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VOL. 33 | NO. 1 | FEBRUARY 2014

NURSE POWE R E

THE QUEENSLAND NURSE

F I W R D E I M OW WE’VE GOT P YOUR BACK


2014

SCHOLARSHIPS AND BOOK BURSARIES QNU members have an opportunity to win one of a great range of financial support packages thanks to the 2014 scholarships and book bursaries. There will be one round of scholarships in 2014. Applications for all scholarships must be received by Monday 19 May 2014. Each scholarship may be awarded in full to one recipient, or in part to multiple recipients. All QNU members are welcome to apply— this includes international students and nurses and midwives on working visas.

SCHOLARSHIPS AVAILABLE QNU Registered Nurse/Midwife Scholarship (total value of $3000) QNU Enrolled Nurse Scholarship (total value of $3000) QNU Assistant in Nursing Scholarship (total value of $3000) Applicants must be financial members of the QNU for the 12 months preceding the application, and currently registered or employed in Queensland. Aboriginal and/or Torres Strait Islander Nurse/Midwife Scholarship (total value of $3000) Applicants must be currently working in or studying nursing or midwifery and be a financial member of the QNU. Pat Nicholls Scholarship (total value of $500) Applicants must be QNU members for the 12 months preceding the application, and working to advance diabetes education and promotion. Bauer-Wiles Book Bursary (total value of $300) Available only to Registered Nurses/Midwives who have been financial members of the QNU for the 12 months preceding the application. University and TAFE Student Book Bursaries (Eight at $500 each) Applicants must be university or TAFE students who are QNU members and must provide proof of enrolment. QNU Annual Conference Observers Five scholarships are available to pre-enrolment/pre-registration students in nursing and midwifery to attend the QNU Annual Conference (16-18 July 2014) as observers. These scholarships cover travel and accommodation where necessary, conference registration and the conference dinner.

APPLICATION FORMS Go to www.qnu.org.au/scholarships to download application forms. You can also obtain application forms by contacting QNU Connect on 07 3099 3210 or toll free on 1800 177 273.

APPLICATIONS CLOSE MONDAY 19 MAY 2014


10 The official journal of the Queensland Nurses’ Union 106 Victoria Street, West End Q 4101 (GPO Box 1289, Brisbane Q 4001) T 07 3840 1444 1800 177 273 (toll free) F 07 3844 9387 E qnu@qnu.org.au W www.qnu.org.au ISSN 0815-936X ABN No. 84 382 908 052

VOL. 33 | NO. 1 | FEBRUARY 2014

NURSE POWE R

Editor Beth Mohle, Secretary, QNU Production QNU Communications team Published by the Queensland Nurses’ Union of Employees Printed by Fergies Print and Mail REGIONAL OFFICES Toowoomba 66 West St, Toowoomba Q 4350 (PO Box 3598, Village Fair, Toowoomba Q 4350) T 07 4659 7200 F 07 4639 5052 E qnutwmba@qnu.org.au

E F I W ER D I M OW P

Bundaberg 44 Maryborough St, Bundaberg Q 4670 (PO Box 2949, Bundaberg Q 4670) T 07 4199 6101 F 07 4151 6066 E qnubberg@qnu.org.au Rockhampton Suite 1, Trade Union Centre 110 Campbell Street, Rockhampton Q 4700 (PO Box 49, Rockhampton Q 4700) T 07 4922 5390 F 07 4922 3406 E qnurocky@qnu.org.au Townsville 1 Oxford Street, Hyde Park Q 4812 (PO Box 3389, Hermit Park Q 4812) T 07 4772 5411 F 07 4721 1820 E qnutsvle@qnu.org.au

FEATURE We’ve got your back

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Cairns Suite 2, 320 Sheridan St, North Cairns Q 4870 (PO Box 846N, North Cairns Q 4870) T 07 4031 4466 F 07 4051 6222 E qnucairns@qnu.org.au DISCLAIMER Statements expressed in articles in The Queensland Nurse are those of the contributor and do not necessarily reflect the policy of the Queensland Nurses’ 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 QNU’s ethical standards, such acceptance does not imply endorsement.

PRIVACY STATEMENT The QNU collects personal information from members in order to perform our role of representing their industrial and professional interests. We place great emphasis on maintaining and enhancing the privacy and security of your personal information. Personal information is protected under law and can only be released to someone else where the law requires or where you give permission. If you have concerns about your personal information please contact your nearest QNU office. If you are still not satisfied that your privacy is being maintained you can contact the Privacy Commissioner whose 1800 number is in the phone book.

www.qnu.org.au

12 2 3 4 5 6 14 15 16

Your union Editorial Your say Tea room

31 18 22 24 25

Local news National news International news Campaign news

Feature Professional Midwifery Nursing and midwifery research

26

Continuing professional development

29

Health reform and governance

30 32 33 34 35 36

Industrial Health and safety Social Calendar Your super Advertising

FEBRUARY 2014 | TQN | 1


YOUR UNION

The power and passion of collective action SALLY-ANNE JONES, QNU PRESIDENT

I started my professional career as an Assistant in Nursing in a residential aged care facility more than 20 years ago.

YOUR COUNCIL

Just a year or two out of high school, with little life experience, the world of politics and nursing as a profession did not seem relevant to my day-to-day work. Yet looking back, it was then that the foundations of my activism were built. I can recall discussion and debate in the tearoom as staff worked alongside QNU representatives to negotiate for improved staff numbers, skill mix and conditions. I began to realise we had an opportunity to shape our workplace for the safety of those we care for and to protect our jobs and conditions. I joined the QNU during my Orientation Week for my first job as a Registered Nurse. I started work as an RN at the time when my organisation was undergoing “corporate recovery”—nursing staff were being cut back and beds were closing. And then came the Nurses and Midwives (Queensland Health) Certified Agreement (EB5). I was very focused on my career at the time, and my young family. I supported my colleagues who amassed in front of the hospital to rally for pay, conditions and patient safety. I was inspired by their actions, their passion for what nurses and midwives deserved for delivering 24/7 care, and also their vision for new roles in nursing and midwifery for administrators, educators and researchers. I wanted to become more involved—so I nominated to join QNU Council, and was elected.

COLLECTIVE ACTION HAS A TIPPING POINT. ONCE IT REACHES A CERTAIN CRITICAL MASS, IT IS UNSTOPPABLE.

I learned so much in those first two years. Council had a wide range of representatives from all nursing levels, different locations and diverse experiences who shared their stories. Over passionate debates we agreed upon the vision and direction of the QNU for the future. After my first two years on Council, I chose not to re-nominate for family reasons—but I became more active in my hospital QNU Branch. The Branch meetings were usually small but occasionally we had cause to call upon all the members to rally together. The power and passion of the greater group was so effective and I learned the power of collective action. Collective action has a tipping point. Once it reaches a certain critical mass, it is unstoppable. As I became more experienced and wanted to be more involved, I renominated for Council and was elected Vice-President.

We worked long and hard and secured expanded roles for nurses and midwives, an acknowledged role in the planning and delivery of health services, and opportunity for further growth. EB6 delivered great professional recognition in the form of remuneration and conditions for public sector nurses and midwives, it also set the standards for the private and aged care sectors. I was then fortunate to participate firsthand in EB8 negotiations, using interestbased bargaining to find common ground and build a new, improved enterprise agreement. But times change, and now we find ourselves under attack and having to fight just to hold onto what we have worked so hard to achieve. The power of our collective has never been more important. I am honoured and humbled that now, as the QNU President and Australian Nursing and Midwifery Federation (ANMF) Vice President, I have the opportunity to participate in helping guide our collective action. I hope you will help me build our critical mass, and join me in the power and passion of collective action.

Sally-Anne

Secretary Beth Mohle ■ Assistant Secretary Des Elder ■ President Sally-Anne Jones ■ Vice President Stephen Bone Councillors Grant Burton ■ Christine Cocks ■ Barbara Jean Cook ■ Karen Cooke ■ Dianne Corbett ■ Jean Crabb ■ Sandra Eales Julie Gard ■ Phillip Jackson ■ Damien Lawson ■ David Lewis ■ Lucynda Maskell ■ Simon Mitchell ■ Fiona C.A. Monk Sue Pitman ■ Karen Shepherd ■ Katy Taggart ■ Kym Volp ■ Deborah Watt ■ Di Webb ■ Charmaine Wicking

2 | TQN | FEBRUARY 2014

www.qnu.org.au


EDITORIAL

We need to understand our power—and use it appropriately BETH MOHLE, QNU SECRETARY

It’s official—our union is now the largest in Queensland. This was confirmed late last year with the release of union and employer association membership statistics contained in the 2012-13 Annual Report of the President of the Industrial Court of Queensland. Achieving this milestone didn’t happen overnight—it is a result of decades of hard work and focus, especially by our local workplace branches and activists who are the lifeblood of our union. Our activists are caring, determined and united, in there for the long haul and for reasons other than “what’s in it for me”. Nurses and midwives remain firmly focused on our professional standards and the quality of care we provide to those in need. This is the output of our labour. For this reason, it is impossible for the QNU to separate the industrial from the professional. The duality of our focus as a “craft union” is one of the reasons for our success. Our growth is never taken for granted. We will continue to be responsive to members’ needs and aspirations, as well as to societal changes and technological advances. In joining the QNU you have recognised we are stronger when we band together to achieve our shared objectives. The face of Australian unionism is changing—it now looks more like you. Most growing or large unions are more likely to be female-dominated service industries like health and education. www.qnu.org.au

As the union for nurses and midwives we work hard to advance both the professional and industrial interests and values of members. In the current hostile industrial environment, it is essential we focus on all available avenues to keep our professions strong, and remain nimble and creative. Our professional power and our critical role as advocates for high quality health care are therefore now in sharp relief. The third QNU Professional Practice and Ethics Conference will be held in Brisbane on Friday 7 March at the Royal International Convention Centre, RNA Showgrounds. This year’s conference will focus on how nursing and midwifery leadership is the essential ingredient for quality patient care. Full details can be found on page 23. I hope to see you there. This conference is one of the many ways in which our union assists in your continuing professional development (CPD). We have a strong CPD focus that we continue to build on—our range of communications (including this journal), our activist training program, our library service, or our online learning initiative via our federal body, the Australian Nursing and Midwifery Federation. Growing members’ professional and industrial knowledge and confidence is central to growing our power and effectiveness as a union. Part of this is understanding the source of the power we hold and how to use it appropriately. Our power lies not only in our clinical expertise but also our moral and ethical standing. For evidence of this, look no further than the results of the Roy Morgan annual survey on the image of professions in Australia.

THE FACE OF AUSTRALIAN UNIONISM IS CHANGING— IT NOW LOOKS MORE LIKE YOU. For the 19th straight year (and every year since being included in the survey), nurses topped the poll, with 90% of those surveyed rating nurses as having ‘very high or high’ ethics and honesty. It is important that we reflect upon and truly appreciate why this is so. We also need to be comfortable holding this power. We are focusing particularly on the issue of power this year. At the 2013 QNU Annual Conference delegates endorsed the establishment of the QNU Nurse Power Fund from 1 July 2014. This fund will enable us to better tell the nursing and midwifery story and communicate our worth and contribution. It will take the form of a weekly payment additional to your normal membership fees (which will be subject to the usual CPI increase), and will be a maximum of $1 per week, depending on your weekly earnings and working hours. More information can be found on page 20. Nurses and midwives are worth this additional investment. In the coming months you will hear more about the establishment of this important fund, a key plank in your Council’s long term plan to grow nursing and midwifery power and influence.

Beth

FEBRUARY 2014 | TQN | 3


YOUR SAY

HAVE YOUR SAY tqn welcomes letters for publication. Letters should be no more than 200 words. Anonymous letters will not be published (we will consider withholding names, but do not accept unsigned letters). Photos may be colour or black and white. All material will go to the Editorial Committee. Send all material in the first instance to: The Editor, The Queensland Nurse, GPO Box 1289, Brisbane 4001 or by email to dsmith@qnu.org.au or by sms to 0481 381 837 The views contained in the ‘Your Say’ page do not necessarily reflect the views of the QNU. For more information and guidance on writing and submitting a letter for inclusion in the ‘Your Say’ section refer to the QNU’s Letter to the Editor policy at www.qnu.org.au/letters-policy

Find us on social media:

/qldnursesunion

Palliative care nurses: a light during the dark days I would like to highlight to your readership how extremely fortunate we, as Queenslanders, are to have access to the services of our palliative care nurses throughout the State. My father, the late Desmond Smith, was diagnosed with a quite aggressive form of bowel cancer in late 2012. It was his choice not to access any form of medical intervention to treat his illness and therefore, “to let nature take its course”. His demise was rapid and severe, and proved to be an extremely challenging time for both himself, family and friends. Our family had the privilege to be assigned to palliative care nurses Wendy Wright and Lesley Whyte, who work through Gladstone District Base Hospital. Wendy and Lesley’s support and skill enabled us to maintain our, “hands on the rudder” in terms of his care and wellbeing in what seemed to be very dark days. In the case of Wendy and Lesley, this support did not stop at 5pm. They were there for us 24/7. This is extraordinary for a team of only two nurses, who are often highly in-demand.

Knowing that we could call on their expertise after hours, gave us the confidence required to care for Des at home right up to the end of his life, a wish he had indicated soon after his prognosis was discussed. Des felt that the palliative nursing he received during those final weeks was highly targeted to both his physical and emotional health needs. It is Wendy’s and Lesley’s breadth of experience and personal commitment to this area of medicine that gave Des the level of care that could not be matched in other specialities of medicine. Despite maintaining heavy work schedules, time always seemed to be available to discuss and plan for changes in Des’ condition and the associated effect it would have on us as a family. It was one of Des’ final wishes that the work of Wendy and Lesley be publicly acknowledged as a token of his gratitude. We felt truly blessed to have had such highly competent, yet sensitive and compassionate professionals backing us up at this very difficult time. Desley Lobley on behalf of the Smith family.

Join us on Facebook The QNU is finally on Facebook! Yes, you now have another great way to keep up to date with your union, while at the same time chat with fellow members in the online world. At the time of going to print, our page has about 500 followers, and so far we’ve used it to promote our campaigns, share our media releases and coverage, and share likeminded posts. “It’s important to find new ways to engage with members,” QNU Secretary Beth Mohle said. “However, it is important for members to remember Facebook is a public forum, that what they write can be seen by anyone—including their employers.” The QNU 2011 Communications Survey showed only a little over half of our members (55%) had a Facebook account and just 4.5% had Twitter. But in the past two years our members have become increasingly tech-savvy. For example the number of members with a valid email address has increased from 48% in February 2010 to more than 80% in September 2013. With such an increase, it seemed logical to expand our social media portfolio.

www.facebook.com/qldnursesunion 4 | TQN | FEBRUARY 2014

www.qnu.org.au


TEA ROOM

tea r

m

WITH DES ELDER, QNU ASSISTANT SECRETARY

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 covering 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 QNU Connect information service.

I intend to travel around Australia this year on a working holiday. Will I still be covered by the QNU if I am working in other states? The Australian Nursing and Midwifery Federation (ANMF) is the peak body for the state branches of the ANMF including the QNU. The ANMF has in place an agreement with all state branches, except the Western Australia Branch, that provides coverage for members who are working in other states. If you are travelling from state to state on short term contracts (less than 12 weeks), you don’t have to resign from the QNU to be eligible for assistance. If you require assistance with a workplace or employment matter while travelling you should contact the QNU. We will liaise with the relevant state ANMF branch to arrange the appropriate assistance. If your contract is 12 weeks or more you should join the ANMF Branch in the state in which you will be working. Remember, Western Australia is the exception. You will need to join the WA Branch of the ANMF to be covered for www.qnu.org.au

any nursing work performed in that state—regardless of the duration of your employment. The QNU’s Professional Indemnity Insurance (PII) policy will cover nurses and midwives* whose primary state is Queensland for work performed anywhere in Australia providing you are a financial member of the QNU. *This excludes nurses and midwives in private (independent) practice.

I work in a private hospital and have been on maternity leave. I plan to return soon on three days per week (I was previously full-time). I have advised my employer of my intention but have been advised they require me to return on my full-time hours. Am I able to insist on only three days per week? You should check your enterprise agreement which should outline the requirements for returning to work after maternity leave. The minimum requirement is set out in the National Employment Standard (NES) of the Fair Work Act 2009 (FWA) at section 65. The FWA allows you to make a formal request in writing for flexible working hours provided you have worked for the employer for at least 12 months before making the request. Your request should set out the details of the change sought and the reasons for the change. Your employer must provide you with a written response within 21 days advising you whether your request is agreed or refused. If the employer refuses your request to go to three days the response must include the reasons for the refusal and the refusal can only be “on reasonable business grounds”. The QNU may be able to represent you in the Fair Work Commission if your

employer continues to refuse your request depending on the specific circumstances of your case. Requesting flexible working arrangements is your right—your employer may be liable to be prosecuted if it tries to disadvantage you in your employment in any way because you have exercised this right. If there are grounds to claim that the refusal of your request constitutes discrimination on the basis of your parental status or family responsibilities, the QNU may also be able to represent you in the Anti-Discrimination Commission of Queensland.

If you have questions for our tea room column email qnu@qnu.org.au

ROVDPOOFDU QI 41::4321

FEBRUARY 2014 | TQN | 5


NEWS

Common sense prevails: changes to General Protections dismissal applications

It’s official—we’re the biggest The QNU is now officially the biggest union in Queensland. The Industrial Court of Queensland recognised the membership figures in its 2012-2013 Annual Report, noting the QNU as having 51,255 members as at 30 June 2013, some 5000 members ahead of the next largest union, the Australian Workers’ Union (AWU). For many years the AWU had been listed as the largest union, however some recent analysis of financial members saw the AWU officially lose some 16,000 members from its books. The Queensland Teachers Union (QTU) is the third largest union, with just over 36,000 at 30 June 2013. The membership figures show unions remain a powerful representative voice for hundreds of thousands of Queensland workers.

6 | TQN | FEBRUARY 2014

In fact, the total union membership figures for Queensland stands at an astonishing 375,656. While this was down on the previous year’s total, much of the net loss can be accounted for by the revised figure of the AWU’s membership. Across the board, many unions increased their membership or held steady. The nature of how we work, our expectations of wages and conditions, and how we communicate about workplace issues is changing. We as employees are changing. Unions must also change. It is a big challenge, but ultimately the union movement will prevail. That’s the advantage of organisations based on democratic principles—whether change happens today or tomorrow, democratic organisations inevitably reflect their membership.

From 1 January 2014, nurses and midwives involved in General Protections dismissal applications in the Fair Work Commission can ask the commission to arbitrate. This means such applications should be resolved much quicker and at reduced cost. A “General Protections” dismissal occurs where a worker has been terminated for particular reasons, such as:  making a complaint or enquiry about one’s employment  becoming a member of a union  taking part in protected industrial action. Previously, these applications could only be heard by the Federal Circuit Court. Applications dealt with by this court are generally not finalised for a very lengthy period of time, and involve highly legalistic processes, meaning lawyers often need to become involved. The need to involve legal representation in these types of applications can be very costly to all parties. This change should therefore benefit workers and their unions as well as employers by avoiding the need to go to court and engage in expensive and lengthy litigation. For more information on what types of circumstances are covered by the General Protections provisions of the Fair Work Act 2009, please visit www.fwc.gov.au/index. cfm?pagename=disputegeneral If you think you have been dismissed in circumstances covered by the General Protections, contact QNU Connect on 3099 3210 or 1800 177 273 (if calling from outside of Brisbane) to obtain initial advice. Please note these provisions do not apply to employees of Local Government entities or Queensland Health. www.qnu.org.au


NEWS

QNU Secretary Beth Mohle joins QSuper board

Former QNU Secretary Gay Hawksworth— retiring QNU representative on the QSuper board.

QNU Secretary Beth Mohle was recently appointed a Trustee Director on the board of the QSuper superannuation fund. Nurses and midwives are one of the largest member groups in QSuper. Beth replaces former QNU Secretary Gay Hawksworth, who had been on the QSuper board since December 2007. The QSuper Board and nomination process was different from previous years due to legislative changes made by the Newman LNP government late last year. This meant significant changes to board composition were made in a very short timeframe. Beth was previously on the board of the HESTA superannuation fund for more than 11 years, at times holding the positions of Chair and Deputy Chair. QNU representation on boards like QSuper provides another avenue for us to advance the interests of members in work and retirement. After the family home, the super accounts of members are usually their largest financial asset, so it is particularly important to act and advocate to protect and grow members’ super account balances. It is widely expected the federal Coalition government will change the representative trustee system aimed at decreasing union and employer organisation representation on super boards.

Be sweet to babies A Canadian paediatric health and research centre has discovered the secret to managing a baby’s pain during flu vaccinations. Researchers at CHEO have discovered that babies and infants who ingest sucrose at the time of getting their vaccination barely feel the sting of the needle. The research project, called Be Sweet to Babies, was designed to help parents find ways to reduce infant pain and stress when it comes to immunisations. Lead Researcher Dr Denise Harrison, said breastfeeding babies or giving them sugar water (also known as sucrose) can help, as can holding them upright in a secure front-to-front position. www.qnu.org.au

Dr Harrison said the sucrose increases endorphins. While breast feeding and sugar water work best for babies up to one year of age, upright front-to-front holding and distraction work for young children. “It’s mind-blowing how these simple distractions can help them,” Dr Harrison said. “It really does give them comfort.” To show the effectiveness of the sucrose hit, the Be Sweet to Babies team put together a YouTube video to help share the information with parents. It is available at http://bit.ly/IraCn0 “Some nurses and doctors don’t know about this, which is why we are trying to show the video to as many people as possible,” Dr Harrison said. FEBRUARY 2014 | TQN | 7


NEWS

ON YOUR SIDE There are no grey areas, no ifs or buts – the QNU’s professional indemnity insurance serves you and you alone. The beginning of a new year is a great opportunity to remind members of one of the key benefits of QNU membership—access to our comprehensive PI insurance.

As you probably know, nurses and midwives are required by national law to have appropriate PI insurance arrangements that cover their full scope of practice. That means a PI scheme that complies with the registration standard issued by the National and Midwifery Board of Australia. Without it you are in breach of the law and your registration to practise is at risk. Every nurse and midwife needs PI insurance. But, let’s get this straight: not all professional indemnity insurance schemes are created equal.

Not meeting the standards In order to be registered with the NMBA, nurses and midwives must be part of a PI insurance scheme that complies with the NMBA’s registration standard. Nurses and midwives are often told by their employer they don’t need the QNU’s PI insurance because the employer has its own PI insurance scheme staff can access. That might sound plausible in theory, but in practice, employers’ schemes usually have limitations –which means you could be left facing disciplinary action or deregistration without anyone in your corner to back you up. The QNU’s PI insurance, on the other hand, is comprehensive, well tested, and unconditional. What’s more, it is just the start of the support network we can offer you as a member if you find yourself in hot water in the course of your work. This support includes officials on hand to offer advice and direction, expert legal advice and representation and the backing of an entire professional body dedicated to protecting your interests—not your employer’s.

QH cannot guarantee coverage It is important to note Queensland Health does not have an insurance policy that meets the NMBA standards. All QH has is Human Resource Policy I3 which leaves it up to a QH “decision-maker” to determine whether or not you are covered by QH’s insurance. The insurance arrangements for Queensland Health—and indeed, many private sector employers—often have caveats in the fine print which give the employer the flexibility to refuse nurses and midwives indemnity. 8 | TQN | FEBRUARY 2014

www.qnu.org.au


NEWS

QH’s policy for example states nurses must have acted “diligently and conscientiously” even to be eligible for cover. Given that almost all cases of negligence and quite a few accidents occur when someone has not acted “diligently or conscientiously”, it’s clear to see how easy it might be for an employer to refuse to cover a nurse or midwife who has been accused of being at fault. This not the case with QNU’s PI cover.

Who is looking after your interests? It’s a matter of common sense—any insurance scheme offered by an employer, whether Queensland Health or a private operator, will always be compromised the organisation’s need to prioritise its reputation over one nurse or midwife. Quite simply they will look after their own interests, not yours. Do you trust your employer to back you if excessive workloads contributed to a death or injury? Do you think they will admit their budget cuts or corner cutting on staff levels are to blame? Do you trust your employer to back you if your word conflicts with a doctor’s?

So what do I get for my QNU cover? Your QNU PI insurance cover gives you liability cover of $10 million for every claim and $70 million over the course of your working life. This covers your legal costs, the plaintiff ’s legal costs, any compensation that may need to be paid, and any other expenses you might incur. You also receive:

Unlimited retroactive cover and run-off cover Retroactive cover is for claims made against you for health care you provided before the insurance cover was in place. Run-off cover essentially protects you from claims that might be made against you after you have left your current employment.

Cover for “Good Samaritan acts” This covers you for nursing or life-saving care you provide during a medical emergency (including ones which occur when you are off duty) or voluntary community service. You are also covered defamation claims made against you in connection with your work. Most private insurance schemes offer limited insurance only. The QNU’s insurance is comprehensive, and gives you access to professional officers, industrial officers, lawyers, and health and safety experts to assist you. Only the QNU can provide you with professional representation in proceedings before AHPRA, the Health Quality and Complaints Commission, the Coroner, or your employer. When you weigh it all up, if you really want to be covered, you can’t go past the PI insurance that comes with your QNU membership. www.qnu.org.au

The case of Margaret Winters The death of Margaret Winters shows just why having comprehensive professional indemnity insurance is so important. In 2008 the Northern Territory Coroner handed down findings on the death of Margaret Winters, a patient who died on 16 December 2006 in the Intensive Care Unit at the Royal Darwin Hospital from an acute subdural bleed which she sustained after she fell. The professional judgment and integrity of the nursing staff on shift that day was called into question. The NT Department of Health, (the nurses’ employer) provided two reports which placed great emphasis on “a lack of prioritisation of patient care” as well as “clinical handover and communication”. Fortunately for the nurses in question, the Coroner accepted the evidence provided by an independent staffing expert, who found the number of nurses on shift was significantly lower than recommended by two different staffing methodologies. The Coroner also found departmental barriers had undermined the professional integrity and judgment of the nursing staff, and criticised the evidence given by the Health Department head as “inaccurate” and “cavalier”. This Coronial Inquest was a long and deeply stressful experience for everyone, including the nursing staff. Having independent, comprehensive professional indemnity insurance is the only way to ensure that in the worst case scenario, you don’t rely on your employer to back you up. FEBRUARY 2014 | TQN | 9


NEWS

Queensland Auditor-General slams outsourced contracts Numbers for outsourcing public services just don’t add up Queensland’s highest independent auditor, the Auditor-General, has released a report slamming the idea that outsourcing and contestability delivers better value for money than publiclyowned services. Queensland Auditor-General Andrew Greaves found that of 62 contracts which had undergone the contestability process, an overwhelming number failed to achieve value for money. According to the report, 41 of the 62 contracts “did not show evidence that supplier performance was monitored against objective and measurable criteria to ensure transparency for supplier performance assessments”. Contestability has been much vaunted by the Newman Government as a means of securing the best solution for the best price. The QNU has long-held “contestability” is a weasel-word for privatisation by stealth. The Sunshine Coast University Hospital (SCUH) was subject to the government’s contestability process. Yet despite intense spin-doctoring on the benefits of privatisation, as well as preventing the public from reading KPMG evaluation documents, the Newman Government still could not make the economic case to justify outsourcing clinical services at the hospital. The Auditor-General’s report notes outsourced government contracts require much greater administrative preparation and management, including development of contract management capability frameworks, risk/value matrices, and improved processes for contract review and renewal. All this additional work will come at cost to the taxpayer, and the government has not explained how it plans to provide or pay for the additional resources needed to implement these recommendations. With $10.9 billion currently spent on outsourced contracts, it is clear a reappraisal of the government’s approach to service delivery is needed. 10 | TQN | FEBRUARY 2014

Changes to Fair Work Act and modern awards The new year brings many changes, including some important changes to the Fair Work Act 2009 and the Nurses Award 2010.

Right of entry—access to lunch or tea room The changes now provide that where a union official exercising a right of entry under the Act and an employer do not agree on where the official should go to speak to members during their workplace visit, the official may go to the lunch/tea room. The changes also place new obligations on employers to facilitate access to travel and accommodation to remote locations not otherwise reasonably accessible. Federal Employment Minister Eric Abetz has already committed to scrapping these workplace rights later this year.

Bullying Under the new changes, a worker who is bullied can get an order from the Fair Work Commission to stop the bullying. A worker is considered “bullied at work” if an individual or group of workers “repeatedly behaves unreasonably” toward them and the conduct creates a health and safety risk.

This can include victimisation, humiliation, intimidation, and threats. Importantly, “reasonable management action carried out in a reasonable manner” is not considered bullying in the workplace. The FWA must commence dealing with an application alleging bullying within 14 days, and penalties can be sought for failure to comply with an order by the FWA.

Consultation about changes in regular rosters or working hours The Nurses Award 2010 has been varied to include a clause requiring consultation about changes to regular rosters or ordinary hours of work. This is in addition to the current requirement for an employer to consult with employees when introducing major changes that is likely to have significant effects on those employees. In addition, all new agreements made after 1 January 2014 must now include a consultation term relating to the introduction of major workplace change (this was an existing requirement) and a change to an employee’s regular roster or ordinary hours of work (this is a new requirement). www.qnu.org.au


NEWS

Fears nurse traineeship may cut aged care wages The QNU fears proposals for a new nurse traineeship could undermine efforts to improve aged care wages. Queensland’s Health Workforce Council (HWC) is considering a proposal for a new Diploma of Nursing. The QNU believes this proposal could allow aged care facilities to employ student Enrolled Nurses at a lower salary than AINs. As a member of the HWC reference group, the QNU has raised concerns about how trainees might be used and abused by employers. “In other jurisdictions trainees are viewed by employers as cheap, dispensable labour,” QNU Assistant Secretary Des Elder said. “So what guarantee do student nurses have that employers won’t just take their cheaper labour, then cast them aside once they become registered in favour of another low-cost trainee?” Under the Nurses Award 2010, a student Enrolled Nurse earns just $16.55-$17.41 an hour while a first year AIN (however titled) earns $17.87 per hour and up to $19.07 if they have the relevant Certificate III qualification. An entry level AIN at Blue Care earns $21.97 an hour. The QNU has also raised concerns relating to shifts and rostering, and the

increased workload for RNs undertaking preceptorships. The QNU submission states that any trainee program should ensure an RN mentor is on shift for each trainee at all times and that there be no more than one trainee per shift. Our submission also included suggestions that trainees must not displace existing workers or their hours, nor should they be rostered on night duty until 75% of their training is complete—and only then in a temporary capacity. We will continue to monitor the debate over trainees and keep our members apprised of the plan’s progress.

ROVMFHBM Plus

experience on your side wills and estate matters family law criminal law property law immigration law personal injury law

Phone

3099 3210 or 1800 177 273 (toll free for outside of Brisbane)

www.qnu.org.au/legalplus www.qnu.org.au

union training program COURSE FEBRUARY

Date

Location

Knowing your entitlements and understanding the award

19-20 Feb

Brisbane

Being a QNU contact in the workplace

26 Feb

Brisbane

Creating a safe workplace (WH&S)

27 Feb

Brisbane

QH - Scope, practice and workloads

11 Mar

Brisbane

Handling grievances in the workplace

12 Mar

Brisbane

Private Sector Nurses – Scope, practice and workloads

13 Mar

Brisbane

Someone should do something about that!

11-12 Mar

Townsville

Nurses and Midwives unite!

13 Mar

Townsville

Private Sector Nurses -Knowing your entitlements

27 Mar

Brisbane

Professional Advocacy – We’re in charge

1 Apr

Brisbane

Your career starts now!

2 Apr

Brisbane

Private Sector Nurses – How to successfully bargain

3 Apr

Brisbane

Being a QNU Contact in the workplace

1 Apr

Rockhampton

QH- Scope, practice and workloads

3 Apr

Mackay

Being a QNU Contact in the workplace

22 Apr

Brisbane

Student Survival Toolkit

23 Apr

Brisbane

Creating a safe workplace (WH&S)

29 Apr

Toowoomba

Professional Advocacy – We’re in charge

30 Apr

Toowoomba

Nurses and Midwives unite!

30 Apr

Brisbane

MARCH

APRIL

TO ENROL IN THESE COURSES—  visit the QNU website at www.qnu.org.au/qnu-training OR

 ring the training unit in Brisbane on 3840 1431 or toll free 1800 177 273 FEBRUARY 2014 | TQN | 11


NEWS

Congratulations Joan St Clair OAM! During this year’s Australia Day citations, midwife and QNU member Joan St Clair was honoured with an Order of Australia (OAM) for service to nursing and midwifery and the community of Goondiwindi. Joan has been a member of the QNU since 1970, and retired from midwifery last year. She says the award came out of the blue. “I only found out when I received a letter a few weeks ago,” she says. “I thought ‘who the heck’s done this?’—I won’t repeat what I actually said out loud.” An active member of her local community, Joan is a founding member of the Blue Nursing Service which provides nursing care in the home (now run by Blue Care), as well as being an energetic volunteer in the Goondiwindi Rotary Club and her local Anglican church. “I’m starting to get an idea of who dobbed me in,” says Joan. “Being a small community, everyone knows everything, so I’ll get to the bottom of it.” Joan denies she has done anything exceptional to deserve the award, saying she just did her job and volunteered her time like everyone else. “You just do your work, you don’t want or expect attention for it—all the emergency services are like that, aren’t they? “It’s the gratitude of the people you care for and the respect of your colleagues that counts.” Joan finished up at the Goondiwindi midwifery group practice last year, and was full of praise for the model.

12 | TQN | FEBRUARY 2014

“It is extremely important the women get allocated a midwife who looks after them most of the time,” she says. “About 6-7 years ago, we never had enough midwifery staff. We needed to do something. “At first there was a lot of groundwork by just a few people—like the new DON— but more and more came on board. “The key is teamwork and communication. The doctors and midwives work extremely well together here. Everyone respects everyone else, it’s a great culture. “The nurses in the wards and the general staff have all backed us too—the cleaners, the cooks, the whole lot. It’s thanks to them it is all working so smoothly. “It’s a great program, excellent for women and excellent for midwives. The only downside is you have to carry a phone. But that’s life—it could be worse!” Joan laughed when asked if she went to Canberra to meet Tony Abbott on Australia Day. “I went to the breakfast put on by the Rotary in the park,” she says. “We have our own Australia Day nominations around town—young citizen of the year, sporting citizen of the year, that sort of thing.” “I don’t want publicity, I’m not that way inclined, it’s better to help the young ones and be patient with them. “We were all young at one stage and you never know everything.”

From our reading of the honours list, it appears Joan was the only nurse/midwife in Australia to be recognised for her work and dedication. Overall, the number of women recognised continued to be down on previous years. So much of our work goes unrecognised, but so many nurses and midwives deserve national acclaim for the great work they do every day—even if they don’t want it! If you know a colleague who might be worthy of commendation next year, visit www.itsanhonour.gov.au

Amanda Davies honoured on Australia Day QNU member and Queensland nurse Amanda Davies was honoured with the Achievement Award by the Queensland Health Director General on Australia Day. Amanda said it was a privilege to be recognised for nursing leadership in Queensland. “It is an exciting time to be in health and my current role as Assistant Director Nursing – Advanced Practice allows me to have a focus at state level and also influence policy direction nationally. Amanda’s work focuses on delivering the Strengthening health services through optimising nursing project. “Being one of the first nurse practitioners to practice in Queensland in 2007, it is fantastic to see so many nurses aspiring to be expert clinicians, with more than 250 nurse practitioners now endorsed in Queensland,” Amanda said. www.qnu.org.au


NEWS

Branch elections wrap up 2014 is off to a solid start for the QNU with the election process for Local Branches now complete. The last of the ballots was held late last year and the full list of results is available online. Under our streamlined elections process introduced in 2012, elections are now only held for delegates and alternate delegates. The Branches then form a Steering Committee from within the elected members. At the committee’s first meeting, they appoint a Chairperson. “We welcome both our new and returning delegates and alternate delegates, and I’d like to acknowledge and thank them all for putting their hands up to defend their members’ rights and help build a stronger union ,” QNU Secretary Beth Mohle said. The QNU’s Local Branches are the heart of our union, the ‘building blocks’ of our democratic structure. They are essentially a group of members who come together to further the interests of nurses and midwives in a workplace or geographic area, or where they have a special interest. Local Branches promote membership participation and two-way communication. The Steering Committee is made up of members who are delegated to attend QNU Annual Conference on behalf of the Local Branch, as well as any QNU Council members who belong to the Branch. “Our delegates and alternate delegates are the crucial link between our members on the ground and the union leadership,” Beth Mohle said. “Our members are our eyes and ears, they are the ones who are in the best position to keep us informed about what’s going on in their workplaces, to recognise service deficiencies, any erosion of conditions and professional concerns—and of course they can feed all this information back to us through their branches.” For a current list of the QNU’s Local Branches and their Steering Committees visit www.qnu. org.au/steering-committees This list includes all Local Branches and the names of members who filled the Steering Committee positions following elections during late 2013. This list also includes branches which have vacancies, including some which still have all positions vacant. www.qnu.org.au

The results of the November/December ballots were: Gold Coast Community Health Nurses Branch

Christine Green and Roseanne Stower

Biggenden Branch

Linda Fuller and Natasha Eggleston

Bundaberg Mater Branch

Elaine Jensen and Barbara Kruger

Charleville District Branch

Anne Horrocks and Robert Scheerer

Currumbin Clinic Branch

Janette Dickinson and Colleen O’Brien

Cairns Hospital Branch

Margaret Gryg, Joanne Taylor, Deborah Mackenzie, Naomi Currie, Madeline Heathfield, Hilary Pearce, Yvonne Hennebery

Townsville Integrated Mental Health Branch

Evan Player and Bruce Fooks

Townsville Community Care/ABI Branch

Mary Laird, Michael Lock, Petronella Cooper and Robyn Taylor

Torres Strait and Northern Peninsula Branch

Michelle Warren and Vickie Tamwoy

Sarina Hospital and Primary Health Care Branch

Catherine Baillie and Tammi O’Shea

Ingham Branch

Silvia Brown and Jillian Cain

Bundaberg Aged Care Branch

Debra Findlay and Melanie Price

Good Shepherd Nursing Home Branch

Patricia Tait and Debra Ramsbotham

Mareeba District Hospital Branch

Pauline Larkin and Ann-Marie Cooper

Ipswich Hospital

Steven Shute, Lee-Anne Moore, Judith Litfin, Dawn Ginnivan, Debra Cannon and Susan Steele

RANIP nurses and midwives can now cash out their airfare entitlements From December 2013, nurses and midwives working in designated remote areas who decide travel in conjunction with recreation leave by means other than commercial flights can apply for a cash equivalent payment. The cash equivalent will be payable only if the employee travels to/from the nearest east coast provincial city in conjunction with the employee’s recreation leave, or to other areas if

previously approved by the Health Service Chief Executive (or delegate). The cash out entitlement is extended to spouses and dependent children. The amount of the cash equivalent payment will be no less than the average cost of return flights from the RANIP (Remote Area Nursing Incentive Package) site to the nearest east coast provincial city in the preceding financial year and is to be paid for each eligible person travelling. FEBRUARY 2014 | TQN | 13


NEWS

$6 - No small price to pay for GP visits

Nurses and midwives join protests against Medicare co-payment New South Wales nurses and midwives were among the hundreds of Australians who protested against proposed changes to Medicare in Sydney in January. About 500 people responded to a last minute social media call-out which marked the first in a series of protests across the country. The Sydney rally on 4 January was followed by similar protests at Perth and Melbourne, and another rally will be held in Adelaide on 25 February. New South Wales Nurses’ and Midwives’ Association Acting General Secretary Judith Kiejda said Australians were entitled to feel cheated by the Abbott government’s plans to charge a $6 fee for all GP visits.

“For decades now Medicare has been sacrosanct—above politics. The idea that all Australians can see a doctor to get medical attention whenever they need to is cherished by almost all of us,” Ms Kiejda said. “Money should never be a barrier to medical care in Australia.” She warned the last time a Coalition government pulled such a stunt following a bumper win at the polls they lost the next election. “That was called Workchoices… and we want to make it clear… that an attack on Medicare, forcing pensioners and everyone else to pay to see a doctor when they have already paid a levy for years, will have exactly the same result,” she said.

The QNU has condemned the federal government’s support for a new $6 fee for GP consultations. In December a National Commission of Audit received a proposal from Tony Abbott’s former health advisor to introduce the co-payment scheme for GP consultations. Under the proposal, patients will be forced to pay $6 to visit their GP for each of the first 12 visits a year. QNU Assistant Secretary Des Elder, said some of the country’s most vulnerable people—the poor and the sick—would be disadvantaged by the change if introduced. “What are the costs to our health system when Australians fail to visit a GP and instead get sicker and sicker?,” he said. “And what are the costs to our health system when Australians unnecessarily end up in our already congested emergency departments?” Nurses and midwives have already experienced first hand the increase in potentially preventable hospitalisations in regional areas where doctors do not bulk bill. The Australian Institute of Health and Welfare estimates in 2010–11 there were more than two million GP-type presentations in emergency departments, which accounted for an estimated 39 per cent of recorded emergency department presentations. “The solution isn’t to further increase the demand on our emergency departments by limiting access to bulk billing GPs,” said Des. “The solution to the burgeoning costs of health and aged care in this country is not to casually erode Medicare and our universal health insurance system by charging for access to health services—QNU members will not stand for this,” he said. “The solution lies in primary health care, and health promotion and prevention, to ensure the burden of chronic illness and ageing is better managed within the community and less dependent on acute care.”

Photo: Peter Boyle, Green Left Weekly

14 | TQN | FEBRUARY 2014

www.qnu.org.au


NEWS

Obamacare finds it tough to overcome private health care provision On 1 January this year, the most significant changes to the US health care system since 1965 came into effect. Popularly known as ‘Obamacare’, the Patient Protection and Affordable Care Act is intended to decrease the rapidly rising pressure on hospital emergency departments by increasing the quality and affordability of health insurance. There are numerous provisions in the legislation, but some of the most important include:  Insurers are prohibited from denying coverage to individuals with preexisting conditions.  All individuals must have an approved insurance policy or face financial penalties (individuals under financial hardship or in recognised religious groups are exempt).  Every state must offer an online insurance exchange where individuals and businesses can compare policies and prices.  Low-income families and individuals will receive a federal subsidy to help pay for insurance.  Businesses which employ 50 or more people must offer health insurance to full-time employees by 2015 or face financial penalties. Despite the dire need for an improved health care system, the legislation was hotly contested by certain political groups. Although a market-based approach to health care reform had originally been championed by Republicans and other conservatives, the Obamacare legislation was fiercely opposed by many supporters of the Republican Party, particularly those from the Tea Party movement. www.qnu.org.au

Many critics claimed the legislation was unconstitutional and an attack on freedom—however the United States Supreme Court upheld the constitutionality of the act.

Expansion of Medicaid Medicaid is the government health insurance program for US families and individuals on low income. The new legislation significantly expands the eligibility for Medicaid, to 133% of the poverty line. That means individuals who earn the poverty line amount per year (US$11,490 or about AUD $13,000) may earn an additional 33% (up to a total of US$15,282 / AUD $17,340) per year and still be eligible for Medicaid. The amount an individual may earn increases depending on the household size. For example, a wage earner living with three dependents may earn up to US$31,322 (AUD $35,544). This is a vanishingly small amount, and it is difficult to conceive how a wage earner with a partner and two children might earn just $31,500 (AUD $35,740) per year and not be eligible for government assistance for health care.

A step in the right direction? While the Obamacare legislation was written with good intentions, the fact is the long-standing aversion to public health care in the US has created a monster. In trying to increase accessibility while permitting private insurance companies to continue their dominance of health care provision, the US government has passed legislation which pleases nobody. The debate over how to manage health care has descended from concern for health and well-being into bitter and acrimonious arguing. Unfortunately, the overly-simplistic yet pervasive rhetoric of ‘freedom’ prevents the US government from establishing a public health care system like those in the UK and Canada and here in Australia. It is clear from the most accessible and affordable healthcare models across the globe that government involvement is critical. The question is how carefully our governments manage these increasingly complex and crucial public services—not whether they manage them at all.

FEBRUARY 2014 | TQN | 15


NEWS

Hospital executives mislead health minister over Logan community midwifery services Metro South Hospital and Health Service executives were recently caught out providing incomplete and inaccurate information to Health Minister Lawrence Springborg about cuts to Logan’s community midwifery services. In a Briefing Note inadvertently sent to Logan midwives, Executive Director of Logan Bayside Health Network Brett Bricknell said the closure of the services are “minor service changes necessary to achieve required reform measures at Logan Hospital”. Acting QNU Secretary Des Elder said Mr Bricknell’s comments could not be further from the truth. “There is nothing minor about abolishing an entire community midwifery service and the impact this has on mothers and their babies,” said Des. “A large proportion of the users of midwifery services in the Logan area are disadvantaged women from culturally and linguistically diverse backgrounds. “A best practice approach would be to increase community midwifery led models—not to abolish them,” he said. Logan health network executives were deceiving the Minister by omission, Des said. “The truth is that community clinics have been abolished and there is now no antenatal care for women who cannot access services in the hospital based model. “There is a very real potential that many Logan women will disengage from antenatal care due to restricted access of services, the increased cost of travel to Logan Hospital or limitations in accessing public transport, as well as the costs of GP visits and private practice midwives,” he said. “There is clearly only one way to get to the bottom of this sorry mess—the Minister must meet with midwives to hear the other side of the story.” 16 | TQN | FEBRUARY 2014

Des said nearly 70 Logan midwives signed a letter to the health minister seeking an urgent meeting to discuss the matter, but at time of going to print he had not responded. “Nurses and midwives are calling on Minister Springborg to listen to them, not just to selective information from within his department,” said Des. Mr Springborg subsequently stated on ABC radio that midwifery services were being consolidated into Logan Hospital. “There certainly has been a change in where the services have been delivered from,” Mr Springborg admitted. Mr Springborg sought to deflect criticism by commenting on the recent hospital access granted to privately practising midwives, negotiated with the QNU. “We provided access to those midwives to a hospital which they’ve never had before,” he said. But Des said the issue of granting hospital access to privately practising midwives had nothing to do with community midwifery services.

“Mr Springborg can’t seriously claim community midwifery services don’t matter because he’s permitted privately practising midwives into the hospital,” said Des. “The fact is not all expectant mothers can make it to Logan Hospital without great cost to their wellbeing, their time, and their wallets. “These are pregnant women, many with health complications, who should be in easy consultation with qualified health professionals, not set up to run an obstacle course before they can get access to the care they need.” As a result of pressure from local midwives and negative media coverage, local management scheduled two staff forums to discuss Logan’s abolished community midwifery services. Local QNU member midwives have been extremely active in holding management to account and will continue their campaign until the community midwifery services are reinstate. www.qnu.org.au


NEWS

QNU’s campaign for a safe blood supply goes public The QNU has gone public with our campaign to educate the community about the critical role nursing plays in maintaining a safe blood supply. In late December, we launched a giant mobile billboard as part our campaign to tell the Australian Red Cross Blood Service (ARCBS) that nursing work must be valued in centres and mobile donor units across the state. The ARCBS recently reported an operating surplus of $12.5 million for the 2012/2013 financial year. Of this surplus, $3.6 million was reportedly reinvested into the business to increase capability, the quality of the service and also operations that reduce risk. Unfortunately it seems the ARCBS is more focused on cost cutting than addressing the risk of nurse staffing shortages or unsafe skill mix. Our campaign is aimed at ensuring ARCBS nurses are operating within the appropriate scope of practice and are supported by the right skill mix and numbers of nurses working in all Donor Mobile Units and donor centres. Meanwhile, nursing staff have suspended undertaking some protected industrial action to demonstrate to the ARCBS their

commitment to achieving an enterprise agreement with the assistance of Fair Work Commission, the independent umpire. The ARCBS are now re-considering their position on items to be included in the agreement. Further conciliation is planned in the Commission.

www.facebook.com/ qldnursesunion

QNU Assistant secretary Des Elder and organiser Kate Snowball with the mobile billboard.

Some cuts don’t heal Do you have a story about the real impact of the LNP government’s cuts to public health services and jobs? It’s been more than 12 months since the LNP state government started sacking nurses and midwives and closing or selling off public health services across the state. We know that after deep cuts like this there will inevitably be consequences—for nurses and midwives and the work you do; for your patients, clients and residents; and within our communities.

We need to communicate the real impact of these cuts on Queenslanders Have you or someone you know been affected by the cuts to public health services and jobs? If you have experienced or heard of increased costs or delays to health care and treatment, unsafe workloads, or a reduction of services, then we want to hear from you.

If we don’t have the evidence to publicly raise our concerns, then what hope do we have of reversing bad decisions? If the community isn’t aware of the real, human impact of these bad decisions then what reason do they have to be concerned? www.qnu.org.au

Like our Facebook page Make sure you visit and like our Facebook page, which contains information about our ARCBS campaign to educate the community.

Do you have a story? We have launched a special page on our website where QNU members, as well as the community, can share their stories with us. Your story could be as simple as a sentence or two describing a particular service or job cut, or your own experience. You can choose to share your story anonymously—your information still provides us with a lead to pursue. The online form takes only a couple of minutes to complete but could make a real difference in our fight to restore and maintain public sector services and jobs. Thank you in advance for sharing your story! www.qnu.org.au/yourstory

FEBRUARY 2014 | TQN | 17


FEATURE

NURSE POWE R

E F I W R D E I M OW WE’VE GOT P

YOUR BACK

18 | TQN | FEBRUARY 2014

www.qnu.org.au


FEATURE

It’s good to know that when the chips are down, somebody’s got your back. For QNU members, that somebody is your union. The QNU was set up by members, for members. Every day, the QNU is active in workplaces and industrial commissions, helping nurses and midwives to work better, smarter, and safer, and with appropriate reward. The QNU can do this because Queensland nurses and midwives understand the value of collective strength.

www.qnu.org.au

The Queensland Nurses’ Union is in your corner

Training and professional development

It’s the core business of the Queensland Nurses’ Union to help members. Whether it’s negotiating better wages and conditions, giving advice and representation to individual members with complex workplace issues, or help is you are injured at work, the QNU is here for you. Last year, the QNU negotiated dozens of enterprise agreements—including the first agreement for nurses working in general practices. And when employers made negotiations difficult—as they sometimes did—the QNU stepped in to help members with workplace campaigns for a fair deal. Just ask nurses and midwives at the Mater Hospital, the Australian Red Cross Blood Service, Embracia Aged Care, and Blue Care. The QNU also helped members with hundreds of individual workplace issues and workers’ compensation claims. In fact, in the financial year 2012-13, the QNU recovered $1.35 million in wage claims or underpaid wages for members.

The QNU recognises that developing and maintaining skills is critical to best practice nursing and midwifery. Our survey results show a strong desire among QNU members to be informed and confident, so the QNU has accordingly invested in our capacity to provide up-to-date industrial and skills-based training, free for members. Last year, the QNU conducted 54 training courses for Queensland nurses and midwives in 10 different locations. This year, we’re offering even more. Be sure to check them out and see how the QNU can help you become better informed and more confident in your decision-making. The QNU also conducts a professional conference on the most current professional, legal, and ethical issues in nursing and midwifery today. The conference is a great place to learn to what is happening at the cutting edge of nursing and midwifery, while contributing to your CPD requirement and building better professional networks.

FEBRUARY 2014 | TQN | 19


FEATURE

This year’s conference is at the RNA showgrounds in March—more details are available on page 23 of this edition.

Nurse and midwife power At the 2013 Annual Conference, QNU delegates passed a unanimous motion to set up a ‘power fund’ specifically dedicated to defending and advancing the interests of nurses and midwives as a profession. The fund is designed to capitalise on the power we as nurses and midwives share when we act as a collective. As health care professionals, we have important stories to tell and solutions to offer. The savage cuts to public health services and nursing and midwifery positions have made crystal clear the fundamental values which guide us in all sectors— values of safety and well-being, of fairness and justice—are under attack.

Safe patients, safe nurses and midwives, better health outcomes, a free, universal, high quality public health care system, supported by prosperous private hospitals, comprehensive primary health care and well-managed aged care services—that’s what the nurse and midwife power fund is devoted to. Governments come and go. The QNU is here to stay.

The government hasn’t got your back We’ve all had good managers and bad managers, just like we’ve had good state governments and bad state governments. It’s part of life—but at the moment, we have a state government sacking nurses and midwives while closing down public services and stripping away workers’ rights. We all remember Premier Campbell Newman’s infamous pre-election promises that ‘no frontline positions will be lost’ and that his government would provide ‘more nurses, not more red tape’. Since coming to power, the Newman LNP government has abolished the positions of over 1100 nurses and midwives. Thousands more positions in health and other industries have been cut. Public services have been closed across the state. Nurses and midwives in all sectors must resist these developments. With the QNU, nurses and midwives in all sectors are standing up for fair wages and conditions, better professional development and consultation, more accountability and transparency, and improved health care standards. Whether you work in the public sector, the private sector, or aged care, your union has your back.

Your employer hasn’t got your back The QNU works at the pointy end of workplace problems. It’s our job to learn about individual and collective cases, and help get them resolved. Time and again, we see nurses and midwives who trusted their employer to look out for them, to discover when push came to shove their employer cared only about themselves. But too often employees leave themselves in a vulnerable position by placing too much faith in their employer. 20 | TQN | FEBRUARY 2014

Look at it this way: if a disagreement develops between you and your employer about whether your workload was a contributing factor to an adverse health event, do you really think your employer will back you? Or another example: the QNU has recently had to issue advice to members about their rights around payment over public holidays—because so many employers were refusing to pay their employees properly. Some employers look for any attempt to cut corners with their employees. Others are simply ignorant of industrial law and their workplace obligations. Many want to do the right thing by their employees, but don’t have the procedures to carry it off. The QNU is constantly reminding— and challenging—employers over their obligations to their employees.

Is the tide already turning? Members are already working together and achieving results in support of public health services and universal health care.

Sunshine Coast University Hospital The local voice could hardly have been more effective on the Sunshine Coast, with local activists securing the future of the Sunshine Coast University Hospital (SCUH) as a free, universal public health service. SCUH had been promised as a longawaited public hospital which would also deliver tertiary education to health practitioner students including nurses and midwives. However, shortly after coming to office the Newman LNP government announced that expressions of interest would be sought from the private sector to deliver this highly complex teaching facility. The community was outraged. Led by QNU members, angry locals held rallies and lobbied MPs to support their constituents. While independent MP Peter Wellington was a staunch supporter of keeping SCUH as a public hospital, the LNP MPs remained silent. The QNU conducted a state-wide campaign against the privatisation of clinical services. www.qnu.org.au


FEATURE

In December, the Newman LNP government finally relented to public pressure and common sense, and backflipped on the sale of the SCUH clinical services. This was a major victory for the people of Queensland and also the state’s nurses, midwives and other health professionals.

to form one large alliance to stand up for healthy, happy communities. Unions, churches, community and ethnic groups, and other representative groups have formed the Queensland Community Alliance to ensure local concerns have a local voice.

A mini-assembly was held at the end of last year, and the QNU hosted a two-day training program for alliance members on the fundamentals of community organising. You can keep up to date with Queensland Community Alliance on Facebook.

Legal challenges to bad legislation Queensland unions, including the QNU, are challenging the Newman LNP government’s anti-union laws in the High Court of Australia. These laws are unfair and unjust, and include requirements such as a ballot of the entire membership for any political campaign item of expenditure over $10,000. This requirement is designed to make it much harder for unions to put the collective views of members in newspapers, on television, and on the radio. In this way, the government tries to silence valid criticism, while preventing the hundreds of thousands of union members across Queensland from collectively participating in the political life of the state. A recent challenge by NSW unions against the O’Farrell Liberal government’s laws on potential expenditure was successful. The High Court declared the NSW government’s anti-union laws to be ‘invalid because they impermissibly burden the implied freedom of communication on governmental and political matters, contrary to the Commonwealth Constitution’. This gives great hope the High Court will find similarly in Queensland, and repeal the Newman LNP government’s antiunion laws. The next mention before the High Court for the Queensland case is expected mid February. These efforts are about defending the fundamental democratic rights of individuals—including the right to organise collectively. Important issues like these cost time and money, and this is precisely the kind of issue the new “power fund” is designed to support.

The Queensland Community Alliance Now, different groups of people from all around Queensland are coming together www.qnu.org.au

2014 will be bigger than ever—for all of us Over the past year, the QNU was proud to participate with thousands of members in countless rallies and protests at health facilities all around the state in defence of nursing and midwifery jobs and the public health care system. At the same time, QNU officials were delivering support and assistance to hundreds of individual members struggling to deal with sudden changes in their employment status and working life. 2013 was incredibly busy, as nurses and midwives worked hard to cope with

2014 will be bigger than ever—for all of us one attack after another. In 2014, nurses and midwives—and the QNU—will be taking the strongest possible message to this government: Endangering patients, residents, and nurses and midwives is not on. Destroying our public health care system is not on. Attacking workers and their unions is not on. 2014 is a new year—so raise your head, stand up straight, and shoulder to shoulder with your fellow nurses and midwives.

2014 IS OUR YEAR FEBRUARY 2014 | TQN | 21


PROFESSIONAL

LOCKED UP: Is this how we care for our mentally ill? There is an old saying that the true measure of a community is how it treats its most vulnerable.

How then do we judge a government that sees fit to lock up the mentally ill simply because they are deemed ‘inconvenient’? Last year the state government issued a directive that from 15 December all acute adult mental health inpatient units should be locked up. The decision—made without consultation—seems designed to prevent police from being ‘inconvenienced’ by having to respond to incidents involving mentally ill patients in the community, and to reduce the cost of returning patients who are absent without permission. The plan is ill-conceived. Locking people with mental illness up—particularly those on voluntary admission—is contrary to current evidence-based practice. Adverse effects include heightened tension and anxiety, and a sense of imprisonment rather than treatment. The directive appears to be based on a section of the Mental Health Act 2000 which gives the Director of Mental Health Queensland the power to develop policy for the treatment of persons with mental illness who require inpatient care. This may include taking necessary action to prevent the recurrence of a ‘significant’ incident that may risk people’s safety. However, in the absence of a significant risk to either an individual or the public there is no basis for the lockdown order. 22 | TQN | FEBRUARY 2014

Lockdown order not based on evidence Neither the state government nor the health department has provided any evidence that existing practices resulted in serious risk to patients or the public. The move to more restrictive process smacks of fear-mongering by portraying mental health patients as dangerous or criminal. While some acute care units around the state have had a policy of locking units in certain circumstances for many years, this is not the way people with mental illnesses should be treated. The Mental Health Act 2000 does not require patients who are involuntarily examined and treated to be compulsorily restricted or locked in. Mandatory detention should be reserved for people whose risk assessment warrants careful supervision and support, and who meet particular legislative requirements. This includes “special notification forensic patients” charged with serious crimes such as homicide and rape. There are dedicated locked facilities and special accommodation units throughout the state for such purposes. These new directives impact voluntary patients who will presumably need to be checked in and out at the door.

There is real concern this could deter people who need care from seeking treatment. The QNU is very concerned this government directive manages patients in a far more restrictive manner than legislation allows, which is why we are seeking legal advice.

Impact on QNU members Then of course there is the impact on QNU members. There are serious questions over what these directives mean for professional practice standards and safe staffing levels. Who is expected to monitor the door? What is the process for risk assessments before a patient is permitted to leave the unit? What are the legal implications for nurses? The QNU has written to department and government representatives including the Attorney-General and Chief Nursing and Midwifery Officer, Dr Frances Hughes. Dr Hughes has been asked what support will be provided for mental health nurses who have been instructed to restrict or confine mental health consumers. The QNU will explore the professional and legal implications for members and provide further advice. If you work in a mental health unit and want further information please contact your QNU Organiser or QNU Connect on 3099 3210 or 1800 177 273. www.qnu.org.au


PROFESSIONAL

Another year kicks off and again the QNU has a great line-up of training courses on offer for members.

2014 training program kicks off QNU CONFERENCE ENCOURAGES NURSES AND MIDWIVES TO LEAD THE WAY

There are a bumper 18 courses scheduled for the first half of this year— all of them free for QNU members. They include courses on workload management, enterprise bargaining and knowing your entitlements. There are also courses for students and nurses and midwives new to the career, and one designed to give members the confidence and knowledge to stand up for their workplace rights. Courses are scheduled to run in Brisbane, Bundaberg, Cairns, Mackay, Rockhampton, Toowoomba, and Townsville. This year the QNU is proud to announce the new ATOM – Activist Training Online Modules. Through ATOM, members can access web-based union education no matter where they are. The six-part ATOM course is designed for members who want a solid understanding of unions and what they do.

This year’s conference—titled Nursing and Midwifery Leadership: Essential for quality patient care—features five speakers and an expert panel discussion. QNU Secretary Beth Mohle said the conference was an opportunity to hear from some of our professions’ leading thinkers and practitioners. “The presentations are always engaging and thought-provoking, and offer members the rare chance to step back from their busy working days to really think about their role as professionals and leaders in health care,” Beth said. “It can be quite revitalising.”

Great nurses and midwives never stop learning—which is why the QNU is offering members the chance to improve their knowledge and leadership skills through our annual Professional Practice and Ethics Conference. www.qnu.org.au

This year, director of the Centre for Quality and Patient Safety Research, Professor Megan-Jane Johnstone will speak about organisational and leadership ethics including the issues of responsibility, integrity and trust. CEO of the Australian College of Nursing, Adjunct Professor Debra Thoms will focus on the impact nurse and midwife leaders can have on the quality of patient care.

“In this current climate of job and service cuts we need members who know their rights and entitlements, can drive campaigns, and feel empowered to stand up for safe workloads and the rights of their colleagues and patients,” QNU Secretary Beth Mohle said. “Our training program is designed to develop the skills and confidence of members so they can play an active role in creating and maintaining better workplaces and a better community.” The courses are open to all QNU members. It is important to note that due to the state government’s changes to the Queensland Industrial Relations Act 1999, industrial entitlement to paid leave for union training is no longer in effect for public sector members. Public sector members are entitled to arrange time off to attend union training or other activities by way of rostering or alternative leave arrangements. For a full list of the courses on offer and to enrol in the course of your choice visit www.qnu.org.au/qnu-training

Dr Kathleen Fahy, Professor of Midwifery at the Sunshine Coast University will encourage nurses and midwives to lead interdisciplinary care teams. Queensland’s Chief Nursing and Midwifery Officer Dr Frances Hughes will speak on the important role the nursing executive can play in safe patient care while Former Deputy Commissioner to the Bundaberg Hospital Commission of Inquiry Margaret Vider will look at quality patient care in the context of the Bundaberg experience. The conference will be held on Friday 7 March at the Royal International Convention Centre at Brisbane’s RNA Showgrounds. Attendance can be counted towards your CPD hours. To register for the conference visit www.qnu.org.au/professional-seminars, call Jenny on 3840 1430 or email events@qnu.org.au Registrations close 24 February 2014. FEBRUARY 2014 | TQN | 23


MIDWIFERY

QNU contributes to nation-wide review of midwifery education The QNU has emphasised the need to encourage and train midwives in regional, rural, and remote parts of Australia in a major review of national midwifery education standards. The Australian Nursing and Midwifery Accreditation Council (ANMAC) is the accrediting authority for nursing and midwifery education. It is ANMAC’s job to identify and give accreditation to education programs which produce nurses and midwives who can practice, become registered, and care for people in a safe and competent manner. ANMAC is conducting a nation-wide review of accreditation standards for midwives. The QNU, through our federal office the Australian Nursing and Midwifery Federation, has contributed to an extensive submission to this review. The ANMF represents the largest number of registered midwives in the country, with over 19,000 members. This is more than half of all registered midwives in Australia. QNU members requested the QNU contribute to this review so the development of standards for accrediting midwifery programs will be attainable for students in their preparatory content, and produce registered midwives capable of delivering all aspects of maternity care. With over 19,000 registered members across the country, the ANMF had a huge job bringing many different viewpoints into a single, unified submission. It was extremely important that the ANMF submission presented a strong, unified voice—so while the submission may not be in concordance with every individual’s view, it does present a powerful collective position. The following points formed the basis for the ANMF submission:  Safe and competent care for birthing women and their babies in Australia is of paramount importance. 24 | TQN | FEBRUARY 2014

 We maintain our support for continuity

 

of care models for midwifery care. Access to a known midwife ought to be available for all pregnant and birthing women regardless of the presence of clinical risk factors. There is no evidence to indicate graduates of the pre-2010 programs are not safe and competent to practice midwifery, and therefore no evidence to suggest there is a need to increase the length of program and/or the number of births attended. All existing evidence points to safe and competent graduates of midwifery education programs. The birth statistics in Australia indicate slowing birth rates. The implication of this for midwifery education programs is insufficient numbers of births to accommodate the excessive birth requirement in the proposed second consultation paper. Our concern is for our members who are Registered Nurses and wanting to do a postgraduate pre-registration midwifery program, and for those undergraduate students choosing a dual

degree program. The on-going viability of these programs is vital to sustaining a workforce, particularly in remote, rural and regional areas of Australia.  Equity of access issues arise where students of midwifery education programs are advised to either reside close to a maternity facility or have their own means of transport, in order to undertake the excessive midwifery practice requirements for large numbers of continuity of care experiences. The QNU strongly endorses the view that we need to prepare a workforce equipped and willing to work in regional, rural, and remote parts of Australia, to protect the viability of already vulnerable and fast disappearing midwifery services in these areas. ANMAC’s review of the midwifery accreditation standards will be referred to the Nursing and Midwifery Board of Australia and the Council of Australian Governments’ Standing Council on Health for finalisation in 2014. The QNU will keep midwifery members informed on the outcome of ANMAC’s review.

www.qnu.org.au


NURSING AND MIDWIFERY RESEARCH

Preventing wound infections after surgery – are we using evidencebased guidelines?

BY DR FRANCES LIN, NHMRC CENTRE OF RESEARCH EXCELLENCE IN NURSING

Surgical procedures are common in hospitalised patients and can result in surgical wound infections. Complications such as surgical site infections (SSIs) occur in up to 30% of surgeries, and SSIs alone comprise 14% of hospital acquired infections (NICE 2008). SSIs are associated with significant morbidity and over one-third of postoperative deaths have been associated with SSI (Astagneau el al. 2001). Evidence-based wound care focuses on reducing the risk of infections and promoting primary healing. Evidence-based clinical practice guidelines (CPGs), standards and position statements relating to promoting wound healing and preventing wound infections have been published by peak professional bodies (AWMA 2011, EWMA 2006, Mangram et al. 1999, NICE 2008). These standards and guidelines emphasise the incorporation of wound care education and research as part of clinical practice. Current use of evidence-based guidelines appears to be limited. The results of a recent Australian study suggest over 50% of surgical nurses are either unaware of, or did not use evidence-based wound management CPGs (Gillespie et al. 2013).

Observing nurses’ daily wound care practices Dr Frances Lin of the NHMRC Centre for Research Excellence in Nursing is leading a team of nursing researchers and psychologists in a series of funded substudies around the use of evidence-based practice guidelines in the management of surgical wounds. www.qnu.org.au

The purpose of the first study is to describe current surgical wound management practices used by nurses in a large teaching hospital. In Phase 1 of this study, hospital policies on wound care will be compared with published evidence-based recommendations. In Phase 2, surgical nurses’ wound care practices will be observed in two ward settings of an acute care hospital. Phase 1 of this study is about to commence.

Making research evidence easier to access in clinical practice The aim of the second study is to increase the use of evidence-based practices in surgical wound care. In Phase 1, researchers will interview nurses and other health care professionals to explore the perceived barriers and facilitators to using evidence-based CPGs. In Phase 2, the research team will focus on these barriers and facilitators to develop knowledge transfer strategies specifically suited to the hospital context. The final phase of this study will evaluate the effectiveness of introducing strategies designed to increase the accessibility and uptake of evidence-based wound care strategies. Phase 1 is set to commence in early March. Ultimately the introduction of contextspecific strategies may help to increase clinicians’ accessibility to the best available evidence. Over the longer term, this may also help to reduce the incidence of postoperative

wound infections, which means patients will go home with less complications and better outcomes after surgery.

References Astagneau P, Rioux C, Golliot F, Brucker G (2001) “Morbidity and mortality associated with surgical site infections: results from the 19971999 INCISO surveillance”, Journal of Hospital Infection, 48, 267-274. Australian Wound Management Association (2011) Standards for Wound Management. West Leederville WA, Cambridge Publishing. European Wound Management Association (2006) Management of wound infection: An integrated approach to managing wound infection: Position Statement. In A. Melling et al. (Eds), Topical antimicrobials and surgical site infection, London, European Wound Management Association, 14-17. Gillespie BM, Chaboyer W, Allen P, Morely N, Nieuwenhoven P (2013) “Wound care practices: a survey of acute care nurses”, Journal of Clinical Nursing, doi: 10.1111/jocn.12479. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR (1999) “Guideline for prevention surgical site infection, 1999”, Infection Control & Hospital Epidemiology, 20(4), 247-280. National Institute for Health and Clinical Excellence (2008) NICE Clinical Guideline 74: Surgical site infection: prevention and treatment of surgical site infection. In National Collaborating Centre for Women’s and Children’s Health (Ed). London: RCOG Press, 4-28.

For more information on the NHMRC Centre of Research Excellence in Nursing (NCREN) in Queensland visit www.griffith.edu.au/health/centreresearch-excellence-nursing NOTE: The research in last edition’s article on patient anxiety in intensive care is supported by the Intensive Care Foundation and The Australian College of Critical Care Nurses. FEBRUARY 2014 | TQN | 25


CONTINUING PROFESSIONAL DEVELOPMENT

C ASE S TU DY

Boundary violations:

sexual relationships with patients The Code of Professional Conduct for Nurses in Australia at Conduct Statement 8 sets out the obligations for nurses treating patients with whom they are having or have had a sexual relationship. The Code states: 5. Sexual relationships between nurses and persons with whom they have previously entered into a professional relationship are inappropriate in most circumstances. Such relationships automatically raise questions of integrity in relation to nurses exploiting the vulnerability of persons who are, or have been in their care. Consent is not an acceptable defence in the case of sexual or intimate behaviour within such relationships. 6. Nurses should not be required to provide nursing care to persons with whom they have had a pre-existing non professional relationship, reassignment of the persons to other nurses for care should be sought where possible. This and other codes and guidelines developed by the Nursing and Midwifery Board of Australia (the NMBA) are used by Tribunals when determining if a nurse has engaged in unsatisfactory professional conduct or professional misconduct in disciplinary proceedings. As recent disciplinary cases show, boundary violations are extremely serious and can result in the loss of registration, especially where a nurse has had a relationship with a vulnerable patient. 26 | TQN | FEBRUARY 2014

Case study: Nurse A Nurse A a was a Registered Nurse at the Maryborough Correctional Centre between March 2006 and July 2009. In 2008, she developed a relationship with a prisoner whom she had extensively treated. While the relationship was not initially physical, the Tribunal found the relationship was at that point “sexualised” in the sense that words or actions between Nurse A and the prisoner “might reasonably be interpreted as being designed or intended to arouse or gratify sexual desires”. Nurse A removed herself from the patient’s care shortly after the relationship commenced and the relationship continued until December 2010. The NMBA commenced an investigation into Nurse A’s conduct during which Nurse A made a number of false statements and was uncooperative. She subsequently admitted she had engaged in unsatisfactory professional misconduct. The Tribunal was highly critical of the apparent lack of importance Nurse A placed on the ethical standards regarding professional boundaries and her lack of insight into her behaviour. In response to Nurse A’s submissions that there was a distinction to be drawn between the period of time the relationship was physical and when it was not, the Tribunal said, “even when a sexual relationship commences after the therapeutic relationship ends, it is improper if there is any suggestion the practitioner has exploited a dependency created during the professional relationship.” This was particularly applicable to Nurse A because the patient, as a prisoner, had no apparent choice in his health care and was socially and emotionally isolated.

BY JULIANA VIRINE, HALL PAYNE LAWYERS

To determine what period Nurse A should be disqualified from reapplying for registration, the Tribunal compared the seriousness of her actions with similar cases. The NMBA argued three years was an appropriate preclusion period. Nurse A submitted this was excessive and that one year would be sufficient. The Tribunal agreed Nurse A’s conduct was not as serious as other cases involving boundary violations and did not warrant a disqualification period of three years. It ordered the cancellation of Nurse A’s registration and prohibited her from applying for registration for 18 months. It further imposed a series of onerous requirements on Nurse A including completion of tertiary level courses dealing with professional boundary management, undertaking counselling about boundary violations, and prohibitions on the manner in which she could be employed. Nurse A was also ordered to pay the NMBA’s costs of $13,500.

Case study: Nurse B Nurse B was a mental health nurse at a Sydney private hospital. A complaint was brought by the Health Care Complaints Commission of New South Wales against Nurse B alleging she had a sexual relationship with a patient for whom she was the primary care nurse. Nurse B admitted to:  engaging in high volumes of telephone calls with the patient during the time that he was an inpatient at the facility  inviting the patient to social events after his discharge and  purchasing an airline ticket for him to accompany her overseas where she was attending an event related to her university studies in law. www.qnu.org.au


CONTINUING PROFESSIONAL DEVELOPMENT

The other allegations concerned Nurse B having a sexual relationship with the patient while he was an outpatient. Nurse B denied these allegations but it was ultimately determined by the Tribunal there was sufficient evidence to substantiate them. It was then for the Tribunal to determine whether the conduct amounted to unsatisfactory professional conduct alone or the higher standard of professional misconduct. The Tribunal considered matters including that:  there was evidence Nurse B knew she was engaged in inappropriate conduct because she been a member of the Nurses and Midwives Tribunal in 2009 (and ought to be aware of the relevant ethical standards) and that her Nurse Unit Manager had raised boundary issues with her  the termination of the professional therapeutic relationship did not mean the relationship became ethically appropriate  it was not necessary to show any harm resulted from the relationship and  the patient was highly vulnerable given his serious health condition. The Tribunal determined these factors were sufficient to find Nurse B engaged in professional misconduct. In doing so it referred to Pillai v Messiter (No. 2) which held professional misconduct requires a practitioner’s conduct to go beyond “mere professional incompetency or .... deficiencies in the practice of the profession” and be “a deliberate departure from accepted standards or such serious negligence as, although not deliberate, to portray indifference and an abuse of the privileges which accompany registration” (Pillai v Messiter [No.2] 1986). The Tribunal cancelled her registration (although she was already unregistered at the time) and disqualified her from applying for a review of her disqualification for a period of three years. Nurse B was also ordered to pay the HCCC’s costs. www.qnu.org.au

Reflective exercise for case study over page »

FEBRUARY 2014 | TQN | 27


CONTINUING PROFESSIONAL DEVELOPMENT

C ASE S TU DY

Reflective exercise: Boundary violations Completing this reflective exercise will contribute to your Continuing Professional Development (CPD) hours. The Nursing and Midwifery Board of Australia requires all nurses and midwives to complete a minimum of 20 hours CPD per registration year for each respective profession for which the individual holds current registration. For example an individual who is a Registered Nurse and a midwife must complete 40 hours of CPD. Please refer to www.nursingmidwiferyboard. gov.au/Registration-Standards. aspx for full details. Effective learning is not simply reading a journal article—it requires you to reflect on your readings and integrate new information where it is relevant to improve your practice. It should include:  looking for learning points/ objectives within the content on which you reflect  considering how you might apply these in other situations to enhance your performance  changing or modifying your practice in response to the learning undertaken.

Consider how the information in these two cases will assist you in the workplace. In a semi-structured reflection these are the types of questions you may ask yourself. How does the content assist me to:  Be strategic and think ahead by considering what circumstances in my professional life may challenge me to maintain professional boundaries when: ◆ a colleague, relative or friend is injured and arrives in my department for care ◆ paying special attention to a patient ◆ gestures and touch in interactions with a patient ◆ giving or receiving a gift from a patient ◆ picking up groceries for a housebound patient ◆ feeding patient’s pets ◆ social contacts with former patients or their relatives ◆ having a sexual relationship with a patient.  Contribute when policies are developed about this issue and reflect on how the expectations should be specified and explained to professionals.  Manage the situation so that any personal relationship/s that existed prior to the professional relationship may be preserved: ◆ Who is responsible for broaching this with the patient/client and what is the process? ◆ What similarities might there be with how professionals disclose errors to patients?  Analyse the impact at workplace level of managing a situation where the person requiring nursing/midwifery care is known to staff: ◆ How best are professional seniors engaged to support decision-making about interventions to maintain professional boundaries and encourage therapeutic relationships?

◆ What are the options in deployment versus patient transfer?

◆ What are the subsequent impacts of deployment on the staffing profile to maintain the quality and safety of the nursing care provided? ◆ What are the impacts on the patient, if transferred?  Consider when or if it is appropriate to accept gifts from patients, consider my organisation’s policies? ◆ What do I need to declare? [usually relates to value] ◆ To whom do I declare it?  Know the implications for my registration if professional boundaries are breached: ◆ Possible disciplinary action by the NMBA ◆ Accusations of unprofessional conduct or professional misconduct. Useful information can be found on the NMBA’s website at www.nursingmidwiferyboard.gov.au/ Codes-Guidelines-Statements/Codes-Guidelines. aspx Following reflection consider how you will retain and share the new knowledge about the importance of ethical practice for you as a professional and what influence it has on the quality and safety of nursing or midwifery care you engage in with the patient/client/woman. To meet the NMBA CPD standard it is important that you can produce a record of CPD hours, if requested to do so, by the board on audit. The time spent reading this article, reviewing the referenced material and then reflecting upon how to incorporate the information into your practice will contribute to your CPD hours. Please keep a record of time spent doing each activity in your CPD record.

The following is an example only of a record of CDP hours (based on the ANMF continuing education packages):

28 | TQN | FEBRUARY 2014

Date

Topic

Description

27-03-10

Coroner’s matter Understanding – workloads the implications of the Coroner’s recommendations for the establishment of effective workload management strategies

Learning Need OR Objective

Outcome

CPD hours

To increase my knowledge about the consequences of workloads demands and skill mix deficits on patient safety .

I have achieved 2.5 hrs a greater awareness of…..

www.qnu.org.au


HEATLH REFORM AND GOVERNANCE

Medicare Locals: where to from here? In 2011, the federal government established Medicare Locals to plan and fund primary health services in communities across Australia— but with the election of a new government, has the future for Medicare Locals changed?

What are Medicare Locals? There are 61 Medicare Locals Australiawide. The previous federal government stated its intention to invest more than $1.8 billion for Medicare Locals to coordinate and deliver health services including after-hours GP immunisation, mental health support, and eHealth. Medicare Locals were designed to be innovative in how they respond to the needs of their communities. For example, they offered:  after-hours walk-in clinics  funding existing general practices to expand and improve their after-hours services to patients  extending pharmacy hours to fill scripts provided to patients outside normal operating hours  supporting mobile GP care to patients in their homes and residential aged care facilities and  providing after-hours outreach care to homeless and vulnerable populations.

What does the new government say about Medicare Locals? Since coming into office last year, the new federal government has made a number of statements regarding the future of Medicare Locals. During a speech to the Australian Medical Association in Sydney in May www.qnu.org.au

2013, then-opposition health spokesman Peter Dutton said a review of Medicare Locals would take place under a Coalition government. Mr Dutton questioned their role and said it was the coalition’s preference to redirect money “away from bureaucracies to front line services”. During the leaders’ debate in August 2013, Mr Abbott said he would not close Medicare Locals, but shortly after attaining office, the new Coalition government initiated a review of Medicare Locals. The consultation phase was very tight—just two weeks in the lead up to Christmas. The review is being overseen by former Chief Medical Officer Professor John Horvath. Professor Horvath is to provide his independent advice to the government by March 2014. Evaluating the success of Medicare Locals in terms of improved health outcomes is challenging, as the connections with general practice, hospitals, local councils, research and other sectors, are still in their infancy. The Australian Medicare Local Alliance (AMLA) has identified some examples of beneficial initiatives including:

 The Inner North West Melbourne Medicare Local is working in partnership with St Vincent’s and Royal Melbourne Hospital to support

the primary care of people with chronic Hepatitis B.

 The Central Queensland Medicare Local has seen a 20% increase in GPs able to access Telehealth in the region since June 2013, and a 600% increase in Telehealth Medicare Benefit Scheme claims since June 2012.

 The Lower Murray Medicare Local is meeting monthly with Consumer Focus Groups to discuss local health needs and priorities, give feedback about health services and service gaps, and deliver health promotion and education activities.

 The Tasmania Medicare Local is active in the Tasmania Health Pathways Project which helps clinicians develop agreed whole-of-systems “care pathways” to break down the silos between hospital and communitybased care. Under the auspice of the ANMF, the QNU is providing support to Queensland nurses working in Medicare Locals, including education sessions regarding professional issues. The Townsville-Mackay Medicare Local invited QNU Professional Officers to undertake sessions in 2013 about governance for quality and safety, and recently a further invitation to lead sessions regarding registration requirements and scope of practice has been offered in 2014. FEBRUARY 2014 | TQN | 29


INDUSTRIAL

QNU wins orders against Blue Care – but the battle is not over Blue Care has been ordered to meet with the QNU in regard to Assistants in Nursing being paid as personal carers.

As reported in the last issue of tqn, Blue Care/Wesley Mission Brisbane (Blue Care), United Voice and the Australian Workers’ Union had agreed in principle on a care and support staff enterprise agreement which included personal carers. However, the indicative tasks listed in the agreement for PCs were actually those of Assistants in Nursing. This was nothing more than an attempt by Blue Care to re-badge AINs as PCs and pay them less even though they are carrying out nursing tasks. Some of the PC tasks listed in the care and support staff agreement are:  provide quality care and support in accordance with the care plan of each individual  contribute to the development of care plans as required  assist with activities of daily living, showering, toileting, dressing, grooming, mobility, eating and drinking as required. The QNU argued in the Fair Work Commission (FWC) that including these tasks in the care and support staff agreement would legitimise Blue Care’s attempt to re-badge AINs as PCs. Blue Care and the other unions argued the QNU could not be a bargaining representative for PCs because our rules did not cover them. The determining factor in coverage is not the title of a worker, but the substantive work they do. The FWC agreed with the QNU. The FWC stated that “some of the work described in the proposed Care and Support Agreement is work that has been considered and treated by Blue Care and other Unions…, as work performed by Assistants in Nursing”. The Deputy President of FWC went on to say “I am satisfied that the QNU … is a bargaining representative for those employees. It is also clear that the work performed by (Blue Care PCs) .......... and .......... is work performed by Assistants in Nursing with the Rules of the QNU.” The FWC then ordered Blue Care to meet with the QNU and other unions to discuss the issue and attempt to reach agreement during January 2014. In the meantime the ballot process for the proposed enterprise agreement will not proceed and cannot resume before 31 January 2014. The FWC has made clear an employer cannot simply re-badge AINs as PCs and have them continue to do the same work for less pay. If you are classified as a PC with any aged care provider but believe that you are doing the work of an AIN you should notify the QNU immediately. Chances are you should be classified as an AIN and receive the wages and conditions which apply to them.

Battle not over yet While the Good Faith Bargaining orders will help, this issue is far from over. The QNU has applied to have employees of Blue Care who are badged as PCs but doing the work of AINs properly classified. This application was put on hold during the Good Faith Bargaining orders hearing, but will resume in March 2014. However, if Blue Care does not agree soon to remove the nursing duties from the proposed care and support staff agreement, the QNU will be launching more activity to ensure nursing staff are granted appropriate wages and conditions. 30 | TQN | FEBRUARY 2014

www.qnu.org.au


INDUSTRIAL

Can Mater afford a fair agreement for its nurses and midwives? Important questions remained unanswered about the true state of Mater’s finances. Mater Public Health Services in Brisbane has already been given the same funding as public hospitals to pay a wage rise for nursing and midwifery staff. Mater has rejected all requests for clarification on its financial situation. As a public interest entity that receives funding from the Queensland Government, Mater Health Services is required to provided a yearly financial statement and report to the Australian Securities and Investment Commission (ASIC). Nurses and midwives hoped that Mater’s ASIC statement and report would give an indication why Mater continually refuses to give them a fair wage rise. However, the QNU believes the Mater has not yet met its obligation to lodge its 2012/13 statement and report with ASIC. The QNU has been unable to confirm if Mater has applied to ASIC to get an exemption to lodge the report within the acceptable timeframe. Mater’s failure to provide the statement and report raises more questions about the organisation’s financial position. According to Mater’s annual report for the year ended 30 June 2012, Mater’s net profit was more than $30 million. The director’s report states: “The operating business performance and earnings outlook remains strong”. www.qnu.org.au

Mater’s bargaining team has indicated Mater does not have a precarious financial position and this was also confirmed by Mater’s Acting CEO in correspondence to the QNU when he stated: “there has never been a point in the negotiation where Mater have stated that we are in a ‘precarious’ financial position”. Mater has already received funding from the government to increase wages of nurses and midwives. It is fair to assume that this money is accumulating interest in Mater’s bank account.

So why is Mater so unwilling to offer a fair deal to its staff ? When asked if Mater will pass to its staff the interest the organisation is receiving from having nurses and midwives’ money in its bank account, the answer has been far from positive. The QNU has repeatedly requested financial information or a confidential briefing that would explain why a better offer cannot be presented, but Mater has repeatedly refused to provide this. Mater is not only offering a wage increase below all other public hospitals in Queensland but is also proposing the removal and reduction of conditions, some of which do not have a cost impact. Mater speaks very highly of its ‘sincere commitment’ to mercy, dignity, care, commitment, and quality, but, Mater’s actions suggest it is not prepared to extend that commitment to its nurses and midwives.

FEBRUARY 2014 | TQN | 31


HEALTH AND SAFETY

Government changes to OHS law will put lives at risk Since coming to power in March 2012, the Newman government has been busy stripping back our industrial rights and workers’ compensation benefits. However many are unaware the government has also been pursuing significant changes in Queensland’s health and safety legislation. These changes include  removal of the right for Health and Safety Representatives to order unsafe work to cease

 restriction on union right of entry for health and safety issues

 changes to regulation around management of asbestos. It is hard to conceive how these changes will make workplaces safer—particularly in the construction industry, which already is responsible for numerous workplace fatalities. These changes are ideologically-driven and, like so many of the Newman government’s other legislative changes, are intended to limit the ability of workers to obtain union assistance. The QNU believes these changes will actually lead to poorer safety outcomes.

New regulation requires effective communication systems In better news, the regulation requiring an employer to provide effective communication systems for remote or isolated workers came into effect on 1 January 2014. This regulation was supposed to take effect on 1 January 2013 but was postponed by the Newman government. Thankfully this regulation will provide for enhanced protection for QNU members who work in the community and those in the remote areas of Queensland.

Atherton members show the way in health and safety representation Atherton QNU Branch members have shown great dedication and commitment by standing up to ensure they have access to suitable health and safety representation. Cairns and Hinterland Hospital and Health Service had sought to restrict Health and Safety Representative (HSR) numbers for the entire faculty to just two HSRs. Clearly a hospital operating 24 hours a day, seven days a week, with more than100 staff of different occupational types needs access to more than two HSRs. 32 | TQN | FEBRUARY 2014

Members at the faculty believed this to be inadequate and pursued a grievance pointing out to hospital management requirements under the Work Health and Safety Act 2011 to negotiate with staff around health and safety representation for a workplace. Ultimately further negotiations with the QNU in attendance resulted in agreement for HSR numbers acceptable to all parties. Elections for the HSR positions are to occur and members at the Atherton QNU Branch are to be congratulated on their perseverance in pursing appropriate HSR numbers.

Beware moves to expand Comcare self-insurance The new Coalition federal government has moved quickly to resume the former Howard government’s program which allowed employers to self-insure under the Comcare workers’ compensation scheme and thereby fall within the confines of federal health and safety control. The previous Labor federal government had imposed a moratorium on private companies selfinsuring with Comcare. The union movement has argued Comcare was not appropriate for workers employed in workplaces with a high risk of injury as the scheme was designed for federal public servants and did not suit all sections of the workforce. This is made clear in recent criticism of Comcare’s role as health and safety regulator for self-insured construction company John Holland. This criticism centred on safety issues and poor regulatory compliance identified by a former John Holland manager at the Brisbane Airport Link Project. In 2011, a John Holland employee was killed at the workplace some 17 months after a memo warning of safety concerns was circulated within the company. Comcare was responsible for ensuring regulatory compliance for the activities of John Holland. Poor regulatory compliance puts lives at risk. Sadly, on this occassion, a John Holland employee paid with their life. Workplace health and safety should be the primary concern of every employer, regulator, and government. Therefore it is very important members contact the QNU if it becomes apparent an employer is moving to look at self-insurance. www.qnu.org.au


SOCIAL

Doctors on Christmas Island condemn health care standards At the end of last year health practitioners went public about the appalling health conditions at the Christmas Island Detention Centre. In a 92-page “letter of concern” sent to the federal government in November last year, a group of 15 doctors revealed the shocking standard of medical care they are made to provide for asylum seekers on Christmas Island. “Many aspects of the IHMS health service fall well below accepted standard for clinical practice and are unnecessarily dangerous,” they wrote. The report included:  A lack of medical supplies.  Drugs requested by doctors not provided.  Three hour queues for medication (for some, up to four times a day).  A high risk of depression among children.  No effective system for identifying children at risk.  Long delays in transferring patients to mainland hospitals increase risk of “life-threatening deterioration”.  Antenatal care is unsafe, inadequate, and non-compliant with Australian standards. The report documents “numerous unsafe practices and gross departures from generally accepted medical standards which have posed significant risk to patients and caused considerable harm”. The doctors criticised flaws in initial health assessments, saying problems were made worse by the new requirement that all asylum seekers who can must depart within 48 hours for Manus Island or Nauru. These initial difficulties are compounded by the practice of confiscating and often destroying any glasses, hearing aids, and prosthetics asylum seekers may have with them. www.qnu.org.au

The letter also details the conditions that most asylum seekers have experienced by the time they are examined. These include:  periods of limited or no food and water intake  motion sickness  sleep deprivation  severe sunburn  poor hygiene  clothing soiled with urine and faeces  skin infections.

Doctors fear repercussions for speaking out The doctors claim their professional integrity has been put at risk and they are being paid to compromise their medical ethics. “Practitioners working within IHMS (International Health and Medical Services) may be putting any registration they have with AHPRA at risk by participating in unethical conduct and in gross departures from clinical standards,” they write. The signatories also describe a conflict of interest between their employer, IHMS, and the Department of Immigration and Border Protection.

IHMS denied the problems were systemic, saying the doctors had been on Christmas Island at a particularly busy time. The doctors say they have been told by IHMS they are “being paid to accept the risk”—but also that they have been advised to “document well” because “there will one day be a Royal Commission into what is taking place on Christmas Island”.

Human Rights Commission finds overcrowding, mental health risk In October 2012, the Australian Human Rights Commission noted concerns about the prison-like nature of Christmas Island detention centre, and the inappropriateness of the Construction Camp for families with children and unaccompanied minors. The commission found significant overcrowding, with strain on access to facilities, as well as limited possibility for communication and education. The commission also reported a substantial increase in demand for mental health services. Meanwhile, the federal government trumpets its ability to ‘stop the boats’ by refusing to release details of exactly who is arriving and what happens to them. Too many of us are showing a blind willingness to accept the government’s spin on how it is treating men, women, and children who need care.

FEBRUARY 2014 | TQN | 33


CALENDAR

If you would like to see your conference or reunion on this page, let us know by emailing your details to dsmith@qnu.org.au

MARCH QNU Professional Seminar Nursing & Midwifery Leadership: Essential for Quality Patient Care 7 March 2014, Brisbane www.qnu.org.au/2014-ppec International Women’s Day 8 March 2014 QNU Meeting of Delegates 10 March, Brisbane 12 March, Gold Coast 18 March, Sunshine Coast 20 March, Toowoomba 25 March, Bundaberg 26 March, Maryborough www.qnu.org.au/mods ‘Diabetes Update’ study day with Kathy Mills, RN, MEd, Credentialed Diabetes Educator 7 March, Burwood East diabetes.ed@optusnet.com.au 2nd Commonwealth Nurses Conference Nursing and Midwives: agents of change 8-9 March, London UK www.commonwealthnurses.org/

APRIL QNU training Professional Advocacy – We’re in charge 1 April, Brisbane Your career starts now! 2 April, Brisbane Private Sector Nurses – How to successfully bargain 3 April, Brisbane Being a QNU Contact in the workplace 1 April, Rockhampton QH- Scope, practice and workloads 3 April, Mackay Being a QNU Contact in the workplace 22 April, Brisbane Student Survival Toolkit 23 April, Brisbane Creating a safe workplace (WH&S) 29 April, Toowoomba Professional Advocacy – We’re in charge 30 April, Toowoomba Nurses and Midwives unite! 30 April, Brisbane www.qnu.org.au/qnu-training

QNU training QH - Scope, practice and workloads 11 March, Brisbane Someone should do something about that! 11-12 March, Townsville Handling grievances in the workplace 12 March, Brisbane Private Sector Nurses – Scope, practice and workloads 13 March, Brisbane Nurses and Midwives unite! 13 March, Townsville Workplace Representatives 1 18-19-20 March, Darwin Private Sector Nurses -Knowing your entitlements 27 March, Brisbane www.qnu.org.au/qnu-training

QNU Meeting of Delegates 2 April, Rockhampton 3 April, Mackay 8 April, Townsville 9 April, Cairns www.qnu.org.au/mods

Australian Telehealth Conference Building for the future 19-20 March 2014, Melbourne www.hisa.org.au/

Palliative Care Nurses Australia 5th Biennial Conference Building a bridge to the future: the wide span of palliative care nursing 6-7 April, Sydney www.pcna.org.au/conference/about

Nursing 2014 Symposium 27-29 March, Las Vegas, Nevada http://lwwconferences.com/event. aspx?eid=7 18th Otorhinolaryngology Head and Neck Nurses Group (OHNNG) Conference Modern Approaches to ENT 29 March -1 April, Brisbane www.ohnng.com.au

RCN 2014 Annual International Nursing Research Conference 2-4 April, Glasgow, Scotland www.rcn.org.uk/research2014 Nursing Education Research Conference 3-5 April, Indianapolis, USA http://nerc.nursingsociety.org/ International Neonatology Association Conference 3-5 April, Valencia, Spain E: secretariat@worldneonatology.com

World Health Day 7 April 2014 No 2 Bullying Conference Identifying bullying / policy, prevention and management strategies 7-8 April, Surfers Paradise http://no2bullying.org.au/ World Day for Safety and Health at Work 28 April 2014 15th National Nurse Education Conference Changing Boards 30 April-2 May, Adelaide www.sapmea.asn.au/conventions/ nnec2014/index.html

34 | TQN | FEBRUARY 2014

MAY QNU training Someone should do something about that! 1-2 May, Brisbane Nurses and Midwives unite! 1 May, Toowoomba QNU Branch Development 1 6-7 May, Brisbane QNU Branch Development 2 8 May, Brisbane Private Sector Nurses – How to fix your Workloads 13 May, Brisbane Being a QNU Contact in the workplace 14 May, Bundaberg Creating a safe workplace (WH&S) 15 May, Bundaberg QH- How to fix your workloads today 15 May, Brisbane Nurses and Midwives unite! 20 May, Cairns Managing workloads through the BPF – a practical plan 21 May, Cairns Professional Advocacy – We’re in charge 22 May, Cairns www.qnu.org.au/qnu-training 5th Australian Emergency Nurse Practitioner Conference 2-3 May, Sydney www.dcconferences.com.au/ nursepracED World Congress of Cardiology 4-7 May 2014, Melbourne Victoria www.world-heart-federation. org/congress-and-events/worldcongress-of-cardiology-scientificsessions-2014/ International Day of the Midwife 5 May 2014 International Nurses Day 12 May 2014 Australian Wound Management Association National Conference A gold standard: research and clinical practice 7-10 May 2014, Gold Coast www.awma.com.au/awma2014 Australian College of Operating Room Nurses 16th National Conference All for one and one for all 21-24 May, Melbourne www.tayloredimages.com.au/ acorn2014/index.html Eating Disorders and Obesity Conference A Shared Approach: assessment, prevention and treatment 26-27 May, Gold Coast http://eatingdisordersaustralia.org.au/ World No Tobacco Day 31 May 2014

JUNE QNU training Knowing your entitlements and understanding the award 3-4 June, Brisbane Handling grievances in the workplace 5 June, Brisbane Workplace Representatives 1 10-11-12 June, Brisbane www.qnu.org.au/qnu-training Emergency Nursing - the door that never closes 7-15 June, Pacific Island Cruise, Carnival Spirit, departs Sydney http://cpdcruises.com.au/ conferences/Emergency-Nursing-thefront-door-that-never-closes/ World Day Against Child Labour 12 June 2014 World Refugee Day 20 June 2014 2nd Annual Worldwide Nursing Conference Health Disparities 23-24 June, Singapore www.nursing-conf.org/

JULY Naidoc Week 7 – 14 July 2014 QNU Annual Conference 16 – 18 July, Brisbane Cancer Nurses Society of Australia 17th Annual Winter Congress Cancer Nursing: Leading in a time of change 24-26 July, Pullman Albert Park, Melbourne http://cnsa.org.au/professionaldevelopment/national-conferences. html

AUGUST 8th International Council of Nurses, International Nurse Practitioner/ Advanced Practice Nursing Network Conference Advanced nursing practice: Expanding access and improving health care outcomes 18-20 August, Helsinki, Finland www.nurses.fi/8th-icn-internationalnurse-prac/ National Forum on Long Term Unemployment Building Capability 18-19 August 2014, Gold Coast http://longtermunemployment.org.au 15th International Mental Health Conference 25-27 August, Gold Coast http://anzmh.asn.au/

www.qnu.org.au


YOUR SUPER

Changing jobs? The R word — it doesn’t have to make you feel uneasy You may think retirement is a long way off and when the time comes, you’ll have a detailed plan in place. It’s not something you’re ready and comfortable to discuss right now. Sometimes though, retirement can happen unexpectedly. Illness, a change in work circumstances or family commitments may mean full-time employment is no longer possible. Instead of being taken by surprise, be prepared. Planning for retirement can give you peace of mind, and help you create the lifestyle you want. This is where your super fund can help. Check if your fund provides education and advice services to members. Your fund may have transition to retirement options to help you transition to retirement while boosting your super. For example, if you’re aged 55+*, HESTA Income Stream’s transition to retirement option may help you boost your super while taking advantage of potential tax breaks. Or, it could allow you to cut back your working hours without reducing your income. HESTA members have access to personal advice about super and retirement planning at no extra cost. The HESTA education and advice team provide group workshops and one-on-one appointments to members — over the phone or in person, often in your workplace. So, if you’re a HESTA member, contact us today, to make plans for your tomorrows. A HESTA adviser can help you make sense of the different super options available so you can plan for your best possible future, today. To make an appointment, visit hesta.com.au/advice or call us at 1800 813 327. With more than 25 years of experience and $25 billion in assets, more people in health and community services choose HESTA for their super. *The age you can access your super (preservation age) increases if you were born after 1 July 1960. Issued by H.E.S.T. Australia Ltd ABN 66 006 818 695 AFSL 235249, 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. For more information, free call 1800 813 327 or visit hesta.com.au for a copy of a Product Disclosure Statement which should be considered when making a decision about HESTA products.

www.qnu.org.au

Take your QSuper account with you. There are plenty of things you might throw out when you change jobs – but your QSuper account shouldn’t be one of them. The times they are a-changin’. What do you do with your super if and when you change jobs? Well, the important thing to remember is that QSuper accepts contributions from most private sector employers for existing members. If you have already moved to a new employer – we’d love to have you back. By reactivating your QSuper account, you’ll continue to enjoy the benefits of being partnered with one of Australia’s largest and most trusted funds. Always evolving. Always innovating. At QSuper, we’re always looking for new ways to improve products and services for our members, such as our new QSuper Lifetime investment option, designed to deliver even better retirement outcomes for members. Another exciting initiative is our new and improved Member Online service. With great features and functionality it’s a more interactive user experience for members. Providing you with peace of mind There’s no substitute for strength and stability in a super fund, so it’s reassuring to know that our accounts have received the highest levels of independent recognition when judged against the best of the best in Australia.1 Staying with QSuper can also offer you a sense of security throughout your working life, as you still have access to our great insurance products, giving you the peace of mind that if the worst should happen, you’re covered.2 QSuper. Not for just anyone. Only people who have worked for the Queensland government – or their partners – are eligible to be QSuper members. So if you’re thinking of closing your QSuper account, be sure to give it plenty of thought first. You won’t be able to re-join unless you, or your partner, start working for the Queensland Government again. Want to reactivate your account? To find out how just head to qsuper.qld.gov.au/changingjobs 1 See superratings.com.au and Chant West for information on ratings and awards received by QSuper. 2 Income Protection is not available for all employees, including police officers and casual employees. For more information regarding the terms and conditions of QSuper’s insurance, including pre-existing conditions, please refer to; qsuper. qld,gov.au/insurance. This information is provided by the fund administrator, QSuper Limited (ABN 50 125 248 286 AFSL 334546) which is ultimately owned by the QSuper Board (ABN 32 125 059 006) as trustee for the QSuper Fund (ABN 60 905 115 063). This information has been prepared for general purposes only without taking into account your objectives, financial situation, or needs. As a result, you should consider the appropriateness of the information for your circumstances and read the product disclosure statement (PDS) before deciding whether to acquire, or continue to hold, a product. You can obtain a PDS at qsuper.qld.gov.au or by calling us on 1300 360 750. All products are issued by the QSuper Board as trustee for the QSuper Fund. Where the term ‘QSuper’ is used in this document, it represents the QSuper Board, the QSuper Fund and QSuper Limited, unless expressly indicated otherwise. © QSuper Board of Trustees 2013

FEBRUARY 2014 | TQN | 35


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Keeping your super on the up and up. With our low fees and proven returns1, being with QSuper really adds up. qsuper.qld.gov.au/fees 1300 360 750

1 SuperRatings Fundamentals report as at July 2013 (Balanced Fund). SuperRatings does not issue, sell, guarantee or underwrite this product. This product is issued by the Board of Trustees. Please consider the PDS on our website to see if it’s right for you. © QSuper Board of Trustees 2014. 7240 01/14

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