VOL. 33 | NO. 6 | DECEMBER 2014
THE QUEENSLAND NURSE
MORE NURSES MEANS SAFER PATIENTS QNU ADDS VOICE TO G20
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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. 6 | DECEMBER 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 More nurses means safer patients
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DECEMBER 2014 | TQN | 1
YOUR UNION
Helping us prove what we already know SALLY-ANNE JONES, QNU PRESIDENT
In early December I attended the QNU’s Keeping Patients Safe symposium, where I had the privilege of listening to Professor Linda Aiken—a preeminent nurse researcher whose work in exploring links between patient safety, nursing workloads, and skill mix has recently been published in The Lancet.
YOUR COUNCIL
Linda’s research has covered over 30 countries in many continents across the globe—the breadth of her data is astounding, and it all points to one very clear conclusion: nursing and midwifery workloads are inexorably linked to patient safety everywhere. Thankyou to Dr Frances Hughes, the Chief Nursing and Midwifery Officer of Queensland and her team at the Nursing and Midwifery Office, as well as Beth Mohle Secretary of QNU—without their organisational skills we may not have had the chance to spend some time with Linda, and this important event may not have taken place. We heard from an amazing array of leaders and researchers who shared their wisdom to help us prove what we already know—nurses and midwives and patient safety go hand-in-hand. Partnering with consumers is an important part of the patient safety agenda. This is shown by its inclusion in the National Safety and Quality Health Service Standards, which also include some nurse sensitive indicators—pressure injuries and falls. Who can remember leaving a shift questioning whether you could face another day and return to work? Nurses and midwives around Australia are increasingly aware of the contradiction between profit-driven
IT IS ABOUT MORE THAN JUST RATIOS. IT IS ABOUT NUMBERS AND SKILL MIX. IT IS ABOUT TRAINING.
healthcare and quality outcomes for patients. We have seen at the seminar how powerful empirical evidence is being gathered to demonstrate what we know to be true. Nursing care counts. Nurses keep patients safe through surveillance, skilled observation, intervention, education, health promotion, in beginning and end of life care. It is also about what is left undone. When the resources don’t match the demand, there is increased potential for “risk-screening” and for omitting seemingly less important aspects of the patient experience. Thanks to research such as Linda’s, the consequences are becoming clearer. They include higher mortality, higher infection rates, more re-presentations, longer length of stay, and poorer patient satisfaction. Linda’s research shows every extra patient above a safe allocation increases patient mortality by 7%. The consequences also include negative effects on the health and well-being of nurses and midwives, which cannot be underrated.
Workplaces where nurses and midwives feel continually overworked and unfulfilled lead to high nurse turnover—a dangerous development for patients, and an expensive problem for health managers. We are learning the value of data and leadership as the foundation for courageous conversations about patient safety and nursing and midwifery. It is about more than just ratios. It is about numbers and skill mix. It is about training. Nurses and midwives count. Who cares? We do!!! Be an advocate for your patients’ safety. Workload reporting is part of our industrial agreement. It is our way to let Executive know when workloads are unsafe and putting patients at risk. You can find more information about Workload grievances at www.qnu.org.au/ workloads I also strongly encourage all nurses and midwives to discover Linda Aiken’s work. It is essential reading for every one of us.
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 | DECEMBER 2014
www.qnu.org.au
EDITORIAL
Our focus for 2015: Keeping patients safe BETH MOHLE, QNU SECRETARY
As 2014 draws to a close it is time to reflect upon our priorities and what drives and unites us—our commitment to providing not only safe but also high quality personcentred nursing and midwifery. With the December visit to Queensland of world-renowned nurse researcher Professor Linda Aiken, we were reminded of the irrefutable international evidence on how we keep patients and residents safe. This requires not only sufficient numbers but also the right mix of nurses and midwives. We know too well that we work in the context of “budget austerity” measures being pursued by governments and private health and aged care providers alike. The story is a familiar one around the globe, and this reality unites us as much as it distresses us. These realisations led us to help form Global Nurses United in 2013 so we can more effectively advance our common global concerns. Time and time again we hear from members that their number one concern at present is the quality of nursing and midwifery they are able to provide. This was the dominant theme from our recent “Your work, your time, your life” research. It has also been repeatedly reinforced to us in the phone conversations we have been making to learn members’ key concerns in the lead up to the next state election. www.qnu.org.au
No matter what the sector, governments will rely on a cooked up “budget emergency” to cut services, jobs, and rights. This all too often results in the pursuit of a short-term “efficiency” agenda that sees nursing and midwifery numbers and skill mix cut. This is occurring despite the wealth of evidence proving the vital contribution we make to patient safety. The economically driven quest for a surplus seems to inevitably trump safety and quality. We are constantly pushed to do more with less. Sooner or later, something has to give. Not surprisingly this is the source of significant ethical distress and physical exhaustion for members. Recently one QNU member employed in a private hospital summed it up well: Driven by profit, it stands to reason that they will always attempt to reduce costs and this often equates to reduced quality of nursing care. I feel that as each year passes, more is expected of nursing staff and I now work harder than ever before. In a resource-constrained environment where the demand for services and acuity of patients continue to increase, our work intensifies. Nurses and midwives are put in an untenable position. At times our licenses to practise—and therefore our livelihoods—are put at risk. We must act decisively to address unacceptable and unsustainable workloads and this will be our particular focus in 2015 when we intensify our campaigning around workloads, safety and quality. Central to the success of this campaign will be our individual and collective capacity to confidently articulate our case to politicians, decision makers, the media, and the broader community.
WE ARE CONSTANTLY PUSHED TO DO MORE WITH LESS. SOONER OR LATER, SOMETHING HAS TO GIVE. The message is simple—we keep our health system both safe and human. If we do not step up to the challenge and get this essential message through, who will? Our members are our union and we know that ensuring patient safety and delivering high quality care is the number one priority. It is also a top priority for our community. This alignment of interests is a powerful one that we must harness, especially in light of the upcoming Queensland election. This year we focused on two key themes. First, we focused on the values that drive and unite us. Second, we have worked to identify and harness the various sources of our power to advance these values. This work has been challenging, especially given that some very powerful forces are working against us. Our values and our power will continue to be in sharp relief as we intensify our campaigning and advocacy around unsustainable workloads and the impact this has on safety and quality. We have no option other than to get organised and make politicians and decision makers responsive to our values and priorities. This will be our focus for 2015 and beyond.
Beth
DECEMBER 2014 | TQN | 3
YOUR SAY
YOUR SAY on Facebook Ebola I am currently in Ohio USA not far from where the latest nurse with Ebola came from. Of course it is all over the news & people are frantic. Let’s hope Australia manages things better if we get Ebola there. It has been interesting listening to the news & the precautions they are taking, especially being concerned about nurses. They are recognizing nurses as being the frontline worker & first to be there & wanting to protect them. What a nice change. Tammy Copley (in the US), 17 October
The QNU’s G20 protest boat Good to know we are being represented. Remind these people that one day they will need a nurse.
Millions of patients around Australia are at risk of being arrested and having their cannabis medication removed from them and their carers thrown in jail. Cannabis is a therapeutic alternative to current medications with a better safety profile. Cannabis is medicine. It’s time to support your patients and advocate for them and return cannabis to its rightful place as a therapeutic medicine. Octavia Ellis, 1 December
My daughter’s life depends on this bill passing. She has been on drugs ever since she was a baby and her body can no longer take it. We are using cannabis oil and it’s proving so effective she is now able to speak to me and her seizures have reduced dramatically. Deborah Camacho, 1 December
Anne Keogh-Casey, 14 November
I had excellent care at the PAH last night from nurses and doctors and it didn’t cost me a cent. Patricia Hovey, 20 November
Those ‘On Time’ ads are soooo annoying!!! Chris Sinclair, 23 November
$7 GP co-payment They seem to be punishing all of us in the general community with every new Tax or with cuts to service unless of course they are multi-millionaires wanting to pay all their workers a pittance!!! Judy Matthews, 25 November
Medical Cannabis Bill 2014 The federal parliament of Australia was presented the “Regulator of Medical Cannabis Bill 2014” last week. I’m asking the QNU to support this Bill and ask that you contact your members and industry partners to do the same. Therapeutic cannabis treats cancer, epilepsy, copd, ptsd, diabetes and many many more medical conditions. 4 | TQN | DECEMBER 2014
My ten year old has failed every medical option given legally. She has Doose Syndrome. So far this year, she has had a broken nose, pushed her teeth back up into her skull, plastic surgery to repair her ear, split under her chin from side to side so her jaw bones were exposed, taken a huge chip off her front tooth (adult tooth), countless egg sized lumps on her head, broken skin and bruises—all due to her seizures. It is not fair that there is a natural medical cannabis that is illegal and could help my daughter and we would be criminalised if we try it. I have had to do CPR on her. I used to carry oxygen everywhere we went. Other children who have severe epilepsy and have been given medical cannabis have had amazing results. I would like that for my daughter, at least the opportunity to try. People I speak to about medical cannabis are unaware of what it is. They think I would make my daughter smoke it—not true, it is an oil used as drops under the tongue. They think I want my daughter to get high—not true, medical cannabis has
the psychoactive element greatly reduced so no high for users. The cocktail of pharmaceuticals that my daughter takes daily can cause liver failure, heart failure, kidney failure, cataracts . . . the list goes on. At 1.00 am this morning, I have to revive my daughter yet again. I am so worried that I will lose her. She is my world. Please support this bill, we would be very grateful for your assistance. Rose Grasmeder, 2 December
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
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TEA ROOM
tea r
m
WITH DES ELDER, QNU ASSISTANT SECRETARY
We sometimes take it for granted that everyone knows their entitlements. However, for new entrants to the nursing and midwifery workforce it is often difficult to understand the plethora of entitlements and payslips covering our profession. In fact many nurses and midwives are uncertain about which allowances, loadings and penalties they are entitled to given the diversity of their work and working hours. The following questions are frequently asked of our QNU Connect information service.
I work full time at a Ramsay private hospital in operating theatres. We are regularly rostered “on call” and recently have been required to work between 20 and 40 hours per fortnight overtime on call in addition to our normal rostered hours. We are feeling very fatigued but management say they can’t do anything about it. Overtime requirements are contained in Fair Work Act 2009 (s.62) and your enterprise agreement, the Ramsay Health Care Australia Pty Ltd and Queensland Nurses’ Union of Employees Enterprise Agreement 2012 – 2016. S.62 of the Fair Work Act 2009 says: Maximum weekly hours of work 1. An employer must not request or require an employee to work more than the following number of hours in a week unless the additional hours are reasonable: a) for a fulltime employee—38 hours; or b) for an employee who is not a fulltime employee—the lesser of: i. 38 hours; and www.qnu.org.au
ii. the employee’s ordinary hours of work in a week. Employee may refuse to work unreasonable additional hours 2. The employee may refuse to work additional hours (beyond those referred to in paragraph (1) (a) or (b)) if they are unreasonable. Determining whether additional hours are reasonable 3. In determining whether additional hours are reasonable or unreasonable for the purposes of subsections (1) and (2), the following must be taken into account: a) any risk to employee health and safety from working the additional hours; b) the employee’s personal circumstances, including family responsibilities; c) the needs of the workplace or enterprise in which the employee is employed; d) whether the employee is entitled to receive overtime payments, penalty rates or other compensation for, or a level of remuneration that reflects an expectation of, working additional hours; e) any notice given by the employer of any request or requirement to work the additional hours; f) any notice given by the employee of his or her intention to refuse to work the additional hours; g) the usual patterns of work in the industry, or the part of an industry, in which the employee works; h) the nature of the employee’s role, and the employee’s level of responsibility; i) whether the additional hours are in accordance with averaging terms included under section 63
in a modern award or enterprise agreement that applies to the employee, or with an averaging arrangement agreed to by the employer and employee under section 64; j) any other relevant matter. Clause 5.11 of the agreement says “a) An employee may be required to work reasonable overtime”. The excessive additional hours described are not reasonable and it would be difficult for Ramsay to argue they are. You are therefore within your rights to refuse to work the extra hours beyond what is reasonable in view of your levels of fatigue and other factors above. It is important that staff document their concerns in writing to management. This is a significant health and safety issue and management has a responsibility to address the problem to ensure fatigue is properly managed. An information sheet on refusing unreasonable additional hours is available from QNU Connect or the QNU website. If you are unable to resolve this issue locally please contact your QNU Organiser for assistance. If you have questions for our tea room column email qnu@qnu.org.au
ROVDPOOFDU QI 41::4321
DECEMBER 2014 | TQN | 5
NEWS
QNU Christmas closure arrangements
Your clean, green union HQ wins state award The QNU has added another feather to its cap, taking out a prestigious state award for its clean, green Brisbane office. The QNU won the City Switch 2014 Signatory of the Year Award for Queensland beating every other small, medium and large organisation in the competition. The citation on our shiny new certificate reads: “The annual City Switch National Awards recognise leading program signatories who have demonstrated outstanding environmental leadership in energy efficiency.” Among the eco-friendly practices that put us over the line are the enviro-efficient designs we used on the West End digs when the building was being revamped. By the time we moved in, the premises had already improved its green credentials, going from a 3 star NABERS rated building to a 4.5 star NABERS rated building just by virtue of refurbishments such as block-out blinds, lights on timers and plumbed water tanks. A concerted effort to reduce energy and water use over the past two years have
bumped those ratings up further, and we are proud to have achieved a five star energy rating for the past two NABERS rating periods, as well as a 5.5 and rare 6 star water rating. Our efforts have seen us reduce our carbon footprint by about 10 000 kwh/ 9 tonnes of carbon dioxide since last year alone. But there were also a raft of little things that impressed the judges such as our recycling program, which not only includes general recycling but also our practice of shredding paper and cardboard for worm farms, our separate compost bins for chook scraps, our toner recycling protocols, and our custom of giving coloured scrap paper to local kindergartens for arts and craft. Another tick was the use of tqn, our staff intranet, and training days to promote environmentally responsible living, thus creating an eco-friendly organisational culture. The QNU will now go into the running against other state winners for the National Signatory of the Year awards.
The QNU offices in Brisbane, Toowoomba, Bundaberg, Rockhampton, Townsville and Cairns will close from 3pm Wednesday 24 December 2014 and will reopen at the regular starting time of 8.30am on Monday 5 January 2014. During this time members who need emergency advice or assistance should ring the Brisbane office on (07) 3840 1444 or 1800 177 273 (toll free outside Brisbane) and leave a message. Officials will be on call to deal with emergencies such as dismissals and they will contact you. We wish all our members a safe and enjoyable festive season. See page 11 for Queensland Health Christmas closures.
QNU/ANMF financial reports online
QNU Secretary Beth Mohle (left) and QNU Finance Officer Jocelyn Connor with the City Switch 2014 Signatory of the Year Award.
6 | TQN | DECEMBER 2014
The Queensland Nurses’ Union of Employees and Australian Nursing and Midwifery Federation (Qld Branch) 2013-2014 financial reports are available at www.qnu.org.au Members without internet access can obtain a hard copy of the report by: applying in writing to: Secretary, Queensland Nurses’ Union GPO Box 1289, Brisbane, Q, 4001 or by phoning 07 3840 1444. The QNU Annual Report will be available for download in January. www.qnu.org.au
NEWS
Nurses in watchhouses? The QNU has written to the Director General of Health Ian Maynard asking for clarification of the government’s position on nurses working in police watchhouses. In October, Health Minister Lawrence Springborg stated the state government’s intention to staff 17 watchhouses with nurses or paramedics for New Year’s Eve, as well as Friday and Saturday nights, from 2 January 2015. The QNU understands these services already exist and have been in practice since 1997. It is not clear if Mr Springborg’s announcement is an extension of the “safe sober centre” trial announced earlier in the month. The “safe sober centre” is for intoxicated people detained by police but not charged with an offence. Such people may be detained for up to eight hours to allow them to “sober up” under the care of nurses, and is intended for people police deem to be at risk or a risk to others. During the draft legislation process for the trial, the QNU made an extensive submission stating our concern the government had not sought input from nurses while developing the plan—not even from the state’s Chief Nurse. The QNU is keen to ensure both the health and safety and the professional responsibilities of nurses are not compromised while working in this new centre. The QNU is still awaiting a response—updates to come.
$5000 Adem Crosby Haematology Award now open Applications are now open for the $5000 Adem Crosby Haematology Award. The award is issued every year to a Registered Nurse caring for haematology or oncology patients in Queensland. Sunshine Coast teenager Adem Crosby was diagnosed with lymphoblastic leukaemia in early 2011. Prior to his relapse and passing in May 2013, Adem had planned to study nursing to care for haematology patients. While undergoing treatment, Adem began fundraising for the Leukaemia
Adem (centre) with his family.
Slow going on Blue Care dispute The legal wrangling around Blue Care’s attempt to have non-nursing staff perform nursing work will extend into 2015. As reported previously, Blue Care has reclassified AINs as personal carers, and is seeking to finalise a new enterprise agreement which permits non-nurses to perform nursing work. The QNU is seeking to have AINs properly classified, and to prevent the finalisation of the agreement which permits non-nurses to perform nursing work.
Correct classification of Blue Care AINs The hearing regarding the correct classification of Blue Care AINs will resume in December, with final submissions likely due early in 2015. A final decision on the matter could take months to be published. www.qnu.org.au
Foundation. Adem’s team of supporters have raised over $383,000. To apply you must be a RN currently caring for haematology/oncology patients in Queensland. The award will cover costs related to undertaking clinical training or to attend either a national or international conference. Applications close 31 January 2015, and the recipient will be announced on 27 February 2015. Visit www.leukaemiaqld.org.au
A favourable outcome would see Blue Care PCs correctly reclassified as AINs.
Care and Support Agreement The QNU is also objecting to the approval of Blue Care’s new Care and Support Agreement which permits nonnurses to perform nursing work. The hearing regarding the approval of the agreement is also scheduled for December, but the QNU is seeking to have this hearing delayed until an appeal decision is published.
Some improvements filtering through to Blue Care staff Fortunately, while all this legal wrangling is going on employees covered by the Care and Support Agreement have been provided with some of the improvements in the proposed agreement—including wage increases and an extra week of annual leave. DECEMBER 2014 | TQN | 7
NEWS
When is an election campaign not an election campaign?
E L E C T IO N
2015
A: When we’re six months out from an election but the date still hasn’t been set! With the Newman government casually dropping $36 million on political advertising, it’s no wonder speculation continues to mount that a state election will be called very soon. Premier Campbell Newman’s LNP have a vast majority in parliament, holding 73 seats to a combined total of just 16 for the ALP, the Katter Party, and independents. That’s why next year’s state election is one of the most important in Queensland’s history—the strongest possible message must be sent that even if the Newman government returns to office, Queenslanders are deeply unhappy with cuts and closures to public health, the sale of public assets, and wholesale changes to our laws and the integrity of our legal system.
SO WHAT ARE THE MAIN ISSUES? TRUST All political parties suffer moments of doubt in the mind of voters. But at the moment the lack of faith in politicians is particularly sharp. There is real concern that state governments will continue to break their pre-election promises while acting without voter approval on issues which affect us all—like public health.
HEALTH The public health system has been under sustained attacked for the past three years. Almost 5000 workers have been sacked from Queensland Health, with community health and Indigenous health particularly hard hit. Services have been reduced or closed entirely, or—in the case of state-owned aged care facilities—sold off to private providers. Now, with executive level health managers quitting en masse, staff satisfaction surveys showing morale at an all-time low, and people increasingly complaining they have been ‘put on the waiting list for the waiting list’, management of the public health system needs a huge revamp.
JOBS Unemployment in Queensland has grown steadily over the past three years, and now sits at 7.0%—it’s highest in more than 11 years, and the highest in the country. The Newman government’s pledge to reduce unemployment to 4.0% is clearly unachievable. In fact, it’s highly unlikely it could even be achieved in another term in office. With thousands of nursing and midwifery new graduates looking for employment, all political parties in the upcoming state election clearly need to have very sound policies for generating new jobs. 8 | TQN | DECEMBER 2014
ECONOMY The slow-down in the mining boom looms as the largest economic obstacle in this state election. A clear, medium-term plan for Queensland’s economic prosperity has been needed for a long time, but political parties continually come up blank. With the Reserve Bank of Australia estimating a ‘sharp decline’ in mining investment will cut 1.25% off GDP growth next year, Queensland is going to need a lot more than a new, taxpayer-subsidised coal mine to jump-start the state economy.
AND FOR THE QNU? Queensland nurses and midwives will be hearing plenty more from the QNU once the election date is announced. For now, the QNU is conducting statewide consultation with nurses and midwives about their election priorities. One thing is certain, though—we will never forget Campbell Newman’s preelection promise to provide ‘more nurses, not more red tape’, soon followed by the sacking of 1,796 nurses and midwives and the closure of hundreds of public health services.
MONEY FOR ADVERTISING, BUT NOT FOR HEALTH The QNU is deeply disappointed the same government which sacked almost 2000 nurses and midwives due to “budget pressures” has found $36 million for political advertising. That amount doesn’t include the “WaitTime Guarantee ” advertisements which have flooded our TV sets recently. Not good enough. www.qnu.org.au
NEWS
AUSTRALIAN NURSING AND MIDWIFERY FEDERATION
union training program
ELECTION NOTICE Fair Work (Registered Organisations) Act 2009 Nominations are called for the following offices: Date
Location
Handling grievances in the workplace
17 Feb
Brisbane
Knowing your entitlements and understanding the Award!
18-19 Feb
Brisbane
Being a QNU Contact in the workplace
24 Feb
Brisbane
Private Sector Nurses: Did you know? – The law protects YOU!
25 Feb
Brisbane
Private Sector Nurses: How to successfully bargain
26 Feb
Brisbane
10-1112 Mar
Brisbane
Creating a safe workplace (WH&S)
17 Mar
Brisbane
Private Sector Nurses: How to successfully bargain
17 Mar
Brisbane
Achieving success in high stakes communication
18 Mar
Brisbane
Professional Advocacy – We’re in charge
19 Mar
Brisbane
QNU Branch Development 1 & 2
24-2526 Mar
Brisbane
Assertiveness Skills
30 Mar
Brisbane
QH 2015 – Operation Change!
31 Mar
Brisbane
QH – Our Consultative Committee’s – How to make them work
1 Apr
Brisbane
Private Sector Nurses – Knowing your entitlements
21 Apr
Toowoomba
Being a QNU Contact in the workplace
22 Apr
Toowoomba
QH 2015 – Operation Change!
23 Apr
Toowoomba
Private Sector Nurses: Did you know? – The law protects YOU!
21 Apr
Gold Coast
Private Sector Nurses - How to successfully bargain
22 Apr
Gold Coast
Professional Advocacy - We’re in charge
28 Apr
Townsville
Handling grievances in the workplace
29 Apr
Townsville
QH 2015 – Operation Change!
30 Apr
Townsville
COURSE
FEBRUARY
MARCH Workplace Representatives 1
APRIL
TO ENROL IN THESE COURSES— visit the QNU website at www.qnu.org.au/qnu-training OR contact your local QNU office and ask them to send you a form OR
ring the training unit in Brisbane on 3840 1431 or toll free 1800 177 273 www.qnu.org.au
Federal President Federal Vice President Federal Secretary Assistant Federal Secretary Written nominations which comply with the rules of the Federation can be made from Wednesday 14 January 2015. They must reach me not later than 12 Noon (A.E.D.T) on Wednesday 28 January 2015. Nominations cannot be withdrawn after this time. Statements: In accordance with Rule 47.4 candidates may submit a 200 word (maximum) statement and a photograph of themselves, in support of their candidature. The statement will be reproduced in a form suitable for posting to voters with ballot material. Statements must reach me not later than 12 Noon (A.E.D.T) on Wednesday 4 February 2015. Statements and photos are preferred by email to vicelections@aec.gov.au ADDRESS FOR LODGING NOMINATIONS & STATEMENTS By Post: Australian Electoral Commission, GPO Box 4382, Melbourne, Vic, 3001 By Hand: Level 8, Casselden Place, 2 Lonsdale Street, Melbourne By Fax: (03) 9285 7149 BALLOT: The ballot, if required, will open on Friday 27 February 2015 and close at 10:00am on Friday 13 March 2015. Changed Address? Advise the Federation now. NOTE: A copy of the AEC’s election report can be obtained from the organisation or from me after the completion of the election. Jeff Webb Returning Officer Tel: (03) 9285 7141 12 January 2015 DECEMBER 2014 | TQN | 9
NEWS
SPECIAL WORKLOADS Nurses and midwives working with the QNU have secured a number of wins in workloads issues recently. It just goes to show that with a plan and support, you can take some control over your own workloads.
Use your workload forms! Currumbin Clinic Recently at Currumbin Clinic, the nurse in charge of a ward identified a workload issue related to admissions. Nurses at the clinic contacted their QNU Organiser, who visited the site and went through the Professional Workload Reporting Form. The issue was also raised at a Branch meeting, where support for the use of the form was endorsed. An extra nurse was rostered on the shift and eased the situation. In another area an AIN was employed to assist with patient care and used as a “float” to cover in other areas when required. As the clinic grew in bed numbers, other areas started to identify workloads and staffing concerns. Nurses again used workload forms to identify staff concerns to management, and the matter was sent to the Local Consultative Committee. The DON soon advised that AINs were being employed to assist in all areas but particularly the area submitting the forms. Nurses at Currumbin continue to submit workload forms to ensure their concerns are heard.
10 | TQN | DECEMBER 2014
St Martin’s nurses win $2000 Nurses at Anglicare St Martin’s aged care facility in northern Brisbane also had a recent workloads win. The QNU became aware of a number of workload concerns at St Martin’s, including meal allowances not being paid for overtime and double shifts and refusal of short periods of Long Service Leave. Staff were also told they needed to attend their yearly performance appraisals in their own non-working time. After consultation with QNU officials, the members secured a process for recording meal allowances, as well as backpay for nurses who had not received their entitlement. In total, $2099.54 was paid to St Martin’s nurses in their next pay. St Martin’s also acknowledged shorter Long Service Leave periods were permissible, and that performance appraisals would be conducted during working hours.
Use your workload forms! Allamanda Private Hospital Nurses at Allamanda Private Hospital have secured management backing for their meal breaks after using workload forms to identify the breaks were not being provided on night duty. Nurses and midwives at the hospital notified their QNU Organiser that staffing issues meant they were not receiving meal breaks, particularly on night shift. After some training in the use of workload forms, nurses on night shift started the process of asking to be relieved for meal breaks. There was some resistance to this, which was noted in the workload forms and submitted to the Local Consultative Committee. A memo was then distributed by executive management to staff and managers advising that meal breaks were to be provided.
www.qnu.org.au
NEWS
REPORT Brisbane nurses win $100,000 Recently nurses at a mid-sized hospital in Brisbane’s west notified the QNU they were unable to take their meal break on night shifts because only two nurses were rostered on each ward/ unit with no meal relief. A meeting between the nurses and QNU officials quickly confirmed the Clinical Services Capability Framework requires two nurses be on duty at all times. The QNU asked the employer to pay overtime to each member for each shift from five hours after the shift commenced. The employer refused, then rejected the QNU’s letter of demand. It was time to get the evidence. Fourteen nurses gave consent for the QNU to request their employee records, including their time and wages. QNU officials delivered Entry Notices to the employer for suspected contraventions. Entry Notices must be delivered 24 hours before the intended entry. The QNU delivered Entry Notices a full week before the intended entry. The employer informed the QNU it would take three whole weeks to locate the employee records. Undeterred, the QNU officials conducted the inspection on the date set out in the Entry Notices—and very quickly located the employee records. So much for three whole weeks. The QNU claimed three hours overtime should be paid per nightshift (based on an average shift length of eight hours) since the Nurses Award 2010 commenced on 1 January 2010. The resisted this claim, but after QNU officials warned we stood ready to file the claim in court, they agreed to pay the 14 QNU members three hours overtime for each nightshift, plus interest. A total of $102,775.77 was paid to the 14 nurses in September.
www.qnu.org.au
Cairns HHS backflips on staff carparking after QNU protest The QNU has secured a significant victory for mental health workers in Cairns, after the Hospital and Health Service backflipped on a proposal to force staff to walk 20 minutes to get to and from fleet cars. Cairns and Hinterland HHS informed staff working at premises on Grafton Street they would no longer be allowed to park their six fleet cars in nearby allocated spaces. Instead they were ordered to park in the small number of allocated spaces in central Cairns, or else at the Cairns Hospital car park six blocks away. The trek meant mental health workers were forced to cancel some outreach work, as they did not have time to get to and from the fleet cars. The new arrangement meant urgent health matters could not be dealt with adequately, not to mention the health implications for staff forced to walk several kilometres through sweltering conditions in the hotter months. QNU Organiser for Cairns Kaylene Turnbull went straight into action, raising
the issue at the very highest levels of health management. “Usually you would discuss and raise it with the nursing director and then the divisional director before you get to the chief executive,’’ said Kaylene. “I actually tried to speak to a divisional director and got palmed off to someone else.” Kaylene took her concerns to the local media, explaining the serious implications to mental health services. In a very short timeframe, Cairns and Hinterland HHS found suitable parking to accommodate fleet cars used by nursing staff in performing their duties. This is an appropriate outcome and a good win for mental health nurses in Cairns—a win which should never have had to be actioned in the first place. If Cairns and Hinterland HHS had consulted nursing staff, the matter could have been quickly resolved before any health services were affected.
Queensland Health Christmas closures Queensland Health has released arrangements for compulsory closure and leave arrangements for the 2014-15 Christmas New Year period. Please note that as prescribed employers, Hospital and Health Services may now set their own closure dates. However, at time of going to print, the QNU understands the dates below cover all QH employees. If new information is received, the QNU will update members via email. Note that part-time employees are only entitled to the concessional leave day when Monday 29 December would be one of their regular, ordinary days of work. Day
Date
Leave
Thursday
25 December 2014
Christmas Day public holiday
Friday
26 December 2014
Boxing Day public holiday
Monday
29 December 2014
Concessional day (leave on full pay without debit)
Tuesday
30 December 2014
Annual/recreational leave, TOIL or accrued hours
Wednesday 31 December 2014
Annual/recreational leave, TOIL or accrued hours
Thursday
New Year’s Day public holiday
1 January 2015
DECEMBER 2014 | TQN | 11
NEWS
QNU ADDS VOICE TO G20 The roadblocks are gone, the koalas are back at the zoo and Vladimir Putin’s shirt remain remains unruffled—yes, the international talkfest that is the G20 World Leaders Lead Summit has wrapped up for another year and so too has the QNU QNU’s G20 program. Merkel and Jinping thrashed out their issues in While Obama, Abbott, Abb House, the QNU joined hundreds of other the fine halls of Parliament Parl advocacy groups in the streets around Brisbane, making activists and advocac and public attention to highlight important the most of the media me social issues. The QNU’s focus was on the need to protect universal healthcare and the introduction of the ‘Robin Hood Tax’. healthca
The Robin Hood Tax message The QNU took to the river on a floating protest boat to spread our Robin Hood Tax message—our voices could be heard and large banners seen by everyone along either side of the riverbank from East Brisbane to the Victoria Bridge. The Robin Hood Tax—more formally known as the Financial Transactions Tax—is a modest levy applied to banks and other financial institutions each time they make a transaction while trading stocks, bonds, derivatives, futures, options and credit default swaps. A levy of as little as .05% on each transaction (about 5 cents in every $100) could reap billions of dollars every year—money which could be used to ensure public health and education are well funded, assist in the global fight against poverty and AIDS, and help tackle climate change. The tax would only target large profits made on risky, high-volume trading and would not affect everyday transactions made by the public. We were joined in our campaign by our colleagues from the NSW Nursing and Midwifery Association and a group of guest nurses from the United States— all of whom rolled into Queensland in a minibus as 12 | TQN | DECEMBER 2014
www.qnu.org.au
NEWS
Ready to set sail on the floating protest boat.
part of the NSW team’s Robin Hood Tax Tour along the east coast. As QNU Secretary Beth Mohle said, the Robin Hood Tax is a concept that was capturing the imagination of activists all across the globe. “It’s a logical reform that could have such far reaching, positive implications at so many levels that it seems like a nobrainer,” she said. “That’s why it’s being so widely championed both here in Australia and internationally.” “For those of us in the health care sector, the potential benefit to public health is extremely significant. “This could make a real difference—not only by expanding universal health care around the world and improving the health and welfare of millions of people living in poverty, but also protecting and improving Medicare here in Australia.” It was a point well made during one of the QNU’s other G20 events—a live cross with health care workers in the Ebola-stricken African nation of Liberia. www.qnu.org.au
The Robin Hood Tax bus tour rolls in to Brisbane.
Hurrah! A merry band of Robin Hooders visits the Gold Coast.
DECEMBER 2014 | TQN | 13
NEWS
Live cross to Ebola workers in Liberia Using Skype we connected a conference room full of health workers, media and guests with nurse Laurene Wisseh and ambulance officer Gorden Kamara speaking from the frontline in Monrovia, Liberia. Ms Wisseh, who has spent the last several months treating Ebola, called on Australian Prime Minister Tony Abbott, President Barack Obama, and other world leaders in Brisbane for G20 to send additional help immediately. “We need the world’s help now to stop the spread of Ebola,’’ Ms Wisseh said. “At the moment we are sharing equipment, sometimes reusing disposable gloves and in the worst case scenario using plastic bags to protect against Ebola. QNU Secretary Beth Mohle said Ebola health workers needed improved Personal Protective Equipment (PPE) and
logistical support to transport equipment immediately. “According to global trade union federation Public Service International, 416 health workers have been infected with Ebola and 233 have died as a result. “One in 10 of all deaths confirmed due to Ebola are healthcare workers—yet these front line carers continue to risk their lives to help their patients and stop the contagion.” Monrovian ambulance officer Gorden Kamara, who operates one of about 15 ambulances currently servicing the country’s 1.5 million residents, said Liberia had just one doctor per 14,000 patients. “To fight Ebola virus disease effectively in Liberia, we need more trained doctors, nurses, hygienists, ambulances, drivers, assorted antibiotics, oral rehydration
salts, vitamins and anti-malarial drugs,’’ Mr Kamara said. “We need a well organised and trained anti-Ebola response hub in each of the 15 political subdivisions of Liberia, equipped with an Ebola Treatment Unit, warehouses stocked with Personal Protection Equipment and supplies for rapid respond to an Ebola outbreak in any part of Liberia. “I am appealing to the President Obama and Prime Minister Abbott and other world leaders to not relent in providing Liberia all the help we need to combat this virus. “We will go anywhere at any time to win the war on Ebola but we need Australia and the world’s help now.’’ The desperate situation in Africa was also one of the key points of a broader G20 forum we hosted later that same day.
Liberian ambulance officer Gorden Kamara speaking via Skype.
National Association of Nigerian Nurses and Midwives (NANNM) President Abdrafiu Alani Adeniji.
14 | TQN | DECEMBER 2014
World nursing leaders make a statement to the media on the Ebola crisis.
www.qnu.org.au
NEWS
G20 Global Health Forum Nursing and midwifery unions from Australia, America, Canada and Nigeria and representatives from Oxfam and Public Service International (PSI) attended our G20 forum on global health. In his presentation, PSI spokesman Daniel Bertossa said the Ebola outbreak was directly linked to poor investment in public sector health systems in West Africa, and the axing of international aid to developing nations. “The grievously high loss of health care workers and the tragic scale of the outbreak in West Africa are similarly due to the senseless imposition of austerity policies and the entirely short-sighted failure to repair and invest in the growth of public sector health infrastructure and health systems in the three most affected countries—Guinea, Liberia and Sierra Leone,” he said. “This situation is deplorable and brings to light gross deficiencies, the shortsightedness of underinvestment in health services and the deeply misguided underresourcing and staffing of health care workers. “The Ebola outbreak clearly highlights the threat posed to societies when quality public health systems are absent.’’ Speaking at the forum NSWNMA General Secretary Brett Holmes said the Ebola outbreak highlighted the need for worldwide universal health care. Mr Holmes said global investment in public health services and hospitals would protect against outbreaks like Ebola. He said the Ebola crisis also highlighted the need to protect tax payer funded public health and hospital services at home such as those provided under Medicare. “Ebola has killed thousands in a country where residents do not have access to adequate public health services or hospitals,’’ Mr Holmes said. “This crisis highlights the importance of public health services around the world and the very real need to protect those provided under Medicare from threats such as the Abbott government’s proposed $7 GP copayment.’’ To donate to provide protective equipment for health workers treating Ebola please visit http://anmf.org.au/campaign/entry/ ebola-appeal www.qnu.org.au
Oxfam G20 Coordinator Claire Spoors
Daniel Bertossa from Public Service International
DECEMBER 2014 | TQN | 15
NEWS
Congratulations Chris Cocks – Emma Miller award recipient 2014 Our heartiest congratulations to QNU member and Councillor Chris Cocks who has been awarded a prestigious Emma Miller award. Chris became a QNU member way back in March 1981. She became a regular attendee at the Nambour Hospital monthly branch meetings in 2001, and quickly stepped up her involvement when the QNU began closing beds during the EB5 campaign in 2002. It was during this long struggle Chris demonstrated excellent leadership qualities, maintaining bed closures against the wishes of management, empowering her colleagues, and ensuring patients felt reassured and understood how the closures tied in with their safety. That EB5 campaign kicked off a decadeand-a-half of QNU activism including roles as QNU Representative on Consultative Forums, Nambour Branch President, Workplace Representative, and most recently QNU Councillor.
And her fighting spirit burns brighter than ever. Last year Chris launched herself into the QNU’s campaign against privatisation of the Sunshine Coast University Hospital. Alongside other dedicated members she was instrumental in gaining thousands of petition signatures and creating community awareness of the pitfalls of privatisation. She donated her days off, weekend after weekend, month after month to attend walks, markets and rallies. QNU Secretary Beth Mohle said she had no hesitation putting Chris’ name forward for an Emma Miller award. “Chris really is an inspiration,” Beth said. “Her outstanding dedication and determination makes a real difference. “She is a true role model for the values of nursing and the values of our union, and I am delighted we have the opportunity to recognise her as an outstanding
Chris Cocks (ri QNU Secretar ght) with y Beth Mohle
unionist through the Emma Miller awards.” The Emma Miller awards are presented annually to recognise extraordinary women involved in the labour movement. It pays homage to Brisbane seamstress and suffragette Emma Miller who helped form the first women’s union in Brisbane in 1890.
Keeping nursing and midwifery strong in Toowoomba After another successful branch-run professional conference, tqn asked QNU Councillor Kym Volp how Toowoomba Hospital QNU Branch sets up and hosts these evenings. BY KYM VOLP FACN, QNU COUNCILLOR
As with many branches, our meeting attendances vary according to the issues at hand, so we sustain an active network of members throughout the year with positive profile events. We do a trivia night in the first half of each year, and a professional conference in the second half. A small team of willing workers pitch in to make the evenings happen, and the focus is on having good fun. The evenings are open to all comers, not just QNU members, and we charge a small fee. Most years we manage to turn a small profit for the Branch coffers, and also make a donation to the Fistula Hospital or APHEDA. In October Toowoomba Hospital Branch organised another great conference. 16 | TQN | DECEMBER 2014
This year speakers and over 120 participants embraced the theme “Conditions of Work and Workplaces”. QNU Secretary Beth Mohle keynoted with a talk on the future of our award conditions. Many members and others remarked to me how impressed they were with Beth’s detailed overview, and especially the reality of the industrial-political power mix we currently face. Brisbane ethicist Dr Fiona Hawthorne was also brilliant in her questions and discussion points on the nature of organisational ethical climates and the effects on the professional practice of nurses and midwives. Takeaway messages on how we manage our responses to the ‘what’ and ‘who decides’, as well as the ‘rights’ and ‘wrongs’ of our advocacy decision practice were spot on. Sue Schoonbeek from Brisbane presented a lively, colourful and realistic take on workplace bullying.
Some levity with humour across this malignant topic entertained us (as in the “Ninja” bully-hierarchy). Sue also offered vital strategies for health workers to protect themselves from bullying. The talks closed out with James Gilbert from QNU giving some important insights on related workplace health and safety concerns around bullying. James, Beth, Sue and Fiona then joined a Q&A panel – always a great way to conclude such an evening. Professional conferences are easy to organise and a lot of fun, and they are a great way of developing professional relationships outside the workplace. The QNU are very encouraging and supportive, so be sure to let your local officials know if your branch would like to host a trivia night or professional conference. Get on top of the hot topics, build the QNU profile, develop local leadership and solidarity, have fun. What’s not to like? www.qnu.org.au
NEWS
Victorians vote out Liberal government after one term In a stunning display of political willpower, Victorian voters have turfed out the Liberal Napthine government after just one term. Historically, Victorian voters have been very reluctant to remove a state government after just one term, but it was not so with the Napthine government, which became the first single-term regime since 1955. Health and education became major headaches for the Napthine government and its failure to generate new jobs underlined broad concern about Victoria’s economic performance. By comparison, the Andrews Labor opposition, with its campaign slogan ‘Putting People First’, promised more investment in hospitals and TAFE, and an end to the controversial East-West Freeway project which cut through inner city Melbourne. Federal factors were also clearly at play, with Prime Minister Tony Abbott making only a very rare—and reluctantly accepted—appearance to campaign for the Napthine government. Exit polls showed 46% of voters rated the federal budget as a key issue when casting their vote.
Newly elected Victorian Premier Daniel Andrews signing the ratios pledge
New Victorian government promises to legislate ratios A month out from the election, ALP leader Daniel Andrews announced one of his first priorities would be to protect and legislate the safe patient ratios that currently exist. Major metropolitan hospitals in Victoria are currently required to roster one nurse to four patients during day shifts and one nurse to eight patients during night shifts. Different ratios are in place for maternity units, regional hospitals special care nurseries, aged care, and emergency departments. The new legislation will also prevent nurse substitution by unregistered health assistants. www.qnu.org.au
The Andrews Government has also promised to implement the ANMF Victorian Branch’s 10-point plan to end violence and aggression in healthcare settings.
Victorian nurses and midwives major players in election outcome Nurses and midwives played a huge role in the election outcome, hitting the streets with firefighters, paramedics, and teachers to doorknock more than 93,000 houses and explain the consequences of different policies on public services.
Nurses were also part of the targeted phone calling—undecided union members who indicated health was an important issue to them received a phone call from a nurse. Of the 6000 union members who identified as undecided, 73% said they would put the Liberal Party last after receiving a phone call. Nurses and midwives also staffed voting booths, handing out how-to-vote cards. In total, 1500 nurses, midwives, firefighters, paramedics, and teachers staffed 130 voting booths. DECEMBER 2014 | TQN | 17
NEWS
Individuals forced to pick up the tab on health spending Individual citizens picked up the tab for the federal government’s decreased spending in 2012-2013, a new report by the Australian Institute of Health and Welfare shows. According to the AIHW’s Health expenditure Australia 2012-2013 report, health funding from the federal government has averaged 43.1% of total funding over the past decade. In 2012-2013, it dropped to 41.4%. The slack was picked up by the nongovernment sector, particularly individual citizens, who paid 17.8% of total health funding out of their own pockets–an increase of 0.9% on the previous year.
Total health spending slows According to the report, total spending on health in 2012-2013 grew just 1.5%– more than three times lower than the
average growth over the last decade, and the lowest rate since the mid-1980s. By comparison, health spending in 20112012 increased by 6.1%, in 2010-2011 by 6.7%. The average increase over the last decade has been 5.1% per year. The spending figures give the lie to the government’s claim a $7 GP co-payment is needed to make our public health system sustainable.
Global Financial Crisis continues to affect health spending The report notes the federal government is still struggling to make up for the enormous loss in tax revenue experienced during the 2007 Global Financial Crisis. While demand for health services—and so pressure for health expenditure— continued to increase through the GFC, tax revenue dropped significantly. Tax revenue has since picked up, but the increase in demand for health services continues.
Australia around OECD level, much less than US As a percentage of Gross Domestic Product, Australia’s health spending in 2012-2013 was around the same mark as the United Kingdom and Norway, and significantly less than Canada, France, and the US. Australia’s health to GDP ratio (9.4%) was marginally more than the OECD median (9.2%). The US was by far the highest spender on health care, spending 16.9% of GDP in 2012-2013.
Total funding for health expenditure as a proportion of total health expenditure, by source of funds 50 45 40
Percentage
35 30 25 20 15 10 5 0 2002-3
2003-4
2004-5
Federal government Individuals
18 | TQN | DECEMBER 2014
2005-6
2006-7
2007-8
2008-9
2009-10 2010-11 2011-12 2012-13
State/territory/local governments Injury compensation insurers
Health insurance funds
Aged care provider slapped with $200K fine for underpaying staff Great news from South Australia last month after the Federal Court fined an aged care provider almost $200,000 for underpaying its workers. Lifestyle SA was fined for shortchanging its on-call workers about $2.5 million in wages and penalties between March 2006 and February 2011. Lifestyle, which runs 11 retirement villages in South Australia, employed staff to monitor emergency pagers for its residents. Some of these staff worked only on weekends and were paid $50 for an eight or 16 hour shift, and an extra $50 each time they called an ambulance. The Fair Work Ombudsman took Lifestyle to court for underpaying 46 employees but the company maintained staff were only ‘working’ when responding to a pager. Eventually Lifestyle conceded it had indeed breached both the Workplace Relations Act and the Aged Care Award and had failed to pay entitlements and penalties including minimum hourly rates, annual leave loading, overtime, casual loading and public holiday penalties. Last year the company repaid staff their full $2.5 million worth of entitlements—even repaying about $70,000 in outstanding wages and penalties that fell outside the statute of limitations. One employee received a whopping $264,000. Lifestyle SA received a $196,000 fine—about half the maximum penalty for this kind of offence. www.qnu.org.au
NEWS
Australia’s Ebola response in private hands Australian nurses and doctors have joined the fight against the Ebola epidemic in West Africa—but it took two months of political games and international condemnation to convince the federal government to offer genuine help. When the announcement was finally made last month, Australia’s highly skilled and experienced Australian Medical Assistance Teams (AUSMATs) were left on the sidelines in favour of private medical provider Aspen. Unlike a number of other non-profit agencies who were already on the ground in West Africa, Aspen had no presence in the country and no staff trained to deal with Ebola, yet they were handed the $20 million contract without a tendering process. The death toll from Ebola has soared to more than 5000 people, most of them in Liberia, Guinea and Sierra Leone and a large number of them health workers. Health experts say the virus is now out of control and predict as many as 250,000 people could eventually become infected. In a QNU live cross to Liberia last month, ambulance officer Gorden Kamara described the desperate shortage of medical staff in his country and the appalling lack of protective equipment for frontline health workers. But while nurses in Queensland and across Australia stood ready to roll their sleeves up, the federal government dithered, saying it was just too risky for them to go. Everyone from the World Health Organisation and Medicines Sans Frontieres to British, African and American leaders called on Australia to join the battle—saying a strong international response was the only way to contain the epidemic. US President Barack Obama committed 3000 troops and 17 field hospitals of 100 beds each. www.qnu.org.au
But the Australian government refused practical support and instead offered a meagre $7 million financial contribution. For more than two months the Abbott government argued it had no way of bringing exposed healthcare workers home safely, then suddenly changed its tune and announced Aspen would establish a 100-bed field hospital in Sierra Leone. Appointing a private medical provider is being viewed in many quarters, including ours, as yet another example of the government shifting service provision to the private sector. We are concerned about the lack of details around Aspen’s planned operations and what this might mean for patients and staff on the ground
We are also disappointed at the small number of nurses who will be able to volunteer via Aspen. We know thousands of health workers, including hundreds of nurses, have put their names down to volunteer. But the Aspen arrangements, which call for only about one in five health workers from Australia, mean very few will be needed. While the QNU welcomes Mr Abbott’s long-overdue response to the crisis, we remain deeply sceptical about the motivation behind a private appointment made without standard tendering processes, and cannot help but feel this is yet another case of the government paying somebody else to take over its responsibilities.
IN OTHER NEWS The California Nurses Association is celebrating victory after securing better protective gear and training for frontline staff working with Ebola patients. 100,000 nurses took to the streets for a National Day on Ebola awareness last month, demanding regulations that would force every hospital in the state to carry optimal personal protective equipment for nurses and other frontline caregivers treating Ebola patients. Their campaign was successful and now the national union—National Nurses United—is calling on the US government and other states to follow the landmark mandatory safeguards that Californian nurses have established.
For more information on the new Californian standards visit: www.nationalnursesunited.org/blog/ entry/ebola-preparedness-whatnational-nurses-united-won-incalifornia/
RN Global Ebola Day of Action – Oakland. CA
DECEMBER 2014 | TQN | 19
NEWS
Carinity nurses hit the streets A determined band of nurses from the Queensland Baptist Church’s Carinity aged care homes hit the streets of Kelvin Grove in December, raising awareness and support for a fair deal on their new enterprise agreement. For the past two years, Carinity has refused to give its nurses a wage rise. Now, after pocketing a cool $10.8 million in profits for 2013, Carinity has finally offered its nurses a wage increase of less than 2%. This is well below inflation, so it is a pay cut in real terms.
Stripping away working conditions Carinity also wants: To be able to call nurses into work for just two hours per shift. To take away paid parental leave from Registered and Enrolled Nurses. To be able to reclassify Assistantsin-Nursing as Personal Carers—that means doing the same work for less money. To transfer employees to lower paid duties without redundancy pay.
To remove the right to take some workplace issues to the Fair Work Commission.
Misleading information Carinity tells its nurses they pay in the top 10% of aged care employers, but the facts show otherwise. Carinity pays the lowest in all classifications amongst comparable aged care employers in Queensland. Less than Blue Care, Anglicare, Ozcare, Prescare, Churches of Christ and RSL in all classifications!
Driven by Christian values? Carinity claims to be driven by Christian values, with a vision to create ‘communities where people are loved, accepted and supported to reach their full potential’. Clearly Carinity doesn’t extend this vision to its nurses. The Carinity board of directors need to come clean about what they are willing to do to support the hard-working nurses in the Baptist Church’s aged care service.
Carinity nurses hit the streets to raise awareness and support for a fair deal on their new enterprise agreement.
20 | TQN | DECEMBER 2014
EB9: Minister hopes fear will keep you silent In October, QNU Secretary Beth Mohle met with Health Minister Lawrence Springborg to discuss concerns about his decision to delay award modernisation, and with it the public sector enterprise agreement. While discussing the government’s failure to allow nurses and midwives to negotiate a wage rise, Beth also passed on the concerns raised by many members who were appalled Queensland Health had sent details about pay changes to their private email accounts. The Minister confirmed he asked Queensland Health to send the emails to staff on his behalf. It is clear the Minister does not want to deal with the QNU as the representative of nurses and midwives. He would rather deal with individuals. Given the culture of fear that has developed since the Newman government came to power, we know some nurses and midwives find it difficult to oppose their employer’s decisions particularly when they are targeted so personally. It seems the Minister is counting on this. Just remember, the government can’t take action against nurses or midwives simply for voicing concerns about their employment. Meanwhile if you would like your name removed from the Minister’s future emails, you should email the DG directly via dg_correspondence@health.qld.gov.au The QNU continues to ensure nurses and midwives receive the entitlements enshrined in EB8, and QNU Organisers are visiting workplaces and Local Branches to discuss this. The Minister can expect the QNU and nurses and midwives to speak up about all matters which threaten to reduce safety. www.qnu.org.au
NEWS
Nurses claim Pulse victory Nurses have claimed victory after voting up a new agreement with increased wages and other improved working conditions at three private hospitals north of Brisbane. Pulse Health management offered a raft of improved wages and conditions following a lengthy campaign of industrial action including stop-work meetings, protest walks, and petitions. Pulse recently offered staff at their Kingaroy, Gympie and Cooroy facilities wage increases of between 5%-8% and back pay to 1 September 2014. Other improvements include ongoing annual pay increases and overtime after 8 hours (or after rostered hours if rostered between 8.5-10 hours). QNU Secretary Beth Mohle said the new agreement was a win for nurses, their patients, and the employer. “The improved wages and conditions being offered should allow Pulse to keep most of their great nurses,’’ she said. “The improved offer is a significant step towards closing the gap between Pulse nurses’ wages and those of other QNU members. “Pulse nurses will now continue to do what they have always done best— provide the highest quality care for their patients. “We would like to thank everyone who campaigned, listened, signed our petition, put stickers on their cars and supported the campaign.’’
Pulse He alth:
OUR W A NEED C GES PR
STAT!
The agreement was approved by a narrow margin at ballot, showing Pulse nurses have plenty of energy left to get a better deal next time. The Pulse offer includes: Back pay to 1 September 2014 of pay increases of between 5-8% and similar increases in future years. No reduction in current conditions. Overtime after 8 hours (or after rostered hours if rostered between 8.510 hours). AIN rates to be to be the same across Kingaroy, Gympie and Eden (Cooroy). 1.3 weeks of long service leave per year. 3 hour minimum payment per shift for casuals (up from 2 hours).
Penalty rates protests come to Cairns The campaign against the removal of penalty rates has expanded from Townsville up to Cairns as workers from all sectors join together to make sure penalties aren’t taken away. In late November, Cairns workers from every walk of life rallied outside local MP Warren Entsch’s office, demanding an end to the creeping plan to remove penalty rates. More than 100 locals showed up to ask Mr Entsch to publicly oppose the removal of penalty rates. The three electorates—Cairns, Cook, and Barron River—are all held by the Newman government. These MPs are coming under strong pressure to retain penalty rates for local workers. Local nurse and QNU member Julie Lentas spoke at the rally, telling the crowd just how much nurses and midwives give up to ensure services are provided to their community— including public holidays like Christmas and Easter, as well as many school and sporting events for their children. The campaign to save penalty rates received very strong support in Cairns, with many locals joining the campaign, lots of media coverage, and 23 new nurses and midwives signing up to become QNU members.
What is the campaign? The campaign to prevent the removal of penalty rates began in July this year in response to increasing noise from big business to cut wages and strip penalty rates. The message to save penalty rates has resonated strongly with everyday people, steadily building momentum wherever it goes. Australians clearly believe weekends still mean something, and workers like nurses and midwives should be compensated missing out on time with their friends and family. Rally activity in Cairns has wrapped up for now, but you can expect to see plenty of regional break outs to save penalty rates in the future. www.qnu.org.au
DECEMBER 2014 | TQN | 21
FEATURE
MORE NURSES MEANS SAFER PATIENTS Nurses have always known it, but Professor Linda Aiken proved it— patient death rates are directly linked to nurse numbers.
22 | TQN | DECEMBER 2014
www.qnu.org.au
FEATURE
In December, renowned nurse researcher Professor Linda Aiken visited Brisbane to discuss her empirical research, which shows virtually every major health indicator is directly linked to nurse numbers. Over decades of careful research, Professor Aiken has built up an enormous amount of evidence about the true impact of nurses to health outcomes. Professor Aiken’s studies show how nurse expertise levels, staff numbers, and nurse to patient ratios play an integral role in determining patient safety. Professor Aiken was kind enough to be interviewed by tqn during her visit. Her insights are simply “must read” for all nurses and midwives.
Can you tell us a little about how you came to be interested in your area of research? From the very first night I was a nurse. Like all new nurses, I was working night shift. I thought I had a good education and I was working in a good hospital, but all of a sudden I realised it was impossible to provide the best possible care. So I got interested in why that was, what are the solutions, and how can we make the commitment of nurses operational in terms of providing the best possible care. To me that required some reorganisation and change in the hospital work environment.
What kind of reorganisation and change? Clearly there weren’t enough nurses to provide good care to patients. We were spending a lot of time doing work arounds—dealing with things like getting the right supplies and dosages that weren’t really nursing jobs but since our patients needed these things, we ended up doing them. We also didn’t have enough administrative people to deal with families and non-clinical things that were going on. So while we need to devote every second to our patients, there are all of these things that need doing to keep the operation going, which pull us away. My research led me to empirically document these problems, and find they are common across all hospitals. Of course it has also led me to search for solutions to fix those problems, to ensure the care that patients deserve can be delivered, and that nurses don’t exhaust themselves to the point of being unsafe providers of care. www.qnu.org.au
The Magnet Hospital Program Professor Aiken’s research is the basis for the Magnet Hospital Program, which initially began in the US but has now spread around the world. Magnet is a groundbreaking initiative to lift the safety standards and health outcomes of hospitals all around the world by establishing strong, high quality nursing. In 2004, Queensland’s Princess Alexandra Hospital became the very first Magnet hospital in the southern hemisphere. Since then, St Vincent’s Hospital in NSW and the Charles Gairdner Hospital in Western Australia have both received Magnet designation.
How do Magnet hospitals support nurses? Magnet hospitals have a commitment to: 1. Employ good middle managers. 2. Investing in nurse education. 3. Having active, empowered nurse representatives on committees. Helping other hospitals achieve Magnet 4. status. DECEMBER 2014 | TQN | 23
FEATURE
How did the Magnet idea start? In the early 1980s, a lot of hospitals in the US had nurse vacancy rates in the double digits. It wasn’t unusual for hospitals to have a 20% vacancy rate. It was strongly undermining quality of care, and it was also very costly. Our research led us to highly successful multinational corporations. These corporations had already been studied closely, and were found to share a number of dimensions—investment in the workforce and particularly in the education of the workforce, a high priority on recruiting and retaining the best people, empowering the workforce to help make decisions and improve the corporation’s product. Then we found hospitals that were immune to nursing shortages and had no vacancy rates, and we looked into why these particular hospitals were more successful than other hospitals. We found they had the same characteristics as these successful multinational corporations. We thought why can’t you replicate those characteristics across all hospitals?
What are some of the ways Magnet hospitals invest in nurses? First, they have a commitment to having good middle management. In the business world you often hear ‘workers don’t leave their jobs, they leave their managers’. A key lesson from successful corporations was that middle management has to be good. Magnet hospitals immediately put an emphasis on getting top quality nurse managers so nurses could have more satisfaction in their work.
“Our research showed hospitals were really underinvesting in their workforce.”
Second, Magnet hospitals invest in the education of their workforce. Our research showed hospitals were really underinvesting in their workforce compared to successful corporations. Corporations were spending up to 10% of their revenue on investment in staff, but hospitals were down below 1%. They started supporting nurses to get additional degrees by paying their tuition—so making an actual investment in the workforce. Third, empowering nurses to speak out on both workforce issues and patient care issues. So nurses have a position on all the committees on workforce policies and patient care policies—and not only have a position, but be expected to speak out, and expect to be listened to.
How have nurses reacted to Magnet—and how does it compare to the reaction from top management? Nurses immediately love this idea. It is obvious to nurses that a lack of nurse staff was undermining care. But although Magnet focuses on nursing, really it is about a change in culture— about understanding that a hospital’s performance depends on how it treats its nurses. This means top management have to understand nurses are a vital part of the quality of their product, and that they have to invest in nurses.
“While we need to devote every second to our patients, there are all of these things that need doing to keep the operation going which pull us away.” 24 | TQN | DECEMBER 2014
Management aren’t necessarily against this, they just approach it differently. So, we showed them the research. We showed them the hospitals that had no vacancies were the same hospitals who were investing in their workforce. Hospital managers were very impressed with this because turnover is so expensive. They were also really interested in the risk management perspective, because they were vulnerable if they couldn’t get enough nurses. Then we showed them the research that proved hospitals which are good places for nurses to work are also hospitals with better outcomes for patients. Our research clearly shows the best hospitals are not only good places for nurses to work, they also have lower mortality, lower infection rates, across the board their health outcomes are better. It really was a perfect case—management could save money by preventing turnover, nurses could improve the quality of care they delivered, and the patients get better health outcomes.
How have the results these compared across different countries? We’re doing research in 30 different countries at different stages of economic development. We’ve found the concepts that make Magnet hospitals have better outcomes work everywhere. It doesn’t matter if you have a health system which is primarily private, like in the US, or public, like in Australia. What can be different is the incentive to improve. In the US, there is strong competition between hospitals. In a public system like Australia, you rely on the desire to improve quality and get better value for the money your government is spending. www.qnu.org.au
FEATURE
The stage is set for the QNU’s patient safety symposium...
On ratios... In California, there are nurse patient ratios. Do you see ratios as the best way to achieve better patient care? We studied the California ratios very rigorously. They have worked in every way they were expected to work, and exceeded expectations. They have solved the nursing shortage because they drew nurses from other states in, they reduced the turnover rate because now there are enough nurses so burnout rates fell, and because there is no nursing shortage, care has improved dramatically. California has the best nurse staffing in the US. It also has the best patient outcomes. By any way you look at it, ratios were successful.
What was the experience with setting patient ratios in California? According to the legislation, hospitals could lose their state licence and their funding if they didn’t implement the ratios. This gave the legislation ‘teeth’ and really motivated hospitals to get the ratios working. Just as importantly, hospitals which implemented the ratios were rewarded. Straight away we saw the really good impact of the ratios was in bringing the lower hospitals up. In the US, we have ‘safety net’ hospitals which look after poorer people. They traditionally have had poorer nurse staffing and poorer outcomes. www.qnu.org.au
Once they implemented the ratios, their health outcomes improved dramatically and so did their retention rates.
How important is wider awareness of nurse staffing? Giving the public good information is incredibly important. Recently the US has made a lot of progress in healthcare transparency. There has been very little transparency in the past. Nobody knew what was going on in hospitals. The general public thought their local hospital was just fine, when it wasn’t. You could be seven times more likely to die in one hospital than in another—but the public didn’t know that. Importantly, our research showed patient mortality had a direct relationship with nurse staffing. So one very important thing our federal government has done is put up a website which contains every hospital by name, and people can see what each hospital’s nurse staffing level and health outcomes are, and compare hospitals with each other. They’ve set up similar websites for aged care facilities and homecare agencies. The public are learning to use these websites. The immediate impact we have seen comes from the providers—health managers are using the websites to compare their performance with other hospitals, and to start improving their nurse staffing when they are clearly out of line with best practice. DECEMBER 2014 | TQN | 25
FEATURE
NO IFS, NO BUTS –
patient ratios save lives
Other symposium speakers:
When nurse researcher Professor Linda Aiken and her colleagues had their research paper accepted into one of the world’s most prestigious medical journals this year it was groundbreaking at two levels. Not only was it the first nurse-authored paper published in The Lancet’s nearly 200 year history, it also gave nurses and midwives across the world the evidence they so desperately needed to support their claim for safe nurse to patient ratios. Presenting her research at the QNU’s Keeping Patients Safe professional symposium in Brisbane earlier this month, Prof Aiken showed very clearly how lower nurse to patient ratios save lives, reduce infection rates and reduce patient re-admission rates. The data she and her research team collected for their groundbreaking paper was drawn from 34,000 nurses and 11,318 patient surveys, across 2087 nursing units, in 617 hospitals throughout 12 European countries.
The key findings were: An increase in a nurse’s workload by one patient increased the likelihood of an inpatient dying within 30 days of admission by 7%. Every 10% increase in bachelor’s degree nurses decreased the likelihood of an inpatient dying by 7%. Patients in hospitals where nurses cared for an average of six patients and in which 60% of nurses had bachelor’s degrees would have almost 30% lower mortality than patients in hospitals in which nurses cared for an average of eight patients and only 30% of nurses had bachelor’s degrees. And it doesn’t end there. The published European study is just part of a massive research project which covers 30 different countries worldwide at different stages of economic development—all of which are showing similar patterns between nursing numbers and education, and patient outcomes. The consistency of results across such a huge sample of hospitals and health systems means 26 | TQN | DECEMBER 2014
it is increasingly difficult for policy makers, directors of finance and politicians to dismiss the research as irrelevant to their particular region or system. Ultimately it becomes foolish to ignore overwhelming evidence just because you don’t like what it proves. What’s more, the research also points out solid economic reasons against austerity measures such as job cuts. It shows that adopting best practices— namely funding more nursing positions and investing in nurse education and professional development—is far more cost-effective than the costs that come with patient complications and readmission, staff burnout and high staff turnover. All this is fantastic news for those of us fighting austerity measures such as job cuts and trying to lock safe workloads into legislation. As Professor Aiken pointed out, patient safety issues that arise in hospitals from overworked nurses are not the result of a global or domestic nurse shortage, it’s a lack of nursing positions being funded in our hospitals. There is a shortage of nursing— not a nursing shortage. In the wake of job cuts across Queensland in the past two years this is certainly a position nurses and midwives in this state can understand. There are plenty of nurses and midwives out there who are willing, skilled, and able to work. “We can’t let this be defined as a ‘nurse shortage’ or we won’t get the right solution,” Prof Aiken stressed. “There is a shortage of care.” “Nursing is the foundation for quality care and until we stabilise the number of nurses at a reasonable level we are not going to get a reduction in medical error.”
Professor Wendy Chaboyer, Director of the National Centre for Research Excellence in Nursing
Professor Jill White, Sydney School of Nursing, University of Sydney
www.qnu.org.au
PROFESSIONAL
QNU questions EN competency standard review The QNU has lodged serious concerns about the first draft of revised competency standards for Enrolled Nurses. The Nursing and Midwifery board of Australia (NMBA) is currently reviewing the national standards, which will replace the current competency standards. The QNU has a number of concerns, including two principles that must be maintained for there to be clarity in the working relationship between the Registered Nurse and the Enrolled Nurse ‘on the floor’.
1. Removing the RN’s supervisory role The proposed EN practice standards remove the RN’s supervisory role and relegate the RN to a ‘point of reference’. The QNU believes this is an inappropriate dilution of the supervisory role of the RN. While workforce pressures may drive this proposed change, there is no evidence in the current educational preparation of the EN to justify such autonomy in the practice of nursing.
2. Reporting to a ‘person in authority’ Several indicators within the standards also refer to the EN reporting to a ‘person in authority’ rather than reporting directly to the RN. The QNU submitted that it is not appropriate for the EN to report the outcomes of nursing care to any person who is not an RN. Only the RN is authorised to make decisions about nursing care or the scope of nursing practice and the NMBA cannot anticipate that a ‘person in authority’ will have any knowledge or capacity to determine an appropriate course of nursing action.
Other concerns Other concerns include attempts to circumvent the RN role, by authorising the EN to: seek clarification and guidance from the healthcare team rather than from the RN www.qnu.org.au
collaborate with the healthcare team in developing plans of care, or in the provision of care, rather than with the RN independently conduct risk analysis and autonomously implement minimisation strategies supervise the clinical competence of AINs and carers in the provision of nursing care. Monash University has been conducting this review of the EN Standards, and the QNU is greatly concerned stakeholders with business interests—including reducing costs by employing fewer RNs— are holding sway over the evidence-based arguments presented by professional bodies such as the QNU and the ANMF. The QNU will monitor developments on this project and we eagerly await further consultation when Monash University releases a further draft of proposed EN standards.
Barrett Centre closure points to real problems in mental health A new report commissioned by Queensland Health reveals the state government’s closure of the Barrett Adolescent Centre for mental health led to increased distress and mental health incidents. Report co-author Associate Professor Beth Kotze said the announcement of the closure led to “a contagion effect of distress and anxiety amongst the adolescents and an increase (sic) number incidents.” Three former patients of the centre have died since it was closed by the state government in January this year. The Coroner is investigating the deaths. While there are plans to fill the void left by closing the Barrett Centre, the QNU is concerned the state government left a shortfall by closing an existing service before replacement services like Residential Rehabilitation Units and Step Up/Step Down Units were in place. According to Queensland Health, the new service—when it eventually comes online—will deliver “alternative, progressive approaches to adolescent extended treatment and rehabilitation care”. Unfortunately in the case of the Barrett Centre, Queensland Health appears to have failed to provide fully staffed and functional services after the centre was closed. This is despite Queensland Health’s responsibility to provide continued access to “safe and high-quality mental health extended treatment and rehabilitation service options as close to the home or community as possible”. Child and Youth Mental Health Services are critical to the health of our young people. It is unconscionable there was no adequate contingency plan to deliver young people the care they needed while new facilities were being built and staffed. DECEMBER 2014 | TQN | 27
NURSING AND MIDWIFERY RESEARCH
Acupoint stimulation for the prevention of post-cardiac surgery nausea and vomiting BY DR RACHEL WALKER, NHMRC CENTRE RESEARCH EXCELLENCE IN NURSING
Postoperative nausea and vomiting (PONV) are frequent but unwanted complications for patients following anaesthesia and cardiac surgery.
Despite pharmacologic treatment, PONV affects at least a third of patients. A Cochrane Systematic Review specific to medicines for preventing PONV concluded that PONV affects around 80 of every 100 individuals undergoing surgery, and that if all 100 were given a drug to prevent PONV, only around 28 would benefit (Carlise & Stevensen, 2006).
The burden of caring for patients post cardiac surgery is immense, with the Australian Institute of Health and Welfare (AIHW, 2013) annual report indicating that in Australia alone nearly 179,000 procedures involving the cardiovascular system were performed between 2011-12. As part of their treatment and recovery, cardiac surgery patients experience varying rates of PONV. A recent North American Randomised Controlled Trial (RCT) reported PONV rates of 39%-42% in cardiac surgery patients (Korinenko et al., 2009), while a systematic review of 10 RCTs estimated 26%-27% of patients experienced PONV (Bainbridge et al., 2006), and 35% of patients in a Canadian study (Klein et al., 2004). Patients report they have a strong preference for avoiding PONV (Lee et al., 2005) and, of 10 negative outcomes of surgery, rank vomiting as the most undesirable outcome and nausea as the fourth most undesirable (Gan, 2006).
Aims of this study The primary aims of the proposed research are to test the efficacy of acupoint stimulation versus placebo for reducing PONV in cardiac surgery patients and to develop an understanding of intervention fidelity and factors that support, or impede, the use of acupoint stimulation, using a knowledge translation approach. 28 | TQN | DECEMBER 2014
www.qnu.org.au
NURSING AND MIDWIFERY RESEARCH
wristband group, with the point of difference being that they will have a sham (without bead) Seaband® wristband applied to their wrists. PONV will be evaluated by the assessment of nausea and vomiting, use of rescue anti-emetics, quality of recovery, and cost. Patient satisfaction with PONV care will be measured and clinical staff interviewed about the clinical use, feasibility, acceptability and challenges of using acupressure wristbands for PONV. Study progress will be reported in tqn.
Contributors to this study Marie Cooke, Claire Rickard, Ivan Rapchuk, Kiran Shekar, Andrea P Marshall, Tracy Comans, Suhail Doi, John McDonald, Amy Spooner.
Trial registration number Australian New Zealand Clinical Trials Registry - ACTRN12614000589684
Acupressure for the treatment of PONV Acupressure is a traditional Chinese medicine thought to restore equilibrium to the body by stimulating specific points (acupoints) that connect the meridians to organs (Abraham, 2008). Although the mechanism for the action of acupressure has not been scientifically investigated fully, it is thought that it may prevent nausea and vomiting through an alteration in endorphins and serotonin levels (Turgut, 2007). A meta-analysis in a recent Cochrane Systematic Review by Lee and Fan (2009) of 40 trials, totalling 4858 participants (all surgical patients without age limits), reported positive effects of PC6 (wrist) acupoint simulation on nausea, vomiting, and need for rescue antiemetics. However, a larger rigorous RCT is needed to provide definitive evidence to inform clinicians regarding the application of this treatment to a cardiac population.
Participants in the study 712 post-cardiac surgery participants will be recruited to take part in a twogroup, parallel, superiority, randomised controlled trial. Participants will be randomised to receive a wrist band on each wrist providing acupressure to PC 6 pressure point using acupoint stimulation or a placebo. www.qnu.org.au
Participants in the acupressure group will have a Seaband® wristband applied on arrival to ICU on both wrists (bilateral application is recommended) by a research nurse ensuring that the bead stimulates the PC6 acupoint and the bands are covered with a light opaque bandage. The wristbands will be removed at 36 hours after admission to ICU just after the final outcome measurement. This same procedure will be applied to participants in the placebo (sham)
References Abraham J (2008) Acupressure and acupuncture in preventing and managing postoperative nausea and vomiting in adults. Journal of perioperative practice,18(12), 543-51. AIHW (2013) Australian hospital statistics 20112012. Canberra: AIHW, Contract No: Health services series no. 50. Cat. no. HSE 134. Bainbridge D, Martin J, Cheng D (2006) Patient-controlled versus nurse-controlled analgesia after cardia surgery - a meta-analysis. Canadian Journal of Anesthesia, 53(5), 492-9. Carlise J, Stevenson C (2006) Drugs for preventing postoperative nausea and vomiting. Cochrane Database Systematic Review. Issue 3: Art. No.: CD004125. Gan T (2006) Risk factors for postoperative nausea and vomiting. Anesthesia & Analgesia, 102(6), 1884-98. Klein A, Djaiani G, Karshi J, Carroll J, Karkouti K, McCluskey S, et al. (2004) Acupressure wristbands for the prevention of postoperative nausea and vomiting in
Acknowledgements We would like to thank the Critical Care Research Group, The Prince Charles Hospital
Funding statement The pilot for this study was funded by the NHMRC Centre of Research Excellence in Nursing, Griffith University. For more information on the NHMRC Centre of research Excellence in Nursing (NCREN) in Queensland visit www.griffith.edu.au/health/centreresearch-excellence-nursing adults undergoing cardiac surgery. Journal of Cardiothoracic and Vascular Anesthesia, 18(1), 68-71. Korinenko Y, Vincent A, Cutshall S, Li Z, Sundt T (2009) Efficacy of acupuncture in prevention of postoperative nausea in cardiac surgery patients. Annals of Thoracic Surery, 88(2), 537-42. Lee A, Gin T, Lau A, Ng F (2005) A comparison of patients and health care professionals’ preferences for symptoms during immediate postoperative recovery and the management of postoperative nausea and vomiting. Anesthesia & Analgesia, 100(1), 87-93. Lee A, Fan L (2009) Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting, Cochrane Database Systematic Review. 2009;Issue 2:Art. No.: CD003281. Turgut S, Ozalp G, Dikmen S, et al. (2007) Acupressure for postoperative nausea and vomiting in gynaecological patients receiving patient-controlled analgesia. European Journal of Anaesthesiolog, 24(1), 87-91. DECEMBER 2014 | TQN | 29
CONTINUING PROFESSIONAL DEVELOPMENT
C ASE S TU DY
For better or worse? Changes to medication management The Queensland Government plans to make expansive amendments to the way drugs and poisons are regulated in Queensland. The draft Medicines, Poisons and Therapeutic Goods Bill 2014 is proposed to replace current legislation that regulates drugs and poisons in Queensland. The current regulation of drugs and poisons in Queensland, the Health (Drugs and Poisons) Regulation 1996 (Qld) requires a person to be ‘endorsed’ by the Regulation to be permitted to ‘administer’ a medicine. The Regulation defines the term ‘administer’ as ‘to give a person a single dose of a drug to be taken immediately’. The Regulation also contains the infamous ‘carer provisions’ which prescribe that a carer does not need endorsement to assist a person to take a drug under certain preexisting conditions: that the person asks the carer for their help that the medicine is dispensed (by a pharmacy) to the person and that the carer follows the instructions on the pharmacy label. The draft Bill proposes a number of measures that are of serious concern to the QNU and on behalf of members we have made a detailed submission to the State Parliament.
Eligible persons Rather than require endorsement to administer a drug, the draft Bill proposes that ‘eligible persons’ will have the authority to administer. The draft Bill also states that a person can be considered an eligible person by virtue of their occupation. 30 | TQN | DECEMBER 2014
This opens the door for unregulated and unqualified personal carers and AINs to be able to administer drugs to residents or patients of an institution, whether a small aged care facility or the Royal Brisbane and Women’s Hospital. But consider the two different scenarios. If your elderly mother was admitted to hospital, you would expect their multiple medicines to be administered by qualified RNs and ENs. This is what happens every day. Queensland Health nursing executives have made very clear they are not going to permit unqualified carers to administer medicines to patients or aged care residents. But according to the draft Bill, if your elderly mother then returns to her private aged care facility, it is possible her multiple medicines will be administered by an unqualified carer. What if the medications carry a significant health risk—even death—if an error occurs? The draft bill does not adequately address this issue. The QNU submission to the Queensland Government on the draft Bill strongly recommends that an ‘eligible person’, at the very least, must be a registered health practitioner.
A plan which is not a plan The draft Bill also prescribes a facility must have a ‘scheduled substance management plan’. At face value, this seems a positive step.
Unfortunately, the draft Bill does not require the plan to be audited, or even that it comply with any professional standards. The plan must state the persons to whom it applies and the training or instruction those persons are required to have. This means a facility could send unqualified carers on a short, nonaccredited training course before telling them to administer medicines. The QNU submission also strongly recommends the draft Bill be changed so only registered health practitioners are the persons to whom the plan applies and therefore are the only persons permitted to administer drugs.
More power to the Chief Executive — but why? The draft Bill also grants the Chief Executive the power to make standards relevant to regulated activities—but such standards and guidelines already exist. In the hospital setting, the National Safety and Quality Health Service Standards include “Standard 4: Medication Safety”. This Standard prescribes that only trained health professionals will administer medicines in the hospital setting. Compliance with these Standards is essential for hospitals to gain accreditation. In aged care, professional standards regarding medication management also exist. These nursing standards prescribe that unregulated healthcare workers such as AINs and personal carers may be delegated by an RN to assist a person with their medicines only where: the person is assessed as able to selfmedicate and the person requires assistance to access the medicine in its packaging. www.qnu.org.au
CONTINUING PROFESSIONAL DEVELOPMENT
Where the person is unable to self-administer their medicines, carers cannot assist and the medicine is to be administered by an RN or EN. This is the standard that should be applied when aged care facilities are accredited. Unfortunately, many facilities receive accreditation despite not applying the standard.
Who accredits the accreditor? The Aged Care Act 1997 (C’th) requires all aged care facilities to comply with all professional standards and guidelines. Yet the Quality Agency—the government body tasked with the accreditation of aged care facilities—does not appear to audit aged care facilities’ compliance with this professional standard. The QNU wrote to the former Accreditation Agency seeking a response to this apparent failure in their duties. In response, they claimed to audit facilities’ compliance with professional standards. However, the evidence from members and from facility accreditation reports did not support that claim. This evidence remains unchanged in reports from the new Quality Agency. The QNU invites the Australian Aged Care Quality Agency to publicly state why many facilities receive accreditation when they do not have systems in place to ensure compliance with the nursing professional standard for medication management in aged care. We will inform Queensland nurses and midwives of the answer, and allow them to determine its credibility.
Serious lapses in medication management are systemic The fact remains that many aged care facilities allow unqualified and unregulated carers to administer medicines to our elderly mothers, fathers, uncles, aunts, grandmothers and grandfathers. Some facilities do this to contain costs so their shareholders can get a better return on their investment. The QNU submission to the state government strongly recommends the Chief Executive prescribes the existing professional standards for the hospital setting and for aged care facilities be locked into the legislation as regulated standards for the management of medicines in Queensland. We consider this to be the bare minimum requirement for the safety of the Queensland public. www.qnu.org.au
Reflective exercise for case study over page »
DECEMBER 2014 | TQN | 31
CONTINUING PROFESSIONAL DEVELOPMENT
C ASE S TU DY
Reflective exercise: Medication management 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.
The following questions are offered as a guide to assist you in identifying your learning from reading and analysing the content of the article. Keep in mind, the proposed changes to medication management in Queensland are not yet law. This exercise is designed to get you thinking about current practices and what impact potential changes might have. Explain and analyse the following questions: 1. The professional nursing standard for medicine management in aged care mandates that carers can be delegated by the RN to assist only when a resident who self-administers their medicines requires physical assistance to access the medicine. Why do you think this standard exists? Consider how the principles of delegation, safety, quality and accountability are applied in this standard. 2. Do you think it is acceptable for AINs to administer medicines as long as the number of tablets they give the patient matches the number on the medication chart? If not, why not? 3. The NMBA says: “Nurses, acting through their professional and industrial organisations, participate in developing and improving the safety and quality of health care services for all people.” If standards are enforced at hospitals but not at aged care facilities, what do you think you, as a QNU member, can do about it? 4. The NMBA also says: “Registered nurses are accountable for making decisions about who is the most
appropriate person to perform an activity that is in the nursing plan of care.” Given that professional nursing standards exists, if an RN allows a non-nurse to administer medicines to all patients/ residents, would the NMBA agree the decision to delegate was compliant with professional expectations? If not, why not? Remember, the QNU provides extensive professional advice for all work sectors through our information sheets. These can be accessed on the members-only section of our website, or by calling QNU Connect. All aged care employers acknowledge the RN is accountable for medication management at their facility—so if you are an RN in aged care, read the relevant information sheets and take back control over your professional liability. Following reflection, consider how you will retain and share what you have learned about the government’s proposed changes to medication management. What potential influence will these proposed changes have on your professional practice? 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):
32 | TQN | DECEMBER 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
MIDWIFERY
A midwife’s tale: continuity of care on Gold Coast BY BETHAN TOWNSEND
Three years ago I was given the choice of either working on birth suite or in a Midwifery Group Practice. I chose Midwifery Group Practice which was connected to a birth centre at the Gold Coast Hospital. At first I was a bit apprehensive about the on-call commitment as I had a three year old son. However I can now say that it was definitely the right decision. I have high job satisfaction, I’m able to give women the care they deserve and the difference in outcomes is incredible. The Midwifery Group Practice outcomes over the past three years are the some of the best in Australia with a caesarean section rate of just under 7%, nearly 70% of our women choosing not to use pharmacological pain relief, and more than 90% of our women still breastfeeding at six weeks postnatal. The job also fits in well with family life because although I’m on call for my women, the hours are flexible and my time is used more effectively when the women need me rather than doing continuous 12 hour shifts. I work in partnership with one other midwife within a small group of four midwives. We have a close working relationship so it is important that we support and trust each other. When you have that trust and are working under the same philosophy there are benefits for the midwives as well as the women. We reflect on practice with each other and share knowledge and experiences in a non-judgemental way which helps us to keep our practice evidenced-based and safe. www.qnu.org.au
We are also very well supported by a women-centred team of obstetricians who we have directt d contact with for consultation and referral if our women develop complications. Although I’ve been a midwife forr over 20 years and have worked in continuity teams before, my whole philosophy on birth has changed since working in a Midwifery Group Practice at GCUH. In the UK where I previously worked I had a caseload of between 80-100 women, visits were short and there was little time to really get to know your women. I didn’t appreciate how continuity could really make a difference even though our outcomes were good. In the MGP we have 40 women a year in our caseload, nd which means we are able to spend time with them. We talk about birth in a positive way, work in partnership to help women and their families make informed decisions about their pregnancy, birth and postnatal care. I really feel that I’m on that journey with them, supporting them along the way, feeling their apprehension and anxiety as well as their strength and belief in themselves. Being able to truly give women oneon-one care in labour is an incredible experience.
Bethan (centre) and new
parents.
It’s amazing to see women trust in birth and have positive, empowering experience. Being a midwife is a very special experience. I feel very privileged and proud to be a part of such an amazing journey in a woman’s life. Working in a continuity model is the best experience of my career to date. I’m now actually working ‘with woman’ as all midwives should. This was the reason I came into midwifery and where my passion has always been and always will be. DECEMBER 2014 | TQN | 33
HEALTH AND SAFETY
WORKLOAD INJURIES: report and keep copies Reporting an incident which leads to an injury can often seem like making a big deal out of nothing. Trust us—it’s not. The QNU has recently assisted a number of nurses and midwives whose failure to properly report an incident has directly led to major problems with their workers’ compensation application. It is absolutely vital you report incidents and hazards to your employer immediately. This has become more relevant as we have seen an increase in employers challenging compensation claims. Often an employer will try to have the claim rejected by denying knowledge of an incident, disputing the applicant’s version of events, or providing irrelevant information. Some nurses and midwives have advised the QNU that even when they have submitted an incident report, it has “gone missing”. This is a very worrying trend. While these problems do not always lead to a claim being rejected, they complicate the issue—which often means an injured worker does not receive compensation as soon as they should.
No matter how minor the incident, submit a report Always submit an incident report when you perform an activity that causes you any discomfort, or you believe could lead to an injury. Be aware your employer may be using a different title than ‘incident report’, so if you are told ‘We don’t have incident reports’, persist until you are given the form you need to report the incident. 34 | TQN | DECEMBER 2014
The QNU has assisted many nurses and midwives who have not reported immediately, believing the pain they are experiencing is temporary and will resolve. These nurses and midwives have continued to work, enduring increasing pain, only to discover they have sustained a serious injury that requires treatment. It is at this time they learn their employer has contested their compensation claim, and the insurer has rejected their claim because they are not satisfied the injury is work-related.
Keep a copy Always keep a copy of the incident report submitted to your employer. Nurses and midwives consistently tell the QNU their incident reports have “gone missing” once provided to the employer and a claim is being investigated. Do not let this happen to you. Protect yourself, your family, and your financial position when injured by keeping copies of your reports.
Psychological injury and workloads Psychological injuries are particularly prone to being underreported and rejected for compensation claims. Psychological injuries can easily be caused by events at work, including problems with heavy and unrelenting workloads. If you feel your psychological well-being is being harmed by an unreasonably heavy workload, it is absolutely vital you complete a workload reporting form. These reports can be used as evidence to meet the “onus of proof ” required to have a compensation claim for a psychological injury accepted. While it is difficult to gain workers’ compensation for psychological injury caused by heavy workloads, one thing
can be guaranteed: claims without supporting documents are never accepted. So remember – always report, always keep a copy.
Employers required by law to have reporting procedure Remember also that the Work Health and Safety Act 2011 requires an employer to have a system for reporting incidents. Workers must also comply with any reasonable instruction on health and safety including reporting incidents and hazards. Some reporting systems are difficult and time-consuming to use—but this is a small price to pay to protect yourself into the future. www.qnu.org.au
OPINION
CHANGING THE DISCUSSION ON DYING WITH DIGNITY The Senate Legal and Constitutional Affairs Legislation Committee is currently looking into a new bill which would permit terminally ill people the right to seek assistance in ending their lives. Jim Soorley, who spoke at the QNU Annual Conference on this matter in 2012, explains his view on why the bill is so important. Several years ago a Newspoll survey showed that more than 80% of Queenslanders support some legislative change around dying with dignity. In Victoria, polling for the recent state election clearly showed three out of four Victorians also support some legislative change. What a shame the politicians of both major parties have no vision and no courage on this important issue. Can you imagine any other issue in our community being ignored by politicians with such numbers supporting change? For some reason the state and federal members of parliament are out of step with community values on this matter. If this immobilised legal debate is to be opened up beyond the moralisers on www.qnu.org.au
one side and the crusaders (that’s me!) on the other, we simply must change the discussion. Doctors, nurses and aged care workers all live in fear that an outdated law full of grey areas may be used to punish, fine or even jail them if they do anything to assist an individual to die. The current suspension of pro-euthanasia advocate Dr Philip Nitschke is a very clear attempt by medical authorities to send a warning to doctors and nurses to be very careful about how they treat the dying. Can we find some common ground in this discussion between those who relentlessly argue their traditional values must be upheld and those who argue for the rights of the dying? We need to move the argument so it is not distracted by claims legislative change could allow for people to be killed who don’t want to die, or they may be killed by their family or whatever, and focus on what legislative changes are necessary to assist the terminally ill to die on their terms in peace and comfort. We know nurses and doctors are committed to human life and that means in some circumstances drug regimes may need to be changed to make the end of life a little easier and certainly less painful.
Many nurses and doctors are afraid of increasing drugs in the final days of life in case some over-zealous police officer or prosecutor decides to pursue them. As a very important first step to break the deadlock in Queensland, we must have legislation to protect any nurse or doctor from the possibility of a charge of homicide or manslaughter if they have prescribed or administered a drug to a terminally ill patient in the belief this drug was necessary to relieve pain or suffering by the patient. There is nothing new in this debate. The ancient Catholic philosopher Thomas Aquinas established the principle of the “Double Effect”—if you are doing one good thing and there happens to be a bad side effect you can still do the good thing. Even the Christian churches should be able to support this small legislative change. It will give much relief to the terminally ill who often live in fear of their final days. It will give peace of mind to nurses and doctors who go about the difficult job of caring for the dying. It may break the nexus in this debate but it will make our society a little more caring to the end of life. DECEMBER 2014 | TQN | 35
PROFILE
Changing the world, one family at a time Earlier this year, Toowoomba midwife and QNU member Jenni Price was named Queensland Midwife of the Year. Jenni took time out to talk to us about her experience as a midwife.
Hi Jenni. Congratulations on the award—how did it happen? Thanks! Women who want to nominate their midwife send in an application form with 50 words on why their midwife was outstanding. I’ve been nominated before—you receive a certificate letting you know—and it’s always really lovely, but you never think you’ll be awarded Midwife of the Year. This year’s theme was ‘Midwives changing the world, One Family at a Time’, and I think that helped me. The lady who nominated me, I’ve been her midwife for all three of her births, as well as one of her sister’s two births, and her other sister’s most recent birth.
That is definitely all in the family. You must come highly recommended. Well, sometimes that is really hard. You do become involved in these moments in people’s lives and often they want you 36 | TQN | DECEMBER 2014
to be part of those lives, but you have to maintain your professional boundaries. You get invited to birthday parties and that sort of thing, but you can’t become more than professional friends until three years after your initial contact. Toowoomba’s a small place and you run into people often!
not often for postnatal follow-up, and I wanted the whole journey. I jumped at the opportunity to work in Toowoomba Hospital’s midwifery model when it arose. Now I’m with the women under my care from the very start, and go along with them until six weeks after the birth. It’s the best continuity of care, and it’s very satisfying.
How did you come to work in the midwifery model of care in Toowoomba?
So how is the future looking for the continuity of care model?
I originally started my nursing career in Toowoomba but spent a few years working around the state before moving back home and working in private practice with an obstetrician. What I was really waiting for was the midwifery model of care at Toowoomba Hospital. I loved working in the private sector, but never got to continue the whole process with mums. I did get to see them for antenatal and postnatal care, but
It’s the way of the future. It’s cost effective, and the desire and the outcomes are there. Our greatest challenge is getting the model rolled out everywhere. It can be hard to organise the set-up and funding—but it’s really appropriate for a large state like Queensland because it’s about permitting women to stay closer to home. It’s also a big change to the way midwives in hospitals are used to working, but it www.qnu.org.au
PROFILE
doesn’t mean the end of the old ways. It’s just another option of care for women, a newer and different way of working. We’re very fortunate in Toowoomba to have so many different choices for women. We also have privately practising midwives with hospital access, so women here have a lot of options for care. That’s the way it should be.
What’s the most difficult decision you’ve had to make? The hard decisions are usually disagreements over care within multidisciplinary teams, it comes with the territory. You have to try to help women in your care fulfil their wishes while maintaining your professionalism and their safety.
How important is it for midwives to belong to a union? I’ve been in the QNU since I graduated as a nurse in 1987. Joining professional associations and taking an interest in how you can improve your profession is just one of those things you have to do. We’re the people with the ideas and the knowledge about how to get better outcomes for women in our care. It’s up to us to work together to get make those outcomes possible. Our union representatives and officials in Toowoomba have worked incredibly hard to help us get what we need. They are very passionate about what they do.
They’ve been involved in all of the specialist panels and committees, making our units work better. It helps a lot by having people you can ring when you have a question and who can help you find the answers you need. It’s a real shame it has become much harder for union officials to come into the facility. It’s important that all key stakeholders are consulted in the interests of clinical improvement. To prevent them from contributing is not providing the best evidence-based outlook for any organisation.
Queensland Midwife of the Year, Jenni Price.
It’s a fine line to walk sometimes. It is! Our job is to explain to our colleagues how the women in our care are thinking, and advocate for what the woman having the birth would like. It’s about building trust and keeping it, listening and giving choices. Even if a woman doesn’t have the birth she set out to have and it’s a really difficult experience for her, if she feels she was listened to and was able to make choices she will still come out feeling it was absolutely wonderful.
What are the most important things for new midwives to keep in mind? Make sure you have a good competency base. Give yourself the widest scope of experience possible before making a decision about where you want to go in your midwifery career. When you are doing your training, watch how different midwives interact with women. It’s so interesting to see how different midwives do birth. Lastly, get a good mentor. Remember, you work with different midwives while you’re doing your training, so if you feel you’d like to work with another midwife who you can relate to, go for it. Once you get into your career you don’t always get the opportunity to work with other midwives, so when you can, you should jump at it. www.qnu.org.au
DECEMBER 2014 | TQN | 37
SOCIAL
QUEENSLAND COMMUNITY ALLIANCE ASSEMBLY COMES TO INALA It’s a warm Wednesday evening and the St Mark primary school hall in Inala, just outside of Brisbane, is abuzz with hundreds of conversations. A bloke in a union polo shirt is listening intently to a woman wearing a gloriously colourful headscarf and flashing pink painted nails as her hands move with her words. Beside him, three young women sit in a huddle of plastic chairs swapping stories like old friends—their sentences tumbling over one another between chuckles. And over near the windows a man in pressed pants and polished shoes talks softly to a woman who smiles encouragingly each time his voice falters. Welcome to the Queensland Community Alliance Assembly. The Assembly is the leading annual event of the Queensland Community Alliance—a collective of congregations, unions, associations and community organisations which are taking a nonpolitical, non-partisan collaborative approach to creating a better Queensland. The QNU is one of 17 founding members of the Alliance, as is the Queensland Council of Unions, the Queensland Teacher’s Union, Together, United Voice, the Uniting Church, the Catholic Arch Diocese and the Multicultural Development Association. The idea is that by pooling the individual power of all these organisations, we can start to have some big wins on policy outcomes that would be out of reach for any one group working alone. The Inala assembly in October was the second held so far and the last big foundation event before the Alliance starts lobbying policy and decision makers. Under the banner of “growing together” the Inala Assembly was an opportunity for the organisations to reconfirm their commitment to the Alliance and pledge to support a new a “Listening Campaign” scheduled for April and May next year. 38 | TQN | DECEMBER 2014
The campaign encourages members to hold events like barbecues, forums, dinner parties, coffee catch-ups or even online chats both to promote the concept of the Alliance and to find out from community members what issues are important to them. The ideas and suggestions drawn from the listening campaign will help the Alliance decide what issues to tackle, how they might be addressed, and what politicians or decision makers may need to be lobbied. In fact ‘listening’ was a key focus of the Inala assembly. A short video shown during the evening summarised the Listening Forum held recently in Logan which drew together dozens of local leaders and residents who had a frank discussion about the services, amenities and changes Logan needs. A similar event was held in Ipswich last month. Back in the hall, the 350 or so Assembly participants were also asked to share their stories of hope and action—a trial run for the kind of discussions they would be asked to host during the 2015 Listening Campaign. QNU official Bob Parker, who has been active in QCA from day one, said after more than 12 months the Alliance was really taking shape.
“We had about 280 people at the first Assembly, so to see those numbers swell this year is just fantastic,” he said. “There were also quite a number of new organisations attending this year—just getting a feel for what we are trying to do.” Bob said building the Alliance has been a slow and steady process but organisers were keen to ensure the foundations were solid. “True community engagement takes time,” he said. “However it is good to see we are finally edging towards the point where we have some priorities on the table and are ready to approach political representatives and other decision-makers for action.” If you would like to know more about the Alliance, including registering your interest in being involved in community conversations, in the second quarter of 2015 please contact Bob at bparker@qnu.org.au
The QNU’s Bob Parker shares his story with other Alliance members.
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.
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 allied health subject areas; many but not all are full text. The QNU’s friendly librarians, Madeleine and Pat. www.qnu.org.au
DECEMBER 2014 | TQN | 39
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
JANUARY
MAY
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/
International Conference on Nursing 4-7 May 2015, Athens, Greece www.atiner.gr/nursing.htm
Inaugural International Conference on Migration, Social Disadvantage and Health Toward developing national and international priorities for migration, health and social wellbeing 11–13 February 2015, Melbourne www.international-migrationconference2015.net.au/ 4th Biennial Nephrology Educators Network Symposium Leading the charge for change 16-17 February 2015, Sydney www.nen.org.au/symposium-2015/ TheMHS Summer Forum Men’s Mental Health: Building a Healthier Future 19-20 February 2015 Crows Nest, NSW www.themhs.org
MARCH Diabetes study day with Kathy Mills, RN, MEd, Dip Business, Credentialled Diabetes Educator. This study day for enrolled and registered nurses covers contemporary and evidence based research on dietary, exercise, psychological and pharmacological management of diabetes mellitus. 6 March 2015 from 9am-4pm at Inner East Melbourne Medicare Local, 6 Lakeside Drive, Burwood East. Free parking. Morning tea, lunch and notes are provided. This study day is eligible for 6 hours professional education. Early bird special (pay by 20 February, 2015) is $220. Full registration fee: $250. All queries to Kathy via email only at diabetes.ed@optusnet.com.au 19th National Otorhinolaryngology Head & Neck Nurses meeting and ASHONS 65th scientific meeting Excellence and innovation 7-9 March 2015, Sydney www.ohnng.com.au/national_ conference.html
40 | TQN | DECEMBER 2014
World Environment Day 5 June 2015 www.unep.org/wed/
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
FEBRUARY 2nd Flinders Centre for Innovation in Cancer Survivorship Conference Life after Cancer – from Recovery to Resilience 6-7 February 2015, Adelaide www.survivorship2015.org/
JUNE
International Women’s Day 8 March 2015 http://www.unwomen.org/ Florence Nightingale Foundation Annual Conference 12-13 March 2015, London www.fnfalumni.org/event-1717850
18th Cancer Nurses Society of Australia Annual Winter Congress Cancer nursing: expanding the possibilities 14-16 June 2015, Perth www.cnsawintercongress.com.au/
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 12th Annual World Healthçare Congress Connecting and preparing leaders for healthcare transformation 22-25 March 2015 Washington DC, USA www.worldcongress.com/events/ HR15000/ 4th Annual eMedication Management Conference 26-27 March 2015, Sydney www.informa.com.au/conferences/ health-care-conference/electronicmedication-management
APRIL World Health Day (WHO) 7 April 2015 www.who.int/world-health-day/en/ 6th Biennial Conference of the Maternal, Child & Family Health Nurses Australia Our voice our future 9-11 April 2015, Perth www.aamcfhn.org.au/
Asia Pacific Cardiorenal Forum 8-9 May 2015, Sydney http://cardiorenal.com.au/ 14th World Congress of the European Association for Palliative Care Building bridges 8-10 May 2015, Copenhagen Denmark www.eapc-2015.org/ International Nurses Day 12 May 2015 www.icn.ch/ 12th Behavioural Research in Cancer Control Conference Bridging the gap 12-15 May 2015, Sydney www.cancercouncil.com.au
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 International Conference on Ageing in a Foreign Land 24-26 June 2015 Bedford Park, South Australia www.flinders.edu.au/ehl/conferences/ ageing/ 3rd Annual Worldwide Nursing Conference 29-30 June, Singapore www.nursing-conf.org/
7th Australian Primary Health Care Nurses Association National Conference 14-16 May 2015, Gold Coast www.apna.asn.au/ 13th National Rural Health Conference People, Places, Possibilities...for rural and remote Australia 24-27 May 2015, Darwin www.ruralhealth.org.au/13nrhc/
World Day for Safety and Health at Work (ILO) 29 April 2015 www.un.org/en/events/safeworkday/
www.qnu.org.au
YOUR SUPER
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A better mortgage? When was the last time you checked if you had the best mortgage for your needs? After your super, your home is likely to be the biggest investment you ever make, so it’s important to ensure you’ve got the right loan. That’s why QInvest has launched a mortgage broking service for QSuper members, their family and friends, so they can make more informed decisions about their home loans. This no obligation service is designed to find the best deal on new loans, refinanced loans, and investment properties, so you can pay off your home loan sooner. In addition to trying to find the best product for you, QInvest LoanFinder also refunds half the ongoing commissions from the lending instituations2 received from the lender. These payments depend on the amount you borrow, but can potentially save you thousands off the cost of borrowing. Most appointments can be conducted over the phone within less than an hour and if you already have a mortgage, you can even use QInvest’s LoanFinder service to see if you can get a better deal with your existing lender. As a QSuper member you can access this service by calling 1800 643 893, or for more details visit qinvest.com.au.
Real Member Case Study: Trevor and Nicky Trevor and Nicky have three young children and were looking for payment stability and a product that would help with their cash flow so they could better meet their monthly expenses. QInvest LoanFinder was able to restructure their finances whilst still allowing funds for renovations and a buffer, as well as saving them an additional $300 a month in repayments. 1. Calculated on the amount of ongoing commission (excluding GST) payable to QInvest. Rebate offer not available to GST-registered borrowers.
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
QInvest Limited (ABN 35 063 511 580, AFSL and Australian Credit Licence number 238274) (QInvest) is ultimately owned by the QSuper Board (ABN 32 125 059 006) as trustee for the QSuper Fund (ABN 60 905 115 063), and is a separate legal entity which is responsible for the financial services and credit services it provides. QInvest also provides advice about investments outside of your QSuper benefit and this may incur an additional fee. This information has been prepared for general purposes only without taking into account your objectives, financial situation, or needs. As a result, you should consider the appropriateness of the information for your circumstances and read the product disclosure statement (PDS) before making a decision. © QInvest Limited 2014
DECEMBER 2014 | TQN | 41
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1300 738 601 www.fleetnetwork.com.au/bonus Fleet Network Pty Ltd. To qualify for this offer you must mention this advertisement to Fleet Network prior to the completion of your initial contract. Vehicle must be new and supplied by Fleet Network. Not valid in conjunction with any other current Fleet Network offers. Employees should consult their employer’s salary packaging policy before entering into a contract. *Subject to Employer policy. Vehicle for illustration purposes only.
One phone call can help take you to a better retirement. If you’re a QSuper member, you have access to quality financial advice tailored to where you are in life. With over 20 years experience, QInvest1 is able to give you the guidance you need to make your money work harder for you, from as little as $55.2 Even better, in most cases this advice fee can be deducted from your QSuper account, so you’re not out of pocket.3 A simple over-the-phone chat with a QInvest Adviser could be the trigger to getting your super in a great place for when you retire. So call QInvest and make an appointment today.
qsuper.qld.gov.au/advice 1800 643 893 1 QInvest Limited (ABN 35 063 511 580, AFSL and Australian Credit Licence number 238274) (QInvest) is ultimately owned by the QSuper Board (ABN 32 125 059 006) as trustee for the QSuper Fund (ABN 60 905 115 063), and is a separate legal entity which is responsible for the financial services and credit services it provides. 2 Information about QInvest fees is available on the Financial advice section of qsuper.qld.gov.au/advicecosts 3. QSuper contributes to the cost of financial advice where it relates to your QSuper Benefit. If you are seeking advice on matters beyond superannuation the fee above will vary, depending on your situation and the nature of advice. QInvest will inform you of the applicable fee before providing you with advice including any restrictions on deducting the advice fee from your QSuper account. This information should not be considered personal advice as it does not take into account your particular circumstances. Consider these issues before you make an investment decision. For more information, visit qinvest.com.au. 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. 8126 21/11/14.