TQN Vol33 [5] Oct14

VOL. 33 | NO. 5 | OCTOBER 2014

THE QUEENSLAND NURSE

YOUR ENTITLEMENT TOOLKIT

2014 winners, left to right: Zoe Sabri, Stephen Brown and Jeanine Young representing the Pepi-pod速 Program.

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Recognise their outstanding leadership and innovation by nominating them in one of three categories: Nurse of the Year Team Innovation Outstanding Graduate

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hestaawards.com.au Issued by H.E.S.T. Australia Ltd ABN 66 006 818 695 AFSL No. 235249 Trustee of Health Employees Superannuation Trust Australia (HESTA) ABN 64 971 749 321. Terms and conditions apply. See hestanursingawards.com for details.

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. 5 | OCTOBER 2014

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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 Your entitlement toolkit

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Cairns Suite 2, 320 Sheridan St, North Cairns Q 4870 (PO Box 846N, North Cairns Q 4870) T 07 4031 4466 F 07 4051 6222 E qnucairns@qnu.org.au DISCLAIMER Statements expressed in articles in The Queensland Nurse are those of the contributor and do not necessarily reflect the policy of the Queensland Nurses’ Union unless this is so stated. Copyright of articles remains with the contributor and may not be reproduced without permission.

Statements of facts are believed to be true but no responsibility for inaccuracy can be accepted. Other material may be reproduced only by written arrangement with the Union.

Although all accepted advertising material is expected to conform to the QNU’s ethical standards, such acceptance does not imply endorsement.

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

www.qnu.org.au

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Your union Editorial Your say Tea room Local news

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Feature

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Social

Professional

35

Opinion

Nursing and midwifery research

36

Profile

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Midwifery

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Library

Continuing professional development

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Calendar

Health and safety

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Your super

Industrial

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National news International news Campaign news

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OCTOBER 2014 | TQN | 1

YOUR UNION

Do you belong to a Local Branch?

SALLY-ANNE JONES, QNU PRESIDENT

One of the QNU structures that connects strategic union activities to each and every one of us in a real and personal way is the Local Branch.

YOUR COUNCIL

In consultation with your QNU Organiser, the role of a QNU Local Branch includes:  Providing a democratic forum for members to discuss and debate industrial, professional, democratic, political or social issues.  Enabling members to determine a position on local issues and grievances in the context of QNU policy.  Organising members to resolve workplace issues.  Explaining and implementing policy on nursing and midwifery issues at a local level.  Improving communication between the union officials and members.  Representing members in negotiations with employers on local issues.  Co-ordinating union campaigns.  Participating at the QNU Annual Conference—the union’s key policymaking forum.

Local Branches are comprised of all members who work in that facility or work area who have joined together to form a Local Branch.

Local Branches are most effective when nurses and midwives are enthusiastic and active in their workplace.

So do you belong to a Local Branch?

If you aren’t sure, you can find out whether there is a Local Branch in your

facility by asking QNU colleagues, or contacting the QNU office.

Your Organiser will be able to put you in touch with an active Local Branch or provide you with a list of some of the issues being dealt with by other Local Branches.

If your workplace doesn’t have a Local Branch—time to set one up!

Setting up a Local Branch is one of the best things you can do as a QNU member.

The QNU website contains detailed instructions on how to establish a Local Branch, but it begins with getting the first meeting planned and advertised.

Each Local Branch has a specific number of Delegates and Alternate Delegates— the people who form the Steering Committee, and who represent the Local Branch at Annual Conference.

The number of Delegates and Alternate Delegates depends on the number of financial members in the Local Branch.

Remember, QNU Council must endorse the formation of a new Local Branch.

After your first meeting, send your nomination to form a Local Branch to QNU Council for endorsement.

Forming a Local Branch may seem daunting, but you will have full support and advice from the QNU. Once your Local Branch is up and running, you and your QNU colleagues can directly feed your issues and concerns into the QNU to shape our union’s activity, direction and action.

It starts with you.

ACTIVE. ENGAGED. EMPOWERED.

Number of Local Branch financial members

Number of Delegates/Alternate Delegates in Steering Committee

10-130 financial members

2 Delegates + 2 Alternate Delegates

131-300 financial members

3 Delegates + 2 Alternate Delegates

301-500 financial members

4 Delegates + 4 Alternate Delegates

501-750 financial members

5 Delegates + 4 Alternate Delegates

751-1000 financial members

6 Delegates + 4 Alternate Delegates

1001-1250 financial members

7 Delegates + 4 Alternate Delegates

1251-1500 financial members

8 Delegates + 4 Alternate Delegates

1501 or more financial members

9 Delegates + 4 Alternate Delegates

Sally-Anne

Secretary Beth Mohle ■ Assistant Secretary Des Elder ■ President Sally-Anne Jones ■ Vice President Stephen Bone Councillors 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 Dan Prentice ■ Karen Shepherd ■ Katy Taggart ■ Kym Volp ■ Deborah Watt ■ Di Webb ■ Charmaine Wicking

2 | TQN | OCTOBER 2014

www.qnu.org.au

EDITORIAL

Freedom from fear

BETH MOHLE, QNU SECRETARY

I love fireworks, so I really look forward to attending the annual Riverfire event in Brisbane each year.

Not only are the fireworks spectacular, but there is something very special about hundreds of thousands of people gathering along the river, the sense of community as well as celebration and taking pleasure together.

A special component of this is the diversity of the crowds—the different ages, social status and ethnicities is a wonderful reflection of our dynamic and cohesive modern society.

This is something we should celebrate more often.

The crowds at Riverfire are huge and getting there can be a challenge, so we normally put the call out to see which family and friends are interested in coming with us.

On checking with my sister the day before, she advised she had been fighting off the flu and wasn’t feeling up to it this year, and besides she was feeling a bit worried about going out in large crowds with all the current talk of threatened terrorist attacks.

This response saddened me and made me think again about the nature of fear.

Freedom from fear is one of the four universal freedoms in the preamble of the Universal Declaration of Human Rights. www.qnu.org.au

A “universal freedom” is one that everyone has a right to, no matter where they live.

These four universal freedoms—freedom of speech, of worship, from want, and from fear—were first articulated by US President Franklin Delano Roosevelt in 1941.

These freedoms are essential, but always under threat—especially when times are challenging.

In the last few years we have been dealing with a lot of fear, especially given the massive job cuts in the public sector and the way employers across all sectors have been emboldened by conservative governments at the state and national levels.

There is an agenda to drive down wages and conditions, while the true value (as opposed to cost) of our current and potential contributions is not recognised.

Throughout this year we have been making phone calls to nurses and midwives to find out what issues are important to them in the lead up to next year’s state election.

Across all sectors, nurses and midwives repeatedly emphasise job security as one of their greatest fears.

I never thought I would see the day when nurses and midwives would be worried about getting and keeping their jobs—but that day is here.

This fear is often accompanied by a sense of hopelessness.

What can be done about job security and the attacks on our hard-won wages and conditions when it appears employers and government have the whip hand?

It is important we take the time to truly understand the nature of the current fears held by nurses and midwives.

We must do this to plan how we can rise above these fears and take action to advance our values and interests.

A “UNIVERSAL FREEDOM” IS ONE THAT EVERYONE HAS A RIGHT TO, NO MATTER WHERE THEY LIVE. This starts with knowing our rights and entitlements, and this is a particular focus of this edition of tqn.

The rights and entitlements we have today were not handed to us on a plate.

They came through collective struggle over generations.

As the old saying goes, knowledge is power, and knowing your rights and entitlements is the first step in building the confidence and courage to fight to protect what is rightfully ours.

It is an ongoing struggle.

There is a lot we need to protect and many further advancements we must achieve.

We must remain focused on achieving this together. QNU members are the union.

Another Roosevelt, first Lady Eleanor, summed it up well: “Surely, in the light of history, it is more intelligent to hope rather than to fear, to try rather than not to try. For one thing we know beyond all doubt: Nothing has ever been achieved by the person who says, ‘It can’t be done.’”

Beth

OCTOBER 2014 | TQN | 3

YOUR SAY

EB9 DELAY In early September, Health Minister Lawrence Springborg contacted public sector nurses and midwives via their personal email addresses, telling them the Newman government had decided to delay award modernisation and enterprise bargaining until December 2015—after the next state election.

A few weeks later, the minister sent another email telling nurses and midwives the Newman government had decided they would have to accept a 2.2% payrise in April 2015—no consultation, no negotiation.

This is a pay cut in real-terms, as the current inflation rate is 3.0%.

The reaction from public sector nurses and midwives was immediate. The QNU was inundated with emails and letters from members outraged these decisions had been made without consultation or negotiation, and that in using their personal email addresses, the minister had breached their privacy.

The health minister was on the receiving end of many extremely critical emails from nurses and midwives—we know, because we were copied into these emails.

You can read the full report on developments in the public sector on page 18.

Below we reproduce a very small sample of the hundreds of emails we received.

A letter to Minister Springborg QNU Member Hilary Pearce was so infuriated by Health Minister Lawrence Springborg’s recent emails advising nurses and midwives of the government’s decision to delay EB9 negotiations she sent him this email in return. We say well done Hilary! What a fantastic response.

I am writing to you in disbelief about your arrogant decision to suspend contract and modernisation negotiations until 2015.

I have been a registered nurse for nearly 21 years and have worked for Queensland Health for 11years (currently in a Grade 7 position).

Without a doubt the last 2 1/2 years of my career have been the most difficult and dispiriting solely due to the impact of your government on my role.

Last year I was faced with the prospect of redundancy despite working diligently and tirelessly to obtain postgraduate qualifications and provide the best service I could to customers of Queensland Health.

As you can imagine, I was not looking forward to the prospect of fighting for my 4 | TQN | OCTOBER 2014

conditions again post a modernisation process but I was heartened to be involved with a strong group of professionals that make up the QNU. In any negotiation there should be a level playing field and open dialogue between parties.

Your government is engaging in bad faith negotiation by not involving the QNU before contacting nurses and in my opinion delaying negotiations purely for political advantage.

I shudder every time your propaganda advertisements appear nightly on my TV with your vision to “fix” the health system.

If you are so determined to fix the system, why are you delaying modernisation processes and EB negotiations?

I would ask that you take steps immediately to address this unfair situation.

I would like to know why our EB9 agreements can’t be negotiated in 2015.

Additionally I would like to see the propaganda advertisements removed from circulation immediately until

information is available to nurses, midwives and the general public about the impact of modernisation on the health workforce.

The playing field needs to be levelled immediately.

I would like to know exactly how much of a pay rise I can expect in 2015.

I would also like an explanation about how your office managed to get hold of my personal email address in the first instance.

The actions of your government in managing staff in the public health sector (doctors/nurses and administration staff ) are deplorable and highlight an extreme underlying fear within your party leading up to the election.

The people of Queensland respect nurses highly and I will be doing my bit to ensure they understand the underhand tactics employed by your government in an attempt to control a powerful body of professionals.

Shame on you and your government Mr Springborg!

Hilary Pearce www.qnu.org.au

YOUR SAY

I am disturbed to hear the steps that the Newman government and Lawrence Springborg have taken!

When I received an email several weeks ago reporting that the award modernisation would take some more time I was concerned but I thought this would give a better opportunity for the government and the unions to negotiate a fair solution.

I did not think this would include the upcoming enterprise bargaining agreement.

This is dismal!

Every time that there is a pay rise Mr Springborg sends out mass emails trying to tell what a good job his government has done, as if he is personally responsible for each and every pay rise we have received. Bah. Industrial relations negotiations are in place for a reason.

If the government continues to dictate to nurses and remove our rights then he is going to risk our fair work conditions and patient safety.

Not Happy, Robert McQueen RN

I would like to note that I have not received emails from Minister Springborg but I have received personally addressed letters at my home address.

In addition to the invasion of privacy question, I would love to know how much this costs the government.

I’m sure I’m not the only Nurse receiving personal mail from the Minister.

Perhaps if he spent less money on propaganda he would find the funds for another 0.8%.

[Name supplied]

I quite agree re: personal emails.

Breach of confidentiality and no permission given.

Communication should have been restricted to QH emails.

He has taken it upon himself to be my spokeman, he is not. QNU is!

Once people or persons take it upon themselves to make decisions for others without consultation, people stop listening and arrogance shines.

I’m not impressed. Let me know what the decision or outcomes are. www.qnu.org.au

Many thanks for your continued communication. Take care all.

Maz Jones (RN)

I personally think nurses are well paid for the work that we do. A pay rise of 2.2% is acceptable given what we are currently paid and what the Nurses in the NGO sector are paid.

Given the standards of care that I see on a daily basis I think some nurses need to lift their performance before think of a pay rise.

Remove enough people and no matter how much technology you have, it’s going to fail.

They have now loaded so much mandatory garbage onto our respective registrations that there is barely enough time in the working day to get this stuff done.

With this comes an expectation that such matters should be done in your own time without any form of remuneration.

They don’t appreciate us, they say they do, but their actions don’t.

[Name supplied]

[Name supplied]

Mr Springborg’s announcement today is just another example of this government’s ongoing contempt for nurses, midwives & public servants in general.

Disregarding due process in this way is nothing more than a thinly veiled attempt to quash discussions on workload, working practices & patient safety. It is not democratic.

This is a cynical move designed to keep nurses & midwives quiet until after the next election, to facilitate the government’s true agenda of eroding our pay, working conditions & penalty rates.

I, for one, am not fooled.

[Name supplied]

“QH giveth and QH taketh away” We are being setup to be demonised in the public eye.

They advertise that they have provided more nurses when in fact they have driven people away. We are so experience-poor that we are all concerned about our safety and our professional indemnity.

They put news articles in the Sunday Mail (only rag I buy) stating that more nurses are earning over $100,000.00 pa and asking what have the nurses got to complain about?

They have put so much emphasis on NEAT and NEST targets that the hospital now has more in common with a factory floor than a healthcare facility.

They expect more productivity with less resources. There is the ignorant belief that technology fixes all. They have no concept that technology is a tool that healthcare professionals use.

I find it offensive that Lawrence Springborg wastes taxpayer’s money to write me a letter outlining how he is looking after nurses and will make us able to understand our pay slips.

Sorry Mr Springborg but I am intelligent enough to understand my payslip just the way it is and it is a condescending approach to use this as the reason for not giving us our full increase as per the CPI index.

[Name supplied]

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 OCTOBER 2014 | TQN | 5

TEA ROOM

tea r

m

WITH DES ELDER, QNU ASSISTANT SECRETARY

We sometimes take it for granted that everyone knows their entitlements.

However, for new entrants to the nursing and midwifery workforce it is often difficult to understand the plethora of entitlements and payslips covering our profession.

In fact many nurses and midwives are uncertain about which allowances, loadings and penalties they are entitled to given the diversity of their work and working hours.

The following questions are frequently asked of our QNU Connect information service.

What are my rights if I am called to a meeting for disciplinary purposes?

Your employer must provide you with ‘reasonable notice’ to attend the meeting, give you an opportunity to respond to any allegations made against you, and provide information about the disciplinary process—including any action that may be taken against you.

‘Reasonable notice’ should be no less than the time you need to arrange a support person who can attend with you.

Prior to the meeting, you may ask for specific details of allegations made against you, but you do not have an automatic right to receive such details.

If you are not provided with details, you have a right to respond to allegations after the meeting.

If you work in the Public Sector, Queensland Health must offer you the opportunity to have a support person attend a disciplinary meeting with you.

If you work in the Private Sector, your employer has no obligation to offer you the opportunity to have a support person attend the meeting.

6 | TQN | OCTOBER 2014

However, you do have a right to ask for a support person to assist at any discussions relating to dismissal or a disciplinary process where dismissal may result.

Your employer cannot “unreasonably refuse” your request to have a support person to assist you.

A support person can be a friend, family member, QNU workplace representative, or work colleague. Depending on the circumstances, it may also be a QNU official.

At all times before, during and after a disciplinary meeting you have a right to be treated fairly.

During the meeting, you have a right to ask for a break to seek advice on how to answer a question or if you should in fact answer a question and compose yourself if you are upset or angry.

You may terminate the meeting if you feel your safety is at risk, for example if you are being yelled or sworn at, not being allowed to answer a question, called derogatory names or you are being asked to do something you genuinely believe is not legal.

If you are ever called into a meeting and police are present, or you are required to make a report to AHPRA, you have a right to seek assistance from the QNU before you discuss anything, answer any questions, or provide a statement.

It is essential you exercise this right.

The QNU strongly recommends you immediately seek QNU advice.

What are my employer’s rights if they want to call a meeting for disciplinary purposes?

Your employer has a right to take reasonable management action and to intervene to address unacceptable conduct.

This includes conducting a preliminary assessment to determine the most appropriate response.

Your employer also has a right to investigate allegations made against you

and to ask you to attend a meeting to discuss those allegations.

You cannot refuse to attend a disciplinary meeting.

It is important you are across your employer’s disciplinary policy, which sets out the procedures they must follow.

If you work in the Public Sector, your employer must follow their policy based on the Commission Chief Executive Guideline 01/13: Discipline and the Public Service Act 2008.

In the Private Sector, section 387 of the Fair Work Australia Act 2009 sets out criteria used by the Fair Work Commission and the courts to test whether your employer has been harsh, unjust or unreasonable when exercising their rights and obligations in relation to disciplinary proceedings that may lead to dismissal.

AT ALL TIMES BEFORE, DURING AND AFTER A DISCIPLINARY MEETING YOU HAVE A RIGHT TO BE TREATED FAIRLY. If you have questions for our tea room column email qnu@qnu.org.au

ROVDPOOFDU QI 41::4321

www.qnu.org.au

NEWS

YOUR UNION IN ACTION Public sector job losses almost 2000 higher than government admits New data reveals public sector job cuts are almost 2000 higher than the Newman government will admit.

The final compilation of the QNU’s Right to Information investigation revealed 4821 hospital and health service jobs have been abolished across the state.

This is 1867 more jobs than the Newman government has acknowledged. The state government will only admit to cutting 2954 health positions since March 2012.

The cuts include more than 1700 nurse and midwife positions, including jobs in emergency departments, intensive care units, oncology, a neonatal intensive care unit for premature babies, indigenous health, surgery, transplant services and many other areas.

Midwife jobs have also been cut in most regions.

More than 700 nurse and midwifery jobs have been cut in the Metro North (northern Brisbane region) alone.

Close to 300 nurse and midwifery positions have also been axed in Metro South, more than 150 in the Townsville region and more than 120 in the Wide Bay region.

The QNU recently polled hospital and health service staff to highlight the human toll the cuts are taking. The results are alarming.

“Nurses and midwives are working unpaid overtime, not taking holidays or sick leave and routinely doing double shifts in order to take up the slack and protect their patients. I’m sad to say they are burning out,” said QNU Secretary Beth Mohle.

“We are very concerned patients and staff are at risk as a result of these massive health cuts.” www.qnu.org.au

Government doesn’t deny true job cut number Health minister Lawrence Springborg did not deny the true figures, claiming only that temporarily vacant jobs didn’t count.

Saying temporarily vacant positions ‘don’t count’ is an attempt to devalue health services, as well as the communities who rely on them.

Perhaps the government would prefer to talk of job cuts in terms of ‘people’ rather than ‘positions’?

Remember, the job cut figures are FullTime Equivalent (FTE). But 1.0 FTE doesn’t always equal one person.

For example, two nurses can fill a 1.0 FTE position at 0.5 FTE each.

The number of people who have lost their jobs thanks to the Newman government’s cuts to public health services is much higher than the number of FTE jobs abolished.

You can bet the Newman government doesn’t want to ‘count’ the true number of people they have put out of work.

Media coverage—and how you can help Extensive media coverage shows Queenslanders are extremely interested to know exactly how their public health services have been slashed under this government.

At last count, the QNU conducted 40 interviews on the release of the new job cut figures (36 radio, seven TV, and four print), with a combined audience of 702,586 between Cairns and Coolangatta.

By communicating the real story to the public we can hold the Newman government to account.

But the work isn’t over. QNU officials continue to seek information about where job and service cuts are occurring.

Nurses and midwives on the ground are the QNU’s eyes and ears for cuts to health jobs and health services.

Keep on top of Queensland Health communications about cuts, and let the QNU know what is happening, so we can tell the public—because you can bet your boots the government won’t be telling them.

Tell us your story at www.qnu.org.au/yourstory In the lead up to the state election in 2015 the QNU will campaign for better workloads in all sectors to keep patients safe. Stay tuned for more on how you can get involved.

OCTOBER 2014 | TQN | 7

NEWS

PRIVATISATION

BY STEALTH – LNP finalises privatisation policy for state election The Newman government has officially adopted its privatisation policy for the upcoming state election.

Selling off Queensland’s public assets and services has been a very strong element of the Newman government’s plans for a long time.

However, anger over the prospect of privatisation has been equally strong all around the state.

Now, the Newman government hopes to keep its privatisation plans while maintaining ‘plausible deniability’—by giving out 99-year leases on public assets.

99-year leases—privatisation by stealth In October, the Liberal National Party endorsed 50-year leases on Queensland’s electricity network, with an option for a 49-year extension.

The policy is a major embarrassment for Treasurer Tim Nicholls, who while in Opposition said “a 99-year lease is as good as giving away the farm”.

The 99-year lease proposal has been widely condemned as “privatisation by stealth”.

The Electrical Trades Union drew comparisons with a similar deal in South Australia, where any electricity network assets that are built or maintained during the life of the 99-year lease become the property of the owner of the lease.

“In 99 years, you’ll expect a lot of work will need to be done, so it’s privatisation by stealth,” said ETU Secretary Peter Simpson.

Public assets and services already sold The LNP endorsement comes as no surprise, given the Newman government has already sold off a number of public assets, including health services.

Since coming to power, the Newman government has closed and sold off the Moreton Bay Nursing Care Unit aged care facility, while many community care services have been sold to Blue Care.

8 | TQN | OCTOBER 2014

Child Care Flexibility Trials In 2013, the QNU and United Voice partnered with Family Day Care Australia to develop a series of flexible child care trials giving nurses, midwives and paramedics access to around-the-clock home-based child care.

Federally-funded childcare flexibility pilots were established in Brisbane central, Toowoomba and Townsville.

Weekend care for school aged children was also offered in Brisbane.

The trial paired nurses and paramedics with family day care educators who worked with families to tailor child care needs around their shift work— including night and weekend shifts.

While a good number of families in Townsville took the opportunity to try out new childcare arrangements, takeup elsewhere in the state was lower than expected.

Results from the trial showed many families did want flexible hours, but only on an ad-hoc basis. In contrast, most childcare providers needed a regular commitment from families in order to be financially viable.

The trial revealed the ongoing difficulties shift workers such as nurses and paramedics face as they try to

juggle their work-life balance around unpredictable and unsociable shifts.

The federal government has decided not to proceed with the flexibility program, but Family Day Care Australia may still be able to offer extended hours care depending on the area.

To make enquiries please contact www.fdca.com.au

www.qnu.org.au

NEWS

Selling off our clinical services As the Newman government ramps up its privatisation push, more and more clinical services around Queensland are being considered for sale.

There is a definite pattern of sales to clinical services—the most profitable services go first. Radiology, pathology, and pharmacy services are the three areas most at risk.

Already we’ve seen health services put up for sale around the state, with more to come.

Rockhampton radiology In July, Rockhampton Hospital officially announced plans to privatise its radiology services.

The chief executive of Central Queensland Hospital and Health Service, Len Richards, refused to rule out job losses.

Of equal concern is the prospect of decreased quality of services—a particularly important point at Rockhampton Hospital, which has been hit by a series of adverse health outcomes in recent times.

Premier Campbell Newman declined to promise any privatisation of clinical services at Rockhampton Hospital would not see quality of care suffer.

Warwick radiology The QNU understands radiology services in Warwick will also soon be privatised.

Warwick services a very large area over the Darling Downs and into northern NSW, and while it will be a short term benefit to the community to receive expanded local radiology services, the fact is the state government should have provided adequate radiology services in the first place.

The long term implications for Queensland’s rural and remote communities are very worrying.

Reliance on privately provided radiology is not a sustainable substitute for properly resourced public services.

These are the kind of services the state government should be providing.

Wide Bay pharmacy The QNU has heard suggestions Wide Bay Hospital and Health Service is considering outsourcing both pharmacy and radiography services. www.qnu.org.au

There has been little detail or movement on this, but we are keeping a very close eye on developments.

Pathology The state government is considering options to outsource pathology services across the state, and has already received a number of feasibility studies on selling off various services.

The difficulty for the government is that pathology is a very strong, effective network, and so is very difficult to make a case to outsource.

It is also very profitable, so we can expect to see ongoing efforts to break the network up and sell it off.

Government deal with Palmer sells millions of Australians down the river Prime Minister Tony Abbott and Clive Palmer have made a disgraceful deal to cut the mining tax as well as the retirement savings of millions of Australians.

Mr Palmer’s back down on the Low Income Super Contribution (LISC) and Superannuation Guarantee targets the lowest income earners.

The LISC helps boost the retirement savings of almost 3.6 million workers who earn $37,000 a year or less— including 2.2 million women.

While the lowest paid workers will be penalised, high earners who already enjoy 30% tax concessions will be left untouched.

The deal also delayed an expected increase in the employer paid superannuation rates from 9% to 12%.

Thanks to the delay, the average 25-year-old worker stands to lose $143,000 from their retirement savings.

The increase is particularly important for low to middle income earners, especially women whose careers are interrupted while raising children.

Metro North scandal In September, Metro North chief executive Malcolm Stamp and executive director of corporate services Scott McMullen were stood down amid allegations they had unfairly awarded a contract to a private provider.

While the matter is now under investigation by the Crime and Corruption Commission and no findings have yet been released, this is another example of the risks of outsourcing.

OCTOBER 2014 | TQN | 9

NEWS

Cairns nurses and midwives paint grim picture A recent QNU survey of health staff in Cairns paints a very grim picture of low staff morale, difficulty in providing quality of care, and growing anger over the Newman government’s handling of public health.

In September, the QNU joined with Together and United Voice to conduct the first of a series of joint union surveys on health staff morale, quality of care, and the performance of the state government in managing Queensland’s public health system.

The first survey covered Cairns Hospital and Health Service. More than 340 nurses and midwives from Cairns region participated in the survey.

A clear majority of respondents say staff morale is worse than it was two years ago.

Other key findings are:  Over 79% rate the government’s performance managing Queensland’s public health system poor to very poor.  81% said that the changes to the public health system over the last two years have made it harder to provide quality health services to Queenslanders.

The findings fly in the face of the Newman government’s claims health staff morale is high, and nurses and midwives are impressed with the government’s performance.

Further surveys will be carried out across the state in the future.

It is absolutely vital the public understands what health professionals think of our public health system, and where it is falling down.

With a state election scheduled for the first half of next year, we cannot permit the government to whitewash over the very serious concerns held by the people who work in the public health system.

10 | TQN | OCTOBER 2014

Bridging the super gap for women Despite the introduction of compulsory superannuation over 20 years ago, most Australian women don’t have anywhere near enough saved for their senior years.

The facts Women have significantly less super saved than men.

According to a 2011 study by the Australian Institute of Superannuation Trustees, the estimated median superannuation balance for women aged between 55 and 64 years is $53,000.

By comparison, men in the same age group have a median balance of $90,000.

This underfunding has meant that many women are forced to rely on the Age Pension for support.

Up to 77% of retired women are dependent on some form of government pension— but the pension is designed only as a safety net, and might not be enough to fund your retirement.

The good news is that the superannuation gender gap is closing.

The bad news is that women still lag well behind men when it comes to accumulating retirement savings.

Lower pay, time out of the workforce to raise children, and shouldering the bulk of unpaid domestic work can make it challenging for women to build a reasonable amount of super.

Easy ways to boost super Ask your superfund if you can benefit some of these ways to boost super:  Your employer may pay some of your pre-tax wage into super. Before-tax salary sacrificing can be a tax-friendly way to grow your super.  Consider making super contributions out of your own pocket. Known as ‘nonconcessional’ contributions, these aftertax super contributions aren’t subject to the 15% contributions tax because you have already paid income tax on this money. Depending on your income, you may also be eligible for a government co-contribution to your fund.  Maybe your partner can make contributions on your behalf? They may be able to claim a tax offset on the contributions made to your fund.

Remember, your individual circumstances may mean these options are not beneficial.

New war nurses memorial in Bundaberg The QNU recently attended the War Nurses Commemoration Service in Bundaberg, laying a wreath at the newly-unveiled Memorial Wall.

It was a wonderful dedication to the brave nurses who served in wars from the Boer War to present day conflicts and peacekeeping tours.

The new Memorial Wall in the park opposite the Bundaberg Hospital features a plaque with names of local nurses who served in World War One.

One of the nurses recounted heartwrenching stories of hardships endured by the nurses.

Special recognition and appreciation was shown to the dedicated nurses who paid the ultimate price for their “boys”.

The QNU is proud to have made a donation to the creation of the Memorial Wall.

The dedication was very well attended, and was a significant and worthy recognition of the contribution of local nurses to the war effort.

www.qnu.org.au

NEWS

Fancy a trip to the local park?

BOOK A SPOT OR FACE A FINE

So much for cutting red tape. Brisbane locals wanting to gather in parks and other public spaces will soon have to purchase a permit, or face fines of up to $5500.

The new proposal from Brisbane City Council, purportedly aimed at protecting green spaces from overuse, means groups of 50 or more people who want to use public spaces across Brisbane may have to pay $300 or risk being fined.

Councillor Matthew Bourke, who was elected as part of former Lord Mayor Campbell Newman’s team, said the law was a bid to balance increasing usage with noise concerns and protection of green spaces.

“More and more people are using our open spaces and parks and that’s putting more pressure on them,” he said.

While there was immediate outcry against the impact on children’s birthday parties and sports and community events, it is far more likely the law may discourage protests and other public gatherings of a political nature.

Protests which draw attendees from diverse groups—such as the recent protest against the federal government’s changes to tertiary education fees—may need to purchase a $300 permit.

But who will pay the $300? Will there be a small contribution from each attendee to cover costs? Or will such protests rely on the generosity of a single person to purchase a permit?

Instead of trying to discourage use of public spaces, Brisbane City Council clearly needs to consider creating more public spaces.

G20 COMES TO BRISBANE IN NOVEMBER The QNU’s Brisbane office will be closed on Friday 14 November as world leaders congregate in Brisbane for the annual G20 Summit.

The G20 Leaders’ Summit from 14-16 November will attract 26 world leaders, around 4000 delegates and 3000 media representatives to the river city.

Friday 14 November has been declared a public holiday for those who work in the Brisbane Local Government area (where the QNU office is located) due to expected road closures and disruptions across the city.

The QNU is planning a number of events to occur in the lead up to, and across the G20 weekend.

On Wednesday 12 November we will welcome our nursing and midwifery colleagues from the New South Wales Nurses and Midwives’ Association, as well as international nursing and

www.qnu.org.au

midwifery representatives from Global Nurses United to the Gold Coast University Hospital.

These nurses and midwives are travelling to health facilities between Sydney and Brisbane as part of our united campaign for a financial transactions tax (FTT) in Australia.

The international campaign for a FTT, also known as the “Robin Hood Tax”, has been led by global organisations concerned about the unrelenting pursuit of corporate greed at the expense of the ordinary citizens.

A FTT of just 0.05% on institutional trades of currencies, stocks, bonds, derivatives, and interest rate securities could raise billions of dollars annually to be used on much needed funding increases in health and aged care programs.

On Thursday 13 November international research on the effects of privatisation on

health care will be launched at a QNU G20 International Forum.

QNU members will have the opportunity to find out more about the global campaign for universal health care at this event.

To find out more about these and other events being planned around G20, visit our Facebook page at www.facebook.com/qldnursesunion

OCTOBER 2014 | TQN | 11

NEWS

YOU HAVE THE POWER TO SAY Recent findings from the QNU’s Your Work Your Time Your Life survey shows Queensland nurses and midwives continue to face increasing workloads and poor skill mix, while struggling to maintain patient safety in the race to provide dollar-driven health care.

Despite changes to both state and federal governments and promises to improve our health system, the push to provide more care with less resources continues.

The majority of survey respondents noted increasing workloads, and attributed this increase to staff cuts and skill mix changes due to financial decisions.

Increased workloads Respondents noted time constraints often meant tasks went unfinished on each shift.

In response to a question about workloads, respondents commented: “Cuts to services that mean higher workloads for front line nurses, which ultimately leads to worse care outcomes for patients, due to stress/fatigue on nurses (public acute).”

“Private health care working staff to the bone, and working on minimum staffing numbers causing patients to pay more for less than standard care (private acute).”

Less time for care Respondents also stressed that constant demands to complete additional tasks meant they were spending more time on non-nursing and non-midwifery activities, which impacted on their ability to provide care to patients.

“Time spent moving patients about because there is pressure on beds and elective surgery targets (public acute).”

“I believe we are constantly being given extra tasks, but are not given enough man hours to complete them AND care for our patients (private acute).”

12 | TQN | OCTOBER 2014

Nurses and midwives bearing the brunt Respondents also reported excessive workloads were resulting in nurses and midwives having to bear the brunt of patient/resident dissatisfaction.

“Workloads leading to a decrease in patient dignity and having to be the face that bears the brunt of dissatisfied patients or ‘clients’ (private acute).”

Health care funding Reduced funding was a major theme in the survey.

Respondents blamed funding reductions on government policy and private providers’ desire to increase profits.

Many respondents noted ‘money saving’ or ‘the drive for profit’ meant cuts in staffing, changes in skill mix (workforce substitution and more inexperienced staff employed), lack of resources, and cheaper products.

“Because of the demands of administration, coal face workers are being pushed to the limit to get numbers through (numbers not patients), because it all revolves around the elusive dollar (public acute).”

Excessive workloads are placing nurses, midwives, and those in their care at risk.

Workloads have clearly become a major issue in all sectors of health care.

The following two case studies compare workload problems in the aged care sector.

Case 1 An RN working at an aged care facility was in charge of nearly 100 residents, and a number of PCAs and AINs across several buildings.

During a night shift, there was an incident where one of the residents sustained an injury that was not detected for some time.

The RN did not become aware of the incident until management sought a meeting with her to discuss the matter the next day.

The RN indicated to the employer that it was simply not possible for her to give more than a cursory check of that number of residents spread over such a wide location on any given night.

However, despite the breadth of her duties and locations, the employer alleged that as the RN in charge she had not given proper care and attention to all aspects of her work and took disciplinary action against her.

The RN had raised workload issues with the employer in the past, but had continued to work under the same conditions.

We know that nurses and midwives can be selfless in their commitment to their patients.

However, as this case study shows, prolonged acceptance of huge workloads provides limited defence in cases where management are investigating adverse events.

By continuing to undertake such a heavy workload it was difficult for the QNU and the RN to argue that the incident occurred in circumstances that were any different to other nights.

As the RN, the responsibility and consequences for inaction in this case rested with her, despite being unaware of the event. www.qnu.org.au

NEWS

TO UNSAFE WORKLOADS

Congratulations to Alexandra Parr and Kim Milowski—winners of our recent membership recruitment competition!

Both Alexandra and Kim were the winners of a nifty new iPad Air each after Alexandra signed Kim up as a new QNU member.

The recruitment drive was a great opportunity to sign up new members and get some one-on-one dialogue about nursing and midwifery around the state.

Overall, QNU membership continues to grow steadily, with particularly strong growth in Registered Nurses, Midwives, and student members.

The QNU now has more than 50,000 members, making us the biggest union in Queensland.

The following case study shows how nurses and midwives have the power to say ‘no’ to unsafe workloads.

Case 2 An aged care facility directed its personal care assistants (PCAs) to administer medication to the residents.

Under the Decision Making Framework for Nursing and Midwifery Practice, where RNs are accountable for making decisions on the most appropriate person to perform an activity in the nursing plan of care, the RN in charge could not allocate this task to PCAs. The RN and employer needed to consider whether to integrate the activity into her own nursing practice and/or whether the employer should initiate a change within the organisation.

As she could clearly not manage such a workload, the RN refused to take on the task.

The employer had no option but to withdraw its directive and put in place proper staffing measures to deal with the workload safely and responsibly.

The power to control workloads rests with the nurse or midwife’s ability to decline to work in a unit/area where the level of acuity or number of patients is unsafe, and there are not enough staff to safely deliver care.

Nurses and midwives have a responsibility to say ‘no’ to workloads when they know they do not have the capacity or resources to work safely.

All nurses and midwives should continue to submit workload forms and advise employers whenever high workloads impact on safe care.

These workload forms should identify tasks you will not be undertaking to manage workloads.

Nurses and midwives keep the system safe for everyone—including themselves. www.qnu.org.au

QNU continues to grow

What can you say?

If your manager asks you to accept responsibility of care for more patients or residents than you have capacity to care for: In my professional judgement the number of patients/residents you are asking me to care for is unacceptably high and therefore unsafe. I can’t accept the allocation of this number of patients/residents.

When you are asked to work in an area that you are not qualified to work in: I do not yet have the skills required to work in this area, so you will need to roster me to work in another area.

When an RN is asked to delegate to an EN or AIN a task, responsibility, or procedure that should remain the responsibility of the RN: I’m sorry, but the Nursing and Midwifery Board of Australia’s Decision Making Framework indicates this is an inappropriate delegation. I am not able to make this delegation.

Gold Coast nurse Sue Neil recognised on Queen’s Birthday A Queen’s Birthday honour for one of our Gold Coast members slipped under our radar last edition, but we’ve caught her this time!

Runaway Bay nurse Sue Neil and husband Colin were both honoured with a Medal of the Order of Australia (OAM) for more than 20 years of service to surf lifesaving.

This is a wonderful achievement, and full congratulations to Sue and Colin. It is always heartening to see QNU members being recognised for contributions to their local community.

Activism is the lifeblood of the QNU, and Sue and Colin have set a fantastic example, now deservedly recognised.

OCTOBER 2014 | TQN | 13

NEWS

AGED CARE New aged care funding arrangements Aged care funding underwent some significant reform in 2014 for new residents entering care.

Prior to 1 July 2014, new residents were required to undergo a means test conducted by Centrelink, which was an income-only test.

Now the means test will combine both income and assets, with some assets being exempt depending on the person’s individual circumstances.

Residents given three choices Also from 1 July 2014, new residents who must contribute to their care now have one of three choices:  A one-off lump-sum payment, called a refundable accommodation deposit (RAD).  A regular rental-type payment, called a daily accommodation payment (DAP).  A combination of both.

If the resident elects to pay the RAD, it must be returned in full to the resident if they leave care or to their estate if they pass away, minus any amounts the resident and the provider agreed should be taken out of the deposit for their care.

If the resident elects to pay the DAP, the lump-sum is calculated using a formula and interest rate set by the federal government.

However, a facility can seek permission from the federal government to charge above the cap if they offer extra services of a significant nature.

Providers not happy about losing interest-free loans Historically, most aged care providers have used accommodation bonds as interest-free loans, or to invest and receive the interest income.

Many providers have complained about the reforms, arguing the resident’s ability to elect to pay a RAD or DAP after admission will inhibit the provider’s ability to accurately forecast their future cash and investment assets.

However, on 14 July 2014, Macquarie Bank stated “Macquarie, which is specialising in aged care accommodation bonds, has estimated the reforms will increase the annual total amount of new accommodation bonds from $4.4 billion in 2011-12 to $8.9 billion in 2014-15.”

If stakeholders like Macquarie Bank anticipate revenue from new

accommodation bonds to more than double since 2012, it is difficult to see any rationale for the complaints of aged care providers.

Bear in mind, in 2011-2012, aged care providers already held almost $10 billion in accommodation bonds in total.

More user pays—but more choice too The reforms to aged care funding have paved the way for aged care to become more of a user-pays system.

However, they have also made the method of payment for accommodation more flexible for prospective residents who can afford to contribute to their care.

The changes have also opened the window for aged care providers to more than double the accommodation deposits received from new residents.

This will only increase their investment income—and their ability to provide more residential places or services in aged care.

When must the decision be made?

The aged care provider cannot ask the resident to agree on the method of payment before they have been admitted to the facility.

The resident can wait up to 28 days after admission to decide whether to make a lump-sum payment or a daily payment or a combination of both.

Lump-sum payment now capped Another change in funding includes the capping of lump-sum payments that a provider and resident can agree upon.

The maximum RAD is set by the federal government and at present sits at $550,000.

Also, all aged care providers must now publish each facility’s maximum RAD on the ‘My Aged Care’ website at www.myagedcare.gov.au 14 | TQN | OCTOBER 2014

www.qnu.org.au

NEWS

AGED CARE Blue Care AINs incorrectly classified as personal carers The battle to ensure AINs retain their standing as health professionals continues in the Fair Work Commission (FWC).

In late August the FWC heard from seven QNU witnesses in the dispute over AINs being incorrectly classified as personal carers.

Blue Care again tried to upset proceedings by introducing new material into evidence that neither QNU advocates nor witnesses had previously seen.

Such tactics are becoming common for Blue Care, and suggest they are deeply concerned about the fundamental weakness of their case.

This time, however, Blue Care’s ploy backfired, as it allowed the QNU barrister to draw out more details of the many nursing duties our AIN/PC members assist the RNs and ENs to perform.

Bundaleer Lodge pays $30k for uniform mistake The QNU has banked a cheque for $20,000 from Bundaleer Lodge— payment of a penalty after Bundaleer failed to pay $10,000 in uniform allowances to 12 nurses.

The QNU members received their $10,000 from Bundaleer some time ago.

The Magistrate found the requirement to wear pink shirts and certain pants or shorts was a requirement to wear a uniform, and, as those items were not supplied to the employees, the uniform allowance was payable.

The Magistrate rejected Bundaleer’s argument the pink shirts and pants or shorts were not a uniform because they could be worn elsewhere.

Bundaleer were ordered to pay the uniform allowance to all 12 members for all of the periods claimed by the QNU, plus 5% interest.

The lawyer acting for Bundaleer said this decision will have big implications www.qnu.org.au

QNU member witnesses Rhonda Orreal, Olwyn Scott, Alba Vignolo, Ruth Morris and Glenis Delmore did a fantastic job describing the work they do and how focused it is on the nursing care of residents.

QNU officials also gave evidence.

The QNU will finalise witness evidence in December.

finalised by the end of this year, and Blue Care AINs can have certainty about their wages and conditions into the future.

Care and Support Agreement Blue Care/Wesley Mission Brisbane continues their efforts to have a new enterprise agreement approved which incorrectly provides for AIN duties to be performed by personal carers, laundry workers, and cleaners.

The QNU strongly objects to the approval. The FWC is due to hear the QNU objections in December.

The QNU is hopeful these issues at Blue Care/Wesley Mission Brisbane will be

beyond Bundaleer—and given the prevalence of employers requiring staff to wear clothing of a certain colour or design, he might be right.

Do you have to wear a uniform?

If so, are you entitled to an allowance— and are you receiving your allowance?

As the experience of QNU members at Bundaleer Lodge shows, it pays to check your enterprise agreement or award to find out.

union training program COURSE

Date

Location

Emotional Resiliance

7 Nov

Brisbane

Nurses & Midwives EB9 - Phase 1

6 Nov 10 Nov 12 Nov 13 Nov 18 Nov 18 Nov 20 Nov 20 Nov

Brisbane Brisbane Toowoomba Bundaberg Cairns Mackay Townsville Rockh’ton

NOVEMBER

ATOM - QNU ONLINE TRAINING MODULES

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

 ring the training unit in Brisbane on 3840 1431 or toll free 1800 177 273 OCTOBER 2014 | TQN | 15

NEWS

Tasmanian government threatens to sack 500 after pay freeze blocked The Hodgman Liberal government in Tasmania is threatening to sack an additional 500 public servants after its attempt to force a pay freeze failed.

The Hodgman government had wanted to override all public sector awards and agreements to impose the open-ended freeze on wages but failed to gain enough support in the Upper House.

The Tasmanian government has now announced it will sack 500 public sector workers—including front line positions— in addition to the 700 it already plans to cut.

The job cuts come on top of funds stripped from the state budget, including $210 million from health and $148 million from education.

Tasmanian unions condemned the government, saying they had suggested more than 60 measures for the government to implement to save money and limit job losses.

Tasmanian nurses and midwives are currently trying to engage in negotiations with the government for their new enterprise agreement—but the government continues attempts to dictate terms.

ANMF Tasmania Secretary Neroli Ellis said nurses and midwives have always been ready to negotiate with the government.

“The fair process of ANMF members negotiating wages and conditions with the government will be upheld,” said Neroli.

“The ANMF is about to start negotiations for a new agreement. The failure of the Bill will give us an opportunity to enable ANMF member’s disputes to be decided by an independent umpire, the Tasmanian Industrial Commission.”

Neroli said it was vital Tasmania provide nurses and midwives with wages and conditions comparable to their interstate colleagues.

16 | TQN | OCTOBER 2014

“Currently we have difficulty in recruiting and retaining nurses and midwives especially in the specialty areas like ICU, NICU, and Mental Health,” she said.

The ANMF Tasmania Branch has already identified and provided the government with suggestions for cost savings and efficiencies to offset the budget cuts for health.

In one instance, a worker sponsored on a 457 visa as a customer service manager was given a job as a cleaner and paid just $28,000.

What about jobs for grads?

It is undeniable many 457 visa holders— particularly in nursing and midwifery— have made invaluable contributions to the public good.

However, if suitably qualified and available graduates are already available in Australia, they should be given priority to nursing and midwifery jobs.

We can’t afford to lose our talented young nurses and midwives.

Labour market: to test or not to test?

457 scheme needs a lot more work The federal government has used the release of a new report titled Robust New Foundations to loosen the requirements for employers who use the 457 visa scheme.

In September, Immigration Minister Scott Morrison announced the government would favour 457 applications for employers who meet certain requirements such as having ‘a good record’.

The QNU is seriously concerned the move is simply a way of permitting more 457 visa approvals with less oversight of the wages and conditions visa holders work under.

Workers being exploited Since the government’s announcement, at least 300 cases have been identified by the Fair Work Ombudsman where 457 visa holders were being underpaid, performing a different job to the job on their visa application, or both.

Unions have been strongly in favour of labour market testing—that is, employers must show they have tried and failed to find a suitable Australian worker before seeking an overseas worker—as part of the 457 visa process.

The Robust New Foundations report recommends abolishing “employerconducted labour market testing” in favour of “a dedicated labour market analysis resource”.

The report argues the current labour market testing requirements are “easily circumvented and do not prevent employers from engaging overseas workers in place of Australians”.

Instead, the report recommends establishing “an ongoing and permanently resourced team embedded in an existing Australian government department, specialising in labour market analysis”.

However, Mr Morrison has indicated the government will not proceed with this recommendation, choosing to retain a diluted version.

Watering down the current testing requirements is an inadequate response to a very real problem.

Labour market testing for 457 visas needs more funding and better systems, not less attention and more exploitation. www.qnu.org.au

NEWS

World Summit looks at impact of climate change on health Australia’s politicians may have given up on tackling climate change, but the rest of the world is pushing ahead—and that includes taking measures to prepare for impending health challenges.

In late September, UN Secretary General Ban Ki-Moon hosted a day-long summit in New York to build momentum towards a new UN agreement on climate change.

One hundred and twenty heads of state attended the summit, as well as many world health leaders.

Climate change is fast becoming a mainstream health concern.

The World Health Organization says urgent action to protect health from climate change is “the defining issue for the 21st century”.

One of the most significant health challenges is air quality.

With over seven million deaths in 2012 caused by air pollution, health professionals at the summit were at pains to argue a global transition to clean energy would see dramatic health benefits and cost savings.

The summit also had a strong emphasis on finance and investment, and many health organisations have taken this on board.

For example, HESTA Superannuation Fund recently announced a restriction on investments in thermal coal.

Other issues included private sector contributions to combating climate change, carbon pricing and disaster-risk reduction, as well as the impact of climate change on energy, finance, agriculture, cities and transport.

to arrive in New York the following day for a UN Security Council meeting about terrorism.

Australia was represented at the summit

by Foreign Minister Julie Bishop.

Heads of state from two of the world’s largest polluters, India and China, also refused to participate.

US President Barack Obama told the summit governments of all countries must put politics behind them to confront the “urgent and growing threat of a changing climate”.

In a pointed comment, he said “nobody can stand on the sidelines anymore”.

Bring it on: First GNU Congress tackles bad government policy and Ebola The First Congress of Global Nurses United, the international alliance of nursing and midwifery unions to which the QNU belongs, was held in Las Vegas in September this year.

Nurses and midwives from all around the world gathered to share stories of what is happening in nursing and midwifery in their countries.

Topics included efforts to counteract austerity measures, privatisation of health services, and erosion of patient care standards.

Other discussions focused on the need for mandated nurse-to-patient ratios, universal health care, and how the climate crisis is impacting our health.

The 1000 attendees also marched through Las Vegas to raise awareness of the Ebola virus, and protest a lack of preparation for outbreaks.

A recent Ebola scare at a California hospital was strongly criticised by nurses after a patient who tested positive for the virus was allowed to come into contact with health workers in a public waiting area for about half an hour before being given the all clear.

As the Congress closed, the US recorded its first case of Ebola, underlining the importance of getting safety procedures right.

The march was followed by a minute of silence for international health workers who have died while caring for Ebola patients in West Africa.

GNU, which was formed in June 2013, welcomed its newest members: Greece, Uruguay, Kenya, Taiwan and Paraguay.

The federation now has 18 countries represented.

120 Heads of State at summit— but Australia not one of them Australian Prime Minister Tony Abbott refused to attend the summit, choosing www.qnu.org.au

OCTOBER 2014 | TQN | 17

NEWS

Newman government tells nurses and midwives to be happy with real-terms pay decrease After arbitrarily delaying award modernisation and EB9 by 12 months, the Newman government has now told public sector nurses and midwives to be happy with a 2.2% pay increase in April next year.

The increase is 0.8% less than the current inflation rate of 3%, so public sector nurses and midwives will be taking a pay cut in real terms.

Compare with the 21.8% increase—an additional $70,000 per year—Premier Campbell Newman received in March this year.

The government tried to limit the political damage by failing to consult or inform the QNU of its decision.

QNU members raised many concerns they wanted to advance through EB9 negotiations, especially quality of care and workloads.

Nurses and midwives are only able to take industrial action to advance their concerns after an agreement has expired.

By extending the agreement for 12 months the government is denying nurses and midwives the opportunity to take protected industrial action.

QNU Secretary Beth Mohle said it was not the first time the Newman government had made unilateral decisions about enterprise bargaining or pay rates.

“Queensland nurses and midwives will be deeply unimpressed that once again the Newman government has made decisions which impact them without consultation or negotiation, and they will certainly not put up with going backwards in terms of pay,” she said.

Newman government blunders on emails—again The Newman government compounded the insult by again sending emails to nurses and midwives personal email addresses.

18 | TQN | OCTOBER 2014

This apparent breach of privacy has been condemned in the strongest possible terms by many QNU members, but so far the only response to queries about how the Health Minister obtained private contact details has been an automated unsubscribe notice.

The QNU has now written three times to the minister asking for an explanation, but no response has yet been received.

Timing of delay is political The announcement means the terms and conditions of the EB8 agreement will be extended to March 2016.

With the Newman government facing a difficult re-election campaign in the first half of 2015, the delay in award modernisation and enterprise bargaining is clearly an attempt to avoid a large and public dispute with more than 30,000 public sector nurses and midwives.

You can bet if the Newman government is re-elected, it won’t be showering nurses and midwives with confetti when enterprise bargaining does resume in 2016.

How did they do this?

The Newman government gave itself the power to impose a pay increase outside of enterprise bargaining as part of changes to the industrial relations law.

By delaying finalisation of award modernisation for QH nurses and

midwives until December 2015 (rather than March 2015 to coincide with expiry of EB8), the Newman government has also taken the opportunity to arbitrarily determine the wage increase for nurses and midwives.

What can we do?

The QNU is urgently consulting with members the direction they would like to take from here.

It is very clear members are extremely angry at being treated so disrespectfully.

The QNU is investigating options for an organisational response, but the government’s new laws makes it extremely difficult to do so.

The best response for individual QNU members is to get involved in local community campaigning during the upcoming state election.

QNU Organisers will be speaking further to members in their workplaces and through QNU Local Branches about this.

You can register your interest in community campaigning, and also provide feedback via feedback@qnu.org.au www.qnu.org.au

NEWS

Pulse Health nurses secure much improved offer Pulse Health nurses have obtained a significantly improved offer from their employer after using protected action to support a fair deal.

Pulse nurses in Queensland were receiving much lower wages than other nurses in Queensland and lower than Pulse nurses elsewhere in Australia.

In fact, nurses at different Queensland facilities were receiving different wages to each other, despite doing exactly the same job for the same employer!

Protected industrial action For weeks, Pulse nurses across the three southeast Queensland facilities stood firm and took protected industrial action to persuade their employer to listen and give them a fair deal.

Action included stop works, street marches and rallies in Kingaroy, Gympie and Eden, and much more, including petitions with more than one thousand signatures gathered from around the state.

The public response was fantastic.

Everyone wants to see nurses, especially the poorly paid Pulse nurses, given a fair wage.

Media coverage has also been very favourable, with strong interest in

radio, print, and online—the industrial action has even been covered by Nursing Standard magazine from the UK.

Pulse comes back to the table After initially refusing to reconsider their substandard offer, Pulse Health management relented in the face of public embarrassment and member action and returned to the negotiating table.

In late September, Pulse agreed to a number of elements from the QNU proposal, although they continued to refuse some significant elements.

QNU claims agreed by Pulse included:  Improved wage rates to be paid from 1 July in 2015, 2016 and 2017 (but Pulse wants 2014 increases to be from around November, when the agreement is approved by the Fair Work Commission).  AIN rates to be increased slightly to be the same across facilities in Kingaroy, Gympie, and Eden.  1.3 weeks long service leave per year.  Three hour minimum payment per shift for casuals (up from two hours).

After considering the new offer, Pulse nurses decided to continue their protected industrial action.

OUR WAGES NEED CPR www.qnu.org.au

Pulse very quickly came back to the table with an even better offer, including:  Pay increases of between 5-8%, backpaid to 1 September 2014, and 3%7% each year thereafter.  No reduction in current conditions.  Overtime after eight hours (or after rostered hours if rostered between 8.5-10 hours).

While this isn’t everything Pulse nurses sought, it is a vast improvement on the original substandard offer.

After much discussion, Pulse nurses agreed to suspend their protected industrial action while the new offer goes to ballot.

The new offer is a much better outcome for Pulse nurses and their patients than there would have been without the nurses taking protected action.

Securing a better deal has taken a lot of hard work and dedication from Pulse nurses, who have invested a lot of their personal time and energy to get an improved deal.

The new deal is a major improvement, and goes to show the value of collective strength, having a clear plan, and having the courage to stand up and act.

Congratulations to all Pulse Health nurses!

STAT! OCTOBER 2014 | TQN | 19

FEATURE

YOUR ENTITLEMENT TOOLKIT In this edition, we look at the step-by-step processes you can use to ensure you can access your entitlements, and keep your workplace as safe as possible.

20 | TQN | OCTOBER 2014

www.qnu.org.au

FEATURE

Our working conditions play a huge role in how we perceive our work, and how much satisfaction we gain from it.

One of the QNU’s primary goals is to improve enforcement of our current working conditions for Queensland nurses and midwives was well as improving members’ terms and conditions.

It’s not an easy task. We all know employers and managers may try to convince members differently about their entitlements. Education is the key to enforcement.

Even when you know your entitlements, there is often a lot of implied and explicit pressure on nurses and midwives not to adhere to their working conditions—to work just a little longer without claiming overtime, or take just a little shorter meal break, or not say anything about a changed shift.

But the simple fact is many of these conditions exist for a specific reason: to keep those in our care, as well ourselves, safe.

The cumulative effects of working too long, or not having enough rest between shifts, or skipping meal breaks, can be very dangerous.

Unfortunately, the QNU has been receiving increasing reports from members of extreme workload pressures.

There is too much to do, and not enough nurses and midwives to do it.

It is having an effect on patient safety, and on our safety, job satisfaction, and our mental health.

Future editions of tqn will have much more to say about workloads.

The conditions we have in the workplace—the hours and arrangements for when and how we work—affect our whole working life and impact us long after the working day is finished.

WORKLOADS IN THE PUBLIC SECTOR As part of EB8, Queensland Health and the QNU devised two notices and processes that need to be followed in every QH unit (EB8 Clause 28.4).

The first notice is called the Workload Low Priority List.

This list is used by nurses and midwives in a unit to identify the low priority activities that will not be undertaken when a workloads issue is identified.

These activities can include data entry, managing telephone calls, moving beds and equipment, downloading documents, and filing.

Queensland Health has directed the timing of admissions and discharges will be aligned with the capacity of available nurses and midwives to complete these processes.

The second agreed form is the Notional Nurse/ Midwife: Patient Ratios form.

Like the Workload Low Priority List, this form has been jointly agreed for use by Queensland Health and the QNU. The Notional Nurse/Midwife: Patient Ratios form is to be displayed in all units.

The ratio is the number of patients to each Registered Nurse/Midwife on each shift. This ratio has to be determined for each unit using the Business Planning Framework.

To comply with the agreement and your award, Queensland Health must display the correct ratio.

If the ratio is not displayed or you believe it is incorrect, you should notify your manager and your local QNU activist or Organiser immediately to discuss this.

Remember: Failure to ensure the ratio is displayed places you and your patients at risk. Failure to comply with the BPF is a breach of the award. www.qnu.org.au

HOW TO USE THE FORMS 1 Identify what the low priority activities on 2 3 4

5 6

7 8

9

your unit are. Display this list so everyone knows what the low priority activities are.

Check the Notional Nurse/Midwife: Patient Ratio form is displayed.

At the beginning of each shift, check whether the Nurse/ Midwife: patient ratio has been met.

Use your professional judgement to determine if the workloads are safe and appropriate.

The staffing skill mix or high patient acuity may mean that even with the minimum ratio present, the unit may not be safe.

If there is a workload issue, ensure a QNU Workload form is completed. Keep a copy!

The QNU workload form tells your management what activities nurses or midwives will not be able to be complete on the shift.

The Workload Low Priority List explains this process and tells us that we must follow the process to keep ourselves and our patients safe.

Make sure you take action on your shift to ensure your workloads are safe. For example, if you are 8 hours short of RN hours on the shift, you need to find 8 hours of nursing activity that would be normally completed on the shift, and stop undertaking those activities.

After your shift, contact your Organiser for assistance using the escalation process to address the workload issue.

OCTOBER 2014 | TQN | 21

FEATURE

WORKLOADS IN THE PRIVATE SECTOR 1 2

3

4

Contact your local QNU activist or Organiser to discuss creating a workload management strategy.

Identify what the low priority activities on your unit are. You can display this list so everyone knows what the low priority activities are.

At the beginning of each shift talk to your colleagues about whether the workloads are appropriate on the shift. Use your professional judgement to determine if the workloads are safe and appropriate.

If there is a workload issue, ensure a QNU Workload form is completed (We have forms for aged care, private hospitals and Australian Red Cross Blood Service. If you need a Workload Form created for your area of employment let us know and we’ll write one with you.)

5

The QNU workload form tells your management what activities nurses or midwives will not be able to be complete on the shift.

6

Make sure you take action on your shift to ensure your workloads are safe.

7

All nurses on the shift need to keep a copy of the workload form and send a copy to the QNU.

8

CLAIMING YOUR ENTITLEMENTS From meal breaks to overtime, if you are going to ensure you are receiving your correct entitlements, you first need to know what they are.

Your entitlements are contained in your enterprise agreement, or you can ring QNU Connect if you are unsure.

You can use the procedure below for any entitlement.

2

Patient admissions of nurses An insufficient number Inappropriate skill mix replaced Sick leave/absence not

this day/shift:

l Inability to take rest pauses/mea Casual/relief staff Patient acuity increases not available Resources/equipment Overtime required failure Technology/equipment OUT to other areas or IN deployed Nursing staff

2

Submit a written grievance (collectively, where possible) to notify your line manager of the ongoing problem and your unsuccessful attempts to resolve it.

4

A meeting at the local level about the problem must take place within 7 days of your notification.

If no satisfactory resolution can be reached at stage 1, the QNU will escalate the matter to the HHS for resolution within 14 days.

breaks

ce:

l judgement what additional

resources are required?

Hours required:

Staffing category: Equipment required: Reason:

tasks the following checked ensuring patient safety, l judgement, therefore on this shift: According to your professiona may not be completed furniture made a low-priority and Moving equipment or will be or have been Making beds Cleaning Admissions Data entry Discharges of beds escorts Bed moves or cleaning Non-essential patient Terminal cleaning Re-stocking of supplies

STEP 4:

5

Answering telephones Filing

Other (please detail)

Staff present on this

shift are:

I/we have verbally reported

the workload issue to:

Team leader

Other

Your name/s: Facility:

Time/Shift:

Work area:

COPIES: COMPLETE, MAKE THREE ONCE THE FORM IS your line manager ■ Give the original to to the Director of Nursing ■ Give the first copy for your own records ■ Keep the second copy the third copy to the QNU. this form to assist you ■ Mail, email, or fax may contact you to discuss Your local QNU organiser issues. in resolving your workload the and your colleagues more forms please contact reporting form. If you need oads This QNU form is a valid or visit www.qnu.org.au/workl QNU on 07 3840 1444

22 | TQN | OCTOBER 2014

Please turn over for

management’s response

X

6

Fax a copy to QNU at 3844 9387 Brisbane: 4639 5052 Toowoomba: 4151 6066 Bundaberg: 3406 Rockhampton: 4922 4721 1820 Townsville: 4051 6222 Cairns: 05/14

Workplace Representative, Local Branch or QNU organiser.

Identify the dispute resolution process in your agreement (for example, Nurses and Midwives (Queensland Health) Certified Agreement (EB8) 2012 Clause 10).

3

arising as a consequen

professiona STEP 3: According to your

your enterprise agreement or award.

Discuss the entitlement with your colleagues to ensure everyone is clear.

It’s best to solve local problems with local solutions—but sometimes that isn’t possible.

If you and your colleagues have an ongoing problem where you cannot adequately access your entitlements like meal breaks, it’s time to escalate the issue—collectively if possible.

Other (please detail) problem/s STEP 2: Brief details of the

5

6

Contact your line manager about ensuring you receive your entitlement.

Sometimes you will need to fill in a form to access your entitlement. If you fill out a form, be sure to keep a copy for yourself.

If your line manager will not approve you to access the entitlement or sign the form, email your line manager to create a record of the issue. These are your entitlements, not your employer’s plaything. Keep a copy of the email and contact the QNU for assistance.

As a basic rule, ensure overtime is authorised before you work it! Do not work overtime unless it is authorised.

YOUR ENTITLEMENTS: HOW TO ESCALATE MATTERS

After your shift, contact your Organiser for assistance using the escalation process to address the workload issue.

on STEP 1: Identify the problem(s)

4

PROCESS TO ENSURE YOU ARE RECEIVING YOUR CORRECT ENTITLEMENT 1 Identify your entitlement by checking

ESCALATION IN THE PUBLIC SECTOR 1 Discuss the issue with your QNU

ADS PROFESSIONAL WORKLO REPORTING FORM — LS PITA HOS PRIVATE

3

If the matter still cannot be resolved, either party must refer the matter to the Nurses and Midwives Implementation Group (NaMIG).

7

NaMIG will consider the problem.

If NaMIG forms a unanimous view on the resolution of the problem, this view must be accepted and implemented by all parties. If NaMIG cannot form a unanimous view on the resolution of the problem, either party may escalate the matter to the Queensland Industrial Relations Commission.

ESCALATION IN THE PRIVATE SECTOR 1 Discuss the issue with your QNU 2

3

4

Workplace Representative, Local Branch and QNU Organiser.

Identify the dispute resolution process in your agreement. a. Submit a written grievance (collectively, where possible) to notify your line manager of the ongoing problem and your unsuccessful attempts to resolve it. b. If the dispute or grievance is still unresolved, the matter is referred to higher management. Steps (a) and (b) must take place within 14 days.

If the matter is still not resolved, it may be referred by either party to a senior official of the relevant union and the appropriate employer representative and/or State Consultative Committee.

If the matter is still not resolved, it may be referred by either party to Fair Work Australia for conciliation and if necessary, arbitration. www.qnu.org.au

FEATURE

STRENGTH IN NUMBERS: PROBLEM SOLVING AT A LOCAL LEVEL Resolving problems requires a strategy.

While the dispute resolution process outlined above is a collective one, using the grievance procedure may only be part of your strategy.

Collective strategies put in place several different avenues of escalation.

Your Local Branch will support and assist you with an escalation strategy.

PART 1: IDENTIFY THE TRUE ISSUE The tool includes a checklist to help you with this.

Discuss the issues so you can narrow down the nature of the problem.

Is it primarily about entitlements?

Or workplace practices (eg. rosters)?

Or employment practices (eg. advertising vacant positions)?

Or health and safety? Lack of opportunity to contribute to decisionmaking? Inappropriate behaviour?

Unprofessional conduct? Resourcing problems?

PART 2: IDENTIFY CONTRIBUTING FACTORS Be aware many problems have multiple contributing factors, including some you may not be aware of.

PART 3: CHOOSE THE RIGHT PROCESS There are many different ways to solve problems.

Options include your Local Branch, your Work Health & Safety Committee, your Health & Safety Representative, workplace health and

www.qnu.org.au

The QNU problem solving tool is summarised below.

See Section 7 of the QNU Local Branch and Workplace Representative Handbook for more details.

Visit www.qnu.org.au/branchhandbook Let your colleagues, Local Branch and QNU Organiser know you think there is a problem. safety committee, your Workplace Consultative Committee, collective grievance process, or the Queensland Civil and Administrative Tribunal (to name just some!).

QNU Connect and your QNU Organiser can help you understand which processes we could use.

PART 4: DETERMINE THE STRATEGY It’s important to have this established before you commence a collective activity.

A strategy will usually involve setting a meeting with members and activists, securing support from your QNU Local Branch, collecting and organising evidence, understanding which processes we use and selecting which ones we want to use and when, understanding how to lodge and escalate a collective grievance, involving your Health & Safety Representative, placing items on the agenda of your local consultative forum, and keeping people informed of progress.

Most importantly, as a group you must have a clear outcome in mind.

31 25

QNU LOCAL BRANCH AND WORKPLACE REPRESENTATIVES

IBOECPPL

IT WAS HARD-WON – SO USE IT! These are just some of the measures you can take to secure your entitlements.

Many of the entitlements we take for granted today were hard-won by earlier nurses and midwives.

It seems strange to think now that not so long ago nurses and midwives weren’t permitted paid maternity leave, and only secured it after determined campaigning from union members.

Many of these union members were nurses and midwives who would never reap the benefits of paid maternity leave themselves—but they understood the value of it to future nurses and midwives.

That’s why it is important we take the necessary steps to ensure our entitlements are understood and implemented.

If you don’t use it, you’ll lose it!

OCTOBER 2014 | TQN | 23

PROFESSIONAL

Making notifications to the Office of the Health Ombudsman A note from the Health Ombudsman The Office of the Health Ombudsman (OHO) is responsible for receiving complaints about health services provided by registered and nonregistered practitioners.

This includes receiving notifications from health practitioners, employers and educators, relating to the health, conduct or performance of registered health practitioners.

These notifications fall into three categories—mandatory, voluntary and self-notifications—as defined in the Health Practitioner Regulation National Law (Queensland) 2009 (the National Law).

Mandatory notifications Nurses and midwives are required to report all ‘notifiable conduct’ to the OHO, in accordance with section 140 of the National Law. These notifications relate to matters of a more serious nature, where public health and safety are at risk.

Voluntary notifications Practitioners may choose to make a voluntary notification to the OHO, on the grounds outlined in section 144 of the National Law. While not mandatory, these notifications are important in identifying and improving systemic issues.

Voluntary notifications of a less serious nature may be referred by the OHO to the Australian Health Practitioner Regulation Agency, or another appropriate organisation, for management.

Self-notifications For examples of notifications, see the CPD article on page 28.

24 | TQN | OCTOBER 2014

Finally, while not managed by the OHO, nurses and midwives should be aware they must self-notify within seven days

to the Nursing and Midwifery Board if certain ‘relevant events’ occur.

These are outlined in section 130 of the National Law and include issues relating to rights to practise, insurance, criminal charges and convictions, billing privileges and other matters.

It’s important to understand that the OHO’s jurisdiction is primarily around complaints in health service delivery, meaning it does not generally extend to industrial relations or human resource related issues.

Matters such as these, that are determined to be outside the OHO’s jurisdiction, will usually be referred back to the health service or organisation in which they have occurred.

If in doubt though, the OHO is happy to answer any questions you may have. You can:  email info@oho.qld.gov.au  call 133 OHO (133 646)  write to PO Box 13281 George Street, Brisbane 4003, or  visit www.oho.qld.gov.au www.qnu.org.au

PROFESSIONAL

REGISTER NOW!

Groundbreaking nursing researcher to visit Brisbane One of America’s most influential healthcare professionals, renowned researcher Professor Linda Aiken will visit Brisbane in December as guest speaker for a QNU patient safety symposium.

Professor Aiken is recognised for pioneering research linking nurse-topatient ratios with patient safety.

Her groundbreaking 2002 study Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction (Aiken et al 2002) found each additional patient assigned to a nurse resulted in:  30-day patient mortality increase by 7%.  Failure-to-rescue rates increase by 7%.  Odds of nursing job dissatisfaction increase by 15%.  Odds of nurse burnout increase by 23%.

Another study, succinctly summarised with the headline ‘more nurses, less death’, found 10%-13% fewer surgical patients in New Jersey and Philadelphia would die

if hospitals in those states had as many nurses as Californian law dictates.

The 2010 study also found the average California medical-surgical unit nurse cared for two fewer patients than the average New Jersey nurse.

California nurses “liked their jobs better and were less likely to feel burned out”.

Professor Aiken’s research has been particularly noteworthy for its use of hard evidence in the form of extensive statistical data.

Now at the University of Pennsylvania’s School of Nursing, Professor Aiken will be guest speaker at a QNU symposium later this year titled Keeping Patients Safe.

There will also be a host of other speakers on the day. More details will be announced closer to the event.

So lock in the date—3 December 2014 at the Brisbane Convention and Exhibition Centre.

For more information or to register visit www.qnu.org.au/keepingpatientssafe

References Aiken L, Clarke S, Sloane D, Sochalski J, Silber J (2002) “Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction”, Journal of the American Medical Association (16) 288, 1987-1993.

Aiken L, Sloane D, Cimiotti J, Clarke S, Flynn L, Seago JA, Spets J, Smith H (2010) “Implications of the California Nurse Staffing Mandate for Other States”, Health Services Research (2) 45.

Special international tional guest speaker

Professorr Linda Aiken University off Pennsylvania School of Nursing rsing (USA)

3 December mber 2014 Brisbane Convention nvention and Exhibition Centre Plus many more speakers.

To register or for more information visit

ROVFWFOUT

www.qnu.org.au/keepingpatientssafe REGISTER NOW! www.qnu.org.au

OCTOBER 2014 | TQN | 25

NURSING AND MIDWIFERY RESEARCH

The use of diaries to promote recovery after critical illness

BY AMANDA ULLMAN (SENIOR RESEARCH ASSISTANT) & LEANNE AITKEN (PROFESSOR OF CRITICAL CARE NURSING)

Admission to intensive care exposes patients and family members to extreme physical and psychological stress.

This stress may cause anxiety, depression and post-traumatic stress disorder (PTSD), which impairs their recovery.

Nurses are actively seeking solutions and tools to assist patients and family members to recover after admission to intensive care.

Patient diaries A strategy that has been in use for some time in a few areas of the world is the use of patient diaries.

These diaries, authored by family members, health care staff or both, provide a background to the critical illness, and an ongoing narrative regarding the patients’ admission to intensive care.

This information is then provided to the patient after intensive care unit (ICU) discharge in an effort to ‘fill

memory gaps’, in the hope of improving psychological recovery.

Cochrane review findings A Cochrane review—a systematic review of primary research—was recently undertaken to assess the effect of patient diaries on recovery in patients’ recuperating from admission to an ICU, and their families or caregivers.

The review included all randomised controlled trials (RCTs) or clinical controlled trials that evaluated the

effectiveness of diaries in terms of reducing PTSD and its symptomatology, anxiety, depression, health-related quality of life and costs.

Electronic searches identified three eligible studies—two describing ICU patients (352 participants) and one describing relatives of ICU patients (36 participants) who had used diaries.

After a critique and extraction of the results of the studies, the review found there is currently no evidence from RCTs regarding the benefits or harms of patient diaries for patients and their caregivers or family members.

Small studies have described their potential to reduce anxiety and depression and post-traumatic symptomatology, but there is no evidence to support their widespread use.

Research exploring the potential development and role of patient diaries in promoting recovery after critical illness is currently underway, led by Professor Leanne Aitken (Princess Alexandra Hospital and NCREN, Griffith University).

This research program involves collaboration between multidisciplinary healthcare professionals including nurses, researchers, psychologists and psychiatrists.

Future NCREN articles will report on the progress of this research.

References  For a full report of the Cochrane review please refer to The Cochrane Database for Systematic Reviews, www.cochrane.org  A critical review of the evidence to surrounding patient diaries is also available in: Aitken L, Rattray J, Hull A, Kenardy JA, Le Brocque R, Ullman A (2013) ‘The use of diaries in psychological recovery from intensive care’, Critical Care 17, 253.

26 | TQN | OCTOBER 2014

www.qnu.org.au

MIDWIFERY

Midwives Australia and private practice midwives

BY LIZ WILKES, MIDWIVES AUSTRALIA

The last few years have seen many changes for professional midwives.

With national registration in 2010, for the first time midwives were placed on a separate register nationally and this effectively separated the profession from nursing.

Since this time midwives have also seen the development of the National Maternity Plan.

The plan has meant the development of a range of new models in maternity care with a particular focus on continuity of care.

These changes have been primarily driven by consumers who want more access to midwives for one-on-one care from early pregnancy, through labour and birth, to six weeks after birth.

As a result the career options for midwives have altered significantly in the last few years.

In particular, self-employment is a more significant option for midwives, with Queensland leading the way.

Thus it is no surprise that private practice midwives have been working in collaboration with the Queensland Nurses’ Union during this period of change to explore many of the options that have developed.

Midwives Australia Midwives Australia is an organisation which supports midwives working in selfemployed practice as “private practice midwives”.

The organisation was founded in 2010 to provide a means to connect midwives who were moving into private practice as a result of the maternity reform agenda that was occurring at a federal level.

Midwives were able to gain a notation from AHPRA called “eligibility” which enabled them to apply for a Medicare provider number and PBS access. www.qnu.org.au

Midwives Australia has provided information, education and tools for these midwives.

Most “eligible” or “Medicare” midwives have needed some guidance to deal with insurance, business start-up, Medicare, private health funds, and working collaboratively with medical colleagues.

However the biggest change has been in allowing midwives to admit their private patients to public hospitals.

Access to hospitals Midwives Australia, the Australian College of Midwives, the Queensland Nurses’ Union and Maternity Choices Australia have worked tirelessly together to ensure that visiting access or admitting rights have been an option for Queensland midwives.

Queensland currently has eight hospitals which work with private practice midwives and to which midwives have admitting rights.

This means public hospitals will allow private practice midwives to admit their clients and provide care, generally birthing care, for women.

This option was outlined as part of the National Maternity Plan and was signed off by each state nationally.

However, so far Queensland is the only state to have implemented this option.

The strong partnerships between consumer organisations, midwifery organisations such as Midwives Australia, and the QNU has certainly assisted.

Meetings have regularly been conducted on these topics and the QNU has also focused valuable time in assisting with lobbying and advocacy on issues for midwives who are expanding their career options into private practice and working in a variety of caseload models with Medicare access.

It’s an exciting time to be a midwife in Queensland. Let’s stay focused, and keep working together.

OCTOBER 2014 | TQN | 27

CONTINUING PROFESSIONAL DEVELOPMENT

C ASE S TU DY

Reporting obligations regarding performance issues and workplace matters LUKE FORSYTH, HALL PAYNE LAWYERS

Health service complaints rarely arise in a vacuum.

As many practitioners will appreciate, a complaint will have a context, a background and a bigger picture.

For the practitioner facing a complaint, the process will often be a stressful and demoralising experience.

For all of the discussion around the mandatory reporting obligations imposed upon nurses and midwives, there are so very many circumstances where the Health Ombudsman (and formerly AHPRA) will not be best placed to deal with the issues, especially at first instance.

When considering registered health practitioners, mandatory reporting obligations arise only in circumstances where you reasonably believe a registered health practitioner, in the course of practising his or her health profession, has behaved in a way that constitutes ‘notifiable conduct’.

The National Law defines ‘notifiable conduct’ as behaviour or an impairment that places the public at risk of harm (and in the case of impairment, substantial harm).

More times than not, workplace issues arising from differences of opinion and personality, and the bulk of emergent performance and conduct issues do not give rise to mandatory reporting obligations.

The “first port of call” for the vast bulk of performance issues will be a practitioner’s employer, not the Health Ombudsman or AHPRA. For employers, where performance is in question or being managed, a complaint to the Health Ombudsman should be a last resort, only where all reasonable management processes regarding 28 | TQN | OCTOBER 2014

concerns have been fairly conducted and exhausted.

Where the crux of a complaint is a systemic issue, the burden of responding to the complaint ought not rest on an individual practitioner.

The new arrangements for the Health Ombudsman to receive complaints regarding a “health service provider” mean that complaints can be made against an entity in the same way as against an individual practitioner, yet we still see complaints falling disproportionally at the feet of individual practitioners.

As the below case studies show, reporting emergent performance issues and attributing responsibility for systemic issues to individuals rarely resolves matters and unduly often burdens practitioners in the process.

Bullying or constructive feedback?

A notification was submitted by a graduate nurse to AHPRA which alleged that her preceptor, a senior RN, had, among other things:  bullied her  set her up to fail  set her up to make a medication error  yelled at her and  consistently made rude remarks toward her.

The RN was assisted to make a submission in response to the allegations.

The submission asserted that what the complainant had perceived as “bullying” or

“rude” was, in fact, constructive criticism designed to assist the complainant in her early stages as a graduate nurse.

It was also submitted on behalf of the RN the matters complained of were properly characterised as “workplace matters” and the subject matter of the complaints had already been adequately dealt with by the employer.

It was noted there had been no public safety issues arising as a result of the RN’s actions and it was therefore not a matter upon which either AHPRA or the NMBA ought to concern itself with.

The NMBA agreed the allegations were industrial in nature and would be better handled at the local level at the place of employment.

The NMBA also agreed the allegations did not identify a risk to public safety, or comment on the nurse’s ability to practise the profession safely and effectively.

The NMBA decided to take no further action in respect of the notification.

The graduate nurse has other avenues available to her to seek to address this issue in her workplace, such as the grievance process.

Fit to work or not?

A notification was submitted by an employer to the OHO about the health of a RN. The complaint alleged the RN had a permanent impairment which “placed the public at risk of substantial harm”.

The RN had sustained a workplace injury.

The RN commenced a return to work program and unfortunately, sustained a second workplace injury.

The employer arranged for the RN to be independently examined by an occupational physician despite the RN www.qnu.org.au

CONTINUING PROFESSIONAL DEVELOPMENT

providing certificates from a surgeon stating the RN was fit to return to work.

The employer then proposed to commence an ill health retirement.

The RN was assisted to make a written submission which stated the complaint by the employer was misconceived in that the RN did not have an impairment.

It was also submitted the NMBA ought to be mindful of complaints that are properly characterised as industrial in nature and which do not give rise to reporting obligations under the National Law. The NMBA has not yet delivered a response to this case, however the RN is hopeful the NMBA will agree the subject matter of the complaint is misconceived such that no further action is required.

Whose medication?

A complaint was referred to AHPRA by the Health Ombudsman about the performance of a RN. The RN’s employer had provided the Health Ombudsman with information about an incident.

The employer alleged the RN had discharged a patient with another patient’s medication and, in contravention of the employer’s policies, had failed to undertake any patient identification or discharge medication processes.

The RN was assisted to respond to the Health Ombudsman by providing a written submission.

At the outset, the RN conceded the discharged patient had inadvertently received another patient’s medication.

Nonetheless, it was submitted on behalf of the RN the complaint was misconceived in that the employer’s policies governing discharge medications did not create a positive obligation on any RN (or employee) to check a patient’s discharge medication before the patient discharged.

Instead, it was submitted this was a systemic issue, highlighted by the fact the employer had undertaken an internal investigation and subsequently amended the policy to ensure such checks were undertaken.

The NMBA has not yet delivered a response to this case, however the RN is hopeful the NMBA will agree the subject matter of the complaint is either misconceived or has already been adequately dealt with by her employer, such that no further action is required. www.qnu.org.au

Reflective exercise for case study over page »

OCTOBER 2014 | TQN | 29

CONTINUING PROFESSIONAL DEVELOPMENT

C ASE S TU DY

Reflective exercise:

Reporting obligations regarding performance issues and workplace matters 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 reporting obligations required of nurses and midwives regarding performance issues and workplace matters including mandatory reporting of another registered health practitioner.

The following questions are offered as a guide to assist you in identifying your learning from reading and analysing the content of the article. Explain and analyse the following questions: 1. How does the National Law define the threshold for ‘notifiable conduct’?

2. Consider the three case studies. As a nurse or midwife, which case studies (if any) would you reasonably believe the registered health practitioner, in the course of practising their health profession, has behaved in a way that constitutes ‘notifiable conduct’. Why do you reasonably believe this?

3. Consider the three case studies. As a nurse or midwife, which case studies (if any) would you reasonably believe a registered health practitioner, in the course of practising their health profession, has not behaved in a way that constitutes ‘notifiable conduct’? Why do you reasonably believe this?

4. Consider the three case studies. As a nurse or midwife, which case studies (if any) would you reasonably believe a registered health practitioner, in the course of practising their health profession, may have behaved in a way that constitutes ‘notifiable conduct’. Why do you reasonably believe this?

5. Which of the three case studies may indicate a systemic issue and why?

6. How does the Health Ombudsman manage a complaint against a “health service proivider”?

7. Who is the “first port of call” for the majority of performance issues, and why?

8. What are the reasonable management processes regarding employer performance?

9. How are reasonable management processes regarding employer performance conducted fairly and exhausted in your workplace?

Following reflection, consider how you will retain and share the new knowledge about the reporting obligations regarding performance issues and workplace matters as a nurse and / or midwife who reasonably believes a ‘notifiable conduct’ has occurred by another registered health practitioner.

What influence will these changes have on your professional practice regarding ‘notifiable conduct’?

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):

30 | TQN | OCTOBER 2014

Date

Topic

Description

27-03-14

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 AND SAFETY

Is it time to have a further look at breaks between shifts?

Fatigue is recognised as a significant hazard in the health industry, whether the risk is to those who use the system or those work in it.

Currently, measures to manage fatigue include working conditions around hours of work, rest pauses and meal breaks. These are contained in nursing and midwifery awards and enterprise agreements.

Many nurses and midwives will remember times before the implementation of 10 hour breaks between shifts, and how difficult the campaign was to secure this condition.

They will likely remember the times they only had six or so hours of sleep after completing a late shift, and having to front up next morning to start an early shift.

This was the kind of working arrangement that endangered patients, as well as nurses and midwives.

What some nurses and midwives may not realise is that even today, not all of us are afforded 10 hour breaks between shifts.

This is because nurses and midwives who rely on the Nurses Award 2010 only receive a minimum eight hour break between shifts.

The relevant clause from the Nurses Award 2010 states:

Rest breaks between rostered work An employee will be allowed a rest break of eight hours between the completion of one ordinary work period or shift and the commencement of another ordinary work period or shift.

An eight hour break doesn’t guarantee an eight hour sleep. With time travelling to and from work as well as preparation (nurses and midwives need showers too!), six hours sleep is about as good as it gets on an eight hour break.

Now consider a circumstance where a nurse was to experience this over several shifts with less than six hours sleep. www.qnu.org.au

Workplace Health and Safety Queensland warn this sleeping pattern can lead to a condition known as “sleep debt”, which is a significant cause of fatigue.

Fatigue is recognised as leading to increased error rates, increased possibility of accidents, and increased risk of injury.

This is the fundamental reason nurses and midwives launched the campaign through the QNU to increase the break between shifts.

In the European Union, Working Conditions-Working Time directive (2003/88/EC) provides a minimum daily rest period of 11 consecutive hours in every 24.

This directive was central to a recent 12 month study of nurses in Norway that examined breaks less than 11 consecutive hours, and the effect on fatigue.

The study found the number of “quick returns” (or shift patterns that meant nurses worked shifts separated by fewer than 11 hours) could predict the risk of fatigue, and the development of “shift work disorder”—a condition of excessive sleepiness related to work and persisting for at least one month (Flo et al 2014).

In this study, our 10 hour shift break would be considered a “quick return” shift.

All nurses and midwives should be thinking about further restrictions on the number of “quick return” shifts.

Discuss with your branch and your colleagues, and engage with your employer to find ways to better manage fatigue.

Reference Flo E, Pallesen S, Moen BE (2014) “Short rest periods between work shifts predict sleep and health problems in nurses at 1-year follow up”, Occup Environ Med 71, 555-561.

OCTOBER 2014 | TQN | 31

INDUSTRIAL

94%

OF NURSES AND MIDWIVES REPORT UNSAFE WORKLOADS IN PRIVATE SECTOR

A recent QNU survey shows the vast majority of private sector nurses and midwives report they are not always able to handle their workload safely.

Workloads and skill mix In a snapshot:  Only 5% of respondents indicated there were ‘always’ enough nurses/midwives to handle the workload safely.  41% of respondents indicated there were enough nurses/midwives to handle the workload safely ‘sometimes’.  29% indicated ‘most of the time’.  24% indicated ‘rarely’ or ‘never’.

Alway s

Are there enough nurses/midwives to handle the workload safely?

Problem lies in regulation of private health facilities

Rarely/never Most of the time

Sometimes

Respondents commented that shifts were often understaffed, staff on leave were not replaced, nurses and midwives were met with hostility when asking for more staff, and nurses and midwives could not provide patients with more than basic care.

A total of 62% of respondents replied ‘no’ when asked if the skill mix in the nursing staff employed in the work unit in the last six months was sufficient.

Patient safety Respondents were also critical of management’s prioritisation of patient safety, commenting that wards are understaffed, staff/patient ratio is 32 | TQN | OCTOBER 2014

inadequate, the profit motive overrides safe care, and there is too much focus on KPIs. The survey showed:  46% of respondents disagreed or strongly disagreed that the actions of hospital management show that patient safety is a top priority.  53% of respondents agreed or strongly agreed that hospital management seems interested in patient safety only after an adverse event.

Respondents reported criticism is not welcomed from staff, management only act after patient complaints, and blame is often shifted to nurses.

The August edition of tqn outlined some of the complex arrangements that regulate private health facilities.

These arrangements are supposed to ensure private health facilities operate according to high standards of practice.

However, the same legislation that establishes these standards also permits Has the skill mix in nursing staff been sufficient in the last six months?

Yes No

Does hospital management only seem interested in safety after an adverse event?

Agreed

Disagreed

private health facilities to avoid reporting publicly on their activities if such information is considered likely to damage their commercial interests.

The legislation also permits the Chief Health Officer to decide whether information should be publicly disclosed or not. So far, the tendency appears to be against releasing information to the public.

When it comes to safety standards, commercial interest appears to override the public’s right to know important information on clinical practice and outcomes in private health facilities.

Our concerns are highlighted by the recent death of an elderly patient at the Sunshine Coast University Private Hospital (SCUPH).

The death also shows why it is so important nurses and midwives in the private sector continue to speak up.

The QNU has received a number of reports from private sector nurses and midwives about incidents and practices that could endanger patient safety. www.qnu.org.au

INDUSTRIAL

Bupa nurses to remain underpaid until 2017 A new enterprise agreement which locks in very low wages for Bupa nurses has been approved by the slimmest of margins.

These reports relate to operating procedures (ACORN), medication management, scope of practice, skill mix and workloads.

Consistent public reporting is needed In the interests of maintaining quality and safety standards, the QNU believes there must be consistency in investigating and reporting publicly on all adverse incidents—whether they occur in the private or public health systems.

The QNU has written to the Chief Health Officer regarding our concerns.

The QNU knows Queensland nurses and midwives take patient advocacy seriously and want to ensure safe standards and practices.

Nurses and midwives in the private sector should continue to raise issues around workloads, skill mix and patient safety with their managers, and to talk with their local QNU representative. www.qnu.org.au

The approval came despite a strong campaign for fair wages, with hundreds of emails and letters sent to the most senior Bupa management in Australia, protests outside facilities in New Farm and Merrimac, and a mobile billboard travelling between Brisbane, Gold Coast and Toowoomba.

Unfortunately Bupa refused to return to the negotiating table, and instead put their unfair wage offer to a vote.

The QNU recommended voting against the proposal, but it was approved by just 18 votes.

Most Bupa AINs will receive a wage increase of just 1% this year. With inflation running at 3%, this a wage loss in real terms.

This also means when the agreement expires in 2017, Bupa wages for Queensland nurses will still be significantly less than most other aged care providers.

Why won’t Bupa pay Queensland nurses the same as NSW and Victorian nurses?

Bupa says it is not financially sustainable, and came about due to “historical differences”.

This is nonsense. Regardless of past history, employees should be paid the same wage for doing the same work.

As for the claim it is not financially sustainable, Bupa recorded a profit of $1.15 billion in 2013. It can certainly afford to pay its staff a fair wage.

Errors may prevent approval In its hurry to put the proposal out to vote, Bupa made numerous errors which may prevent the agreement from being approved by the Fair Work Commission (FWC).

They include:  The agreement is not signed by a bargaining representative. The agreement won’t be approved unless Bupa remedies this fundamental mistake.  Misleading explanation of the agreement. A flyer distributed by Bupa misrepresented what wage increases most employees would receive under the proposal.  Bupa may not have taken the necessary steps to explain the agreement to employees who come from non-English speaking backgrounds. Employers must ensure this is done.  The classifications in the agreement are out of date.  The QNU has received reports some employees were unable to log on and vote on the agreement. The QNU is seeking further detail from members in this situation.

Bupa puts PROFITS

before

RESIDENTS

$1.15 billion profit in 2013 but nurses are overworked and underpaid

OCTOBER 2014 | TQN | 33

SOCIAL

It’s time to end the targeting of Aboriginal women

The shameful targeting of Aboriginal women in the legal and criminal justice system must be halted.

The rates of imprisonment for Aboriginal women in Australia have rocketed up by 86% in the past decade according to Sisters Inside, an independent community organisation which provides counselling and support services to women in the criminal justice system.

In comparison, the imprisonment rate for non-indigenous men has grown only around 3%.

CEO of Sisters Inside Debbie Kilroy blamed the trend on “systemic and structural racism and sexism”, and has asked all women—indigenous and nonindigenous—to join a campaign aimed at halting it.

“We can achieve a great deal with simple changes, like making non-payment of fines a non-jailable offence,” she said.

“We can look more closely at our domestic violence laws which have been ‘de-gendered’ so that it’s likely Aboriginal women defending themselves against a violent partner will have an order slapped on her as well by the police.

“We can also change the way we deal with those situations, which have become infected by the prejudices of some lawyers.

“For example, if a man has been stabbed, they’ll ask his wife if she did it and she’ll say, yes—that’s it, she’s done.

34 | TQN | OCTOBER 2014

“Then I go in and say, ‘so your husband got stabbed, tell me what happened’.

“And then you get a long and horrific history of the violence she’s endured for years until finally, she’s fought back. It changes the story.”

Ms Kilroy also called for more emphasis on programs that not only engage young at-risk Aboriginal women, but programs that provide reliable and trustworthy connection for them.

“Long-running programs around art and sport provided by Sisters Inside had kept troubled Aboriginal girls out of courts and detention centres,” she said.

In October, Sisters Inside hosted the Are Prisons Obsolete? conference featuring world-renowned activists Angela Davis, Kim Pate and Gina Dent, Australian journalist and commentator Anne Summers, and international experts on decarceration and women’s experience including Sharon McIvor (Canada), Deborah Coles (UK), Erica Meiners, and Cassandra Shaylor.

Australian experts included Antoinette Braybrook, Priscilla Collins, Amanda George, Melissa Lucashenko, and Megan Davies.

Women with lived prison experience also attended, and the conference was

“WE CAN ACHIEVE A GREAT DEAL WITH SIMPLE CHANGES, LIKE MAKING NONPAYMENT OF FINES A NON- JAILABLE OFFENCE”

the scene of a lively auction of young indigenous women’s art.

Sisters Inside was partly defunded by the Newman government shortly after coming to power in 2012.

Not-for-profit organisations—including the QNU—made donations to this vital service to ensure women prisoners in Queensland continue to have access to counselling and support services.

You can donate too by visiting www.sistersinside.com.au/ fundforchildren.htm www.qnu.org.au

OPINION

MIXED GENDER

ACCOMMODATION COUNCILLOR KYM VOLP, FACN

The values of nurses and midwives are based on the core ethic of caring, built upon professionalism, advocacy and holism.

We recognise ourselves by these values.

Our conduct in practice is based on indispensable and knowledgeable human caring, the ethical obligations of sharing our humanity with vulnerable others, keeping the system safe and human.

This is our “value proposition” in today’s dominant market language.

This is how and why we continue to sustain high trust with the communities we serve.

It could be said the most critical buffer between the patient and the ‘system’ is the nurse or the midwife.

We understand however, that some people are trying to erode and disregard the value of nursing and midwifery.

Most of us do nursing and midwifery in institutional environments where numbers or ‘performance metrics’ are prioritised in approaches to care and service.

This obsession with numbers distorts our purpose.

It diminishes the capacity for vulnerable patients to be treated respectfully as humans.

Patients are reconfigured as beds (Hau, 2004).

Mixed gender bed, body and bathroom spaces It has proven difficult to successfully articulate our value in the current contest of political and economic directions. www.qnu.org.au

We confront this test in the case of mixed gender accommodation for inpatient men and women in Queensland public hospitals.

Protesting nurses are given short shrift with the gagging dismissal: “Same gender bed spaces? Same gender bathrooms?

Naah… just a block to patient flow… and what? …informing and consenting patients in ED – naah, no.”

How powerful is the new truth in de-humanising care?

How powerful has the process of normalisation become in trying to unhinge our values of advocacy and holism?

Resistance in the face of this kind of power takes awareness, courage, and knowing the point beyond which a practice is not acceptable.

There is no defence for mixed gender wards, which leave nurses and midwives stressed in dealing with concerned patients and families.

Nurses, midwives, and consumer groups elsewhere have led successful ‘dignity drives’ where system failure has been scandalised.

For example, in the UK active prohibition of mixed gender wards—with breaches and penalties made public—have applied since 2007.

In New South Wales a similar policy is in effect.

This is established best practice— although one would hardly need scientific evidence to be convinced in this case of the “right thing to do”.

In Queensland 2014, we have no policy or strategy that reflects best practice or that mitigates the risks experienced by inpatients and their families, as well as nurses and midwives.

The risks are well documented.

These include ethical risks, as well as risk around governance, clinical safety, cultural appropriateness, service user rights, and service reputation.

It is incredible that with this risk profile, we are disregarded in our ongoing advocacy for the rights of patients to respectful treatment.

Think slippery slope The mixed gender bed, body and bathroom space issue is one where all nurses and midwives can take the lead with courage and confidence.

Putting managerial values before human caring places entire organisations on a slippery slope.

It raises the question “What next?”

References: Hau, WWM (2004) “Caring holistically within new managerialism” Nursing Inquiry 11(1), 2-13.

OCTOBER 2014 | TQN | 35

PROFILE

QNU nurse named state’s top dad Toowong Private Hospital mental health nurse and long-time QNU member Andrew Butwell was named Queensland’s Father of the Year last month. This is his story.

When you listen to Andrew Butwell speak, you get the feeling few things ever slow him down.

The Toowong Private Hospital credentialled mental health nurse not only talks fast, but speaks with genuine enthusiasm for his family, his work and his life.

A single dad to four children, a junior rugby league manager and Director of specialised housing service Mantle Housing, Andrew balances his work and family commitments with such aplomb you’d never guess he’s endured adversity that has sent many into despair.

In November 2006, Andrew’s life changed irrevocably when he was severely injured in a brutal attack.

“They (police) don’t really know what happened, but I was assaulted and thrown over a walkway,” he said.

When he woke in hospital, Andrew was paraplegic.

“I went through a grieving process, I was angry and frustrated—but I looked around the unit and saw blokes who were quadriplegic and on breathing machines and I thought “well, I’ve got it pretty good really”—so I just got on with it.”

“There’s no question my nursing background helped with my recuperation.

I was way ahead of the game mentally in understanding the challenges of being paraplegic.”

With the help of his family and a good deal of his own grit, Andrew spent just four months in rehab at the Princess 36 | TQN | OCTOBER 2014

“... THESE DAYS I GIVE EVERYTHING A GO AND OFTEN SURPRISE MYSELF AT WHAT I CAN DO. IF I TRY AND IT DOESN’T WORK, I FIND A WAY AROUND.” Alexandra Hospital and returned to work two months earlier than expected.

“There was never any question of not returning to work—I had to go back.

“There’s no way I was leaving this world without providing for my family.

“I knew I didn’t have to be doing all the physical nursing stuff—the brain is still ok, it’s just the lower part of me that doesn’t function,” he said.

“So I wrote to the Queensland Nursing Council and they agreed there was no reason why I couldn’t keep my registration.”

Andrew took on a program position within Toowong’s mental health team.

Initially working part time and from home, Andrew began developing a Mental Health Nurse Incentive Program (MHNIP) for the hospital and in 2008 the federal government gave the project the green light.

Six years later and with a Masters of Mental Health Work from USQ under his belt, Andrew is now the Community Services Manager at Toowong Private.

He oversees the care of about 130 patients, about 100 of whom reap the benefits of the fully-fledged MHNIP. Andrew also has his own patient caseload to manage.

“There was a bit of trepidation initially about home visits and meeting people face to face, but in the end I thought what’s really stopping me?”

“And you know, not one patient has ever said they had a problem with me being in a wheelchair—in fact a lot of them don’t even see me in the chair anymore,” he said.

“Some have even said they start to realise their situation may not be so bad and they give themselves a bit of an uppercut.”

For Andrew the focus now is on making sure he has plenty of time for his children and tackling every roadblock head on.

“I used to love mowing the lawn, building pergolas, getting my hands dirty and going to the beach with the kids, and it really frustrated me I couldn’t do some of those things anymore,” he said.

“But these days I give everything a go and often surprise myself at what I can do.

If I try and it doesn’t work, I find a way around.”

“Although, let me tell you, a wheelchair in sand—well that’s just a disaster!” *The Queensland Father of the Year awards are hosted by Scripture Union Queensland in partnership with RSL Queensland. www.qnu.org.au

YOUR LIBRARY

QNU LIBRARY: a world of knowledge at your fingertips QNU members have access to thousands of medical and nursing texts through the union’s very own library. Based in Brisbane but servicing members all over the state, the library is a great resource and just one of the many benefits of being a QNU member.

Loans from the QNU collection Books and videos are available for loan to all QNU members at no charge.

Books can be ordered online, by phone, by fax, or by visiting the library. There is a maximum of 4 items per request.  Postage to members is paid for by the QNU with return postage being the responsibility of the member.  Periodicals are not available for loan but articles may be photocopied in the library at 15 cents a page.

Interlibrary Loans The QNU Library belongs to a network of health libraries (GRATISNET). Requests for photocopies of journal articles should be submitted on copyright request forms giving full citations and accompanied by a cheque or money order.

allied health subject areas; many but not all are full text.

For the next 12 months (until the beginning of October 2015) we are conducting an online trial of this database.

During this time members will have remote online access to CINAHL and are urged to make use of this not only as a source of information but also as a way of developing online searching skills.

Visit www.qnu.org.au/library to access CINAHL (members only).

Literature searches Charges for literature searches no longer apply.

We encourage members to hone their library search skills but if you have trouble finding relevant articles for assignments or difficulty accessing nursing information generally, the QNU librarian can conduct searches to find suitable citations.

NORMAL LIBRARY HOURS Monday - Friday 9am–3pm (closed 1pm–2pm)

07 3840 1480 library@qnu.org.au www.qnu.org.au/ library

Small groups can book the library for study sessions.

Contact the library for details.

Location: Level 1, 106 Victoria Street West End, QLD, 4101 Phone: 3840 1480 / 3840 1443

Samples of the citation required:  Journal articles NURSING MANAGEMENT Vol. 30 (9) Sep. 1999: pp. 16-17 KEELING, Bett.

How to allocate the right staff mix across shifts.  Books WATSON, Jean. Postmodern nursing and beyond. London: Churchill Livingstone, 1999.

Interlibrary Charges  Charges apply only to items supplied by libraries outside the GRATISNET network.

 Photocopies of articles: $3.30 (incl. GST) each.  Book loans: $6.60 (incl. GST) each.

Access to CINAHL Plus with full text Members are welcome to visit the library to access CINAHL, a database which indexes more than 4000 journals from nursing and The QNU’s friendly librarians, Madeleine and Pat. www.qnu.org.au

OCTOBER 2014 | TQN | 37

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

OCTOBER QNU training Health & Safety Representative training for nurses and midwives 27,28,29,30,31 October,Brisbane www.qnu.org.au/qnu-training Lung Health Promotion Centre at The Alfred 27-28 October, Spirometry Principles & Practice Ph: (03) 9076 2382 Email: lunghealth@alfred.org.au Safe Work Australia Week 27 October-2 November

2nd International Conference on Nursing & Healthcare Exploring the Possibilities towards Better Healthcare 17-19 November, Chicago, USA http://nursing2014.conferenceseries. net 17th South Pacific Nurses Forum Nurses collaboratively rowing (leading) the way 18-21 November, Tonga http://www.spnf.org.au/ Universal Children’s Day 20 November

JANUARY Winter Global Nursing Symposium Nursing Practice, Nursing Education, Nursing Management, and Disaster Management 9-10 January 2015, Los Angeles, USA www.uofriverside.com/conferences/ global-nursing-symposium/2015winter-global-nursing-symposium/

MARCH International Women’s Day 8 March 2015 http://www.unwomen.org/

MAY International Conference on Nursing 4-7 May 2015, Athens, Greece www.atiner.gr/nursing.htm International Day of the Midwife 5 May 2015 www.internationalmidwives.org/ World Red Cross Day 8 May 2015 www.icrc.org/eng/resources/ documents/misc/57jqz6.htm

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 QNU training Nurses & Midwives EB9 - Phase 1 6 November 2014,Brisbane Emotional Resiliance 7 November 2014, Brisbane Nurses & Midwives EB9 - Phase 1 10 November 2014, Brisbane Nurses & Midwives EB9 - Phase 1 12 November 2014, Toowoomba Nurses & Midwives EB9 - Phase 1 13 November 2014, Bundaberg Nurses & Midwives EB9 - Phase 1 18 November 2014, Cairns Nurses & Midwives EB9 - Phase 1 18 November 2014, Mackay Nurses & Midwives EB9 - Phase 1 20 November 2014, Townsville Nurses & Midwives EB9 - Phase 1 20 November 2014, Rockhampton www.qnu.org.au/qnu-training 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 6th Australian Rural and Remote Mental Health Symposium The Practitioner’s Voice 12-14 November, Albury, NSW http://anzmh.asn.au/rrmh/ International Day of Tolerance 16 November

Asia Pacific Cardiorenal Forum 8-9 May 2015, Sydney http://cardiorenal.com.au/ International Nurses Day 12 May 2015 www.icn.ch/

Australasian College for Infection Prevention and Control Conference 23-26 November, Adelaide, SA http://www.acipcconference.com.au/ 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 Aids Day 1 December International Day for People with a Disability 3 December QNU Symposium with international speaker Professor Linda Aiken (University of Pennsylvania School of Nursing) Keeping Patients Safe 3 December, Brisbane www.qnu.org.au/ keepingpatientssafe Human Rights Day 10 December

Florence Nightingale Foundation Annual Conference 12-13 March 2015, London www.fnfalumni.org/event-1717850 Australasian Cardiovascular Nursing College 9th Annual Conference 13-14 March 2015, Sydney www.acnc.net.au Australian Pain Society 35th Annual Scientific Meeting Managing Pain: from Mechanism to Policy 15-18 March 2015, Brisbane www.dcconferences.com.au/aps2015

13th National Rural Health Conference People, Places, Possibilities...for rural and remote Australia 24-27 May 2015, Darwin www.ruralhealth.org.au/13nrhc/

JUNE World Environment Day 5 June 2015 www.unep.org/wed/

12th Annual World Healthçare Congress Connecting and preparing leaders for healthcare transformation 22-25 March 2015 Washington DC, USA www.worldcongress.com/events/ HR15000/

APRIL World Health Day (WHO) 7 April 2015 www.who.int/world-health-day/en/ World Day for Safety and Health at Work (ILO) 29 April 2015 www.un.org/en/events/safeworkday/

International Council of Nurses (ICN) International Conference and Council of National Representatives (CNR) Global Citizen, Global Nursing 19-23 June 2015 Seoul, Republic of Korea. www.icn2015.com/ 3rd Annual Worldwide Nursing Conference 29-30 June, Singapore www.nursing-conf.org/

38 | TQN | OCTOBER 2014

www.qnu.org.au

YOUR SUPER

You don’t need a lawyer to claim Why women need to boost their super Women haven’t always enjoyed the same super rights as men. In fact, until the 1970s, some women were even excluded from super when they got married.

While super rights for women have thankfully improved, many continue to miss out on valuable super benefits.

On average, women are still paid less than their male counterparts. Plus, the amount of super women generate during their working lives is often impacted by career breaks to care for family and a greater tendency to work part time.

Coupled with the late introduction of compulsory super in 1992, these factors have left many working women at a disadvantage when it comes to their super savings.

That’s why it’s so important for women to take a proactive approach to managing their super.

By keeping track of your account balance, choosing investment options that meet your needs, and contributing a little extra, you can keep your super on track for the retirement you want.

At HESTA, we’re here to help our members every step of the way.

In fact, most of our 785,000 members are women, so our Superannuation Advisers, Member Education Managers and Financial Planners understand the challenges women face in building their super.

Take your first steps to a better tomorrow today — to start changing your future.

Visit hesta.com.au/boostmysuper for ideas on how you can boost your super or call 1800 813 327 to speak to a HESTA adviser.

With more than 25 years of experience and $28 billion in assets, more people in health and community services choose HESTA for their super.

Issued by 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. 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, 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

More and more our televisions and newspapers are featuring advertisements from law firms offering to help you claim on the insurance you have as part of your superannuation.

When you see these ads the one thing you need to remember is that as a QSuper member you don’t need a lawyer to make a claim for your insurance inside super.

If you want to make a claim on the insurance provided as part of your QSuper membership, all you need to do is submit a claim form to QSuper.

You don’t need a lawyer to fill it out, but if you do need help you can contact QSuper and one of our Member Services Officers will explain what you need to do, including the type of information you need to provide as part of your claim.

If you do decide to submit a claim you will be allocated a case manager who will contact you and keep you upto-date while your claim is assessed.

As a QSuper member you have access1 to different types of insurance, including death and total and permanent disability (TPD) and income protection.

Death and TPD insurance is designed to provide financial support for you and your loved ones in event of your death, or if you suffer a permanent disability.

Income protection provides financial support if you suffer an injury or illness that prevents you from working temporarily. In most cases, you will be paid up to 75% of your salary for up to two years while you are off work.

There are age limits and conditions for eligibility for insurance, so if you want to know more about your insurance cover call us, 1300 360 750 or visit qsuper.qld.gov.au.

1 Access to insurance is subject to eligibility criteria including age and pre-existing conditions.

Find out more at www.qsuper.qld.gov.au.

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. Where the term ‘QSuper’ is used it represents the QSuper Board, the QSuper Fund or QSuper Limited (as applicable), unless the context indicates otherwise. 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 PDS before making a decision. You can obtain the PDS from our website at qsuper.qld.gov.au, or call us on 1300 360 750. © QSuper Board of Trustees 2014

OCTOBER 2014 | TQN | 39

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OOPS! I meant US. Great ser vice and low rate.

40 | TQN | OCTOBER 2014

Interest rates are current as at 27/08/14 and subject to change.

Terms, conditions, fees and charges apply. Applications are subject to credit approval.*Comparison rate calculated on a loan of $150,000 for a term of 25 years, repaid monthly.

WARNING: This comparison rate is true only for the examples given and may not include all fees and charges. Different terms, fees or other loan amounts might result in a different comparison rate. Members Equity Bank Limited ABN 56 070 887 679. Australian Credit Licence 229500. 213954/1014

www.qnu.org.au

Health Ed Professionals® & OSCA Health Education® Course lecturers Heather James & Anne Evans-Murray

Acute Cardiac Care Course Gold Coast: Monday 1 to Saturday 6 December 2014

Acute Complex Care Course Caboolture: Monday 17 to Saturday 22 November 2014 Gold Coast: Monday 24 to Saturday 29 November 2014 For Registered & Enrolled Nurses, Ambulance Officers, students.

Recognised for credit articulation at Griffith & QUT Universities as one elective subject for:  Pre-Registration B. Nursing  Post Graduate Certificate cources Post Graduate Masters cources.

These courses are presented in intensive mode (9.00 – 5.00) over 6 days plus assessments, and are equivalent to a one semester university course in teaching and study time. The Complex Care course includes adult ALS certification. Endorsed by RCNA for award of 45 CNE points.

Undergraduate students (Residents) $775.00 Gold Coast - $800.00 Caboolture RN’s /EN’s, AO’s $1,500.00/$1,525.00, O/S students: $1,600.00

Adult Advanced Life Support Level 2 – 2 days

Connect with us

13-14 Oct, 10-11 Nov, 8-9 Dec Course fees: RN/EEN $495.00 Undergrad students $375.00 Doctors $695.00 ACN, RACGP & ACRRM Accredited

Adult Advanced Life Support Recertification 4 Oct, 12 Nov, 10 Dec Course fees: RN/EEN $265.00 Undergrad students $180.00 Doctors $330.00

More course information available from: info@healtheducation.com.au Heather James: 0407 135 332 or Anne Evans-Murray: (07) 5563 3054 All details & secure registration: www.healtheducation.com.au

/qldnursesunion

POSTGRADUATE WEEK: 27-31 OCTOBER Book an appointment online with course experts life-less-ordinary.org/postgraduate/book

Education & Arts | Health Sciences | Law & Business | Theology & Philosophy

www.qnu.org.au

Australian Catholic University – CRICOS registered provider: 00004G

A LIFE LESS ORDINARY

1300 ASK ACU OCTOBER 2014 | TQN | 41

Australia’s healthiest carrot is now doing the rounds.

WIN a trip to New Zealand’s BIG CARROT!

Did you know nurses can now enjoy the same benefits we’ve been offering our teachers for more than 40 years? Join the TUH health fund now and you could win a fantastic New Zealand holiday valued at $5,000, including a visit to the Big Carrot.* Plus you get your third month’s premium free. Now that’s a healthy carrot.

Switching funds is easy. We’ll do all the paperwork for you! Visit tuh.com.au/bigcarrot or call us on 1300 360 701 for a comparison.

*Competition closes 19 December, 2014. Full terms and conditions available at tuh.com.au/bigcarrot or phone 1300 360 701.

Outstanding nurse, outstanding future.

If you’re just as motivated about patient care as you are about health reform, then postgraduate nursing at QUT is the best way to an outstanding career.

You can be confident that you’ll learn from influential leaders in Australian nursing, and that our courses are informed by QUT nursing research which is independently ranked as above world standard.

Flexible external and part-time options are available.

Commonwealth Supported Places offered for entry in 2015.

Apply now, places are limited.

Find out more at www.qut.edu.au/postgraduate-nursing

CRICOS No.00213J © QUT 2014 HLT-14-1226 20334

42 | TQN | OCTOBER 2014

www.qnu.org.au

Long shifts made easy.

Car leasing made easy.

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State 2013

Call: 1300 185 958 www.QLDleasing.com.au

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Your super.

Your fund.

Your future.

We see our members as integral pillars of the community. Your contribution and service is something we deeply respect and it’s why everything we do is for your benefit.

And by employing staff who work with your best interests in mind, you can be sure we’re doing all we can to help you reach your best super outcome. Put simply, members come first at QSuper – always have, always will.

qsuper.qld.gov.au/care 1300 360 750 This product is issued by the QSuper Board (ABN 32 125 059 006) as trustee for the QSuper Fund (ABN 60 905 115 063). Consider whether the product is appropriate for you and read the PDS before making a decision. You can call us to obtain a PDS or visit our website. © QSuper Board of Trustees 2014 7850 8/14

44 | TQN | OCTOBER 2014

www.qnu.org.au

Use y your salary wisely Your own dedicated Salary Packaging specialist

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| TQN | 45 2014 www.qnu.org.au Fleet Network Pty Ltd. To T qualify for this offer you must mention this advertisement to Fleet Network prior to the completion of your initial contract. Veh V icle must be new and supplied OCTOBER byy Fleet Network.

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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/