tqn Vol 33 [3] June 2014 by Queensland Nurses and Midwives' Union

VOL. 33 | NO. 3 | JUNE 2014

THE QUEENSLAND NURSE

WE CELEBRATE NURSES AND MIDWIVES

FEATURE:

An economy in crisis?

More people in health and community services choose HESTA for their super

‘Super Fund of the Year’

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Product ratings are only one factor to be considered when making a decision. See hesta.com.au/ratings for more information. H.E.S.T. Australia Ltd ABN 66 006 818 695 AFSL No. 235249, the Trustee of Health Employees Superannuation Trust Australia (HESTA) ABN 64 971 749 321. For more information, 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.

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 Editor Beth Mohle, Secretary, QNU Production QNU Communications team Published by the Queensland Nurses’ Union of Employees Printed by Fergies Print and Mail

VOL. 33 | NO. 3 | JUNE 2014

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 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 An economy in crisis?

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.

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Your union Editorial Your say

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Midwifery

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JUNE 2014 | TQN | 1

YOUR UNION

Connecting with you and through you SALLY-ANNE JONES, QNU PRESIDENT

It is only five weeks until the QNU Annual Conference.

YOUR COUNCIL

The political and industrial landscape we live and work in has changed many aspects of our lives since last conference. It has been an extremely busy and challenging year in all health settings, both industrially and professionally. If you are a nominated and elected Branch (Steering Committee) official, you will have submitted your conference resolutions by now, and be taking the list of all resolutions back to your Branches to debate and agree on a position to represent at conference. The QNU is a truly democratic union— the Secretary, the Assistant Secretary, President, Vice President and the Council are nurses and midwives from a variety of health settings who are elected every four years by the membership of working nurses and midwives of the QNU. Each worksite has the opportunity to form a Branch of nominated and elected nurses and midwives who as delegates to conference will represent the views of their worksite colleagues. This means each worksite can represent their own varying interests and experiences. At conference, Branch delegates debate and vote on a range of topics that shape the political, industrial, professional, environmental and social policy for the QNU for the following year. As the largest union in Queensland, the QNU plays an important role in the union movement. Our union has successfully represented tens of thousands of nurses and midwives by organising members and using

collective resources to achieve a range of conditions, including:  wage increases and improvements to working conditions  38 hour working week and accrued days off  annual leave and loading  sick leave  long service leave  penalty rates for shiftwork, overtime and working unsocial hours  parental and other family leave (including paid maternity leave in many workplaces)  superannuation. All of these benefits have been achieved by QNU nurses and midwives, despite opposition from employers in the public, private and aged care sectors. Without unions, many of the working conditions we currently have simply would not exist. Annual Conference is our opportunity to clarify the working conditions we want, and how to achieve them. It is connecting with you and through you that the QNU has become such a strong and successful union. If you are not sure whether your workplace has a Branch, or QNU Representatives, contact QNU Connect on 3099 3210. QNU Connect can help you identify your Branch Steering Committee, your local QNU Organiser, or ask how to start a Branch yourself. Being an active part of the QNU means your voice is stronger. With the QNU, you can speak for yourself, for your profession, for those in your care, and for your community.

WITHOUT UNIONS, MANY OF THE WORKING CONDITIONS WE CURRENTLY HAVE SIMPLY WOULD NOT EXIST. Delegates voting at the 2013 QNU Annual Conference.

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

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www.qnu.org.au

EDITORIAL

! I X TA

BETH MOHLE, QNU SECRETARY

Over the years I have learnt never to waste a taxi trip, no matter how long or short. Taxi trips provide a great opportunity to learn the key issues for a local community and identify shared issues of concern. On my way to Mackay airport recently, I was picked up by a woman driver in her early 60s. Her bright Hawaiian shirt matched her friendly manner. I asked how the local economy was going. She said thanks to the decline of the mining boom it had been slow in the Mackay region for the last 12 months. She had her fingers crossed it would turn around soon—but she also hoped it would teach everyone to move beyond short term thinking of boom and bust. She also spoke of the health system. Her husband had private health insurance, but prostate cancer had led to treatment in a major private hospital in Brisbane. They were now $14,000 out of pocket. She and her husband couldn’t understand how this could be. He had been paying so much and still there was this unbelievable fee. She also worried about the potential delay in the National Disability Insurance Scheme. Her daughter was in her late 20s and moderately disabled. www.qnu.org.au

She needed specialist care that was not available locally. Waiting lists were long. When she said the type of health care we provided to everyone is the mark of how civilised we are, I said I couldn’t agree more. When she asked where I worked, I told her I worked for the Queensland Nurses’ Union and so I knew nurses and midwives care deeply about ensuring everyone gets high quality health and aged care. I told her about the more than 1300 nursing and midwifery jobs cut over the last 18 months. Thanks to the information given to me by QNU activists the night before, I was able to tell her of the health service cuts in the Mackay area. I told her we were fighting back, with and for our local communities. I told her about the Hervey Bay campaign to keep Level 5 ICU services at the local public hospital. I told her local nurses and midwives were instrumental in this campaign, and thanks to them Hervey Bay Hospital would indeed keep their ICU services. As we pulled up at Mackay Airport, I wished we had more time to talk. It was a topic we both cared about deeply, and it didn’t seem right finishing up with so much left to say. As I was leaving her cab she called out: “Keep fighting for us!” “Count on nurses and midwives and the QNU,” I called back. “We’re not going anywhere.” Sometimes we can feel overwhelmed by the multiple responsibilities we have as nurses and midwives, as unionists, as family members, friends, and carers. Sometimes the forces organised against us can seem insurmountable.

“COUNT ON NURSES AND MIDWIVES AND THE QNU,” I CALLED BACK. “WE’RE NOT GOING ANYWHERE.”

But nurses and midwives will always be there for our patients and our communities. It’s what we do. We’re not going anywhere. We are the knowledgeable and passionate health system insiders who stand up for others when they can’t stand up for themselves. We do this every day, person-to-person, together, when we work and through our collective campaigning. Now, we are turning our collective campaigning strength toward the next state election. Across the state, we are asking nurses and midwives to help identify the key issues and how they can be solved. We want to know how nurses and midwives should respond together to the challenges we face. This starts with one-on-one conversations, including the occasional taxi ride. What should be the future of our health care system? What should our governments’ spending priorities be? Who should pay, and how much? A single conversation can make all the difference.

Beth

JUNE 2014 | TQN | 3

YOUR SAY

Australia’s public health system is world class

Words of warning from a Mater employee

I am a permanent resident skilled migrant and had only been living in Australia for about 14 months when I was admitted to the PA hospital through the emergency department with a severe gastric disorder. Worried about my health and this new lifelong condition to manage, my anxiety was heightened by the thought of a big hospital bill at the end of my stay. I was not familiar with the public health system in Australia and assumed it would be similar to state-run health services in my home country. As a short-term contract worker (the only work I can find in the current market), I had lost my income and my job due to my illness and was trying to figure out how I would pay for what I thought would be thousands of dollars in medical care. I had resigned myself to loaning money from family, though with my job gone (and no access to Centrelink) I had no idea how I was going to repay. I can only imagine how frightening this situation might be for someone without family support, or someone whose family are poor or also sick. When I was told I was covered under Medicare I could not quite believe it. I’d had x-rays, blood tests, drips, medication and excellent medical care during my 11-day hospital stay—including fantastic nurses. I cannot tell you how grateful I am. Australia can be really proud of this Medicare system—it is one of the few systems where everyone really is treated equally, and it means people can get on with getting better, rather than worrying about bills. So I wanted to thank the QNU for its hard work protecting Medicare, I’ve seen the news and I know you are fighting a good fight. Rest assured I will sign and share every petition, I will spread the word, I will stand up and be counted—not even for me, but for all those people worse off than me who should be able to access care when they need it without worrying how to pay for it.

I am a concerned employee at Mater Mother’s Hospital. Mater management has withheld pay from nurses and midwives—tax payer funding that was given to them by the state government. They are currently paid 9% less than nurses in public hospitals and haven’t received a pay rise in 3 years. They have also cut nurses professional development allowance which is used to ensure staff have training and up to date with latest medical procedures and technologies. Most importantly this ensures patients receive the best care from highly skilled staff. I know nurses and midwives are now leaving Mater. I am afraid how this will affect the safety of mums and bubs. Mater is funded the same as a public hospital. Mater nurses and midwives do the same job as in a public hospital. So why are they paid less? The money given to Mater is public money—our money, given by us to the government, and from the government to Mater. Why hasn’t the government been more proactive in forcing Mater to pay nurses and midwives? Our government won’t hold Mater to account, and sadly it is our mums and bubs who will pay the price.

Patient VU Brisbane 4 | TQN | JUNE 2014

Name witheld Brisbane

TJHO!VQ!UP!TVQQPSU

HEALTH CARE ALL RVFFOTMBOEFST http://bit.ly/1kywVCi

I will be forever grateful I must apologise for not writing sooner but it’s taken me a while to digest that the AHPRA case has been finished and I have been cleared of any wrongdoing. I am so very grateful to the QNU and Hall Payne Lawyers for all the assistance you have provided to me. I really didn’t have anyone else to turn to. When I started nursing in the 1970s, I took an oath never to join a union (the head nun insisted we all did so), but thank goodness Matron Dawn Murray in Gladstone convinced me that wasn’t such a good idea. I joined in 1985 and haven’t been struck down by lighting so far. Thank goodness I was a member of the QNU when I was wrongly accused. Please relay my gratitude to all those involved in my case. I will be forever grateful. Anne-Marie D’Arcy Toowoomba

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

Connect with us:

/qldnursesunion www.qnu.org.au

TEA ROOM

tea r

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’m an AIN in aged care and I’ve heard we will soon be answerable to a new government body if complaints are received about our performance. Is this true? The office of the Health Ombudsman will become operational from 1 July 2014. The Health Ombudsman will be responsible for receiving and dealing with health service complaints—against AINs, PCs, RNs, ENs and midwives—and investigating “systemic issues” pertaining to a health care provider, including aged care providers. Previously, regulation of health practitioners was limited to those registered with the Australian Health Practitioners Regulation Agency (AHPRA), such as RNs, ENs and midwives. In Queensland the Health Ombudsman will now have power to take action against all health practitioners, including AINs and PCs. For employees registered with AHPRA the Ombudsman will have the power to notify “immediate action” against the employee. www.qnu.org.au

For PCs and AINs (who are not registered with AHPRA), the Health Ombudsman still has the power to issue “interim prohibition orders” if the Ombudsman believes the AIN or PC’s health, conduct or performance poses a “serious risk” to persons, or to protect public health or safety. The interim prohibition order has immediate effect from the time it is issued. A “serious risk” could include:  practising unsafely, incompetently or while intoxicated  financially exploiting a person  engaging in a personal or improper relationship  discouraging the person from seeking clinically accepted care or treatment  making false or misleading claims about the health benefits of a particular health service  making false or misleading claims about qualifications, training, competence or professional affiliations. This edition of tqn contains further information on the new requirements of the Health Ombudsman legislation. A Continuing Professional Development exercise for RNs, ENs and midwives on the new Health Ombudsman is on page 32. There is also useful information about the Health Ombudsman in the December 2013 edition of tqn at page 30. You can access this article online through the QNU website. If you are the subject of a complaint it is important you contact the QNU immediately. If the Health Ombudsman raises concerns about an incident you were involved in, write down your recollection of the incident in detail as soon as possible. This will assist QNU officials and our legal representatives to provide the necessary assistance to you.

CONTINUING PROFESSIONAL DEVELOPMENT

Add to your CPD hours with the QNU’s article on the new Health Ombudsman: Article on page 32, reflective exercise on page 34. Remember to keep a record of your CPD hours!

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

ROVDPOOFDU QI 41::4321

JUNE 2014 | TQN | 5

NEWS

HESTA nursing awards

Cape York safe infant sleeping program receives national nursing award The team behind an innovative Cape Yorkbased infant safe sleeping program shared the highest honours at the 2014 HESTA Australian Nursing Awards in May. The Pēpi-pod® Program—based at the Apunipima Cape York Health Council— has taken out the Team Innovation Award at the 2014 HESTA Australia Nursing Awards held in May. Pēpi-pods aim to reduce the high rates of Sudden Unexpected Death in Infancy (SUDI) among Aboriginal and Torres Strait Islander communities. The program originated in New Zealand where they saw the first drop in SUDI among the Maori population in a decade. The name originates from Pēpi, which is Maori for baby. The term ‘pod’ symbolises protection of precious new life. Infants up to six months old of families with known risk factors for SUDI are provided with a portable, polypropylene box, which is transformed into an appealing infant bed with a culturally suitable fabric cover, tight fitting mattress and bedding. Apunipima Cape York Health Council partnered with the University of the

Sunshine Coast (USC), Children’s Health Queensland, and Change for our Children New Zealand to roll out the program. Program leader and QNU member, Professor Jeanine Young from USC, said the pods enable safe sleeping places for babies who aren’t in cots. “Aboriginal and Torres Strait Islander babies are 3.8 times more likely to die suddenly and unexpectedly, than nonIndigenous infants,” said Professor Young. “We know that infant deaths are associated with co-sleeping in hazardous circumstances, particularly for preterm or low birth weight babies, or where smoking, alcohol, drug use or unsafe sleep environments are present,” she said. On behalf of the team, Professor Young accepted a $10,000 grant from ME Bank. “More than 30 Pēpi-pods have been distributed to families and there are plans to extend the service to more Cape communities in 2014,” said Professor Young. “We will buy much-needed iPads which will help engage the communities we work with and assist them in providing data and feedback to us.”

Now in its eighth year, the annual HESTA Nursing Awards recognise nurses, midwives, personal care attendants and Assistants in Nursing. Nurse of the Year was award to Victorian nurse Steve Brown, and Outstanding Graduate was also awarded to a Victorian nurse, Zoe Sabri.

The 2014 recipients are: NURSE OF THE YEAR: Steve Brown—of Northwestern Mental Health, Victoria (the mental health arm of Melbourne Health) — for his role in implementing the Police Ambulance Clinician Emergency Response (PACER) system, to improve the crisis management of people living with mental health. OUTSTANDING GRADUATE: Zoe Sabri—of the Royal District Nursing Service in Springvale, Melbourne—for her work assisting elderly clients to continue to live safely in their own homes. TEAM INNOVATION: The Apunipima Pēpi-pod® Program—based at Cape York Health Council—for their work with Indigenous Australians in helping reduce the rates of Sudden Unexpected Death in Infancy (SUDI) among Aboriginal and Torres Strait Islander communities. The award recipients share in a $30,000 prize pool, courtesy of longterm HESTA awards supporter, ME Bank. HESTA is the leading super fund for health and community services, with more than 770,000 members and $27 billion in assets.

’ h their ‘Team Innovation The Pepi-pod team wit ards. Aw g rsin Nu ian tral award at the HESTA Aus

6 | TQN | JUNE 2014

www.qnu.org.au

NEWS

Honouring wartime nurses Brisbane has held its first ANZAC candlelight vigil in April to honour nurses who served in World War One. More than 150 community members and nurses, some wearing the original WW1 scarlet capes and veils, gathered with candles beside the memorial statue of a nurse and soldier in Brisbane’s ANZAC Square to remember the enduring dedication and determination of nurses who worked in horrific wartime conditions to deliver life-saving care to ANZAC soldiers. Vigil organisers Dr Margaret Steinberg and Dr Clifford Pollard spoke in honour of ANZAC nurses from the Royal Brisbane Hospital, which in 1915 was Brisbanes Brisbane’s only hospital.

Shipped to the Greek island of Lemnos to care for the wounded from the Gallipoli Campaign, these ANZAC nurses faced appalling conditions—lacking tents, bandages, medicines and beds—that meant they had to sleep on the ground beside their patients. Inspired by the courage and compassion of Brisbane’s heroic Matron Grace Wilson CBE (1879-1957), the dedicated team of 40 nurses who served in the conflict saved the lives of more than 7000 wounded ANZACs with only 143 fatalities. The vigil is set to be an annual event. The QNU received significant interest from members who were unable to attend this year’s vigil—so put the date in your diary now for next year.

a parasol and notebook Grace Wilson holding nos island during the “doing a round” on Lem n. aig mp Ca Gallipoli

Source: Australian War

Memorial

You have the power to keep your workplace safe QNU’s 2014 Health and Safety Yearbook is about to come off the printing press, chock full of research material, information sheets, activities and motivational stories encouraging nurses and midwives to take control of safety in their workplace. Every year the QNU receives hundreds of calls from distraught and anxious members who have been injured at work or have been reported for making errors where health and safety issues such as fatigue, workloads and poor safety standards have been a contributing factor. This is why we are urging nurses and midwives across all sectors to tap into their collective ‘power’ and stand up for their right to a safe working environment. When nurses and midwives take a stand on health and safety issues— such as fatigue and manual handling – not only are they protecting their own safety, but they are also protecting the safety of their patients. Drawing on the ‘Nurse Power, Midwife Power’ theme, this year’s book reminds nurses and midwives that they have the power—personally, collectively, legally and with the backing of their union—to create and maintain healthy workplaces. The 2014 Health and Safety Yearbook will be available in digital format on our website at the end of this month. You can also contact the QNU Brisbane office for copies on 3840 1444 or toll-free outside Brisbane on 1800 177 273.

Community members and nurses at the candelight vigil. www.qnu.org.au

JUNE 2014 | TQN | 7

NEWS

New study finds better health outcomes for newborns in public hospitals Rates of neonate morbidity among low-risk women are higher in private hospitals, a landmark study from researchers at the University of Western Sydney has found. Using data from 691,738 women during the period 2000-2008, the study confirmed the well-known higher rate of obstetric intervention in private hospitals—but less expectedly, also found worse health outcomes for newborns. Women who birth in private hospitals have long been held to have better maternal and perinatal outcomes compared to women who birth in public hospitals. In large part, this was based on the assumption women in private hospitals are less socio-economically disadvantaged and healthier than women in public hospitals.

Report findings However, the UWS study found newborns in private hospitals have higher rates of morbidity, including feeding difficulty (4.0% compared with 2.4% in public hospitals), birth trauma (5.0% compared with 3.6%), hypoxia (1.7% compared with 1.2%), jaundice (4.8% compared with 3.0%), and respiratory problems (1.2% compared with 0.8%). The difference in birth trauma is largely attributable to higher rates of scalp trauma from use of forceps and vacuum, and a higher rate of neonatal conjunctivitis.

8 | TQN | JUNE 2014

Babies born in a private hospital were also much more likely to experience some form of resuscitation.

Possible contributing factors Possible contributing factors to these higher morbidity rates include higher rates of elective delivery at an earlier gestation (jaundice), and higher use of epidural anaesthesia, caesarean section, instrumental birth, and opioid analgesia (feeding difficulties). The report notes breastfeeding outcomes are positively associated with uncomplicated, unassisted vaginal birth where the mother and infant remain together, and breastfeeding is started within an hour of the birth and following skin-to-skin contact. The report adds to the body of evidence suggesting obstetric intervention for low-risk women contributes to increased morbidity for babies, and hence a higher cost of healthcare. Serious review is needed of many widely accepted birthing practices, including early term delivery, instrumental birth, and high intervention rates. The full report, which was co-ordinated by University of Western Sydney Professor Hannah Dahlen and published in May 2014, can be viewed by visiting www.bmjopen.bmj.com and using the search term ‘obstetric intervention’, or by visiting http://bit.ly/1pcamuU

Ruling gives opportunity for reduction in weekend penalty rates A recent ruling in the Fair Work Commission threatens to become ‘the thin end of the wedge’ in a move to reduce weekend penalty rates— including for nurses and midwives. The FWC ruling targets restaurant workers, but could potentially be broadened to workers in other sectors, including health. The majority of a five-member Fair Work Commission full bench ruled “transient and lower skilled” (ie. casual employees) restaurant workers should have their penalty rate for working on a Sunday reduced from 75% to 50%. While the full bench found “working on Sundays involves a loss of a day of family time and personal interaction upon which special emphasis is placed by Australian society”, it also deemed the penalty rate tended to “overcompensate” lower-skilled workers for working on Sundays. The attempt to devalue and underpay employees who work outside normal hours is one of the worst examples of growing inequality in Australia, and should be resisted at every turn.

End of the line for QNU App After almost two years in operation, we have closed down the QNU App for smartphones. The app certainly had its uses when it was first launched in May 2012 offering subscribers the latest news, an easy way to pay fees and a portal for feedback to the QNU. But as the QNU has expanded into social media with Facebook, Twitter and Instagram accounts and with the launch of a new online membership portal called Memberlink, the App had outlived its usefulness. The App was withdrawn from iTunes and Google Play in May and is no longer functional. www.qnu.org.au

NEWS

How’s your super? A little checking can go a long way QNU members are being encouraged to make the most of financial planning services available through their superannuation providers. Recent research found a growing number of Australian women would not have enough super to provide for a comfortable retirement. The findings, commissioned by Women in Super and conducted by Rice Warner, revealed a $383 billion superannuation shortfall for Australian women of working age. The study found many female employees were either unable or unwilling to set aside voluntary contributions. Factors included debt, an inability to afford voluntary contributions, lack of understanding and concerns the government could change super laws. QNU Secretary Beth Mohle encouraged women to explore super options. “Sadly women are saving less super than men as a result of lower wages and time off to raise children,’’ Beth said. “However women need to take an active interest in their financial futures. “The investment of $10 or $20 a week could go a long way to ensuring a happy retirement. I encourage all QNU

www.qnu.org.au

members to think seriously about voluntary contributions or salary sacrificing while we continue to lobby all governments on gender inequity and super.’’ According to QSuper, contributions of $10 a week invested over 30 years could boost super nest eggs by more than $30,000. For more information see qsuper.qld. gov.au/members/super/contributions/ voluntary.aspx The Abbott Government’s recent announcement of plans to lift the pension age from 65 to 70 has highlighted the need to make additional super contributions. The federal government also plans to cut the existing Low Income Superannuation Contribution (LISC) rebate for workers earning less than $37,000. Under the LISC, employees including working mothers and other casual and part-time employees, receive up to $500 a year paid into super accounts as rebates for taxed super contributions. Women in Super’s Save the LISC campaign can be viewed at keepsuperfair.com.au

Call for urgent action as suicide rates skyrocket The highest suicide rates in 10 years have prompted Australian mental health authorities to call for urgent action. Spokesman for mental health charity SANE Australia Jack Heath said suicide was the leading killer of Australians aged between 15 and 44—and numbers were on the rise. Mr Heath said the recently released ABS Causes of Death report showed suicide claimed 2535 Australians in 2012, almost twice as many as were killed in Australian road-related incidents. The overall suicide rate for 2012 was 11 per 100,000 compared to 9.9 the year before. Mr Heath said the figures were startling. “These figures make a compelling case for renewed action on suicide prevention,” Mr Heath said. The ABS report found middle-aged men were most likely to kill themselves, while suicide among girls aged 15 to 19 increased by 63% from 2011 to 2012. The suicide rate was 2.5 times higher for males and 3.4 times higher for females of Aboriginal and Torres Strait Islander descent. While the 49 National Suicide Prevention Strategy projects are funded until June 2015, the government has deferred making a funding decision beyond this date until November this year, when the National Mental Health Commission review is released. Anyone experiencing anxiety, depression or suicidal thoughts can call Lifeline 24/7 on 13 11 14 or visit www.lifeline.org.au/crisischat (8pm-4am AEST). JUNE 2014 | TQN | 9

NEWS

TENS OF THOUSANDS HIT THE STREETS FOR LABOUR DAY About 30,000 marchers from dozens of unions packed Brisbane streets on Labour Day in May, joining thousands of others at similar events around Queensland. Marches at Gold Coast, Ipswich and Toowoomba also saw record numbers turn out.

by the Newman government’s cuts to workplace health and safety laws. Marches and activities were also held in Bundaberg, Maryborough, Barcaldine, Cairns, Emu Park, Mackay, Moranbah, Rockhampton and Townsville.

Judging by sentiment on the day, the record turnout reflected increasing concern about the actions of our state and federal governments.

Nurses and midwives were out in force once again, with hundreds donning ‘Nurse and Midwife Power’ t-shirts (or capes!) and joining the QNU ensemble.

In the shadow of Worker’s Memorial Day for employees killed at work, marchers were particularly angered

This was the 123rd year of Labour Day in Queensland, and again it recognised the role of unions

in campaigning for and securing important working conditions for all Australians, including health and safety laws, compulsory superannuation, paid maternity leave, and fair wages and working conditions. People in all corners of the country are clearly gearing up to challenge state and federal governments with an axe to grind against working Australians. It was heartening to see so many families, friends, and colleagues turn out to support one another and stand up for our hard-won achievements.

BRISBANE 10 | TQN | JUNE 2014

www.qnu.org.au

NEWS

BUNDABERG

CAIRNS

TOOWOOMBA

IPSWICH

GOLD COAST TOWNSVILLE

BRISBANE BRISBANE

www.qnu.org.au

JUNE 2014 | TQN | 11

NEWS

INTERNATIONAL DAY OF THE MIDWIFE ■ 5 MAY | INTERNATIONAL NURSES DAY ■ 12 MAY

CAKES, DANCES, AND A GLOBAL MESSAGE Early May is always one of our favourite times of year— our chance to celebrate nursing and midwifery! Thanks to the strengthening relationships with nursing and midwifery unions abroad, this year’s celebrations were bigger and better than ever. In Queensland, celebrations kicked off on 5 May, with a get-together and workshop hosted by the QNU for International Day of the Midwife. This was a fabulous opportunity for key stakeholders to take stock of how far the profession of midwifery has come, and what we need to do to achieve future goals. International Nurses Day saw celebrations large and small in hospitals, community health centres, and aged care facilities all around the state. No celebration of nursing and midwifery is complete without a slice (or two) of cake, and the QNU is always happy to help with that! QNU Organisers delivered 107 scrummy cakes across Queensland, as well as our hugely popular ‘I heart nurses and midwives’ bumper stickers. At our community stall in Brisbane’s Queen Street mall, we had a lineup of passers-by all keen to show how much they ‘heart’ nurses and midwives too—you can see more than a hundred photos on the QNU Facebook page www.facebook.com/ qldnursesunion The celebrations in Brisbane culminated in a flashdance in the middle of the busy lunchtime crowd at Queen Street Mall. You can catch footage of the dance on the QNU Facebook page too. 12 | TQN | JUNE 2014

QUEENS STREET MALL FLASHDANCE

www.qnu.org.au

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INTERNATIONAL DAY OF THE MIDWIFE ■ 5 MAY | INTERNATIONAL NURSES DAY ■ 12 MAY

CAKE, CAKE AND MORE CAKE... ACROSS THE STATE!

NURSES & MIDWIVES

www.qnu.org.au

JUNE 2014 | TQN | 13

NEWS

INTERNATIONAL DAY OF THE MIDWIFE ■ 5 MAY | INTERNATIONAL NURSES DAY ■ 12 MAY

Health care is a human right Our celebrations here in Australia were part of a broader international celebration with a very firm message that health care is a human right. Leading nurse and healthcare unions in 12 countries in the Americas, Africa, Asia, Australia, and Europe held coordinated actions to step up efforts to promote patient safety, protect health care services, and ensure access to health care for all. The actions included the prevention of health service privatisation, legislation for safe staffing laws, protesting the harmful health effects of climate change, and a call for a “Robin Hood” tax on stock and bond trading to raise money for basic human needs. In each country, the actions were led by affiliates of Global Nurses United (GNU), an international federation of nurses and healthcare worker unions formed in June last year. The QNU is very proud to be a founding member of the GNU.

In the Dominican Republic, the Sindicato Nacional de Trabajadores de Enfermeria held marches in the cities of Santo Domingo, Santiago, Barahona and San Pedro de Macorís demanding a bigger budget for public health and against the privatisation of health services.

Tragedy at Baillie Henderson raises questions over safety priorities

serious ongoing psychological trauma from the attack is very real.

The recent jailing of a 27 year old man for his part in a violent group attack on three nurses at Toowoomba’s Baillie Henderson Hospital has prompted the QNU to ask why it has taken so long for improved safety procedures to be authorised. Three nurses were attacked by seven male patients in the Ridley Unit of the hospital on 19 January last year. The attack involved the patients attempting to use furniture as weapons against the nurses. A fourth nurse had the unenviable task of operating the security panel, contacting backup, and facilitating entry to the unit, unable to assist her colleagues while they struggled to restrain their attackers. One of the nurses suffered serious face and skull injuries, and the potential for 14 | TQN | JUNE 2014

In South Korea, the Korean Health and Medical Workers Union organised a national tour that will continue until 23 May in opposition to health care privatisation and emphasising the need for improved staffing. In the Philippines, the Alliance of Health Workers staged a Health Workers’ Day of Action in Manila to stand up for health care workers and public health care and protest the proposed Trans-Pacific Partnership Agreement which would open up to foreign investors the purchase of 72 hospitals—including the right to terminate the employment of all workers at the hospitals.

Has bureaucracy got in the way of staff safety? The QNU remains concerned at the lapse in time between the incident and the implementation of safer workplace procedures. Some 12 months after the incident, an independent investigation made 62 recommendations, including 24-hour security at the medium security Ridley Unit. During this time, nursing staff at Baillie Henderson held grave fears for their safety—not least due to reluctance from health bureaucracy to provide adequate security during the investigation. In the aftermath of the incident, the QNU consulted with nursing staff and on their request ensured appropriate security measures were in place for the duration of the investigation. Although local staff and some managers have willingly taken steps to improve

In Brazil, the Federação Nacional dos Enfermeiros organised a five-day encampment to protest poor working conditions, while nurses and nursing students also hit the streets in the national capital Brasilia and participated in a public hearing to push for national legislation to reduce nurses’ working hours. This is just a handful of the dozens of actions taken by nurses and midwives all around the world in early May. You can quickly see the many common threads we share: ensuring appropriate health care regardless of individual wealth, opposing privatisation of health services, ensuring safety of nurses and midwives as well as patients. Nurses and midwives in every country confront and overcome challenges big and small, every single day. We may not overcome every challenge immediately, but in early May we showed the world we always have the resilience to prevail.

safety in the unit, the QNU remains concerned at the length of time taken to conduct the investigation and hand down recommendations. The QNU continues to work with nursing staff at Baillie Henderson to ensure safe procedures are implemented—including safety measures beyond those recommended in the report. Amid the procedures and bureaucracy of investigations, it is often too easy to lose sight of the human cost. The four nurses who confronted this situation acted with incredible bravery, always holding the well-being of each other and the patients as their highest priority. Sadly, it has been the QNU’s experience that nursing staff who are exposed to this type of terrible event may never fully recover. Safety at work should be the highest priority of every employee—staff, management, and offsite bureaucracy. www.qnu.org.au

NEWS

It’s YOUR professional practice framework: You make the decisions that impact on safe nursing and midwifery care The QNU is aware of increasing pressure on nurses and midwives to set aside concerns over safe nursing and midwifery care in favour of managerial directives. Be very clear about this: nurses and midwives are held responsible for safe delivery of care. In the event of an adverse health outcome, a nurse or midwife will be held responsible, regardless of what instructions or directives were issued by management. Faced with a choice between safety and obedience, nurses and midwives are professionally obliged to choose safety. Any directives or work instructions from non-nursing or non-midwifery staff which impact on your scope of practice must be referred to the relevant senior nurse or midwife. Your scope of practice is the regulatory framework that keeps your patients, your colleagues, and you safe.

Nursing and midwifery consultative forums: who has a say? Nursing and midwfiery consultative forums manage nursing and midwifery issues that may require action, intervention and policy changes. They are run BY nurses and midwives, FOR nurses and midwives. While it is not unusual for representatives from management or HR to attend these forums, it is NOT permitted to defer nursing and midwifery decisions to these representatives. Their role is purely to clarify process, for example, recruitment and selection. It is unlawful for any nurse or midwife to defer to management or HR representatives for decision on nursing and midwifery professional practice.

Any nurse or midwife who does attempt to defer in this way must be corrected, and the decision must be made by nurses and midwives. Issues requiring decisions by nurses and midwives include: 1. Workloads (numbers and skill mix of nurses, patient acuity). 2. Professional practice issues (scope of practice and other regulation matters). Nurses and midwives are required by law to provide safe patient care in a safe working environment. Nurses and midwives have a duty of care to keep patients, colleagues, and themselves safe. It’s YOUR decision. Don’t let anybody try to take it away from you.

Exercising your professional judgment For example, a Registered Nurse on a surgical unit maybe be directed to provide care to six high acuity patients with the assistance of an Enrolled Nurse. Prior to accepting this delegation, the RN must assess: 1. The condition of the patients. 2. Provision of the treatment and care required within the RN’s scope of practice. 3. Provision of a comprehensive clinical handover on these patients. 4. Knowledge of the scope of practice of the Enrolled Nurse. These are questions the RN must answer to their own professional satisfaction prior to accepting or refusing the delegation of care.

What to do if you identify a problem If during this process you identify a problem: 1. Identify the problem and what is required to address it. 2. Report, escalate to your line manager or above. 3. Record and document priorities if the problems are not addressed. You cannot be directed to undertake activities that place patients at risk. www.qnu.org.au

JUNE 2014 | TQN | 15

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Nurse endoscopists: soon to be part of the QH workforce? The ability for Queenslanders to access endoscopy procedures through the public health system is becoming increasingly difficult. Public sector demand easily outstrips capacity. Current figures indicate as many as 3000 patients have waited for up to eight years for endoscopy procedures, and the waiting list continues to grow. By 2018, the annual demand for endoscopies is expected to exceed 100,000 and the burden of disease will be extreme. Queensland Health currently has 50 FTE specialists available to perform endoscopies. By 2018, the number needed to meet demand will reach 100 FTE specialists.

Introducing the nurse endoscopist To increase endoscopy capacity in the public sector, the Nursing and Midwifery Office of Queensland (NaMOQ) developed a position paper outlining potential pathways for nurses to become nurse endoscopists in Queensland. In other countries (UK, NZ, Canada and the Netherlands) nurse endoscopists have developed a role whereby they provide a range of gastroenterology procedures including endoscopies. The collaborative arrangements in these countries have been positive and have shown nurse endoscopists can greatly relieve demand for the procedure. It is vital Queensland nurses and midwives develop a strong, unified position on the strategies currently being considered by health administrators to meet rising endoscopy demand. Not all strategy options are favourable for our profession or for the delivery of care. The options currently on the table include:  outsourcing endoscopy procedures to the private sector  increasing staff productivity in ways not yet developed  redesigning service models 16 | TQN | JUNE 2014

 increasing workforce capacity through expanding the number of nurse endoscopists. Queensland Health has developed a planned introduction of nurse endoscopists through Hospital and Health Services (HHS). As of May, at least seven HHSs have registered their interest in introducing nurse endoscopists.

QNU concerns about the role The QNU certainly supports Advance Clinical Practice Nurses but we want to ensure they have the appropriate knowledge, skills and expertise to undertake endoscopy procedures. Our position is that nurses undertaking endoscopies should be at least in the associate position Grade 6-7a or above. We also argue this role must not described as simply a “nurse endoscopist” as endoscopy is only one activity of a gastroenterology nurse. Our position is that the appropriate training effectively results in gastroenterology specialisation. Appropriate titles, depending on nursing grade, scope of practice and level of specialisation, would be Advanced Clinical Practice Nurse-Gastroenterology, CNC-Gastroenterology or Nurse Practitioner-Gastroenterology. We are keen to ensure the holism of care provided is not undermined by breaking the role of the gastroenterology nurse down into separate tasks. The role must also not become so taskdriven that it can sit within a medical model as a technician. The QNU supports the idea of up to 15 nurses who currently work in gastroenterology undertaking further qualifications in a speciality (i.e. endoscopy), but is concerned that restricting the role title to, for example, ‘advanced practice in endoscopy’ would be too task-focused and does not holistically express the care delivered by gastroenterology nurses. Appropriate academic education is required, and the process by which a nurse is deemed “advanced practice” has to be further clarified.

work in developing the advanced clinical gastroenterology nurse role. While this is worth exploring–it must be done collaboratively and well. To read the complete document highlighting the relevant demographics and intended pathways please access: http://bit.ly/endoscopist

A sad reminder of the danger of cutting safety laws On 28 April, workers in Queensland observed Workers’ Memorial Day—the international day of remembrance for workers killed, disabled, injured, or made unwell by their work. This year’s memorial day was particularly poignant given the recent laws passed by the Newman government which limit safety checks and reduce workers’ compensation. Some 300 people attended a memorial ceremony at the Queensland Council of Union in Brisbane.

Forty-four Australians killed at work in 2014 Already this year to 7 April, 44 workers have been killed across Australia. Take a moment to consider this. Forty-four people who, like you, said goodbye to their loved ones at the start of a normal day, headed off to work, and never came home to their families and friends. It could be any of us. We owe it—to our families, our friends, our colleagues, and those of us who head off to work and never come home—not to allow this government to permanently weaken workplace health and safety laws.

Well worth looking into The reduction in the number of people developing and dying from gastrointestinal cancer is well worth the www.qnu.org.au

NEWS

MEMBERSHIP FEE CHANGES

2014-15 FEE SCHEDULE

To ensure the QNU remains the strong, vibrant and assertive organisation you need it to be, membership fees will rise slightly in July. We never take the decision to increase fees lightly, but it is critical we have the resources we need to protect members, be a strong voice for our patients, promote our profession and ensure nursing and midwifery remains at the heart of healthcare. QNU Council has endorsed a 2.5% fee rise effective from 1 July 2014. This is in addition to the $1 a week (or less) to establish our Nurse Power Fund which will support industrial and professional campaigning. The fee rise is less than expected because we have done a good deal of work making our systems and processes smarter and more effective. It is also less than the CPI rise which averages about 2.6-2.9%. As well as access to a wide range of professional and industrial support, your QNU membership includes professional

indemnity insurance cover (PII) which is a legal requirement for registration. And don’t forget—your union fees are fully tax deductible at tax time! If you have any queries you can contact QNU’s membership section on (07) 3840 1440 or toll-free outside Brisbane on 1800 177 273. NOTE: If you are a Public Sector member and are salary sacrificing your union fees, please advise Remserve of the new rates.

CLASSIFICATION

QNU Code

Yearly $

Half Yearly $

Monthly Fortnightly Direct Debit Direct Debit/ $ PRD* $

Registered Nurse/Midwife: over 24 hrs per week

R1/M1

638.70

319.36

53.23

24.56

Registered Nurse/Midwife: up to 24 hrs per week

R2/M2

479.00

239.50

39.92

18.43

Enrolled Nurse: over 24 hours per week

518.40

259.20

43.20

19.94

Enrolled Nurse: up to 24 hrs per week

388.80

194.40

32.40

14.95

Asst-in-Nursing: over 24 hours per week

452.60

226.30

37.72

17.41

Asst-in-Nursing: up to 24 hrs per week

339.40

169.71

28.28

13.05

Inactive members (non practising nurses only)

124.10

62.06

10.34

4.77

Nurses covered industrially by other unions

174.80

87.41

14.56

6.72

Unpaid supervised practice/refresher courses

174.80

87.41

14.56

6.72

Tertiary student working up to 16 hours per week as an AIN or PC

174.80

87.41

14.56

6.72

Fulltime University/TAFE students

62.50

31.25

5.21

n/a

* PRD for existing members only

DON’T FORGET: YOUR UNION FEES ARE FULLY TAX DEDUCTIBLE AT TAX TIME! For more information contact QNU’s membership section on 3840 1440 or toll free outside Brisbane on 1800 177 273 or email member@qnu.org.au www.qnu.org.au

JUNE 2014 | TQN | 17

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The QNU is in your corner  manipulating rosters (so as to

Worried bosses take aim at unions In the past two years we have seen an increasingly negative attitude towards workers’ rights at both a political and employer level. Some managers and employers, emboldened by anti-union legislation from the government and worried about the potential power of unions to keep employers to account, are using their positions to discourage union activism in the workplace. Using heavy handed tactics against unions and activists in the workplace, particularly in health facilities, is an attempt to undermine people who stand up for safe workloads, fatigue management and professional skill development—all of which are critical for patient safety. But we can certainly stand up against anti-union behaviour and it starts by knowing what this behaviour looks like. The QNU has noticed some recent examples of anti-union behaviour that we have taken up on behalf of members. These include:  engaging in one-on-one discussions (particularly on disciplinary matters, trying to deny your right to have a union observer present)  attempting to use performance management to intimidate 18 | TQN | JUNE 2014

disadvantage, make life difficult)  restricting access to union training  taking or threatening to take legal or disciplinary action for union activity. It is illegal for employers or managers to take ‘adverse action’ against an employee just because that employee has a workplace right or exercises a workplace right. Essentially a person has a workplace right if:  it is written in an award or enterprise agreement  they can undertake legal action about their workplace  they can make a complaint or inquiry about their employment through proper grievance processes. Adverse action can include:  sacking or refusing to employ someone because they belong to a union  altering an employee’s position to their disadvantage  discriminating between an activist and other employees. It is also perfectly legal for employees to:  organise union meetings  distribute union materials  represent the views of their union  seek union representation. Protecting the working rights of Queensland nurses and midwives is something the QNU does best, so it’s no surprise we take attacks on our ability to do this very seriously.

Earlier this year we ran a fantastic training course called Nurses and Midwives Unite! designed to help nurses and midwives identify and stand up against anti-union activity in the workplace. We are hoping to run a similar course in the first half of 2015. We also encourage you and your colleagues to report any anti-union behaviour or adverse action to your QNU Organiser so we can follow it up. You can also contact QNU Connect on 3099 3210 or tollfree outside Brisbane 1800 177 273.

Phew! Being a nurse or midwife can be exhausting—not just the demands of day-to-day work, but also the legal and registration requirements. It’s all part of being a professional— and so is knowing who you can call on for help when you need it. Just remember: don’t go it alone. The QNU has got your back.

www.qnu.org.au

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20 14

What does health gain and lose in the budget?

The QNU has sent a submission to Senate representatives urging them to reject the 2014 budget, particularly the GP copayment which will disadvantage vulnerable Australians. The budget cannot be implemented unless it passes the Senate.

BUDGET LOSERS

GP co-payment

 All Australians born after 1958 will

Patients can expect to make a contribution of at least $7 to the cost of most visits to the GP and out-ofhospital pathology and diagnostic imaging services. Each of these visits will cost $7—so a trip to your GP ($7) followed by a blood test ($7) and an x-ray ($7), then a return visit to the GP to get the results ($7) will cost a total of $28. Doctors will be offered an incentive to encourage them to charge Commonwealth concession card holders and children under 16 no more than the $7 contribution for the first 10 visits. After the first 10 visits, the doctor will be paid an incentive if they provide the service to the concessional patient for free. An internal government review has warned the $7 GP co-payment will strongly encourage corporate owners of medical services to maximise profits by unnecessarily referring patients to ‘in-house’ specialists for services they don’t need.

have to work until they are 70 before being eligible to receive a pension.

 Sick people will pay more for medicines and a $7 co-payment per visit to the GP. On the upside, if they are so poor they have a concession card and so sick they have to visit more than 10 times, they don’t have to pay for more than 10 visits.

 Young unemployed have to wait six months before they can get the dole, and can only receive a maximum of six months benefit for every 12 months they are out of work.

 Public health has lost $50 billion in new funding over eight years.

 Public schools have lost the funding they would have gained under the Gonski plan—around $30 billion.

 Public service will lose 16,500 employees.

 University students will have to pay higher fees.

 Disability pension holders will face eligibility checks under tighter qualification criteria.

 ABC and SBS lose 1% of their annual funding.

 The environment has had $1.3 billion slashed from renewables investment, the $2.55 billion commitment to the government’s ‘direct action policy’ will now be spread over 10 years instead of 4 years, and while $525 million has been given to the ‘Green Army’, $438 million has been slashed from Landcare. www.qnu.org.au

Fees for GP-type presentations at emergency departments States and territories will be permitted to charge a patient contribution for GP-type attendances at public hospital emergency departments.

Public hospital funding The government has stripped $80 billion out of the health budget over eight years. In 2014-15, the government will provide $14.8 billion to the states and territories for public hospitals. Commonwealth funding to public hospitals will increase every year but from 2017-18 the government will introduce revised funding arrangements that remove funding guarantees.

Drugs and medicines From 1 January 2015, patient contributions to PBS medicines will increase, with the concessional copayment increasing by 80c and the general co-payment increasing by $5. There will also be an increase in the number of prescriptions per patient before the PBS safety net thresholds are reached. JUNE 2014 | TQN | 19

NEWS

End of Medicare Locals From 1 July 2015, the government will establish new Primary Health Networks with a smaller number of local networks replacing Medicare Locals. The Primary Health Networks will have General Practice as the cornerstone and be clinically focused and responsible for ensuring that services across the primary, community and specialist sectors work together in patients’ interests. The government will also explore models of primary health care funding and coordinated delivery, including partnerships with private insurers.

End of payments The government will also reduce or terminate some Commonwealth payments including:  National Partnership Agreements on Preventive Health  Improving Public Hospital Services  and certain concessions for pensioners and seniors card holders. The states will be expected to continue contributing to these arrangements at their own expense.

Health agencies to close or merge The government will transfer to the Department of Health the essential functions of:  the Australian National Preventive Health Agency  Health Workforce Australia  and General Practice Education and Training Ltd with a view to closing these agencies. The functions of the Australian Organ and Tissue Donation and Transplantation Authority and the National Blood Authority will be merged with a view to establishing a new independent authority. The Private Health Insurance Ombudsman’s responsibilities will be transferred to the Office of the Commonwealth Ombudsman. The functions of the Private Health Insurance Administration Council will be transferred to the Australian Prudential Regulation Authority and the Department of Health with a view to closing the agency. Back office functions between the Department of Health and the Australian Sports Commission will be shared.

Aged care The $1.5 billion in funding intended for the aged care Workforce Supplement has been transferred to the general funding stream. This means residential and community care providers have received the increase without needing to sign enterprise agreements, or any other conditions. In addition, regional, rural and remote aged care providers will receive an additional $54 million over the next four years. The Payroll Tax Supplement paid to some residential care providers will be discontinued.

BUDGET WINNERS  While low and middle earners suffered permanent reductions to income, politicians took a 12 month ‘pay freeze’.

 Public school chaplains got a $245 million boost.

 High income earners keep huge tax breaks from negative gearing and superannuation contributions. On the other hand, those on incomes greater than $180,000 must pay a 2% debt levy for the next three years.

 Infrastructure receives $11.6 billion in funding for new projects.

 Mine-owners no longer have to pay the Minerals Resource Rent Tax.

 Medical research will receive the interest earned off a $20 billion ‘future fund’—although it is not clear which medical researchers will benefit.

Cancer screening In 2014-5 the government is providing $95.9 million to expand the National Bowel Cancer Screening Programme from 2015, to enable all Australians aged 50-74 to be offered free bowel cancer screening every two years. When fully implemented, over four million Australians will be invited to undertake screening annually and more than 12,000 suspected or confirmed cancers will be detected each year. 20 | TQN | JUNE 2014

www.qnu.org.au

NEWS

Who takes the biggest hit?

New health productivity and performance commission

Percentage change in disposable income after Federal Budget Percentage 0

-2

-4

-6

-8

-10

-12

-14

-16

-18

-20

On benefits

Single, 23, Newstart Lone parent, 1 child aged 3, Parenting Payment Single Lone parent, 1 child aged 6, Parenting Payment Single Lone parent, 1 child aged 8, Newstart

Low income

Lone parent, 1 child aged 3 (67% AWOTE) Lone parent, 1 child aged 6 (67% AWOTE) Lone parent, 1 child aged 8 (67% AWOTE)

During 2014-15, the government will work with states and territories to create a new health productivity and performance commission. Subject to consultation, the new commission would be formed by merging the functions of:  the Australian Commission on Safety and Quality in Health Care  the Australian Institute of Health and Welfare  the Independent Hospital Pricing Authority  the National Hospital Performance Authority  the National Health Funding Body  and the Administrator of the National Health Funding Pool.

Middle income

Single income couple, 2 children aged 3 & 6 (100% AWOTE) Single income couple, 2 children aged 6 & 9 (100% AWOTE) Dual income couple, 2 children aged 3 & 6 (100% & 33% AWOTE)

High income

Dual income couple, 3 children aged 3, 6 & 9 (100% & 33% AWOTE) Single person (300% AWOTE) Couple, no children (150% & 100% AWOTE)

Support for mental health programs In mental health, the government is providing $14.9 million to expand the headspace youth mental health network by 10 sites, taking it to 100 across Australia by 2015-16. The government will also support research into youth mental health through an $18 million investment in a National Centre of Excellence for Research into Youth Mental Health.

AWOTE: Average weekly ordinary time earnings for full-time employees. Projected to be $1583.30 per week in 2016-17. Source: https://crawford.anu.edu.au/sites/default/files/news/files/2014-05/sharing_the_budget_pain_background_note.pdf

Medical research

School sports

The government will establish a $20 billion capital-protected Medical Research Future Fund from 1 January 2015. The interest earned on the fund, amounting to an estimated $1 billion per year when fully mature, will support basic, applied and translational research in priority clinical areas. Initial funding will come from the 2014-15 health budget and funds left after winding up the Health and Hospitals Fund established under the previous government. An additional $200 million will be allocated to dementia research.

The government is providing $100 million for the Sporting Schools Initiative, encouraging school children to take part in sport-based physical activity before, during or after school. The funding will directly link schools with sporting clubs to assist them to run activities across 35 major sports such as football, netball, tennis and gymnastics.

www.qnu.org.au

Extra GP places The government will support training for up to 300 extra GPs a year by boosting GP training places from 1200 to 1500 places in 2015.

Extra nurse and allied health care scholarships The government will also train more nurses and allied health care workers by expanding the number of scholarships available, providing $13.4 million over three years to support about 500 more scholarships.

YOU CAN HELP The QNU has designed a lobbying kit to help you stand up for our health system and universal health care. To download the kit and for more information visit www.qnu.org. au/2014-fed-budget-cuts JUNE 2014 | TQN | 21

NEWS

Kellogg charged after locking 220 workers out of Memphis facility The US government has charged the wellknown breakfast cereal producer Kellogg with multiple and serious violations of federal law after the company locked out more than 220 workers from the Memphis facility in October last year. The workers were locked out after rejecting the company’s proposal that all newly-employed workers must be casuals with no guaranteed hours, and significantly lower pay and benefits. Kellogg factories have already been closed in Australia and Canada as the company shifts to a low-wage workforce. A complaint filed by the Bakery, Confectionary, Tobacco Workers and Grain Millers International Union (BCTGM), alleges Kellogg insisted the union bargain on and agree to changes to a contract that was still in effect. The complaint also alleges Kellogg threatened to lock out workers if the union did not agree to the changes. When the BCTGM resisted, Kellogg locked the workers out. BCTGM President David Durkee also criticised the company for conducting a ‘disingenuous and misleading public relations campaign’ around the EB negotiations. The BCTGM has released a series of powerful videos depicting Kellogg’s workers’ fight against the company’s rampant greed. The union has posted the videos at www.kellogggreed.com from where you can also send a message to the company.

Tennessee government caught trying to swap taxpayer money for anti-union deal The Tennessee government has been caught trying to persuade Volkswagen to reject unions with ‘financial incentives’ paid for with public money. Leaked documents suggest Tennessee Governor Republican Bill Haslam tried to give Volkswagen $300 million in public money in return for influence over Volkswagen’s approach to automaker unions. In 2011, Volkswagen opened a new facility in Chattanooga, Tennessee. In 2013, Volkswagen disclosed plans to expand production at their Chattanooga facility. The proposal was greatly welcomed by the Haslam administration, which offered $300 million in taxpayer funding for the project to proceed. However, Volkswagen also announced it was talking with the United Auto Workers union (UAW) to form a “worker’s council” on its Chattanooga plant operations. Rumours soon began to circulate the Haslam administration’s incentives were tied to Volkswagen rejecting the UAW.

The Haslam administration denied this was the case. However, leaked confidential documents state the $300 million in incentives “are subject to works council discussions between the State of Tennessee and VW being concluded to the satisfaction of the State of Tennessee”. As workers at Volkswagen prepared to vote whether to join UAW or not, the Haslam administration withdrew the incentive offer. In a letter to Volkswagen, Mr Haslam accused the company of “favouring the UAW”. Leaked emails show officials in the Haslam administration were in direct contact with anti-union organisers brought in to fight the UAW. The UAW has asked for new elections in Tennessee, on grounds the current political leaders have interfered in legal industrial arrangements. For the full report, visit www. newschannel5.com/story/25122909/ haslam-administration-linked-300moffer-to-vw-uaw-process

In January over 100 locked-out BCTGM workers from the Kellogg cereal plant marched with 1000 community members in Downtown Memphis in the annual Martin Luther King Day parade. Source: http://thegreenredshow.wordpress.com/

22 | TQN | JUNE 2014

www.qnu.org.au

NEWS

Blue Care case against AINs delayed There has been another delay in the long battle to have Blue Care personal carers correctly recognised as Assistants in Nursing. The five day trial of the QNU’s original request to have PCs recognised as AINs was scheduled for May. However, Blue Care arrived at the Fair Work Commission with a completely re-written submission, which outlined a different case to the one they presented in November last year. In addition to running a different case on why they want to replace AINs with PCs, Blue Care is also seeking to prevent a number of QNU witnesses from providing evidence. Although Blue Care has had the QNU witness statements for seven months, they waited until just before the hearing to complain. As the QNU barrister said, Blue Care had carried out “an old fashioned ambush”. The QNU declined to respond to Blue Care’s new argument without a chance to read the argument and prepare a proper response—especially since Blue Care had now placed much of our witness evidence in dispute. We were therefore left with no alternative but to postpone the hearing so we could properly prepare a response and potentially find more witnesses. The hearing will now take place in late August. All of the witnesses deserve thanks for their patience and determination. While waiting until August is not ideal, it is better than going into such an important case without being completely prepared. Approval of proposed Care and Support Agreement Blue Care has filed the proposed Blue Care/Wesley Mission Brisbane Care and Support Agreement with the Fair Work Commission for approval. www.qnu.org.au

The QNU is opposing the approval for several reasons. One of those reasons is that it lists nursing duties in the Personal Carers classification. It would also require support workers such as laundry workers, cleaners and even maintenance employees to assist in providing care to residents. This is completely unacceptable on several levels. First, these employees get paid even less than PCs. Second, they probably did not sign up to perform direct resident care. Blue Care is trying to get the lowest paid workers in its workforce to perform nursing duties instead of paying them as AINs.

According to the Aged Care Accreditation Agency, more than 82% of Blue Care residents are classified as high care. AINs have traditionally been employed in “nursing homes” where residents are high care—therefore Blue Care carers should be classified as AINs. PCs have traditionally been employed in low care hostels. If you are classified as a PC in Blue Care or Wesley Mission and are interested in being involved in our campaign to get you properly classified as an AIN, please contact lead QNU Organiser Bernie O’Connor in the Brisbane office on 3840 1444. JUNE 2014 | TQN | 23

NEWS

Mater Public nurses and midwives vote YES Following 18 months of extremely difficult enterprise bargaining Mater Public nurses and midwives have accepted the latest offer presented by Mater management. The accepted agreement was the fourth proposal put to nurses and midwives after Mater management continued to make substandard offers. Enterprise bargaining was extremely challenging in the face of Mater’s insistence on removing hard-won conditions from nurses and midwives—including professional development allowance. Mater nurses and midwives have done well to achieve the best offer within an enterprise bargaining system which bad employers can use to their employees’ disadvantage. Mater nurses and midwives, with the assistance of the QNU, pursued every possible avenue to improve the agreement, including protected industrial action and conciliation before the Fair Work Commission. In May, nurses and midwives made the final informed decision to accept the latest proposal. While the agreement does not secure all that Mater nurses and midwives deserve, it is an improvement on the other three offers rejected earlier. Once the agreement is approved by the Fair Work Commission nurses and midwives will receive back pay from May 2012. Some of the behaviour, attitudes, and tactics used by Mater against nurses, midwives, and the QNU during these negotiations have been deeply regrettable, and divergent from the mission and values Mater purports to uphold. Unfortunately, the current federal and state political environment has encouraged bad employers to make unwise decisions when negotiating enterprise agreements. This behaviour will not benefit employers in the long run. Throughout enterprise bargaining, the commitment, hard work, and endurance of Mater’s workplace representatives in pursuing a better deal for nurses and midwives was exemplary. Mater workplace representatives consistently represented nurses’ and midwives’ views to management, and pushed for an improved offer in the face of behaviour designed to intimidate. The improvements now secured in the agreement would have been impossible without the hard work of Rose Voyzey, Nicholas Croft, Angela Spencer, Kerry Robertson and Joan Macrow. Each of them deserves special thanks.

24 | TQN | JUNE 2014

www.qnu.org.au

FEATURE

An economy in crisis?

Over recent years, we’ve seen budgetary belt tightening across the globe. But is Australia’s situation really as dire as our governments would have us believe or is it scaremongering that will do us more harm than good?

www.qnu.org.au

The debate There is currently a high-profile debate raging in Australia about how best to deal with the aftermath of the Global Financial Crisis (GFC). We have the Queensland LNP government running a multi-million dollar advertising campaign trying to convince us to sell state assets to pay off debt. The federal Coalition government wants to abolish Medicare and free public hospitals, extend the retirement age, restrict pensions, cut the minimum wage, and the hit list on ordinary Australians goes on. Dollar numbers in the billions and trillions get thrown around like confetti. The reality is, like all debates, there are elements of truth on all sides. Australia and Queensland both have more government debt than they had prior to the GFC. It is not as high as other countries, and it’s certainly not out of control.

The current scaremongering While we should be careful and diligent, the state’s and nation’s financial situations are more than manageable. There is certainly no need to throw away important social gains such as universal health care—which actually started or were put in place in more challenging times than these—in a mad and unnecessary rush for budget surpluses. A budget surplus is the amount of money left over after a government has collected all its income and paid all its bills. A budget surplus should not be prioritised over the provision of great social support services, like public health care for all Australians. In the effort to achieve a budget surplus, it will be Australia’s most vulnerable citizens, such as the poor and the sick, as well as low income earners, families, and the elderly, who will be left behind. JUNE 2014 | TQN | 25

FEATURE

A lot of the current scaremongering comes from vested political and corporate interests, which want to get their hands on things like our public hospitals, other quality public assets and more of your money. Many in the corporate sector are also using the opportunity to try and force you to pay to access support services which should be free.

Learning from the past Australia, like other countries, had a choice to make when the Global Financial Crisis (GFC) hit a few years ago. Do we: ď&#x201A;§ repeat the mistakes of the 1930s Great Depression and throw hundreds of thousands out of work; or ď&#x201A;§ act quickly, as a nation, to protect as many jobs and family incomes as possible? Australia, again like most other countries, made the sensible decision

to avoid the harsh mistakes of the Great Depression, which destroyed large numbers of individuals, families and small businesses.

fair-minded local and international experts are pointing out. There is another important issue the scaremongers often fail to mention. If Australia had not acted to save jobs during the GFC, our current economic situation would be much worse. The bill for unemployment benefits and retraining would have gone through the roof as consumer spending and the number of people in paid work decreased, leading to a drastic drop in income tax and GST tax paid to the government. Besides, debt is a universally used economic tool to support the good of the nation. Just like many Australians take out a house mortgage with a view to achieving a better life, it is reasonable that our nation will have some level of debt in order to ensure no one gets left behind.

However, avoiding a repeat of those disastrous Great Depression days did cost money. The federal government introduced a $42 billion stimulus and spending package to get us through the GFC. The decisive action taken in Australia worked. In fact, Australia came out of the crisis much better than most other similar countries. Our national debt is lower than most other countries, as is our unemployment rate and budget deficit. This has not stopped some people, for political reasons or for personal business gain, trying to create the impression that Australia is in a financial mess. This is nonsense, as most

If Australia is in trouble then the rest of the world is doomed

(Source: Federal Budget 2013-14)

Net debt remains very low by international standards, with the average net debt position of the major advanced economies expected to be around 93 per cent of GDP in 2014.

Comparison of government net debt for selected economies 2012-2018 Per cent of GDP

Per cent of GDP

175

150

125

100

0 Australia

Euro area

Japan

UK Source: IMF Fiscal Monitor April 2013 and Treasury.

26 | TQN | JUNE 2014

www.qnu.org.au

FEATURE

The current sky-is-falling strategy is just not helping the economy, and is likely to haunt the Abbott government as plummeting consumer confidence translates into subdued economic activity and more tax revenue write downs. (Business Spectator, 8 May 2014)

constantly pointed this out during its recent, and very successful, campaign against Queensland public hospital privatisation. The US health system costs nearly twice as much to run as the Australian system does and tens of millions of Americans still miss out on quality health and hospital care. Superficially attractive arguments about “making the rich pay” are just the thin end of the wedge leading to massive increases in health costs for everyone and reductions in quality at the “charitable” end of the system. The QNU will confront these superficial cost arguments, which are simply distractions designed by corporate interests and their political supporters to introduce a “profits before patients” health system.

Wages and working conditions Where are we now? Queensland and Australia as a whole do have moderate budget deficits and more debt than they did prior to the Global Financial Crisis (GFC). This does not mean we are in a crisis. In fact, most countries have much higher deficits and debt than Australia. The GFC reduced the amount of revenue our governments collect, by many billions of dollars. A decline in tax collections is a key reason for our current national deficit and debt. As last year’s budget papers point out, if tax collections were at the same level as just before the GFC the federal budget would be at least $24 billion a year better off. While everyone, including the government, has to carefully manage expenditure when their income drops, the real challenge is to identify ways to increase income fairly and sustainably. The obsession, in some quarters, with the cost of the age pensions and public health services—both necessities—is diverting energy from the vital work of growing national and state income. We should demand our national leaders and our own local politicians put as much energy into growing the economy, industry and, as a consequence, national and state taxation income as they currently seem to be putting into cost cutting or GP and medication fee rises. www.qnu.org.au

There are also various tax options, such as the introduction of a ‘Robin Hood’ financial transactions tax on financial trading, which could raise billions of dollars annually and plug the current revenue hole. Importantly, the tax was recently implemented by the European Union. This type of fairer policy option, where the corporate sector shoulders more of the tax burden than families and pensioners, will be pursued by the QNU in its dealings with governments.

Health budgets One area always targeted by the scaremongers is health, especially universal health care for all Australians (Medicare)—a policy area important to nurses and midwives and, of course, their patients, clients and residents. It is again targeted in the federal Commission of Audit and the Abbott government’s first budget. Just remember that powerful vested interests have never been happy with a universal, government-funded health system like Medicare. They see it as a potential cash cow for their companies if only they could get fees and so-called co-payments introduced or increased and hospitals privatised. However, this “Americanisation” of our health and hospital system would be more expensive for individuals, families and society as a whole. The QNU

Whenever debates about the national finances occur Australia’s wage rates and working conditions always come up. Again it is mostly vested interests taking the chance to grab a bit more back from working people. Hard won conditions like penalty rates, annual leave and the minimum wage come under attack. We have heard it all before. We Australians are justifiably proud of our developed country, which has a history of fair and decent wages. We showed through the Your Rights at Work campaign that we will fight to protect these achievements.

No one should be left behind Australia’s (and Queensland’s) financial situation has, like other nations, been affected by the Global Financial Crisis. However, it is more than manageable than corporate interests and their political supporters would have us believe, and there certainly no need for the wholesale destruction of a fair society. Let’s work things through sensibly and, as we have done before, defend important achievements like Medicare and decent, secure jobs. Achievements left to us by our parents and grandparents that ensure no one gets left behind. Let’s also demand our political leaders get smarter about growing national income and revenue and stop the excessive emphasis on cost and job cutting. JUNE 2014 | TQN | 27

PROFESSIONAL

Standing up for somebody what is advocacy and why do we do it? Advocacy is at the core of our professional identity. It is the driving force of everything we do. Advocacy underpins our code of ethics, our conduct, and our decision-making. It is embedded in the laws and regulations which codify our profession (NMBA 2007). But exactly what is advocacy, and why is it so important to nursing and midwifery?

The origins of advocacy Our advocacy is tied to care. Traditionally, it has focused on the nurse or midwife’s actions on behalf of an individual in an environment where delivery of care is taking place. This was commonly described as “patient advocacy”. Sounds simple, right? However, as we all know from our dayto-day experience, advocating on behalf of one individual often requires actions that affect people beyond just that individual. So advocacy also forces us to consider our obligations to groups of people, even to communities and society more broadly. This is what we call “professional advocacy” (Grace 2001, Mahlin 2010). Advocating for both groups and individuals at once can be extremely complicated—but not necessarily incompatible.

Patient advocacy Nurses and midwives recognise a number of features of patient advocacy, namely that it:  relates to the individual patient or woman and infant, with the primary obligation of the nurse or midwife to the individual in day-to-day practice  is based on the concept of vulnerability and includes defending a patient’s rights and protecting patients from harm 28 | TQN | JUNE 2014

 relates also to ‘doing good’, including    

professional ethical decision making underpins codes of practice and the ethics of the professions recognises patient autonomy and participation in decisions about their health care requires us to challenge barriers in the system to address inequity and unfairness requires ‘working together’ with the patient and each other as colleagues.

Queensland nurses and midwives and patient advocacy Thanks to the foundational work undertaken by the QNU in the Nurses: Worth Looking After campaign (2006) and the Let’s Talk Nursing project (2008), we have a very clear idea of what Queensland nurses and midwives regard as the core values of nursing and midwifery. Those core values are caring, professionalism, holism and advocacy. It is upon these four domains that the QNU’s nursing and midwifery values are based.

Professional advocacy Professional advocacy focuses on the role of the nurse or midwife in the relationship between the recipient of care and the broader health system. Here, the nurse or midwife is the pivotal link who mediates the competing demands of the patient or woman and infant in the system (Volp 2006). Professional advocacy:  draws on the stated purpose of the profession  looks beyond the immediate practice environment

 aims to address the barriers in health care to enhance outcomes for patients and women and their babies  relies on collegiate collaboration and trust  protects the individual and the public—which may require us to report unprofessional practice  encompasses individual patient advocacy. To meet our professional obligations, nurses and midwives must advocate on behalf of individuals and the community, both locally and globally. Doing this effectively is one of the biggest professional challenges we face.

How do we meet the challenge of being effective advocates? It can be discouraging as an individual nurse or midwife to feel you are not acting effectively on behalf of your patients or mothers and their babies. While your intentions are good, you find you are blocked at every turn by ‘the powers that be’—bureaucracy and institutional barriers. By acting together we can achieve more effective advocacy. This is where the second branch of QNU values—union values—comes in. The QNU has a long history of advocacy: for patients, for mothers and their babies, for the broader community, for the health system, and for each other. The QNU’s union values of fairness, equality, opportunity, and collectivism, form a bedrock on which you can build your own patient and professional advocacy. From long experience, we know two of the key components of advocacy are collectivism and activism. www.qnu.org.au

PROFESSIONAL

else –

This is the power that comes from doing something together. As nurses and midwives our professional collectivism and activism must be:

 consistent with the NMBA’s professional standards  a daily expectation of our professional lives  essential if we are to take the lead and exercise power in health care decision making. We must all confront and embrace the challenge of building ‘collective advocacy to extend the reach of individual nurses to address systemic problems in healthcare and bureaucracies’ (Mahlin 2010). www.qnu.org.au

Professional development leave is your right

By working together as activists to address professional issues, Queensland nurses and midwives are leading the way in fulfilling this critical role.

References Grace PJ (2001) “Professional Advocacy: widening the scope of accountability”, Nursing Philosophy, vol 2, pp. 151-162. Mahlin M (2010) “Individual patient advocacy: Collective responsibility and activism within professional nursing associations”, Nursing Ethics, vol 17, pp. 247-254. Nursing and Midwifery Board of Australia (2007), Codes and guidelines. www.nursingmidwiferyboard.gov.au/CodesGuidelines-Statements.aspx Volp K (2006) “Respect, recognition, reward: defining nursing”, The Queensland Nurse, Queensland Nurses Union.

The QNU has received reports that some public sector nurses and midwives have been having difficulty accessing their professional development leave (PDL) for courses and conferences—including the QNU Annual Conference. PDL is provided for in the Nurses and Midwives (QH) Certified Agreement (EB8), Part 3 Employment Conditions, Clause 22. According to the Agreement, PDL for activities “relevant to nursing and midwifery practice” is an entitlement that “applies to all permanent enrolled nurses, registered nurses and midwives (Nurse Grade 3 and above) working 16 hours or more per fortnight.” The definition of professional development activities relevant to nursing and midwifery practice is extremely broad and can include matters related to industrial and professional practices, as there are significant overlaps in these areas. However we understand some managers are using all sorts of excuses to refuse PDL applications, sometimes incorrectly citing sections of the Queensland Health HR policy G15 on nurses and midwives PD entitlements. Professional development leave is an EB8 entitlement that provides a nurse or midwife with leave and an allowance to advance their interests as a professional. It is not for managers to tell a nurse or midwife what or where their interests might be. PDL is your right, your entitlement, and if you are being denied legitimate PDL—no matter what other clauses and policies managers may try to intimidate you with—you have grounds for a grievance. If you are having difficulty asserting your right to PDL contact QNU connect on 3099 3210 or 1800 177 273 (tollfree outside Brisbane) or your local organiser. JUNE 2014 | TQN | 29

NURSING AND MIDWIFERY RESEARCH

Minimising sacral pressure injuries Acutely and chronically ill hospitalised medical-surgical patients are at high risk of developing pressure injuries (PIs) during their admission.

This may lead to pain, complications, and prolonged length of stay at considerable cost to the patient, the health service and the wider community. In Queensland in 2011, the rate of hospitalacquired PI was 8.8%, increasing to 15.1% for patients with reduced mobility (Centre for Healthcare Improvement 2012). Although recent Australian cost data are not available, Graves, Birrell and Whitby (2005) predicted the cost of PI in public hospitals in 2001-02 was $285 million, with 398,000 bed days used. The federal government recently introduced a system of financial penalty for development of severe PI in hospitalised patients. Individual health services are penalised $30,000 for every stage 3 PI and $50,000 for every stage 4 PI (Queensland Health 2012). Prevention of PI therefore represents a state and national priority in terms of patient outcome and economic efficiency.

Prevention via prophylaxis

RACHEL WALKER (NHMRC Centre of Research Excellence in Nursing (NCREN), Griffith University) LEISA HUXLEY (Princess Alexandra Hospital) MELANIE JUTTNER (Princess Alexandra Hospital) LEANNE AITKEN (NHMRC Centre of Research Excellence in Nursing (NCREN), Griffith University and Princess Alexandra Hospital) 30 | TQN | JUNE 2014

The sacrum is identified as one of the most common sites for PI. Silicone foam boarder dressings have been proposed as one strategy to prevent sacral PIs. The use of these dressings in critical care and high dependency settings has resulted in a decrease in the incidence of PIs (Brindle & Wegelin 2012, Chaiken 2012, Santamaria et al. 2013, Walsh et al. 2012). However findings from published studies are inconsistent and we do not know if these apply to medical-surgical patients.

General medical-surgical focus This study will be the first conducted within a hospitalised general medical-surgical patient population. General medical-surgical contexts are quite different to critical care settings due to their high patient turnover and acuity. As a result, hospital-acquired PI in generalised health environments continues to challenge quality outcomes for patients and health

services (Allman, Goode, Burst, Bartolucci, & Thomas 1999, VanGilder, MacFarlane, Meyer, & Lachenbruch 2009).

Study aims While the overall outcome of the program of research is to reduce the prevalence and severity of PIs in high risk hospitalised patients, the specific aims of this pilot randomised controlled trial are to test feasibility in relation to study administration (recruitment, randomisation, retention, compliance, eligibility criteria, suitability of protocol instructions and data collection questionnaires), resource and data management (suitability of site, time and budget allocation, management of personnel and data), intervention fidelity (treatment dose, violations) and effect size (Lancaster, Dodd, & Williamson 2004, Leon, Davis, & Kraemer 2011, Thabane et al. 2010).

Intervention Eighty patients who are assessed as being high risk for PIs will be recruited in surgical and medical admission points in a large Queensland tertiary hospital. Consenting patients will be randomly allocated via a web-based computer-generated process to either a control group (routine care) or an intervention group (routine care and a sacral prophylactic dressing). At each 72 hour point following recruitment, de-identified high resolution digital photographs will be taken of each participantâ&#x20AC;&#x2122;s sacrum and emailed to a blind assessor for evaluation. The use of digital photography to assess PI represents a practical solution to the problem of blinding of the outcome assessor to reduce bias in the diagnosis and staging of PI (Baumgarten et al. 2009). Study progress will be reported in future editions tqn.

Acknowledgements We would like to thank the nursing leaders and clinicians in the participating wards, within the Divisions of Surgery and Medicine at the Princess Alexandra Hospital for their enthusiastic support for this study. www.qnu.org.au

NURSING AND MIDWIFERY RESEARCH

References Allman, R. M., Goode, P. S., Burst, N., Bartolucci, A. A., & Thomas, D. R. (1999). Pressure Ulcers, Hospital Complications, and Disease Severity: Impact on Hospital Costs and Length of Stay. Advances in Wound Care, 12(1), 22-30. Baumgarten, M., Margolis, D. J., Selekof, J. L., Moye, N., Jones, P. S., & Shardell, M. (2009). Validity of pressure ulcer diagnosis using digital photography. Wound Repair and Regeneration, 17(2), 287-290. Brindle, C. T., & Wegelin, J. A. (2012). Prophylactic Dressing Application to Reduce Pressure Ulcer Formation in Cardiac Surgery Patients. Journal of Wound Ostomy & Continence Nursing, 39(2), 133142. Centre for Healthcare Improvement. (2012). Statewide 2011 patient safety bedside audit report. Brisbane, QLD: Queensland Health. Chaiken, N. (2012). Reduction of Sacral Pressure Ulcers in the Intensive Care Unit Using a Silicone Border Foam Dressing. Journal of Wound Ostomy & Continence Nursing, 39(2), 143-145. Graves, N., Birrell, F. A., & Whitby, M. (2005). Modeling the economic losses from pressure ulcers among hospitalized patients in Australia. Wound

www.qnu.org.au

Repair and Regeneration, 13(5), 462-467. Lancaster, G. A., Dodd, S., & Williamson, P. R. (2004). Design and analysis of pilot studies: recommendations for good practice. Journal of Evaluation in Clinical Practice, 10(2), 307-312. Leon, A. C., Davis, L. L., & Kraemer, H. C. (2011). The role and interpretation of pilot studies in clinical research. Journal of Psychiatric Research, 45(5), 626-629. Queensland Health. (2012). 2012-2013 Queensland Hospital Admistted Patient Data Collection: Manual of instructions and procedures for the resporitng of QHAPDC data, Version 1. Brisbane, QLD: Queensland Government. Santamaria, N., Gerdtz, M., Sage, S., McCann, J., Freeman, A., Vassiliou, T., . . . Knott, J. (2013). A randomised controlled trial of the effectiveness of soft silicone multi-layered foam dressings in the prevention of sacral and heel pressure ulcers in trauma and critically ill patients: the border trial. International Wound Journal, n/a-n/a. Thabane, L., Ma, J., Chu, R., Cheng, J., Ismaila, A., Rios, L., Goldsmith, C. (2010). A tutorial on pilot studies: the what, why and how. BMC Medical Research Methodology, 10(1), 1.

VanGilder, C., MacFarlane, G., Meyer, S., & Lachenbruch, C. (2009). Body Mass Index, Weight, and Pressure Ulcer Prevalence: An Analysis of the 2006â&#x20AC;&#x201C;2007 International Pressure Ulcer Prevalenceâ&#x201E;˘ Surveys. Journal of Nursing Care Quality, 24, 127-135. Walsh, N. S., Blanck, A. W., Smith, L., Corss, M., Andersson, L., & Polito, C. (2012). Use of a Sacral Silicone Border Foam Dressing as One Component of a Pressure Ulcer Prevention Program in an Intensive Care Unit Setting. Journal of Wound Ostomy & Continence Nursing, 39(2), 146-149.

This study is funded by the NHMRC Centre of Research Excellence in Nursing and an Early Career Researcher Mentored Grant from the Centre from Health Practice Innovation, Griffith University. For more information on the NHMRC Centre of research Excellence in Nursing (NCREN) in Queensland visit www.griffith.edu.au/health/centreresearch-excellence-nursing

JUNE 2014 | TQN | 31

CONTINUING PROFESSIONAL DEVELOPMENT

C ASE S TU DY

A new regulatory framework for Queensland nurses and midwives

BY GEORGE SOUTHGATE, HALL PAYNE LAWYERS

This article will examine what Queensland nurses, midwives and unregulated health care workers can expect from the new health service complaints regime to be administered by the Queensland Health Ombudsman. It also considers what impact the relationship between the Australian Health Practitioner Regulation Agency (AHPRA) and the new Health Ombudsman may have on the regulatory framework for nurses and midwives.

The current regulatory framework for nurses and midwives The Health Practitioner Regulation National Law Act 2009 (the National Law) provides the legal framework for the regulation of health professionals including nurses and midwives. One objective of the National Law is to protect the public by only registering nurses and midwives who are suitably trained and qualified to practice in a competent and ethical manner. The National Law requires health practitioners, employers and education institutions to notify AHPRA if they suspect a breach in conduct, performance or health issues. Any restrictions AHPRA applies on the practice of a nurse or midwife must be imposed only if it is necessary to ensure health services are provided safely, ethically and with appropriate quality. Currently, AHPRA supports the Nursing and Midwifery Board of Australia (NMBA) to manage investigations into the professional conduct, performance and health of 32 | TQN | JUNE 2014

registered nurses and midwives in Queensland. Student nurses and midwives may also be subject to conduct and health processes by the NMBA. Until now, complaints or notifications about Queensland nurses and midwives could be made to either AHPRA or the Health Quality and Complaints Commission (HQCC).

The Health Ombudsman — a new regulatory framework On 1 July 2014, the office of the Queensland Health Ombudsman will come into effect under the Health Ombudsman Act 2013 (the Act). This will be a new era in health service complaints management in Queensland, including a revised regulatory framework for Queensland nurses and midwives. The Act will modify how the National Law operates in Queensland particularly in relation to the health, performance and conduct of nurses and midwives. The Act also establishes the position of Director of Proceedings, who will decide whether proceedings should be taken against nurses in the Queensland Civil and Administrative Tribunal (QCAT). Establishing the new complaints regime in Queensland has meant the state government must close the Health Quality and Complaints Commission on 30 June 2014. The functions of AHPRA and the NMBA will remain the same. However, there will be changes to the way complaints against nurses and midwives are received and administered.

From 1 July 2014, all health service complaints are to be received by the Health Ombudsman. Notifications will be treated as if they are a complaint to the Health Ombudsman.

The Health Ombudsman’s role Nurses and midwives The Health Ombudsman’s role will be to manage all serious allegations against Queensland nurses and midwives—specifically, matters where a nurse or midwife may have engaged in professional misconduct, or where a nurse or midwife’s registration may be suspended or cancelled.

Unregulated health care workers In a new development, the Health Ombudsman will also receive complaints about unregulated health care workers including Assistants in Nursing (AINs). This means that AINs will be exposed to actions being taken against them by the Health Ombudsman.

Complaints management Once the Health Ombudsman accepts a complaint, there are a number of actions that may follow, including referring the complaint to AHPRA. Note, however, it is not entirely clear which matters will be referred to AHPRA. The Health Ombudsman’s other powers are the same as the powers exercised by AHPRA and the HQCC. This includes:  assessing the complaint  taking immediate action (suspending registration or imposing conditions on registration)  investigating the complaint  conciliating the complaint. www.qnu.org.au

CONTINUING PROFESSIONAL DEVELOPMENT

Relationship between AHPRA and the Health Ombudsman Much has been made of the powers of the Health Ombudsman, particularly the power to take immediate action against nurses and midwives without having to conduct an investigation first. The Health Ombudsman will deal with serious allegations against Queensland nurses and midwives—but it remains unclear how. Similarly, the option for referral to AHPRA will remain, but the process for this is unclear. Allegations requiring immediate action relate to a nurse or midwife engaging in professional misconduct, or where a nurse or midwife’s registration may be suspended or cancelled. Matters for referral to AHPRA and the NMBA may include other competence issues. Although the Health Ombudsman’s office will soon commence operations, it remains unclear exactly how the interaction between AHPRA and the Health Ombudsman will work in practice. All will be revealed after the Health Ombudsman’s office opens in July this year.

What if you have a notification made against you? The QNU can advise and arrange representation by Hall Payne Lawyers for financial members on registration matters with AHPRA and complaints to the Ombudsman. Notify the QNU to request assistance and representation as soon as you are made aware of any complaint against you. Any delay in seeking legal representation from the QNU may prejudice your matter. www.qnu.org.au

Reflective exercise for case study over page »

JUNE 2014 | TQN | 33

CONTINUING PROFESSIONAL DEVELOPMENT

C ASE S TU DY

Reflective exercise:

A new regulatory framework for Queensland nurses and midwives 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 the possible impact of changes in legislation which will allow for the introduction of the Health Ombudsman in Queensland on your professional practice. The following questions are offered as a guide to assist you in identifying your learning from reading and analysing the content of the article. 1. What will be the relationship between AHPRA, the NMBA and the Health Ombudsman from 1 July 2014? 2. What action could the Health Ombudsman follow in relation to a health service complaint against a nurse, midwife or AINs? 3. What possible issues can you identity with the closure of the Health Quality Complaints Commission and the opening of the Health Ombudsman? 4. Provide an example: when do you think a complaint would be referred to the Health Ombudsman? 5. Provide an example: when do you think a complaint would be referred to AHPRA/ the NMBA by the Health Ombudsman? 6. Why should an Assistant in Nursing be aware of the legislative changes in the Health Ombudsman Bill 2013? 7. As a member of the QNU, describe when and why you would contact the QNU if you have been advised of a complaints matter against you?

Useful information can be found on the following websites or past editions of tqn: 1. The Health Ombudsman Bill 2013 www.legislation.qld.gov.au/Bills/54PDF/ 2013/HealthOmbudsmanB13.pdf

2. tqn December 2013—background and summary of the Ombudsman Bill 2013 (page 30) 3. The QNU provided a detailed submission regarding positive and negative aspects of the Health Ombudsman Bill 2013. This submission can be accessed on the QNU website under ‘Reports, submissions & Inquiries’ (or you can do a search on the website), or at www.qnu.org.au/_data/assets/pdf_ file/006/465594/Health-Ombudsman-BillQNU-submission.pdf 4. HQCC, quality in healthcare background information: www.hqcc.qld.gov.au/News/Pages/ Background-information.aspx Following reflection, consider how you will retain and share the new knowledge about the changes in legislation affecting reporting of complaints matters to the Health Ombudsman and AHPRA/NMBA. What influence will these changes have on your professional practice regarding complaints matters? 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):

34 | TQN | JUNE 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

HEALTH REFORM AND GOVERNANCE

Medicare Locals are gone – but can their benefits be replaced? The Medicare Locals project will come to an end next month after the Abbott government announced in May they would be transferred to a system of Primary Health Networks. Medicare Locals were established in 2011 to work with GPs and other primary health care providers to ensure all Australians, regardless of where they live, had access to effective primary health care services. The peak national body for Medicare Locals, the Australian Medicare Locals Alliance, will be dissolved on 1 July 2014. A small number of Medicare Locals will remain in operation but will be re-titled as Private Health Networks (PHNs). PHNs will commence operation from 1 July 2015. No firm number has yet been given but the QNU understands it is likely to be one rural PHN and one metro PHN per state, while territories will simply have one PHN overall. General practitioner involvement in PHNs will be increased. Interested parties will be invited to tender to run PHNs, which will not provide health services but rather will act as coordinator of services. Although still under development, Medicare Locals delivered significant benefit to local communities. Some examples of innovations and initiatives included:

Closing the Gap The Central and North West Queensland Medicare Local commenced Mount Isa’s Strong Mums Away From Home program in January 2014. This program provided support to mums from outlying indigenous communities, and linked them with the local maternity ward.

Developing links with Hospital and Health Services Metro North Medicare Local in Brisbane recruited nine General www.qnu.org.au

Practitioner Liaison Officers to improve communication between hospital outpatient services and primary care, and to explore ways to improve the patient journey.

After hours services The Central Queensland Medicare Local conducted after hours workshops for GPs and practice support personnel. The CQML then established the Emerald after hours service co-located at the Emerald Hospital. Five new after hours services were established in Gladstone, and 42 practices were scheduled to continue or expand current services.

Midwifery services The My Midwives Rural Outreach— Darling Downs service, with funding support from Darling Downs South West Queensland (DDSWQ) Medicare Local, launched a service offering women the opportunity to have continuity of midwifery care in rural areas.

Nurses in general practice Medicare Locals’ Nursing in General Practice Program offered significant support to build the capacity of practice nurses. The Australian Nursing and Midwifery Federation—your federal union—worked closely with Medicare Locals on a range of projects in the program, particularly the development of resources for publication and education workshops.

QNU workshops The ANMF and the QNU also participated in a number of workshops through Medicare Locals, offering advice to practice nurses involved in leadership

demonstration projects and clinic demonstration projects. Participants in these workshops confirmed the critical role nurses and midwives play as advocates and explored opportunities to exercise power as professionals to influence heath care decision making. Nurses and midwives were also able to gain a better understanding of the role the QNU plays in drawing nurses and midwives together as a collective force for the benefit of the community as well as our professions.

Can PHNs do the job? Clearly, in the 18 months they were in operation Medicare Locals delivered identifiable benefits to the community. Medicare Locals also provided nurses and midwives opportunities for professional development, including improved workforce planning, and scope for innovative service models. Whether PHNs can deliver benefits equal to or better than Medicare Locals remains to be seen. JUNE 2014 | TQN | 35

INDUSTRIAL

AN EPIC JOURNEY:

MERCY CQ NURSES SECURE NEW AGREEMENT

Great wins for Far North Queensland

36 | TQN | JUNE 2014

Mercy CQ acute nurses finally have a new agreement after an epic 6 year campaign to secure a new deal. Way back under John Howard’s prime ministership, Mercy CQ acute nurses were some of the unfortunate few to find themselves on a Workchoices agreement. That agreement expired in 2008. It is reasonable to think a new agreement would be signed quickly—but it was July 2013 before Mercy CQ put a proposal to ballot. The proposal was so poor only around 10% of nurses even bothered to vote. Those that did voted it down. This meant nurses at Mercy CQ remained stuck on the Workchoices-era agreement. The QNU compared the agreement to the Nurses Award 2010—the bare minimum wages and conditions for nurses and midwives. About 19 conditions in the award were significantly better than the 2005 agreement, including:  an extra week’s annual leave  200% (rather than 150%) public holidays penalty  2% higher casual loading  $182 per year more uniform and laundry allowance. After consulting with Mercy CQ nurses, the QNU lodged an application with the Fair Work Commission to terminate the 2005 agreement. Mercy CQ quickly agreed to raise most of the conditions up to the award level. In February 2014, the much improved proposed agreement was voted up by 282 nurses and midwives to 10.

here have been some great wins for nurses and midwives in Far North Queensland in the past couple of months. A QNU member in a small public health facility in North Queensland had been fighting for nearly six years to be paid properly after missing out on 10 hour breaks between shifts. The member was seeking payment for about 40 incidents dating back to 2004. In 2009 the member began collecting shift data from the relevant rosters and lodged a claim. But when the payroll debacle started wreaking havoc with pay-packets in 2010, the claim was significantly delayed.

However, the new agreement still contained a number of conditions worse than the award. The Fair Work Commission, which approves all agreements, will not approve an agreement which is worse than the award. After the QNU took Mercy CQ to the commission in two occasions, Mercy CQ finally gave 11 undertakings, including:  abolition of trainee provision including base rates as low as $10.69 per hour  the agreement cannot be undermined by any other agreement (individual or collective)  employees are allowed representation at all stages of the grievance procedure  ordinary hours limited to 76 per fortnight  untaken ADOs paid out on termination  recognition of all previous service for existing employees for paypoint progression  a 10 hour break following all shifts (including 10 hour shifts)  payment of 76c per km for all work use of a private vehicle (not just on recalls)  no debiting of TOIL annual leave balances for the same period  entitlement to meal break  and others. The agreement was approved by the commission on 24 April 2014. Congratulations to Mercy CQ nurses— for their new agreement, and on their admirable patience!

When the payout did come, it was wrong— just $600, well below what was owed. But in good news out of the north this month, this member has finally received the correct sum.

Bluecare AIN also had a fantastic win after being paid at the wrong pay-grade for more than two years. The nurse was recently awarded about $9000 in adjusted pay. These victories are just two more reasons why it pays to be a QNU member and have someone in your corner to ensure you are paid correctly. www.qnu.org.au

INDUSTRIAL

AWARD MODERNISATION UPDATE The Queensland government is currently ‘modernising’ the state’s industrial relations framework, which in simple terms means Queensland Health nurses and midwives will soon have a new—and perhaps drastically reduced—award for their minimum workplace conditions. Our concern is to ensure that ‘award modernisation’ is not just an excuse to strip you of long standing award conditions forever. Minister guarantees no disadvantage

Workloads and safe professional practice

The QNU has secured a written guarantee from the Queensland Health Minister that no employee will be financially disadvantaged as a result of the award modernisation process. The guarantee was received after several meetings and written requests from the QNU. A copy of the Minister’s letter of 13 May is available on the QNU website www.qnu.org.au/modernisation2014 (members only).

The critical issue underpinning nursing and midwifery workloads is the professional obligation to practice in a safe manner. This obligation extends to themselves as well as the patients they care for. Indeed, in modernising the award the Queensland Industrial Relations Commission (QIRC) must consider the safety, health and welfare of employees. QIRC must also consider the public interest, which includes the impact on the community. This means the safety of persons in the care of nurses and midwives must be considered. To ensure nurses and midwives can fulfil the obligation to practice safely, the QNU has suggested a new clause on safe professional practice be included in the modern award. This new clause would ensure a structure around safe professional practice that supports the professional judgement of nurses and midwives. This is essential, as we know policies and directives can be changed in the future.

Workload management is here to stay The QNU also raised with the Minister our concern the legislation prevents workload management provisions from being included in a modern award. This could prevent the Business Planning Framework (BPF) from remaining in your award. The Minister’s position is that the BPF is “one of the many success stories across Queensland Health”. He has formally acknowledged the BPF is a framework he will guarantee, and has advised the QNU he is happy to secure its future through policy or Ministerial directive. www.qnu.org.au

Extension on deadline The deadline for finalising the modern award has been extended to 31 August

2014 by the Attorney General and Minister for Justice. The revised deadline has changed the priority of health awards to be completed. Health awards to be completed by 31 August 2014 now include:  Nurses and midwives  Medical officers  Health professionals (including dentists and health practitioners) The Minister’s request has moved the deadline for hospital and health service employees covered by the District Health Service Award - 2012 (predominantly admin and operational staff ) to 30 April 2015. The expiry date for the enterprise agreement covering these employees is 31 August 2014—meaning there agreement will be extended by regulation as it is not possible to negotiate a new agreement without a modern award being place. Members can access the full raft of material on award modernisation at www.qnu.org.au/modernisation2014 (members only). At the time of going to print we are yet to receive an exposure draft of the modernised award, though this will be made available to members as soon as it is released. JUNE 2014 | TQN | 37

MIDWIFERY

The world needs midwives today: International Day of the Midwife On 5 May—International Day of the Midwife—the QNU hosted a workshop in Brisbane to celebrate advances made by Queensland midwives and to develop the Queensland Midwifery Action Plan. Representatives from the QNU, the Midwifery Reference Group, the Australian College of Midwifes, the Maternity Coalition and Queensland Health participated in the workshop.

Key priorities Continuity of care models The workshop identified that prior to any implementation of a model, targets and plans must be robust and measurable, and must meet the expectations of midwives, women and families, the local community, the government, the Nursing and Midwifery Board of Australia, and the Hospital and Health Services. Participants agreed to plan a forum for midwives focusing on Midwifery Group Practices and other continuity of care models to engage clinicians and reenergise them in taking on the risks and barriers in midwifery. We must ensure continuity of care is recognised as an integral model that provides choice and access to women.

Increase the number of public sector facilities implementing continuity of care The workshop identified the importance of engaging the key stakeholders in each facility and Hospital and Health Service (HHS) to increase the number of continuity of care models. We must also develop a policy which can be applied across each HHS, which includes any localised considerations, and which provides supporting evidence.

Identify the current process of the eligibility status of midwives The workshop identified the need to develop a framework which identifies 38 | TQN | JUNE 2014

Participants at the QNU International Day of the Midwife workshop.

the key organisations involved in determining the eligibility status of midwives. By doing this, we can focus on the critical stakeholders to ensure it is the midwifery profession who determines the eligibility status of midwives. The current determination process is complex and includes organisations such as ANMAC, the NMBA, AHPRA and other government agencies. While midwifery organisations like the Australian Nursing and Midwifery Federation and the Australian College of Midwives are consulted, they are not decision-makers. Together with this framework, a position paper will be developed that clearly articulates why midwives must determine the standards and criteria for midwife eligibility status. Currently the basis for eligible midwives is working as a midwife for three years— but there is no objective reason for this.

Identify funding mechanisms and other barriers The workshop identified Medicare funding related to private practice midwives as the key funding mechanism preventing the development of midwifeled models.

Other barriers include workload management issues, and lack of engagement from HHS Board members. Collaborative work—with the Midwifery Reference Group, our internal stakeholders, and other key groups—is the key to overcoming these barriers.

Future priorities Priorities for developing midwifery in Queensland Health through the Queensland Midwifery Action Plan include: 1. Further work on communicating clear and unambiguous definitions. What are continuity of care and primary development models? 2. Develop a communication strategy on materials for nurses and midwives, the community and politicians. Midwifery-led models must be included in the review of the Clinical Service Capability Framework. 3. We must develop the local evidence base for midwife-led models, including a data set and a robust key performance indicator framework. Overall, the workshop was a great opportunity to take stock of our situation, celebrate midwives and midwifery, and ensure we are on the right track for the future. www.qnu.org.au

HEALTH AND SAFETY

Changes to federal workers’ compensation could place you at risk As if the Newman government’s changes to workers’ compensation were not bad enough, things may soon get worse for some Queensland nurses and midwives. The Abbott government introduced a bill to parliament in March this year containing changes to the federal workers’ compensation system. These changes make it much easier for all national employers—including health employers—to move from state-based workers’ compensation schemes to the Commonwealth scheme, Comcare. This change is a serious risk to your workers’ compensation for a number of reasons, as compared to Queensland, Comcare has:  extremely limited common law entitlements, which severely restrict your ability to sue a negligent employer if you are injured and thereby secure your financial livelihood  inferior coverage of injuries sustained travelling to and from work and  historically poorer return-to-work outcomes.

If lots of large employers left the state scheme, the state-based insurer’s financial position could be significantly weakened, leaving it vulnerable to further adverse changes in the future. Worse, when an employer moves from the state-based workers’ compensation scheme, appropriate health and safety protections are lost because the employer is covered by a scheme that was not designed for nurses and midwives. Comcare was designed primarily for public servants. Public servants are exposed to an entirely different set of health and safety risks than nurses and midwives. In particular, as many of us know all too well, nurses and midwives are a particularly high risk for musculoskeletal injury. The previous federal government had effectively stopped national employers jumping across to Comcare by placing a moratorium on granting any further self-insurance licenses. The Abbott government’s changes by comparison roll it all back—and that’s not good news for nurses and midwives.

What can you do? Contact your federal member of parliament and email them to express your concern over the bill, and that you do not support these changes to workers’ compensation and will not support a politician who endorses them. You can find out who your federal member of parliament is at www.aph.gov.au www.qnu.org.au

MEMBERS IN MANAGEMENT What to do when the inspector calls Among the many responsibilities of nursing managers, obligations when a Workplace Health and Safety (WPHS) Queensland inspector enters the workplace are amongst the least understood. WPHS inspectors have significant power at their disposal, including an ability to conduct a workplace investigation if they so desire. These powers give them the right to interview people in the workplace, take measurements and photos, require the presentation of documents, take affidavits, remove samples, require a person to answer questions, and more. Members in management positions should be aware inspectors are required to notify the employer or the “most senior management person onsite” when they arrive. Often this will be a senior nurse. You must give reasonable help to the inspector when exercising their powers, unless you have a reasonable excuse—this requirement also extends to your colleagues. Those individuals who do not assist the inspector could face fines as well as possible sanctions from their employer. A full list of the inspector’s powers can be found at http://www.deir.qld.gov. au/workplace/law/compliance/workinspections/index.html An example of a reasonable excuse as to why you are unable to immediately assist the inspector could be an emergent clinical issue requiring your attention. You should make this known to the inspector if you are the “most senior management person onsite” at the time, and negotiate a suitable compromise. The QNU understands nurses and midwives at various workplaces have not always been given adequate information by their employer—so be sure to make yourself aware of your obligations, including to staff. If a WPHS inspector arrives and you are unsure how to proceed, notify your employer in the first instance, and always remember you can call the QNU if you still have concerns. JUNE 2014 | TQN | 39

SOCIAL

THE CRUELEST CUT OF ALL Amid the outrage over a savage federal budget for a false economic crisis, the largest single cut seems to have gone almost unnoticed. The Abbott government is stripping $7.6 billion out of the foreign aid budget over five years by freezing funding at its current levels. Previously, foreign aid was always determined as a percentage of Gross National Income (GNI). After 2016-2017, it will increase in line with inflation. Currently, the foreign aid budget is 0.33% of GNI. By 2017-18, it will be cut to 0.29% of GNI.

What’s the point of foreign aid anyway? Foreign aid has long been given a number of different interpretations. The most obvious explanation is a desire by a wealthier country to help alleviate and hopefully eradicate poverty from a poorer nation. Others suggest it is a way of ‘buying influence’ either in the countries receiving the aid, or with the broader global community by being perceived as a ‘good global citizen’. Yet others say it is an investment to reduce the chances we will have to pay more in the long run—for example, by helping impoverished countries protect themselves against natural disaster, or reducing the economic factors which can encourage terrorism or lawlessness. There are elements of truth to all of these explanations. Australia has historically been a generous donor, but that has changed in recent years.

But why should we sacrifice our own economic well-being for foreigners—especially when we have a budget crisis? First, we don’t have a budget crisis. As the feature of this edition makes clear, the idea our national economy is in danger is both ludicrous and dangerous, and has been manufactured for political reasons. Second, the amount of foreign aid given by Australia is a microscopic part of our national income—less than 0.5%. The idea that somehow we can improve our economic position by cutting our aid levels of 0.33% down to 0.29% of our national income is ridiculous. What isn’t ridiculous is the difference that remaining 0.04% makes to people who are trying to survive on less than $2 a day. So maintaining—or even increasing—our current foreign aid contributions won’t affect the well-being of our national economy, and we can certainly afford it.

But how do we know the money is helping, and not simply filling the pockets of corrupt politicians? This was precisely the finding of the Australian government’s 2011 Independent Review of Aid Effectiveness— that while foreign aid could alleviate poverty, it wasn’t always spent as effectively as it could be. Unsurprisingly, the feature missing from ensuring foreign aid was spent with maximum effectiveness was appropriate government oversight. That’s right—the independent report found the key reason aid might not be spent effectively is because Australian governments can’t be bothered. The report attributed:  lack of a unified sense of strategic purpose across government  the need to reform the government’s budget processes  the dangers of fragmentation and stretching the program too thin  and the need for greater public involvement and transparency. That’s why cutting $7.6 billion is a copout. The federal government simply didn’t want to do the hard work to set up appropriate governance and accountability measures.

Cuts condemn millions in Asia-Pacific The Asia-Pacific region is home to the largest number of people suffering food shortages in the world. It is also particularly vulnerable to the devastating natural disasters which come with climate change. The cuts also mean Australia has abandoned its commitment to the Millenium Development Goals, which include eradicating extreme poverty and hunger, achieving universal primary education, and combating HIV/AIDS, malaria, and other diseases. The QNU has been a strong supporter of the Millenium Development Goals, particularly to reduce child mortality and improve maternal health.

How to be a winner? Open a detention centre One of the few foreign beneficiaries of the federal budget is Papua New Guinea, which will receive an increase in aid for hosting the Manus Island detention centre. Sadly, human misery has a long history of being a money-spinner. With this federal budget, the Abbott government has shown it will gladly pay so somebody else can deal with the misfortune of others.

An Australian helicopter drops off aid to a remote town outside Banda Aceh, Indonesia after the tsunami in 2005. © Commonwealth of Australia 2014

40 | TQN | JUNE 2014

www.qnu.org.au

YOUR LIBRARY

Give your studies a boost with eBooks QNU members now have access to nursing eBooks online through the QNU library. So far the library has three popular texts available as eBooks: Potter and Perry’s Fundamentals of Nursing, Tabbners Nursing Care 5E and Understanding Pathophysiology. In their hardcover form, these three books—which are expected reading for a number of nursing courses—can cost hundreds to purchase and are heavy to carry. But now you can view them in their entirety as eBooks on your desktop computer, laptop tablet or iPad. “Two members can access any of these books electronically at the same time,” librarian Pat Vincent said. “This effectively doubles our loaning capacity for these important texts which is great news for students and indeed any member who wants to read them.” Traditional hardcopies are still available in the library. The library is keen to expand its eBook collection and is currently searching for books that are common to most Queensland nursing curricula. If you would like to ‘borrow’ an eBook or have suggestions for eBooks the library might acquire, phone the library on 3840 1480 or 3840 1443 or email library@qnu.org.au.

NORMAL LIBRARY HOURS Monday, Wednesday, Friday 8.30am–2.30pm Tuesday, Thursday 9am–4pm 07 3840 1480 library@qnu.org.au www.qnu.org.au Small groups can book the library for study sessions. Contact the library for details.

The QNU’s friendly librarians Madeleine (left) and Pat. www.qnu.org.au

JUNE 2014 | TQN | 41

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

JUNE World Day Against Child Labour 12 June 2014 Lung Health Promotion Centre at The Alfred 18 June, Asthma Management Update 19-20 June, Spirometry Principles & Practice 25 June, Paediatric Respiratory Update Ph: (03) 9076 2382 Email: lunghealth@alfred.org.au Drug and Alcohol Nurses of Australasia (DANA) Conference 2014 Speak Up 18 - 20 June 2014, Sydney www.danaconference.com.au World Refugee Day 20 June 2014 2nd Annual Worldwide Nursing Conference Health Disparities 23-24 June, Singapore www.nursing-conf.org/

JULY Naidoc Week 6 - 13 July 2014 Lung Health Promotion Centre at The Alfred 15 July, Educating & Presenting With Confidence 16-18 July, Asthma Educator’s Course 24-25 July, Smoking Cessation Facilitator’s Course 30–31 July, Creative Behaviour Change Coaching For Chronic Illness Ph: (03) 9076 2382 Email: lunghealth@alfred.org.au

AUGUST International Day of the World’s Indigenous People 9 August Lung Health Promotion Centre at The Alfred 18-19 August, Spirometry Principles & Practice Ph: (03) 9076 2382 Email: lunghealth@alfred.org.au 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 Community Health Nurses Western Australian Conference No man is an Island 22-24 August 2014, Rottnest Island, WA http://chnwa2014.iceaustralia.com/ 15th International Mental Health Conference Mental Health: Innovation | Integration | Early Intervention 25-26 August, Surfers Paradise www.anzmh.asn.au/conference/ 15th International Mental Health Conference 25-27 August, Gold Coast http://anzmh.asn.au/

QNU Annual Conference 16 – 18 July, Brisbane

APNA Continuing Education for Nurses in General Practice 29-30 August, Townsville www.apna.asn.au/nigp

AIDS2014 Conference - Nursing Welcome Reception 19 July, 5-7:30pm, Melbourne. Email: emily.wheeler@ashm.org.au or call (03) 9341 5244 http://www.aids2014.org/

15th Asia-Pacific Prostate Cancer Conference Together in discovery and care 31 August - 2 September, Melbourne http://prostatecancerconference. org.au/

Cancer Nurses Society of Australia 17th Annual Winter Congress Cancer Nursing: Leading in a time of change 24-26 July, Melbourne http://cnsa.org.au/professionaldevelopment/national-conferences. html APNA Continuing Education for Nurses in General Practice 25 – 26 July, Brisbane www.apna.asn.au/nigp

42 | TQN | JUNE 2014

SEPTEMBER 9th National Conference of the Australian College of Nurse Practitioners New Frontiers – Building future generation 2-4 September 2014, Sydney http://acnp.org.au/events/15

Lung Health Promotion Centre at The Alfred 3–5 September / 15 – 16 October, Respiratory Course 3–5 September, Respiratory Course (Module A) Ph: (03) 9076 2382 Email: lunghealth@alfred.org.au 18th International Conference on Cancer Nursing 7-11 September, Panama City http://chnwa2014.iceaustralia.com/ International Literacy Day 8 September QNU Meeting of Delegates 8 September, Brisbane 10 September, Gold Coast 16 September, Toowoomba 18 September, Sunshine Coast 23 September, Rockhampton 24 September, Mackay 30 September, Bundaberg 18th International Conference on Cancer Nursing 7-11 September, Panama City www.isncc.org/?page=18th_ICCN 3rd World Congress of Clinical Safety (3WCCS) Clinical Risk Management 10-12 September, Madrid, Spain www.iarmm.org/3WCCS/ Nurses For Nurses Network 2014 Annual Conference Practice Innovation in a Contemporary Nursing Landscape 20-27 September, Norwegian Jade, Departing Venice, Italy http://cpdcruises.com.au/ conferences/Nurses-for-Nurses-2014Annual-Conference/ CATSINaM 16th National Conference Embrace the difference within our people 23-25 September 2014, Perth http://catsin.org.au/

OCTOBER QNU Meeting of Delegates 1 October, Hervey Bay 8 October, Townsville 9 October, Cairns International Day of Older Persons 1 October Mental Health Week 5-12 October

Lung Health Promotion Centre at The Alfred 15–16 October, Respiratory Course (Module B) 23–24 October, Managing COPD 27-28 October, Spirometry Principles & Practice Ph: (03) 9076 2382 Email: lunghealth@alfred.org.au Safe Work Australia Week 27 October-2 November QNU Professional Symposium 30-31 October 2014, Brisbane

NOVEMBER Australian College of Nursing National Nursing Forum 2-4 November, Adelaide www.acn.edu.au/forum The National Primary Health Care (NPHC) Conference 5-7 November, Canberra http://amlalliance.com.au/events/ national-primary-health-careconference-2014 Lung Health Promotion Centre at The Alfred 11 November, Educating & Presenting With Confidence 12-14 November, Asthma Educator’s Course 20-21 November, Smoking Cessation Facilitator’s Course Ph: (03) 9076 2382 Email: lunghealth@alfred.org.au International Day of Tolerance 16 November 2nd International Conference on Nursing & Healthcare Exploring the Possibilities towards Better Healthcare 17-19 November, Chicago, USA http://nursing2014.conferenceseries. net Universal Children’s Day 20 November International Day of the Elimination of Violence Against Women 25 November The Emerging Face of Midwifery Education & Research Conference 28 November, Darwin Email: arminda@dreamedia.com.au

DECEMBER

World Mental Health Day 10 October

World Aids Day 1 December

National Indigenous Mens Conference 13-15 October, Cairns www.indigenousconferences.com

International Day for People with a Disability 3 December Human Rights Day 10 December

www.qnu.org.au

YOUR SUPER

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 $27 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

There’s romance in retirement Superannuation may not seem like most romantic topic, but when it comes time to retire you want to know that you have done everything to help secure a solid retirement for both you and your spouse. As one of Queensland’s largest superannuation funds QSuper wants to make sure we do everything we can to help our members have a great retirement. Our members appreciate our low fees, solid returns1, access to personal financial advice and our seminar program, and we think their spouses will enjoy these benefits too. Any QSuper member can open an accumulation account for their spouse2, even if they’ve never worked for Queensland Government. QSuper accepts contributions from both Queensland Government and non-Queensland Government employers, so members’ spouses can have their current employer contribute to their new QSuper account. While it may not be the most extravagant gift for your special someone, there definitely is some romance in planning a great retirement with your spouse. Members can find out more by visiting qsuper.qld.gov.au or calling 1300 360 750.

1. Past performance is not a reliable indicator of future performance. 2. Subject to eligibility, please refer to the Accumulation Account Product Disclosure Statement available at www.qsuper.qld.gov.au or by calling 1300 360 750 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). All products are issued by the QSuper Board as trustee for the QSuper Fund. This information has been prepared for general purposes only without taking into account your objectives, financial situation, or needs. Consider whether the product is appropriate for you and read the product disclosure statement (PDS) before making a decision. You can download the PDS from our website at qsuper.qld.gov.au, or call us on 1300 360 750 and we’ll send you a copy. © QSuper Board of Trustees 2014

JUNE 2014 | TQN | 43

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JUNE 2014 | TQN | 45

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ME Bank’s relationship with the National Breast Cancer Foundation (NBCF) began in 2005 with its inaugural sponsorship of the Women in Super Mother’s Day Classic. Nine years on, we’re proud of our ongoing support, raising funds for research for breast cancer prevention and cure. Our support of NBCF extended to the launch of the PINK Debit MasterCard® in May 2011. Each time a purchase is made using the card, ME Bank donates 1 cent to NBCF research projects. Through this card, our ongoing sponsorship of the Mother’s Day Classic and other fundraising initiatives, ME Bank has donated more than $300,000 to NBCF research since 2011.

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For a super outcome, rely on experience. At QSuper we have been looking after our members’ futures for more than 100 years. Now, as one of Australia’s largest super funds, we manage more than $43 billion for over 530,000 members. And with some of the lowest fees and proven solid returns1, it’s easy to see why QSuper adds up.

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UPDATE YOUR OWN DETAILS AND MORE, MUCH MORE! The QNU has changed the way you update your details with the launch of an exciting new portal called MEMBERLINK. Through MEMBERLINK, as a financial member you will be able to: update your own details pay fees update your password (choose your own) print tax statements for the last three financial years

request a new membership card print your own PII letter, and contact either the Membership section, QNU Connect or send an email to our general email address.

To access MEMBERLINK visit https://member.qnu.org.au/