InScope No22 Winter 2022

The official journal of the Queensland Nurses and Midwives’ Union

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Winter 2022

owards gender equality

The age of face masks

The view from the other side A NURSE’S PERSONAL CANCER JOURNEY

PLUS!

CPD CONTENT ON SOCIAL MEDIA AND DEFAMATION, WOUND MANAGEMENT IN TREATING MELANOMA AND MORE...

Give your career a boost!

Applications for QNMU scholarships now open

QNMU members have a chance to win financial support packages thanks to the QNMU's 2022 scholarships and book bursaries program.

There are three great packages up for grabs in this round: ■ Aboriginal and/or Torres Strait Islander Nurse/Midwife Scholarship: Enables an Aboriginal and/or Torres Strait Islander working in nursing or midwifery to enhance their professional skills through appropriate study ($3000).

■ Research Scholarship: Assists a member to undertake a specific project or research study that will advance the strategic, professional, or organisational interests of the QNMU ($5000).

■ Assistant in Nursing or Personal Carer Scholarship: Assists a member to attend a relevant conference or seminar, or to undertake an accredited course, relevant to their nursing work ($3000).

To read more about the criteria for selection, or to complete your application, head to www.qnmu.org.au/ scholarships

05/22

Applications close on 15 July, so don’t miss out.

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Winter 2022

INDEPTH

Half a century of midwifery transformation

THE OFFICIAL JOURNAL OF THE QUEENSLAND NURSES AND MIDWIVES’ UNION ISSN 2207-6018 ABN 84 382 908 052 106 Victoria Street West End Q 4101 (GPO Box 1289 Brisbane Q 4001)

INDEPTH

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The view from the other side: A nurse's personal cancer journey

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Finding solutions to a dysfunctional health system

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07 3840 1444 1800 177 273 (toll free) F 07 3844 9387 E inscope@qnmu.org.au W www.qnmu.org.au EDITOR Beth Mohle, Secretary, QNMU PRODUCTION QNMU Communications team: Linda Brady, Melissa Campbell, Cameron Gledhill, Stephanie Lim, Lou Robson, Luke Rutledge, Jannine Sione, Analiza Smart, Kathleen Smith PUBLISHED BY The Queensland Nurses and Midwives’ Union AUTHORISED BY K. Veach, Acting Secretary, Queensland Nurses and Midwives' Union, 106 Victoria St West End 4101.

PRINTED BY Kingswood Print Signage, 80 Parramatta Rd Underwood 4119

The age of face masks Cherbourg members bunker down to keep their community safe

Towards gender equality It's time to celebrate.

QNMU turns 40!

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Who will win the QNMU Nursing and Midwifery Excellence Awards?

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You are union

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Reconciliation: An ongoing call to action for all nurses and midwives

Change of government offers hope for a better Australia "Growing our own": Nurses and nurturng are the key to growing the first nations health workforce

Navigating shift work and complex menstrual cycles

CPD

REGULARS

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INSIGHT

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TEA ROOM

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WINS

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JUST IN

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IN VIEW

Wound management in treating melanoma

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INCOMING

Respecting women's safety at work - how far have we come?

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ADVERTISING

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Progress on state health commitments

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Securement bundles for PIVCs: Is this a simple and innovative way to reduce device failure?

Voller and proposed changes to the defamation law to combat social media trolling

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What to do if your legal case becomes a matter of public record online

Using point-of-care technology to improve detection of tissue injury related to pressure injuries

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Work environment and basic work health and safety at COVID testing sites

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DISCLAIMER: Statements expressed in articles in InScope are those of the contributor and do not necessarily reflect the policy of the Queensland Nurses and Midwives’ Union unless this is so stated. Copyright of articles remains with the contributor and may not be reproduced without permission. Statements of facts are believed to be true but no responsibility for inaccuracy can be accepted. Other material may be reproduced only by written arrangement with the Union. Although all accepted advertising material is expected to conform to the QNMU’s ethical standards, such acceptance does not imply endorsement. Where individuals in this publication are described as registered health practitioners and/or QNMU members, this was accurate, to the best of our knowledge, at the time of writing. No representation is made as to the current status of the individuals’ registration.

For the current status of an individual’s registration, please refer to the NMBA register, at www.ahpra.gov.au. Visit www.qnmu.org.au/privacy to read our privacy statement.

Cover photo: QNMU member Sally Kriel (Clinical Nurse Consultant)

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insight

All roads lead to

Lucynda Maskell QNMU Vice President

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AFETY has been a union cornerstone forever.

It is synonymous with unions and is a matter relevant to and shared across all unions.

It is no surprise then that QNMU Council maintains a strong commitment to securing and improving members’ safety, and that safety is embedded within the QNMU Strategic Plan.

So what does our safety work look like?

■ Our QNMU Ratios Saves Lives and Money campaign has a particular focus on improving physical, psychological and cultural safety at work for members. This campaign is across all sectors and is for every member.

■ Our QNMU ambitions articulate good secure jobs and safe positive practice environments. Closely linked to this is our goal to increase the number of nurses and midwives who can exercise greater autonomy and control of their practice and their work environment. The two are inextricably linked. Research has shown where environments are collegial and have safe workloads, patient outcomes improve. When respect and kindness prevail, it can also make a secure job a good job.

■ Council makes ongoing improvements to strengthen the tools members can use to improve safety.

As an example, the QNMU position statement on Cultural Safety was endorsed in December 2021. It encourages nurses and midwives to develop an understanding of and respect for cultural difference and cultural needs; and maintains that culturally unsafe practice must have

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Safety

QNMU Council maintains a strong commitment to securing and improving members’ safety... the same reporting, notification, and governance processes as physically and psychologically unsafe practice.

■ QNMU Officials have been involved in lobbying for the inclusion of control hierarchies in the Queensland psycho-social Code of Practice. This is important work – work not always visible yet integral to improving government laws. It complements the work we do collectively as members advocating for safety every day.

■ QNMU education offers courses which can empower members on their ability to influence and affect change in their work environments, for example the Positive Practice Environment course and online events such as Empathetic Leadership.

■ On offer too are resources such as QNMU Policy Statements, developed largely by members, which detail QNMU policy on matters such as collegiality; and Information Sheets which provide guidance on safety matters ranging from workload and grievance processes to Workplace Health and Safety.

■ Physical safety for nurses and midwives during the COVID-19 pandemic has highlighted how the safety work we do is not always terribly visible. Who would really have guessed the QNMU would have to take a case to the

Industrial Commission and to WorkSafe to highlight concerns around fit testing for Personal Protective Equipment? Similar battles for hard hats in blue-collar industries were won many years ago – in stark contrast to our continuing battles in our femaledominated professions.

■ And of course, the QNMU continues to achieve wins for members and for workplaces that support and improve safety at every level.

Our work in this space is never done.

But we will continue to prioritise, advocate and innovate as a council and a union, all the while knowing that all roads must lead to safety.

QNMU COUNCIL president :

Sally-Anne Jones

vice president : secretary :

Lucynda Maskell

Beth Mohle

assistant secretary :

Kate Veach

councillors :

Julie Burgess Madonna Cameron Christine Cocks Karen Cooke Tammy Copley Nikki Emblen Michael Hall Chris Johnson Damien Lawson David Lewis Simon Mitchell Fiona Monk Emma Murphy Sue Pitman Cathy Rose Ashleigh Sullivan Michelle Sunderland Janelle Taylor Kym Volp Samantha Woodhouse Deb Woods

insight

Getting our

voice heard Beth Mohle QNMU Secretary

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HE 2022 federal election was like no other I can recall. The political landscape has been fundamentally reshaped, with the two major political parties needing to do some serious soul searching. Look no further than the “teal wave” of independents winning six lower house seats in three states and the Greens picking up three seats in Brisbane.

The large number of independents in the lower house will mean that the Albanese government will need to consult then negotiate with the independent cross benchers, the majority of whom are women - women who felt strongly that their voices were not heard by the major parties on the issues that mattered to them.

Our union lobbied intensively on the issues of concern to members, as did our federal body the Australian Nursing and Midwifery Federation.

This was shaped by feedback from members via a survey conducted in January on their top concerns.

As a result, our political lobbying focused on:

Guaranteeing real change for aged care: Including legislated ratios with mandated minimum care minutes and the right skills mix, at least one RN on site 24/7, greater transparency and accountability and ensuring funding is tied to care and improved wages and conditions for aged care workers.

Reducing pressure on Emergency Departments and hospitals: Including nurse-led walk-in centres across Queensland to decrease unprecedented demand on EDs; expansion of the successful Nurse Navigator role to support timely access to care and help patients navigate our complex health system; and urgent

workforce planning to ensure sufficient numbers of nurses and midwives to cope with ever increasing demand.

Expanding Medicare: Including expanding Medicare reimbursement arrangements for nursing and midwifery services and implementing all recommendations of the Nurse Practitioner Reference Group that formed part of the recent review of the MBS.

Fixing job security: Including fundamental industrial relations policy reform to deliver more permanent jobs, and fair and reasonable wages and working conditions, especially given the current inflationary environment and longterm low wages growth.

Building a healthier, fairer, and more equal society: Including implementing the Uluru Statement from the Heart that is so fundamental to addressing systemic health and other disadvantage experienced by our First Nations people, taking urgent and decisive action to address the climate crisis and fixing Australia’s housing affordability crisis.

Significantly we were able to secure some important commitments that we now look forward to being implemented.

I’d like to acknowledge and thank all our passionate activists who have worked so hard over a long time lobbying political candidates and raising community awareness of these concerns. You are an inspiration.

Some of our issues, especially relating to aged care and the need to grow wages and fix job security, were a prominent feature of the recent election campaign. Other were not as prominent as we would have liked.

All will continue to be a focus of our ongoing lobbying efforts.

The big surprise for me was that health policy and funding were not a more prominent focus for either of the two major political parties. This is particularly puzzling given we are still in the midst of a pandemic that is revealing major long-term fault lines in our health and aged care system.

There is an urgent need to address our flawed policy and funding models, governance arrangements and the fragmented nature of our acute, primary health, aged care and disability sectors — not to mention the entrenched power imbalances in our health and aged care system that prevent nurses and midwives and other health professionals (like allied health and pharmacists) working to their full potential. This is central to supporting innovation and sustainability of our health and aged care system.

There is more than enough work to go around – we need to be empowered to work to full scope, trusted with budget and other delegations and respected for the vital contribution we can make.

Spaces must be created to have honest and respectful conversations about these critical issues. To do so, we need to ensure we have seats at the tables where decisions are made so our voices can be heard.

Elections are mere punctuation points. We may well be disappointed that all our priority issues did not receive sufficient attention, but we cannot give up. Those with power count on others giving up, being worn down by the battle and the disappointment.

We didn't give up on aged care and we won! Now our work continues.

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QNMU members frequently contact us with questions about their wages, entitlements and other workplace conditions. Being informed about your agreement, workplace policies and procedures and any other professional and industrial issues is the first step to ensuring nurses and midwives receive what you are due.

Our Tea room series, which appears in every edition of InScope, explains some of the common queries we receive from members. If you have any topics you’d like covered, we’d love to hear your suggestions – email inscope@qnmu.org.au

Getting your best tax return in 2022 The following tax advice is general in nature and should not be relied upon as detailed advice. It has been provided for QNMU members by Etax Accountants. Please note, the QNMU cannot provide members with tax advice – members should seek any necessary tax advice from an authorised registered tax agent.

How can I maximise my tax return in 2022?

The simplest way for nurses and midwives to maximise their tax return for 2022 is to make sure you are claiming all your legitimate tax deductions for the 2021/22 tax year.

What is a tax deduction?

A tax deduction, put simply, is an expense occurred as a result of a work-related activity or purchase.

For example, if you travelled between hospitals during shifts or purchased a work-related item out of your own pocket, good chances are you’ll be able to claim this back as a tax deduction, as long as it is legitimate.

How do I know if my tax deduction is legitimate?

There are a couple of requirements you must meet to ensure your tax deduction is eligible to claim on your tax return. If you can answer yes to the below, then your deduction is usually claimable:

1 You paid for the item, and 2 The item is directly related to your work, and

3 You were not reimbursed for the purchase, and

4 You have a receipt, tax invoice or evidence to support your claim

What are some of the deductions I can claim as a nurse or midwife?

While the list for claimable tax deductions is quite large, not every deduction possible will apply to you.

Below are some of the most common tax deductions for nurses and midwives: Memberships and union fees: Includes QNMU fees or other nursing/midwife registration fees.

Work uniform: Designated uniforms or protective clothing costs (purchased by you) and the laundering of your uniform.

Tools of the trade: Clinical equipment such as stethoscopes, reference books, nursing fobs, etc.

Car expenses: If you have travelled from one workplace to another in your own car you can claim 72c per km up to 5000km. This does not include home to work travel.

Computer or laptop: A work-related portion of personal computer use.

Mobile phone: A work-related portion of your personal mobile phone use.

Subscriptions and books: Nursing and midwifery magazines, books and other journals directly related to your job.

Home office expenses: Work-related percentage of costs such as internet and electricity if you’re required to work from home.

Self-education expenses: If you’re studying to further your current role (including short courses like first aid or OH&S), then the costs are usually claimable.

If your study is to get a new job (or your first job) the expenses are not claimable.

Are there any changes to my tax return due to COVID-19?

Yes, there are! The main change that may impact your tax return as a nurse or midwife is the ability to claim Rapid Antigen Tests (RATs). If you have purchased a RAT for the requirement of testing before being able to start work, and you have met the previously mentioned requirements for tax deductions, then your RAT expense is usually claimable.

Still need more tax help?

If you’re not sure, just ask a tax agent. Don’t forget, tax agent fees are deductible too!

About Etax Consultants: Etax.com.au is an online accountancy group offering fast, easy tax return services with no hidden charges.

If you have questions about our Tea room column, email memberconnect@qnmu.org.au

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wins

Members save withdrawal service from closure HATS OFF to our members in north Queensland who saved the Cairns Day Withdrawal Service from closure.

Staff at the rehabilitation facility were given just a few days’ notice of plans to close the service, with management claiming it was part of an escalation plan designed to redirect resources to the region’s pandemic response.

The closure was announced without staff consultation, and the service’s three nurses (all QNMU members) were told their clients would be channelled back into the Cairns Hospital Emergency Department – the very place the service was designed to keep them out of.

As a patient-focused team, the nurses were concerned their clients would become lost in the system without access to appropriate care,

so they contacted their local QNMU organiser.

When meetings with immediate management failed to resolve the matter, members took their concerns to the service director, armed with a solution.

Acknowledging the need for additional pandemic staff, the team presented a staffing arrangement that balanced both the withdrawal service’s needs and needs of the pandemic response.

Their solution was a hit and was adopted almost immediately!

The service remains open and the Cairns region’s pandemic workforce received the boost it needed.

What a great example of how our health system and communities benefit when nurses engage in problem solving and their employers listen.

QEII Emergency Department secures more nurses QEII HOSPITAL EMERGENCY Department has recruited an additional 13.5 FTE nurses after members and management worked collaboratively to resolve staffing shortages.

ED members had been dealing with significant staffing issues which led to unmanageable workloads, missed meal breaks, overtime, and increased sick leave.

After submitting workload reporting forms, members worked with management via a collaborative steering committee to address concerns. Throughout the consultation process, staff were surveyed on their issues, as well as satisfaction levels postrecruitment.

The committee determined a new model of care was required if staffing issues were to be addressed properly and after reviewing the Business Planning Framework, management realised an additional 13.5 FTE were needed.

MAKING IT WORK: Casual nurse Trish Svanosio (left) stepped into the team so CNC Naomi Neal (middle) could help boost the COVID response ranks. Together with nurse educator Jennifer Brazier (right) and Lorraine Armstrong (not pictured) who stepped into the CNC position temporarily, they ensured the Cairns Withdrawal Day Service kept its doors open.

We’re pleased to report the additional staff, who have now been recruited, have already had a positive impact on the ED – importantly, staff are reporting more manageable workloads and time to take meal breaks.

Well done to our members for persisting with this grievance!

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Perseverance for fit testing pays off A QNMU MEMBER has helped make her aged care home safer, after she continually called on management to provide fit testing for staff.

Management repeatedly ignored our member’s request for appropriate PPE fit testing, even after the workplace was hit with COVID-19 positive cases.

Instead, staff were informed they could simply place a P2/N95 mask over their face and “breathe in and out”, and if the mask went in and out then they were sufficiently fit tested.

“I informed management this wasn’t right and we have to be hooked up to a machine or hood for appropriate fit testing,” our member said.

“They had even provided mandatory training on fit testing for staff and it clearly outlined that it is the employer’s responsibility to make sure fit testing is correctly provided.

“Despite repeatedly raising this with management, then escalating it to my state manager and Director, they continued to ignore my requests for fit testing.

“I was even told that I had more chance of contracting COVID-19 in a supermarket than in my workplace.”

However, our member knew fit testing was of the utmost importance and wasn’t going to let the matter go.

now agreed to provide fit testing for staff on site.

“I stood my ground and said I can’t work until I get fit tested. The whole situation has caused me great distress and anxiety and I’m disappointed at the lack of support from management.

She sourced an external provider to undertake fit testing for staff at her workplace at a cost, and requested reimbursement for that cost.

“They’ve had plenty of time to organise fit testing for staff as COVID-19 has been around for years now. Of the three facilities they run, two were in lockdown due to positive cases and not one staff member had been fit tested.

When management denied this request, she worked with her QNMU organiser to overturn this decision.

“It’s appalling and I encourage anyone who hasn’t been fit tested to stand up and speak out.”

‘I can’t work until I get fit tested’ Realising she wasn’t going to back down on safety, management have

Well done to our brave member for achieving this outcome – her perseverance has made her aged care home safer for residents, colleagues and herself.

Salvos management finally provide nurses with company vehicle PERSISTENCE has paid off for Townsville members working at Salvation Army in the Drugs and Other Alcohol Services.

For years, nurses were required to drive their clients to the nearby GP clinic using their own private vehicle (and petrol).

The QNMU first raised this issue as a serious concern to senior management in 2017.

I was even told that I had more chance of contracting COVID-19 in a supermarket than in my workplace.

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Shockingly, it’s taken nearly five years for Salvation Army management to see sense and provide a company vehicle so nurses can transport their clients without having to use their own car.

Our members’ determination to keep the pressure on management and not let this issue go is what led to this great outcome … although we share members’ frustration and agree it should not have taken so long!

wins

Harbour Quays members win backpay for testing HARBOUR QUAYS aged care members celebrated a backpay win in May after management agreed to pay them for time spent taking pre-shift rapid antigen tests (RATs).

The backpay claim arose after the Gold Coast facility introduced a new RAT policy at the start of the year in which staff were required to complete a RAT before every shift, attending work early to take the test onsite in “the car park/lower basement”.

The policy was eventually changed on 23 March but, given RAT tests generally take about 15 minutes to complete, members had by that stage accumulated hours of unpaid time.

The QNMU argued that nurses who followed the RAT directive and attended work early were entitled to be paid for their additional time at the applicable rate (including shift penalties or overtime).

Following negotiations with the QNMU, management have now agreed to backpay employees who attended work early between 5 January and 23 March, at a rate of 15 minutes per shift.

This is a great result!

If you are having a similar issue at your workplace, make sure you contact your local QNMU organiser or Member Connect for advice.

Paid family and domestic violence leave for 3 million workers AUSTRALIAN UNIONS have won 10 days paid family and domestic violence leave in a landmark Fair Work Commission case.

The QNMU has long campaigned for all members to have access to 10 days per year or more of paid family and domestic violence leave – which is something we had already secured for public sector members and many working in the private and aged care sectors.

Now, the Fair Work Commission’s in-principle decision will mean nearly three million people who work under federal Awards should have access to the same entitlement – this includes QNMU members who work under the Nurses Award 2020 and the Aged Care Award 2020 instead of an enterprise agreement (EA).

This win of 10 days paid domestic violence leave in federal Awards will increase the likelihood of employers agreeing to the QNMU’s same claim in new EAs.

Employers have a crucial role to play in helping stop family and domestic violence, and providing paid leave to all workers is an important aspect of this.

But there’s another really important step still to go.

It is now up to the Federal Government to decide whether to extend the leave to all workers covered by the National Employment Standards (NES), ensuring the right covers an additional 8.4 million workers.

The Australian Labor Party made this commitment prior to the election but Scott Morrison and the LNP did not.

If 10 days per year of paid family and domestic violence leave becomes a NES, all QNMU members in the private and aged care sectors will be immediately entitled to that leave, regardless of whether a member’s EA includes the same right or not.

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The Union’s aged care wage increase case ALL THE EVIDENCE IS IN

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HE EVIDENTIARY part of the hearings for the Union’s aged care work value case in the Fair Work Commission (FWC) wrapped up on May 11.

The Union’s case is for a variation of the Aged Care Award and the Nurses Award to provide a 25% wage increase to the minimum Award rate for PCWs, AINs, ENs and RNs working in aged care.

If the FWC awards the full 25% it will give those who work on Award rates a full 25% bump, and give members, who work on enterprise agreements with payrates higher than the award, whatever percentage increase is still needed to bring it up to the new higher Award rates.

the real-life impact of low wages, the excessive workloads and their effect on resident care, and the emotional load aged care workers carry.

Former Opal AIN Sheree Clarke noted how her low wages and limited hours was barely enough to keep a roof over her head.

“ I have not been able to

save a deposit to get a loan to buy a house or unit. I have not attempted to rent a house or unit somewhere, because I am not confident of having enough income each fortnight to pay rent on a house or unit. This is why I live in a caravan park, she wrote.

”

Final oral submissions from lawyers (including the Union’s) are scheduled for August 2 and 3. The FWC’s decision will follow later in the year or possibly early next year.

Pat McLean, who worked as an EN with Blue Care, noted she couldn’t afford private health insurance, life insurance or dental treatment; and would ration hot showers and heater use in winter just to pay her electricity bill.

The QNMU provided five witness statements as part of the evidence before the full bench of the FWC, which included testimonials about

Our members also painted a very clear picture of the physical demands of the job – including the exhaustion of being on one’s feet all day, the onerous

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work of showering and moving heavy or fragile people, and the challenges of managing violent or abusive residents.

“

I compete in triathlons. In a triathlon I run 21 kms, ride 90 kms and swim 2 kms. I am physically and mentally strong, but despite how fit I am, I am often shattered after my shift in aged care, Regis AIN Dianne Power said.

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Their statements – which can be read online at bit.ly/3NA3CFx — presented an honest and powerful overview of the current state of working in aged care, and we are hopeful the FWC will agree aged care workers should be better paid for the vital work they do, and award the full 25% pay increase.

Prior to the election the Labour Party committed to funding any wage increase recommended by commission, so an FWC win would be a great outcome indeed.

Visit bit.ly/3NA3CFx to read the QNMU member witness statements.

just in

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UNIONS

WIN A

5.2% MINIMUM WAGE INCREASE,

4.6% INCREASE TO AWARD RATES

HANKS to strong campaigning by unions and thousands of workers, Australia’s minimum wage will increase by 5.2%. This increase was recently handed down by the Fair Work Commission (FWC).

currently in enterprise negotiations with their employer, this win puts the pressure on employers not to offer an increase less than that of the minimum wage if members demand it through collective action.

The 5.2% increase will apply to workers on the minimum wage. Award rates, however, will be increased by 4.6%, with a minimum rise of $40 per week.

Aged care members

This increase will apply to nurses, midwives, AINs and carers to whom the Nurses Award 2020 or any other federal Award applies – in other words, those who are not employed by Queensland Health and who are not covered by an enterprise agreement.

The increase does not affect employees who already get paid more than the new minimum Award wages.

The June minimum wage increase is the largest since 2010, and is a step in the right direction towards offsetting cost of living increases and preventing real wages cuts for the country’s lowest paid workers.

While this 4.6% increase will not apply to a majority of private hospital and aged care members (who are covered under enterprise agreements) this win gives us increased bargaining power.

Private hospital members As we know, our strength in bargaining comes from the collective voices of our members.

For private hospital members who are about to enter into, or are

Aged care workers’ wages are already far lower than the average for nurses in Queensland and the wage rates for some AINs and carers are barely above the award minimums. You have also experienced slow wage growth over the last few years, meaning your wages have fallen behind the rising cost of living.

The QNMU (through our national body the ANMF) is still pursuing a 25% increase to minimum (Award) wages for aged care nurses, AINs and carers through our FWC case.

During the recent election, the Federal Labor Government committed to supporting and funding the outcome of this case.

We won’t know the outcome of this case for some time still, so we are continuing to seek wage increases from your employer in the meantime.

You and your colleagues work tirelessly to care for your residents during these difficult times, despite challenging working conditions. You deserve fair wages.

The QNMU will continue to argue for further increases that lift Australia’s minimum Award wages to a living wage.

QNMU has long campaigned for better wages for nurses and midwives working on minimum and Award rates.

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QNMU wins big at Labour Day Awards IT WAS a big night for the QNMU at the Annual Labour Day awards in May winning a whopping four awards!

Health needs urgent care campaign – another shared win, this time with the United Workers Union.

We took home the Best Community Campaign gong for our It’s not too much to ask campaign calling for genuine reform in aged care on the back of the Aged Care Royal Commission findings. We shared top place in this category with the Services Union for their campaign against North Burnett Regional Council job cuts.

And just when we thought things couldn’t get any better, we were thrilled to see our very own Industrial Officer Vonnie Semple awarded the prestigious Kath Nelson Award for her commitment to the principles of unionism and social justice – a well-deserved honour for Vonnie with her 35 years of commitment to the union movement.

Our fantastic First Nations Branch took out the Regional Activism Award for their excellent COVID vaccination roll out work – again we shared top spot with the Services Unions for their Wujul Wujul Aboriginal Shire Council activities.

We also won Best Union Story in the Mainstream Media for coverage of our

QNMU invited to Queensland Parliament to speak on mental health

Phew, what a haul! Well done and thank you to everybody involved in these campaigns and activist activities.

None of us do it for accolades of course, but sometimes a little recognition from fellow activists is rather nice.

There are about 4800 nurses working in mental health in Queensland today, however, hospital wards are routinely understaffed, community mental health nurses report untenable workloads, and residents of rural and remote areas struggle to receive timely mental health treatment due to lack of services.

The QNMU’s recommendations to the Committee included:

THE QNMU was invited to speak at the Inquiry into the opportunities to improve mental health outcomes for Queenslanders at Parliament House earlier this year.

Secretary Beth Mohle spoke at the 10 March hearing, alongside Research and Policy Officer Julie Lee, and QNMU members Katrina Cox and Chris Dawber who are both senior mental health nurses.

The Committee were interested in hearing about the experiences of working in mental health, particularly the challenges of the work and how to resolve them.

We highlighted the urgent need for a robust, sustainable mental health workforce in Queensland.

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■ lobbying the Nursing and Midwifery Board of Australia to reinstate the endorsement for nurses with a mental health qualification, to give due recognition for the specialist training, skills, and knowledge required to become and practice as a mental health nurse

QNMU Industrial Officer Vonnie Semple was awarded the prestigious Kath Nelson Award at the 2022 Labour Day Awards for her commitment to the principles of unionism and social justice.

Congrats Vonnie!

Nurse Navigators and enabling these roles to work to their full scope of practice.

Visit https://bit.ly/3xbenr2 to read the final report which was released in June 2022.

Some of the issues we raised around nurse-led models of care, scholarships, and working to scope of practice, have been put forth by the Committee as official recommendations. The QNMU will be closely following the progress of these recommendations becoming tangible actions in the coming months.

■ an ongoing scholarship or financial incentive scheme specifically for nurses and midwives to support and encourage them to obtain a mental health qualification.

Currently there are few avenues of financial assistance in Queensland.

Mental illness not only affects the individual but may also affect that person’s family, friends, colleagues, and acquaintances. It is not only enduring and complex, but can also impact generations, communities, and society at large. It is therefore vital that we look for ways to improve the mental health outcomes for all Queenslanders.

■ funding and promoting nursing-led models of care in mental health, such as employing more mental health Nurse Practitioners and

Without a mental health workforce, there would be no mental health service system – and the backbone of mental health services are nurses.

just in

Three cheers for US! CELEBRATORY cake, raffles and a cuppa shared with colleagues were just some of the ways nurses and midwives around the state celebrated International Day of the Midwife (5 May) and International Nurses Day (12 May) this year.

Celebrating solidarity!

Labour Day 2022 WHAT A fabulous day of solidarity and hope!

From Brisbane to Cairns, QNMU members joined thousands of workers across the state to celebrate Labour Day in May – a day that celebrates the history and legacy of worker activism, and acknowledges the union movement’s continuing fight for safer jobs, and better wages and conditions.

In bright t-shirts and with campaign placards held high, QNMU nurses and midwives made great use of the day and the looming federal election to urge Queenslanders to put health and aged care first at the ballot box to help us keep our communities safe.

Thanks to everyone who joined in, see you again next year.

It’s been another big year and once again nurses and midwives have been at the heart of it.

These commemorative days are a chance for us to pause from the busyness of our day-to-day work and acknowledge the importance of what we do.

Our work is vital to the wellbeing of our communities, which is why we will never stop advocating for the safe, positive working environments nurses and midwives need and deserve.

Three cheers for nurses and midwives!

Head on over to our social pages on page 64-67 and see if you can spot your friends and colleagues, or yourself!

If you could change one thing about the health system, what would it be?

More staffing. I want to be able to say to my colleagues, ‘I’m going for my 15 minutes now’. I want to be able to go to my patients as soon as they press their buzzers. I want to be able to go to the toilet when I want, and not have to wait eight hours.

Sharleen Frederiksen, RN Caboolture Hospital

I think they need to put more funding into more beds, and more funding for allied health, and nurses and doctors who look after those beds. Increase the funding for health care, increase the bed capacity for hospitals, and increase the number of health professionals working in the field.

James Bugtay, RN Logan Hospital

We need better and ongoing support for new nurses, especially during the pandemic. I feel like we’ve been thrust into this crazy time, and it’s sink or swim at the moment. It’s leading to really high levels of burnout in those first few essential years of training.

Marni Kaddatz, RN Caboolture Hospital

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QNMU calls on private health insurers to support minimum ratios THE QNMU is turning to private health insurers for support in our campaign for ratios in Queensland’s private hospitals.

While we’ve achieved some excellent outcomes legislating minimum nurseto-patient ratios in Queensland’s public hospitals and state-run nursing homes, private hospital providers consistently refuse to consider similar arrangements.

For years, providers have ignored the conclusions of world-leading research, which prove very clearly that Queensland Health’s minimum ratios have made our hospitals safer for staff and patients, and continue to save the system millions of dollars thanks to decreased adverse events.

More than 43% of Australians held private insurance hospital coverage plans in 2020, so we believe it is in the best interests of health insurers that private hospitals implement minimum nurse-to-patient ratios to ensure their clients continue receiving high quality care.

We have now written to various health insurers – including Medibank, Bupa, HCF, HBF, NIB, GMHBA, Teachers Union Health, Teachers Health Fund and Australian Unity – calling on them to lead the way in advancing the need for minimum nurse-to-patient ratios within Queensland’s private hospital sector and inviting them to meet and discuss with us how we might progress this.

To find out more about our ratios campaign, visit www. qnmu.org.au/ratiossavelives

What happens if you exceed your super contribution cap?

Why it’s important to keep track Take control of your super and learn: • • •

How much you can contribute per year Strategies to build super tax-effectively How super contributions are taxed

Read more This information and all QSuper products are issued by Australian Retirement Trust Pty Ltd (ABN 88 010 720 840, AFSL 228975) as trustee for Australian Retirement Trust (ABN 60 905 115 063). Any reference to “QSuper” is a reference to the Government Division of Australian Retirement Trust. This is general information only, so it does not take into account your personal objectives, financial situation, or needs. You should consider whether the product is right for you by reading the relevant product disclosure statement (PDS) and Target Market Determination available at qsuper.qld.gov.au or call us on 1300 360 750 to request a copy. Where necessary, consider seeking professional advice tailored to your individual circumstances. SPON-700. 05/22.

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Unions save lives AND THE RESEARCH PROVES IT

NEW RESEARCH out of the US suggests unions have saved thousands of lives in aged care during the COVID-19 pandemic.

The research, published in Health Affairs, America’s leading peer reviewed journal of health policy thought and research, offers scientific evidence that unionised aged care facilities had proportionally fewer COVID deaths than non-union facilities during the June 2020 to March 2021 study period – findings attributed largely to the role unions play in improving workplace safety.

The research found “unions were associated with 10.8 percent lower resident COVID-19 mortality rates, as well as 6.8 percent lower worker COVID-19 infection rates”.

The authors further claim that across the American aged care industry, unionisation may be associated with as many as 8000 fewer resident deaths.

“Unionised workers in essential industries have better access to paid sick leave, SARS-CoV-2 testing, and personal protective equipment,

and they may also be less likely to work multiple jobs and to live in settings associated with SARSCoV-2 transmission. Such factors may decrease COVID-19 infection rates among nursing home workers, reduce the spread of COVID-19 between workers and nursing home residents, and thereby lower resident COVID-19 mortality rates,” the research noted.

The research on resident mortality was draw from 13 350 nursing homes across all 48 continental US states – 2242 or 16.8 per cent of which had a health care worker union presence.

The secondary research stream examining infection rates among workers was drawn from a larger sample of 13 449 homes, 2302 of which were unionised.

QNMU Acting Secretary Kate Veach said while the findings were based on a US data, it was testament to the benefits of unions everywhere and their active pursuit of safe working conditions.

“Safety at work is one of the cornerstones of the union movement

and absolutely a foundational principle of the QNMU,” she said.

“The best comparable example of this in Australia, is in state-run nursing homes in Victoria, which thanks to ANMF lobbying, have mandatory safe staffing levels,” she said.

“State-run facilities with ratios have fared significantly better during the Omicron wave so far, recording only three deaths in total up to the end of February, compared to an average of 17 resident deaths every day in privately run facilities where there are no ratios.”

“We now we have further evidence of how critical our work around safety – including safe staffing levels – is, it saves lives, by the thousands.”

Research article details:

Dean, A., McCallum, J., Kimmel, S. D., & Venkataramani, A. S. (2022). Resident Mortality And Worker Infection Rates From COVID-19 Lower In Union Than Nonunion US Nursing Homes, 2020–21: Study examines resident mortality and worker infection rates from COVID-19 in US unionized nursing homes, 202021. Health Affairs, 10-1377.

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Workers Memorial Day remembers those who never came home

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VERYBODY has a right to feel physically safe at work – the right to expect they’ll do their job then go home to family and loved ones unharmed at the end of the working day.

with a phone call from my sister telling me that our Dad had died at work,” Elesha said.

Every time I hear accidents in the

But in the past 12 months to February this year, 25 Queensland workers have died on the job, while hundreds of others have suffered lifechanging serious injury or illness.

“No words can explain that feeling and it breaks my heart to think of anyone else who has experienced that.”

This year’s commemorations came in the wake of a damning report released by the Australian Council of Trade Unions that showed a 32 per cent surge in workplace fatalities and an eight per cent increase in workplace injuries from 2018.

That’s everyday working people, just like us.

Those workers, and hundreds of others before them, were remembered on 28 April as Queenslanders gathered to mark Workers Memorial Day. This year’s event was particularly significant for the QNMU’s own Growth and Campaigning officer Elesha Dawson, who lost her father Graham in a mining accident in September last year.

Speaking at the event Elesha said her dad gave so much to his family, but his five grandchildren would now grow up without his love and support.

“Every time I hear about other accidents in the news, I immediately remember how it felt to be woken up

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The statistics are even more disturbing when the report points out the Morrison Government’s failure to implement any of the reforms recommended by the Review of Australia’s Work Health and Safety laws in 2018.

“It’s an appalling legacy. Nurses and midwives, indeed all workers, deserve a government that takes the safety of the country’s workforce seriously,” QNMU Assistant Secretary Kate Veach said.

“It’s why we must always be vigilant, why we must hold governments and policy makers to account and keep safety central to all we do. As the Workers Memorial Day motto says, we must continue to fight for the living.”

about other news, I immediately remember how it felt to be woken up with a phone call from my sister telling me that our Dad had died at work.

Elesha Dawson, QNMU Growth and Campaigning officer

Pictured: QNMU Secretary Beth Mohle supports Growth and Campaigning Officer Elesha Dawson during the Workers’ Memorial Day gathering in April.

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Vale Cathy Styles

Leader, pioneer and passionate advocate for midwifery and women’s health

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HE QNMU was sad to hear of the passing of long-time member and friend Cathy Styles in May. A Registered Nurse and Midwife for 30 years and a QNMU member for 28, Cathy was a well-known and well-respected nursing and midwifery leader in Queensland.

A passionate advocate for midwifery and women’s health, Cathy was instrumental in setting up the birth centre in Townsville in 2008, and later the Sunshine Coast University Hospital’s midwifery group practice and the eligible private practicing midwives’ group. She had also been a member of the QNMU’s Midwifery Reference Group since 2013.

Colleagues at the Sunshine Coast Hospital and Health Service where Cathy was Nursing Service Director of Women and Children’s Services said Cathy was always positive and respectful, and had both a great sense of humour and a strong work ethic.

They remembered her fondly for the loyalty, support and guidance she offered nurses and midwives over the years, and for her determination to ensure best practice outcomes for patients and their families.

and Midwifery Officer Shelley Nowlan bestowed upon Cathy The Nightingale Tribute – an acknowledgement used around the world to honour nurses no longer with us.

“Nursing and Midwifery is a service profession that cannot be lived in isolation. Nurses and Midwives rely on each other for the synergistic effect of teamwork in our efforts of care giving. It is appropriate that we honor our colleagues not only during their career, but also at the end of life’s journey.

Nursing and Midwifery is a calling, a lifestyle, a way of living. Nurses and Midwives here today honor our colleague Cathy Styles who is no longer with us and her life as a Nurse and Midwife.

Cathy is not remembered by her years as a nurse or midwife, but by the difference she made during those years by stepping into people’s lives, and by special moments.

Our thoughts are with Cathy’s family and friends at this time. She will be dearly missed.

Cathy was an active and engaged member of the Office of the Chief Nursing and Midwifery Officer, and was also a member of the Australian College of Midwifery and the Australian College of Nursing, and the Association of Queensland Nursing and Midwifery Leaders.

In recognition of Cathy’s contribution to nursing and midwifery in Queensland and particularly her role in growing and developing future nursing and midwifery leaders, Queensland Chief Nurse

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The view from the other side A NURSE’S PERSONAL CANCER JOURNEY

Photo: Lou O'Brien

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Clinical Nurse Consultant, mother of two and QNMU member Sally Kriel was diagnosed with stage 1 bowel cancer in August 2018. In this article, Sally shares her unique experience as a patient through the eyes of a skilled nurse in a bid to raise awareness of the prevalence of bowel cancer, particularly in young people, and to share a perspective on opportunities for new beginnings after a personal health crisis.

My diagnosis I always describe myself as one of the ‘lucky’ ones. A few months after my 38th birthday and after returning to work after having my second baby, I began to experience some ongoing abdominal pain and cramping. As my symptoms were new for me and had lasted for approximately four weeks, I had decided to discuss them with my GP. My symptoms could easily have been put down to IBS, food intolerances, ‘women’s issues’, or something to ‘keep an eye on’. I didn’t have bleeding or the low hemoglobin we often associate with bowel cancer.

Sure, I was tired – but what parent of young children isn’t?

Thankfully my GP decided to look beyond my age and investigate to ‘cover all bases’. Just six weeks later after a colonoscopy, I was told “I’m sorry you have cancer”.

Because I acted on my symptoms early and my incredible GP referred me for a colonoscopy, my cancer was diagnosed early. My treatment was a right hemicolectomy to remove the right side of my bowel. Thankfully, I didn’t need chemotherapy or radiation treatment.

emergency presentations, and from well-meaning loved ones. In the early stages of my recovery, I would find being told that I was ‘too young’ to have bowel cancer quite distressing.

Hearing those words didn’t support me through my recovery, it increased my vulnerability as a patient, and increased my husband’s fear.

Bowel cancer symptoms can include: ■ a change in bowel habits including diarrhoea, constipation or the feeling of incomplete emptying ■ a change in the appearance or consistency of bowel movements such as thin bowel stools

Today when I hear the words “wow you are young to have had bowel cancer” from health professionals and the community (I heard it just last month when I went in for my surveillance colonoscopy), I use it as a teaching opportunity.

■ blood in the stools

The misconception that bowel cancer only affects older adults can make it more difficult for a younger person to access diagnostics tests, and as a result, they may experience a delay to diagnosis and treatment.

This is important. Being aware of the symptoms and prevalence of bowel cancer is essential for primary care, outpatient, and emergency department health professionals.

■ unexplained fatigue

■ abdominal pain, bloating or cramping ■ anal or rectal pain ■ a lump in the anus or rectum ■ weight loss ■ tiredness and/or anaemia (pale complexion, weakness and breathlessness) ■ blood in the urine or passing urine frequently or during the night, change in urine colour – dark, rusty or brown.

Source: Cancer Council Australia https://www.cancer.org.au/cancer-information/types-ofcancer/bowel-cancer

Young-onset bowel cancer in Australia is on the rise, with 10 per cent of people diagnosed under the age of 50 years. One in 13 Australians will be diagnosed with bowel cancer in their lifetime – it is Australia’s second deadliest cancer (behind lung cancer) and the deadliest cancer for Australians aged 25-44 years.

I have found that despite the increasing prevalence of bowel cancer in Australia, younger patients are often told they are ‘too young’ to have the disease. I have heard these words so many times since my diagnosis – during my hospital stay, during

Checkup: Sally getting her 12 month scan after undergoing a hemicolectomy following bowel cancer.

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indepth My greatest lessons As a nurse, walking in the patient’s shoes has been hugely humbling and insightful. I have learned more in the past three years about what it is to be a health consumer than I have in my now 21 years of nursing. There have been so many lessons, and I wanted to share some of them with you in the hope of improving another patient’s health journey: ■ I want to encourage people to be more in tune with their body, to listen to and act on symptoms early. Our health really is our greatest asset. It is important to prioritise physical and emotional health.

■ Bowel cancer can be a stigmatised condition, and commonly thought to be ‘an old man’s disease’. Very few people like to talk about their bowels, so if a patient is reporting bowel symptoms please consider them carefully.

■ It is important healthcare

Sally with husband Yuri, and their two sons.

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professionals are aware of the statistics for young-onset bowel cancer. If an adult under 50 years presents with bowel cancer symptoms – please look past their age and investigate to rule out bowel cancer.

■ If you are a health professional who finds yourself wearing the patient’s shoes, please be kind to yourself. It certainly is an adjustment to find yourself on the other side of the bed or consulting table. Allow yourself to be the patient and receive the support and care you need. It is OK to ask lots of questions and don’t put pressure on yourself to know everything about your condition and treatment plan. It is also OK to grieve the loss of your good health (hopefully temporarily) and need emotional and psychological support.

■ Equally when treating a health professional, it is helpful to talk to us just like any other patient. In that moment we can be vulnerable, fearful, sad, and forgetful- just like any other patient.

New Beginnings I found that some of my greatest recovery challenges were the lesser discussed and more ‘invisible’ impacts of cancer. The challenges of parenting through recovery, diet confusion, exercising through symptoms, carer strain, financial strain, cancer fog, body image hurdles, end of life discussions, returning to work, and the mindset challenge of a lifetime, all needed navigation through trial and error.

During my early recovery, I promised myself I would give back to the cancer community and share some of my greatest lessons and to this end I recently published a book A Woman’s Guide to Navigating the Invisible Cancer Load.

I wrote the book to guide other women through their cancer journey. I have shared my story and important insights from the cancer community and experts to hopefully help make the cancer journey for other women a little easier. I have been lucky to be offered many opportunities since my illness and have now launched a new National Survivorship Network with Bowel Cancer Australia. It is free and is an excellent resource for patients and their carers, and a great place for nurses to refer their patients to.

Sally and Christopher John, who is the CEO of Bloomhill Cancer Care.

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During my early recovery, I promised myself I would give back to the cancer community and share some of my greatest lessons...

Further reading: To find out more about Sally’s journey head to: theawakenedmumma.org www.instagram.com/the_ awakened_mumma_wellness/ www.facebook.com/ theawakenedmumma/ The Movement Wellness Beyond Diagnosis (closed Facebook group) https://bit.ly/3Q1cnKx The Bottom Line Podcast https://apple.co/3Mz7LZ0

...I recently published a book A Woman’s Guide to Navigating the Invisible Cancer Load.

Sources: Bowel Cancer Australia: https://www.bowelcanceraustralia.org/facts Cancer Council: https://www.cancer.org.au/cancerinformation/types-of-cancer/bowel-cancer

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The age of

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face masks L

iving in a COVID world means personal protective equipment (PPE) such as face masks and respirators are an absolute necessity and will be for a long time to come. But what’s it costing our environment, and should we be concerned about its long-term impacts?

It is estimated 129 billion face masks and 65 billion gloves are used globally every month during the COVID-19 pandemic.

The market for disposable face masks is estimated to have increased from $800 million in 2019 to a whopping $166 billion in 2020. That’s a 20,650 per cent increase!

Now, well into our third year of the pandemic, it’s likely these already staggering figures have further increased.

Based on usual patterns of disposal, around 75 per cent of COVID-19 related plastic PPE waste ends up in landfills or ocean environments.

Given the rapidly evolving nature of the pandemic and the need to respond quickly, there hasn’t been time to prioritise or consider the environmental impact of consuming such enormous amounts of PPE. But according to experts, it’s something we should take very seriously.

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indepth The cost to our environment and health Dr Micah Peters is the National Policy Research Adviser at the Australian Nursing and Midwifery Federation, and has written many evidence-based resources regarding COVID-19 and PPE. Dr Peters said the massive uptake in face masks and PPE use is a significant threat to both wildlife and global ecosystems.

“Masks and other PPE can be ingested by wildlife or become tangled around necks, wings and fins, causing injury, sickness and a slow, painful death for animals,” he explained.

“Common surgical masks take about 450 years to fully decompose, and many plastics break down into harmful microplastics and contain contaminants that enter the ecosystem.

“There is increasing evidence that microplastics can enter food chains so these impacts also have a detrimental effect on people who rely on healthy ecosystems to grow food.”

QNMU member and Clinical Nurse Margaret Lehan believes it’s an issue that also has a significant impact on our community’s health.

Dr Micah Peters Dr Micah Peters is the National Policy Research Adviser at the Australian Nursing and Midwifery Federation and Director of the National Policy Research Unit based at the University of South Australia’s Rosemary Bryant AO Research Centre.

Micah has written many evidence-based resources regarding COVID-19, personal protective equipment in the pandemic context, vaccination, and workforce policies and practices. Micah’s background is in evidence-based health care, evidence synthesis research, and the implementation and evaluation of best clinical practice across health and aged care settings.

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“There is a direct correlation between the health of our environment and the health of our people and community – our increased use of single use plastic items has an impact on climate change and in turn, leads to an increase in related illnesses like heat stroke and asthma,” Margaret said.

“We also need to consider that the manufacturing of PPE uses large amounts of resources and it all adds to our carbon footprint.”

These concerns are shared by environmentally conscious members of the public who, at the start of the pandemic, might have opted for reusable cloth masks rather than disposable ones.

However, since the emergence of the highly infectious Omicron variant, experts have cautioned against cloth masks due to their lack of efficacy, with some claiming they are “little more than facial decorations”.

Instead, we’re now encouraged to wear well-fitted respirator masks as a first choice (N95, KN95, or P2 masks).

And as we well know, in a clinical environment, single-use PPE like surgical masks and respirators are vital for infection prevention and control and are not easy to substitute with reusable options.

Offsetting our carbon footprint A passionate environmentalist, Margaret was the winner of the inaugural QNMU Research and Innovation Award for her recycling initiatives at The Prince Charles Hospital.

She believes the best thing we can do is consider what we can offset in other areas of the workplace to reduce the impact on our environment.

“While we can’t recycle masks and gloves, we can recycle the cardboard boxes they come in if you’re working in a non-COVID or non-infectious area,” Margaret said.

“There’s no cost for cardboard to be collected so that’s actually reducing the hospital’s waste cost as well as environmental footprint.

“PVC recycling is something that can massively reduce our environmental footprint – PVC never breaks down and is highly toxic, but it can definitely be recycled. There are so many other items that can be recycled, we need only look.

“There are also potential financial savings in all areas of recycling which could be diverted back into patient care or staffing – a win-win situation.”

Due to the changing nature of the pandemic, Margaret said it is not always clear if certain recycling practices can continue. But support from management with good communication and education will go a long way to empowering staff to recycle.

“Understandably, the pandemic takes priority – people are tired and overworked. There are many passionate people across our hospitals who want to do something but recycling practices may not be well supported.

“Our health services have a responsibility to consider recycling in future planning, so that when wards are planned and built there is space allocated for recycling bins and storage.

“I can’t stress enough how vital education is – a lot of staff want to

indepth recycle but don’t know how or what can be recycled. We need to incorporate this into our inductions for new staff and ensure there are proper recycling bins and signage in place.

“If we put this into our future planning and ensure there is room for these strategies, we can make it so much easier for staff to recycle.”

We all have a part to play Dr Micah Peters said we are only now starting to understand the range of flow-on effects from increased PPE waste.

He believes it’s vital we address and improve waste management and recycling practices so better systems can be put in place to help minimise the detrimental impact single use plastics have on global environments.

And governments and health care providers have a vital role to play.

“The surge in the need for single use PPE during the pandemic has also coincided with the increased manufacture and consumption of single use plastics more broadly,” Dr Peters said.

“This means there must be across the board consideration of how public policies and laws that govern industry, waste disposal, the environment, and health can minimise harmful waste and instead support healthy environments.

“Governments and health care providers need to have strong and effective policies and practices that help to minimise the risk that waste from health care poses both now and in the future.

“Addressing these risks must be part of a broader and proactive effort to tackle the ways in which humans impact the environment, including pollution and climate change.”

We know the pandemic is here to stay, at least for the foreseeable future, and Margaret believes it’s vital we change our mindset and make recycling a habit.

“Future generations aren’t going to be able to solve our environmental problems, it’s not going away and we need to do something about it now,” she said.

“Those of us who work in health have a duty of care – we come into our professions because we want to help and to heal, and that extends to our environment as well.

“We need to make recycling second nature because every little thing adds up and our small actions can make a difference.

“But at the same time, we are in a pandemic situation so we need to be kind to one another and just do what we can, every bit helps.”

Our environmentally sustainable health care services policy The QNMU’s Policy Committee (QPC) recently undertook a review of our new environmentally sustainable health care services policy.

The policy outlines the importance of health care services being environmentally sustainable by optimising the use of resources and minimising the release of waste into the environment.

It also highlights the need for health care staff to be educated on the importance of environmental sustainability, and how our practices and processes in the workplace can assist in ensuring an environmentally sustainable health care service.

Remember

References

McCallion, A., McGain F., and Borg, K. (2022, January 29). Have you stopped wearing reusable fabric masks? Here’s how to cut down waste without compromising your health. ABC News. https://www.abc.net.au/news/2022-0129/covid-omicron-fabric-masks-n95-kn95respirator/100788406

Recycling is encouraged and well promoted at TPCH

Bruno, G. (2022, January 13). Why you should upgrade your mask as the COVID-19 Omicron variant spreads. 7 News. https://7news.com. au/lifestyle/health-wellbeing/why-you-shouldupgrade-your-mask-as-the-covid-19-omicronvariant-spreads-c-5288347

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What can health staff do to offset our environmental footprint?

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ASSIONATE environmentalist and CN Margaret Lehan said while we can’t recycle PPE used in infectious wards (it has to go to landfill or be incinerated depending on your workplace’s infection control procedures and policies), there are lots of other items found in health care facilities that can be recycled to help offset our environmental footprint.

Cardboard boxes: We can recycle the cardboard boxes that products come in right down to smaller medication boxes. This prevents them from going into general waste.

Sanitiser gel bottles: The bottles can be pulled apart and their pieces can be recycled into the co-mingled recycling bin.

Batteries: These can be recycled for free and preventing them from going into landfill means harmful battery chemicals don’t end up in our soil.

Printer cartridges: The plastic from printer cartridges can be recycled and ink can be reused.

Drink containers: Most hospitals have recycling programs similar to Containers for Change.

Pens: We love our pens and go through a lot of them! While we can’t recycle them in hospitals, we can collect used pens and take them to Officeworks to be recycled.

TEDs and SCUDs: These can all go in the recycling bin!

!

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Old mobile phones and broken electrical equipment: Organisations like Reverse Garbage and Substation33 reuse and repurpose these items to give them a new lease on life. Social workers will also often accept old mobile phones and donate them to patients in need for safety or care follow ups.

Procedure packs: There are lots of plastic components in procedure packs and many items remain unused and clean. If they’ve just had saline fluid in them, they can be recycled.

Medication trays: At the Prince Charles Hospital (Margaret’s workplace), medication trays are made from sugar cane by ECHO (the European Commission Humanitarian Aid) and are biodegradable and compostable.

Let’s hope this fantastic initiative is extended to more hospitals!

IV bags, Hudson masks and oxygen tubing: The PVC from these items can be recycled. Everything that isn’t PVC needs to be removed – for example, a Hudson mask’s stainless steel nasal bridge should be removed and placed in the co-mingled recycling bin, and its oxygen connector and elastic straps should be removed. The remainder can be placed in a PVC recycling bin. Common products that can be made from recycled PVC include outdoor furniture, play mats, garden hoses, gumboots, and many more!

Last but not least, Margaret said talking to people and educating them on the importance of recycling to help raise awareness is also a great way to start.

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Those of us who work in health have a duty of care – we come into our professions because we want to help and to heal, and that extends to our environment as well.

Margaret Lehan, QNMU member, Clinical Nurse and passionate environmentalist

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Cherbourg members bunker down to keep their community

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The small south Queensland community of Cherbourg was hit by two floods this year about six weeks apart, but each time hospital staff stepped up to the challenges, demonstrating dedication to their profession and great support for each other and the community they proudly work in.

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HEN RAIN started bucketing down in Cherbourg earlier this year, the locals knew exactly what was coming.

Despite hydrologists assuring Cherbourg Hospital management there wasn’t going to be any major flooding, ENs Dallas Robinson and Margaret Allcock knew it was only a matter of time before “Big Shot Bridge” went under and the town became cut off at the bridge and local gullies.

“Talking to some of the Cherbourg Residents and Elders out there, everyone was convinced it was going to flood, so we were like, “Yeah, let’s get prepared”,” Dallas said.

“These were not the first floods we’ve been through since we started working here.”

Cherbourg in Wakka Wakka country, about 250 kilometres north-west of Brisbane, is one of those towns that has been hit, not once, but twice by flooding so far this year, leaving people stranded on either side of the swollen Barambah Creek for three or four days each time.

For Dallas, Margaret and their colleagues who could make it in – including those who walked to work when the roads became impassable for cars – this meant camping out at the hospital to make sure the inpatients and walk-ins, including dialysis patients, could still get proper care.

Dallas and a Cherbourg local check out the river level during the floods.

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“We had some of us up in the Palliative Care Unit. There were staff down the back in the Donga accommodation and

indepth we had operational staff sleep in the staff dining room - we had people everywhere! In the January flood, the doctor even brought his camper trailer,” Dallas said.

Hospital staff stuck on the wrong side of the river went to help at the nearest facility they could safely travel to.

“You go and pitch in because they’re probably in the same boat with staff that can’t get in,” Dallas said.

Stuck for four days with reduced staff, the Cherbourg nurses were doing 12-hour shifts during the January floods with just five nurses (including the DON), a medical officer, and one operational staff member on deck to keep the meals coming and hospital clean.

Top team: (left to right) Enrolled nurses Margaret Allcock, Kristine Baulch and Dallas Robinson, and DON Cecily Labuschewski were all on hand to provide continuous care for the Cherbourg community during the February floods.

In February they were better prepared with more supplies and workforce, which included eight nurses (including a dialysis nurse), a midwife, a multi-skill nursing team and a medical officer.

In a race against rising water and blocked roads, the QAS took the forestry dirt road with a police escort.

“We get to Wondai where we were to offload to another ambulance,” Dallas said.

“But that ambulance got a code one call, so we had to travel all the way through to Kingaroy.

“All I could think of is we got to get back or we’re going to get stuck.”

But for all the drama, both Dallas and Margaret said working through the flood was quite social and uplifting.

“There’s really great community spirit,” Margaret said.

“My colleague Kris, an EN, described it as ‘real camaraderie during a struggle’.”

Nurse Dallas Robinson and her patients making the quick dash to Kingaroy as the floodwaters rise.

“Our Indigenous security staff Stafford and Tanya took on extra security shifts… and a clinical nurse who was in her third trimester of pregnancy also pitched in to help out and support everyone,” Dallas said.

“Of course, we were also lucky, there was no lives lost and we didn’t get the extent of damage other areas did.”

Dallas said while there were still medical challenges to manage, it was

a matter of simply “making the best of it”.

“You can be out there and make it harder than what it has to be, or you can get out and go for a walk of the morning, check the water levels, talk to the locals,” she said.

“And when you do that, it reassures, it makes people think, ‘Okay, we’re all in it together within the community.

There are people here to look after us’.”

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Photos supplied with permission.

But there were still hairy moments, including an ambulance dash to get two patients to Kingaroy before the river went over again.

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Half a century of midwifery transformation Not many people can spend almost 50 years in a profession and still light up when they talk about their work. But newly retired midwife Marilyn Slark loves reminiscing about the joys of her long career.

O

VER THE COURSE of her remarkable 48-year career, Marilyn has helped bring thousands of babies into the world, supported countless families, and experienced firsthand the exciting progress we’ve seen in midwifery and maternal care.

After graduating as a nurse in 1976, Marilyn worked in hospitals in Gosford and Coonabarabran before moving to the United Kingdom.

It was there Marilyn decided to become a midwife and pursued postgraduate study, before returning home and settling in Brisbane. She worked at Sunnybank Private Hospital for 20 years and Buderim Private Hospital for 13 years.

“I always knew I would become a nurse so that really wasn’t a difficult choice for me,” Marilyn said.

“And coming from a small town, I thought I’d end up living rurally, so having skills in midwifery made the most sense to me - I thought it would be useful. And it turned out that I absolutely loved it.”

Like many midwives, the highlight of her career has been the opportunity to nurture the mothers and babies in her care.

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“It was always a privilege to be there and support mothers and their babies. I felt very honoured to be with them during that time,” she said.

The evolution of midwifery While her passion for the role didn’t ebb in 48 years, advancements in education and technology changed the care of women and how they birthed. With it, the role of the midwife was under constant transformation.

“It’s interesting because all the small changes don’t seem like much at the time, but when you look back, you realise we’ve come a long way,” Marilyn said.

“When I first started in the late 70s, midwifery was quite structured and clinical. At that time, birthing was very bed-oriented - babies went to the nursery at night, and they had regimented breast-feeding times.”

By the early 80s, innovative technology offered midwives new ways to provide care, monitor patients and conduct observations.

“It was exciting. I trained using the Pinards, but suddenly we were

using Sonicaids. CTG machines and ultrasounds were introduced!

“We had demand feeding, and skin-to-skin contact. Calm birthing and water births also became an option for women, plus we moved toward a midwifery-led model of care, IVF pregnancies and ongoing education.”

Advocating for mums and bubs Now it’s almost unthinkable that a mother wouldn’t receive an ultrasound (or three) or have the option to birth in whatever position she found most comfortable, but this was the reality for many years.

And as a profession both dominated by women and centred around them, midwives have been at the forefront of changes to how women birth.

“Women advocating for other women to create change – to me, that’s what a midwife is. You’re your client's advocate. It’s a huge responsibility, and it’s a privilege,” Marilyn said.

“I think a lot of the changes stem from midwives trying to get away from being so clinical, with the women

Graduation in 1976

Weekly newsletter from 1976

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ured with Marilyn pict and bub um m a new . de just livered

Marilyn (bottom right) with her midwifery training group in Plymouth, UK

being more informed – especially when birth is perceived as natural.

“Midwives support mothers in their choice of birthing positions and plans.”

Building trust With conversations around mental health increasing, particularly in the past few years, not surprising to see this focus extend into maternity and postnatal care.

“I think we’re becoming more mindful with the education we provide our mothers both antenatally and postnatally. We’re more aware that our mothers are carrying around a lot of stress and that they do need us. They need extra care, particularly after birth,” Marilyn observed.

“Women have more autonomy in the birthing experience, with access to a lot of information from the internet and midwifery education, so if there is a change to their birthing plans it can be overwhelming for them. But as midwives, we have a duty of care for a safe outcome for mum and baby.”

And that’s why as midwives, building trust with patients is so important.

Some of Marilyn's nursing memorabilia

“Personally, my main goal for mothers and families postnatally is to show them encouragement and support, and give them the confidence to be a parent,” Marilyn said.

“You think back to before the sixties and honestly it seems like it was survival of the fittest.

“We didn’t hear about many traumas from women who have had miscarriages, but did they share them? Was there a place for them to share them? They just had to take it in their stride.

“Now, we have those hard conversations and there’s follow up and programs in place for them, and I think that’s an incredible step in the right direction.”

Though many things have changed in the maternity ward over the past 50 years, the heart of midwifery remains the same – supporting a woman through birth and advocating for her during one of the most intense and emotional experiences of her life.

It’s this passion and dedication that will remain with Marilyn, even as she hangs up her pinnard and looks forward to a well-earned retirement.

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indepth

Finding solutions to a dysfunctional health system S

OMETHING the pandemic has painfully highlighted is that Australia’s health system is complex and disjointed, and it’s not often clear who has responsibility for what.

We’re now used to watching our federal politicians blame their state counterparts for whatever failings are occurring in the health system at any given time, and vice versa from our state politicians.

From shifting responsibility for who was meant to secure enough Rapid Antigen Tests at the beginning of 2022, to a lack of clarity over postCOVID return to work requirements, responsibility is divided and collaboration is rarely incentivised.

The result is fragmented care and shifting costs. Unfortunately, the loser is always our patients and those working in the system, including nurses and midwives.

But if there’s something else the pandemic has proved, it’s that it’s always best to listen to expert health advice – and not just during a pandemic.

If we truly want to fix the fundamental flaws of our complex health system, then decision makers need to be prepared to listen to and be guided by those who work in it.

A voice at the table In December 2021, the QNMU made a submission on behalf of members to the Queensland Government’s Inquiry into the provision of primary, allied and private health care, aged care and NDIS care services and its impact on the Queensland public health system.

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Our submission outlined not only the critical issues facing our health system today, but the solutions nurses and midwives are proposing.

Speaking at the inquiry, QNMU Secretary Beth Mohle advocated not only for nurses and midwives to have a greater voice, but for that voice to be heard.

“Nurses and midwives know the health system, they work in it 24/7,” Beth said.

“They have the solutions to the many problems that exist.

“Unfortunately, their voices are far too often not heard.

“We saw at the very beginning of the COVID-19 pandemic what was possible when the potential was unleashed and nurses, midwives and other health workers were able to work to full scope.

“We need this to continue. We need empowerment of the health workforce to get on and do the job they are capable of doing.”

Focus on causes, not symptoms One of the most fundamental flaws of our health system is the focus on the symptoms of a strained system, not the causes of that pressure.

“For example, ambulance ramping is a symptom of a bigger problem,” Beth said.

“The problem is the drivers of this demand… you cannot have a focus on

activity-based funding alone because it is a constant driver.”

The QNMU believes there is an urgent need to reframe funding by focusing on value-based health care, which places patients and their health outcomes at the centre of health care.

“We are not focusing on quality outcomes for people and doing things differently, so we need to quarantine funding for new models of care that will relieve pressure on our system.

“At the moment, the funding model privileges activity over innovation.”

Tip the system on its head Beth said we need to rethink the way we deliver health care services.

“They need to be in the community and as close as possible to people’s homes, whether that home is a nursing home, a disability service, or a community-based centre.”

That’s why the QNMU has long campaigned for the creation of local Queensland health hubs, redirecting demand away from hospitals and into community settings to ease pressure on our busy EDs and ensure appropriate care is delivered when and where Queenslanders need it.

Thanks to this campaigning, the Labor Federal Government has committed to implementing 50 Urgent Care Clinics across Australia.

These bulk-billing centres will deliver care for non-life-threatening illnesses, such as broken bones, wounds and minor burns, with no out-of-pocket costs.

The QNMU will liaise with Labor about how these centres should be staffed. While it remains unclear how many of these centres will be nurseled, we believe Nurse Navigators and Nurse Practitioners must have a leading role to play in this new community health model, as we’ve seen with the successful walk-in community clinics in the ACT. In responding to our asks regarding health innovation, Labor had this to say: “In government, Labor will explore new models of care to ensure healthcare is meeting the needs of

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Things have to fundamentally change.

all Australians, regardless of where they live. If you understand the crucial role of nurses and midwives in the healthcare system, it is clear that these models of care will undoubtedly rely heavily on nurses and midwives.”

Fail to plan, plan to fail In developing any new models of care, the right workforce planning must be done.

Incredibly, no federal workforce planning has been done for nursing and midwifery since 2014, which was when the Federal Coalition Government disbanded the agency known as Health Workforce Australia.

The last review indicated Australia needed an additional 85,000 nurses by 2025 and 123,000 by 2030 … and that was before the pandemic came along.

During the recent federal election, the QNMU sought commitments from all parties to undertake urgent workforce planning to ensure there are enough nurses and midwives available to meet increasing demand.

We will seek to ensure the new Labor Federal Government does this work.

“You cannot have a system that is running at more than 100 per cent capacity all the time and then have something like a pandemic come along and not be under pressure,” Beth said.

But if we truly want to support our exhausted workforce, we have to plan better.

This fundamentally goes to our long-standing call for minimum ratios across all sectors, because if governments are incapable of planning for the future needs of our health and aged care systems, then at least there is a minimum staffing requirement etched in law.

And if the pandemic has demonstrated anything, it’s the need to have proper baseline staffing from the outset so we are in a better position to respond in a crisis.

“COVID provides us with an opportunity to reset and pivot so that we are all paying attention to the fact that we cannot continue business as usual,” Beth said.

“Things have to fundamentally change.”

Unfortunately, we’re now seeing the consequences of that lack of planning.

Increasing workloads, understaffed shifts, double shifts and regular overtime… all things which lead to burnout.

s lutions To read our full submission, head to https://bit.ly/3LR87tW

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owards gender equality

T

HE NEW Queensland Women’s Strategy 2022-2027 released by the State Government in March focuses on economic security. The QNMU have been extensively involved in the consultation process – writing public submissions and letters to ministers stating our concerns.

In the World Economic Forum Gender Gap Report 2021, Australia ranked 50th in the world – well below other Commonwealth countries such as New Zealand (4th), the United Kingdom (23rd) and Canada (24th).

Despite excellent education levels among women, Australia was found to have poor economic participation and opportunity for women, poor representation of women in politics, and poor health and survival (World Economic Forum, 2021a).

This suggests there are significant systemic, structural, and social issues hindering gender equality in Australia that must be addressed through broad reforms across all levels of government and society.

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Gender pay equity Gender equality cannot be achieved until there is gender pay equity. Women and men who perform the same work, or work of equal or comparable value, should be paid the same amount.

The determinants of gender pay inequity are complex. Some contributing factors include the historical and continued undervaluing of women’s work, workplace conditions, workplace participation, how work is organised, education and training opportunities, and casualisation and precarity of employment (ANMF, 2017).

workplace culture, even in the face of various organisational policies and guidelines. If policies and guidelines are not adhered to, or are deliberately misapplied, then they are not only ineffective but also potentially damaging because they give a false and misleading impression that the organisation has addressed the issues.

However, the primary source of gender pay inequity is gender discrimination, where the skills, responsibility and working conditions of women are not valued as highly as men.

For example, QNMU members report facing gender discrimination upon returning to work after maternity leave. Declining applications for flexible working arrangements, refusal to reinstate employees at their previous pay rate, and being overlooked for career progression opportunities due to gaps in continuous employment are just some of the ways in which women can be disadvantaged for having children or having carer responsibilities.

Gender biases and discrimination are especially difficult to address because of their insidious and entrenched nature in existing

While individually, these types of cases may suggest issues at the micro level, it is critical to consider the cumulative impact of individual cases

indepth of discrimination and the broader systemic implications and messaging it creates.

The impact of the COVID-19 pandemic The COVID-19 pandemic has highlighted and exposed existing gender inequalities that continue to persist in society and manifest in economic inequality. The McKinsey Research Institute reported that women’s jobs were 1.8 times more vulnerable to the effects of the pandemic than men’s (Madgavkar et al., 2020), due to: ■ a higher proportion of women in industries hit the hardest by lockdowns, such as hospitality, retail, and recreation ■ the higher likelihood of women being employed on a part-time or casual basis, and ■ the higher likelihood of women leaving the workforce or reducing their work hours to undertake additional unpaid care work.

Such economic implications are likely to extend beyond the pandemic and result in long-term setbacks in workforce participation and income, creating a ‘snowball effect’ for women (Azcona et al., 2020).

This compounds into so-called ‘scarring’, where the interruption of career and being out of work has long-term effects on earnings and career progression. Being out of the workforce for an extended period, for whatever reason, may lead to skills erosion, the declining relevance of experience, losing touch with professional networks, and generally becoming less attractive as an employee to employers (Wood et al., 2021). This will further widen the gender pay gap and hinders progress towards gender equality.

What can be done?

There is a global call for genderresponsive economic approaches that specifically address existing and predicted gender inequality (Cochran et al., 2020). This includes: ■ tackling unpaid childcare, for example, through policies that encourage both spouses to work, family-friendly policies, and measures to change social norms about childcare responsibilities ■ investing in women-dominated industries and occupations, such as services jobs and healthcare ■ ensuring women’s safety in the workplace by strengthening the prevention of, and response to, violence against women, and ■ increasing the representation of women in leadership positions through scholarships, training and mentorship programs (Fitzsimmons, Yates, & Callan, 2021).

Identifying and rectifying gender inequality is everyone’s responsibility. Failing to act enables gender stereotypes to persist around perceived skills, experience, skill value, and capacity.

References: Australian Nursing & Midwifery Federation. (2017). Gender Segregation in the workplace and its impact on women’s economic equality. Melbourne: ANMF. Azcona, G., Bhatt, A., Encarnacion, J., Plazaola-Castaño, J., Seck, P., Staab, S., & Turquet, L. (2020). From Insight to Action: Gender Equality in the Wake of COVID-19. New York, US: UN Women.

Cochran, J., Diallo, B., Qayum, S., Seth, A., & Staab, S. (2020).

Addressing the economic fallout of COVID-19: Pathways and policy options for a genderresponsive recovery. UN Women.

We are therefore hopeful that the new Queensland Women’s Strategy will have a major impact on the lives of future generations.

Fitzsimmons, T. W., Yates, M. S., & Callan, V. J. (2021). Towards Board Gender Parity: Lessons from the Past – Directions for the Future. Brisbane: University of Queensland.

We are also campaigning to secure commitments to gender pay equity from the state government.

Madgavkar, A., White, O., Krishnan, M., Mahajan, D., & Azcue, X. (2020). COVID-19 and gender equality: Countering the regressive effects. McKinsey Global Institute. Retrieved from https://www.mckinsey.com/ featured-insights/future-ofwork/covid-19-and-genderequality-countering-theregressive-effects

Gender wage gap The gender wage gap in Australia is currently 14% based on average weekly full-time earnings across all industries and occupations, meaning that on average, women earn $261.50 per week less than men (Workplace Gender Equality Agency, 2021a).

Over a year, the full-time total remuneration gender pay gap is a staggering 20%. In other words, men who work full-time earn about $25,000 more per year than women (Workplace Gender Equality Agency, 2021b).

Even in healthcare some penalties and conditions are less for female dominated coccupations.

Find out more at www.qnmu.org.au/EB11

Wood, D., Griffiths, K., & Crowley, T. (2021). Women’s work: The impact of the COVID crisis on Australian women. Grattan Institute. Retrieved from https:// grattan.edu.au/wp-content/ uploads/2021/03/Womenswork-Grattan-Institute-report. pdf Workplace Gender Equality Agency. (2021a). The Gender Pay Gap. Retrieved from https:// www.wgea.gov.au/the-genderpay-gap Workplace Gender Equality Agency. (2021b). Australia’s Gender Pay Gap Statistics.

Retrieved from https://www. wgea.gov.au/publications/ australias-gender-pay-gapstatistics World Economic Forum. (2021).

Global Gender Gap Report 2021. Geneva, Switzerland: World Economic Forum.

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indepth

It’s time to

celebrate

QNMU turns Break out the party hats everyone, because the QNMU is about to turn the big four-oh!

Y

es, it’s been 40 years since our union (then called the Queensland Nurses’ Union) broke away from the Royal Australian Nursing Federation to become a union its own right.

And what a 40 years it’s been!

What started with a modest membership of just 13,898 nurses has blossomed into Queensland’s largest union, more than 66,000 members strong and drawn from nurses and midwives across all classifications and sectors.

Over the years, as we advocated for members and their industrial and professional rights and needs, we’ve taken on all manner of challenges from site-level issues such as carparking and rostering to the big battles that have changed the face of our professions – that have made our workplaces safer, expanded the scope of our work and delivered better outcomes and care for our patients and residents.

Clearly we have a lot to celebrate, and in our next edition of InScope we want to highlight some of our most memorable moments.

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during the EB5 public sector negotiations of 2002.

Are you most proud of our long-standing campaign to protect Medicare – which started when we became foundation members of the Public Hospital Health and Medicare Alliance (PHHAMAQ) way back in 1998?

Maybe you are one of the first Enrolled Nurses to undertake medications training in 1998, or were a public sector nurse who was quick to take advantage of the ground breaking professional development leave we negotiated in EB6.

Do our Workplace Health and Safety wins tickle your fancy? Maybe the No Lift by 2000 campaign that lead to better lifting policies and fewer injuries, or our recent work ensuring proper PPE fit testing for COVID workers?

What do you think we should include?

Or were you part of the campaign for public sector ratios in 2016, or watched them roll out to acute mental health wards or public residential aged care facilities in 2019 or 2020 respectively?

Are you a public sector nurse who has enough years under your belt to remember the Chunder Bucket Express? The largest nursing strike in Queensland history! More than 10,000 nurses taking a stand against unsafe workloads and poor pay

And if it’s pay campaigns you reckon need revisiting, well… take your pick! Our private sector wage parity campaign in 1996? The EB6 public sector pay negotiations which made Queensland nurses among the best paid in the country?

So we want to know, what’s been your favourite QNMU highlight?

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!

Oh, then there’s the QNMU’s statewide Aged Care Secret Audit that uncovered the true reality of aged care staffing levels and care provision in 2018, complemented of course by superb testimony from our members who fronted the Aged Care Royal Commission more recently.

Or what about our work last year developing the Swim Standards for safer workloads in maternity?

Or maybe it’s our cultural and social commitments that have made you proud to be a member. The forming of our award winning First Nations Branch perhaps? Or maybe our LGBTI reference group?

There is so much to choose from!

We look forward to wandering down memory lane with you!

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To help us select the best moments, we’d love you to drop us a line with your ideas (and photos if you have them!). Simply email inscope@qnmu.org.au

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Navigating shift work and complex menstrual cycles I

WANT TO highlight the importance of women’s health. My passion is to give hope to women like me who experience menstrual challenges, spotlight how shift work can affect hormones and, by extension, our experience as nurses or midwives.

Underlying hormonal conditions such as polycystic ovary syndrome (PCOS), endometriosis or fibroids can affect the ability to deliver optimal patient care during different times in the menstrual cycle.

BY MADDI MUNRO, QNMU MEMBER AND REGISTERED NURSE

Hormones and havoc A hot, yet frequently unspoken, topic that we all need to hear: how hormones impact many working nurses and midwives.

According to healthdata.org, 1.53 billion women are living with gynaecological diseases. Many women will experience a hormonal imbalance or gynaecological conditions that create a cascade of symptoms and can wreak havoc.

This article was originally published in Nurse and Midwife Support.

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Although nurses and midwives choose our professions for a reason, we often aren’t prepared for the demands of shift work, especially night shift and how the irregular schedule can affect our health and wellbeing.

Many of us experience common symptoms of hormonal and gynaecological conditions including tiredness, anxiety, pelvic pain, burnout, PMS, cramping and fatigue.

Combined with shift work and our caring nature, the symptoms can be exhausting especially during a pandemic. Crippling pain and struggling to function at work can lead to nurses and midwives exhausting sick leave.

I have experienced all this firsthand and am motivated to share my story to create awareness surrounding this topic, which is unfortunately still treated as taboo.

I want to let those in similar circumstances know that you are not alone!

What can we do?

Some of these conditions require support, understanding and symptom management such as dietary changes, lifestyle interventions and adequate sleep.

To prevent increasing levels of burnout in female-dominated professions, I seek to raise awareness. I’ve found education is vital to understanding the complexity of the issues.

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Prevention and education is key

Menstrual mindset

I cannot stress this enough — prevention and education is key.

Be in the mindset that whatever you do, always consider: How does this best support me and my menstrual cycle?

Research the facts.

Find a mentor.

Read books.

Speak to friends — you will be surprised how many have similar problems.

Go on social media – there is abundance of educational videos and posts about the menstrual cycle.

Track your cycle with apps/journals – I personally use Flo. Get to know what you are putting in your body, including hormonal contraceptives.

I have extensively researched menstrual issues, and here are some interesting facts I’ve learned: ■ Cycle-syncing and roster-perfecting are some solutions that can help to resolve hormone-related burnout.

As Alisa Vitti outlined in her book In the Flo, the four different phases in the menstrual cycle have different requirements — dietary adjustments, certain exercises and hormonal fluctuations must be reflected in our everyday practice.

■ Recent research has shown that exercise during menstruation can in fact ‘turn on’ fat storage, particularly high intensity interval training. I found this absolutely fascinating — that despite our good intentions of working out, it can actually be bothersome and counterproductive for your body during this time of the month.

■ Women in the UK have founded a program called Red whereby women are entitled to menstrual leave when experiencing severe symptoms.

Attend educational seminars/conferences – they can even contribute to your CPD. Talk to your GP, a gyno, or even an endocrinologist.

Your perspective and routines will change once you develop an understanding of how you can incorporate this information into daily practice.

■ If I am feeling tired, is the gym a good idea today? Should I perhaps go for a gentle walk or yoga session instead?

■ I am craving sweets. Should I opt for fruit or something else instead to best support my hormones?

■ Liaise with your manager to request nights that best suit you.

Although difficult, expressing your needs to your manager to prevent sick leave on rosters may be an option.

It is important for your manager to understand your situation.

Explore your sense of self I have found that nurses and midwives find it hard to say no — but sometimes we need to, to prevent burnout and fatigue.

Sometimes it is important to politely decline the agendas and expectations of others and to ask for support when you need it.

My goal is to grow a community of nurses and midwives to help us understand, love and respect ourselves.

Prevention and education is key

I have become more fascinated in learning about the intricacies of the menstrual cycle. I have delved deeper into how I can live life with abundance and treat my body well.

I have practiced seed cycling whereby I add seeds as a source of fibre and nutrients to meals in accordance with which phase I am in, moon cycling depending on the moon phase, acupuncture, repose and renewal techniques, and meditation and deep breathing — all of which are forms of self-care.

Navigating your menstrual health and other health issues can be stressful. For more info or for a discussion, contact Nurse and Midwife Support on 1800 667 877.

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Who will win the

te t e Od

N

OMINATIONS for the QNMU Nursing and Midwifery Excellence Awards have officially closed and our awards committee is currently busy sifting through a pile of fantastic nominations.

The winners of the four main categories will share in a prize pool of $20,000 to further their professional development.

y d n

A

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at their research on how health impacts with land and country – that connection, and the concept of how land care is health care,” she said.

For Kathryn Hooper, who won the Aunty Dulcie Flower and Aunty Gracelyn Smallwood award, the win gave her an opportunity to boost her qualifications.

The prizemoney helps winners pursue learning and development opportunities and activities they might not have otherwise considered.

“I put the $5000 from this award towards the cost of undertaking further higher degree research. It also gave

“I used my prize money to

Winners will be announced at our gala ceremony at the Tivoli in Brisbane on 28 October.

(Australia’s only First Nations dual sector tertiary education provider) and spent time with the postgraduate co-ordinator looking

One finalist will also be named the People’s Choice winner, as voted by the public, and be awarded a professional development prize of $1000.

Winner of last year’s Excellence in Leadership and Governance Award Andy Carter chose to share his good fortune with colleagues.

Finalists for the QNMU’s 2022 Nursing and Midwifery Excellence Awards will be announced at our upcoming QNMU Annual Conference (and live-streamed via Facebook).

“I visited the Batchelor Institute

purchase 200 books as resources for all RBWH nursing and midwifery leaders,” he said.

“I am using these resources as a vehicle to create discussion, debate and feedback around nursing and midwifery cultural change and transformation.”

Other winners looked to build their knowledge base.

me an opportunity to attend some workshops on trauma informed care and narrative therapy to enhance my knowledge and skills in working and honouring the world’s oldest living culture.”

Ka t

Positive Practice Environment Award winner Odette Best went on a study tour to Mparntwe (Alice Springs) late last year, spending time at the Desert Knowledge Precinct.

hr

yn

VOTE FOR THE

PEOPLE’S CHOICE AWARD Finalists for the QNMU’s 2022 Nursing and Midwifery Excellence Awards will be announced at our upcoming QNMU Annual Conference (and live-streamed on Facebook), which means entries will soon be open for the People’s Choice Award.

The People’s Choice Award allows you to vote for the finalist who you believe makes the most outstanding contribution to a positive practice environment in their workplace.

The finalist with the most votes wins $1000 towards their professional development.

VOTE

WIN

Voting will open from 28 July at www.qnmu.org.au/Awards once our finalists are announced at our Annual Conference.

Everyone who votes is automatically entered into the draw to win one of five $50 Coles/Myer gift cards.

Thank you to our Award partners

Pictured L to R: 2021 QNMU Awards winners Sophia McLaren, Kathryn Hooper, Odette Best and Andrew Carter.

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You are

union

BY DR LIZ TODHUNTER, QNMU SENIOR RESEARCH AND POLICY OFFICER

W

E OFTEN look to the history of the Australian union movement to inspire us and set the platform for the future.

However, it is also worthwhile to reflect on the origins of the union movement in the UK where the early literature tells us much about ‘the struggle’ and to consider the current state of unions in the US, the centrepiece of liberal democracies where there is hope for union renewal.

First published in 1897, Industrial Democracy is the seminal work of Sidney and Beatrice Webb, prominent scholars of the British trade union movement.

In this work, the Webbs analysed the constitution of nearly every trade union in the UK to determine the methods and regulations they used to achieve their objectives.

Even in those early years, unions clearly articulated their shared purpose and vision.

The Webbs found there were common aspirational threads throughout these statements – safe working conditions, an eight hour working day, higher rates of pay for working Sundays (penalty rates), fair wages, legislation to enforce these conditions, abolition of individual contracts and settlement of disputes through arbitration, to name just a few.

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And in a prescient moment, the National Union of Gasworkers and General Labourers sought “to raise wages and where women do the same work as men, to obtain for them the same wages as paid the men”.

Who would have thought?

More than 120 years later, these fundamental objectives endure.

The first principle of the union movement is that a single worker cannot effectively stand alone against the disproportionate power of an employer, but many workers together can balance the scale.

Yet despite the economic and social benefits such unity has produced, union membership has decreased significantly in almost all advanced economies.

Australia unionism reflects the international trend.

Over the past two years, the COVID-19 pandemic has drawn attention to the challenges faced by workers.

For example, the pandemic highlighted the difference between workers who had the ability to work from home and those who had to leave their homes for work.

These ’essential’ workers risked their own health to keep the whole community safe by operating the

health system, providing transport, and keeping retail venues open.

The pandemic also highlighted how so many non-union workers experienced poor working conditions, lacked job security, had limited or no access to paid leave, were not provided with appropriate Personal Protective Equipment, and importantly lacked any capacity to voice their concerns to the employer.

So many jobs lost and so many workers left standing.

The economic and social crisis brought on by the pandemic demonstrated how unions leave no one behind.

At a time when Australians were struggling, the union movement fought hard to ensure all workers were protected and provided for.

Unions are important institutions for democracy. Without them, there would be no counterforce to the relentless momentum of capitalism where the pursuit of greater, faster economic growth leaves no space for those who cannot keep up.

It is ironic, therefore, that we look to the US, no shining star in its handling of the pandemic but the heart of global capitalism, for inspirational leadership on union growth.

In April 2021, President Joe Biden established a White House taskforce

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dedicated to ‘mobilising the federal government’s policies, programs and practices to empower workers to organise and successfully bargain with their employers’.

In February 2022, the taskforce chaired by Vice President Kamala Harris tabled a report containing 70 recommendations around three stated goals: ■ Position the federal government as a “model actor”.

■ Use the federal government’s authority to support worker empowerment by providing information, improving transparency, and making sure existing pro-worker services are delivered in a timely and helpful manner.

■ Use claimed authority to leverage the federal government’s purchasing and spending power to support workers who are organising and pro-worker employers.

By accepting the recommendations in the report, President Biden explicitly recognised the important role unions play in taking the nation forward.

As he has famously said, “The middle-class built America — and unions built the middle-class.

Everything that supports a middleclass life was made possible by unions. On Labour Day, we honour all those workers — and their enduring

movement — that keep our economy moving and make our nation strong”.

And so it is here in Australia.

Unions benefit everyone. It is through the efforts of all those unionists who have gone before that we have a standard working week, a weekend, penalty rates, job security, leave, health and safety protections, protections against discrimination and harassment, pay increases, and many, many more entitlements.

As union members you take the country forward.

You help to improve the working lives of Australians.

You take the risks, raise your voice, carry the burden of your non-union colleagues and help those less fortunate.

You are the strength and the power.

A single worker cannot effectively stand alone against the disproportionate power of an employer, but many workers together can balance the scale.

Be so proud.

YOU are union.

References

Webb, S., & Webb, B. (1914). Industrial Democracy.

Longmans, Green and Company.

Harris, K. & Walsh, M. (2022). White House Task Force on Worker Organizing and Empowerment. The White House. https://www.whitehouse.gov/wp-content/ uploads/2022/02/White-House-Task-Force-onWorker-Organizing-and-Empowerment-Report.pdf

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indepth

CHANGE OF GOVERNMENT

offers

hope for a

better AUSTRALIA

B

Y THE TIME counting closed for the night on election day May 21 and ABC’s election analyst Antony Green had made his last call for the evening, the political landscape in Australia had changed.

True, a dozen or so seats still remained in play, but it was clear Albo was in, ScoMo was out, women’s votes hit home and teal and green were the new black.

But what does it mean for us? For the QNMU and our goals and hopes for health, workers and civil society?

Aged Care action Importantly, it represents a significant milestone for our campaign to fix the aged care sector and our quest to have the recommendations of the Aged Care Royal Commission implemented.

During the election, the QNMU and our national body the ANMF successfully secured four critical commitments from Federal Labor, including: ■ a registered nurse in every nursing home 24 hours a day ■ a mandated minimum 215 minutes of care per resident per day ■ funding real wage increases for aged care workers ■ ensuring funding accountability for providers.

This Labor government represents our best hope yet for real change in this sector, so we have every right

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to be excited. The challenge now is keeping the pressure on to make sure these pre-election commitments aren’t watered down.

Better health, better health systems We also look forward to the new government making good on their commitment to implement strategies to reduce the pressure on our hospitals, particularly Emergency Departments.

The ALP’s proposal to establish 50 walk-in Urgent Care Clinics, is particularly promising.

So too are plans to address workforce planning which had been woefully neglected under the previous regime. Planning is also about ensuring the workforce is appropriately skilled and is working to the full scope of their practice – which means establishing clear career pathways for nurses and midwives in all corners of the country.

Other promises we will be watching closely for include: ■ $100 million to train 500 Indigenous health workers and funding to boost critical life-saving treatments in First Nations communities.

■ The establishment of an Australian Centre for Disease Control – a timely announcement given the COVID-19 pandemic and the troubled vaccination roll-out.

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We will also be looking out for the new National Nurse and Midwife Health Service we campaigned for, to provide nurses and midwives with professional support services to help manage burnout and stress – an issue close to home for many QNMU members.

More for Medicare As the architects of Medicare, it is perhaps not surprising Labor pledged a $1 billion boost to the universal health care scheme – a move that is particularly welcome after years of it being wound back under the LNP. The funding should make it easier and more affordable to visit the GP, and will set up a program of grants to

help GP clinics cover the cost of staff training and new equipment.

Medicines should also become cheaper thanks to a promise to reduce the cost of medicine on the Pharmaceutical Benefits Scheme by about $12.50 per script.

In their pre-election campaign, the Greens called for dental and mental health treatment to be included in Medicare, so this may also be an area to watch.

Meanwhile, we will continue to lobby for an expansion of Medicare reimbursement arrangements for nursing and midwifery services, and for the implementation of the recommendations made by the Nurse Practitioner Reference Group during the recent review of the Medical Benefits Scheme.

Before he was elected Prime Minister, Anthony Albanese signed the pledge to support our election asks for aged care.

Better for workers Labor made a number of preelection policy announcements designed to improve the lives of working Australians, many of which unions have long lobbied for.

One of the key policy platforms for both Labor and the Greens was secure jobs, so we can only hope this translates into solid progress in this direction.

Labour has pledged to make secure work an objective of the Fair Work Act, ensuring it is at the heart of Fair Work Commission decision-making, though how this will translate into real outcomes is still to be seen.

Other work-life promises the union movement has been vocal on include: ■ support for a 5.1 per cent increase to the minimum wage to help alleviate cost of living pressures for low-income earners. We are pleased to note the FWC has since awarded a 5.2% increase (see page 9).

■ $5.4 billion to increase childcare subsidies for about 96 per cent of Australian families – with low-income families expected to have about 90 per cent of their fees subsidised ■ implementation of all 55 recommendations of the Respect@ Work report released in March 2020 (see page 62 for more) in a bid to end workplace sexual harassment, sex-based discrimination and victimisation

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indepth ■ addressing the gender pay gap by making it mandatory for large companies and corporations to publicly publish gender pay gaps and imposing a ban on secrecy clauses around pay disclosure, and ■ tackling affordable housing shortages by building 30,000 new affordable houses and introducing a scheme to help thousands of families into new homes.

We also expect Labor to honour its commitment to extend the 10 days family and domestic violence leave provisions recently won in the Fair Work Commission for Federal Award employees, to all workers covered by the National Employment Standards (NES), which is particularly applicable to QNMU members in the private and aged care sectors.

Kinder, fairer, more compassionate future As a progressive organisation with values that embrace compassion, inclusiveness and fairness, this election result offers real hope we might see an end to short-sighted divisive politics that breeds discrimination and meanness, and rejects science.

And it’s not just the Labor win we can point to. The success of the Greens and the rise of the climatefocused Teal independents suggests a turning point where Australian voters are looking for real leadership and multi-lateral action on the social issues that affect our current and future social wellbeing.

The two stand out issues are the promise of decisive action on climate change and a commitment to implementing the Uluru Statement from the Heart in full.

■ Climate: If ever there was a chance for real progress on climate change legislation, this red-teal-green parliament is it. Labor has promised to implement future-ready policies, legislation and practices that genuinely and pro-actively address the climate crisis, which include a 43% emissions reduction target by 2030, and net zero by 2050.

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It also boasts a $3 billion investment in renewable energy and green metals funding for new energy jobs and training, and plans to reinstate the Climate Change Authority.

We welcome these promises, and will be watching to see if and how Labor works with the Greens and the Teals to develop truly multilateral agreements on tackling climate issues.

■ First Nations: Politically sidelined over the past three years, implementing the Uluru Statement from the Heart is long overdue, and something the QNMU campaigned for during the election.

seekers; and we hope we’ve seen the last of our rainbow friends in the LGBTIQ community being used as political punching bags.

All in all this new Labor government, and a lower house featuring a number of independents, offers a good deal of hope, but there is still much to do.

Anthony Albanese and his team made a lot of promises pre-election and in the next three years, it’s incumbent on us to continue our campaigns to ensure they live up to those committments.

The Statement with its calls for Voice, Treaty and Truth is a fundamental step towards addressing the deep systemic disadvantage experienced by First Nations people in this country.

There is hope that what started with Kevin Rudd’s National Apology to the Stolen Generations in 2008, might now continue under this new Labor government, in a more ideologically progressive parliament, and will address not only the issues of formal recognition, a treaty and enshrined political voice, but also have a real impact on matters such as health and education, economic advancement, and deaths in custody.

As a progressive union, we are also hopeful this new government signals a change to how other marginalised groups in our community are treated.

For example, we are hopeful it leads to kinder and more humane approaches to refugees and asylum

hope

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GROWING OUR OWN NURSES AND NURTURING ARE THE KEY TO GROWING THE FIRST NATIONS HEALTH WORKFORCE 46

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Kelly Trudgen loves a good yarn.

And when she’s talking about nurturing and encouraging First Nations nurses and health workers, you can’t help but be drawn in by her passion and enthusiasm.

A Gumbaynggirr woman, from Yellow Rock, Urunga, Kelly is the Nursing Director, COVID Response for the Aboriginal and Torres Strait Islander Health Division based in Meanjin (Brisbane). She’s also a co-chair of the QNMU’s First Nations Branch.

An incredible networker with professional connections in just about every First Nation’s health body in the state (and more than a few federally), Kelly’s primary role is stakeholder engagement – to be a conduit between health bodies and the First Nations community, particularly its health workforce.

“It’s really about having those yarns about everything COVID – so from COVID vaccinations right through to COVID response,” Kelly said.

“We (report) back to the Division on how we are performing (in community) but we also do consultation with the community about what they want.”

Kelly’s role means she travels all across the state connecting with everyone from nurses in remote communities to policy makers in city boardrooms. This has consolidated her belief that nurses should be “growing their own” – that nurses should be leading the development of the First Nations nursing workforce through mentoring and support, and advocating for systemic changes that facilitate pathways for professional development.

It starts, she says, by identifying talent within the existing workforce, particularly early career nurses and Indigenous health workers engaged in nursing work, and helping them recognise their potential.

“Nurses… we’re the mothers of the profession. We’re the nurturing ones and we should be nurturing them, because some of these kids, they want to go on to become nurses or doctors or something else, and if we don’t help

facilitate their learning we risk (losing them),” she said “And they’re such a very valuable part of the workforce because a lot of them live and work in those communities and (they’re likely to continue to) if we could help them along the way.”

She points to the likes of a "real gun" young health worker she met recently.

“I reckon he could probably do medicine, personally, but he’s like, ‘Oh, sis, I’m going to be like you’.

“They had cardiologists out there and he was doing the whole workup for them, doing all of the bloods, weights for BMI and all the rest of it. Then he was actually doing venepuncture, taking bloods.

“They also do things like audiometry assessments for the Deadly Ears program for kids.

“This is the thing, we’ve got this skillset… but nurses don’t actually nurture that and say, ‘Actually, these are really good skills you’ve got. Have you ever thought about going to uni and becoming a nurse?’”

Building confidence Kelly said a good deal of nurturing young talent is about building confidence and offering mentoring that understands the realities of First People’s experiences.

“About 57% of the health workforce in ACCHO’s (Aboriginal Community Controlled Health Organisations) identify, but in HHSs a lot just don’t,” she said.

“I had one new grad nurse (come up to me) and said, ‘Kelly, I’m Aboriginal too’. Then she told me a very sad story that she didn’t identify when she applied for the job because she was too scared that she wouldn’t get a job if she identified as being Aboriginal. It really broke my heart.”

“So I got her to join… the First Nations Branch. In branch, we are family, we do support each other, we do have each other’s back.

“We understand there’s been sociotrauma, we have that lived experience where the system’s been shot and not looked after us before… the institutionalised racism.

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indepth “So many of our people think, ‘This is all I can be’. So I’d love to help empower these nurses so they can come up.”

She said reconciling their professional lives with their cultural identity can be quite challenging for some First Nations health care workers, particularly early career practitioners who are not yet confident in their professional practice.

“I was delivering workshops with indigenous health workers and getting them up to speed for vaccinating… I got one in and, God bless her, she’d done her (vaccination) modules... but she was too scared (to do the vaccinations),” she said.

“These kids live and work in community, so they go home to their aunts, uncles, mums, dads, brothers, sisters, and so they don’t want to be seen as the, I guess, perpetrators of harm, because that was a big thing with COVID vaccination.

QNMU First Nations Branch Co-chair and Nursing Director, COVID Response for the Aboriginal and Torres Strait Islander Health Division Kelly Trudgen joined forces with Vaccination Ambassador and rugby league legend Johnathan Thurston, and Aboriginal GP and Public Health Medical Officer, Dr Mark Wenitong to encourage COVID-19 vaccination uptake among Queensland’s First Nations peoples.

“It was like they were holding the Kryptonite and they didn’t want to be the ones actually giving it to their family.”

“So, it’s about getting them across the line and giving them that confidence, being there for them and helping them learn.”

“Nurses… we should be nurturing them, because some of these kids, they want to go on to become nurses or doctors or something else, and if we don’t help facilitate their learning we risk (losing them).”

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Nurse-led transition pathways Many learning pathways for First Nations health workers and nurses, however, particularly those in remote communities, are blocked by poor access to resources and support, which is why Kelly believes it is imperative for nurses to step up and advocate for better resourcing and alternative ways of learning that are both practical and culturally appropriate.

“I was talking to a public health nurse (up North) on Wednesday they’ve only got 3G reception at the best of times, and not everyone has NBN access,” Kelly said.

“Not everyone has internet at home, (and) they live in overcrowded homes, so you don’t have a space to study when they go home.

“There are sociocultural issues too like they don’t want to move away to Townsville, [but] if we could almost have the old, dare I say it… hospital-

based staff training... If they’ve worked up on a Cert 3/Cert 4 level already, why aren’t they allowed to go down for two weeks for residential and the HHS pays for them, or we sponsor them, and then you come back and work and do your practical?

“There needs to be some sort of transition pathway for them…and I think nurses really need to lead it.”

Kelly said creating professional development and upskilling opportunities for mid- and later career Indigenous nurses and midwives is also critical, not only for their own career progression but also to boost the ranks of Aboriginal and Torres Strait Islander people in leadership where they can provide voice, visibility and vision within the workforce, and help foster culturally and psychosocially safer workplaces.

“What that results in… is a sustainable workforce, because people will remain in the workforce,” she said.

“That’s our role as nurses.

We should be facilitating that development.

“Nurses really need to do that mothering, that nurturing [and] I think if we did that, I really sincerely believe we would actually find that we could grow a lot of our own, and in the right environment.”

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RECONCILIATION:

AN ONGOING CALL TO ACTION FOR ALL NURSES AND MIDWIVES

BY KATE VEACH QNMU ASSISTANT SECRETARY

N

URSES and midwives are the largest and most trusted group of health professionals and as such have an important role and significant responsibility in Australia’s reconciliation journey.

Reconciliation in healthcare is key to creating a system that understands and values the positive and protective aspects that culture and selfdetermination have on the health and wellbeing of Aboriginal and Torres Strait Islander peoples – and how we can achieve health equity and equality.

Reconciliation Australia tells us that “At its heart, reconciliation is about strengthening relationships between Aboriginal and Torres Strait Islander peoples and non-Indigenous peoples, for the benefit of all Australians.”1 As nurses and midwives, we know strong relationships with individuals and communities deliver the best health outcomes. We know firsthand the benefits that listening, partnering, and collaborating can bring to the health and wellbeing of those connecting with the healthcare system.

Reconciliation guides us to consider the interrelated dimensions of five key areas - historical acceptance; race relations; equality and equity; institutional integrity; and unity2 - and how these dimensions can assist in the development and delivery of culturally safe practice in healthcare.

For instance, we must acknowledge and understand the significance of Australia’s historical past and the devastating effect colonisation has had and is still having on Aboriginal and Torres Strait Islander peoples as a direct result of land dispossession, violence, and racism.

We must acknowledge and take action to eliminate all types of racism in healthcare, in particular, the high levels of institutional racism prevalent in the healthcare system as documented in the Health Equity Report .

unfinished business of reconciliation in Australia. It is a call to act on and be braver about reconciliation every day.

We must acknowledge the role of nursing and midwifery in the harm that has been done in not challenging racism and discrimination in the healthcare system.

■ Learn more about reconciliation by visiting Reconciliation Australia’s website ■ Get involved in your workplace Reconciliation Action Plan (RAP) – if your organisational does not have a RAP, then get the process started by visiting Reconciliation Australia’s website ■ Join the QNMU in supporting the Uluru Statement from the Heart ■ Join the QNMU in supporting the Australian Human Rights Commission’s campaign Racism. It Stops With Me. ■ Learn more about Cultural Safety and the benefits of Culturally Safe practice and Culturally Safe organisations – you can also familiarise yourself with the QNMU Cultural Safety Position Statement, NMBA and CATSINaM joint statement on Culturally Safe care, and the NMBA’s standards for practice ■ Make reconciliation a standing agenda item in consultative forums and your local branch meetings.

We must recognise, respect and be led by Aboriginal and Torres Strait Islander peoples’ self-determination in all areas of life, especially healthcare, and work together to close the gap on health inequities.

We must make sure workforce planning incorporates the growth and development of Aboriginal and Torres Strait Islander peoples with a variety of entry, career, and leadership pathways available across every level of the healthcare system.

We must seek and demand a wide range of opportunities be created in our political, organisational and community structures for Aboriginal and Torres Strait Islander peoples to ensure their voice is front and centre in decision-making.

We must respect and value the more than 65,000 years of cultures and histories of Aboriginal and Torres Strait Islander peoples - the longest and most continuous histories of any in the world.

This year’s National Reconciliation Week’s theme - Be Brave. Make Change. – was a call to tackle the

There are many ways you can learn more about and get actively involved in reconciliation:

Together we can build the strong relationships needed to deliver a just, equitable and reconciled Australia.

References

1. (What is reconciliation? - Reconciliation Australia).

2. https://www.reconciliation.org.au/reconciliation/whatis-reconciliation/

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Progress on state health commitments

BY DENISE BREADSELL, QNMU PROFESSIONAL OFFICER

A

T THE last Queensland state election, the QNMU, on behalf of members, successfully lobbied the Palaszczuk Labor Government to support initiatives that would benefit Queensland’s nurses and midwives across all sectors.

The commitments hallmark the QNMU’s focus on workloads, safety and job security for members.

The QNMU continues to work, primarily with Queensland Health, to ensure the promises made at the last state election are actioned and implemented.

The commitments are supported by collaborative working groups.

To ensure you, as members, are kept in the loop about this work, we’ve put together a brief outline of our progress on these state health commitments so far, as follows:

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Ratios exploration work This continues to focus on the four inscope clinical settings of emergency departments, maternity wards, operating theatres and prison health services. Subworking groups have been established to support project development across each of the clinical settings. Sub-working groups are comprised of subject matter experts, QNMU officials and the Office of the Chief Nursing and Midwifery Office.

Each sub-working group were asked to make recommendations, by the end of May 2022, regarding models for testing, trial site locations and expected outcome measures from trials. Evaluation of the trial sites will start in October 2022, to provide project recommendations to the government.

Emergency Department Project Officer The Nursing Project Officer – Emergency Department, Sally Anne Jones has been appointed to collaborate and lead initiatives with stakeholders associated with the project established to address emergency department access, demand management and contemporary models of care workflow. A literature review and a review of all emergency department Business Planning Framework documents has been completed. This is in preparation for a range of virtual town hall and engagement sessions

that will be undertaken across the state to ensure a variety of clinical and nonclinical roles are able to provide direct input into the development of report recommendations to the government by the end of 2022.

Positive Practice Environment Standards Reportcard development (incorporating the QNMU Positive Practice Environment Standards)

The working group has completed a mapping process review to identify how and where data is currently collected and what future opportunities exist to develop the reportcard. A facilitated group session was held in May 2022, to explore options and the future development of a reportcard and then make recommendations to the Nursing and Midwifery Implementation Group for further consultation and decision.

The work that follows will scope the best platform to host the reportcard, which was due to be in place by 30 June 2023.

Professional development program to be enhanced to improve uptake and remove barriers Design is under way and includes the potential for scholarships, to support nurses and midwives to gain new

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skills and qualifications in areas of strategic need within the health system, such as mental health and palliative care. There is further work being done to update the Lifelong Learning Framework. This is to pursue opportunities to minimise critical workforce skill gaps through transition support including possible scholarship programs and leveraging opportunities for mental health and palliative care workforces.

Health Equity for First Nations people The QNMU recognises the significant health inequities experienced by First Nations people. We have received commitments to develop strategies to achieve health equity partnerships underpinned by a First Nations Health Equity Framework.

Hospital and Health Services have been working on developing sitespecific Health Equity Frameworks in consultation and collaboration with local First Nations communities, community-controlled health services and their First Nations staff.

A specific pilot program for combatting Rheumatic Heart Disease in Aboriginal and Torres Strait Islander communities has been commenced by Cairns and Hinterland Hospital and Health Service.

These commitments to close the gap will support the provision of

culturally safe health care experience for patients, staff and communities to grow and sustain the Aboriginal and Torres Strait Islander health workforce at all levels.

Queensland Health will also develop and implement a First Nations Workforce Strategy focusing on leadership, training, recruitment and retention, led by the Chief Aboriginal and Torres Strait Islander Health Officer. Currently: ■ QNMU sits on the Tier 3 working group to develop the workforce strategy, accountability measures and implementation strategy for this government election commitment.

■ A project under First Nations leadership will examine workforce models of care, services reform, clinical governance, cultural scope of practice initiatives and cultural safety.

■ Queensland Health has commenced recruitment to a position which will research best practice models of care with a specific focus on cultural safety.

■ QNMU is currently negotiating with Queensland Health, as part of the EB11 negotiations, to include a culturally safe Midwifery practice domain in the development of a separate generic level statement for midwives. This domain will encompass cultural safety and ensure we are embedding cultural safety as everybody’s business into industrial instruments.

5800 additional nurses and midwives over the life of the commitment (from

the baseline numbers of September 2020) At the December 2021 quarter, there had been an increase of 1,874.08 Minimum Obligatory Human Resource Information (MOHRI) Full Time Equivalent (FTE) positions across nursing and midwifery workforces in the public sector.

CPD 1. Identify the First Nations priority areas. How does a focus on these areas benefit all nurses and midwives in Queensland?

2. Consider two or more Government election commitments of your choice. Why are these commitments important to nurses and midwives?

3. Consider one other issue, not considered in these commitments.

Why is this issue important to nurses and midwives? As a QNMU member, how would you plan out and implement and lead change to improve this issue?

Don’t forget to make note of your reflections for your record of CPD at www.qnmu.org.au/CPD

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Securement bundles for PIVCs IS THIS A SIMPLE AND INNOVATIVE WAY TO REDUCE DEVICE FAILURE?

BY DR AMANDA CORLEY, CONJOINT RESEARCH FELLOW (VASCULAR ACCESS), SCHOOL OF NURSING AND MIDWIFERY, GRIFFITH UNIVERSITY & NURSING AND MIDWIFERY RESEARCH CENTRE, ROYAL BRISBANE AND WOMEN’S HOSPITAL CO-AUTHORS: PROF NICOLE MARSH, PROF AMANDA ULLMAN AND PROF CLAIRE RICKARD

P

ERIPHERAL intravenous catheters (PIVCs) are the most common and prevalent invasive medical device used in hospitalised patients and are the mainstay of intravenous therapy delivery.

In Queensland public hospitals alone, 2,686,315 PIVCs were purchased in 2016, representing 97.8% of all vascular access devices used (Tuffaha et al., 2014). But, over half of PIVCs fail before treatment is complete, resulting in pain and discomfort for patients from reinsertion attempts, and financial liability for healthcare institutions.

High failure rates have persisted for decades, reflecting the lack of attention placed on innovative strategies to improve PIVC insertion and maintenance.

Encouragingly, efforts to reduce PIVC failure are now a national priority with the recent release of the first PIVC Clinical Care Standard from the Australian Commission on Safety and Quality in Health Care (Australian Commission on Safety and Quality in Healthcare, 2021).

We know that effective PIVC dressing and securement is an important nurse-led strategy to prevent PIVC complications and failure; however, the most effective way of achieving this is unclear.

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The literature provides little guidance to nurses regarding which dressing and securement product or products results in increased PIVC longevity and reduced complications (Marsh et al., 2015; Rickard et al., 2018).

Like clinical care bundles in vascular access and other aspects of healthcare (Aggarwal, et al., 2019; Pronovost et al., 2006) a bundled PIVC securement intervention involves combining individual dressing and securement products, understanding that each has a role in PIVC security and stability.

To better understand the role of individual dressing and securement products in PIVC complications, data from a large global survey of PIVC care practices was explored to identify associations between PIVC dressing and securement products and PIVC complications (Corley, Ullman & Mihala et al., 2019).

After testing these in a pilot randomised controlled trial (Corley, Ullman & Marsh et al., 2019), we found that it was feasible and safe to conduct a larger study to determine the effectiveness of the bundled securement intervention on reducing PIVC failure.

Importantly, the nursing staff and patients reported high levels of satisfaction with the PIVC bundles.

We are progressing this body of research to further examine nurses’ choices around PIVC securement when designing innovative bundled securement interventions as a patient safety strategy to reduce the unacceptably high rate of PIVC failure.

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This informed the development of evidence-based securement bundles, the components of which were:

1. From observations made within your clinical practice, what factors contribute to PIVC complications and ultimate failure?

■ two sterile tape strips in a chevron pattern around the PIVC hub,

2. What dressing and securement strategies do you use to prevent premature PIVC failure?

■ a bordered transparent dressing plus two tape strips over the dressing, +/■ a tubular bandage.

Don’t forget to make note of your reflections for your record of CPD at www.qnmu.org.au/CPD

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References

Aggarwal, G., Peden, C.J., Mohammed, M.A., Pullyblank, A., Williams, B., Stephens, T., Kellett, S., Kirkby-Bott, J. and Quiney, N., 2019. Evaluation of the collaborative use of an evidencebased care bundle in emergency laparotomy. JAMA surgery, 154(5), pp.e190145-e190145.

Australian Commission on Safety and Quality in Health Care. Management of Peripheral Intravenous Catheters Clinical Care Standard. Sydney: Australian Commission on Safety and Quality in Health Care; 2021.

Corley, A., Ullman, A.J., Marsh, N., Larsen, E.N., Mihala, G., Harris, P.N.A. and Rickard, C.M., 2019. SECURE-ment bundles to prevent peripheral vascular access device failure–The SECURE-PVAD trial: Study protocol for a pilot randomized control trial. Vasc Access, 13(3), pp.6-14.

Top: PIVC failure due to suboptimal dressing and securement Below: PIVC securement bundle consisting of sterile and non sterile tapes, bordered polyurethane dressing and tubular bandage

Corley, A., Ullman, A.J., Mihala, G., Ray-Barruel, G., Alexandrou, E. and Rickard, C.M., 2019.

Peripheral intravenous catheter dressing and securement practice is associated with site complications and suboptimal dressing integrity: A secondary analysis of 40,637 catheters.

International Journal of Nursing Studies, 100, p.103409.

Marsh, N., Webster, J., Mihala, G. and Rickard, C.M., 2015.

Devices and dressings to secure peripheral venous catheters to prevent complications. Cochrane Database of Systematic Reviews, (6).

Pronovost, P., Needham, D., Berenholtz, S., Sinopoli, D., Chu, H., Cosgrove, S., Sexton, B., Hyzy, R., Welsh, R., Roth, G. and Bander, J., 2006. An intervention to decrease catheter-related bloodstream infections in the ICU. New England journal of medicine, 355(26), pp.2725-2732.

Rickard, C.M., Marsh, N., Webster, J., Runnegar, N., Larsen, E., McGrail, M.R., Fullerton, F., Bettington, E., Whitty, J.A., Choudhury, M.A. and Tuffaha, H., 2018. Dressings and securements for the prevention of peripheral intravenous catheter failure in adults (SAVE): a pragmatic, randomised controlled, superiority trial. The Lancet, 392(10145), pp.419-430.

Tuffaha, H.W., Rickard, C.M., Webster, J., Marsh, N., Gordon, L., Wallis, M. and Scuffham, P.A., 2014. Cost-effectiveness analysis of clinically indicated versus routine replacement of peripheral intravenous catheters. Applied health economics and health policy, 12(1), pp.51-58.

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What to do if your legal case becomes a matter of public record online

BY KALINA PYRA, SENIOR ASSOCIATE, QNMU LAW

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D

URING your career as a nurse or midwife, you might find yourself involved in a legal case where there is a ‘reported decision’ – that is, a judgement or ruling that is published in law reports and publicly accessible via the internet.

Unless there is a suppression order on names of those involved, in general, final decisions by courts or tribunals are searchable online using your name.

Depending on the nature of the decision, this might have a negative impact on you when looking for work, since many employers now Google prospective employees.

So, what can you do if your case is part of the public record, appears at the top of the search results for your name, and is negatively affecting your employment in some way?

In reality it is extremely difficult to stop your name being searched and found online. Because Google is simply a search mechanism for third party content, not the actual host of the content, it has no capacity to remove offending content.

However, there are some strategies you might employ to wrest back a little control and mitigate the damage.

Going direct to the source In the case of a court or tribunal decision, you might try contacting the court registry to request a “no index tag” be added to the decision, so it remains searchable on the more restricted court website but does not appear in public Google searches.

You could also ask that the description of the case be changed so that it is vague and does not refer specifically to you in a way that identifies you.

The difficulty with these kinds of requests is that there are public interest, transparency and accountability reasons for having court decisions easily searchable for the public and legal practitioners.

You would have to provide compelling reasons as to why your interest in having the decision supressed is more important than the public interest in having it openly available.

This could include domestic violence issues where the perpetrator is unreasonably directing people to the court decision in an effort to damage your reputation.

You could also attempt to bring an application to the court to have the names of the parties in the decision suppressed.

Suppression of a party’s name generally occurs to protect the privacy of the parties (particularly patients) in health disciplinary decisions of the Queensland Civil and Administrative Tribunal (QCAT). However, it is considered to be in the public interest for disciplinary decisions against health practitioners to be published, for transparency reasons.

In other kinds of cases it might be possible to apply to have the names of the parties suppressed, for example, if your name is unique, the case is a private matter unrelated to your nursing, and information in the case is personal and embarrassing and there is no corresponding benefit to the public in disclosing those facts.

Pushing down This strategy requires significant effort, may have only a limited effect and may take a long time to show results (if any).

It involves promoting or creating more favourable or neutral online content in

the hopes of pushing content that is not beneficial to you further down in search results or in feeds or timelines.

If you have social media accounts, you could try increasing the number of your posts over all platforms in the hope of promoting them above the legal case.

This increase in engagement might help if your case is posted on social media feeds, but is unlikely to have any impact on website content.

You would also need to ensure your posts comply with AHPRA and NMBA social media guidelines, and do not relate to your nursing.

Get professional assistance There are firms which help rectify online reputations, but engaging them can be very costly.

Conclusion Having a publicised court decision can sometimes cause difficulties for a practitioner. If this happens to you, it is wise to be open about the decision with potential employers if it appears as one of the first searches online.

If there are real concerns which override the public interest of having the decision available and searchable, then seek legal assistance to provide further advice on how you might manage your specific circumstances.

What can they see?

The easiest way to get a reasonably accurate understanding of what an average person can see when they Google your name, either log out of your browser and clear the cache and search history before Googling it, or conduct your test search in a private window or incognito mode.

CPD Reading and reflecting on this article may count towards your Continuing Professional Development. Be sure to record the hours on your Record of CPD at www.qnmu.org.au/CPD

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CPD

Work environment and basic work health and safety at COVID testing sites

BY JAMES GILBERT, QNMU OCCUPATIONAL HEALTH AND SAFETY OFFICER

M

EMBERS will often contact the QNMU seeking advice about which basic amenities an employer is required to provide nurses and midwives at the workplace.

This is often triggered when members are moved to a new facility or building, or when renovations are occurring.

Since the COVID pandemic generated a pressing demand for temporary workplaces such as testing centres and vaccine hubs, the provision of amenities, or lack thereof, has become a hot issue for QNMU members.

It is important for members to know that employers are obliged to provide appropriate facilities at all workplaces, even in an emergent situation.

So what are their obligations?

Under the Work Health and Safety Act 2011 the ‘Person Conducting the Business or Undertaking’ (PCBU) – which is generally the employer, must eliminate risks arising from the work environment or minimise the risk as far as reasonably practical.

More detailed advice on this obligation can be found in sections 40 and 41 of the Work Health and Safety Regulation 2011, as well as the Managing the Work Environment and Facilities Code of Practice which can be downloaded using Worksafe Queensland’s search bar. www.worksafe.qld.gov.au/laws-andcompliance/codes-of-practice In Queensland, employers are required to comply with the Code of Practice or provide an equivalent or higher standard of safety than it dictates.

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This means if you work in a COVID testing site, even one set up in haste, you should not be expected to work in a facility of a lesser standard.

The work environment The Code poses a number of questions and suggestions to help people who manage work environments provide appropriate facilities. For example: ■ Does the work involve exposure to infectious material or contaminants?

they propose any changes that could impact your health and safety.

If you have a Health and Safety Representative (HSR) ask them to assist you.

And finally, make sure you use the employer’s incident reporting system.

If these actions do not achieve a resolution please contact the QNMU.

If so, workers may need access to shower facilities before they leave the workplace.

■ Do workers need to change out of their clothes?

If so, they may need change rooms and personal storage.

■ What is the level of physical activity?

This will affect the ideal comfortable air temperature.

Clearly these are matters that must be considered in vaccination and testing workplaces. Other amenities that are required, even in temporary workplaces, include toilets, drinking water, dining facilities and handwashing areas.

So what should I do if our workplace doesn’t meet these requirements?

In the first instance you should raise issues with your managers, pointing out what the Code requires, in an attempt to rectify concerns at the local level.

It is also important to remember your employer must consult with you when

CPD 1. Why is it important that all workplaces including temporary facilities comply with obligations to ensure a safe work environment?

2. How does insisting on a safe workplace align with your obligations as a registrant to NMBA standards?

3. What type of work environment issues could impact on the health and safety of patients?

Don’t forget to make note of your reflections for your record of CPD at www.qnmu.org.au/CPD

CPD

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CPD

Voller and proposed changes to the

defamation law to combat

social media trolling

BY MITCH DOUGALL AND ALISON ROSSITER, QNMU SERVICING INDUSTRIAL OFFICERS.

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CPD

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OU MIGHT have heard co-workers or shock jocks bandying about claims they have been defamed or that someone’s comments are defamatory. But what is defamation?

Defamation is a tort (a civil wrong) that comprises all of the following legal elements; 1. something has been communicated or published 2. the communication has been received by a third party 3. the communication is false or misleading and has or is likely to cause serious harm to the reputation of the person who is taking the legal action (the plaintiff), and 4. the communication identifies the plaintiff.

So far so good, but what’s to stop the rich, powerful (and sensitive) from using defamation law to stifle public debate and criticism with plentiful claims of defamation?

Well, some would argue that already happens – you can form your own judgement from recent high-profile cases (Dutton vs Bazzi or Porter vs Milligan for example).

Fortunately, the existence of legal defences and the exorbitant cost of running a defamation case does deter some wouldbe plaintiffs. The defences against a claim or defamation include truth, honest opinion, absolute privilege for comments made in Court or during Parliamentary proceedings, qualified privilege for matters of public interest and innocent dissemination.

The Morrison Government recently proposed changes in response to the important High Court’s decision in Voller (Dylan Voller’s case against media outlets over defamatory comments left on their social media feeds). In Voller, the High Court decided the operator of a social media page can satisfy the publication element of defamation (see point 1 above) in respect of comments made by third party posters.

This means a page operator can be liable for defamation for a comment made by an anonymous poster on their page, even when the page operator was unaware of the comment and did not consent to it!

The proposed Social Media (AntiTrolling) Bill 2022 attempts to unwind the Voller decision by making social media page operators immune from potential defamation liability for third party posts.

Instead of the page operators being responsible for posting by third parties, it would instead be social media service providers like Facebook and Twitter who

would be deemed publishers of posts by third parties. The bill creates a defence for service providers that have a complaints scheme that, among other things, allow a complainant to request contact details of third-party posters and discloses the poster’s contact details to the complainant if the poster consents. Service providers will also need the poster’s consent to take down posts following complaints.

The proposed bill has been criticised by defamation lawyers who believe it will make it even more expensive and difficult for plaintiffs to prove their claims. With a new government in place, the future of the bill and whether it will be further amended and address those concerns is yet to be determined. For the time being, the decision in Voller decision stands. That means if you operate a social media page you could be held liable for defamatory posts by third parties.

You should be vigilant about any posts you make online, particularly if you can be identified through your social media account. You can be held liable for defamation even if your post was only viewed by handful of followers. You should never make defamatory comments about co-workers. Not only could you face the threat of a defamation claim, but you might also lose your job for bullying or bringing your employer into disrepute.

The QNMU recommends you think very carefully before posting on social media.

Ask yourself: would I still post this comment if I was certain that everyone I know, including my employer, will read it? If the answer is no, keep it to yourself!

CPD 1. Who do you think should be responsible for third party comments on social media?

Why? 2. Consider how you engage with social media platforms. How can you practically protect yourself against a possible defamation claim?

3. Have you ever regretted posting something online? How did it affect you? Were there consequences? What lessons did you learn?

4. How do you determine whether you should or should not post? What rules of thumb do you employ?

Don’t forget to make note of your reflections for your record of CPD at www.qnmu.org.au/CPD

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CPD

Using point-of-care technology to improve detection of tissue injury related to pressure injuries

BY PROFESSOR WENDY CHABOYER, DIRECTOR, NHMRC CENTRE OF RESEARCH EXCELLENCE IN WISER WOUND CARE, MENZIES HEALTH INSTITUTE QUEENSLAND, SCHOOL OF NURSING AND MIDWIFERY, GRIFFITH UNIVERSITY

U

SING risk assessment tools followed by various preventative strategies has been a cornerstone of pressure injury prevention (PIP) for decades, yet about eight per cent of adults will develop a hospitalacquired PI. Clearly, we need to rethink current practice.

Point-of-care technologies support clinicians in their bedside decision making and improve patient care.

Nurses have been using bedside technologies such as pulse oximetry and telemetry for decades. A relatively new device, called a subepidermal moisture scanner (SEMS), is beginning to be used internationally in both clinical practice and research.

SEMS measures localised oedema and has been associated with the development of future PIs. While various devices such as ultrasound and thermography may be used to detect tissue damage, most require special training to use and interpret the readings. The Provisio SEMS is a small hand-held device that overcomes these issues and can easily be used by bedside nurses (see picture).

Our team recently completed a systematic review focused on the ability of SEMS measurement to predict PI in adults in any care setting (Chaboyer, 2022).

Only six studies met our inclusion criteria and of those, only four could be used in the meta-analysis.

In our small review of a total of 483 participants we identified

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that abnormal SEMS was a strong predictor of future PI development in people who were PI free at the time of recruitment to the studies.

We also found that the time from abnormal SEMS to the development of a PI was, on average, four days.

However, two thirds of the studies were at moderate risk of bias.

Despite this, there are reports that the SEMS is being used internationally in some clinical settings (Musa, 2021).

The National Institute for Health and Care Excellence recommends that while SEMS is a promising point of care technology, good quality research is needed before it should be adopted into routine clinical practice, a recommendation that our review supports (National Institute for Health and Care Excellence, 2020).

Our Wiser Wound Care team is taking on this challenge, embarking on a program of research to contribute high quality evidence on the potential benefit of SEMS.

CPD 1. What difficulties do you face when trying to identify if a patient is at risk of a PI? 2. How do you decide if the PIP strategies you implement for at-risk patients are effective?

Don’t forget to make note of your reflections for your record of CPD at www.qnmu.org.au/CPD

References

Chaboyer, W., Coyer, F., Harbeck, E., Thalib, L., Latimer, S., Wan CS., Tobiano, G., Griffin, B., Campbell, J., Walker, R., Carlini, J., Lockwood, I., Clark, J. & Gillespie, B. (2022). Oedema as a predictor of the incidence of new pressure injuries in adults in any care setting: a systematic review and meta-analysis. International Journal of Nursing Studies, 128, 104189 Musa, L., Ore, N., Raine, G., & Smith, G. (2021).

Clinical impact of a sub-epidermal moisture scanner: What is the real-world use? Journal of Wound Care, 30(3), 198- 208. https://doi. org/10.12968/jowc.2021.30.3.198 National Institute for Health and Care Excellence.

(2020). Sem scanner 200 for preventing pressure ulcers. NICE. https://www.nice.org.uk/ guidance/mtg51

CPD

Wound management in treating melanoma

BY SHAHN COBURN, SENIOR CNC, MELANOMA INSTITUTE AUSTRALIA

A

USTRALIA has one of the highest global incidence of melanoma, with Queensland the highest of all the states (Australian Institute of Health and Welfare, 2021). Prevention and early detection are vital to ensure better outcomes and help to reduce melanoma’s impact.

The majority of melanomas are a result of UV damage, which is preventable through sun safe behaviour and education. Regular skin checks and knowing your skin are fundamental, along with seeking professional assessment of any new or changing lesions.

The ABCDE algorithm (asymmetry, border irregularity, colour variation, diameter and evolving/changing) can help people determine if a lesion is of concern (Melanoma Institute Australia, 2021) and Melanoma Institute Australia has also developed a primary risk calculator to help determine an individual’s risk of developing a primary melanoma (Melanoma Institute Australia, 2022).

Treatment For early-stage Melanoma – early stage being defined as melanoma insitu (MIS), stage I and stage II – wide local excision remains the standard treatment (Gershenwald & Scolyer, 2018; Melanoma Institute Australia, 2021b). Obtaining a clear margin

reduces the risk of local recurrence however, achieving this often leaves a significant deficit that requires alternative closure techniques (Faries et al., 2017). While primary closure is the optimal method for smaller excisions, larger defects mean patients will have flap repairs or skin grafts and these wounds often require more post-operative care (Melanoma Institute Australia, 2021).

Post-operative care usually involves wound dressing regimes, and these regimes need to facilitate optimal healing environments where moisture is balanced, the risk of infection is minimised, and the wound is supported through the different phases of healing. Wound care should also consider quality of life and aim to have minimal impact on the patient’s day-to-day routine (Ubbink, 2015).

Dressing selection and regime is often clinician based and will be influenced by one’s experiences however, all have the same end goal.

Wound assessment is a key part of selecting the correct dressing at the correct time and provides rationale as to why a particular dressing is being used.

The dressing regime should aim at being minimally disruptive to patients, and this can often be as simple as allowing the patient to shower the wound. Showering also has been

proven to lower the bioburden, debride the wound and allows normality (Ubbink, 2015).

Patients should be provided with pre-operative and post-operative education regarding the dressing regime, approximate healing time and activity during this time. This can help alleviate anxiety, allow patients to plan or make alternative arrangements for activities such as work, and gives them a sense of when they will be able to resume regular activities (Yeh, Wu &Tung, 2018).

Education of nursing staff is also imperative. Nurses should be confident and competent in selecting dressing types and be able to explain the reasoning behind their dressing choice and frequency of dressing change (Moran, Briscoe & Peglow, 2018).

CPD 1. How can wound care affect a patient’s quality of life?

2. What are the main goals in wound healing?

Don’t forget to make note of your reflections for your record of CPD at www.qnmu.org.au/CPD

References

For a full list of references visit https://bit. ly/3NuNPYL

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CPD

Respecting women’s safety at work – how far have we come?

Implementing the Respect@Work Report recommendations

BY ASHLEIGH PAWSEY, QNMU RESEARCH AND POLICY OFFICER

I

N MARCH 2020, Sex Discrimination Commissioner, Kate Jenkins, released the landmark Respect@Work: National Inquiry into Sexual Harassment in Australian Workplaces report after a lengthy 18-month inquiry by the Australian Human Rights Commission (AHRC) into sexual harassment and sex-based discrimination in Australian workplaces.

The Respect@Work Report represents the most elaborate examination in decades of sexual harassment in the workplace.

The overarching findings of the report indicate that more needs to be done to prevent and eliminate sexual harassment in the workplace, and significant cultural and structural changes are required at all levels to achieve real change.

The report outlines 55 recommendations to comprehensively reform how Australia responds to and prevents sexual harassment in our workplaces. Key recommendations include extending women’s rights and employer obligations to prevent harassment, such as imposing positive duties on employers to eliminate sex discrimination, sexual harassment, and victimisation, as far as possible.

Visit https://bit. ly/3H4R46Q full list of the recommendations.

Federal Government response – what’s changed?

The Federal Government is facing sustained pressure to take further action on workplace sexual harassment.

Prominent female advocates such as Brittany Higgins and Grace Tame, and other advocacy groups continue to agitate for legislative change, including the implementation of all Respect@Work recommendations.

Prior to the election, the Morrison Government followed up with with the release of their plan – A Roadmap for Respect: Preventing and Addressing Sexual harassment in Australian Workplaces.

Whilst the roadmap agreed to support the Respect@Work Report recommendations, ‘in principle or in part’, the response did not indicate support for all of the recommendations relevant to federal law reform.

Shortly after, the then-Morrison Government passed the Sex Discrimination and Fair Work (Respect at Work) Amendment Act 2021 (Respect@Work Act) as a legislative response to the roadmap.

The Bill was publicly criticised for adopting a mere six of the fifty-five Respect@Work recommendations (recommendations 16, 20, 21, 22, 29 and 30) and for the missed opportunity to codify an entitlement

of 10 days paid family and domestic violence leave in the Fair Work Act 2009 (Cth) to support women escaping violent relationships.

The Act’s introduction will undoubtedly have some positive impacts on Australian workplaces, such as extending the time for making a sexual harassment complaint to the Australian Human Rights Commission from six to twenty-four months and clarifying that sexual harassment is a form of serious misconduct that can warrant immediate dismissal.

However, these impacts predominantly relate to expanding the rights of employees, rather than placing any additional burden on employers to prevent, address or eliminate harassment.

In doing so, it largely ignores measures that can reform how sexual harassment is dealt with in the work health and safety, fair work and sex discrimination jurisdictions and support a more proactive approach to stamping out sexual harassment.

Additional state and federal reviews are underway to address the outstanding recommendations from the Respect@Work report, however, the hope now is that the new Labor government will fulfill its election promise and fully implement all 55 report recommendations without delay.

References:

Australian Government. (2021). A Roadmap for Respect: Preventing and Addressing Sexual Harassment in Australian Workplaces. Retrieved from https://www.ag.gov.au/sites/default/files/2021-04/roadmaprespect-preventing-addressing-sexual-harassment-australian-workplaces.pdf Australian Human Rights Commission. (2020). Respect@Work: Sexual Harassment National Inquiry Report (2020). Retrieved from https://humanrights.gov.au/our-work/sex-discrimination/publications/ respectwork-sexual-harassment-national-inquiry-report-2020 Sex Discrimination and Fair Work (Respect at Work) Amendment Act 2021 (Cth)

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CPD

CPD 1. How would you describe sexism, sexual harassment, or violence in your workplace?

2. What recommendations from the Respect@Work report do you support?

3. Can you provide specific examples of how any of the Respect@Work recommendations you support could be implemented in your workplace?

4. Are there any additional recommendations or reforms not included in the report, that you can think of?

Don’t forget to make note of your reflections for your record of CPD at www.qnmu.org.au/CPD

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Happy International Nurses and Midwives Day!

in view

Whether it was celebrating with cake or simply having a well-deserved cuppa with some colleagues, we hope all QNMU members had a fantastic International Day of the Midwife (5 May) and International Nurses Day (12 May)!

PROUD

nurse

PROUD

midwife 64

in view

BOOK PRIZE WINNER

Superhero day dress-ups!

The gorgeous Cleo, daughter of Registered Nurses Kellie Dwyer and Ben Minnis, dressed up as both mum and dad for Superhero day at school! We love it when our kids hold so much love and value in the work we do as nurses and midwives.

Guess the nursing experience!

QNMU members at Coorparoo Community Care Units ran a guessing competition this International Nurses Day – staff were asked to guess the total combined nursing/caring years of those working in the service. The total was 329 years!

L-R: Brett RN, Shelly CN, Sarah CN, Gazala RN, Kim EN and Sharon EN

Nurses spread their wings Not all heroes wear capes… but all angels have wings! What a creatively talented nurse QNMU member Wendy Patterson (Caboolture Hospital) is! She painted this artwork for International Nurses Day. Nurse pictured is QNMU member Molly Sotheran. Thanks for sharing, ladies!

Spreading the word at pre-poll Nurses and midwives really do have a powerful voice – when we speak, people listen. Thanks to our fabulous members from John Flynn Hospital Beth, Sharon, Anne and Cathy who volunteered their time during the election run-up to talk to the community about aged care.

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in view

SOLIDARITY FO R E V E R !

Labour Day 2022 in pictures From Brisbane to Cairns, QNMU members joined thousands of workers across the state to celebrate Labour Day in May. It was great to see so many nurses and midwives turn out to march with their colleagues and fellow union members – and remember, while we have much to celebrate, the fight for better working conditions is never done!

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in view

WIN

ONE OF THESE GREAT BOOKS FOR YOUR FAB PHOTO Remembered by heart: An anthology of Indigenous writing

by Sally Morgan From life in the desert to growing up on a mission, enduring devastating policies in the 1930s to bravely seizing new opportunities in the 1960s, these are fifteen true stories reflecting a diverse range of Aboriginal Australian experiences.

National Reconciliation week at the PAH PAH Aboriginal and Torres Strait Islander Hospital Liaison Officer Tanya Kitchener (second from right) and her colleagues Melissa Cooke and Kapun Morris pictured here with QNMU Organiser Rebecca Rooney, held a Reconcilliation Week event at the hospital, promoting the liaison service and providing information about how far people travel to access the PAH. The centrepiece was the amazing artwork created by Tanya’s team and patients which centred around family connection and recognition.

Aged care nurses rally outside Regis facilities Our brave nurses and carers at Regis Aged Care (supported by community members) stood up for a fair go, with rallies held in Cairns, Townsville and Caboolture recently. Management have made a dismal wage offer and one of the worst proposed agreements we’ve ever seen. Keep up the good fight everyone!

The roar behind the silence: Why kindness, compassion and respect matter in maternity care by Sheena Byrom This book offers information, inspiration and practical suggestions to support maternity care workers, policy makers, and funders across the world in their quest to deliver sensitive, compassionate and high-quality maternity services. It highlights evidence-based examples of good practice, and practical tools for making change happen.

What happened by Hillary Clinton Hillary Clinton reveals what she was thinking and feeling during one of the most controversial and unpredictable US presidential elections in history. She takes readers inside what it was like to run against Donald Trump, the mistakes she made, how she has coped with the devastating loss and how she managed to pick herself back up.

Email full-size pics and image details to inscope@qnmu.org.au for our 'in view' pages for your chance to win.

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5

incoming

M AY

On International Nurses and Midwives Days For International Nurses Day and International Day of the Midwife, we asked our Facebook community what being a nurse or midwife means to them (although we acknowledge three words just wasn’t enough for many!).

MJ After 42 years of Nursing I still feel “Humble, Privileged & Honoured” to say I am proud to a Nurse.

Like · Reply

KP There isn’t just 3 words to describe nursing. It’s Rewarding, being there putting a smile on the patients and family, travelling on their journey with them being there for their highs and their lows.

It can be debilitating, in that it’s not just the patients having their highs and lows but as a nurse you have these feelings as well. You feel sad when they are sad, you’re happy when they are happy. By the end of the day you can be totally drained, and as nurses we go back and do it again the next day.

It’s learning, not just pen to paper or reading articles, it’s learning how different people respond to different things. Learning how to adapt to different situations, to different people.

Like · Reply

JD It is the highest honour to work in Aged Care, to hold their hand and listen to their life story, wipe away their tears when they are lost and sad, to laugh with them, enjoy each and every day.

Life and time is precious in old age

💖💙

Like · Reply

SB Respect and honour to all Nurses in their field, you are doing amazing job. I hope you continue to receive better working condition and good pay for all the super hero work you do daily.

Thank you Like · Reply

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RM I have so many beautiful midwives to thank for their support. Happy Midwives day you special bunch. In three words: awe inspiringly wonderful.

Like · Reply

💕

TD Sharing a momentous journey with a woman and her family which has the potential to empower her to emerge from her birth feeling strong and powerful and help her entering motherhood with confidence as we walk alongside her in this whole continuity of her journey!

H A P PY IN TE R N ATI O N A L DAY O F TH E

midwife QNMU

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H A P PY IN TE R N ATI O N A L

M

AY

nurses day

💖💖💖💖

Like · Reply

KM To be a nurse isn’t just to do the job required and then just head home. It’s a way of life, a lifestyle and a part of what makes us, us. It gives us a sense of belonging in the world. I look at nursing and being a nurse as a verb.

It’s a doing and what we do.

Nursing is a selfless career.

You put patients first before yourself as everything you do is for the patient/s. Hence the need for passion, compassion and care in clinical practice being attributes to reasons why we do what we do.

Like · Reply

💕

ER Sheer joy to support women and their partners in parenthood Like · Reply

SLH Rewarding, fulfilling and passion! I love the fact I became a nurse! It’s been a challenge but it’s my calling!

Should have done it a long time ago. Thankful that I work alongside so many beautiful people!

Like · Reply

QNMU

CP Sharing special moments. I love seeing the smile on parents faces when they look at their brand new baby or when the parents learn a new skill. So rewarding!

Like · Reply

GD Supporting First Nation Womens in First Nations Models in midwifery care to Grow Deadly Families and increase better outcomes that benefits all Australians. And Happy International Day of the Midwife to all my colleagues 2022!

💜

Like · Reply

JOIN THE CONVERSATION Follow our social media pages and be a part of the conversation on hot topics and what’s important to nurses and midwives.

/qnmuofficial

incoming On Labor’s pledge for new Medicare Urgent Care Clinics CP This cannot happen soon enough! I have wanted this to happen for years!

Like · Reply

On election promises to fix aged care LR They need to start viewing Aged Care as part of the health system & not just accommodation for older people with high care needs.

TH The model is already operating in QLD. The centre has been going for 4 years and it’s been a huge success. It takes pressure off 3 major hospitals. It’s run by senior clinicians - Emergency/rural trained nurses and doctors who love their job. The culture is amazing and the patient wait times are very efficient.

The community values the service therefore it has incredible support to develop more to areas that need greater support.

Like · Reply

SB You should not be able to call a facility a nursing home if there are no nurses! Simple!

Like · Reply

KB Not just more staff needed but quality caring staff. This is a person’s home, the residents need to stop being treated like a number or a dollar value and get back to holistic person centered care.

Like · Reply

I’m a Registered Nurse who had a serious incident at my workplace that I thought was completely mishandled. My superior had me questioning if I would still have a job, which made me anxious and unable to focus for nearly two weeks with no resolution in sight.

Cue the QNMU. The lady listened, advised and asked me to write a detailed statement of events. She said she could hear the anxiety in my voice.

The case is now closed.

Within three days of speaking with the QNMU, I had gone from an anxiety-ridden mess, wondering if I was going to have a job, with no communication or clarity from upper management, to a meeting with HR and upper management where I was cleared of the accusations.

Multiple Governments have not risen to the challenge over many, many years.

Like · Reply

Editor to the

Later that afternoon, she advised me she had spoken to the head of HR and after discussing the matter, they agreed the issue had been blown massively out of proportion.

There needs to be enough nurses to prevent exacerbations of chronic conditions & effectively manage palliation at least, & enough Personal Care Workers to provide good quality care & be able to spend time with people.

The Royal Commission didn’t give us any surprises & I believe that nothing will change unless the recommendations are mandated & supported financially.

Letter

I’d love to sincerely thank the QNMU. Anonymous QNMU member

On members donating their time in unpaid breaks and overtime RDV A half hour each shift is nearly $5000 a year of unpaid overtime.

Like · Reply

JM Recently retired but after working in aged care for many years all nurses put in overtime and many graciously accepted working overtime, companies always paid if they logged overtime hours, as we know many, many donated hours. They were very dedicated, loyal, caring inspiring individuals.

Comment

OF THE MONTH

I have met so many great friends during my career, there have been many laughs and tears, and I have learnt so much, not only from my colleagues but most importantly my patients. It’s not been easy at times but through support of friends and colleagues, I am proud to say that I am still loving my job after 37yrs in the profession not bad!!!

LB

Like · Reply

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YOU MAKE A DIFFERENCE

union 1.

an act or instance of uniting or joining two or more things into one 2. something that is made one When the time comes to stand up for yourself, for a colleague or for a patient, having the support of more than 67,000 other QNMU members makes a difference.

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The QNMU is now hosting monthly mentoring workshops for nurses and midwives who are interested in learning about mentoring relationships and creating opportunities to connect with like-minded professionals.

Find out more and register your interest to attend a session via www.qnmu.org.au/events

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What happens if you exceed your super contribution cap?

Why it’s important to keep track

Personal super contributions can be a tax effective way to save for retirement, provided you don’t exceed the cap amount set by the Australian Government. If you do, you may pay extra tax on those contributions.

Take control of your super and learn: How much you can contribute per year

Strategies to build super tax-effectively Why it’s important

Read more This information and all QSuper products are issued by Australian Retirement Trust Pty Ltd (ABN 88 010 720 840, AFSL 228975) as trustee for Australian Retirement Trust (ABN 60 905 115 063). Any reference to “QSuper” is a reference to the Government Division of Australian Retirement Trust. This is general information only, so it does not take into account your personal objectives, financial situation, or needs. You should consider whether the product is right for you by reading the relevant product disclosure statement (PDS) and Target Market Determination available at qsuper.qld.gov.au or call us on 1300 360 750 to request a copy. Where necessary, consider seeking professional advice tailored to your individual circumstances. SPON-700. 05/22.

Have you got your copy of the QNMU’s limited edition commemorative book yet?

IN OUR WORDS : STORIES AND REFLECTIONS

BUY ONE TOD AY!

FROM QUEENS LAND’

IN OUR

S NURSES AND MIDWIVES

WORDS Stories and reflectio ns from Queensland’s nurses and midwive s

IN OUR

WORDS Stories and reflection s from Queensland’s nurses and midwives

In Our Words was origin ally published online as a Christmas gift to QNMU members at the end of 2020 – a challenging year that saw plans to celebrate Internation al Year of the Nurse and the Midw ife sidelined by a global pandemic.

A collection of more than 50 small stories written by QNM U members from across the state , In Our Words reminds us of who we are, what we do and why we do it.

Now released to the public, printed and bound, these stories can be read and reread, cherished and shared for years to come.

Some stories are inspir ational and reflective while others are heartbreaking or laugh -out-loud funny – but together they shine a light on the nurses and midwives of Queensland.

Over the past few years we’ve been sharing the heartwarming stories of our passionate Queensland nurses and midwives on social media and in our journal – stories that inspire, make us smile and laugh, and some that make us cry.

But they all make us proud to be nurses and midwives.

This collection of stories and experiences from the frontline has been compiled into a beautiful limited-edition hardcopy book – a keepsake of who we are and what we do.

These are our stories, in our words.

To purchase a copy, visit www.qnmu.org.au/InOurWords