InScope No9 Autumn19 by Queensland Nurses and Midwives' Union

The official journal of the Queensland Nurses and Midwives’ Union

Autumn 2019

Why mentoring matters

FLIGHT NURSES: TAKING TO THE Are you getting quality sleep?

PLUS!

Skies

CPD CONTENT ON FLEXIBLE WORK ARRANGEMENTS, ACCESSING PATIENTS’ HEALTH RECORDS & MORE

N CH PE R O MA 18

QNMU Scholarships now open The QNMU’s scholarship program aims to provide financial assistance to members to help progress their studies, professional development and research, and grow our nursing and midwifery professions.

CURRENT SCHOLARSHIPS: ■ Gay Hawksworth Leadership Scholarship – $10,000 awarded whole or in part to a Registered Nurse or Midwife to undertake a recognised/accredited leadership course relevant to their profession. ■ Grow Your Own: New Grad QNMU Conference Scholarship – QNMU Local Branches can nominate a new graduate to attend our Annual Conference as an observer this year (17 – 19 July). Up to 20 new grads may be sponsored. A total of 14 scholarships will be offered throughout the year. Keep an eye on your emails, including your monthly qnews, to find out when more scholarships open.

Apply online at www.qnmu.org.au/scholarships APPLICATIONS OPEN 18 MARCH 2019

Autumn 2019

INDEPTH

Whatever helps you sleep at night

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) 07 3840 1444 1800 177 273 (toll free) F 07 3844 9387 E inscope@qnmu.org.au W www.qnmu.org.au T

EDITOR Beth Mohle, Secretary, QNMU PRODUCTION QNMU Communications team: Linda Brady, Melissa Campbell, Stephanie Lim, Lou Robson, Luke Rutledge PUBLISHED BY The Queensland Nurses and Midwives’ Union AUTHORISED BY B. Mohle, Secretary, Queensland Nurses and Midwives' Union, 106 Victoria St West End 4101. PRINTED BY Kingswood Print Signage, 80 Parramatta Rd Underwood 4119

INDEPTH

CPD

13 14 20 24 26 30 34 36 38 43 44

46 48

Accessing patients' health records: what are my rights?

49 50

Flexible work arrangements

52 53 54

"Scrub the Hub" dry time. Are you waiting long enough?

Atherton midwives deliver for community with MGP Whatever helps you sleep at night Taking to the skies Taking the plastic out of surgery Managing fatigue one entitlement at a time

Preventing sacral pressure injuries: the use of foam dressings.

Mentoring student nurses and midwives. Why do we do it and how should we do it?

REGULARS

INSIGHT

TEA ROOM

WINS

JUST IN

Freedom of Association and how the law protects us

CALENDAR

It's all about fairness this federal election

IN VIEW

INCOMING

ADVERTISING

Period pains — the tax on sanitary items Virtual reality in aged care Findings from the Banking Royal Commission

Meet Lucynda Maskell, QNMU Vice President

Examining our professional values Air assisted transfer devices

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. Visit www.qnmu.org.au/privacy to read our privacy statement.

Cover photo: QNMU member Melissa Green. Photo by Event Photography.

insight

Looking ahead: campaigns, conference and activism

Sally-Anne Jones QNMU President

ONCE AGAIN, the year is marching by quickly and there is much in the media relating to the health sector to keep us thinking and talking – My Health Record, pill testing, NDIS rollout, medical and nursing staff workloads and fatigue, and of course, the Aged Care Royal Commission. At the Aged Care Royal Commission ANMF Federal Secretary Annie Butler recently gave evidence in one of the many hearings that will be held throughout the coming year. Her two-hour testimony presented the experiences and struggles of thousands of staff (by whatever title and rank) who nurse the frail elderly in residential facilities across the country. She shed light on the inadequate current funding arrangements and lack of related public accountabilities, and highlighted the chronic underresourcing and the impacts on the residents and staff. She told Ruby’s story, our story. She shared a way forward with the ANMF’s research on safe skill mix and staffing. A copy of the transcript can be found at https://bit.ly/2txygYG It is well worth reading and I am sure there will be many more opportunities to attend hearings during the course of the Commission. It is important that we do not lose our energy and determination on this campaign. There is still a long way to go before we see the industry change for good. Remember, the Royal Commission is not the doer… it is the finder and reporter! Don't forget, there are only a few months until our Annual Conference,

...a Branch can be a place to develop relationships with nurses and midwives not in your unit and increase the visibility and realness of the union in your workplace. and preparation is well under way in each of your Branches for development and lodging of your motions. At our last Council meeting, a few of us were discussing the challenges of meeting quorum at Branch meetings, which led to a further discussion about what makes a Branch active or passive and the impact this has on building our union’s power. Branches are the life blood of the QNMU. These are the structures where members can get together as a collective, talk about shared issues and concerns, and think about how to do something about them. At last year’s Conference, we had a lot of new Branches and we acknowledged the loss of other Branches that had been around for a long time. This demonstrates how alive our union is — always changing and adapting. I do think that perhaps we are stuck in our thinking about the purpose and function of Branches. Some are very formal, and this may be one of the reasons why it sometimes feels passive with not many attendees. Apart from the formal links that lead to resolutions at Conference (which then form the policies and direction of our union), a Branch can be a place to develop relationships with nurses and midwives not in your unit and increase the visibility and realness of the union in your workplace.

It can also be a place to run social and networking activities to increase participation, host professional events for education, provide information and make sure there is a place to raise your voice where you are not alone. Transformational activism — or the idea that everybody shares the load of addressing the issues and working as a collective to find solutions — is the means by which enthusiasm, action and collective power will invigorate your Branches. It helps each and every member energise and participate in raising the voice of nurses and midwives to make the whole health system better, fairer and safer.

QNMU COUNCIL SECRETARY :

Beth Mohle

ASSISTANT SECRETARY : PRESIDENT :

Sandra Eales

Sally-Anne Jones

VICE PRESIDENT :

Lucynda Maskell

COUNCILLORS :

Julie Burgess Christine Cocks Karen Cooke Tammy Copley Dianne Corbett Jean Crabb Michael Hall Raquel How Shelley Howe Christopher Johnson Damien Lawson David Lewis Dallas Meyers Fiona Monk Sue Pitman Melanie Price Karen Shepherd Katy Taggart Janelle Taylor Kym Volp Deborah Watt Charmaine Wicking

insight

fear

Don’t let distract us from what matters 2019 is a federal election year and it is time to make our voices heard about the issues that matter to nurses and midwives. With public hearings now underway in Adelaide for the Royal Commission into Aged Care, safety and quality in aged care is front of mind for everybody. It’s an issue that is vitally important to all Australians for one reason or another, and therefore it should be an issue for our politicians this federal election. Our campaign to establish legislated minimum staffing ratios in aged care is gaining momentum and our longheld concerns are being confirmed by distressing reports of neglect in aged care. This is the result of entrenched systemic failures and we must ensure that accountability for this is sheeted home to those with the power to prioritise action. And we cannot wait until next year, when the final report of the Royal Commission is due, for action. Last year we started securing commitments from Queensland sitting members, Senators and candidates to support ratios in aged care. We will be intensifying our lobbying in coming months. We need members to be asking their local politicians and candidates to give firm commitments on ratios and other issues that matter to us. We know from members that these issues include: ■ Achieving legislated ratios in all sectors to deliver safe workloads ■ Securing adequate and sustainable funding for health and aged care

Beth Mohle QNMU Secretary

■ Refocusing our health and aged care systems to support genuine person-centred care ■ Ensuring transparency and accountability for health and aged care funding ■ Restoring fairness and balance to our industrial relations system ■ Protecting penalty rates ■ Addressing the rising cost of living ■ Narrowing the significant superannuation gap for women ■ Supporting innovative models of nursing and midwifery to promote wellness and address health inequalities ■ Providing paid domestic and family violence leave for all workers. In the coming months we will be contacting members in marginal seats to ask you about these and other issues that matter to you, as well as let you know about our commitments we have already been able to secure. These conversations are very important because they enable you to tell your union first-hand your hopes and fears. It is easy for us to get overwhelmed by our fears, especially when election campaigns are often depressingly negative and aimed at fostering fear!

months, but we must continue to refocus discussions on the issues that matter to our professions and the health of our communities. Politicians and candidates will try to divert us to their “safe territory” — there will be plenty “look over here” distractions thrown our way. Some of the debate will be destructive and divisive. Sadly, a clear vision and hope for a better future may be in short supply. That is why we must remain firmly focused on what matters to us. We cannot allow our issues and needs to be ignored or lost in the noise that inevitably comes with election campaigns. Not only do we need to secure commitments on our issues, we must also ensure promises are delivered after the election. There are many of us, and we are members of the most trusted professions. We have the power to shape the national political debate — one conversation at a time. To see who has signed up to our aged care campaign, visit www.qnmu.org.au/ RatiosForAgedCare

The sad truth is that during election campaigns we endure a lot of negative ads because they are effective. But we should not settle for this. We must not be diverted by fear tactics and dog whistle politics. There will likely be plenty of this in coming

tea room m Q A

We sometimes take it for granted that everyone knows their entitlements. However, for new entrants to the nursing and midwifery workforce it is often difficult to understand the plethora of entitlements and payslips across our profession. In fact, many nurses and midwives are uncertain about which allowances, loadings and penalties they are entitled to given the diversity of their work and working hours. The following questions are frequently asked of our Member Connect call centre.

A reminder to think twice before posting on social media What you say on social media, including Facebook, can have real-life consequences to your registration and career. Even ‘sharing’ something with your friends can land you in trouble. Here are some useful tips to consider when posting online: ■ Refrain from posting, sharing or ‘liking’ controversial, offensive or discriminatory material, or material that conflicts with your professional obligations as established by the NMBA. You cannot control what someone else may perceive is offensive or discriminatory. Forwarding some material, even after hours, may still be a breach of a social media policy. ■ Be aware that ‘private groups’ on social media sites are often much less private than group members would like. Your ‘social media friends’ may not actually be a friend in the general sense. Posts can be screenshot and shared without your consent. ■ Refrain from using Facebook groups as a forum to air workplace grievances or discuss sensitive or controversial matters either related to your profession or your workplace. This includes photos of patients, relatives and charts, even if they are not identifiable. ■ Check your privacy settings and set them as high as possible. Consider removing references to your employer on your social media page — this might include editing your profile details to exclude your employer’s name or removing pictures of you at work or wearing your uniform.

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

■ Refrain from using your own social media log in for work-related purposes, such as logging into Facebook to use Spotify. Logging off incorrectly or not at all on a work computer may result in someone else accessing your account.

■ Consider the risk that content you post on social media may be picked up and re-published in another forum. There are a whole range of issues to consider when posting online – the above is not an exhaustive list. QNMU members can read our information sheet on social media at www.qnmu.org.au/ infosheets (under ‘professional series’). An extensive CPD article was also published in the 2017 Winter edition of InScope, which you can read online at https://bit.ly/2CXpBDd.

Working interstate? Stay covered with the QNMU QNMU members are often required to travel to different Australian states to undertake nursing or midwifery duties. One of the many benefits of being a member of the QNMU is that you are automatically a member of our national body, the Australian Nursing and Midwifery Federation (ANMF). If you are working interstate for a maximum of three months, your union membership should remain with the QNMU to ensure you remain covered by our Professional Indemnity Insurance policy. However, you just need to let us know before travelling so that you can obtain cross-border membership. Essentially, this means that if a work-related issue arises while you are working interstate, you can call the union branch in that state for assistance (for example, if working in Victoria, contact the ANMF Victorian Branch). However, if you will be working in another state for longer than three months, you must transfer your membership over to the appropriate ANMF branch. The QNMU can assist you with transferring your membership.

wins

Improved working conditions in aged care and private sectors NURSES and midwives in the private sector and aged care will benefit from the latest review of the Nurses Award 2010, thanks to the QNMU and our national body the ANMF securing a suite of improvements. The Award is a safety net of minimum pay and conditions for all Australian nurses and midwives working in the private and aged care sectors (Queensland Health nurses and midwives are covered by the State Award 2015). It is reviewed every four years by the Fair Work Commission (FWC) in consultation with unions and other key stakeholders. Throughout the latest review, a number of QNMU aged care members provided evidence (including cross examination) to the FWC. This evidence was instrumental in painting a picture of the working lives of nurses and midwives and highlighting what improvements were needed. Congratulations and thank you to those members who assisted!

Changes to the Award While many of the following improvements are already included in many enterprise agreements, they are now protected in the Award. ■ Domestic and Family Violence: Five days’ unpaid family and domestic violence leave per year. ■ Requests for flexible working arrangements: Employers must genuinely try to reach an agreement with parents or carers who request

flexible work arrangements, and provide detailed reasons for any refusal. ■ Casual conversion: Long-term (12 months) casual workers can request conversion to permanent employment. ■ Deduction from final wages: Employers cannot deduct more than one weeks’ wages if a nurse or midwife does not provide the required notice before resigning. Employers also cannot deduct any other entitlements owed, such as accumulated leave. ■ Remote recall: Nurses and midwives required to work remotely (e.g. via telephone) must be paid at the appropriate overtime rate for a minimum one hour, in addition to any on-call allowance. ■ Free from duty and on-call: Nurses and midwives must be free from duty for a minimum two full days each week or four full days each fortnight or eight full days each 28-day cycle. Duty includes any on-call time. ■ Rest breaks between rostered work: The minimum rest break between ordinary shifts is now 10 hours (unless eight hours has been agreed between the employee and employer). If a nurse or midwife does not get this minimum break, they must be paid at double time until released from duty. ■ Meal breaks: Nurses and midwives must receive a meal break between the fourth and sixth hours of a shift

(if the shift is longer than five hours). If required to be on duty during a meal break, an overtime penalty of all time worked will apply. If required to remain available during a meal break but a meal break can be taken, a 30-minute payment at ordinary rate will apply. In addition to these improvements, the FWC also determines an annual wage increase. Last year saw a 3.5% increase, with this year’s to be determined before the end of the financial year. The above is not an exhaustive list. QNMU members can read the Award in full at www.qnmu.org.au/wages_ conditions or contact Member Connect on 3099 3210 or 1800 177 273 for more information.

Need some support? QNMU members needing advice or support can contact Member Connect on (07) 3099 3210 or 1800 177 273 (toll-free). We’ll do our best to help you secure wins like the ones you’ve read today!

wins

Are you being paid your correct pay bracket? A BRISBANE aged care nurse recently received more than $5000 in backpay after a QNMU site visit revealed she had been chronically underpaid. The Registered Nurse (RN) and QNMU member said the pay issue was only revealed when a QNMU Organiser visited the facility to discuss pay brackets. The QNMU Organiser advised staff they were being paid in the wrong bracket and should file payroll inquiries with their employer.

The QNMU jumped in and before I knew it I had received $5000 in backpay.

“We did but our bosses didn’t action those payroll inquiries very quickly. In fact, after six months we went back to the QNMU,” the RN said. “The QNMU jumped in and before I knew it I had received $5000 in backpay. “My pay is now increased and in the right bracket, but I wouldn’t have known if the QNMU hadn’t come out for a visit and talked to my colleagues about ensuring our pay was correct. “For aged care nurses every cent matters, but it’s more important than that. “It’s about being treated with respect by your employer and not having corners cut at your expense. “It is important to check you’re getting the pay you’re entitled to because aged care staff earn every cent.” The RN said she used the money to fund Christmas. “Let’s just say we had a much better Christmas than we otherwise would have,” she said. “I also gained a much better understanding of what the QNMU can do for aged care nurses. “There are things the union can do for us and it doesn’t mean we have to get in trouble. “Being paid correctly is only fair so I encourage members to ask the QNMU for advice and double check their pay is right.”

Members can check their pay bracket by searching their agreement at www.qnmu.org.au/wages_conditions, or call Member Connect 1800 177 273.

wins

Penalty rates win for Bolton Clarke staff BOLTON CLARKE bosses have withdrawn their proposal to abolish penalty rates for all staff for work between 6pm and 10pm seven days a week.

While Bolton Clarke has backed down on a number of other proposed cuts, they still pursue cuts to wages and conditions for nursing staff.

This successful outcome was thanks to many QNMU members and supporters who engaged with our meme on social media and helped put the pressure on Bolton Clarke – so congratulations!

This includes seeking broken (split) shifts with few protections, stripping casual staff of their casual loading on public holidays and reducing major leave entitlements to rock-bottom legal minimums.

We were also successful in reversing Bolton Clarke’s decision to reduce tea/rest breaks from 15 minutes to 10 minutes. They have now agreed to maintain 15-minute breaks after we strongly opposed the reduction in a recent bargaining meeting.

QNMU members will be standing up against these threats to hard-won wages and conditions, so please keep an eye out for information from the QNMU and support our nursing staff by sharing our messages on social media.

Queensland Nurses and Midwives' Union

Bolton Clarke threatens to abolish afternoon * PENALTY RATES for all staff * For work until 10pm.

QNMU

AH Good luck if they do, they won’t have any nurses left! Like · Reply

DM Bring on the Royal commission. Investigate. Like · Reply

Backpay for qualification allowance IF YOU’RE a Queensland Health nurse or midwife and have obtained a postgraduate qualification in addition to your basic qualification, it might pay to check you’re receiving your correct qualification allowance — because for one member, it was the difference of almost $9000. Under the Nurses and Midwives Award – State 2015, QH nurses and midwives may progress a pay point if they have undertaken further studies relevant to the skills required for their position.

The entitlement applies to Nurse Grade 5 — 7 and Nurse Grade 9 who have not already reached their maximum classification pay point. This QNMU member undertook a graduate certificate in critical care, but realised she was being paid the same hourly rate as her colleague who did not hold a post-graduate qualification. “I had contacted payroll a few times prior, but they assured me I was receiving it,” the RN said. “But there’s no way to tell on your payslip, so I rang the union to clarify where I stood and my rights.”

Complete the form… every time After some back and forth between the QNMU and QH, the member discovered she had not completed the qualification allowance paperwork after moving to another position within the hospital.

...there’s no way to tell on your payslip, so I rang the union to clarify where I stood and my rights. “Every time you change position — even if it’s in the same hospital and under the same management — you have to fill out the paperwork again, which I didn’t realise,” the RN said. “With the union’s assistance, I definitely felt supported and wellinformed.” Ultimately, the member received nearly $9000 in back pay. “It was nice to finally receive an acknowledgment for that extra skill that they weren’t previously paying me for.”

Note: Following EB10 negotiations, the qualifications allowance also applies to Department of Education nurses from April 2019. All nurses and midwives should check their agreement for details.

wins

16% pay rise

for Allity members NURSES and carers at Allity’s Villa Serena facility will receive a pay rise of up to 16%, after being paid a lower rate than other employees for years. The increase is the result of Allity staff voting up their new Enterprise Agreement. Over the course of the last agreement, some pay rates slipped below the Award each year, leading management to not only offer this significant pay rise, but to also introduce a provision that will ensure all nursing and care staff remain at least 2% above the Award throughout the life of this new agreement. It’s a welcomed provision, which will prevent staff from slipping below the Award when the Fair Work Commission (FWC) looks to raise the minimum wage in the coming years. Other improvements in the new agreement include a workload management clause to make it easier for members to raise workload issues, and automatic progression to the next pay point for part time employees after working 1786 hours or 12 months. Staff will also be able to access personal leave for family and domestic violence purposes. With a 97% ‘yes’ vote, the agreement is now awaiting approval from the FWC.

It pays to read your journal... FOR QNMU member Andrew McPhail, it paid to read his Spring 2018 edition of InScope – if he hadn’t, he would have missed out on thousands of dollars in backpay! In September 2018, we reported a huge win for UnitingCare Health (UCH) members, who received significant annual leave loading backpay and crediting of annual leave, which amounted to hundreds of thousands of dollars. By then, Andrew no longer worked for UCH, but believed he was still entitled to compensation dating back to October 2015. “I worked for UCH for seven years, and about 18 months before leaving someone said there was an error with the calculation with annual leave and leave loading based on the new

“After resigning, I read in the QNMU journal that UCH nurses had a win, and I thought, ‘Okay, for the first time in 40 years I’m going to call the union, I’m doing this. “The union was fabulous — not only did I get the leave loading but I got the annual leave as well.” Andrew ended up receiving several thousand dollars just before Christmas last year. “People need to really be aware of what their entitlements are,” Andrew said. “It had been dragging on for well over a year, so obviously UCH thought it would just go away. “Don’t let your employer pull the wool over your eyes, because they will and do.”

After resigning, I read in the QNMU journal that UCH nurses had a win, and I thought, ‘Okay, for the first time in 40 years I’m going to call the union... Andrew McPhail

enterprise agreement,” Andrew said.

just in

UPCOMING

EVENTS

There are plenty of events coming up in the next few months, so make sure you mark your calendars – you won’t want to miss these!

2019 QNMU Annual Conference

JULY

17-19

SAVE THE DATE! This year’s conference will take place from Wednesday 17 to Friday 19 July. We’ll once again have an exciting line-up of dynamic speakers and an engaging professional day for you to look forward to, not to mention plenty of networking opportunities.

Labour Day march WE HOPE you’ll join us in marching for change at this year’s Labour Day celebrations on Monday 6 May. Come along and bring your family and friends — you’ll also receive a free QNMU t-shirt! Marches will take place at various locations across Queensland. Keep an eye out for more information soon.

International Day of the Midwife and International Nurses Day

MAY

5/12

IT’S THE time of year to celebrate us! International Day of the Midwife (5 May) and International Nurses Day (12 May) are an opportunity for us to pause and reflect on how much we contribute to our community each and every day. Stay tuned for information on upcoming IND/IDM events and how you can get involved.

MAY

Mother’s Day Classic fun run TIME TO pick our fave pink outfits for this year’s Mother’s Day Classic fun run! The annual fundraiser event will be held around the nation on Sunday 12 May, to raise vital funds and awareness for breast cancer research. The Brisbane event will be held at South Bank Promenade near the Brisbane River, but there are many ways you can get involved even if you don’t live in Brisbane. Find out more at www.mothersdayclassic.com.au

Labor commits to Gayle’s Law FEDERAL Labor will establish a national Gayle’s Law banning singlenurse postings in rural areas if the party wins at the next election. Labor health spokeswoman Catherine King said a Labor government “would work with states, territories and other stakeholders to make this a reality”. The legislation is named after South Australian nurse Gayle Woodford, who was murdered while working in SA’s remote community.

just in

aged care royal commission: providing a voice for members THE AGED Care Royal Commission has officially kicked off. At the preliminary hearing, Commissioner Richard Tracey said the following: “The Royal Commission is a oncein-a-lifetime opportunity to come together as a nation to consider how we can create a better system of care for elderly Australians that better aligns with the expectations of the Australian people. The hallmark of a civilised society is how it treats its most vulnerable people, and our elderly are often amongst our most physically, emotionally and financially vulnerable.” Aged care providers were asked to provide details of instances of sub-standard care and complaints received over the past five years, as well as actions they have taken to respond to these complaints and improve their services.

anmf provides evidence to Commission Australian Nursing and Midwifery Federation (ANMF) Federal Secretary

Annie Butler has already presented evidence to the Commission on behalf of 275,000 members (including QNMU members). In her statement, Ms Butler spoke about the issues we know are occurring in aged care, including increasingly unmanageable workloads, a lack of transparency around funding, and most importantly, a lack of staff due to no legal requirement for minimum nurse-toresident ratios. You can read Ms Butler’s full statement at https://bit.ly/2txygYG

qnmu keeping focus on ratios The ANMF has established a team of aged care experts to prepare for the Royal Commission, including preparation for our submissions. The QNMU will contribute to this process and draw on the extensive material we have gathered over many years of campaigning and responding to inquiries into aged care.

Members can also make their own anonymous submission to the Royal Commission at https://bit.ly/2Aln6dg Presenting the evidence that supports minimum staffing ratios and appropriate skill mix in aged care will be the key to our submissions. QNMU members should rest assured they will be well represented throughout this Royal Commission. We know the issues you face at work on a daily basis and what the solutions are, and we will do everything we can to ensure your voices are heard throughout all aspects of the Royal Commission. For more information and regular updates, head to www.qnmu.org.au/ RatiosForAgedCare

It pays to belong to your union THE NUMBERS don’t lie – if you’re a union member, you are more likely to earn more than non-unionised workers. According to data published by the Australian Bureau of Statistics recently, employees in workplaces with union representation earn on average almost $300 a week more than non-unionised employees – that’s an average difference of more than $15,000 per year. This is certainly the case for most Queensland nurses and midwives covered by enterprise agreements, especially in workplaces where members are prepared to use their collective strength to bargain for more than the bare minimum. For example, Queensland Health nurses and midwives get paid on average 8.76%

more than what is set in the State Award 2015, thanks to wage increases negotiated over many enterprise agreements. This will increase to 14.3% once EB10 pay rises kick in over the coming years. And significantly in the private hospital sector, nurses and midwives employed by Queensland Fertility Group are paid on average 66% more than what is set in the Nurses Award 2010, thanks to members’ willingness to stand up and take collective action. The ABS data also revealed that today’s average union member is more likely to be over 40 and female, with ‘health care and social assistance’ ranking as one of the most highly unionised professions.

just in

Compassion shines through for Townsville QUEENSLANDERS are no strangers to the devastating effects of flooding. And it’s in difficult times like these that we see compassion and courage shine through, especially from our amazing nurses and midwives. When devastating floodwaters hit Townsville in February,, the community rallied together to ensure residents who had d been evacuated had the essential items they needed. “Our community spirit has been beyond anything you could imagine,” QNMU Townsville branch delegate Jo Konings said. “Within the first 24 to 48 hours of the disaster our evacuation centres and local groups were absolutely inundated with donations from members of the community, so much so that some centres were saying ‘please don’t send us any more!’ “While some nurses were unable to negotiate high flood waters to get to work, their colleagues performed double shifts and long hours to care for patients during the unfolding crisis.” Nurses and midwives returned to work as soon as it was s safe to do so, but continued to support their colleagues who had been affected by the disaster. “The effects of the disaster are so widespread that in almost every unit of Townsville Hospital at least one person has been impacted in some way, with many having lost everything including their homes,” Jo said. “Each individual unit has rallied around those nurses to support them and in the ICU we’ve been able to provide donations of furniture, toiletries and money to aid our affected nurses. “Many other units are supporting their nursing colleagues in similar ways, opening their hearts and homes to those affected.” Recovery and clean-up efforts are now well and truly under way and the QNMU Townsville branch are focused on supporting colleagues and the community in moving forward. “We have schools here that have lost many resources and one particular school that still hasn’t reopened. It was decimated in the floods and they’ve lost books, stationery and other resources,” Jo said. “The Townsville branch has been in touch with the school and we’re awaiting the school’s assessment and collation of resources so we can best support them through donations of resources and a book drive to restock their library.” While there’s a way to go before Townsville fully recovers, it’s safe to say the community’s strength and resolve will see them through.

In February, QNMU Council voted to donate $10,000 for the Premier’s Appeal, and an additional $10,000 to the Queensland Country Women’s Association to assist with their rural relief efforts on the ground. We’re also glad to have been supporting individual members, including providing advice on how they can claim special leave arrangements or government financial assistance.

just in

NURSES TELL DEPRESSION TO #GETFLOSSED BRIGHT shirts and free pink fairy floss… what could be better? For nurses at the Gold Coast University Hospital ED, it’s a conversation starter to talk about mental illness among hospital staff and spread the word that depression can #getflossed! Loud Shirt Fairy Floss Friday was started by a group of junior doctors in New South Wales in 2017, and quickly drew the attention of GCUH ED nurses, who held their first event in 2018. This year, the ED staff social club paid for the hire of two fairy floss machines, which they set up in the ED staffroom courtyard. Staff came in on their days off to hand out free fairy floss, collect donations, and have conversations with other hospital staff about mental health.

GCUH Clinical Nurse and QNMU member Toni Taylor said ED staff hoped more hospitals would follow in years to come. “Especially with ED workers, we see people on the worst day of their lives every day of our lives, and we see some pretty terrible stuff, so that does affect us,” Toni said. “There’s still a lot of stigma around it, but one in four people have a mental illness so it’s likely to affect one of us at some stage. “The message we’re wanting to spread is that it’s okay to talk about mental illness and depression, it’s normal.” This year’s event took place in February, so there’s plenty of time to organise a Fairy Floss Friday in your own workplace next year.

Pictured above: Gold Coast University Hospital ED nurses

Visit www.fairyflossfriday.com for more information.

indepth

Atherton midwives deliver for community with MGP ERSISTENCE is key when driving change in your workplace. That was certainly the case for midwives at Atherton Hospital, who spent two years advocating for a change to their model of care.

Their hard work finally paid off late last year when the hospital launched its Midwifery Group Practice (MGP) — or as the midwives call it, an ‘allinclusive model’. Put simply this ‘all-inclusive model’ means expectant mothers have access to a single known midwife through their entire pregnancy journey, including the labour and birth.

Registered Midwife Tanya Fleming said she and her colleagues at Atherton Hospital saw the benefits first-hand from the Mareeba MGP, which is located a short distance from Atherton and has been operating for 10 years. “There were about 20 women a year in our catchment area going to Mareeba to access their model of care,” Tanya said.

Representatives fro m Atherton Hospital and Atherton Midwives and Mothe rs Association joined QNMU member Tanya Fleming (right) at the launch of the MGP.

“As a midwife in a small all community, that was a bit disheartening because we couldn’t offer the women in our home town what they wanted.”

While only a small percentage of Australian women can access a primary midwifery model with continuity of carer, results show time and again that women who experience this model of care are more likely to have a positive birthing experience.

The journey to implement the MGP has been years in the making.

Benefits include higher rates of breast feeding, lower need for intervention pain relief, and an increase in the likelihood of the baby being born at term and healthy.

“Our community has wanted an MGP for a long time and by engaging with a very active consumer group, we have been able to make it happen,” Tanya said.

There are also many benefits for the midwives themselves, including improved job satisfaction and a broader scope of practice.

“They were very proactive in voicing that they wanted this change for the community. We partnered with them along the whole journey.”

Long road to success

Tanya said the success w also down to the was m midwives themselves. “We had a good team of m midwives who were really p passionate and motivated t support the change. to E Even when things were c challenging, we supported e each other through the j journey.”

e) Tanya Fleming (centr Registered Midwife P. MG on ert Ath the at the launch of

Informed consumers The goal of implementing midwifery-

led models of care across Queensland is an ongoing and challenging task. But success can breed success — and there is much we can learn from those who have already undergone the process. “You have to put yourself out there and engage with consumers and build connections and relationships with the community,” Tanya said. “When the consumers are informed of what is possible for their care, they are more likely to want to be part of that change with you. “Consumer voice is invaluable.”

Women embracing change Although the MGP has only been operating since November last year, midwives are already noticing the benefits. “Sometimes I have to pinch myself – it’s a dream come true for me as a professional,” Tanya said. “It’s empowering to go to work and know I can deliver the best care possible, and that’s reflected in the women. They are really embracing it. “The implementation of MGP is a really positive change for the women and the community as a whole.”

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Whatever helps you sleep at night It’s the dreaded thought that weasels its way into your mind just as you’re about to slip off into the land of Nod … “Did I chart that??”

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E ALL know how hard it is to ‘switch off’ and catch those precious Z’s after a long, busy shift. Yet sleep always seems elusive when we most need it. An estimated 7.4 million Australian adults don’t get enough sleep, and it’s no surprise that health care workers are among the most sleep deprived of the population. Frequently having to work shifts outside usual day time hours or having to be on call can be highly disruptive to regular sleep patterns and can take a real toll on our bodies. In the long run, this can have dangerous consequences. Professor Siobhan Banks is a spokesperson for the Sleep Health Foundation and Co-Director of the Behaviour-Brain-Body Research Centre at the University of South Australia.

She’s conducted studies with various groups of health professionals to investigate the impact of sleep loss on health and performance at work… and the results are concerning. Prof Banks said working shifts can increase the risk for a range of chronic diseases like cardiovascular disease, type 2 diabetes and obesity. Shockingly, it has even been linked to breast cancer in females. “We’re not able to say what causes it and we don’t quite know what the mechanisms are. Some speculate it could be the increased exposure to light which can then impact melatonin production, but there’s still a lot of debate around that,” she said. “Probably some of it is to do with the general misalignment of the body clock but there’s significant research being undertaken to try and understand this better.”

...working shifts can increase the risk for a range of chronic diseases like cardiovascular disease, type 2 diabetes and obesity. Professor Siobhan Banks

indepth TICK TOCK – WHAT’S HAPPENING TO OUR BODY CLOCK? So what’s actually happening to our bodies when we’re working nights? Studies have shown night shifts can throw out the body’s cicardian rhythm which can seriously affect our body’s systems. According to Prof Banks, on a regular day shift our body’s cicardian rhythm is very much aligned to a daylight schedule. Most of our bodily needs and functions (like hunger, digestion, blood pressure and bowel movements) are organised around our day time body clock and that 24-hour schedule. “The morning light is what helps keep our body clock regular and is why we find ourselves waking up at around the same time every morning,” Prof Banks said. “We may be awake on a night shift but the biological rhythms that control bodily functions remain stuck on a day time rhythm. “When our body clock gets thrown out of whack like that we call it

cicardian misalignment. It can also be quite stressful on the body to be awake when you normally should be asleep and that persistent stress is what leads to a higher risk of metabolic and cardiovascular diseases down the track.” Unfortunately (but not uncommonly) working night shifts tends also to go hand in hand with sleep deprivation, as many shift workers struggle to get sufficient sleep or as restful a sleep during the day. This can eventually lead to what’s known as shift work sleep disorder, which is essentially an extreme exhaustion. “Shift work sleep disorder is part of a group of cicardian rhythm disorders, where your internal body clock is just unable to cope with the irregular sleep/wake schedule,” Prof Banks explained. “This means the person is simply not able to adapt and they experience extreme exhaustion, often not being able to sleep at all during the day and then feeling extremely fatigued at work.”

DANGERS OF FATIGUE Sadly, an extreme level of exhaustion isn’t out of the ordinary for many nurses and midwives working night shifts. As many as 75% of healthcare workers on alternating shifts have experienced fatigue while on duty, and lack of sleep has been closely associated with an increased risk of medical errors. And we all know night shifts are anything but quiet, often requiring an even higher level of attention to detail. “Night shift work in general does return an increased rate of errors – some are minor and some are major,” Prof Banks revealed. “Cognitively we know the brain slows when you’re fatigued. You’re not able to respond as quickly, problem solve as well or be quite as creative. “However there are systems in place in hospitals and facilities to catch errors. In fact, we often see nurses double checking each others’ work when they know others are tired. It seems a natural tendency… to help each other out that way.”

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HOW TO SNOOZE AND NOT LOSE STRUGGLING to fall asleep is a common complaint for many shift workers, and research shows we’re simply unable to get as much sleep during the day as we would at night. Which means we’ve really got to make those z’s count! While much of this will depend on what works best for your situation, sleep health specialist Professor Siobhan Banks shares her tips for grabbing a decent snooze. ■ Aim to reduce things that contribute to wakefulness, such as bright light and noise. ■ Use good block out blinds or shutters to minimise light in the bedroom. ■ Create white noise in the background to block out any regular day time noises like cars going past or dogs barking. (Tip: you can use a white noise machine or have the fan going) ■ Ensure the bedroom is nice and cool or regulate the temperature with air conditioning. ■ Utilise sleep aids like ear plugs and eye masks.

But the dangers of sleep deprivation are present even beyond the end of a shift. Findings from a research project in New Zealand revealed one in three nurses have fallen asleep while driving home from work. These findings were echoed by a number of QNMU members, who took to social media to share their stories of similar close shaves. “I fell asleep on the motorway coming home from a night shift once,” one member commented. “I was lucky it was only for a few seconds, but I’ve also run red lights because of my lack of concentration after the graveyard [shift]. And while yes I should have known better, I can see how easy it is to do.” Another shared her daughter’s close encounter with death, saying she fell asleep behind the wheel after night shift, hit a bridge and ended up on the edge of a 20 foot drop into a river. “Lucky she survived, but it resulted in a fractured pelvis and sacrum and [she] had to be cut from the wreck.”

Yet another social media user said she had tragically lost three colleagues over her four decade nursing career, all of whom had fallen alseep at the wheel on the way home following a late or night shift.

While there are some who see the graveyard shift as a necessary evil in their careers, there are a number of health professionals who voluntarily choose to work night shifts simply because they prefer it.

The long terms effects of sleep deprivation are also cause for concern.

QNMU member and RN Joy Daly has worked nothing but nights for almost three decades, and said she wouldn’t have it any other way.

In a Tech Insider video, Professor of Neuroscience and Psychology at the University of California, Matthew Walker, described how a lack of sleep could prevent the brain from being able to intially make new memories. He even suggested sleep deprivation could increase the risk of Alzheimer’s disease and have a negative effect on our reproductive and immune systems.

THE LIFESTYLE FACTOR It may sound scary, but unfortunately it’s not easy for us in the health profession to avoid shift work. Our patients and residents need our care after hours.

“For me it’s always worked and I couldn’t imagine not working nights. I’ve done it for so long it’s probably a preferred shift for me,” Joy said. “Initially, I made the choice to do night shifts because my husband worked days, so it meant there would always be someone with the kids.” As the years passed and her kids were grown, Joy found night shift continued to give her more flexibility than a day shift could. And over the years she’s honed her night shift routine to perfection. Before starting a string of night shifts, Joy won’t even try to sleep

indepth during the day before the first of her shifts begins. Instead, she aims to sleep in a little longer that morning (by half an hour to an hour) and have a quiet, restful evening at home in the lead up to her first shift. “I do eight-hour shifts starting at 11pm and finishing at 7.30am in the morning. I also choose to do six shifts in a row – I don’t have to but it’s my preference because I find it helps get me into that routine a bit quicker,” she explained.

For me it’s always worked and I couldn’t imagine not working nights. I’ve done it for so long it’s probably a preferred shift for me. Joy Daly, RN, QNMU member

“I’ve also worked out exactly how many hours of sleep I need to have, and I adjust my sleeping patterns to suit. “For example, if I have something on in the morning then I’ll sleep from midday onwards. If I have something on in the afternoon instead, I’ll sleep in the morning when I get home from my shift, wake up in the afternoon to do stuff, then take another nap in the late afternoon before my next shift begins. “I find this actually gives me more flexibility with my day than any other shift could.”

MAKING IT WORK It could be argued that shift workers like Joy are then at an increased risk of chronic health problems from routinely working late shifts. Yet this isn’t always the case. Studies conducted by Prof Banks’ research group showed there are some shift workers who are actually very healthy. These shift workers were able to cope well with shift work and get sufficient rest. “Some of our research has been around trying to understand what it is these workers do, and how it is that they’ve rearranged their lives so that they are able to cope better with shift work than others,” Prof Banks said. “Essentially, it’s not only about ensuring you have quality of rest, but also considering the overall amount of rest you’re getting in a 24-hour period. “We know shift workers are unable to get as much sleep during the day than they would at night, so

indepth if splitting that sleep up into two separate sleep periods works for you, then that’s great.”

KNOWING YOUR ENTITLEMENTS –

Prof Banks likened our body’s ability to adapt to shift work as similar to experiencing jet lag while on holiday.

HOW DOES YOUR AGREEMENT PROTECT YOU?

In general, our bodies take a while to adjust to a new time schedule. When a person works alternating day and night shifts, it’s often found we’re switching to a different shift when our bodies have only just begun to adjust.

The QNMU has negotiated a suite of industrial entitlements for nurses and midwives to help manage fatigue in and out of the workplace. Turn to page 26 to find out more.

Prof Banks’ research continues to use strategies around light exposure to adjust the body clock and help shift workers adapt to new schedules. “This involves utilising light at night to adjust the body’s circadian rhythm – depending on the brightness of the light you get and when you get it, you can start to move your body clock to a later schedule bit by bit.” Prof Banks said further research was being conducted to specifically delve into the issue of weight gain and metabolic issues in shift workers, to identify practical advice and good techniques for shift workers to maintain a healthy diet.

Bibliography

INQUIRY INTO SLEEP HEALTH AWARENESS IN AUSTRALIA The QNMU recently made a submission to the Standing Committee on Health, Aged Care and Sport on the Inquiry into sleep health awareness in Australia. In our submission, the QNMU recommended sleep health be included in the education, training and professional development for health practitioners. Read the full submission here: http://bit.ly/2ICcGN7

Deloitte Access Economics (2017). Asleep on the job: Costs of inadequate sleep in Australia. https://www. sleephealthfoundation. org.au/publicinformation/specialreports/asleep-on-thejob.html Sleep Health Solutions (2018). Professions prone to sleep deprivation and how it affects your job. https://www. sleephealthsolutionsohio.com/ blog/professions-prone-sleepdeprivation/ Health Times (2017). Impact of night shift on nurses. https:// healthtimes.com.au/hub/ nursing-careers/6/practice/ nc1/impact-of-night-shifton-nurses/1606/ HelloCare (2019). One in three nurses have fallen asleep while driving home from work. https:// hellocaremail.com.au/1-3nurses-fallen-asleep-drivinghome-work/ HelloCare (2018). Sleep deprivation: “Wakefulness essentially is low-level brain damage”. https://hellocaremail. com.au/sleep-deprivationwakefulness-essentially-lowlevel-brain-damage/

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TAKING TO THE

Skies

Imagine helping a mum-to-be birth her baby while youâ&#x20AC;&#x2122;re 12,000 feet in the air. Or taking down obs with hundreds of stars twinkling right outside your window. For flight nurses Louise Burton and Melissa Green, the skyâ&#x20AC;&#x2122;s the limit when it comes to helping Queenslanders in their time of need.

Photo: Royal Flying Doctor Service

indepth S ANY midwife can attest, babies can come into the world in some weird and unexpected places… none more unexpected than smack bang in mid-flight!

Royal Flying Doctor Service (RFDS) flight nurse and midwife Louise Burton was on a routine transport flight with her pilot one day when they were diverted to a remote location to transport a pregnant mum to hospital. Upon arrival, Louise discovered the woman was already having contractions and the baby was in a breech position and about to be prematurely born. The clock was ticking. Louise consulted closely with doctors and medical co-ordinators over the phone to determine if she could safely transport the woman in the aircraft on her own. “We had a lot of discussions and I was armed with as much pre-birth information I could get purely from an assessment of the woman, as I had no access to ultrasound scans or previous antenatal history,” Louise said. “Her contractions settled down after I administered the appropriate drugs and eventually we made the decision to fly her to a hospital.” All was going well until the plane was nearly on its final descent, when the mum-to-be suddenly cried, “I need to push!”

“And push she did!” Louise recalled. This little baby would not wait! “There was nothing else I could do but help her birth her baby midair! “We came to land only a very short time after that and I had an appropriate team meet us, which included a paediatrician, a neonatal intensive care nurse with a warmed cot and a crew of a few others to assist. “It was the best thing to be able to hand over to them the care of a little one who was breathing spontaneously and doing okay. That was an absolutely lovely feeling and will always be a stand out for me in my career.” And what a career it’s been.

SOARING TO NEW HEIGHTS Louise has worked in various roles within emergency and critical care for almost three decades. She’s been a flight nurse for nearly 20 of those years, having worked at every Queensland RFDS base in primary health and aeromedical transport. Now working at the Brisbane RFDS base, Louise said flight nursing is a vastly different experience to that of working in a hospital setting. “We’re in and out of different air strips, we get to see some amazing views and we’re picking up people from all across Queensland,” Louise said.

It was the best thing to be able to hand them a little one who was breathing spontaneously and doing okay. That was an absolutely lovely feeling and will always be a stand out for me in my career. Flight nurse Louise Burton Photo: Louise Burton

indepth “We work outside a lot and we’re generally flying with a single pilot in a small aircraft. “It can be a challenging role but I think a lot of us in flight nursing enjoy that challenge and enjoy tapping into different skills.” In Queensland, a central coordination centre (called Retrieval Services Queensland) receives calls for all inter-hospital transfers. These calls are then triaged and tasked to one of seven bases in Queensland — Brisbane, Bundaberg, Rockhampton, Townsville, Cairns, Charleville and Mount Isa. On a usual shift, Louise will begin by conducting pre-flight checks in the aircraft to ensure it is completely stocked and all equipment (including safety equipment) is working. “We’re pretty much heading out from the beginning of a shift as we move a large number of patients, so we’ll receive a tasking almost straight away,” Louise explained. “We can move up to seven patients in a 12-hour shift but it depends how far we’re going and the severity of the case. “We sometimes do short hops — what we refer to as ‘milk runs’ — where we pick up a non-acute patient who may be well enough to travel on with us and collect another patient. “But we’ve got to be very flexible. If something more urgent comes in we’ll be diverted mid-air.”

ON THE CASE Over at the Cairns base, RFDS flight nurse Melissa Green works with a small but dedicated team of health professionals to ensure Queenslanders in rural and remote areas get access to life-saving care and treatment. The highly skilled team comprises of 27 medical officers (a combination of primary health and aeromedical doctors), eight pilots, 10 aeromedical flight nurses and 19 primary health care nurses. “In Cairns we take on a lot more primary taskings. Our patients are usually from cattle stations or very remote areas where there isn’t a

Photo: Royal Flying Doctor Service

hospital as we know it,” Melissa explained. “Most of them are single nurse posts or a small clinic with a single GP, so even though the care the patient may receive is of a high quality, they wouldn’t have access to health services and equipment like that of a hospital. “We often have to provide information or advice to the patient over the phone, then fly out and bring them back into Cairns where we have a tertiary hospital.” It’s a job that requires resourcefulness and quick-thinking, and Melissa said she’s often faced with the challenges of logistics.

“That’s something that usually happens in a cardiac catheter lab in a hospital and requires a highly skilled clinician to initiate the medication, so it’s quite unique to do that out in the field,” she said. “I also recently transported a 14-year-old boy who had been bitten by a three-metre snake and he was two and a half hours from the nearest help. “We were able to provide immediate advice to his mum over the phone on how to deal with the snake bite, then collect them from the nearest clinical area and bring them back into Cairns to receive definitive care.

“I’ve intubated a patient on the veranda of a homestead with ringers and their mates assisting, then had to load the patient in the back of a ute and travel with him 45 minutes back to our aircraft,” she recalled.

“Without our intervention, these patients wouldn’t have received the help they needed and it’s a great feeling to know they are both okay.”

“Logistics are sometimes a big issue and we need to consider how we’re going to get to the patient with limited equipment when we can’t fit everything we need on the back of a ute.

The cases Louise Burton gets called to can range from complicated traumas and emergencies to elderly folk with fractures.

“But I guess the challenge is what I love about this job.” Earlier in the year, Melissa had been called out to a remote property where a man was experiencing a heart attack. Melissa administered medication to break down the clot and prevent further muscle damage to the heart, then transported the patient back to Cairns.

It’s a high-pressure job, and no two days are ever the same.

“We kind of do everything that comes through the door!” Louise said. “Generally our cases are interhospital transfers or traumas from accidents, but any situation that cannot be cared for within the remote, rural or regional centres and requires a higher level of care may get transferred. “We also tend to move a lot of patients that fall under the ACS (acute coronary syndrome) umbrella as well

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THE FLIGHT NURSE PATH Their work is incredibly varied and diverse, so it’s no surprise that flight nurses need to be armed with an arsenal of well-honed skills to prepare them for a broad range of cases. They must firstly be a Registered Nurse or Midwife and have completed a minimum of five year’s postgraduate experience. Within those five years, flight nurses are also required to have obtained a minimum three years of critical care experience (either in an emergency department or an intensive care unit).

myself working in a big hospital for the rest of my career,” Louise said. “While I was doing a single nurse posting in Thargomindah I got to meet the flying doctor team who came out to transport some of our sick patients, and I was so inspired by these amazing nurses who just seemed to take everything in their stride. I was immediately motivated and knew that’s what I wanted to do! “One of those nurses wrote out a career pathway for me on a spare bit of scrap paper, and I had this scrap paper pinned to my study board for years!” Years of study and hard work also paid off for Melissa, who looks back fondly on the memory of her first ever flight as a newly qualified flight nurse.

While this may sound daunting to some, for both Louise and Melissa the hard work was a small price to pay to achieve their dream of becoming flight nurses.

“It was a fantastic feeling. I was so excited and in awe of the clouds — I kept taking photos! — and the pilot thought it was just hilarious,” Melissa recalled.

“I realised from an early age that as much as I loved nursing I couldn’t see

“I had been worried about how I would cope with the long days,

Without our intervention, these patients wouldn’t have received the help they needed and it’s a great feeling to know they are both okay. Melissa Green

with writing notes in the air and in a confined space, but I just naturally fell into the role and I love it.” Louise said the experience of a flight nurse was like no other and she’s passionate about encouraging new graduates to consider flight nursing as a career. “We often only have one or two patients at a time and I love being able to dedicate the entirety of my time to them, even if it’s just an hour or two while we’re flying,” Louise said. “I often think about the ratios that nurses are fighting for in hospitals and feel lucky that we have that time to spend with our patients because it’s a really important part of their journey.” Find out more about flight nursing at Flight Nurses Australia www.flightnursesaustralia. com.au or about careers with the Royal Flying Doctor Service (Queensland) at www.flyingdoctor.org.au/qld

it 's a great feeling

as critical patients who are intubated or ventilated, so these are often quite complicated patients.”

Photo: Event Photography

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Taking the plastic out of surgery Plastic. Our hospitals are full of it.

HEAP, easy to produce and very versatile, plastic and more specifically single-use plastic has become invaluable to modern day health care, balancing our expectations around infection control and hygiene with fuss-free convenience.

But there is a downside. Not only is plastic a product of the petrochemical industry that produces huge quantities of carbon emissions, it also has a ridiculously long shelf life, which means we are dumping it faster than it can break down. The result is that wherever it ends up – in our oceans or as landfill — it builds up, choking wildlife, slowly leeching into our soil and air, finding its way into our food chain, and adding to the production of methane — a greenhouse gas with a global warming potential 25 times greater than carbon dioxide. The troubling fact is, Australian hospitals toss thousands of kilos of disposable plastics into landfill every day, contributing to this plastic waste problem. But it’s not all bad news.

Some hospitals are actively working to tackle the problem head on. Check out these great initiatives.

PVC recycling One of the most common plastics used in health care is polyvinyl chloride (PVC). It’s the plastic made from oil and salt that is commonly used for disposable medical gear, including oxygen masks and IV fluid bags, and for flooring and wall coverings. It gets tossed into landfill by the tonne. In fact, an estimated 50 million IV bags alone end up in Australian landfill every year. But for the past 10 years, the Vinyl Council of Australia in conjunction with 130 hospitals across Australia and New Zealand have been working on a recycling program that reduces PVC waste.

drive for greener health care and its membership of the Global Green and Healthy Hospital Alliance. “We also had some very strong champions within our teams, staff at the coalface who were happy to be leaders of this initiative,” Ms McGaw said. According to Ms McGaw, once the challenge of finding suitable space for the recycling bins had been resolved, and staff were given a little training, the program was rolled out in theatres, ICUs and emergency departments. Staff can recycle select PVC products including oxygen masks and tubing, IV bags and suction tubing, but they must remove metal clips, hard plastic parts and elastic. “Removing those non-recyclables is absolutely critical, otherwise the whole lot could be dumped if you have too much,” Ms McGaw said.

Eleven of those participating hospitals are in Queensland, including Mater Health.

She said the key was making the process as easy as possible for people to do the right thing.

Mater Health Services’ Environmental Sustainability Project Officer Ngaire McGaw said Mater joined the program in line with its

“For example in one area we have a small recycling bin right next to the sink with a pair of scissors on a piece of string at the ready,” she said.

Photo: Mater Group

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Once the recycling bins are full, they are taken to a PVC recycler who washes, grinds and heats the material and turns it into pellets that can be used for new products such as industrial hoses, garden hoses, vinyl flooring, playmats and carpet backing. It is estimated a 300-bed hospital could recycle as much as 2.5 tonnes of PVC every year. Mater currently recycles about one tonne but Ms McGaw is confident they can do more. “In fact, we’ve just signed off on a process for PVC recycling in our birthing suites for the first time,” she said.

Finding alternatives While recycling is one course of action, another is to reduce plastic use in the first place. Earlier this year, Brisbane’s Princess Alexandra Hospital announced it was replacing the plastic kidney dishes used throughout the hospital with a new biodegradable alternative made from sugarcane fibre. Despite not having a plastic or wax lining, the medical grade sugarcane kidney dish is soak proof, oil and waterproof.

The move will save about 650,000 plastic dishes from becoming landfill. The decision was made after the hospital ran a trial of the new dishes in a wide variety of medical circumstances, including hot and cold liquid and received unanimous support from the hospital’s clinical staff. The hospital will continue to use its existing supply of plastic dishes until they run out, but as of 18 February, only the eco-friendly dishes are now available for ordering.

Queensland’s PVC recyclers

Get onboard! These are just two examples of how hospitals are addressing the problem of plastic waste. If you’d like to join them or want more information, contact: ■ Vinyl Council of Australia: (03) 9510 1711 or visit www.vinyl.org.au/registeryour-interest-form ■ Sugarcane kidney bowls: email renae.mcbrien@health. qld.gov.au ■ Global Green and Healthy Hospital Alliance: www.greenhospitals.net

John Flynn –Gold Coast Lady Cilento Childrens’ Hospital Mater Hospital Brisbane Mater Private Hospital Springfield Prince Charles Hospital

And if your workplace has a sustainability project you want to share, drop us an email at inscope@qnmu.org.au

Princess Alexandria Hospital Robina Hospital –Gold Coast Redlands Public Hospital Royal Brisbane and Woman’s Hospital St Andrews War Memorial Hospital –Uniting Health Wesley Hospital—Uniting Health

Pictured above: QNMU member Jill Cranswick (far left) is the theatre nurse and recycling champion from the Mater Private Hospital Brisbane — she is with nursing students and a ward services staff member.

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one entitlement at a time 26

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As nurses and midwives, we enter our professions understanding shift work is part and parcel of our careers, and we will inevitably experience fatigue. But it is not necessarily shift work itself that causes fatigue. Back-to-back nights followed by an early… working overtime and arriving at work the following morning… working through meal breaks due to lack of staff… These are just some of the scenarios that cause fatigue, and they generally all come down to poor rostering and/or a lack of staff. Over the decades, the QNMU and our national body, the ANMF, have negotiated various entitlements to ensure best practice rostering which in turn encourages a healthy work-life balance and minimises fatigue. But as many nurses and midwives know, securing these rights in the Award or an enterprise agreement is quite different to enforcing them in practice. It’s up to every nurse, midwife and carer to ensure they are informed about exactly what these rights are and how they operate… and to call out poor rostering and staff shortages.

Your rights – an overview

enterprise agreements and relevant Awards to find out what entitlements apply to them.

Nursing and midwifery rosters must consider practices to minimise the health risks associated with work in accordance with the Work Health and Safety Act 2011.

We strongly encourage members requiring specific advice to contact the QNMU.

Employers have a duty to provide employees with a safe and healthy work environment and must assess risks, and implement and review control measures to prevent and/or minimise risk exposure. Where an employer is proposing to change the regular roster or ordinary hours of work, the employer must consult with affected employees and the QNMU about the proposed changes. The following information provides a brief overview of various workplace entitlements around rostering and fatigue management and is not an exhaustive list. The information draws on entitlements from both the public and private sectors, so members should check their individual

Rest breaks between shifts Extensive research into shift worker fatigue indicates nurses and midwives should ideally have 11 to 12 hours between rostered shifts. This allows for eight hours sleep, plus a sufficient break from professional responsibilities and time to undertake personal activities. Today, the majority of awards and agreements provide employees with a rest break of 10 hours between shifts. By mutual agreement between the employer and employee, the 10hour rest break may be reduced to eight hours. However, this is not ideal because over time it can create a ‘sleep debt’.

indepth If the employer requires an employee to resume work without eight or 10 hours off duty, overtime may then apply.

nurse or midwife’s health and worklife balance.

In some circumstances, employees may be entitled to fatigue leave from their employer.

The overtime penalty differs depending on your agreement, classification and shift, but will vary from anywhere between time-and-ahalf to double time-and-a-half.

Overtime

Meal breaks

The occasional overtime here and there may seem reasonable, yet many nurses and midwives report to the QNMU their safety concerns about having to work excessive overtime on a regular basis.

Not being able to take meal breaks is one of the more common issues nurses and midwives report.

This often results in nurses and midwives having to use their personal leave (such as sick leave) to recover from lengthy back-to-back shifts. This should not be the norm, as it’s generally a good indication that staff numbers have not kept up with increases in acuity or patient numbers. Generally, working shifts above 12 hours increases the risk of fatigue from medium to high. So when deciding whether your employer’s request to work additional hours is reasonable, you should take into account: ■ any risk to your health and safety from working additional hours ■ your personal circumstances, including family responsibilities ■ the needs of your workplace. If you have reached high levels of fatigue or don’t wish to do additional hours because of your fatigue levels, make your employer aware you are using your professional judgement to decline further hours so other arrangements can be made.

It’s easy to see why it happens: things get busy, patients and residents still need to be looked after, and there is often no one else to fill in to allow a nurse or midwife to leave the ward. But that doesn’t mean it should happen. At the end of the day, this is a fatigue issue and poses a risk to patient safety. Generally, meal breaks should be taken between the fourth and sixth hours after beginning work. Various penalties apply in instances where meal breaks cannot be taken. For example, if a Queensland Health nurse or midwife is unable to take their meal break during those hours but they can take it later in the shift (ie: after the sixth hour), a penalty payment of 30 minutes at ordinary time applies. Other conditions and exceptions do apply. For example, some private hospital agreements include provisions requiring nurses and midwives to be paid at double time until they are able to take their break. Members should check their own agreement to see what entitlements apply to them.

The overtime penalty serves a two-fold purpose: to financially compensate the nurse or midwife for working beyond their rostered hours, and to encourage employers to ensure they have adequate staffing levels so that overtime does not become a regular occurrence.

Of course, not every measure to minimise fatigue can be captured as an industrial entitlement.

A similar reasoning also applies to the penalties around on-call and recall — that is, excessive on call and recall should not be the norm, as it has long-term negative effects on a

A lot of issues arising from fatigue are caused by the roster itself, meaning managers have a responsibility to ensure they are rostering in a way that is good practice.

Best practice rostering guidelines

In 2009, the QNMU — in consultation with Queensland Health — published the first edition of the Best Practice Rostering Guidelines. These guidelines are designed to support the implementation of the agreement by not only setting out specific industrial entitlements, but also providing managers with practical advice, research and checklists on how to develop a roster that won’t adversely affect staff. While the document does simply serve as a ‘guideline’, it is in the best interests of everyone that managers use it as a tool when rostering. The information draws on up-todate literature, as well as the legal requirements regarding employers providing employees a safe and healthy work environment (as set out in the Work Health and Safety Act 2011. Although the guidelines were developed in consultation with Queensland Health, all employers must consider the risks associated with roster design. Therefore, the guidelines are relevant to all sectors. Promisingly, the QNMU is aware of numerous workplaces where these best practice rostering guidelines

indepth have triggered conversations amongst staff, prompting many members to challenge their local rostering conventions and contact the QNMU for assistance.

The struggle to say ‘no’

solutions, and to ensure nurses and midwives are working in accordance with their industrial entitlements. Indeed, every year the QNMU assists hundreds of members with reclaiming their entitlements, including meal breaks and overtime.

Fatigue risk management will not be achieved, however, if the employer does not take a proactive approach when developing rosters and shift design.

Highlights from 2018 included $11,500 recovered for a Healthscope member who hadn’t been taking her second meal break for two years, and $50,000 in overtime recovered for another member who was never able to take their meal break.

QNMU member and Clinical Nurse Kaye Bell said she has often been rostered in ways that cause her fatigue and has frequently challenged management about her rostering through workload grievances.

To find out more about the grievance process or for assistance with recovering your entitlements, contact your Member Connect on 3840 1444 or 1800 177 273 for outside of Brisbane.

Kaye also said what happens in practice does not always reflect what is written in the agreement or guidelines.

A way to go Despite having secured a suite of entitlements that act as a safety net for our health and wellbeing, feedback from QNMU members like Kaye Bell suggests we still have a way to go. Of course, things will never be perfect. But the work does continue. For example, our campaign for legislated ratios in all sectors is all about ensuring manageable workloads and, in turn, minimising fatigue. But most importantly, a nursing and midwifery workforce that demands their rights provided under the Award and their agreement is just as powerful as any industrial entitlement.

In 1948, Australia’s trade union movement won the right for workers to have a 40-hour, five-day working week.

“The entitlements are there for the right reason, and when they’re used properly they are a good thing. I believe that firmly,” Kaye said.

Back then, the call was known as the ‘eighthour day’ — eight hours of work, eight hours of recreation, and eight hours of rest.

“But management continually do thoughtless things, like rostering someone to start a shift on a Monday morning after finishing night shifts on a Sunday.”

But back then, employers argued the reduction in working hours would result in lower productivity and cost increases, and the case that determined the final ruling took two years to complete.

Today, these conditions seem like a no-brainer.

But as was the case with the introduction of the 44 and 48-hour week prior to this, no such hits to the economy occurred.

Kaye said it was also not uncommon for annual leave to be scheduled on a day directly following a night shift – something that is not allowed unless mutually agreed between the nurse or midwife and the manager.

Source: Sydney Morning Herald, https://bit.ly/2Ww4wZu

“A lot of people are afraid to speak up,” Kaye said. “Whether it’s not taking your meal break or staying around for a long time after a shift so you can finish your notes – nurses struggle to say no. “Then people get cranky, they’re tired, their reaction time is slower, there are drug errors, their handover is not as concise and clear as it should be. “Over time, it has an impact.” Which is precisely why a formal workloads resolution process exists. It is through this process that nurses and midwives can work with the QNMU and their employer to address particular rostering patterns and find

1983 strike meeting Ballymore

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PERIOD

pains

After 18 years of protest, the tax on tampons and sanitary pads in Australia has finally been removed.

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HE 10 per cent ‘tampon tax’ was officially scrapped on 1 January this year after a landmark vote in the Senate made all sanitary products including pads, tampons, leak-proof underwear, menstrual cups and maternity pads GST free.

It’s been a long battle. When the GST was introduced in 2000, the Howard government slapped the tax on feminine hygiene products because they were “nonessential” and didn’t prevent illness. They — and every government thereafter — ignored the fact that tampons and pads were not ‘luxury’ items but a necessary part of life every month for most women and trans men. So, while condoms, lubricants and Viagra remained tax-free, we had to fight to explain the difference between sanitary pads and men’s shaving cream. Politicians argued that removing the tax would reduce funds available for federal health initiatives — some even warning that it was women’s health that could miss out. But the tampon tax was never just about the money — it was also about the principle. It wasn’t enough that women had to deal with cramps, migraines, bloating, breakouts and mood swings about 500 times over the course of a lifetime. But when we tried to make this natural biological cycle a little more bearable — we copped a tax. We were being levied for being female and it was manifestly unfair. We were eventually victorious and that’s certainly cause for celebration, but in a global sense it’s worth reminding ourselves that while we won a battle, we still haven’t won the war. For women elsewhere in the world, menstruation and the cultural, social and religious perceptions around

it have a deep impact not only on matters of equality, but also on their health, education, and personal safety.

UNCLEAN, unclean! Historians say beliefs around menstruation stem from ancient times when menstruation’s connection to reproduction was not understood. For tribal people who associated blood with hunting and death, the concept of a women bleeding in sync with a 28-day lunar cycle may have seemed mysterious and even dangerous. No wonder these predominately patriarchal societies developed superstitions around menstrual blood being tainted or having dark properties. And so it has been passed down through the years so that even today the concept of menstruation being ‘unclean’ and ‘impure’ remains a common thread in many cultures and has given rise to practices that isolate women or restrict their activities. When strictly applied many mainstream faiths, including Judaism, Islam and Hinduism, prohibit men from having sex with a menstruating woman, believing it will make a man ‘impure’. Judaism and Hinduism take it a step further by saying even the touch of a menstruating woman can make a man unclean. In some communities in Rwanda, however, having sex with a woman on her period isn’t just ‘unclean’ — it is believed it can kill a man. In India’s Jhabua region there is a belief that menstruation is a disease and as such women are not allowed to sleep on beds; while in Sumba, Indonesia it is believed sexually transmitted diseases are the results of women deceiving men and having intercourse while they are menstruating.

The notion of ‘impurity’ means women are also often prohibited from entering holy places and participating in religious rites, lest they taint them. Shinto women are forbidden from climbing sacred mountains because they are considered "polluted" by their menstrual blood. Mensturating Muslim women, on the other hand, are permitted to make pilgrimage to Mecca but are not allowed to circle the Kaaba (the holy cube) or touch the Koran. Orthodox Eastern Christians object to women taking communion during menses; and menstruation has been used by Western Christianity in the past as an excuse to exclude women from becoming priests. And if being banned from the marital bed and the temple isn’t bad enough, many ‘unclean’ women are also prohibited from entering kitchens, cooking, bathing or joining family celebrations. Women in Burundi are banned from washing or cooking near any shared utensils as some believe their menstrual blood will kill family members, and even Rastafarianism claims menstrual blood contains “poisonous powers” and that people who eat menses-tainted food might die.

GENDER equality This very idea that a woman has times where she is untouchable and ‘unclean’ has real ramifications in terms of gender equality. Quite aside from the fact that these attitudes inherently put women at a disadvantage, it isolates and stigmatises women and breeds social taboos which serve to keep women compliant and ashamed. Even worse, it can put women’s lives at risk.

indepth In parts of western Nepal, a menstruating woman is believed to be the carrier of a curse which renders anything she touches infertile or barren. As a result, menstruating girls and women are banished to a cattle shed or menstruation hut away from the home, all day and night for the full duration of her period. Every year a number of these women and girls die of hypothermia, asphyxiation from lighting fires in the poorly ventilated huts, and snake and animal attacks. In 2005 Nepalese authorities made the practice illegal but the tradition continues in some rural areas with surveys in 2010 suggesting as many as one in five women still followed the custom.

THE POVERTY trap Perhaps the greatest challenge for millions of menstruating women globally is poverty. In India, a lack of toilets and water supply in the sprawling slum areas of big cities like Delhi and Mumbai mean women must walk, often alone and at night, to a community tap for their hygiene needs during menstruation, leaving them vulnerable to harassment, robbery and sexual predators. In parts of Africa, particularly rural areas where sanitary pads are unavailable or too expensive, women and girls will use whatever they have on hand to manage the menstrual flow, including rags, old clothes, toilet paper, newspaper and even leaves.

developing countries to skip school during their monthly period.

their periods as if it is all something to be hidden or ashamed of.

UNICEF reports state that one third of girls in South Asia miss school during their period because there simply aren’t enough toilets and clean water at their schools to help them manage it, and it is a similar situation in African countries where girls simply drop out of school because they end up missing too many days.

But on a positive note, the fight against the tampon tax has contributed to this normalisation process.

Familia Human Care Trust in Kenya estimates that a girl can lose as many as 13 learning days every school term, and about 156 days or the equivalent to almost 24 out of 144 weeks over four years of high school. The result is that many girls leave school with lower levels of education, continuing the cycle of poverty and marginalisation, and increasing the likelihood of them marrying young and ending up in poorly paid and insecure menial jobs.

NORMALISATION is

key

The only way we can improve the situation for menstruating women and trans men is to break down the taboos around menstruation and normalise discussion about what is fundamentally a natural human biological cycle. And that’s quite the challenge. It’s hard enough in the Western world where, despite the march of feminism, health education, and noholds barred social media lives, girls are still taught to be discrete about

It opened up discussion in the media, parliament and around watercoolers about cycles and flows and menstrual health, and every witty protest placard and tampon costume helped chip away at the stigma. There is a long way to go before this reaches the corners of subSaharan Africa, but we’ll take every win we can.

BREAKING: Unicode Consortium has unveiled plans to add a period emoji to smartphones following a campaign by Plan International to normalise discussion about periods. In other great news, a film which highlights the experience of menstruating women in India and the work of The Pad Project charity just won the Oscar Award for short documentary. It’s called Period. End of Sentence.

And it’s not just the developing world. Homeless women in Australia and other parts of the western world also face the daunting challenge of finding sanitary products and the privacy to change and wash.

HOW CAN YOU help?

Using toilet paper is common and soiled clothing may be cleaned in dirty water without soap and used repeatedly after being dried indoors without sunlight, leading to bacterial and yeast infections, dermatitis and other gynaecological problems.

personal hygiene products every year for women experiencing homelessness and poverty.

ABSENTEEISM The lack of sanitary products, clean water, toilets and waste disposal also force many young women in

Share the dignity: Collects pads, tampons and

Visit www.sharethedignity.com.au

Plan International: Supports girls in developing countries by providing health and menstrual hygiene education, and affordable washable pads. Visit www.plan.org.au/give/change-for-girls

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Source: https://flashbak.com/25-vintage-feminine-hygiene-ads-that-offered-freedom-396964/ingenue-oct-1970-7/

A LITTLE BIT

of history

1500s BC First known reference to a tampon-like item. Medical text Papyrus Ebers suggests Egyptian women used soft papyrus tampons while Roman women used wool. 1000s AD Earliest mention of pads. The ancient Byzantine encyclopaedia the Suda claims 4th century ancient scholar/philosopher Hypatia threw one of her used menstrual rags at a suitor to discourage his advances. 1830s Doctors prescribe tampons doused in opium for period pain relief. 1888 Southall’s Pads (UK) becomes the first disposable menstrual product available commercially. It’s a variation on WWI battlefield bandages made of a wood pulp called Cellucotton. Meanwhile Johnson & Johnson launch Lister’s Towels in the US. These pads were secured in place by a belt worn under one’s clothes. 1931 Dr Earle Haas patents the first modern tampon with the trademark tube applicator. 1933 Haas sells his patent to businesswoman Gertrude Tenderich who launches Tampax (see ad on right).

1937 Actress Leona W Chalmers (US) patents and markets the first menstrual cup made of vulcanised rubber. But WW2 rubber shortages and women’s preference for disposables meant the product failed.

1987 The first moderately successful menstrual cup, The Keeper, makes its mark. It is later superseded by softer, hypoallergenic, medical grade silicone varieties like the Diva Cup.

1990s Sanitary pads get wings and advertisers use blue liquid for the first time to illustrate pad and tampon absorbency.

1950s Smaller, more discrete tampons without applicators arrive on the market.

2015 Thinx releases the first commercially available period underpants, allowing women to freebleed without discomfort or leaks. It’s the same year 26-year-old runner Kiran Gandhi creates a stir after freebleeding while competing in the London marathon.

1960s & 70s Thinner pads for lighter

2016 Thinx underwear ruffles feathers

days are launched – the result of new technology like waterproof layers and quilting.

1972 Thanks to a new adhesive strip, Kotex and Stayfree launch the first beltless sanitary pads.

with ads that feature trans men in their unisex period underwear. For a fun look at period history check out https://youtu.be/hcmEXEumy0

Bibliography AFP, (2018), A Third of girls in South Asia miss school during periods: report, The Japan Times. (www.japantimes.co.jp/ news/2018/05/22/asia-pacific/socialissues-asia-pacific/third-girls-southasia-miss-school-periods-report/#. XFKQ9S1L3s0 ) Biriwasha, M, (2008), In Africa, Menstruation Can be a curse, Rewire News. (https://rewire.news/ article/2008/03/25/in-africamenstruation-can-be-a-curse/ Greville, G., (1998), The Evolution of New Rastafari, The Dread Library (http:// debate.uvm.edu/dreadlibrary/greville. html ) Guterman,M, Mehta, P, and Gibbs, M., (2007), Menstrual Taboos Among Major Religions. The Internet Journal of World Health and Societal Politics. Volume 5, Number 2. (http://ispub.com/ IJWH/5/2/8213) Museum of Menstruation and Women’s Health, The Kotex belt. (www.mum.org/ koaubl56.htm) Parrillo, A & Feller, E., (2017), Menstrual hygiene plight of homeless women, a public health disgrace, Rhode Island Medical Journal, December. (www.rimed. org/rimedicaljournal/2017/12/2017-1214-pov-parrillo.pdf) Stanley, A., (1995), Mothers and Daughters of Invention, Rutgers University Press, USA. (https://books. google.com.au/books?id=uRJt7QqA7 GEC&pg=PA216&lpg=PA216&dq=ad hesive+maxi+pads+invented&source= bl&ots=l5teJekqfk&sig=7bVFNhyz4gJ 3jTfZ59JkuBQXmUY&hl=en&sa=X&ei =g_1PVMi0M7STsQTT8IKoAw&redir_ esc=y#v=onepage&q=adhesive%20 maxi%20pads%20invented&f=false) UNICEF, (2018), Fast Facts: Nine things our didn’t know about menstruation. (www.unicef.org/press-releases/fastfacts-nine-things-you-didnt-knowabout-menstruation) Water Aid, (2015), If men had periods – manpons (video) (www.youtube.com/ watch?v=zOMPS2zkE1M) WaterAid, (2014) We Can’t Wait: A Report on Sanitation and Hygiene for Women and Girls. (http://worldtoilet.org/ documents/WecantWait.pdf) Wikipedia, Culture and Menstruation, (https://en.wikipedia.org/wiki/Culture_ and_menstruation) Wikipedia, Menstruation (https://en.wikipedia.org/wiki/ Menstruation#Society_and_culture) Wikipedia, Sanitary napkin, (https:// en.wikipedia.org/wiki/Sanitary_ napkin#History)

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A whole new world

Virtual reality in aged care Elderly Australians in aged care facilities are exploring Arctic icecaps, riding Venician gondolas and swimming with Great White sharks. The use of virtual reality (VR) headsets is becoming a reality in Australian aged care — with a growing number of providers introducing VR goggles and a range of adventures to reduce boredom and increase joy for elderly residents. It makes sense. In 2019, VR technology is increasingly accessible. Headsets range from $19 to $900 and can be easily connected to a smart phone or PC to access a range of “virtual experiences”. Those taking on a VR adventure can scuba dive, trek the Antarctic, run with wolves, explore the canals and waterways of Venice, or ski Aspen — all from the comfort of an armchair or bed. VR is being pitched as an exciting escape for the elderly who may experience complex and often painful conditions in the later years of their lives. And there’s no denying that boredom is an issue for tens of thousands of Australians in our nation’s aged care facilities. Complaints from residents include a near-complete lack of activities at many facilities, which can lead to depression, isolation and increased illness. Aged care nurses regularly state that due to chronic understaffing,

there’s not enough time to properly feed or bathe residents, let alone sit down and have a chat.

theatrical performances, can now be experienced from the comfort of their home.”

The days of having enough nurses on staff to converse or spend quality time are unfortunately few and far between, and statistics show, sadly, around 40 per cent of residents don’t receive a visit from friends or relatives.

For those living with dementia, it can be a chance to reminisce. For others, it’s a chance to relive hobbies such as diving or swimming now unavailable to them due to age, illness or injury.

VR could offer a reprieve from boredom – and a chance to relive life without injury or illness.

Staff and family looking to bond with their relatives can also experience the VR adventure at the same time on another device.

Victorian aged care provider BlueCross last year claimed to be the first Australian provider to offer virtual reality experiences for their 1700 residents. BlueCross, which have 33 facilities in Victoria, rolled out VR technology in September 2018 to enhance the “wellbeing, mood and engagement levels of both residents living with dementia and those who are cognitively well.” Their website reads: “This exciting technology is now a part of the leisure and lifestyle program offered at BlueCross. Using a smart phone, goggles and blue tooth headphones, it brings a 360-degree immersive experience to the residents. “Experiences that previously may have been outside a resident’s reach, such as travel, adventure, aquatics, even classical concerts and

American company Aged Care Virtual Reality (ACVR) also claim to have helped Australian aged care residents experience VR with trials at Mercy Health facilities. It’s important to remember, however, that the key to ensuring aged care residents get the contact, support and care they need is evidence-based staffing and skill-mix levels so staff have the time to spend with those in their care. To learn more about the BlueCross VR experience visit https://bit.ly/2RS39kx To learn more about ACVR or watch a Channel 7 report on the use of VR in aged care visit www.agedcarevirtualreality. com

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A missed opportunity to clean house Findings from the Banking Royal Commission OPINION BY DEBORAH TWIGG, QNMU RESEARCH AND POLICY OFFICER

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HE SHOCKING revelations from public hearings of the Banking Royal Commission in 2018 were alarming but hardly surprising.

accountable for their illegal actions, and no recommendations were made to rein in the obscene pay packets bank executives currently receive.

We watched, unamused and unsurprised, as CEOs and executives of banks admitted to knowingly cheating Australians of their hardearned savings.

The following are some of the key recommendations made by Justice Hayne.

The simple truth is, the pursuit of profit was put above the interests of their customers or compliance with the law.

■ Mortgage brokers must act in the best interests of the intended borrower and not the bank providing the loan.

From the public hearings we learned that banks:

■ The borrower, not the lender, must pay the mortgage broker a fee for their service.

■ charge fees for no service ■ charge deceased people, taking money from customers who had been dead for up to a decade ■ lend to those with no capacity to repay ■ pay exorbitant bonuses and incentives to bank executives. These revelations only served to further erode the public’s trust of the banking sector. The recent release of the Royal Commission into Misconduct in the Banking, Superannuation and Financial Services Industry’s final report paints a depressing picture of the greedy and dishonest behaviour by our banks, yet has completely missed the perfect opportunity to clean up Australian banking. Financial regulators such as the Australian Securities and Investments Commission (ASIC) also came under fire for their performance. Commissioner Kenneth Hayne has made 76 recommendations from the inquiry.

Banking

■ The banking code be amended to provide access to banks for those who live in remote areas or with poor English language skills. ■ Banks will not be allowed to charge dishonour fees on basic accounts.

Superannuation A single default fund for all workers has been recommended. This means a customer is ‘stapled’ to their super fund and it travels to any new jobs with them, preventing super fund members from accruing small default funds.

Insurance ■ Funeral expense insurance would be defined as a financial product and subject to financial service laws. ■ A cap is to be added to the commission car sellers receive for add-on insurance products. ■ Hawking of insurance products would be banned. While some of these recommendations are welcome, this

is an entirely missed opportunity for much-needed reform in the banking industry. Finance Sector Union (FSU) National Secretary Julia Angrisano said we needed bold solutions. “We got marginal, incremental change that does not address the underlying issues,” Ms Angrisano said. “This should have been a Royal Commission which would begin a major fix for the financial services industry. “Instead, it has failed to deal with many of the problems and kicked other problems to the regulators to deal with.”

What happens next? The Morrison government has said it won’t be implementing any of the recommendations until after the federal election. This means that while banks have been slapped on the wrist and their reputations put through the wringer, they will continue to extract mega profits from their customers. Banks will have their work cut out for them to regain the public’s trust, and this starts with fundamentally changing the way they do business and treating Australians with honesty and fairness. As the Royal Commission into Aged Care Quality and Safety continues, it’s likely we’ll see similar themes identified, such as profits before people and regulatory failure. Let’s hope that lessons are learned from the Banking Royal Commission, and real change is achieved.

The Federal government said it would “take action” on the recommendations but have failed to specify what that means. Labor however have pledged to implement 75 of the 76 recommendations in full, and to implement the remaining recommendation, which addresses Mortgage Broker remuneration, after some minor adjustments. However, none of the recommendations identify how or if individuals and banks will be held

This should have been a Royal Commission which would begin a major fix for the financial services industry. Instead, it has failed to deal with many of the problems and kicked other problems to the regulators to deal with. Finance Sector Union (FSU) National Secretary Julia Angrisano

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Union rights, human rights Freedom of Association and how the law protects us

VERY year, workers across Australia participate in Labour Day marches.

In part, it’s about celebrating the rights we enjoy today that workers previously fought for and won through their unions. But there is also another significant reason why workers take to the streets every year in May and wave our flag: because we can. Belonging to a union and collectively bargaining for improved wages and conditions may seem like a fairly obvious and basic right. But for millions of people around the world, the reality is very different, and the right to collectively negotiate improved conditions, take collective action, or even simply join a union, varies dramatically. There are extreme cases that seem a world away from our situation at home. Between 1986 and 2009, for example, more than 2500 trade unionists, including teachers, were murdered in Colombia, with most cases going unsolved. Cases in other countries are less extreme, but still surprising due to the Western values we share. Collective bargaining in some industries in the United Kingdom, for

instance, has been restricted to only include pay, hours and holidays (and some employers will only negotiate on pay). In the United States, more than 1700 workers had their employment unfairly terminated in 2017 because of their union support or membership. But in Australia, thanks to our strong legal protections, employers are far less likely to treat an employee unfairly due to union activity. This is particularly the case for nurses and midwives, who have the collective strength of the largest union in the country (the ANMF, of which the QNMU is the Queensland branch). But that doesn’t mean we should become complacent. Illegal adverse action against employees, including nurses and midwives, does occasionally occur. Which means our protections are only as strong as we are willing to enforce them. In other words, we all have a responsibility to not only stand up and defend our rights, but also use them.

Where do our freedoms come from? Around the world, the idea of ‘freedom of association’ – that is, the right to belong to a union – is

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Adverse action – How does the law protect you? Examples of adverse action may include: ■ unfair/sudden changes in rostering ■ reducing your hours ■ treating you less favourably than other employees ■ a disciplinary investigation or warning, or anything that makes your employment less secure ■ dismissal or suspension ■ threatening to carry out any of the above.

The law provides union members with strong protections for: ■ participating in protected industrial activity ■ making an inquiry or complaint regarding your employment (such as concerns about inadequate staffing and skill mix, or being directed to work outside your scope of practice) ■ seeking to be represented by the QNMU ■ holding an official QNMU workplace position.

Remedies for adverse action include: ■ a fine of up to $63,000 for employers ■ a fine of up to $12,600 for individual managers involved ■ an order to reinstate you to your old job if you were dismissed ■ an order to compensate you (e.g. for wages lost because of a cut in your hours).

recognised in various treaties and declarations, including the Universal Declaration of Human Rights. Freedom of association also encompasses the right to organise and collectively bargain. Both concepts are interlinked – there’s not much point in joining a union if you can’t collectively negotiate through enterprise bargaining, and you can’t collectively bargain if you aren’t able to join a union. Both principles are two distinct conventions of the International Labour Organisation (ILO). Australia ratified both in 1973. In Australia, these fundamental workplace rights are deeply rooted in our country’s history. University of Queensland School of Law Professor Graeme Orr said the origins of Australia’s workplace protections date back to the Constitution itself. “If you go right back to the nineteenth century, the law was literally called the ‘master and servant’ law,” Professor Orr said. “Being a member of a union under the old law we inherited from Britain meant you could be accused of being part of an illegal conspiracy. “But when white Australia was founded, we got a Constitution with […] a provision that guaranteed

fair working conditions through conciliation arbitration. “So this Australian ethos — the idea of a fair go — said that unions needed to be part of a three-way system: the independent umpire, employer groups and unions. “That process could only work if you had unions, employer voices and the Commission arguing it out in a rational way.”

Law of the land In Australia, our right to freedom of association is protected in the Fair Work Act 2009 by ensuring we are free to join unions, be represented by unions, and participate in lawful industrial activities. It’s in stark contrast to laws in many other countries, including some democracies that we may incorrectly assume are similar to our own. In the United States, for example, the law makes it extremely difficult for workers to organise and seek representation from their union. Interestingly, the United State has not ratified either conventions of the ILO. “In Australia, unions have a guaranteed place at the bargaining table,” Professor Orr said. “Whereas in the United States, unions have to win a secret ballot and get a majority of workers — union

indepth members or not — to say they want the union to represent them.

there takes the form of mass street protests.

“It’s a political competition – the employer has the right to exclude the union as much as individuals have the right to try and organise in that workplace.

“It’s an incredibly bad situation — both factory owners and the State respond harshly by firing workers, threatening them, violently dispersing rallies, and you even have numerous cases where protesting workers are killed, in several cases by police.”

“Employers literally pay consultancy firms to help bust unions and stop them organising in the workplace.”

Other end of the spectrum Unfortunately, the laws in the United States seem almost encouraging compared to other countries around the world, where the situation is more dire and, in many cases, a matter of life and death. International Centre for Trade Union Rights (ICTUR) Director Daniel Blackburn described many countries’ commitment to workers’ rights as merely “lip service”. “Bangladesh is a key example, where they have ratified ILO C87 [freedom of association], but to all intents and purposes, unions remain practically banned from the export zones where the main garment factories are,” Mr Blackburn said. “When dissatisfaction has no proper channel into bargaining and negotiation, it boils over […] and that’s precisely why labour activism

In other countries, the violations of union and workers’ rights are more subtle, but achieve the same goal of preventing workers from organising. “There are countries where no one gets murdered for trade unionism, but their rights are tied up by legal restrictions,” Mr Blackburn said. “In Turkey, for example, there are double thresholds for union recognition, meaning unions need to organise not only majorities within a workplace, but also recruit large memberships across whole economic sectors before they can secure bargaining rights.”

But our rights are protected, right? Well, yes and no. It wasn’t that long ago that the Howard government introduced WorkChoices — a shameful attempt to wind back workers’ conditions, reduce workers’ collective power, and make it easier for employers to sack their employees.

Australian unions, including the QNMU, fought these changes through a public campaign, and the legislation was eventually overturned when Australians voted in a Labor government in 2007. Now, with another federal election around the corner, workers are campaigning to Change the Rules on a range of issues, including the rules that determine our industrial system. Thanks to an unbalanced and broken system, wage growth has flatlined and profits are going to the big end of town. More workers are now in insecure and casualised employment, making it difficult to bargain for fair wages and conditions. Much of these problems stem from that fact that the law has been narrowly written and lawyers have devised ways around provisions that were meant to protect workers. This federal election is an opportunity to change this. You can find out more about the campaign at www. changetherules.org.au.

Adverse action Fortunately, the law in Australia (under the Fair Work Act) not only protects our right to join a union, but also enables workers to take action.

“In Australia, Labour Day is as much about marching to protect our rights and celebrate our union achievements as it is about marching because we can.” 41

indepth Significantly, the law prohibits an employer taking adverse action against an employee for exercising their rights. However, that’s not to say that some employers don’t occasionally break the law. In fact, every year the QNMU assists a small number of members with adverse action claims — a process that is necessary to ensure employers do not get away with treating their workers unfairly. In 2014, QNMU member and former Australian Red Cross Blood Service (ARCBS) Enrolled Nurse Sandi Emblem was stood down and ultimately dismissed because she took protected industrial activity and because she was entitled to a higher wage than a Donor Service Nursing Assistant (DSNA). The QNMU’s case against ARCBS was based on the claim that ARCBS made false allegations about Sandi’s workplace conduct, and after terminating her employment, replaced her EN position with at least one DSNA. “It was all an entire shock to me, I was upset, worried and stressed,” Sandi said. “But I knew we had a right to stand up for ourselves, and I never believed I’d done anything wrong, so it was a matter of fighting for what I knew was right.” The QNMU progressed Sandi’s case against ARCBS through the courts and it finally concluded with the judge ruling in Sandi’s favour. ARCBS has been ordered to pay compensation to Sandi and a penalty to the QNMU totalling over $56,000. At the time of going to print, these orders had been suspended pending an appeal by ARCBS. Nevertheless, it is a win for Sandi and a warning to all employers who ignore the laws that protect all Australian workers. And despite Sandi’s case being an extremely rare ordeal for a nurse or midwife to have to go through, many workers are still fearful of exercising their rights. Sandi said she believed nurses and midwives, in particular, wrongly thought they did not have the right to question management about the status quo. “I think there’s always the fear there, they worry about their hours being cut or losing their jobs,” Sandi said. “So many nurses and midwives don’t know their rights, they only look at the potential consequences rather than what they’re actually entitled to. “But we are protected, and we have a voice and we can exercise our rights to protect our jobs. “We all have to have standards and there needs to be balance and fairness, and that’s where it’s good to have the support of your union.”

Bibliography International Trade Union Confederation (2013) United Kingdom, regular violations of human rights, viewed January 2019, https://survey.ituc-csi.org/United-Kingdom.html#tabs-3 International Centre for Trade Union Rights (2019) Monitoring and interventions, viewed January 2019, www.ictur.org/Interventions.html Australian Government Attorney-General’s Department (n.d.) Right to freedom of assembly and association, viewed January 2019, www.ag.gov.au/RightsAndProtections/HumanRights/Humanrights-scrutiny/PublicSectorGuidanceSheets/Pages/Righttofreedomofassemblyandassociation.aspx United Nations (n.d.) Universal declaration of human rights, viewed January 2019, www.un.org/ en/universal-declaration-human-rights/

OUR RIGHTS: USE ’EM OR LOSE ’EM. If you b believe li your employer l may h have taken adverse action against you, the QNMU is here to help. Contact Member Connect on 3099 3210 or 1800 177 273.

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It's all about fairness this federal election... ITH A federal election looming (and likely to be held by late May), there is much for nurses and midwives to consider.

Whether it’s protecting our penalty rates, securing legislated ratios in aged care, or demanding adequate funding for our universal health system, the outcome of the federal election does affect our day-to-day work as health professionals. Elections are an opportunity for nurses and midwives to secure commitments from political parties on issues that matter to our professions and those we care for. This election we are asking all political parties to Change the Rules through the Australian Council of Trade Union’s national call for fairness and equality. This is a call from all Australian workers, but for nurses and midwives we particularly want to see real action to fix our broken aged care system. Our Ratios for Aged Care: Make them law now campaign is well under way. We’re calling on all politicians to legislate minimum nurse-to-resident ratios and skill mix in Australia’s private aged care sector. We also want to see greater transparency and accountability for aged care providers, including mandatory public reporting on staff numbers, skill mix and spending. Right now, many providers are putting profits before resident care and safety, and our nurses and carers are suffering. We know the community is on our side, but now it’s time for our politicians to act. Already, many Queensland Labor and Greens MPs and candidates have signed to support ratios in aged care. You can see the full list at www.qnmu.org.au/ RatiosForAgedCare

Other commitments We are also asking all political parties to commit to: ■ Restoring and protecting our penalty rates — with weekend and public holiday penalty rates already stripped away in the retail and hospitality sectors, we are in danger of passing on less to the next generation. Upon reducing these penalty rates, the Morrison federal government promised an increase in productivity and employment. Neither has occurred. For nurses and midwives, penalty rates make up a significant portion of our take-home pay, and already employers (particularly in aged care) are attempting to reduce penalty rates in new enterprise agreements. ■ A fair superannuation system that pays women for every dollar they earn, including while taking maternity leave, and closes the retirement gender pay gap. ■ 10 days paid family and domestic violence leave for all workers.

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■ Restoring health funding – with hundreds of millions of dollars still owing to Queenslanders for health services already budgeted for, we want to see this funding restored and a better funding model in future. ■ Value the role nurses and midwives play in our health care system, including addressing funding and structural barriers to midwifery continuity of care models, and funding Nurse Practitioner and Nurse Navigator positions to enhance patient-centred care. We have written to all parties on the issues you care about. Keep an eye out for their full responses.

You can make a diﬀerence There will be plenty of opportunities for nurses and midwives to get involved once the election activity has kicked off. Keep an eye on your emails, our social media channels, and our website — www.qnmu.org.au — you may even receive a friendly phone call from us.

a free copy of On Fairness

This federal election is all about fairness — fairness for families, fairness for workers, fairness in our society.

ACTU Secretary Sally McManus’ recent book On Fairness looks at how stagnant wages, gender pay inequalities and insecure work have contributed to Australia’s rising inequality. To win a free copy of Sally’s book, tell us what you think fairness means for nurses and midwives — what does fairness look like in your workplace?

Send your 50-word response to comms@qnmu.org.au and we’ll let you know if you’ve won!

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Meet

Lucynda Maskell QNMU Vice Presidentt

URSES and midwives of the QNMU, please say hello to Lucynda Maskell.

Lucynda is a Clinical Nurse Consultant from Weipa in far-north Queensland and is also the QNMU’s democratically elected Vice President. She is currently employed at the Malakoola Primary Health Care Clinic, where she has worked closely with the local Napranum people for the past 13 years providing both primary and emergency care. Having worked in both metropolitan and rural locations across Queensland since 1993, Lucynda brings years of experience and knowledge both to her nursing work and her work for the QNMU.

I’m very committed to improving our nursing and midwifery voice and influence in Cape York... I cannot imagine my career without our union. Conference motions for change and to share their stories that provide context around the industrial and professional issues we in isolated areas face.

Starting next edition, Lucynda will be writing a regular column for InScope… but first, we thought you might like to get to know her a little better, so we sat down with Lucynda to ask her a few questions.

Many of these motions have led to real change, such as the EB10 improvements around on-call conditions, and some improvements to the Rural and Remote Incentive Package (with more coming through EB10).

How have you advocated for nurses and midwives during your time on Council?

What are some of your current responsibilities as a QNMU activist?

Being a QNMU Councillor from a remote area has allowed me to share concerns and ideas on how the QNMU can advocate for improved conditions.

I’m very committed to improving our nursing and midwifery voice and influence in Cape York. I represent members in the Torres and Cape through various consultative forums, including the EB10 review of Rural and Remote incentives, the Queensland Health Occupation Violence

I have helped Cape York delegates to design and articulate their Annual

Implementation Committee subgroup for rural and remote issues, and another steering group focused on guiding and implementing the NMBA’s decision to remove Scheduled Medicines Endorsement.

How does nursing in a rural community differ to working in a metropolitan area? Bringing accessibility of health care to people is a cornerstone of primary health. Attaining endorsement for scheduled medicines and being a recognised immunisation provider allows those qualified nurses to treat according to protocol and give scheduled immunisations without needing a medical officer order. This means our practice can differ greatly from nursing in metropolitan areas, and this autonomy can be greatly rewarding.

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What are some of the unique challenges for rural and remote nurses and midwives? The challenges vary dramatically between each HHS and even individual sites. Safety is always a concern, with generally limited staff numbers and an increased risk for those doing on-call arrangements in isolated areas. The availability of occupational violence prevention and training is also dependent on the HHS. My understanding is that it can range from as little as a 15-minute DVD to a more comprehensive program.

What are some of the highlights from your nursing career? Nursing has been incredibly rewarding on all fronts. I hold particularly fond memories of being a (then) QNU Organiser and helping members to rally in EB5 when, for the first time in Queensland, nurses shut beds and some regional members bused to Brisbane Parliament House to rally on the â&#x20AC;&#x2DC;Chunder Bucket Expressâ&#x20AC;&#x2122;. I cannot imagine my career without our union. The ability to contribute and be a valued member of the QNMU community has helped grow my confidence to advocate not only for our professions but for the patients and communities I work amongst.

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Accessing patients’ health records: what are my rights? S NURSES and midwives, we have certain professional obligations in relation to accessing the clinical records of patients or residents while performing our duties at work.

A very simple, general rule applies: nurses and midwives should not access, view, read or share a patient’s medical records unless there is a legitimate clinical reason (i.e. you are involved in the care of the patient). In the course of performing our duties, nurses and midwives have access to sensitive personal and medical information. The professional therapeutic relationship between nurse/midwife and patient/resident requires that this information only be used for the purpose of providing nursing or midwifery care to that patient or for another legitimate clinical reason.

What is a clinical record? Generally speaking, a clinical record is any data or information gathered or generated to record the clinical care and health status of an individual. This may be in electronic or hard copy format. Your employer may also have their owns standards and policies defining what a ‘record’ means to them. With the introduction of electronic record keeping systems, particularly in the public sector, health professionals face new challenges in ensuring their access to clinical records is authorised or otherwise appropriate. Electronic record management systems are usually introduced with the intention of establishing userfriendly, reliable and real-time records of all clinical matters relating to a patient.

In addition to their professional obligations, nurses and midwives are also required to comply with their employer’s policies and procedures regarding access to patient records.

However, electronic records systems are often accessible to a large number and broad range of clinicians, including nurses and midwives.

These policies will normally detail the circumstances under which a nurse, midwife or other health professional can read or otherwise access a patient record.

For example, concerns have been raised about Queensland Health’s electronic medical record system, where clinicians can access the records of patients in any hospital

where the new system has been implemented. This easy access to a large body of clinical information means there is the potential for staff to intentionally or inadvertently access records of patients they are not providing care for.

Accessing records of family or friends or ‘high proﬁle’ patients The QNMU has received enquiries from members regarding allegations of unauthorised access to the clinical records of partners, family or friends (or indeed former partners or friends) who are receiving care at their workplace. While it is human nature to want to ensure your loved ones are receiving the best care while in a health care facility, curiosity and concern for their welfare are not legitimate reasons for accessing their clinical records. To identify instances of unlawful or unauthorised access to the medical records of relatives, employers (particularly large ones) will often perform routine audits of employee access to patient records. Audits may be performed to cross-match access by those with the same family name as patients. Audits may also be performed on access to the records of high-profile

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patients (such as media personalities or patients who have committed criminal offences known to the public) to determine whether there has been unauthorised access to or viewing of those records.

Potential risks of improperly accessing patient records If your employer believes you have accessed a patient’s records without authority or without legitimate clinical reason, they may commence a disciplinary process. In engaging with this process, you should consider: ■ whether you have received appropriate training on the electronic records management system ■ whether your access to the electronic record was intentional or inadvertent ■ if the access was unintentional or accidental (for example, you entered the wrong patient’s details) ■ if the access was intentional, whether you had a clinical reason (whether it was ‘authorised’ by your employer or not) for the access ■ whether you otherwise had authority from your employer to access the record. If you dispute the allegations, it may be worthwhile considering whether the

access could have been a third party using your log-in details, or whether you may have failed to log-out after previously using the system. This possibility exposes some of the flaws of electronic records systems in hospitals and other health care facilities. To that end, it is important to remember that keeping log-in details confidential and logging out after using computers or mobile stations (particularly when they are located in shared spaces) is crucial to protecting the confidentiality of patient records, and in protecting yourself against allegations of inappropriate conduct. Depending on the seriousness of the allegations and the findings of any investigation, the outcomes of a disciplinary process may include warnings, forfeiture of increment increases, or even dismissal. Given that the matter of accessing patients’ clinical records is also a professional nursing and midwifery issue, AHPRA may also commence their own investigations into whether the NMBA Code of Conduct or Standards of Practice may have been breached.

A reminder... A nurse or midwife’s right of access to a patient’s clinical records, whether electronic or paper-based, is restricted to those occasions where

there is a legitimate clinical reason for that access, or where their employer has authorised such access. Depending on the circumstances, inappropriate access to or viewing a patient’s records may lead to your employer taking disciplinary action or AHPRA taking action in relation to your registration.

REFLECTIVE QUESTIONS 1. Why is it important to limit the access of patient’s clinical records to those who have a legitimate clinical reason for doing so? 2. Consider what you might do in circumstances where you have accessed the clinical record of a family member without a legitimate clinical reason or other authority from your employer. 3. Could accessing a patient’s clinical record where there is no legitimate clinical reason for doing so be considered a boundary crossing or violation? Why/why not? Don’t forget to make note of your reflections for your record of CPD at www.qnmu.org.au/CPD

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Preventing sacral pressure injuries: The use of foam dressings PROFESSOR BRIGID. M. GILLESPIE & DR RACHEL. M. WALKER FOR THE EEPOC TRIAL GROUP, SCHOOL OF NURSING & MIDWIFERY & MENZIES HEALTH INSTITUTE, QUEENSLAND, GRIFFITH UNIVERSITY

Up to 20% of hospitalised patients develop pressure injuries Patients are at high risk of developing pressure injuries (PI) during hospitalisation. Internationally, the incidence of hospital acquired pressure injuries (HAPI) ranges from 6.4% to 11.6%.1,2,3 Locally, results of the 2014 Queensland Bedside Audit (QBA) identified 60% of patients were at risk of HAPI.4 In many hospitals across Australia, the use of dressings to prevent sacral HAPI is increasing.5,6 However, high quality evidence of their effectiveness is lacking and their use may be contributing to financial burden.

Recent pilot study In 2014 Griffith researchers conducted a pilot randomised controlled trial using foam dressings in a general medical-surgical population of high risk patients.7,8 This trial involved 80 at-risk patients who were randomised to either standard care or standard care with a silicone foam boarder dressing applied to their sacrum. A blindedto-intervention outcome assessor undertook outcome assessment using digital photography. As this was a feasibility trial and the results based on a small sample of patients, the benefit of applying foam boarder dressings in this high-risk population remains unclear.8

REFLECTIVE QUESTIONS 1. Think about what guides your decision-making when caring for patients at risk of PI. Do you consider context, cost and evidence?

The EEPOC Trial Preparations are currently underway for a larger definitive trial, funded by the National Health and Medical Research Council. Our multi-site study, coined the Efficacy and effectiveness of Prophylactic foam dressings in the prevention of sacral pressure injuries in at-risk hospitalised patients (EEPOC) trial will be the first undertaken in the general medical-surgical population, focusing on the most frequent site of HAPI, the sacrum. This nurse-led trial combines the expertise of nurse researchers and clinicians, a health economist and a biostatistician. The aim of the EEPOC trial is to determine the clinical and cost effectiveness of prophylactic foam dressings compared with standard care alone in high-risk general medical-surgical patients. The trial will be undertaken in partnership with four public hospitals in southeast Queensland. We anticipate that the results of this multicentre clinical trial will provide definitive evidence that can guide future practice.

Want to know more? Please contact Professor Brigid Gillespie or Dr Rachel Walker at r.walker@griffith.edu.au

2. Do you feel you have the information you need to make the best decisions for PI prevention? Donâ&#x20AC;&#x2122;t forget to make note of your reflections for your record of CPD at www.qnmu.org.au/CPD

References 1.

Gunningberg L, Hommel A, Baath C, Idvall E (2013). The first national pressure ulcer prevalence survey in county council and municipality settings in Sweden. Journal of Evaluation of Clinical Practice, 19(5):862-7.

2. Kottner J, Wilborn D, Dassen T, Lahmann N (2009). The trend of pressure ulcer prevalence rates in German hospitals: results of seven cross-sectional studies. Journal of Tissue Viability, 18(2):36-46. 3. VanGilder C, Amlung S, Harrison P, Meyer S (2009). Results of the 2008-2009 International Pressure Ulcer Prevalence Survey and a 3-year, acute care, unit-specific analysis. Ostomy Wound Management, 55(11):39-45. 4.

Patient Safety Unit (2015) 2014 Queensland Bedside Audit Gold Coast Hospital and Health Service Inpatient Report. Queensland Department of Health.

5. Brindle & Wegelin J (2012). Prophylactic Dressing Application to Reduce Pressure Ulcer Formation in Cardiac Surgery Patients. Journal of Wound Ostomy & Continence Nursing, 39(2):133-42. 6. Chaiken N (2012). Reduction of Sacral Pressure Ulcers in the Intensive Care Unit Using a Silicone Border Foam Dressing. Journal of Wound Ostomy & Continence Nursing, 39(2):143-5. 7.

Walker R, Aitken LM, Huxley L, Juttner M. (2015). Prophylactic dressing to minimize sacral pressure injuries in high-risk hospitalized patients: a pilot study. Journal of Advanced Nursing,71(3):688-96.

8. Walker R, Huxley L, Juttner M, Burmeister E, Scott J, Aitken LM. (2017). A Pilot Randomized Controlled Trial Using Prophylactic Dressings to Minimize Sacral Pressure Injuries in High-Risk Hospitalized Patients. Clinical Nursing Research, 26(4):484-503.

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Flexible work arrangements IN BOTH the public and private sectors, you are entitled to request a flexible working arrangement (FWA) and your employer has an obligation to consider your request. Amongst other things, the request may be for a change in the hours you work, a change in a roster pattern, a different location or a transition to retirement. Regardless of whether you work in the public or private sector, your employer now has an obligation to genuinely consider your request and if they refuse, provide you with reasons as to why they cannot accommodate that arrangement. If you are considering making a request, the following information will be of assistance:

PUBLIC SECTOR You have two options when making a request for an FWA.

Option 1 Under the Queensland Employment Standards set out in the Industrial Relations Act 2016, you are entitled to request an FWA in writing. This request must state the change you require and the reasons for the change. Within 21 days of making this request your employer must provide you with their decision as to whether they will grant your request.

PRIVATE SECTOR of request cannot be unreasonably refused. Guidelines have been established to assist in the consideration of an FWA and allows for different methods of working to be considered. The following principles set out in the guidelines must be considered when a request is made: ■ Flexibility can take many forms for a variety of reasons – don’t discriminate. ■ Come from the position of ‘how can we make this work?’.

If your request is unreasonably refused, you can make an appeal to the Queensland Industrial Relations Commission within 21 days.

■ Be creative and solutions-focused.

Option 2

■ Cultivate an open and trusting environment.

Your Enterprise Agreement (EB10) requires your employer to consider requests for an FWA and this type

■ Understand the business outcomes. ■ Promote a ‘guilt-free’ attitude to requests.

■ No one-size-fits-all – every employee and situation is different.

REFLECTIVE QUESTIONS 1. What do you think is meant when the guidelines state “promote a guiltfree attitude to requests”? And why is this important? 2. Why is important that employees be given a valid reason if their FWA request is refused? What would you consider a valid reason? What would you consider an unreasonable excuse? Don’t forget to make note of your reflections for your record of CPD at www.qnmu.org.au/CPD

To be eligible to make a request under the Fair Work Act 2009, you must have worked with your employer for at least 12 months and be an employee who: ■ has parental or carer responsibilities ■ has a disability ■ is 55 years or older ■ is experiencing or providing care to someone experiencing family violence. From 1 December 2018, model terms for requests for an FWA will be inserted into all modern awards and will apply if you make a request under the National Employment Standards (NES). The NES requires your employer to organise discussions with you about your request within 10 days of receiving your request. They must also give you a written response to your request within 21 days. Any employer who mismanages or refuses a request without proper consideration or fails to provide detailed reasons for refusing an FWA can face financial penalties. If you have made a request to your employer for an FWA and you think you have been unreasonably refused this request, please contact the QNMU immediately.

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Mentoring stu d s e s a r n u d m ent n idw iv i t?

es d n a do t i e o d w e d w Why do shoul how HE NURSING and Midwifery Board of Australia (NMBA) under the auspices of the Australian Health Practitioner Regulation Agency (AHPRA) is the body that develops standards, codes and guidelines for the nursing and midwifery professions.

They outline a code of conduct which must be adhered to by each profession and these codes contain the following principle: Nurses/Midwives commit to teaching, supervising and assessing students and other nurses/midwives in order to develop the nursing/ midwifery workforce across all contexts of practice. Our statutory regulatory body requires that we teach, supervise and assess students. Role descriptions often reiterate this aspect of nursing and midwifery, and for many it is an integral part of their role requirement and practice. However due to increasing workloads and high levels of stress across all sectors some nurses and midwives have come to

view this as an added burden to their already overwhelming role.

centred care and a positive work culture.

It is important though to take some time to reflect upon this obligation to other nurses and midwives and realise that this is more than a mandated requirement.

The role of the mentor is to help the student make sense of their practice through application of theory; assessing, evaluating and giving constructive feedback and facilitating reflection on practice, performance and experiences.

We need to view this teaching and supervising role as a mentoring relationship and something that is a key element in preparing the next generation of nurses and midwives for practice.

Passing on the knowledge Mentoring is defined in this case as a relationship in which a more experienced or knowledgeable person helps to guide a less experienced or knowledgeable person in the workplace. This therefore is an opportunity to shape the future of our professions, the time to build the foundation of positive professional practice environments and instil the desire to work in areas which embrace patient

Being a mentor means being a positive role model who not only helps a student develop their skills but acts in the public interest by helping develop students who act in a safe, competent manner when they too are registered. It is, in fact, one of the most critical roles in the healthcare system and therefore should be appropriately considered and resourced. As we are all required to be mentors we should strive to be good ones. To become a good mentor, it is not enough to possess a high degree of knowledge or experience, but to impart that in a supportive manner and in ways that maximises the learning potential of the student.

CPD Research into mentorship of student nurses has identified a number of qualities and skills that characterise an effective mentor. These can be broadly described as: ■ an ability to develop a relaxed and supportive relationship ■ a high level of knowledge and clinical skills ■ an ability to assess the learning needs of the mentee so as to effectively supervise and evaluate learning ■ awareness of the pressures and demands of the course on the students ■ demonstrating an effort to help the student. Mentoring is a partnership between the mentor and the mentee and although potential mentors may argue they have limited time to be a successful mentor, especially when they have a full workload themselves, it is in their own interest to explore this relationship for it is an investment in the future of the nursing and midwifery professions and potentially a future colleague in the workplace. Many nursing and midwifery bodies see the importance of developing good mentors in helping promote their areas of expertise, and as tools for recruitment and retention of staff. They understand that growing their own workforce – one that not only has experience in their unit as students but has also formed relationships within their new teams — is a great way to develop loyal staff.

Training is important In order to benefit from these arrangements, it is important that mentors have appropriate training and skills development in being a mentor.

planning for your time with your student mentee. Mentors should also have a person that they can debrief with and discuss their own reflections, thus mentors can become mentees in their own mentor/mentee relationships. It is also important for mentees to come prepared as this relationship is a two-way street. Tips for mentees include: ■ clarifying your goals, having clear expectations and specific outcomes about the mentoring relationship ■ come prepared, pre-reading or knowing general information about the new environment is recommended

achievable way of overcoming issues such workplace bullying and horizontal violence and promoting psychological safety which benefits nurses, midwives and those we care for. We are instructed by our statutory bodies that we must teach, supervise and assess, however for the increased satisfaction of all and the benefit of healthcare into the future we should embrace this ask as an opportunity to develop effective mentorship programs and opportunities. We are stronger together and this approach to developing the future workforce can only benefit everyone.

REFLECTIVE QUESTIONS

■ respect the mentor’s boundaries 1. Think back on your own student experience. Was it productive and positive? How did it shape your practice? What could have been done differently?

■ take action between shifts by following up questions with your own reflection and study. When positive mentorship roles develop in the workplace the result can be transformative, not only to the student nurse whose positive experiences can shape their entire future career, but also to the workplace, which can build a positive practice environment that personifies person-centred care and exemplifies the type of healthcare workplace students aspire to work in.

2. If you’ve ever been a mentor, consider your performance. Was the relationship supportive? Did it help foster a positive practice environment? Are there things you might do differently? 3. Are you aware of what kind of training is available to potential mentors?

Mentors themselves can experience a level of work and personal satisfaction that comes from nurturing future nursing and midwifery practice and guiding an individual to make informed decisions on patient care and other issues. Actions, such as mentoring, that build a positive practice environment, are a significant and

4. How might a positive mentormentee program help reduce bullying in the workplace? Don’t forget to make note of your reflections for your record of CPD at www.qnmu.org.au/CPD

References 1

Royal College of Nursing, Guidance for mentors of nursing students and midwives, retrieved from https://www.ed.ac.uk/files/imports/fileManager/

Al-Hamdan, Z, Fowler, J, Bawadi, H, Norrie, P, Summers, L, and Dowsett, D, Student Nurses’ Perceptions of a Good Mentor: A Questionnaire Survey of Student Nurses in the UK, USA and Jordan, International Journal of Humanities and Social Science, Vol. 4 No 3, February 2014, retrieved from http://www.ijhssnet.com/journals/Vol_4_No_3_ February_2014/24.pdf RCNGuidanceforMentorsofNu rsingStudentsandMidwives.pdf

Minority Nurse, Mentoring Nurses towards success, March 30 2013 retrieved from https://minoritynurse. com/mentoring-nurses-toward-success/

Mills, J, Lennon, D & Francis, K, Mentoring matters: Developing rural nurses knowledge and skills, Collegian Vol 13 No 3 2006

These arrangements can vary from formal training through education institutions to inhouse skills development programs. The key is to be mentally and physically prepared for mentorship, have the resources of your workplace behind you and be actively involved

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“Scrub the Hub” dry time Are you waiting long enough? KAREN SLATER, RN, PHD (CANDIDATE), ASSISTANT DIRECTOR OF NURSING, INFECTION MANAGEMENT AND PUBLIC HEALTH AND CLAIRE RICKARD, RN PHD, PROFESSOR OF NURSING THE ALLIANCE FOR VASCULAR ACCESS TEACHING AND RESEARCH, GRIFFITH UNIVERSITY AND THE PRINCESS ALEXANDRA HOSPITAL

OST PATIENTS have a peripheral intravenous catheter (PIVC) during hospitalisation. Nurses play an important role in ensuring the PIVC care provided is both evidencedbased and appropriate.

To prevent infection, experts agree on the need to thoroughly decontaminate the needleless connector (NC) attached to the PIVC with an antiseptic solution, this practice is commonly referred to as “scrub the hub”.1,2 The time needed to scrub the NC varies in the literature from five-60 seconds3, with most international guidelines recommending at least 15 seconds.1,2 It is important that NCs are allowed to dry after decontamination, before using the PIVC – otherwise the antiseptic is ineffective. Some manufacturers recommend allowing 30 seconds for the NC to dry, however there are no published studies to confirm this very lengthy dry time. Such a long drying time is impractical making clinician compliance highly unlikely.

The study The aim of this experimental study was to test the drying time of three commonly used preparation pads/swabs: 70% isopropyl alcohol (Reynard), 70% isopropyl alcohol and 2% chlorhexidine (CHG) (3M), and 10% povidone-iodine (Livingstone).4 The NC was scrubbed vigorously for 15 seconds, and then tested for dryness. The NC was considered dry when tissue paper (white for povidoneiodine, and blue/purple for alcohol, and alcohol with CHG) was firmly placed on the NC with moisture not observed on the paper. Dryness tests commenced 15 seconds after the scrub and were repeated at five second increases or decreases until dry time was established. Each test required

a new 15 second scrub. The testing for povidone-iodine was increased to 30 seconds as it was still visibly moist at 60 seconds. Once dryness was established, the procedure was repeated four times to ensure reliability. Testing was in a non-clinical area, and patients were not involved.

Results The testing revealed that NCs swabbed with alcohol after a 15 second scrub were consistently dry at five seconds. Isopropyl alcohol and 2% CHG was consistently dry in 20 seconds. The NC swabbed with Povidone-iodine 10% was still not dry at six minutes (the final measurement).4

Implications for practice Isopropyl alcohol alone is the most time-efficient antiseptic agent. Although isopropyl alcohol and 2% CHG has greater antimicrobial activity, this would only be effective if all staff wait 20 seconds before using the PIVC. Povidone-iodine 10%, considering its long dry time, precludes it as a reasonable antiseptic agent for NC decontamination.

procedure. These important but simple procedures reduce patient morbidity and mortality caused by bloodstream infections.

REFLECTIVE QUESTIONS 1. How long do you wait for the NC to apply after ‘scrubbing the hub’? Go ahead, time yourself — is it what you expected? 2. How might the properties of the antiseptic and the design of the NC used in your facility affect dry time?

The other issue highlighted by this study was the need for antiseptic wipe/swab packaging to include better instructions to guide healthcare workers on effective use. Instructions generally only pertain to skin use, and not the cleaning of inanimate objects such as NCs. “Scrubbing the hub” with antiseptic and friction, then allowing the antiseptic to dry are important to reduce the microbial load on NCs. Nurses must also adhere to hand hygiene guidelines, ensuring that they wash/decontaminate their hands before drawing up medication, immediately prior to accessing the NC and at the completion of the

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

References 1.

Intravenous Nursing Society. Infusion therapy standard of practice. J Infus Nur Soc 2016;39(1 Suppl.), S1-S159.

2. O’Grady N, Alexander M, Burns L, Gerberding JL, Heard SO, Maki DG, et al. Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis.2011;52(9)162-93. 3. Moureau NL, Flynn J. Disinfection of needleless connector hubs: clinical evidence systematic review. Nurs Res Pract 2015;Article796762. 4.

Slater K, Fullerton F, Cooke M, Snell S, Rickard CM. Needleless connector drying time-how long does it take? Am J Infection Control 2018;46(9):1080-1081.

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Examining our professional values Sandra Eales QNMU Assistant Secretary Y 2019 focus is on the core professional values that underpin nursing and midwifery.

Advocacy, caring, professionalism and holism were identified as core shared values in research commissioned by the union and undertaken by Councillor and Activist Kim Volp in 2006. Understanding nursing and midwifery is necessary to ensure an effective and sustainable workforce. We must also recognise what threatens the integrity of our professions and what erodes the wellbeing of individual nurses and midwives. Moral distress occurs when there is a gap between the values we hold and the way we work, when an individual knows what is right but is constrained from acting accordingly by the dominant power or belief system. Anger, frustration, guilt and powerlessness are all emotional responses to this experience, and the effects of those negative feelings linger in our bodies and minds. Individuals need to emotionally process negative situations through empathetic connection with others to prevent burnout, and one way this can be achieved is through reflective practice. Moral distress has been the subject of nursing, bioethicist and medical studies for years but remains the daily experience of many nurses and midwives. It’s those days when we fail to advocate for a patient or a colleague due to a need for self-protection, when we go home at the end of a shift cataloguing the “missed care” because of understaffing or other accumulated experiences that can result in compassion fatigue or burnout.

Increasingly, we see distress caused by a lack of control over our practice due to chronic understaffing, lack of value within the system, and having no voice in the workplace. Moral distress is recognised as a workplace health and safety hazard, negatively impacting the work environment but also directly causing harm to the individual experiencing it1. In order to avoid this recognised hazard we must identify it, understand the internal and external constraints involved and then act to eliminate it. Understanding the core values of nursing and midwifery is the first step in protecting the integrity of our professions.

practitioners to process experiences and information. A safe and supportive reflective practice is also the key to building trust within teams, which underpins good collaborative practice. For organisations to remain true to their values, it is imperative they ensure nurses and midwives have a real voice. Over the next few issues I will explore in greater depth each of the QNMU professional values and discuss the strategies we need to employ to protect individual wellbeing and our professional integrity.

Nurses and midwives ‘love their work but hate their jobs’

REFLECTIVE QUESTIONS 1. Name some of the internal and external factors that inhibit or constrain your ability to provide quality nursing or midwifery.

There is an intrinsic reward in nursing and midwifery when the practice meets the values.

2. What measures are (or could be) taken in your workplace to reduce the incidence of moral distress of nurses, midwives and doctors?

But when there is a gap it makes us sick and weakens the profession. Consequences of moral distress include burnout, emotional withdrawal from colleagues and patients and often leaving the job or profession altogether.

3. What can you (as an individual) and we (as the professional collective) do to protect the moral integrity of our professional community?

What can we do to look after each other and ourselves?

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

In order to deal with moral distress we must talk about it. We must identify the values in conflict and address root causes, internal and external2. ■ Recognise and name it

References

■ Increase self-awareness of strengths and weaknesses

■ Speak up Psychologically healthy workplaces require space and time for

Weber, E., (2016) ‘Moral Distress, Workplace Health, and Intrinsic Harm’, Bioethics, Vol. 30, issue 4, pp 244-50. (Wiley Online Libraryhttps://doi.org/10.1111/ bioe.12181)

2. Hambric, A., Davis, W., Day Childress, M., (2006) ‘Moral distress in health care professionals. What is it and what can we do about it?’, The Pharos, Winter pp16-23.

CPD

Air assisted transfer devices:

CCORDING to Workplace Health and Safety

Queensland, 62% of serious injury claims in Queensland are musculoskeletal disorders. As a result, Queensland adopted the

good for nurses, good for patients

Musculoskeletal Disorder (MSD) Action Plan 2016-22 which aims to reduce such injuries by 30%.

Nurses and midwives of course will know of the implications of sustaining an MSD in their workplace which not only affects their capacity to work, but their ongoing physical and psychological health. Members often ask what they can do to ensure they have the best chance of avoiding a workplace injury given the extensive manual handling activities in healthcare. These tasks, particularly the manual handling of people, are determined as hazardous manual tasks in the Work Health and Safety Regulation 2011 and, as a result, your employer is required to pay particular attention to reducing your risk of injury. This means providing access to technologies and equipment that most effectively reduces the risk when you are providing care to your patients. While many nurses and midwives are familiar with the use of 'air assisted transfer devices', more commonly known as HoverMatts and HoverJacks, the QNMU remains concerned that their use is not more widespread. A recent conversation with an injured member highlighted this problem. The member had apparently been given a directive that HoverMatt use should be restricted to bariatric patients, rather than be used more widely for other patients. The directive was issued despite the member being injured while attempting to transfer a patient who was confined to a bed requiring full nursing care.

Photo: HMS Medical

CPD

Why a HoverMatt would have helped

gain access to this equipment. You can

A recent environmental scan conducted by the Institute for Safety, Compensation and Recovery Research 2018 (ISCRR) noted manufacturer advice that HoverMatts, when used for patient transfers and patient repositioning, was likely to eliminate injuries related to these tasks, and had the added advantage of reducing patient skin integrity issues during the moving process.

HSR’s if you are uncertain.

This is because the technology used in HoverMatts reduces the friction associated with most transfers, which means little forceful exertion is needed to move the patient. So, you would have to ask why would you limit their use to particular patients? Obviously, these devices come at a cost so this is the likely reason, however, Workplace Health and Safety legislation in Queensland requires your employer, who is referred to as a ‘Person conducting a business or undertaking’ (PCBU), to consider a number of other factors before deciding not to obtain a sufficient number of HoverMatts simply because of their price. The next question members should ask is “Do we have a Health and Safety Representative (HSR)?” This is because an HSR can advocate on your behalf to

contact the QNMU to find out more about HoverMatts have now been around for some time, so we suggest you consider your own workplace and decide whether this technology would be useful given our experience that many work areas rely on old technology such as pat slides.

REFLECTIVE QUESTIONS 1. How can using a HoverMatt be beneficial to patient skin integrity management? 2. Do you believe advocacy for the use of air assisted transfer devices in workplaces is consistent with nursing and midwifery standards and if so why? 3. Standard for practice 3.1 states a registered nurse “considers and responds in a timely manner to the health and wellbeing of self and others in relation to the capability for practice.” How would HoverMatt use assist in maintaining a nurse’s capability to practice? Don’t forget to make note of your reflections for your record of CPD at www.qnmu.org.au/CPD

Bibliography Workplace Health and Safety Qld Office of industrial Relations (2017) Musculoskeletal Disorder (MSD) action plan 2016-22 www. worksafe.qld.gov.au/__data/assets/ pdf_file/0015/141342/5638musculoskeletal-disorder-actionplan-2016-17.pdf McMillan ,J. Moo, A. Newnam, S and de Silva, A. (2018) Improvements in patient handling for worker and patient safety, Current and emerging approaches for worker and patient safety interventions. The Institute of Safety, Compensation and Recovery Research (ISCRR). www.iscrr.com.au/__data/assets/pdf_ file/0004/1321771/Environmental-Scan_ Improvements-in-patient-handling-forworker-and-patient-safety.pdf

CALENDAR

March QNMU education 20 March, Sunshine Coast QH Rostering – Equity & work life balance 21 March, Sunshine Coast Someone should do something about that! 20-21 March, Rockhampton Professional Culpability – Where do I stand? 22 March, Rockhampton Kickstart Education - Assertiveness Skills ($100) 22 March, Brisbane QNMU Branch Development 1 27-28 March, Brisbane QNMU Branch Development 2 29 March, Brisbane www.qnmu.org.au/education

QNMU Meeting of Delegates 19 March - Toowoomba 20 March - Bundaberg 21 March - Maryborough 25 March - Rockhampton 26 March - Mackay www.qnmu.org.au/mod

42nd Australian Association of Stomal Therapy Nurses Conference Power of connections – coming together 17-19 March 2019, Sydney www.stomaltherapyconference.com/

ANMF Working Hours, Shifts & Fatigue Conference 22 March 2019, Melbourne www.anmfvic.asn.au/events-andconferences/2019/03/22/copy-ofworking-hours-shift-and-fatigueconference

15th National Rural Health Conference 24-27 March 2019, Hobart www.ruralhealth.org.au/15nrhc/

Australian Healthcare Week 27-28 March 2019, Sydney www.austhealthweek.com.au

April QNMU education Kickstart Education – Work Matters – How to play to your strengths & manage your weaknesses ($100) 2 April, Brisbane Someone should do something about that! 23-24 April, Brisbane Workplace Representatives 1 30 April – 2 May, Brisbane www.qnmu.org.au/education

Making An Impact Conference Linking People, Purpose and Processes in Healthcare 3-4 April 2019, Melbourne https://makinganimpact conference2019.eventbrite.com.au

Australian Primary Health Care Nurses Association National Conference Building on the Best 4-6 April 2019, Adelaide www.apna.asn.au/conference

Art & Science of Relaxation 9 April 2019, Sydney www.artandscienceofrelaxation. com/art-and-science-of-relaxationseminars/

Art & Science of Relaxation 11 April 2019, Coffs Harbour www.artandscienceofrelaxation. com/art-and-science-of-relaxationseminars/

International Society of Nephrology’s Biennial World Congress of Nephrology 12-15 April 2019, Melbourne www.isnwcn2019.org/

Art & Science of Relaxation 30 April 2019, Geelong www.artandscienceofrelaxation. com/art-and-science-of-relaxationseminars/

May Art & Science of Relaxation 1 May 2019, Melbourne www.artandscienceofrelaxation. com/art-and-science-of-relaxationseminars/

Health and Environmental Sustainability Conference 2 May 2019, Melbourne www.anmfvic.asn.au/events-andconferences/2019/05/02/2019anmf-health-and-environmentalsustainability-conference

QNMU education Handling grievances in the workplace 8 May, Townsville No excuse for abuse! 9 May, Townsville Ethical decision making 10 May, Townsville Knowing your entitlements & understanding the Award! 15-16 May, Brisbane Kickstart Education - Think on your feet ($495) 22-23 May, Brisbane Creating a safe workplace (WH&S) 23 May, Bundaberg Being protected at work 24 May, Bundaberg Kickstart Education - Conflict management skills ($100) 29 May, Brisbane QH Rostering – Equity & work life balance 29 May, Mackay Being protected at work 30 May, Mackay www.qnmu.org.au/education 12 May 2019 www.mothersdayclassic.com.au

Leading the way: Nursing and midwifery quality, research and education 2-3 May 2019, Newcastle www.nursingmidwiferyconference. com.au/

International Nurses Day

Nurses and Midwives Wellness Conference

22 May 2019, Canberra www.artandscienceofrelaxation. com/art-and-science-of-relaxationseminars/

7th BioCeuticals Research Symposium 3-5 May 2019, Sydney www.bioceuticals.com.au/education/ event/7th-BioCeuticals-ResearchSymposium

Mind Heart Connect | Creating Resilient Lives 3-5 May, 2019, Gold Coast http://www.mindheartconnect.com/ hp2019/

Nurses: A voice to lead - Health for all 12 May 2019 www.icn.ch/what-we-do/campaigns/ international-nurses-day

Council of International Neonatal Nurses Conference Enriched family - enhanced care 5-8 May 2019, Auckland, New Zealand www.coinn2019.com/

Labour Day march 6 May 2019 Keep an eye out for more information soon

Lowitja Institute Indigenous Health & Wellbeing Conference 17-20 June 2019, Darwin www.nirakn.edu.au/event/2019lowitja-institute-internationalindigenous-health-and-wellbeingconference/

Cancer Nurses Society 22nd Annual Congress The complexity of cancer care: what will the future of cancer nursing look like? 20-22 June 2019, Melbourne www.cnsacongress.com.au/

International Council of Nurses (ICN) Congress Beyond Healthcare to Health 27 June - 1 July 2019, Singapore www.icn.ch/events/icn-congress2019-singapore

July QNMU Annual Conference 17-19 July 2019, Brisbane

Art & Science of Relaxation

Undergraduate Student Nurse/ Midwife Student Study Day 24-25 May 2019, Melbourne www.anmfvic.asn.au/eventsand-conferences/2019/05/24/ undergraduate-student-nurse-andmidwife-study-day-2019

National Reconciliation Week 27 May - 3 June 2019 www.reconciliation.org.au/nationalreconciliation-week/

#NextCare Health Conference 30-31 May 2019, Brisbane www.nextcarehealthconference.com.au

International Day of the Midwife Strengthening midwifery globally 5 May 2019 www.internationalmidwives.org/ icm-events/idm-international-dayof-the-midwife.html

A new era for global dermatology 10-15 June 2019, Milan, Italy www.wcd2019milan.org/

Mother's Day Classic fun run

4th Australian Nursing and Midwifery Conference

3 May 2019, Melbourne www.anmfvic.asn.au/events-andconferences/2019/05/03/2019nmhp-anmf-nurses-and-midwiveswellness-conference

24th World Congress of Dermatology

June QNMU education 4-5 June, Brisbane Workplace Representatives 2 6 June, Brisbane Professional Culpability – Where do I stand? 12 June, Brisbane QH – How to make the BPF work for nurses & midwives 12 June, Brisbane Creating a safe workplace (WH&S) 13 June, Brisbane Handling grievances in the workplace 13 June, Brisbane QH Rostering – Equity & work life balance 17-21 June, Brisbane Health & Safety Representatives training for nurses & midwives 25 June, Brisbane QH – BPF for NUMs & MUMs 26 June, Brisbane Being protected at work 27 June, Brisbane QH Consultative Committees – How to make them work 27-28 June, Gold Coast Someone should do something about that! www.qnmu.org.au/education

September QNMU Meeting of Delegates 3 September – Brisbane 5 September – Gold Coast 10 September – Sunshine Coast 11 September – Townsville 12 September - Cairns 17 September – Toowoomba 24 September – Rockhampton 25 September – Mackay 30 September - Bundaberg www.qnmu.org.au/mod

International Council of Nurses (ICN) 21st International Conference on Nursing 25-26 September 2019 London United Kingdom www.icn.ch/

October QNMU Meeting of Delegates 1 October - Hervey Bay www.qnmu.org.au/mod

November 19th International Prader-Willi Syndrome Organisation (IPWSO) Conference 13-17 November 2019, Havana, Cuba www.ipwso.org/conferences

If you would like to see your conference or event on this page, let us know by emailing the details to inscope@qnmu.org.au

Nurses and midwives are #proudtobeunion! Nurses and midwives showed the nation we were proud to be union on the first ever National T-Shirt Day on 2 February.

in view

Thanks to everyone who took part by donning their fave union shirt.

in view Welcome to our new grads A big welcome to all new nursing and midwifery graduates. We loved meeting everyone at orientation and grad days across Queensland â&#x20AC;&#x201D; welcome to the nursing workforce! Townsville

Townsville

Redcliffe

CQHHS Clinical

Rockhampton

Blast from the past Nursing uniforms sure have evolved over the years! We loved the nostalgia of looking back on some of the uniforms of days gone past, sent in by our wonderful members.

in view

Joanne Armstrong (1991-1993)

Margaret Taylor (now Kearnan), front row far right, at the Roma Hospital 1961 nurses graduation.

Lisa Nicol at her graduation

Angela Fischer (2008)

BOOK PRIZE WINN ER

CQHHS Pathway to Excellence Program Launch Nurses and midwives at Rockhampton Hospital took part in CQHHSâ&#x20AC;&#x2122; Pathway to Excellence Program Launch on 1 February at the Rockhampton Business Unit. The program aims to recognise health care organisations that demonstrate a commitment to establishing a healthy work environment and workplace for staff.

incoming On the use of hidden cameras in aged care CH Hidden cameras are not the answer. Well trained and enough staff with enough time for all care is the answer. There is never enough of anything sadly but staff are doing their very best and I have experienced great staff going out of their way to make sure residents are happy and safe. Thank you to all the wonderful staff working in aged care.

ONTH COMMENT OF THE M

Like · Reply

Hidden Hidden Hidd en cameras are not the answer. an Well trained and enough staff with enough time for all care is the answer. There is never enough of anything sadly but staff are doing their very best and I have experienced great staff going out of their way to make sure residents are happy and safe. Thank you to all the wonderful staff working in aged care. NE

On an aged care staff being told by a manager to “suck it up, sweetheart” ARW I bet they tell the residents to suck it up as well. Not good enough. People in aged care pay a lot to be there and deserve 100% better care. Like · Reply

TS I’m hoping things will change but I’m not sure anything will come of the Royal Commission. Businesses just don’t care. Like · Reply

DT That is shocking but so true. It is happening in a lot of aged care homes, it’s just that people don’t put it out there. A little bit of compassion goes a long way. Like · Reply

JM Another management comment to staﬀ who say we need more staﬀ is “if you don’t like it, there’s the door”! Absolutely disgusting - zero care factor, as their hands are tied. Like · Reply

On under-resourcing in midwifery services HA The midwives are ready and willing. Funding is what is needed to pay for the positions. Like · Reply

WM The whole system of postnatal care is broken – but who is listening – certainly not our politicians and that’s who have the money. Like · Reply

NB Because it’s a business. [The] poor midwives I see don’t eat [or] drink all day… they don’t get toilet breaks either. Seven mums equals 14 patients, but until hospitals count babies as patients lives are at risk. Like · Reply

SM I’m an AIN who supports cameras. If I’m ever accused of something I’ll have evidence to back me up. If you have nothing to hide you have nothing to worry about. Like · Reply

LMR You can’t invade residents’ privacy like that. Those with cognitive impairment are incapable of giving consent. Staﬀ have rights too. This problem DOES NOT exist where there are 1) adequate numbers of registered staﬀ and 2) there is a regulator with teeth that does regular, impromptu inspections and 3) unions have rights of entry to workplaces to inspect work practices. Facilities have to be held accountable for their treatment of our most vulnerable citizens. Like · Reply

CY Get cameras. Who cares if people know they are there. That’s a positive deterrent. A picture tells the story and can’t warp the truth. 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 What do you think makes the relationship between a midwife and the woman so unique and special?

Theresa Rudd

Sharney Grant

Janene Rattray

Student midwife (Caboolture)

RM/RN (Redcliffe)

Midwife educator (Caboolture)

We’re there at a time when someone is really vulnerable and it’s a relationship that can make or break the woman becoming a mother, and the partnership becoming a family. It’s got long lasting and wide-reaching implications.

WIN

The relationship between midwife and woman is emotional, supportive, and on a deep level. The midwife becomes special to the woman even in her future as she will always be part of her childbearing experience.

Being with a woman during childbirth is a really intimate experience. It’s such a special time in her life and it’s something she and her family will always remember, so making that experience the best it can be is super important.

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Email full-size pics and image details to inscope@qnmu.org.au for our 'in view' pages for your chance to win

Union Training Program FEBRUARY – JUNE 2019 Wed 20 – Thurs 21 Wed 27 – Thurs 28

MARCH

MAY

JUNE

Fri 29

Someone should do something about that!

QNMU Branch Development 1

QNMU Branch Development 2

ROCKHAMPTON

BRISBANE

Wed 8

Thurs 9

Fri 10

Thurs 23

Handling grievances in the workplace

No excuse for abuse!

Ethical decision making

Creating a safe workplace (WH&S)

TOWNSVILLE

BUNDABERG

Fri 24

Wed 29

Being protected at work

QH Rostering – Equity & work life balance

Being protected at work

BUNDABERG

MACKAY

Tues 4 – Wed 5

Wed 12

Mon 17 – Fri 21

Tues 25

Workplace Representatives 2

Creating a safe workplace (WH&S)

Health & Safety Representatives training for nurses & midwives

QH – BPF for NUMs & MUMs

BRISBANE

Wed 26

Thurs 27

Thurs 27 – Fri 28

Being protected at work

QH Consultative Committees – How to make them work

Someone should do something about that!

BRISBANE

GOLD COAST

22 March

2 April

22 – 23 May

29 May

Assertiveness Skills

Work Matters - How to play to your strengths & manage your weaknesses

Think on your feet

Conflict management skills

BRISBANE

Thurs 30

KICKSTART EDUCATION Kickstart Education are heavily subsidised courses for QNMU members run by external educators.

Courses are extremely popular and book out quickly. Avoid being disappointed. Get your enrolment in early. For all training courses available or to enrol visit www.qnmu.org.au/education or phone 3840 1431

Product ratings are only one factor to be considered when making a decision. See hesta.com.au/ratings for more information. Issued by H.E.ST. Australia Ltd ABN 66 006 818 695 AFSL235249, the Trustee of Health Employees Superannuation Trust Australia (HESTA) ABN 64 971 749 321. This information is of a general nature. It does not take into account your objectives, financial situation or specific needs so you should look at your own financial position and requirements before making a decision. You may wish to consult an adviser when doing this. Before making a decision about HESTA products you should read the relevant product disclosure statement (call 1800 813 327 or visit hesta.com.au/pds for a copy), and consider any relevant risks (hesta.com.au/understandingrisk).

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QNMU IS MAKING A DIFFERENCE MEMBER BENEFITS INCLUDE: Top shelf professional indemnity insurance coverage – AHPRA compliant and no excess fees

Access to a team of professional, industrial and legal experts for all work-related matters

Hotline support whenever you need assistance

Extensive training program with courses across Qld

Free access to our CPD Portal, your one stop online shop for all your CPD needs – all content is free, including access to the ANMF’s clinical CPE site

Member-only publications including our quarterly professional magazine, InScope, delivered to your door or inbox

AND MUCH MORE...

IN 2017/18, THE QNMU: Assisted 27,000 members through our Member Connect call centre

Provided expert representation for 3100 members

Recovered $2.24 million for members

Assisted 158 members with WorkCover claims

Provided legal representation for a further 239 members including representation for coronial investigations and coronial inquests

Provided legal representation for 285 members responding to OHO or AHPRA notifications or investigations

As a nurse or midwife, you get best bang for your buck with the QNMU. No other organisation offers the same benefits or value for money.

(07) 3840 1444 or 1800 177 273 (toll free for outside Brisbane)