, SLHD on 9515 8416.
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Funded by the Australian Government Nursing Careers Allied Health - Issue 13 | Page 3
www.ncah.com.au Issue 13 2 July 2012 We hope you enjoy perusing the range of opportunities included in Issue 13, 2012. 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 firstname.lastname@example.org “FACT, NOT FICTION” The NCAH Magazine distribution is independently audited by the Circulations Audit Board. Total Audited Print and Digital Distribution: 24,823 The NCAH Magazine is the most widely distributed national nursing and allied health publication in Australia Next Publication: Publication Date: Monday 16 July 2012 Colour Artwork Deadline: Monday 9 July 2012 Mono Artwork Deadline: Wednesday 11 July 2012 For all advertising and production enquiries please contact us on +61 (0) 3 9271 8700, email email@example.com or visit www.ncah.com.au If you would like to change your mailing address, or be included on our distribution, please email firstname.lastname@example.org
Published by Seabreeze Communications Pty Ltd Trading as NCAH. ABN 29 071 328 053. © 2012 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.
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Advertiser List AHN Recruitment Alliance Health Services Group Ambulance Service of NSW Australia and NZ Mental Health Association Australian College of Midwives CCM Recruitment CQ Nurse Employment Office Geneva Health Health Recruitment Specialists Katherine Regional Aboriginal Health Service Lifescreen Medacs Australia Mercy Health & Aged Care Central QLD. NSW Health Illawarra Shoalhaven Local Health District NSW Health Mid North Coast Local Health District NSW Health Southern Health Reform Transitional Office Nursing and Allied Health Rural Locum Scheme Oceania University of Medicine Oxford Aunts Care Quick and Easy Finance Ramsay Figtree Private Hospital Ramsay Greenslopes Private Hospital Remote Area Health Corps Royal Prince Alfred Hospital Southwest Healthcare Warrnambool Western NSW Local Health District
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Nursing Careers Allied Health - Issue 13 | Page 5
Debby’s career takes off After 26 years of working in hospitals, Debby Jones needed a change. Flicking through a copy of Nursing Careers Allied Health magazine one morning, Debby found just what she was looking for. An advertisement for a flight nurse with NSW Air Ambulance set Debby on an unexpected and exciting new career path. Debby is one of 32 flight nurses in NSW responsible for transporting rural and regional patients by air to metropolitan and tertiary centres. Last year, Air Ambulance carried more than 5000 patients, flying nearly 2500 missions for 6500 hours from Melbourne to Brisbane and from the Darling River to Lord Howe Island. As a registered midwife, Debby loves the variety that comes with her job including looking after mothers antenatally, during labour and post partum. “The ideal is not to have a delivery and we try to make it work that way but it doesn’t always happen,” she said. Earlier this year, Debby helped a woman deliver her baby in a rural airport car park unable to reach the nearest hospital in time. “The weather was shocking and she was having contractions every minute. We got her off the plane and into an ambulance but she was fully dilated,” she said. Among her list of memorable jobs include the delivery of a breech baby 10,000 feet in the air between Walgett and Dubbo and the delivery of a 27-week-old baby in a rural hospital. With no midwifery equipment on site, Debby used bed lamps, an oven bag, foil, bunny rugs and a hair dryer to keep the premature baby warm until neonatal transport arrived. Page 6 | www.ncah.com.au
Flight nurses are registered nurses and registered midwives with experience in critical care specialities such as emergency, intensive or coronary care. Debby says flight nurses are trained in emergency deliveries and are unfazed by whatever the job throws at them. “It can be a tricky job and you can have nasty things happen but if things do go wrong we’re qualified and trained for those things,” she said. The medical equipment onboard is identical to devices found in a hospital, just on a smaller scale that is suitable for air travel. With only a pilot to accompany them, flight nurses are solely responsible for the care of the patients they transport, an aspect of the job Debby finds most rewarding. “The time that I’m with them, they almost get everything but their fingernails done for them,” she said. “I love the job, I get more time with the patients and I go home satisfied and that is all because of the care I am able to give.”
Flight Nu rse Air Ambu lan Sydney Do ce Base mestic Air Permanen port, Masc t Full Tim ot e
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Nursing Careers Allied Health - Issue 13 | Page 7 20/01/2012 12:34:43 PM
NURSE UNIT MANAGER INTENSIVE CARE/CRITICAL CARE UNIT Applications are invited from suitably qualified/experienced Registered Nurses for the Nurse Unit Manager role in the Intensive Care/Critical Care Unit at our Warrnambool Base Hospital site. This 165 bed hospital has recently completed a $115m redevelopment which included a state of the art, 6 bed (with room for expansion) Intensive/ Critical Care Unit The Nurse Unit Manager (NUM) is responsible for the effective and efficient management of the human, physical and financial resources within the Unit. The NUM actively leads the ICU/CCU team in a consultative and participative manner ensuring well planned and coordinated services to clients and their families and providing clinical leadership to foster patient focused and outcome directed nursing care. Further information is available from Sue Morrison (Director of Nursing) on telephone 03 5563 1435 or via email Warrnambool Campus email@example.com Ryot Street, Warrnambool 3280 Applications are to be submitted online via our website under careers and need to include: full personal particulars, www.southwesthealthcare.com.au qualifications and experience; together with the names of two (2) referees by Tuesday 31 July 2012. 2010 Regional Health Service of the Year Warrnambool Campus Ryot Street, Warrnambool 3280 www.southwesthealthcare.com.au 2010 Regional Health Service of the Year
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Allied Health Subacute Manager • Senior management role • Shepparton based • Attractive salary package
An exciting opportunity exists for an allied health professional to join an innovative and dynamic team at Goulburn Valley Health, Shepparton. The Allied Health Clinical Lead – Subacute Programs, is a full time position and will provide clinical leadership and program coordination in the subacute service area to ensure safe, effective and high quality allied health is provided across the subacute programs at Goulburn Valley Health. As an AHPRA registered and/or accredited allied health professional, your extensive clinical knowledge in the area of subacute service delivery, and management and leadership experience in the health sector, will be supported by excellent
interpersonal and communication skills. In this role, you will work collaboratively with inter-professional teams and have well developed skills and experience in applying evidence base approaches to subacute service development for allied health. A competitive remuneration package is being offered to attract the highest calibre applicant. You can obtain further details from our website at:
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Olivia’s holistic cancer centre opens its doors by Karen Keast The first patients are about to begin walking through the doors of Melbourne’s outstanding $189 million Olivia Newton-John Cancer and Wellness Centre.
vaccines and treatments for all types of cancer and will become home to the largest clinical research site of the internationally-renowned Ludwig Institute world-wide.
The world-class facility, which is attached to the Austin Hospital in Heidelberg, will open the doors to three of its seven levels on July 2.
In officially opening the centre, Ms Newton-John said she decided to lend her name to the initiative knowing it would offer wellness programs and an integrated wellness centre, something that was missing when she fought her own battle against breast cancer 20 years ago.
The centre will offer radiation, day oncology and one floor of research along with a drop-in service and group programs such as Look Good Feel Better, individual consultations, mediation, relaxation, music and arts therapy. Inpatient wards and a palliative care unit are due to open in mid-2013, and once fully complete the centre will include 64 oncology and haematology in-patient beds and 28 palliative care beds. The centre will also boast dedicated research into
“From my own experience I know what a gap there was in the delivery of truly holistic cancer care and how much there was a need for a cancer centre and philosophy that gives equal support to patients’ well-being as it does to surgery, chemotherapy, radiotherapy and research,” she said. For the full article visit NCAH.com.au Nursing Careers Allied Health - Issue 13 | Page 11
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Call for Abstracts Now Open. Visit the Symposium website for full details.
Australian Rural & Remote 4 Mental Health Symposium th
You are invited to join us at the 4th Australian Rural and Remote Mental Health Symposium in Adelaide, when we will explore National and State initiatives and programs that address peoples’ needs, now and in the future. The program will include a diverse range of presenters including some of Australia’s leading academics and clinicians. You will experience a broad range of presenters who will report how their programs are “Putting People First” and what their research indicates for the future.
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Registered Midwife Permanent Full and Part Time positions available Port Macquarie Base Hospital
Australian Rural & Remote Mental Health Symposium
We are seeking experienced and enthusiastic Midwives to join our team at Port Macquarie Base Hosp Port Macquarie is the major metropolitan hub of the Hastings Macleay region located on the scenic mi coast of New South Wales where the Hastings River meets the Pacific Ocean, and is an easy four ho drive north of Sydney.
The area is a paradise for those who love the outdoors. You name it, it's right here at your door; from kayaking and surfing, to paragliding, bushwalking in nearby national parks, deep sea fishing, whale w and stunning coastal walks. Port Macquarie also boasts a vibrant CBD with an exciting variety of shop cafes, restaurants and pubs. Within an easy commuting distance from Port Macquarie are a number of idyllic villages, from coastal to rural hamlets. Affordable housing, excellent education and recreation facilities, combined with all th benefits of a healthy lifestyle make this region one of the fastest growing in the State. With 161 beds and four theatres, Port Macquarie Base Hospital provides 24 hour Emergency Service Critical Care, Obstetrics/Gynaecology, Medicine, General and Vascular Surgery, Orthopaedic Surgery
Ophthalmology, Gastroenterology, Pediatric Care and Mental Health Services to the people of the surrounding areas.
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If you have demonstrated experience, knowledge and competency in midwifery along with recent birth experience and would like to know more, please contact: Sandra Eadie (Maternity Unit Manager) 02 55242403
RegisteredMidwife Midwife Registered Permanent Fulland andPart PartTime Timepositions positionsavailable available Permanent Full Port Macquarie MacquarieBase BaseHospital Hospital Port
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The name it, it, itâ€™sit's right The area areaisisaaparadise paradisefor forthose thosewho wholove lovethe theoutdoors. outdoors.You You name right here at yo here at your door; from sailing, kayaking and surfing, to paragliding, bushwalking kayaking and surfing, to paragliding, bushwalking in nearby national parks, deep sea fish in nearby national parks, deepPort seaMacquarie fishing, whale stunning and stunning coastal walks. alsowatching boasts aand vibrant CBD coastal with an exciting v walks. Port Macquarie also boasts a vibrant CBD with an exciting variety of cafes, restaurants and pubs. shops, cafes, restaurants and pubs. Withinan aneasy easycommuting commutingdistance distancefrom fromPort PortMacquarie Macquarieare area anumber numberofof idyllic villages Within idyllic to rural hamlets. Affordable housing, excellent education and recreation facilities, comb villages, from coastal towns to rural hamlets. Affordable housing, excellent benefits of a healthy lifestyle make this region one of the fastest growing in the State. education and recreation facilities, combined with all the benefits of a healthy lifestyle make this region one of the fastest growing in the State. With 161 beds and four theatres, Port Macquarie Base Hospital provides 24 hour Emerg With 161Care, bedsObstetrics/Gynaecology, and four theatres, Port Macquarie Hospital provides 24 Critical Medicine,Base General and Vascular Surgery, Orthop hour Emergency Services, Critical Care, Obstetrics/Gynaecology, Medicine, Ophthalmology, Gastroenterology, Pediatric Care and Mental Health Services to the peo General and Vascular surrounding areas. Surgery, Orthopaedic Surgery, ENT, Ophthalmology, Gastroenterology, Pediatric Care and Mental Health Services to the people of the If you have demonstrated experience, knowledge and competency in midwifery along w surrounding areas. experience and would like to know more, please and contact: If you have demonstrated experience, knowledge competency in midwifery Sandra Eadie (Maternity Manager) 02 55242403 along with recent birthing experience and would like Unit to know more, please contact:
Sandra Eadie (Maternity Unit Manager) 02 55242403
Nursing Careers Allied Health - Issue 13 | Page 13
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www.ramsayjobs.com.au Nursing Careers Allied Health - Issue 13 | Page 15
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MIDWIVES! WE WANT YOU! The Mater Hospitals in Mackay and Gladstone, operated by Mercy Health and Aged Care Central Queensland Limited, are seeking Registered Midwives in these rapidly growing areas of Queensland. MATER MISERICORDIAE HOSPITAL – MACKAY & GLADSTONE Registered Nurse/ Midwife: provides family-centred nursing care in collaboration with other health professionals and significant other to ensure safe, efficient and effective management of the patient. You must be both a Registered Nurse and Registered Midwife to apply for this role. Terms: Hours and employment terms are fully negotiable with full-time, part-time and casual positions available that attract a base hourly rate range of $28.61 to $36.76 ($35.19 - $45.22 casual) dependant on comparable prior service + superannuation and penalties. Enquiries: Apply and/or gain more information about these positions at www.mercycq.com/jobs where the positions are listed under available positions. Alternatively, contact the Human Resources Department, on (07) 4931 7478 during business hours or email email@example.com “we are an equal opportunity employer”
Nursing Careers Allied Health - Issue 13 | Page 17
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Midwives push for homebirthing choice And she’s concerned if Australia reacts to recent negative publicity surrounding homebirthing, the consequences could be dire, including potentially pushing more women into the underground freebirthing movement. The pressing issue confronting Australia’s privately practising midwives is one of insurance. Since the collapse of HIH in 2001, no insurance has been available for privately practising midwives providing homebirthing services.
Homebirthing continues to be a contentious issue in Australia. The death of a renowned Victorian homebirthing advocate and the deaths of three homebirthed babies in South Australia have left homebirthing supporters reeling. Now Australia’s privately practising midwives face yet another homebirthing hurdle but they are rallying in a bid to give women a choice on where and how they give birth, writes Karen Keast. Hannah Dahlen finds the negative media headlines surrounding homebirths frustrating. The Australian College of Midwives spokesperson, University of Western Sydney Associate Professor of Midwifery and privately practising midwife is a renowned, vocal advocator of homebirths. Dr Dahlen says homebirths are safe for low risk women with a competent registered midwife, well networked into a responsive health service and she believes women with high risk factors should give birth in hospital. But Dr Dahlen, who has spent more than 20 years working in high risk delivery wards in major hospitals, fears homebirthing in Australia is under threat. Page 20 | www.ncah.com.au
Now under national law, Australian midwives can practise in a range of settings, including homes, as long as specific registration conditions are met. Without commercial professional indemnity insurance, the Commonwealth, states and territories have moved to provide privately practising midwives with an exemption from the requirement to hold professional indemnity insurance for providing intrapartum homebirthing services until July 1, 2013. Australia’s health ministers will meet in August to discuss the issue and while the deadline is a year away, Dr Dahlen fears if a solution is not found soon, the uncertainty will affect women falling pregnant as soon as September. “It’s a looming crisis,” she says. “The crucial issue is as of June 30, 2013, if insurance is not found for midwives… homebirthing could become an illegalised practice.” Homebirthing has recently faced a torrent of negative publicity. The issue made headlines earlier this year when a renowned homebirthing advocate died after giving birth to her second child in her Melbourne home.
And in early June, a South Australian coronial inquest found three babies who died during or after planned homebirths would have survived had they been born in hospital by caesarean section. The births, which all involved complications, were assisted by midwife Lisa Barrett who withdrew her midwifery registration in January last year and was acting as a birth advocate. SA deputy coroner Anthony Schapel found the deaths “could and should have been prevented” in a more appropriate clinical setting. Dr Dahlen, who spoke at the inquest, says the Coroner highlighted serious system and legislative flaws that contributed to the incidents, and she now fears the negative headlines could tarnish homebirthing and jeopardise the future of the birthing option in Australia. “We must find a solution for 2013 and we mustn’t react,” she says. “If we go and change laws based on the case in South Australia, we are changing laws on one midwife and three women, which will impact on hundreds of women and midwives. “It’s really important not to have a reflex reaction but a measured, sensible response. “Six or seven babies die every day in hospital. Every two weeks a mum dies in childbirth in hospital. “We have a very skewed perspective in this country.” Australian Institute of Health and Welfare figures reveal that of the 294,540 women who gave birth to 299,220 babies across Australia in 2009, 863 were homebirths, representing 0.3 per cent of births. The figures show there were two fetal deaths at homebirths in 2009, while there were 2,339
fetal deaths in hospitals and birth centres across the nation. In the South Australian coronial inquest, Coroner Schapel recommended that only midwives registered under national law should be allowed to practise midwifery and “it ought to be regarded as an offence, punishable by law, for midwives to practise midwifery without registration with the Nursing and Midwifery Board of Australia pursuant to the national law”. Dr Dahlen, who helped formulate the ACM’s position statement on homebirth services, welcomes the move but expresses concerns at one of the Coroner’s other recommendations. That recommendation calls for new legislation to “impose a duty on any person providing a health service, including midwifery services, to report to the South Australian Department of Health and Ageing the intention of any person under his or her care to undergo a homebirth in respect of deliveries that are attended by an enhanced risk of complication, for example but not limited to, homebirths involving the birth of twins or known breech birth at term”. Dr Dahlen says if enshrined in legislation, the move may push more women towards freebirthing, where there is no medical assistance, or intrude on the rights of women to choose their path through pregnancy and birth. Anecdotal evidence suggests freebirthing is on the rise in Australia. Dr Dahlen, who is involved in a large study on the movement, says while there are no statistics on how many women are choosing to freebirth, there is “no shortage” of women wanting to share their experiences. And she says many women who have experienced previous traumatic births now want to avoid the hospital system. continued overleaf Nursing Careers Allied Health - Issue 13 | Page 21
enthusiasm and watching them move from the girl and into a mother…the look on their faces of ‘look what I did’. “It’s wonderful watching women make their own choices and showing them that they can do it and it’s perfectly safe for low risk women.” Like Dr Dahlen, Ms Dempsey has concerns about what will happen when the deadline expires next year; for birthing women and also for her midwifery career.
“Some studies are telling us one in 10 women are coming out of childbirth with symptoms for post-traumatic stress disorder,” she says. “That’s terrifying. We have got to look back at the system that allows this trauma in the first place.” Dr Dahlen practises at Midwives @ Sydney and Beyond, a small group practice with six midwives, providing care in the woman’s choice of setting. Privately practising midwife Robyn Dempsey, a colleague of Dr Dahlen’s, has attended about 400 homebirths in almost 20 years. After completing her midwifery training at a Sydney hospital in 1990, Ms Dempsey birthed her own three babies at home, under the care of a midwife, and also launched her own midwifery practice. Ms Dempsey says on average about 16 per cent of her birthing mothers are transferred to hospital, for either pain relief or emergency care, but no mothers or babies have lost their lives under her care. “I think women need to have a choice of having their babies wherever they want to,” she says. “The most amazing thing I find is working with first-time mums. They are just full of Page 22 | www.ncah.com.au
“If no solution is found, I won’t be able to offer women births at home, which collapses an 18 year midwifery practice,” she says. “It’s just really sad. The government needs to come to the party and provide us with insurance.” Dr Dahlen says Australia should look to New Zealand where homebirthing is not outside the norm. In New Zealand, 78 per cent of women choose midwifery care and opt to give birth either at home, at a birth unit or in hospital. “New Zealand has got it right,” she says. “They have got a very good clinical pathway they have developed for their midwives. “The government has given the funding to women... saying ‘here is the package you can go and pick a midwife, a GP or an obstetrician’. “You can have your baby pretty much wherever you want to have your baby. “It’s a fundamental human right that a woman should be able to give birth to her baby where she wants to,” Dr Dahlen says. “I believe that if we can birth right I feel we can get anything right. That’s how strongly I believe in it.”
Be part of the effort to improve Indigenous health
Are you a Registered Nurse, RN/Midwife or Allied Health professional? Have you thought about being part of the effort to close the gap in Indigenous health outcomes? Now is the time to get involved. RAHC has opportunities for urban-based health professionals to undertake short-term paid placements in remote Indigenous communities in the Northern Territory. Visit our website now to apply or register your interest then let us know your availability. Our team can find remote placement opportunities that work around your current job and you.
rahc.com.au Nursing Careers Allied Health - Issue 13 | Page 23
Cameron cares for paediatric nursing by Karen Keast “What did the ocean say to the beach? Nothing, it just waved back.” Cameron Harwood keeps a few jokes up Cameron Harwood his sleeve in the hope of bringing smiles to the faces of his young patients. “I have got some appalling jokes that I pull out,” he says. “Really bad ones and most of the people I work with have heard them about 50 times. “It helps when you can get them smiling and pulling faces, and generally having fun in those situations really helps them to get their mind off what’s happening.”
so it was a bit of an adjustment for me and I had to change my perception of what nursing was about. “I wasn’t fixing anyone, I was helping to maintain their health.” Cameron is now one of a growing number of male nurses in the female-dominated nursing profession. Cameron grew up in a house of boys and now has a wife, who is a community nurse, and two girls, aged 18 months and 3. “I am surrounded by women wherever I go,” he says, laughing. “I guess there are some guys out there who would struggle with that. I find it to be a blessing, I guess.
Cameron is a Registered Nurse and senior nurse on his ward at The Children’s Hospital at Westmead, Sydney, where he has worked since he first started out as a graduate nurse in 2002.
“It gives me a healthy opportunity to express the caring, nurturing side which most guys don’t know how to express.”
“I have always wanted to help people and I have always loved working with kids and it seemed the best combination of those elements,” he says.
“I think it’s really important to have male nurses in the health care setting,” he says.
“When people are in need I love helping out in any way that I can.” Cameron works in a medical day stay unit at the hospital where most of his patients have chronic blood disorders and immune deficiencies and receive donated blood. After mostly surgical experience at the hospital, Cameron says beginning in the ward was, at first, an adjustment. “In our situation the kids’ conditions don’t get cured, we are just maintaining their health and Page 24 | www.ncah.com.au
Cameron hopes more men will consider a career in nursing.
“Having a guy who can show that he cares and be there for other people and express emotion and compassion even is such a big thing for a guy to be able to show – we don’t have that role modelled enough in our society.” Cameron is passionate about helping kids and their families through tough times, and hopes to have a long career working in paediatric nursing ahead of him. “Wherever I go or wherever I am in 10 years from now I want it to be in paediatric nursing,” he says. For more articles visit NCAH.com.au
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Physiotherapist thrives on working with older people by Karen Keast Betty Ramsay was advised becoming a physiotherapist.
As a student in Scotland, her school’s careers advisor told her it would be “working with old people and it will be boring”. Fast-forward several decades and Betty, a research physiotherapist at Neuroscience Research Australia in Sydney, thrives on working one-on-one with older people. “I find older people fascinating. There are a lot of hidden gems out there with a lifetime of stories,” she said. Betty occasionally rides her Honda motorbike to her appointments with older people, and is always amazed at their reactions. “A couple of the men have been worried and told me to be careful but at least three of the ladies I have spoken to said ‘I rode a motorbike after the war’,” she said. “I enjoy the interaction with older people a great deal and helping them with their problems in strength and balance and mobility, and increasing their confidence in being able to get out again.” Betty moved to Australia in 1996 and has since worked at a private practice, at St Vincent’s Hospital in Darlinghurst and at Sacred Heart Hospice. It was a move to community health that sparked Betty’s interest in falls prevention, prompting her to take on a major research role at NeuRA in its Falls and Balance Research Group. Since she began at NeuRA almost five years ago, Betty has worked on a major posthospital exercise study, involving 340 older people who had recently been in hospital. Page 26 | www.ncah.com.au
The intervention included a 12 month weight bearing exercise program designed to improve strength and balance. “We were trying to look at how we could hopefully prevent falls for people who had been in hospital,” she said. “They are less active; usually they are in bed or sitting in a chair next to the bed. Therefore they are more at risk of falling when they go home.” The data for the study is currently being analysed with results expected soon. Betty is now working on a national hip fracture database for hospitals across Australia and New Zealand; reviewing hip fracture patients and their care in hospitals.
“The aim is to maximise the health care of older people who have experienced hip fractures,” she said.
“There needs to be more focus on how we can encourage older people to be more active and stay independent and in shape for old age,” she said.
“In years gone past, they have not always been prioritised…and older people can end up with complications following surgery and long recovery times.”
“No-one ever warns you when you are young how difficult it is when you are old. “I think that people who are in their 80s and 90s now may not have had much of a lifetime of keeping active,” she said.
Betty said often older people who have experienced a fall develop a fear of falling, which can sap their confidence; preventing them from taking part in activities and even refusing to leave their home.
“For the ones that do keep more active it may make a greater difference in their old age.
And she said as the Australian population continues to age, more physios will be needed to help keep older people active.
“As a school girl back in Peebles, Scotland, I could never have imagined that working as a physio with older people would be such a perfect choice for me,” Betty said.
“It’s not exactly the glamorous side of physiotherapy like sports injuries…but I love working with older people. They are incredibly engaging. It’s rewarding work.
For more articles visit NCAH.com.au
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RDNS researcher urges nurses to help asthma patients by Karen Keast An Australian researcher has found a concerning number of older and frail people are dying of asthma. Royal District Nursing Service Institute senior research fellow Dr Dianne Goeman has warned asthma deaths are an issue for all health practitioners and called for targeted interventions to reduce the asthma mortality rate. Dr Goeman, who conducted a study into the circumstances surrounding Australian asthma deaths since 2005 after being awarded an Asthma Foundation of Victoria research grant, said RDNS nurses were at the frontline of home nursing and health care, and able to observe the extent of the problem. “RDNS has a large number of older clients with asthma and COPD (chronic obstructive pulmonary disease) and are therefore in a unique position to assist their clients to achieve better asthma outcomes,” she said. While asthma deaths have decreased in the past three decades, Dr Goeman said the rate of mortality due to asthma in older people had not dropped as dramatically as it had in younger people. Asthma deaths in Australia are high compared to international standards. Statistics show 416 Australians died of asthma in 2010 and 411 people died of asthma in 2009, with asthma ... health care expenditure on asthma, particularly those over 50 years is expected to increase exponentially. – Dr Dianne Goeman Royal District Nursing Service Institute Senior Research Fellow Page 28 | www.ncah.com.au
recorded as an associated cause in another 1,344 deaths. Dr Goeman said asthma mortality increased with age, with 995 or 64 per cent of asthma deaths between 2005 and 2008 occurring in those aged over 70. “Asthma is predicted to continue to be a major disease burden in Australia over the next two decades and health care expenditure on asthma, particularly those over 50 years is expected to increase exponentially,” she said. Dr Goeman said people over 65 with asthma also had the second highest presentation rate to emergency departments, after children. A medical sociologist, Dr Goeman presented the research, the first research on asthma deaths in the country since the late 1990s, at the International Primary Care Respiratory Group Conference in Edinburgh for this year’s World Asthma Day. Dr Goeman conducted the research with respiratory physicians Associate Professor Jo Douglass, Professor Michael Abramson and Dr Celia Zubrinich from the Alfred Hospital along with research officer Edwina McCarthy.
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RDNS nurses take action by Karen Keast Nurses at Australia’s iconic Royal District Nursing Service are taking protected industrial action in a push for better pay and entitlements. More than 800 nurses at Australia’s oldest and largest provider of home nursing and health care services are wearing Respect Our Work campaign t-shirts to work and enforcing bans, including clerical and administrative work linked to funding, non-critical client assessments and refusing deployment between RDNS centres. The action has been designed to impact on RDNS financially, amid claims the State Government is underfunding the service. Nurses have stressed existing RDNS clients and urgent clients will continue to receive care but nurses have not ruled out upping the bans to four-hour work stoppages and bans on non-urgent call outs and non-urgent admissions and referrals. The action comes after 11 months of negotiations failed to secure a new agreement. Nurses working at 20 RDNS centres across Victoria, spanning Melbourne, Ballarat, Geelong, Queenscliff, Wodonga and Wangaratta to the Macedon Ranges, are lobbying for parity with public sector hospital nurses’ and midwives’ wages and allowances. The push includes a 2.5 per cent pay rise per annum over the proposed four-year agreement, back-paid to March, and a $1000 professional development allowance in the first year with $900 for subsequent years. RDNS has matched the pay rise but has offered allowances of up to $700 with conditions. Page 30 | www.ncah.com.au
The Australian Nursing Federation Vic Branch states the organisation’s plans to implement the pay rise once it’s been formally approved through the Australian Electoral Commission and Fair Work Australia would result in delays and leave some nurses out of pocket at least $10,000. The union is also fighting to maintain current entitlements including sick leave and carers leave and demanding better staffing arrangements. ANF Vic Branch assistant secretary Pip Carew said nurses are taking action as a last resort. “RDNS nurses are very proud of this iconic community nursing service because it has a reputation for skilled and experienced nurses who care for patients recently discharged from hospital, people with chronic and terminal illnesses and homeless people,” she said. “They’re very concerned that if their conditions are reduced, if their workloads are not addressed and if they’re paid significantly less than hospital nurses then RDNS will very quickly have a serious nurse shortage of its own making.” RDNS chief executive officer Steve Muggleton said the action was disappointing. “We have offered 2.5 per cent and we are very close to resolving a range of other demands - but it’s got to be said we’re working through these issues in extremely challenging economic times, not only for RDNS but also for the state and federal governments and the private and public sectors across Australia,” he said. For the full article visit NCAH.com.au
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Nursing Careers Allied Health - Issue 13 | Page 31
Autism training vital for maternal child health nurses says psychologist by Karen Keast Training maternal child health nurses in the early warning signs of autism spectrum disorders in children aged 15 to 24 months could be the key to early diagnosis and intervention, according to an Australian psychologist. La Trobe University Associate Professor Cheryl Dissanayake, director of the Olga Tennison Autism Research Centre, said the average age of ASD diagnosis was in children aged four but an earlier diagnosis was pivotal to early treatment and a better outcome for children to overcome social, behavioural and cognitive difficulties. In a Victorian trial, the Social Attention and Communication Study known as SACS, 241 maternal child health nurses were trained to use a developmental surveillance approach to identify infants with an ASD through their routine assessments at eight, 12, 18 and 24 months of age. More than 20,000 children were monitored for the early autism phenotype, marked by a lack of key behaviours, which are indicative for ASD development at each age. The warning signs include reduced and atypical eye contact, reduced social smiles, failure to follow a point or initiate pointing, lack of imitative behaviours and limited or no pretend play. The trial found 81 per cent of the children nurses referred to the La Trobe University team for a thorough developmental assessment were found to have autism while almost all of the remaining children had either a Page 32 | www.ncah.com.au
Dr Dissanayake, who has detailed her research in the Australian Psychological Society journal InPsych, said a variable pattern for the onset of autism meant a oneoff screening was not the solution. “We now understand that the onset of autism symptoms is variable during the first two years of life, with signs evident in some children from birth, while others may appear to be developing typically but then fail to progress, and yet others who may lose some of the skills already developed,” she stated in her article. The success of SACS and accuracy of early clinical diagnoses of ASDs at 24 months led to the creation of Australia’s first early diagnostic clinic for ASDs, focusing on children aged under three, at La Trobe University in July last year. A lack of funding has meant the clinic is only open one day a week, thanks to philanthropic funding. Dr Dissanayake said children aged two to five years in the clinic’s first intake of 20 children with an ASD had all shown major developmental gains in just one year of intervention. “Those who were younger when they began intervention made the best progress over this time,” she stated. “We do not know the causes of autism and we have no cure, so intervention to enhance development and reduce symptoms is of crucial importance.” For more articles visit NCAH.com.au
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Nursing Careers Allied Health - Issue 13 | Page 33
Tasmanian nurses fly interstate for work by Karen Keast Tasmanian nurses with families are flying interstate for shift work as the state’s health woes continue to bite. Experienced nurses are picking up shifts in Queensland and New South Wales and flying home in between shifts to spend time with their families. Other nurses, including graduate nurses, are moving interstate to find work after 287 nursing positions were trimmed from the public sector in the wake of State Government funding cuts. But nurses have received a reprieve with the Federal Government’s announcement of a $325 million lifeline for the beleaguered health sector, including an opportunity for an expected 20 nursing positions to be created at new walk-in clinics forecast for Hobart and Launceston. Australian Nursing Federation Tasmanian branch secretary Neroli Ellis said the news had left nurses feeling more optimistic. “We welcome that announcement and nurses are feeling there’s more hope there,” she said. Ms Ellis said the announcement came on the back of “pretty desperate times” in Tasmania. “Nursing has always been a career that had secure employment so it’s quite unique in Tasmania that nurses and most other public sector workers now are facing insecure work going into the future.”
employment. There’s lots of opportunities interstate to do five or six shifts in a row. “That’s the reality for them. Nurses have got mortgages like everybody else.” Ms Ellis said about 30 nurses a month are venturing interstate for work while a recent union survey found 40 per cent of respondents are considering either leaving to work interstate or exiting the nursing profession. “Many are going to Queensland, New South Wales and Victoria; predominantly going to Queensland,” she said. “There are better conditions and they are recruiting and there’s the climate.” Graduates are also leaving, she said. “We have about 350 graduates a year and there were less than 60 positions last year. “It’s pretty sad to see our profession being treated in this way.” The Federal Government’s rescue package includes $31.2 million for an extra 2600 surgeries over four years, $15.4 million to address gaps in mental health services and $53.9 million to train more medical specialists and provide more scholarships for nurses and allied health professionals.
Ms Ellis said nurses with families are increasingly balancing travel between states for work.
About $22 million will be spent establishing the walk-in clinics, which will provide care for minor illnesses and injuries, free of charge and for extended hours, while reducing demand on the state’s emergency departments.
“The nurses I am talking to are aged in their 30s and have families. They have got to have
For more articles visit NCAH.com.au
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