Tqn Vol34 [2] Apr15 by Queensland Nurses and Midwives' Union

VOL. 34 | NO. 2 | APRIL 2015

THE QUEENSLAND NURSE

Restoring respect and stability to nursing and midwifery

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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. 34 | NO. 2 | APRIL 2015

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 Restoring respect and stability to nursing and midwifery

Cairns Suite 2, 320 Sheridan St, North Cairns Q 4870 (PO Box 846N, North Cairns Q 4870) T 07 4031 4466 F 07 4051 6222 E qnucairns@qnu.org.au DISCLAIMER Statements expressed in articles in The Queensland Nurse are those of the contributor and do not necessarily reflect the policy of the Queensland Nurses’ Union unless this is so stated. Copyright of articles remains with the contributor and may not be reproduced without permission. Statements of facts are believed to be true but no responsibility for inaccuracy can be accepted. Other material may be reproduced only by written arrangement with the Union. Although all accepted advertising material is expected to conform to the QNU’s ethical standards, such acceptance does not imply endorsement.

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

www.qnu.org.au

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Your union Editorial

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Midwifery

APRIL 2015 | TQN | 1

YOUR UNION

Representing you in the greatest trade union in Australia

SALLY-ANNE JONES, QNU PRESIDENT

On Thursday 27 November 2014, elections for Australian Nursing and Midwifery Federation Federal Office bearers were called.

YOUR COUNCIL

The positions of Secretary, Assistant Secretary, Vice-President and President were open to nominations. I nominated to run for the position of Federal President. The results of the ballot have now been announced and I have had the honour of being elected as the incoming Federal President of the ANMF. I accept this responsibility with a great deal of humility, and thank you all for your votes and support for me to work for you—representing nurses and midwives in the greatest trade union in Australia! Established in 1924, the Australian Nursing and Midwifery Federation (ANMF) is the only organisation in Australia representing the industrial and professional interests of nurses, midwives, and Assistants in Nursing. The ANMF has over 240,000 members working across Australia in cities and towns, rural, regional, and remote locations, and in every area of health, health prevention, and aged care. There are many challenges ahead, both for Australia’s health and aged care systems, and for us as nurses and midwives. Nurses and midwives from the ANMF are working with governments, community and consumer groups, health

I ACCEPT THIS RESPONSIBILITY WITH A GREAT DEAL OF HUMILITY, AND THANK YOU ALL FOR YOUR VOTES AND SUPPORT FOR ME TO WORK FOR YOU and aged care providers, and other health care professionals to find solutions and build a sustainable health workforce for the future. The ANMF campaigns to raise political awareness and lead political action. Our strength lies in our people—all of us as members and the community—dedicated to improving public policy on health, aged care, education, employment, industrial relations, and all areas of social justice. I would like to take this opportunity to acknowledge Coral Levett, the outgoing Federal President. I would like to thank her for personally and professionally mentoring me as Federal Vice-President. Coral is also the President of the New South Wales Nurses and Midwives’ Association. Coral is a Registered Nurse with 33 years of experience and has been a passionate trade union activist the entire time.

She has been involved in a wide range of campaigns and activities, from fighting to save public hospitals from privatisation, to achieving nurse to patient ratios in NSW and influencing political and industrial health agendas. Coral has been Federal President of the ANMF for 12 years and she has provided exemplary leadership, advocacy, professionalism, and representation. We have been lucky as a profession to have her—her influence cannot be understated. I welcome the opportunity to continue to work with Lee Thomas who has been re-elected as the Federal Secretary, Annie Butler, the Assistant Federal Secretary, and welcome warmly Maree Burgess as the Federal Vice President to our leadership team. The next few years in all sectors of health will be challenging as governments change and priorities shift. The work of the ANMF in representing nursing and midwifery professions and advocating for safe, affordable healthcare for all Australians will be vital.

Sally-Anne

Secretary Beth Mohle ■ Assistant Secretary Sandra Eales ■ President Sally-Anne Jones ■ Vice President Stephen Bone Councillors Julie Burgess ■ Christine Cocks ■ Karen Cooke ■ Dianne Corbett ■ Jean Crabb ■ Barbara Hastie ■ Shelley Howe Phillip Jackson ■ Damien Lawson ■ David Lewis ■ Lucynda Maskell ■ Simon Mitchell ■ Fiona C.A. Monk ■ Sue Pitman Dan Prentice ■ Karen Shepherd ■ Katy Taggart ■ Kym Volp ■ Di Webb ■ Charmaine Wicking ■ Julie Wilson

2 | TQN | APRIL 2015

www.qnu.org.au

EDITORIAL

The dust is settling – let’s focus on delivering BETH MOHLE, QNU SECRETARY

What a start it has been to 2015. The lessons of the historic Queensland election result are still being digested by political commentators and the broader community. This will no doubt go on for some time, and we all have our theories about why the “Newman experiment” was so roundly rejected by a broad spectrum of voters. One thing needs to be kept at the forefront of all minds—the LNP lost power, and the ALP must convince the electorate they can govern responsibly and fairly. Before 31 January, the result of the ALP forming government was seen as a remote possibility. Now it is a reality, albeit, a fragile one. The focus has now turned to Labor’s governing and delivering on commitments for both nurses and midwives, and the broader community. Many ALP election commitments are particularly important to nurses and midwives, including rebuilding our health system after savage job and service cuts, and re-establishing fair industrial relations and workers’ compensation frameworks. Some key aspects of the ALP’s nursing and midwifery commitments are:  Nursing Guarantee—includes a commitment to legislate in the first term a minimum nurse/midwife-topatient ratio in conjunction with the www.qnu.org.au

proper application of the Business Planning Framework (BPF). This policy also commits to providing 400 additional “Nurse Navigator” positions.  Refresh Nursing—aims to increase the employment of nurse and midwife graduates by supporting the employment of 4000 positions over four years as part of an overall nursing and midwifery workforce strategy.  School Aged Health Services Program— provides for an additional 20 school nurses, including restoring the eight positions that were cut in Metro South HHS. Additionally, nurses and midwives can make a significant contribution to achieve the proper implementation of other ALP health policy commitments, including those related to patient safety and quality, mental health services for young people, taking action on the diabetes challenge, and protecting Queensland’s children from preventable infectious diseases. The Nursing Guarantee policy is of particular importance given a key issue for nurses and midwives across all sectors is their ability to deliver safe patient care in “dollar driven” health and aged care systems. The QNU launched our Ratios Save Lives campaign in January to highlight these concerns and advance strategies to improve patient/resident safety. We have the evidence that demonstrates not only that Ratios Save Lives, but also that nurses and midwives are well placed by sheer virtue of our skills, number, and location to drive improved care coordination and patient safety. During the state election campaign, we lobbied all political parties to commit to legislating minimum nurse/midwife-topatient ratios and skill mix levels in the public sector.

RATIOS

SAVE LIVES Our long-term objective is to achieve this for all sectors. Our community has a right to be guaranteed the same level of care no matter where they are. All major parties but the LNP committed to support this legislation for the public sector, as did Independent Member for Nicklin Peter Wellington. We have now begun the work to ensure this commitment is delivered. We have also flagged with the new Health Minister Cameron Dick the urgent need for clarity around the new government’s wages and broader industrial relations policies. This is critical given the previous government’s decision to extend our public sector enterprise agreement by 12 months. This new political environment is fluid and presents opportunities as well as risks. If we have the passion to drive the creation of a carefully considered plan and persevere until our objectives are achieved, then I’m confident nurse and midwife power will deliver vastly improved outcomes for our patients and residents. We have the evidence and the opportunity—we just need the confidence to advance our case in our daily working lives. By understanding our individual roles while continuing to work together, we will succeed.

Beth

APRIL 2015 | TQN | 3

YOUR SAY

YOUR SAY on Facebook On penalty rates and Tony Abbott’s claims people can just refuse shift work Ok Tony I won’t go to work this weekend, because I don’t feel like it, I will stay home with my family like the rest of Australia does, so my patients won’t get their Chemo, have their blood taken, blood transfusions given, platelets given, FFP given, because I don’t feel like working this weekend. Shall we just close the ward at 1700 on Friday and reopen at 0900 on Monday? M Warren

worry that I’ll be sat in a corner without dignity. Everyone in Australia needs to think about their future and fix this now. R Daly

Now all we have to do is convince the federal government that people over 65 are still regarded as people and worth taking care of in the same way as our young. The elderly deserve dignity and the same standards of care. I believe this country does discriminate against our elderly. I will never give up my fight for them and I have trust that my Union will not forget this fight. N Langley

On the ALP winning the State election Remember this is NOT the same ALP govt that started the sell-off of assets. We need to give them time but keep them accountable. T Copley

The people have spoken. Now, let’s hope those WE have voted in listen and act. L Kruse

I know people that graduated twelve months ago have applied for hundreds of jobs and only a handful of interviews. I work in Aged Care. I studied from AIN to change fields. I’m actually contemplating changing my career entirely as there are no nursing jobs! I hope Labor follows through with their promises.

A bouquet of thanks Nurses are the heroes of our society. A nurse’s day contains dirty work, sad work, shift work, dangerous work, stressful work the lot, and loving attention, they saved my life too many times to count. Support Nurses in better conditions and pay claims. F Fife

On the scrapping of Queensland’s surgery wait time guarantees If anyone actually believes there was no wait they were fooled. I know people who were waiting when they were advertising as having 0 people waiting. Makes me wonder where they get these bloody figures from. K Stewart

S Pennell

On ratios Staff ratios save lives and needs prompt regulation across all health sectors. There’s no denying the statistics. It’s amazing that something so simple and evidently necessary needs to be pushed so hard to implement. The government needs to be on task fast and pay attention. K Young

On QNU’s call for mandated RN levels in aged care facilities Does anyone want to be old and not have good quality carers? Now is the time to find a solution. The older I get the more I 4 | TQN | APRIL 2015

I’d like to know where the Doctors and Nurses are in this debate. Those professionals “who perform the tasks” should be included in every decision making process. Pencil pushers and seat warmers should have very little input into decision making when it comes to the clinical side of running a hospital. I Rapkins

30 million won’t go far. Need to build some Qld Health public run nursing homes to get the geriatrics out of the acute hospital beds. More RNs would work the aged care industry if it had the same standards as our hospitals. R Daly

ANMF federal secretary Lee Thomas re-elected, Sally-Anne Jones elected president Nurses and midwives around the country have re-elected Lee Thomas as federal secretary and elected for the first time our own Sally-Anne Jones as federal president in recent Australian Nursing and Midwifery Federation elections. Lee returns to her role, while SallyAnne—who is also president of the QNU—replaces the outgoing president, Coral Levett. This is a great result. The positions were challenged, and the election of Lee and Sally-Anne can be seen as a strong endorsement of their leadership. NSW RN Annie Butler was re-elected as assistant federal secretary, and Maree Burgess, who is also president of ANMF Victoria, was elected as vice president.

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. 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 tqn also sources Your Say comments from the QNU’s social media accounts in the public domain.

The views contained in the ‘Your Say’ page do not necessarily reflect the views of the QNU. For more information and guidance on writing and submitting a letter for inclusion in the ‘Your Say’ section refer to the QNU’s Letter to the Editor policy at www.qnu.org.au/letters-policy

Connect with us:

/qldnursesunion www.qnu.org.au

TEA ROOM

tea r What should I do if Queensland Health takes disciplinary action against me? The following are important tips to remember if an incident at work has the potential or does result in disciplinary action: 1. As soon as practicable (within 48 hours), write down your version of the incident. 2. If asked to attend a disciplinary meeting, or you are advised that a disciplinary process will commence, download and print a Member Request for Representation form from the QNU website, fill it out, attach your summary of the incident, and send it to the QNU. 3. Don’t be unnecessarily antagonistic toward your manager. It is advisable to take a support person with you to any meeting (either a QNU official or a colleague). 4. Read the HR Policy – Discipline E10 (QH-POL-124). 5. If you are given a letter containing the allegations, read this thoroughly— especially the time frame given to respond—and provide a copy to the QNU. 6. It may be determined by QH that the nature of the allegation warrants your suspension from duty. Remember that this is not disciplinary action. 7. Ensure you keep the incident and disciplinary process confidential. There are avenues to appeal a disciplinary action, and the QNU can assist you with this.

I’m returning to work after parental leave. What right do I have to change or reduce my hours? For members within Queensland Health, the Family Leave Award (State) 2012 and the HR policies Flexible Working Arrangements and Parental Leave outline the entitlement. www.qnu.org.au

m Private sector employees should refer to their enterprise agreement or the National Employment Standards under the Fair Work Act 2009. You have the right to request a flexible work arrangement if you have worked continuously for your employer for at least 12 months prior to the parental leave, and have a child younger than school age. A flexible work arrangement can take various forms including changes to your hours or your work pattern. A request for a flexible work arrangement must be made in advance of your anticipated return to work (normally four weeks). The request should be in writing and detail the reasons for the change and the start and end dates. A statutory declaration must also confirm you are the primary caregiver of the child. The employer must respond to your request in writing within a set period of time. The employer may refuse on ‘reasonable business grounds’. However, they must articulate the full details of any refusal. If your employer attempts to unreasonably refuse a request for flexible work arrangement, contact the QNU.

My manager reduced my hours after making a negative comment about my union activity. Can they do this? Definitely not! All members are protected from repercussions—called “adverse action”—for speaking up about workplace issues and other union activity. Sections 346 and 347 of the Fair Work Act 2009 provide protections for industrial activity and outline what those activities might include. For example, you might decide to assist the QNU in your own time to promote the Ratios Save Lives campaign, attend a local union rally, ask your colleagues to sign a petition, put a QNU sticker on

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.

A FLEXIBLE WORK ARRANGEMENT CAN TAKE VARIOUS FORMS INCLUDING CHANGES TO YOUR HOURS OR YOUR WORK PATTERN.

your car, or write a letter to the editor of your local paper. All these activities are lawful! It is unlawful for a manager to take adverse action against you because you have engaged in union activity. Members who experience unfavourable changes to their rostered hours or have an unexpected disciplinary meeting must contact the QNU immediately so that an adverse action claim can be made. If you have questions for our tea room column email qnu@qnu.org.au

ROVDPOOFDU QI 41::4321

APRIL 2015 | TQN | 5

NEWS

for QNU Annual Conference? This year’s QNU Annual Conference will be held on 15, 16 and 17 July at the Brisbane Convention and Exhibition Centre. Comprehensive information will be sent to each Local Branch shortly, including all Annual Conference deadlines. Below we detail some of the most important information.

Who can attend? Elected delegates from branches are eligible to attend. If they are unable to attend, an elected alternate delegate from their branch can attend in their place. If a branch has not elected enough delegates to fulfil their quota, alternate delegates may also attend to make up the numbers.

How do I submit notices of motion? Much of Annual Conference is devoted to debating and voting on different notices of motion from branches. Until 27 April, Local Branches can submit notices of motion via the QNU website.

PAUL’S PERFECT PLACARDS PRESENT PERTINENT POINTS OF PATIENT PROTECTION PUSH AT POLLS

Re-nominating as a workplace representative Workplace representatives who are eligible to re-nominate have been sent the relevant form. Please ensure this form is completed and returned in order for you to continue as a workplace representative. If you became a workplace representative within the last year, you are not required to fill in the form and will not have been sent one. If you have changed workplaces, you will have been removed as a workplace representative and will need to apply again for your new workplace. Photo: Contributed

ARE YOU READY

A special login is required to access the submission page of the website—details of the login were sent to branches in December last year. If you have not received your login, please contact Jenny Gett at the QNU on 3840 1430. Please note notices of motion must be submitted via branches—they cannot be submitted by individual members. Each branch should ensure “notices of motion for Annual Conference” are on their next meeting agenda. Branches do not have to submit all the notices of motion at one time. Multiple individual motions may be submitted.

2014 QNU Annual Conference

Hats off to QNU member Paul Scott who put our Ratios Save Lives campaign front and centre at the polling booth in January. Paul, who is also the current chair of the Robina Local Branch steering committee, made his own placards to explain ratios and let voters know which political parties supported them. He even decked out his car with dozens of our ratios flyers to grab the attention of passers-by! 6 | TQN | APRIL 2015

www.qnu.org.au

NEWS

Nurses and midwives to pay less for registration Nurses and midwives will pay less for their national registration fee for the 2015/16 year. The Nursing and Midwifery Board of Australia will reduce its annual fee to $150, which is $10 less than the previous fee. The lower fee took effect from 9 September 2014, and applies to the next registration renewal for nurses and midwives, which is due by 31 May 2015. QNU Assistant Secretary Sandra Eales said the reduced fee was a welcome change for nurses and midwives around the state. “This announcement shows that the NMBA recognises the everyday pressures put on our hard-working members,” Sandra said. “With costs rising in other areas, every little bit helps, and this will be a welcome relief for our nurses and midwives.”

Plenty of MODs still to come The QNU is encouraging delegates to attend their upcoming annual Meeting of Delegates (MODs), with meetings still to take place in Bundaberg, Maryborough, Townsville, Cairns, Rockhampton and Mackay. There’s certainly a lot on the agenda to discuss. Meetings will include an update on our Ratios Save Lives campaign, including what the next steps are towards implementing the government’s commitment to legislated ratios in Queensland Health facilities. Our Ratios Save Lives claims will have significant impact on our members in all sectors, and we want to ensure everybody is up to date on exactly what we’re asking, how they will be implemented, and where the QNU is headed in the near future. We’ll also have an update on the campaign to restore Professional Development Leave for the purpose of attending QNU Annual Conference. Visit www.qnu.org.au/mods for times and venues.

THE RETURN OF OUR The state government will return our Labour Day holiday back to its rightful place in May starting next year. The move corrects the former AttorneyGeneral Jarrod Bleijie’s decision to shift the public holiday to October. Queensland unions, including the QNU, never recognised the former government’s change of holiday—for the past three years, Queensland nurses and midwives proudly marched on the first Sunday of May. This year, the QNU will celebrate Labour Day on Sunday, 3 May in Brisbane. Our Ratios Save Lives campaign will be the focus of our march, and will tie in with the Queensland Council of Union’s theme of ‘Stand for Queensland’. Similar to previous years, the march will begin from Turbot Street in Brisbane city at 10am, ending at the RNA Showgrounds. www.qnu.org.au

BUNDABERG

MARYBOROUGH

TOWNSVILLE

CAIRNS

APRIL

ROCKHAMPTON

MACKAY

MAY

LABOUR DAY

This will be followed by a family fun day which will include rides for the kids and live entertainment (including Great Aussie Band, Dr Bombay, and the Combined Unions Choir). Other marches and celebrations around the state will take place on Sunday at the Sunshine Coast, Mackay, Townsville, Maryborough and Bowen, while Ipswich, Bundaberg, Cairns and the Gold Coast will celebrate Labour Day on Saturday, 2 May. This year’s marches are particularly important. While we celebrate all that we’ve achieved for working Australians, including the eighthour shift, penalty rates, and the minimum wage, it also serves as a timely reminder to the current federal government that we’ll do everything we can to ensure we keep our working conditions.

APRIL 2015 | TQN | 7

NEWS

It’s time we had a chat Are you worried about crime and security in your neighbourhood? Do you have enough public transport around your suburb? Are there enough green spaces for kids to play where you live?

These are the sort of questions that will be tossed around all tables great and small in south-east Queensland in the coming months as the Queensland Community Alliance gets stuck in to what it calls its “table talks”.

The Queensland Community Alliance is a collection of faith groups, charities, unions, community organisations, and ethnic associations working together for the common good. It currently covers the south-east corner, but plans are well underway to roll it out across the state. The table talks are part of the Alliance’s 2015 Listening Campaign which encourages people to hold barbecues, forums, dinner parties, meetings, coffee catch-ups, or even online chats to get a better understanding of the issues that are important to each local area. It’s based on the concept that a good citizen is one who listens to what is going on in their community, and a strong organisation is one which works collaboratively with other stakeholders to solve problems. The table talks give people an opportunity to raise issues of concern and share stories about living in their neighbourhood. Some of the stories from talks held in Logan last year were so powerful they brought some to tears.

This kind of personal storytelling helps enrich our understanding of how we live, love, and learn together as a community—and how we can do it better. The ideas and suggestions drawn from the Listening Campaign will help the Alliance decide what issues to tackle first, how they might be addressed, and what politicians or decision makers may need to be lobbied. The QNU has committed to holding 40 table talks around Brisbane and nearby districts over the next couple of months— they are among more than 300 planned throughout the region. The Listening Campaign will run throughout April and May. For more information about the Alliance and the Listening Campaign visit the QCA webpage at www.qldcommunityalliance.org or contact Bob Parker at the QNU on 3840 1426 or bparker@qnu.org.au

Those were Des’s days...

to Assistant The QNU bade farewell r this year, lie ear Secretar y Des Elder paring for pre of y but amid the frenz election p sna s an’ Campbell Newm to dig ce an ch a get we just didn’t ted da y ull htf lig de se out all tho th dodgy wi e let mp (co s oto ph archive his ng ati nineties fashion) illustr QNU career. rsight has But as you can see, that ove now been fixed. QNU for 38 Des was a member of the up his boots. ng hu ly nal fi he years before worked in A Registered Nurse who passionate a s wa s mental health, De QNU a ing om bec ore activist bef the position d employee in 1991. He hel April 2011. ce sin of Assistant Secretary come to an But all good things must ire and put ret end and Des decided to e of a sail sid ty sal his feet up—on the d! boat we are tol g-time nurse QNU Councillor and lon has since les Ea and midwife Sandra e. rol the stepped up to

8 | TQN | APRIL 2015

www.qnu.org.au

NEWS

Art program changing lives for young women The Young Women’s Aboriginal Art Program has seen some wonderful outcomes over the past year, thanks in no small part to the QNU donating $10,000 to the Sisters Inside Fund for Children. The program, which exposes young women to Aboriginal art and allows them to learn new techniques and mediums, aims to get kids whose mothers are in prison off the streets and engaging in activities of interest to them. Sisters Inside CEO Deb Kilroy said the program was making a significant difference in the lives of these young women, with all of them having now returned to school. “It’s about engaging them in a way that interests them. A young person is not going to engage with you if they’re not interested in doing the activity,” said Ms Kilroy. “What’s happened over these past twelve months with the QNU funding is all of them have stopped offending and being arrested by police. There have been no new charges or arrests, they’re not engaging in that type of activity.” The $10,000 goes towards funding transport so the children can meet for their art class, as well as food. The money also funds the occasional excursion, such as a trip to the local art gallery where the kids can view professional artworks and bring ideas back to their own works. Ms Kilroy said the money also helps fund the girls playing touch football once a week in the winter season. “It’s something that this group of young women love doing. It was about identifying their energy and what they wanted to do,” she said. “They love art, so they do art. They wanted to play touch football, so they play touch football.”

union training program COURSE

Date

Location

21 Apr

Toowoomba

22 Apr

Toowoomba

23 Apr

Toowoomba

21 Apr

Gold Coast

22 Apr

Gold Coast

28 Apr

Townsville

29 Apr

Townsville

30 Apr

Townsville

4-5 May

Sunshine Coast

5 May

Brisbane

6 May

Brisbane

8 May

Brisbane

APRIL Private Sector Nurses – Knowing your entitlements Being a QNU Contact in the workplace QH 2015 – Operation Change! Private Sector Nurses: Did you know? – The law protects YOU! Private Sector Nurses - How to successfully bargain Professional Advocacy - We’re in charge Handling grievances in the workplace QH 2015 – Operation Change!

MAY Knowing your entitlements and understanding the Award! QH 2015 – Operation Change! Private Sector Nurses - Scope, practice and workloads Assertiveness Skills Professional Advocacy – We’re in charge QH 2015 – Operation Change! Being a QNU Contact in the workplace Someone should do something about that! Achieving success in high stakes communication QH 2015 – Operation Change! Someone should do something about that!

12 May

Mackay

14 May

Rockhampton

15 May

Rockhampton

18-19 May 20 May

Brisbane

26 May

Cairns

27-28 May

Cairns

2-3 Jun

Hervey Bay

2-3 Jun

Roma

11 Jun

Brisbane

12 Jun

Brisbane

15-19 Jun

Brisbane

JUNE Someone should do something about that! Knowing your entitlements and understanding the Award! QH-ENAP- How to achieve role recognition Achieving success in high stakes communication Health & Safety Representative training for nurses and midwives

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 ww

APRIL 2015 | TQN | 9

NEWS

QNU calls for health jobs creation to be targeted and methodical The Labor Party’s election victory comes with a range of policy commitments, many which relate directly to nurses and midwives. One of the most important is the creation of thousands of new jobs. The QNU is working very closely with the government on implementing nurse/midwife-to-patient ratios, including how and where these jobs are established. While the new jobs are an exciting development for nurses and midwives, QNU Secretary Beth Mohle is urging caution with the rollout. “There were more than 1800 nursing and midwifery jobs cut under the Newman government, so the new Labor government must be extremely methodical with how it distributes these new positions,” Beth said. “Understandably, the government is keen to announce where these jobs are going, but it is vital we use the Business and Planning Framework and a needs analysis to determine exactly where these new nurses and midwives are needed.” During the state election, Labor campaigned on various health announcements, including their Refresh Nursing, Nursing Guarantee and School Aged Health Services Program policies.

Refresh Nursing The Refresh Nursing policy outlines the government’s plan to guarantee 12 months’ employment for 1000 graduate nurses, or 4000 graduates over four years. As further incentive to hire qualified graduates over casuals or foreign workers on 457 visas, the government will also grant additional funding to Hospital and Health Services for every graduate they employ, as well as instructing HHSs to employ locally trained nurses.

Nursing Guarantee There will also be an additional 400 new nursing and midwifery jobs distributed across metropolitan and regional areas, implemented on a patient-needs basis and the severity of previous job cuts. 10 | TQN | APRIL 2015

The government has stated it will ensure the BPF is used to roster a set number of qualified nurses on each shift. One nurse per four patients in acute wards during the day (and one to eight during night shifts) is the likely starting point for negotiations. HHSs will be required to monitor and publicly report how they are complying with these new ratios to maintain transparency.

School Aged Health Services Program The new government has also promised to rebuild the School Aged Health Services Program, which was cut by the LNP government. Twenty nurses will be employed in schools to help prevent long-term health problems through early detection. The program will target areas where it is difficult for families to access health care, such as remote communities or where families struggle with financial or social disadvantage. The QNU will continue to hold regular meetings with the health minister to ensure Queensland’s nurses and midwives are well represented while all these policies are put in place. It is, of course, still early days and we’ll be monitoring closely what the government does to ensure it delivers its promises.

Queensland nurses and midwives honoured on Australia Day A number of nurses and midwives from across the country were honoured at this year’s Australia Day ceremony, including three from Queensland. QNU member Robyn Dealtry from Toowoomba was awarded an Order of Australia for her services to nursing and medical education. Throughout her 50 years working in the nursing profession, Robyn has specialised in pain management. She authored the first pain management distance education course, and has presented and lectured on the subject in New Zealand, India, Malaysia, Singapore and Israel. Robyn said she is greatly honoured to accept the OAM on behalf of all nurses and midwives. Other Queensland nurses and midwives honoured with an Order of Australia included Margaret O’Driscoll for her services to the community and to nursing, and Valerie Rose for her services to community health. While we know nurses and midwives don’t choose this career path to be rewarded with honours, it is always heartening when our colleagues and wider profession are recognised. So a big congratulations to all the nurses and midwives who received this high honour—a well-deserved achievement. www.qnu.org.au

2015

NEWS

SCHOLARSHIPS AND BOOK BURSARIES QNU members have an opportunity to win one of a great range of ﬁnancial support packages thanks to the QNU’s 2015 scholarships and book bursaries. There will be one round of scholarships in 2015.

SCHOLARSHIPS AVAILABLE QNU Matron Grace Wilson Scholarship (total value of $3000) QNU Enrolled Nurse Scholarship (total value of $3000) QNU Assistant in Nursing Scholarship (total value of $3000) Applicants must be ﬁnancial members of the QNU for the 12 months preceding the application, and currently registered or employed in Queensland. Aboriginal and/or Torres Strait Islander Nurse/Midwife Scholarship (total value of $3000) Applicants must be currently working in or studying nursing or midwifery and be a ﬁnancial member of the QNU.

Applications for all scholarships must be received by Wednesday 20 May 2015.

Pat Nicholls Scholarship (total value of $500) Applicants must be ﬁnancial QNU members for the 12 months preceding the application, and working to advance diabetes education and promotion.

Each scholarship may be awarded in full to one recipient, or in part to multiple recipients.

Bauer-Wiles Book Bursary (total value of $300) Available only to Registered Nurses/Midwives who have been ﬁnancial members of the QNU for the 12 months preceding the application.

All QNU members are welcome to apply— this includes international students and nurses and midwives on working visas.

University and TAFE Student Book Bursaries (Eight at $500 each) Applicants must be university or TAFE students who are QNU members and must provide proof of enrolment. QNU Annual Conference Observers Five scholarships are available to pre-enrolment/pre-registration students in nursing and midwifery to attend the QNU Annual Conference (15-17 July 2015) as observers. These scholarships cover travel and accommodation where necessary, conference registration and the conference dinner.

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

APPLICATIONS CLOSE WEDNESDAY 20 MAY 2015 www.qnu.org.au

APRIL 2015 | TQN | 11

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Nurses and midwives rise to occasion during Cyclone Marcia Nurses and midwives in northern Queensland worked above and beyond to help patients and residents throughout Tropical Cyclone Marcia and the aftermath. Hospital and aged care staff worked tirelessly to provide safety and ensure their patients and residents continued to receive high quality care, despite staff being concerned for their own loved ones and many receiving damage to their own properties. Many facilities were without power, and it was often difficult to get hold of generators. Fortunately, there was no lasting damage to health facilities, although the Rockhampton QNU office did suffer roof and water damage. There have been some concerns raised, however, regarding disaster planning and implementation during the cyclone, including reports of minimal discussion with staff as to who was available to stay on premises.

The QNU is currently investigating these claims. Nurses and midwives can be rightfully proud of their own efforts. Both the Queensland Premier and Health Minister expressed to QNU Secretary Beth Mohle how impressed they were with the work done by the nurses and midwives during the disaster. Beth has written to the Directors of Nursing from all facilities involved to congratulate all nurses and midwives for their hard work. “On behalf of the Council of the Queensland Nurses’ Union, I pass on our congratulations for a job very well done. We are all so proud of your efforts in such difficult circumstances,” said Beth. If you require any assistance following on from Cyclone Marcia, please do not hesitate to contact Rockhampton QNU Organiser Grant Burton on 4922 5390.

Photo: Jeff - from the sea (Flickr)

Vanuatu begins rebuilding after Cyclone Pam The massive clean-up effort continues in Vanuatu, following the devastation caused by Cyclone Pam—the largest cyclone to hit the South Pacific.

Children stand outside the remains of their homes. Up to 60,000 children have been affected by Cyclone Pam.

Australia has sent a team of 20 medical staff, including nurses and midwives, who will begin their work in Port Vila where the country’s main hospital was partly damaged by the cyclone. Their efforts will initially focus on treating wounds and monitoring infectious disease outbreaks. At least 11 people have been confirmed dead from the disaster. The union movement’s overseas humanitarian aid agency Union Aid Abroad – APHEDA is currently calling on people to donate money towards medium-term recovery efforts. Funds will be spent on rebuilding housing and water supplies, as well as re-establishing crops and small-scale food production. To donate, call 1800 888 674, or visit apheda.org.au and click ‘make a donation’. The QNU stands by our friends in Vanuatu during this difficult time. Photo: UNICEF Asia Pacific (Flickr)

12 | TQN | APRIL 2015

www.qnu.org.au

NEWS

New clinic offers suite of midwife-led maternity services Brisbane mothers now have another option for how they wish to carry out their pregnancy journey. Midwives and Mothers Australia (MAMA) Services has opened a new centre in East Brisbane, offering innovative services from fully qualified and experienced midwives and health professionals. After working in other private practices and running birthing classes from their own homes, MAMA directors Mae’t Pearson and Kelli Zakharoff decided to partner together and open their own service. “What makes us different from other midwifery services is our postnatal day stay,” said Mae’t. “A lot of mothers report that they feel isolated and left without support and help after their birth.” Mae’t said their additional post-birth services allowed them to pick up issues that weren’t being detected elsewhere. “We look purely at the mother and child, and provide not just physical support, but also emotional and psychological support, such as for women who suffer post-traumatic stress disorder after their birth,” Mae’t said. The centre offers a range of services, including postnatal care, pregnancy and ‘mum and bub’ yoga, massage courses, a pregnancy and infant chiropractor and hypnobirthing classes. The QNU has long supported the need for midwifery models of care outside the traditional hospital setting, particularly midwifery-led models. Over many years state and federal reviews of maternity services have recommended reform to enable midwives to provide woman-centred care in a range of practice settings.

Despite successive health ministers demonstrating some commitment to reform, there remain many barriers that prevent these models rolling out—from cultural and structural resistance at the organisational level to a medical model of obstetric service delivery. There have also been difficulties with insurance and Medicare arrangements for privately practising midwives. Services like MAMA—which give women maternity options under the expert hand of registered and experienced midwives, while also making Medicare and private health insurance rebates available—help bridge the gap between demand for midwiferyled models of care and supply.

Mother’s Day Classic .... Sunday, 10 May Lace up those sneakers and get those legs pumping ladies and gentlemen, because the Mother’s Day Classic is just around the corner. Thousands of people around the state will be walking or running on Sunday 10 May to raise money for research into breast cancer programs and the National Breast Cancer Foundation— and you can join them! With events in Brisbane at Southbank and the Gold Coast at Broadbeach, there will also be a number of regional events held around the state in Bundaberg, Cairns City, Chinchilla, Dalby, Emerald, Hamilton Island, Innisfail, Joyner (North Brisbane), Kingaroy, Mackay, Mitchell, Monto, Palm Cove, Sunshine Coast, Tannum Sands, Texas, Tieri, Tin Can Bay, Toowoomba and Townsville. www.mothersdayclassic.com.au www.qnu.org.au

MAJOR SPONSOR mebank.com.au APRIL 2015 | TQN | 13

NEWS

GALLIPOLI NURSES SHOULD BE EQUALLY RECOGNISED BY PHILIP CASTLE

The slogan “you can’t live without nurses” has been an absolute truism and certainly applied to the diggers cared for by nurses through the disastrous Gallipoli campaign from April to December 1915. Until recently there has been little recognition of their magnificent role—but they were there, in the thick of it, at three Australian General Field Hospitals in Cairo, Alexandria and perhaps the most heroic of all, at Lemnos, from August to January 1916. Many diggers may well have died without their care and many who did die have had the comfort of an Aussie nurse in their last moments. Of course, a number of nurses also paid the ultimate price for their service. The Australian War Memorial records 21 deaths of nurses on its Honour Roll but many historians consider it was well over 35. The most significant aspect of the more than 3500 Australian nurses who volunteered to serve during WWI was their motives for going. They went not to kill Huns or Turks. They went because they were concerned about who would care for their brothers, uncles, neighbours, friends and loved ones. They were motivated by care

and compassion and overcame huge hurdles to get on with the task under terrible circumstances. They were wonderful Australians and showed remarkable courage, innovation, and resilience whenever they served, but particularly in that first year. These nurses should be as iconic as Simpson and his donkey or the ANZAC heroes at the Nek, Lone Pine and Hill 60, whose stories are now being repeatedly told during these months of recognition 100 years later. The nurses’ role is exemplified by Brisbane woman Matron Grace Wilson who was in charge at Lemnos. She was a teacher at Summerville before training as a nurse at Royal Brisbane Hospital and like all Gallipoli nurses, had a minimum of five years’ experience in general hospital nursing before heading abroad. But nothing could have prepared them for the carnage they witnessed in 1915. They mostly cared for very young men, some in their teens, who suffered horrendous injuries because of the lethal development of weaponry such as machine guns, artillery and gas. Often the wounded and dying had lain untreated for days in dirty conditions, hastily treated in

crowded casualty clearing stations. They were then transported by mostly filthy transport vessels, some still manure-strewn from transporting horses and donkeys, returning from the peninsula. The nurses attended on these vessels and came close to shore. Many reported shrapnel hitting the transports and one nurse reported cradling a soldier whose jaw was shot off by a sniper. Many fallen men were buried at sea. For those who survived the passage to the field hospitals, conditions were appalling. At Lemnos there was insufficient water and the nurses’ and doctors’ medical supplies had become lost in transit. When Matron Wilson arrived in August there were no tents and the wounded and dying were lying in the open. Gangrene, typhoid and dysentery were rampant. The nurses ripped their petticoats for bandages, and stopped washing themselves fully and cut their hair to save water. Their food was poor, they were paid a corporal’s wage— which was less than the British and Canadian nurses—often performed medical procedures normally done by doctors, and they administered anaesthetics. And they were innovative, one Aussie nurse even developed the era’s best treatment for typhoid there. Arrival of Australian nurses at Lemnos August 1915.

Photo: Australian War Memorial

14 | TQN | APRIL 2015

www.qnu.org.au

NEWS

The nurses’ care of the dying was beyond the comprehension of the paternalistic military regime, which preferred them to treat the least wounded first so these soldiers could quickly return to the front. Contrary to all their triage training, nurses were told to give lowest priority to those with limb, head, and chest wounds. As we commemorate the 100th anniversary of the landing at Gallipoli this April, we should ensure nurses are remembered for their important contribution. These wonderful angels should absolutely be among Australia’s iconic legends. Philip Castle is a retired journalist and academic with a degree in history and a particular passion for shedding light on the largely unrecognised role of WW1 Anzac nurses. His grandfather was at Gallipoli, his father was a bomber pilot with the RAAF in the UK and Philip himself served at the Australian Embassy in Saigon during the Vietnam War. His eldest daughter is a nurse.

You can’t lives without nurse

NURSES AND MIDWIVES CELEBRATE PROUD PROFESSIONS This year nurses and midwives right across the world will proudly celebrate International Day of the Midwife on 5 May and International Nurses’ Day on 12 May. The QNU will mark both days by hosting a breakfast on Wednesday 6 May for key dignitaries and any Queensland nurses and midwives who would like to attend. ‘The First Anzac Nurses’ will be the theme of the breakfast, and author and historian Susanna de Vries—who received an Order of Australia for her services to Australian art and literature in 1996—will feature as the guest speaker. Ms de Vries OAM has written 15 books, some about Australian heroines of World War 1, including the personal stories of nurses and midwives during Gallipoli. The breakfast will also include a focus around South Brisbane nurse Grace Wilson, who served as a nurse in the Australian Army during both World Wars.

She was also a matron at the military hospital at Lemnos Island near Gallipoli and, prior to being deployed overseas, at the Royal Brisbane Hospital. The QNU has renamed the Registered Nurses/Registered Midwives scholarship in honour of Matron Grace Wilson, and will include a presentation to the winner of the scholarship. We would love to see as many people as possible attend this breakfast to mark the great achievements of those who have served and continue to serve in our professions. If you would like to attend, please RSVP to the QNU’s Brisbane office by 27 April 2015 (see below).

YOUR SPECIAL INVITATION TO CELEBRATE

THE FIRST ANZAC NURSES

Matron Matr on Grac race e Wi Wilson lso lson o

WITH A BARBEQUE BREAKFAST

7.30-9.00am Wednesday 6 May 2015 Queenssla and Nur u se s s’ Uni n on, 106 Victo or a Street, West En oria End End

Raffl R Ra affl fle pr proc o ee e ds wil ill su ill supp p or pp ort the 1339 Cl th Club b.

Costt $30 (Book k tab able le of 8 fo for or $2220 20) 0)

NU UMB MBER E S ARE LIM MIT ITED ITED D – BOO OOK NO OW W!!

RSV S P 27 Apri ril il 20 2015 15 Special gu guesst Su ussa an nna de Vr Vrie iess OA O M (hi h sttor oric i all aut utho h r an ho nd ar a tist st)) To bookk please visit www www.qn .qn q u.org. qn u.o u.o org. g au/ g. au 20115_i 5 nd nd Fo For o mo more re iinf nfform orma ation on ple please ase ph p one 077 384 3840 0 1444 or email eve vents nts@qn @qn nu.org. u..org.au u.o

5 M AY I N T E R N AT I O N A L DAY O F T H E M I D W I F E 1 2 M AY I N T E R N AT I O N A L N U R S E S ’ DAY www.qnu.org.au

ROVFWFOUT

APRIL 2015 | TQN | 15

NEWS

AGED CARE Awaiting decision on Blue Care ‘Personal Carer’ matter

After almost two years of submissions, the Blue Care matter ended in December last year. In February 2013, Blue Care announced it would not employ any more AINs. In March, the QNU took Blue Care to the Fair Work Commission over the following matters: 1. re-badging AINs as Personal Carers (and paying them about $1.50 per hour less) 2. the attempt to have an enterprise agreement approved which would remove AINs from the nursing agreement and put them under the care and support agreement with lower pay. The QNU, which has pursued these matters relentlessly, hopes the commission will release its decisions within the next couple of months.

Now it’s Carinity’s turn Carinity Aged Care—formerly Baptist Care—is now attempting to do the same thing with their AINs. During negotiations, the QNU sought a commitment from Carinity that AINs will be retained in the third-level nursing carer role. Carinity refused, saying they can’t make any commitments until the Blue Care decisions are released. Clearly, if Blue Care is successful, Carinity will follow suit. 16 | TQN | APRIL 2015

Carinity are also following a similar strategy to Blue Care in trying to downgrade AINs. PCs with a certificate III currently get paid $1.10 less than AINs with a certificate III. The QNU has many members at Carinity who are classified as either 1. AINs, or 2. PCs who are doing AIN work. The QNU has asked to be included in negotiations for the Carinity care and service enterprise agreement, but we have been refused a seat at the bargaining table. We have filed an application in the commission for Good Faith Bargaining Orders to allow us to negotiate for our members.

Carinity insults nurses with new offer Carinity also continues to insult its nurses with a substandard new offer. The QNU forced Carinity to attend the commission to obtain the minutes of bargaining meetings and updated employer draft agreements. Carinity tried to cancel the conference, and when that failed sent an ‘Employee Relations Manager’ who had no authority to negotiate. Carinity finally agreed to provide the QNU with the materials we requested, but we are monitoring closely as Carinity has broken this promise before.

In February, Carinity made yet another insulting wage offer, with increases of just 1% from July 2014, 1% from January 2015, 1.75% in 2016, and 2% in 2017. The QNU’s relentless pursuit has forced Carinity to make some changes to their proposed agreement—again, we are monitoring closely to ensure Carinity follows through with its promise. Carinity is still trying to reduce conditions, including:  Overtime after 10 hours, not eight.  Minimum shift length of two hours.  Reducing paid parental leave to six weeks full pay.  Removal of the right to take workplace disputes to the commission.  Reducing workplace relations training leave to two days.  An annual leave clause inferior to the clause in the Nurses’ Award 2010.  Refusal to guarantee that AINs won’t be reclassified as PCs. The QNU is seeking minimum nursing ratios as outlined in our Ratios Save Lives claim. Recent media reports concerning events at Carinity’s Kepnock Grove only highlight the need for our ratios to be implemented. www.qnu.org.au

NEWS

PRIVATE HOSPITALS QNU launches action against Red Cross over treatment of nurses The QNU is conducting three cases in the Federal Circuit Court against the Red Cross alleging unlawful adverse action against three nurses who are QNU members. The QNU alleges one of the reasons for adverse action was their participation in protected industrial action. All members are protected from repercussions—called “adverse action”— for speaking up about workplace issues and other union activity. The QNU alleges the Red Cross dismissed one nurse who was replaced by a cheaper Donor Services Nursing Assistant. The QNU also alleges two other nurses were forced to resign with fabricated warnings and degrading use of

‘performance improvement processes’ (PIPs) because they stood up for the interests of fellow nurses, and due to their activity as workplace representatives, particularly in enterprise bargaining in 2013/2014. The maximum penalty that the Court can impose on the Red Cross is $51,000 per contravention, and $10,200 for each contravention by its managers, Rhiannon Fealy and Lisa McIllroy.

Nurses being pressured not to claim travel time Covert pressure is being applied to Red Cross nurses to travel directly between their homes and Donor Mobile Units up to three hours a day without going via their base donor centre. Nurses who succumb to that pressure are then not being paid for their travel time—as they should be. The QNU encourages Red Cross members to attend at their base donor centre, not a DMU, at their rostered start and finish times, and travel in paid time between their base donor centre and the DMU.

Private Hospital enterprise negotiations 2015 There are 16 private hospital agreements due to expire this year. To ensure members secure the best replacement agreement, all nurses and midwives need to be involved with and informed about negotiations in their workplace. The best way to get all the latest information is to be a QNU member. To ensure we can get information to you, make sure your contact details are up to date, especially where you are currently working and your email address. You can update your details by visiting https://member.qnu.org.au/ The QNU provides members with wage comparisons, condition comparisons and information about where your employer sits in relation to the rest of the health sectors.

With your local workplace representatives and based on your feedback we prepare logs of claim and negotiate with your employer for a new agreement. It is extremely important that you give the QNU feedback. Whether it is filling in a survey or coming to a report back session on the latest offer, we can only make your views heard by your employer if you tell us. The best outcomes are achieved when members work together and support each other. If you want to know if your agreement is being negotiated this year, contact QNU Connect and look out for information from the QNU.

Most importantly, get involved!

Remember—it’s your enterprise agreement. Make it a good one. www.qnu.org.au

New website brings you even closer to the QNU The QNU is excited to announce the launch of our new website, which will go live in the coming weeks. The new website will mark a complete overhaul of the QNU’s communications system, which, through the use of new technology, will be far more efficient and userfriendly. The website will incorporate many new features, all designed to encourage more user engagement so the QNU can better communicate with nurses and midwives. We’re also planning a series of stand-alone pages for our current campaigns, which will mean easy access to information for the public and supporters. These will be promoted through future journals, qnews and the website. And in a bid to be more environmentally friendly and cut costs, future editions of our tqn journal will also be available to view online. If you would like to view future editions of tqn exclusively online, please contact QNU Connect to cancel the postage of your printed copy. APRIL 2015 | TQN | 17

NEWS

LOADS WORKLOADS WORKLOADS Fixing our workloads with ratios— the first step is with YOU The new government has publicly committed to implementing nurse-topatient ratios in the public sector. But it’s not a case of ‘job well done’. Every public sector nurse and midwife has a responsibility to help ratios become reality. The first step is to know what the notional patient ratios for safe practice are for your unit. Every public sector nurse and midwife can and should be using the BPF now to ensure safe workloads. It is not enough to wait on new legislation and regulations—we have to show we understand what safety looks like, and how to make it happen. Have you ever read your service profile? Does the service profile align with your day-to-day working experience? Your service profile should contain the notional nurse/midwife-to-patient ratios. These ratios must be displayed in your unit. If you don’t know your ratios or if they are not displayed, you should ask for them. If the notional ratios do not seem right, it is up to you to ask questions about who was consulted and how it was calculated. Feed your concerns back to your professional line manager, as well as your QNU Organiser. This is vital—whether it is calculated ratios, skill-mix, or non-compliance with the BPF. If your professional judgment says staffing is inadequate, do not just accept it. If the nurse-to-patient ratio you have is inadequate, report it. If it is not immediately rectified, escalate with a workloads grievance. Whether the problem is a one-off occurrence of increased acuity or due to 18 | TQN | APRIL 2015

chronic understaffing, do not just accept conditions that put you or your patients in harm’s way. Every nurse and midwife has a role to play in supporting the progress and implementation of safe patient ratios. Take a stand, and demand that the BPF be used as it should be.

RATIOS

SAVE LIVES Time for the ombudsman to step up on workloads? There is a great deal of genuine excitement about the prospect of safe nurse/midwife-to-patient ratios in Queensland. For too long, heavy workloads have been an obstacle to safe, quality health care. But the power to tackle heavy workloads does not only lie with nurses and midwives. Many nurses and midwives may not know the regulator also has power to take action on unsafe workloads.

Nurses, midwives, and regulators Currently, many nurses are being put in the difficult position of being the sole RN on a shift in an aged care facility, responsible for the wellbeing of hundreds of residents. When that risk to patients materialises and incidents occur, those nurses find themselves answering complaints made to the regulator. The Nursing and Midwifery Board of Australia exercises its regulatory

power with respect to individual practitioners. However, the new Office of the Health Ombudsman has regulatory power in relation not only to individual practitioners but also to facilities. That means the Office of the Health Ombudsman can take a holistic view of incidents which occur as a result of inadequate staffing levels or dangerously high workloads. Unfortunately, the Office of the Health Ombudsman has so far failed to investigate systemic issues—such as inadequate staffing levels. This is despite nurses and midwives having recently identified such problems and attempting to approach the ombudsman. The QNU hopes the renewed focus on safe workloads in health care will encourage the ombudsman to use the powers given to it, and investigate facilities where nurses and midwives report systemic issues with workloads. www.qnu.org.au

NEWS

WORKLOADS WORKLOADS WORK Gympie Hospital nurses relieve workload pressure with more staffing It was good news for workers at Gympie Hospital emergency department, who, together with the QNU, liaised with hospital management to resolve a workload issue. Nurses at the Gympie ED were shortstaffed for most of 2014, all too frequently creating unsafe conditions for both staff and patients. Workplace morale was low, with members expressing that they were frequently unable to complete patient documentation, undertake patient observations, or provide analgesia in a timely manner. Stress and fatigue became the norm. As is so often the case, the high level of nursing skill and experience meant the shifts were completed despite inadequate nursing hours. It became normal for nurses to start their rostered shift early, work on their day off, or work overtime at the end of an eighthour shift. At first, a handful of members contacted the QNU through emails and phone calls.

www.qnu.org.au

But as more nurses began to realise they could no longer keep working under such stressful conditions, members began escalating their concerns by submitting more workload reporting forms. Over time, the majority worked collectively to share information, attend meetings, and encourage each other through the process. The QNU brought up these issues on behalf of members in a number of forums, including monthly meetings with the Director of Gympie Health Services and the Local Nursing Consultative Forum. The QNU also submitted a referral to a Specialist Panel, and a meeting between QNU officials and members and Sunshine Coast Hospital and Health Service management saw all parties

NURSES AT THE GYMPIE ED WERE SHORT-STAFFED FOR MOST OF 2014...

work together to strategise solutions and discuss BPF calculations. A resolution has been reached, which includes the temporary recruitment of 1.4 FTE RN hours onto the ED roster from early January 2015.

Workload issues contribute to patient tragedies in Mossman and Atherton The need for safe workloads has been raised in the most tragic circumstances, following the deaths of three hospital patients in Mossman and Atherton after they failed to receive timely treatment. All three patients died as a result of infections, with each case calling into question the level of care they received in regards to treatment. The Coroner identified a number of issues that influenced the circumstances leading to the patients’ deaths, including understaffing—particularly of medical staff—and overwork and fatigue. Other issues identified included a breakdown in communications and an inappropriate discharge without appropriate consideration of all relevant factors. Disturbingly, the investigation also uncovered a culture in the hospital whereby nurses on night shift were discouraged from asserting their concerns about a patient’s wellbeing when communicating with on-call doctors. The QNU urges all nurses and midwives to overcome these reservations about calling on-call medical staff—it’s about ensuring the safety of your patients as well as protecting yourself. Although there is no substitute for adequate staffing, we also encourage staff to use all available tools to help manage patient deterioration, including the Adult Deterioration Detection Tool. For full details on these cases, read the CPD article on page 34. APRIL 2015 | TQN | 19

NEWS

Unpaid wage win for mental health nurses In July last year, QNU nurses working in the Prison Mental Health Service notified the QNU of an anomaly in their working hours. As they are situated at The Park and come under Section C of the Queensland Health Nurses and Midwives Award – State 2012, they should have been working an 8 hour day with a paid meal break. However, due to an administrative decision nurses had actually been working 8.5 hours with an unpaid meal break. After their attempts to be compensated for this anomaly were unsuccessful, the nurses requested assistance from the QNU. After meeting with the nurses, the QNU lodged a backpay claim extending back to 2010 for the half hour meal break. This claim was recognised by the employer, West Moreton Hospital and Health Service, but it took a considerable time to establish the detail for each member. The claim was complicated by the fact some nurses were no longer working in that area. Others had left Queensland Health altogether. As of February 2015, the QNU’s efforts have recovered more than $100,000 for the nurses. It took a while, but it is worth the effort to ensure nurses and midwives get their correct entitlements.

So remember—it is in your interests to check your payslips! 20 | TQN | APRIL 2015

QNU reclaims nearly $4 million for members In the first six months of this financial year, the QNU recovered nearly $4 million for Queensland nurses and midwives. This extraordinary amount includes claims for back pay, compensation for injury, and super income protection. The QNU regularly assists members who have had their claim for compensation for work-related injuries rejected. This assistance has resulted in a significant number of claims being successful after QNU representation and submissions. The claims involve both physical and psychological injuries. Common law claims are referred to the QNU panel lawyers and negotiated through QNU Legal Plus. This assistance has resulted in many members successfully receiving damages for injuries caused by their employer. From July to December 2014 just over $1.85 million in compensation was received by QNU members—including one payout of $700,000. The QNU has also recovered significant money for unpaid entitlements. The article on the left details just one case, where more than $100,000 was recovered for members who were not paid their meal break entitlement. More money was recovered by the QNU for members whose QSuper income protection claim was stopped or rejected. The QNU remains committed to pursuing proper payment of entitlements and assisting members in having compensation claims reviewed.

It pays to know your entitlements! www.qnu.org.au

NEWS

Scrapped GP co-payment gets rebirth Almost one year on from the federal government’s first budget, Tony Abbott has vowed to scrap the unfair GP co-payment. But already there are signs it could be brought back from the dead by allowing GPs the option of charging gap fees to bulk-bill their patients. Mr Abbott has already proposed the GP co-payment three times (reviving it twice after scrapping it before the Victorian and Queensland state elections). Then, on the eve of the NSW state election, it was scrapped again. We all know the fight to protect Medicare is far from over. In announcing the tax was no longer government policy, new Federal Health Minister Sussan Ley stated she would ensure “bulk billing remains for concessional patients and the vulnerable”.

Even if that is true, it leaves the obvious question about what will happen to the rest of us. It’s not looking good. Concern was sparked in February, when Ms Ley told parliament “if you can pay a little bit more, then we will ask you to do that, and if you are in a higher income bracket, again, you might have to pay something extra again.” And while the government says it has dropped the GP co-payment, it continues with the fundamental lie which motivated the co-payment in the first place: that our world-class Medicare system is “unsustainable”. The Prime Minister’s insistence that the GP co-payment is “dead, buried and cremated” should be taken very lightly indeed. Mr Abbott said the same thing about WorkChoices, but now his government has ordered a complete overhaul of

Education deregulation still the heart of government’s agenda The federal government has again failed to push through its controversial tertiary education reforms, with the Senate rejecting its second attempt to deregulate universities. Under the deregulation policy, a nursing degree currently costing $18,000 and taking 12 years to pay off would cost $60,000 and take 23 years to pay off. Prior to the vote, Education Minister Christopher Pyne gave parliament an ultimatum: either pass the reform by March, or the government would scrap funding for certain research and support programs, jeopardising the jobs of 1700 researchers. Unsurprisingly, this announcement sparked public outrage, and Mr Pyne soon backed down from his threat. In a further attempt to woo crossbench senators, Mr Pyne also announced the government would www.qnu.org.au

penalty rates, working conditions and the minimum wage. QNU Secretary Beth Mohle said it was time the government put forward some productive legislative proposals that would support those who worked in the health sector, including nurses and midwives. “While we welcome the government’s announcement to scrap this co-payment proposal, we’re certainly not kidding ourselves that the chaos and lack of consultation we saw throughout the past year is over,” she said.

split the reform into two separate pieces of legislation, with parliament voting on deregulation and the $1.9 billion cut to university courses as separate issues. Appearing on Sky News, Mr Pyne declared, “I’ve fixed it. I’m a fixer.” But Mr Pyne hasn’t “fixed” anything—by his own admission, everything is up for negotiation but the core of the reform itself: deregulation. Mr Pyne said he plans to propose university deregulation legislation to parliament for a third time, despite universities calling for a fresh debate—one that doesn’t use research programs as a bargaining chip. Every Australian deserves the right to access a university education if they want, without the prospect of a lifetime of debt hanging over their head. Queensland nurses and midwives will continue to stand up for a tertiary education system that is accessible to everyone—no matter how much money you have. APRIL 2015 | TQN | 21

NEWS

Overhaul to international criminal history checks may affect you The Nursing and Midwifery Board of Australia has released a new procedure for checking international criminal history. The procedure only affects new applicants or current practitioners who have a criminal history outside Australia. It does not apply to the domestic criminal history check procedure. Under the new procedure, those with an international criminal history must apply for a history check from an approved supplier from the Australian Health Practitioner Regulation Agency.

Who is affected? If you’re applying for registration, you will have to provide the check if:  you declare a criminal history from overseas, or  you have been primarily based in a country other than Australia for six months or more since turning 18.

If you’re renewing your registration and there has been a change to your criminal history outside Australia since your last declaration, you must provide an international criminal history check. You will also have to provide a check if you’re renewing and you’ve previously told the NMBA you’ve been charged with an offence outside Australia. This offence must be punishable by a prison sentence of 12 months or more. You must also provide the check if you have been convicted of, have pleaded guilty to, or are the subject of a finding of guilt by a court for an offence outside Australia that is punishable by imprisonment.

Some New Zealand nurses and midwives also affected The new procedure will also affect some nurses and midwives from New Zealand who obtained registration under the Trans-Tasman Mutual Recognition process.

Changing the conversation from ‘budget cuts’ to ‘revenue raising’ Many governments today are opting for short-term fixes to budgets by cutting spending and investment— but what we really need are longterm plans to raise revenue. The Robin Hood Tax is one such plan. It’s an idea that is fast gaining traction in the United States and the European Union. The Robin Hood Tax would impose a modest levy (as little as 0.05%) on financial institutions when they make transactions while trading stocks, bonds and other trades. It could reap billions of dollars every year, which could be spent on foreign aid, public health and education. But ensuring this tax becomes a reality will be hard with governments that are too scared to force big corporations to pay their fair share. Just look at Federal Treasurer Joe Hockey, who recently broke his promise to prevent multinational companies from avoiding paying 22 | TQN | APRIL 2015

their fair share by accessing offshore tax havens. Originally announced in 2013, thee own government said it would crack down on international companies that were stem. exploiting loopholes in the tax system. But a single line hidden in last year’s Mid-Year Economic and Fiscal Outlook showed Mr Hockey has completely tely walked away from this promise.. “The government will not proceed with a targeted antiavoidance provision to address certain conduit arrangements involving foreign multinational enterprises.” In its December 2014 meeting, QNU Council passed a resolution endorsing a Robin Hood Tax in Australia. With a review of our tax systems recently commencing you can bet you’ll be hearing more about the Robin Hood Tax in 2015.

It will affect those who:  have declared since 4 February 2015 a criminal history outside of Australia, or  have lived or been primarily based outside Australia for six or more consecutive months when aged 18 or more. The person applying for the check is required to pay the cost. On average, this is around $163.90 per country.

Be sure to have your check completed early Due to the time it takes to obtain the check, those affected will need to submit their application well before they begin practising as a nurse or midwife. During the consultation phase on this issue, the QNU provided extensive feedback via the ANMF on the various options proposed by the NMBA. In particular, the QNU lodged concerns regarding the substantial cost to applicants, as well as the length of potential delays caused by this process. Unfortunately, the NMBA did not accommodate our concerns in this instance.

QNU Council resolution on Robin Hood Tax: “Prominent Australian economists have recently identified a revenue problem in our economy rather than a so-called budget emergency. “Instead of shifting our public health services further down the track of an Americanised, two-tier system, the implementation of a global Financial Transaction Tax, or Robin Hood tax, would help fund the continued delivery of equitable government services, including universal public healthcare for people around the world. “We endorse the Robin Hood tax campaign as it will provide the funds needed now and into the future to help ensure equitable access to quality public healthcare for all.”

www.qnu.org.au

NEWS

Ebola still alive despite losing headlines The Ebola crisis may no longer be making headlines in Australia, but it is still a critical issue. Despite showing signs of slowing down in the last few months, there are still cases of people being diagnosed with infection, including one British health care worker who recently tested positive while working in Sierra Leone, and one American whose condition has deteriorated to critical. According to reports, up to 10 people are diagnosed with Ebola every day. The latest figures show that there have been at least 10,000 deaths caused by Ebola, and more than 23,000 cases of infection. Currently, there are 27 Australian Red Cross aid workers in Africa operating on the frontline to tackle the disease. Last year, QNU Council donated $500 to the Global Nurses United, which was pased on to the Liberian National Private Sector Health Workers Union. The money helped pay for a generator and laptop.

Council also donated $10,000 to the Australian Red Cross Ebola Appeal, which will go towards providing access to medical treatment and care for those affected by Ebola, as well as raising awareness in communities on the prevention and transmission of the disease. The money will also provide counselling to affected families and communities. Although there are currently no drugs that have proven to be effective against Ebola, there have been recent promising medical developments to tackle the virus. Researchers in Sierra Leone have started a new phase-two trial of an experimental drug, which was developed in Canada. Scientists are hoping to have a clear outcome soon, and will determine its impact by comparing patients with others being treated elsewhere. If the trials show positive outcomes, scientists will move straight into a third phase of clinical trials. Read the full article at http://news. sciencemag.org/africa/2015/03/newebola-drug-trial-starts-sierra-leone NHS doctors and nursess prepare to join the fight against Ebola in Sierra Leone.

Greece sees explosion in number of illegal nurses The financial crisis in Greece is taking a heavy toll on the country’s health care system, with patients now paying illegal nurses to perform medical procedures. The New York Times reports budget cuts and austerity measures imposed on Greece effectively ended their universal health coverage and stripped hospitals of nurses. One top hospital official said he believed half of the nursing care in Greece’s hospitals now comes from 18,000 illegal providers. With many Greeks now lacking the money or insurance to hire licensed caregivers, people are turning to unskilled workers from temporary nursing agencies. University of Bath professor Thanos Maroukis said these agencies are taking “over control of the hospitals’ workplace”. According to The New York Times, illegal nurses often pose as family members and distribute business cards advertising 12 hours of nursing for less than $60. In normal circumstances, hospital security would expel these unauthorised visitors, but due to staff shortages, nurses have little power to do anything about it. Police cutbacks have also made it difficult for police to control the problem, with hospital raids being a rare event. To read the full article, visit www.nytimes.com/2015/02/08/ business/greek-austerity-spawnsfakery-playing-nurse.html 

Photo: DFID - UK Department for International Development (Flickr)

www.qnu.org.au

APRIL 2015 | TQN | 23

NEWS

Daniel Slavin

We will defend our penalty rates Thousands of people rallied outside Queensland’s Parliament House on March 4 to protest the federal government’s plans to wind back penalty rates. The Brisbane protest was part of a nation-wide day of action, with large crowds gathering right across Queensland, including at the Gold Coast, Townsville and Mackay, as well as in Sydney, Melbourne and Canberra. Penalty rates, the minimum wage and working conditions are all under the microscope thanks to a Productivity Commission review announced by the Abbott government. Around the country 50,000 people—including a 2000-strong Brisbane crowd—sent a message loud and clear: we will fight to keep our working conditions. QNU member and EN Daniel Slavin was a guest speaker at the Brisbane rally, and spoke on behalf of all Queensland nurses and midwives. “I know many nurses rely on penalty rates to compensate for lost weekends with their kids or for working Christmas away from loved ones, just to make ends meet,” said Daniel. “Faced with such a massive reduction in the incentive to work such unsociable hours, I— like many nurses and midwives—will just leave the profession altogether. “We took a stand when the LNP Newman government cut 1800 nurses and midwives, in addition to a range of essential public health services. “We will continue to make a stand to ensure every Queenslander receives high quality public health care where and when they need it. “We will continue to defend our penalty rates.” Other guest speakers included QNU Secretary Beth Mohle and Queensland Premier Annastacia Palaszczuk, who both pledged their support for fighting any attacks on the working conditions we’ve fought so hard to secure. The QNU also participated in the Canberra rally, where Jenny Miragaya from the ANMF ACT branch addressed a 1000-strong crowd on the importance of defending our world-class Medicare system. 24 | TQN | APRIL 2015

Burton with QNU QNU Organiser Grant ss and Karen Cooke. rge Bu ie Jul rs Councillo

QNU working with government on EB9 and award modernisation In addition to working with the government on a plan to deliver ratios, the QNU is also in negotiations regarding EB9 and award modernisation. Wage increase All public sector nurses and midwives received a $500 increase to their base annual rate at the end of March. As a result of the regulation made by the former LNP government in September last year, public sector nurses and midwives have also received a 2.2% wage increase from 1 April. Both these changes will be paid on the payday commencing 22 April. To check your new wages visit www.qnu.org.au/eb8-wages

EB9 The QNU has written to Health Minister Cameron Dick seeking urgent clarification on the government’s position regarding the former LNP government’s decision to extend EB8 by 12 months.

It’s vital nurses and midwives have clarity around the government’s wages policy and whether the government is considering pay increases above 2.2%. We’re continuing to have discussions with the government on the commencement of EB9 negotiations.

Award modernisation suspended Treasurer and Industrial Relations Minister Curtis Pitt has asked the Queensland Industrial Relations Commission to suspend the award modernisation process while the government consults with key stakeholders. This is a promising sign. The modernisation process was only ever commenced by the previous LNP government to dilute or remove your most basic working entitlements. Thanks to the QNU insisting the process not be rushed, discussions about ‘modernising’ your award never advanced beyond preliminary stages. It is now time to abandon this unfortunate episode altogether. www.qnu.org.au

NEWS

PUBLIC HOLIDAYS NOT WORKED Nurses and midwives to be paid after QNU takes Ramsay to court

Last year some 600 QNU private hospital members responded to our survey concerning payment for public holidays not worked. These survey findings led the QNU to suspect a number of employers were breaching the National Employment Standards (NES) and the Fair Work Act with respect to members’ public holidays entitlements.

The NES and the Fair Work Act Under the National Employment Standards, all employees except those employed by the Queensland government are entitled to be absent from work on a day or part-day that is a public holiday. Employees who are asked to work on a public holiday are entitled to reasonably refuse. Under Section 116 of the Fair Work Act, an employee who is absent from work on a day or part-day that is a public holiday must be paid at the base rate of pay for their ordinary hours of work.

The QNU investigates John Flynn Hospital The QNU decided to further investigate these suspected breaches. Nurses and midwives at Ramsay’s John Flynn Hospital on the Gold Coast were very active around this issue, so John Flynn was the first subject of QNU investigation. The QNU obtained timesheets from 1 January 2010 of more than sixty nurses and midwives at John Flynn. www.qnu.org.au

After examining the timesheets, the QNU commenced proceedings in the Federal Circuit Court of Australia. Conducting proceedings for all of our John Flynn members would have unduly delayed the claim, so we selected 22 members as claimants to conduct a test case. The test case is intended to benefit the claimants, and all QNU members to whom the Fair Work Act applies. We filed our claim in the court in early January 2015. The claim is for the court to order Ramsay to:  pay 22 members who worked at John Flynn for unpaid public holidays, and  pay them interest on those amounts, and  re-credit to them all paid leave debited on a public holiday (including annual leave, personal leave, long service leave and ‘purchased’ flexi leave), and  pay a fine of up to $51,000 per breach, and more. QNU workplace representatives from John Flynn attended court in Brisbane on 2 March 2015 with QNU officials in support. Ramsay had a Queen’s Counsel, another barrister, and the partner of one of the biggest employer-side law firms around.

The court made various directions including for mediation to occur before a trial. Afterwards, Ramsay wrote to the claimants individually, effectively admitting they had done wrong, and saying the relevant paid leave and ADOs would be re-credited and payment would be made to the claimant for a public holiday not worked and not yet paid for. The QNU will support an appropriate penalty discount for Ramsay if, as promised, they re-credit leave and pay claimants before being ordered to do so by the Court. However, Ramsay should also pay an appropriate penalty as a deterrent against other failures to pay nurses and midwives correctly. The QNU expects Ramsay and all other private hospital employers of QNU members to pay members for unpaid public holidays they have not worked. The QNU also expects backpay to 2010, re-crediting relevant leave and ADOs, and payment of the equivalent of penalties. We cannot, however, pursue justice for nurses and midwives who are not QNU members. APRIL 2015 | TQN | 25

FEATURE

Restoring respect and stability to nursing and midwifery

When Campbell Newman conceded defeat just after 11pm on election day, Queenslanders felt some hope the long and difficult days were over.

Almost 5000 positions were abolished in Queensland Health during the LNPs time in office, including more than 1800 nursing and midwifery jobs. The Newman government also radically changed the relationship between the QNU and Queensland Health. Between the loss of jobs, changes to law and an end to genuine consultation, the relationship, trust and momentum we had developed with Queensland Health

26 | TQN | APRIL 2015

on critical nursing and midwifery issues, such as models of care and criteria led discharge, was compromised. Decision making on health policy and direction occurred only at the political level as stakeholders were sidelined, and a dollar driven agenda saw budgets come before patients. None of this served our community well and the community, it seems, responded.

The QNU certainly could not have predicted the LNPâ&#x20AC;&#x2122;s shock defeat, but we absolutely welcome the change and the opportunity to get back on track. Nurses and midwives have quite a list of issues they want addressed, and are determined to ensure this government makes Queenslandâ&#x20AC;&#x2122;s health system and the welfare of patients and health workers a priority.

www.qnu.org.au

FEATURE

Some of our key issues are: Return to interest-based negotiations and collaboration We are very keen to return to a more mature and collaborative relationship. This means taking an interest-based problem solving approach to finding solutions to the challenges facing the health system, with particular focus on work around critical areas such as ratios and workload matters, models of nursing and midwifery care, working arrangements, productivity improvements, and career structures. We are particularly eager to revitalise the Nurses and Midwives Implementation Group (NaMIG) which traces its roots back almost 10 years ago to the EB6 agreement, and has the capacity to be an excellent forum for collaboration, strategising, and problem solving.

Reverse changes to the Industrial Relations Act Changes made to the Industrial Relations Act 1999 under the previous government were designed to weaken the position of employees. They restricted workers’ access to union support, information and training, stripped long standing provisions on matters such as job security, roster flexibility, discrimination, and workload management, and brought back the bad old days of individual contracts. We seek full reversal of these changes. We want this government to commit to the principals of collective bargaining and collective agreements, and we want to see a full reinstatement of all the content deemed “non-allowable” by the previous government including workload management tools.

Legislation of ratios Prior to the 2015 state polls the Labor Party made a commitment to legislate minimum nurse/midwife-patient ratios in Queensland Health facilities. We will be holding this government to that commitment and expect mandated ratios across Queensland Health to be an early priority. For more on our ratios campaign see the adjoining article on page 28. www.qnu.org.au

Reinstatement of the EB schedule and halt to Award Modernisation We will be seeking assurances from this government that it will return to the recognised schedule of enterprise bargaining and re-establish meaningful negotiations with the QNU. Treasurer and Industrial Relations Minister Curtis Pitt has asked the QIRC to suspend the award modernisation process while the government undertakes consultation with key stakeholders. The modernisation process for nurses and midwives had not advanced beyond preliminary stages and should be abandoned altogether. The LNP government’s decision to delay the award modernisation process until December 2015 and EB9 negotiations until early 2016 has created unnecessary uncertainty for public sector nurses and midwives. Nurse and midwives need urgent clarification about the new Labor government’s position on the previous LNP government’s decision to extend EB8 by 12 months.

Restart discussions on models of care We want to see greater effort to roll out the models of care currently being used in limited capacity throughout Queensland—these include midwife-led models and midwifery team models, shared care arrangements with GPs, and a combination of midwife-led and collaborative care/team models which utilise a range of health workers collaborating in a multi-disciplinary team to provide maternity care. We also want a greater focus on continuity of care. Queensland has already agreed in principal to advance continuity of care models through the Australian Health Ministers’ Conference, but despite this, it remains underutilised.

Return of a nursing and midwifery voice to health governance

But in the past few years nurses and midwives have been sidelined and our contribution to the health system undervalued. The evidence of this is clearly seen in the cuts to senior roles and the removal of nurses and midwives from decision-making and governing bodies, boards and committees. We will be advocating for nurses and midwives to be reinstated to their rightful position within these groups as self-governing professionals with unique skill sets and perspectives.

Protecting public health While we welcome the new government’s pre-election pledge to retain state assets, we remain concerned about contracting out arrangements throughout Queensland Health facilities which amount to a privatisation by stealth. Services such as pharmacy, radiology and pathology are particularly vulnerable with a number of HHSs already in favour of outsourcing these services. We will defend strenuously the right of all Australians to have access to quality health services based on need and not on the ability to pay.

Addressing local issues Across the state, managerial decisions have negatively affected members and allowed a culture of fear and insecurity to prevail. It’s time to replace these feelings with hope the new government will deliver nurses and midwives a safe and secure work environment. The QNU will be working with Local Branches to identify and address local issues, so make sure you attend your next branch meeting to have your say.

There are untapped opportunities for nurses and midwives to make Queensland’s health system work better, smarter, and safer. APRIL 2015 | TQN | 27

FEATURE

RATIOS: IT’S ALL ABOUT PATIENT SAFETY

In January this year, the QNU launched its campaign for mandated nurse/midwife-to-patient ratios. The aim is to improve the safety and quality of health services in Queensland by making it law that every public sector unit and ward has a set minimum safe staffing level, complete with appropriate skill mix. National and international studies have empirically proven that ratios work. They save lives, reduce hospital stays, reduce adverse outcomes, and—when deployed properly—can even save health system dollars. In the article below, we give you a summary of the proposal we put to the new state government so you can see what we are asking for and why. You can read the full claims document online at www.qnu.org.au/ratiossavelives Before we begin, it is important to keep in mind that ‘nurse-to-patient ratios’ is just a broad, manageable term we use to label our campaign—in reality it’s so much more. 28 | TQN | APRIL 2015

The most important things to note are:  Nurse-to-patient ratios also means midwife-to-patient (where it makes sense, of course).  Ratios describe the minimum number of nurses required to deliver care to a set number of patients.  We use 1:4 as a generic ratio. Actual working ratios will depend on the unit/ ward.  Nurse-to-patient ratios are not the only aspect of the campaign—it also includes skill mix.  When we talk about legislating for the public sector that does not mean we are ignoring private facilities and aged care—quite the contrary! The idea is to start where we can get the biggest buyin and use that as a benchmark and a pressure point for the other sectors.  This is a long haul campaign. It could take some time to lock it in across all sectors, but we won’t stop until we do.

The starting point: what we want the government to do 1

2 3

Mandate and enforce (via legislation and regulation standards) minimum nurse/midwife-to-patient ratios and skill mix levels for Queensland Health facilities, to act as a care guarantee in conjunction with the proper application of the Business Planning Framework workload planning tool. Mandated ratios in private hospitals. Mandate and enforce (via legislation and regulation standards) the participation of public, private and aged care sectors in minimum nursing/midwifery data sets that monitor and openly report nurse/ midwife ratios, skill mix levels, and quality outcomes across Queensland. Urgently review the adequacy of nurse numbers, skill mix, and quality indicators in residential aged care facilities across Queensland to determine the parameters of safe staffing for the purposes of mandating minimum nurse-to-resident ratios and skill mix levels. Mandate and enforce via legislation that a Registered Nurse is present on shift in residential aged care facilities at all times to improve the safety and quality of care delivery in parity with the New South Wales’ Public Health Act 2010.

Why make these claims now? Safe staffing principles such as skill mix and staffing levels are not consistent across healthcare services in Queensland. This has led to unsafe work environments, inequality in patient outcomes, and high levels of staff dissatisfaction.

How will these claims help guarantee safe levels of care in Queensland? Mandating minimum ratios will simplify the workload planning process and maximise compliance. Mandating that a Registered Nurse is on duty at all times in residential aged care facilities demonstrates a commitment to safety and quality of care. Our ratios claim also calls for data on ratios, skill mix, and quality outcomes for all health sectors to be made publicly available—both for the purpose of www.qnu.org.au

FEATURE

transparency and as an incentive for healthcare providers to improve their accountability and clinical performance.

Why should ratios and skill mix levels be mandated in Queensland? National and international studies have irrefutably proven the number of nurses/ midwives, the skill mix, and the practice environment directly affect the safety and quality performance of health services. Mandating ratios and skill mix protocols improves patient satisfaction, lowers mortality, decreases readmission rates, and reduces adverse events such as infections, pressure injuries, and postoperative complications. For Queenslanders, this means they are likely to spend less time in hospital and receive more personal nursing or midwifery care than they do now. The statistics, drawn from numerous empirical case studies, show:  Every one patient added to a nurse’s workload is associated with a 7% increase in deaths after common surgery.

 Every 10% increase in bachelor-

Better staffing is good for patients and the public purse

educated nurses is associated with a 7% lower mortality.  Every one patient added to a nurse’s workload increases a medically admitted child’s odds of readmission within 15-30 days by 11% and a surgically admitted child’s likelihood of readmission by 48%.

An Australian study demonstrated increasing Registered Nurse hours by as little as 10% resulted in the following decreased incidence of adverse events:  45% central nervous system complications

Enforcement of ratios and skill mix levels

 37% GI bleeding

Everyone will have their role to play when it comes to enforcing ratios and skill mix. The government will need to outline monitoring and reporting mechanisms as part of its legislation. Health organisations will need to develop policies, standards and guidelines to enforce and monitor implementation of ratios at their facilities, and will need to comply with reporting requirements. Nurses and midwives will be required to follow not only organisational policies and standards, but also the Nursing and Midwifery Board of Australia clauses about ensuring patient safety by reporting on skill mix and staffing needs.

 34% UTIs  27% failure to rescue  19% pressure ulcers  15% sepsis  11% pneumonia If we take four of these adverse events (septicaemia, pressure ulcers, gastrointestinal bleeding, and UTI) and apply the percentages above to the average cost of an individual adverse event (based on a Queensland and Victorian study), there is an estimated 23% decrease in the total expenditure for 100 episodes of each event.

Figure 1: Cost per 100 episodes of selected adverse event with additional Registered Nurse hours DESCRIPTOR

COST PER EPISODE

COST PER 100 CASES

REVISED COST AFTER INCREASE IN RN HOURS

SAVINGS MADE AFTER INCREASE IN RN HOURS

Septicaemia

$9,420

$942,000

$800,700

$141,300

Pressure ulcers

$8,461

$846,100

$685,941

$160,759

Gastrointestinal bleeding

$4,211

$421,100

$265,293

$155,807

UTI

$3,675

$367,500

$242,550

$124,950

$2,576,700

$1,993,884

$582,816

Total for 400 adverse events

A Queensland Health example: From November 2012 to October 2013, Queensland Health reported 2102 hospitalacquired pressure injuries ranging from stage 2 to stage 4.

Figure 2: Costs for pressure ulcers episodes in Queensland Health DESCRIPTOR

Pressure ulcers

www.qnu.org.au

COST PER EPISODE

COST FOR ALL 2102 CASES

REVISED COST AFTER INCREASE IN RN HOURS

SAVINGS MADE AFTER INCREASE IN RN HOURS

$8,461

$17,785,022

$16,006,519

$1,778,502

APRIL 2015 | TQN | 29

PROFESSIONAL

Research highlights problems with safety frameworks The vital focus on patient safety and quality has waned in recent times, thanks to the job and service losses in the public health sector and a lack of oversight in the private sector.

The fallout has seen increased workloads for nurses and midwives and concerns about patient safety. Now more than ever, nurses and midwives must act to keep the system safe. A recent QNU review of the quality and safety regulation framework across the public, private and aged care sectors indicates there are serious problems in Queensland. Our research highlighted the following concerns:  Despite laws and reporting guidelines in the private sector, actual enforcement rests with the Private Health Facilities Regulation Unit. This body operates with just four staff for the whole state.  Federal and state laws protect the commercial interests of private health facilities, preventing transparency of important safety and quality processes.

The way information is disclosed is not the same between the private and public sectors.  Although HHSs are required by law to set up a safety and quality committee, the QNU remains concerned some do not have separate committees specifically for this purpose. The former LNP government scaled back the QH Patient Safety Centre, and there has been no annual public report since 2011.  QNU members have advised that aged care services only ensure adequate staffing levels and adhere to proper operational requirements when they know they are about to be inspected. Once the inspection is complete, facilities revert to operating under previous inadequate standards.  Staff are confused about the various options available for reporting individual issues. In July 2014, the Office of the Health Ombudsman

EARLY BIRD PRICE NHMRC Centre of Research Excellence in Nursing (NCREN)

Skin Integrity: State of the Evidence Symposium FRIDAY JULY • BRISBANE CONVENTION & EXHIBITION CENTRE FRIDAY 3131 JULY • BRISBANE CONVENTION & EXHIBITION CENTRE 30 | TQN | APRIL 2015

(OHO) replaced the Health Quality and Complaints Commission as Queensland’s independent health complaints agency. The OHO has certain responsibilities that were previously performed by the Australian Health Practitioner Regulation Agency (AHPRA), but does not deal with individual complaints.  Increasing workloads, ‘dollar-driven’ health care, and less resources are putting pressure on nurses and midwives to perform their roles. This affects their ability to provide patients with safe, quality care. This means it has become more important for nurses and midwives in all sectors to report incidents that may compromise safety and quality. It is equally important to escalate matters if there is no resolution. The QNU is there to help you with this.

WHO SHOULD REGISTER? Nurses, Midwives, Medical Practitioners employed in hospital settings, and health students. Early bird by 26 June 2015 $80 plus gst (i.e. $88 in total) Final registration by 17 July 2015 $100 plus gst (i.e. $110 in total) For any enquiries, please contact Helen Liu at 07 5552 8931 or ncren@griffith.edu.au REGISTER ONLINE griffith.edu.au/skin-integritysymposium www.qnu.org.au

NURSING AND MIDWIFERY RESEARCH

Prophylactic application of negative pressure to high-risk surgical wounds BY B.M. GILLESPIE FOR THE NHMRC CENTRE FOR RESEARCH EXCELLENCE IN NURSING

Wound management and the prevention of surgical site infections (SSIs) is an important clinical issue for investigation. The gravity of the problem lies in the fact that in developed countries such as Australia, one elective surgery is performed annually for every 12.4 people (AIHW, 2010). Of concern is that SSIs occur in up to 30% of all surgical procedures, and are the third most commonly reported hospital-acquired infection (Mangram et al., 1999). In an effort to reduce the incidence of SSI, the use of negative pressure wound therapy (NPWT), such as vacuum-assisted closure, is increasing in Queensland hospitals despite a lack of evidence supporting its clinical effectiveness.

Results of recent pilot studies using NPWT During 2012-14, NCREN researchers conducted two pilot trials using NPWT in different patient populations. The first trial was conducted in obese women with a BMI≥30 undergoing elective caesarean section, while the second trial involved patients undergoing elective total hip replacement. In the first trial involving 92 women, 12 out of 44 of the standard dressing group and 10 out of 43 of the NPWT group developed a SSI (Chaboyer et al., 2014). However, there was a slightly higher incidence of blistering in the NPWT group—4 out of 44 compared to 1 out of 43. During the second trial of 70 patients, 2 out of 35 in the NPWT compared to 3 out of 35 patents in the standard dressing www.qnu.org.au

group developed a SSI (Gillespie et al., 2015). Again, patients in the NPWT group experienced more wound complications than those in the standard dressing group—24 out of 35 compared to 15 out of 35. While the results were based on small samples, the benefit of applying prophylactic negative pressure to high risk surgical wounds remains unclear.

Future research Preparations for a larger trial, funded by a $2.85 million grant from the National Health and Medical Research Council, are currently underway. This nurse-led trial combines the expertise of obstetricians, midwives, a health economist, and a biostatistician. The aim of the ADding negative pRESSure to improve healING (DRESSING trial) is to determine the clinical and cost effectiveness of prophylactic NPWT compared with standard dressings on surgical wounds in obese women undergoing caesarean section.

In the absence of compelling evidence, this large multicentre trial is expected to provide definitive evidence that can guide future practice.

Want to know more? Please contact Associate Professor Brigid Gillespie, NCREN.

Source List Australian Institute of Health and Welfare (2010), Australia’s hospitals 2008-09 - at a glance, AIHW: Canberra. Chaboyer, W, Anderson, V, Webster, J, Sneddon, A, Thalib, L & Gillespie, BM (2014) “Negative Pressure Wound Therapy on Surgical Site Infections in Women Undergoing Elective Caesarean Sections: A Pilot RCT”. Healthcare, 2. Gillespie, BM, Rickard, CM, Thalib, L, Kang, E, Finigan, T, Homer, A, Lonie, G, Pitchford, D & Chaboyer, W. (in press) “Use of Negative Pressure Wound Dressings to Prevent Surgical Site Complications after Primary Hip Arthroplasty: A Pilot RCT”. Surgical Innovation. Mangram, A.J., et al. (1999), “Guideline for prevention of surgical site infection”. Infect Control Hosp Epidemiol, 20(4): p. 247-280. APRIL 2015 | TQN | 31

LEGAL

When can I take it?

LONG SERVICE LEAVE

—the myths and what you need to know BY JAMES STEDMAN, HALL PAYNE LAWYERS

A common misconception is that employees in Queensland cannot take long service leave until they have given 10 years of continuous service. It is true that the Industrial Relations Act 1999 creates an entitlement to take long service leave after 10 years. However, the act merely sets a baseline—it does not prevent long service leave from being taken sooner if agreed between the parties. Members employed by Ramsay Health Care and RSL Care, for instance, are entitled to apply for long service leave after seven years because of the terms of their enterprise agreement. This is also the case for Queensland Health employees.

What happens if I leave before my entitlement accrues? The act allows employees to receive pro rata long service leave payments after seven years if:  the employee’s service is terminated by their death  the employee terminates their service because of illness, incapacity, or because of a domestic or other pressing necessity  the employer dismisses the employee for a reason other than the employee’s conduct, capacity or performance  the employer unfairly dismisses the employee  the employee had a reasonable expectation that their employment would continue for 10 years and the employee was prepared to continue the employment, but their employment contract expired before 10 years. A number of enterprise agreements permit pro rata long service leave to be paid prior to seven years if the employment ends due to certain circumstances, such as retrenchment or ill-health retirement. Employees that resign their employment to take up other employment will not usually be eligible for long service leave if their entitlement has not yet accrued.

Can I cash out my leave while still employed? Most QNU members do not have a cashing out clause in their enterprise agreement. These members may apply to the Queensland Industrial Relations Commission if they require their long service leave to be paid to them instead of taking the time off work. The QIRC dealt with 215 new long service leave applications in the 2013-14 financial year and routinely allow employees to cash out long service leave if they can demonstrate financial hardship or compassionate grounds.

How much do I get?

James Stedman is a solicitor at Hall Payne Lawyers and was formerly a Workplace Servicing Officer at the QNU. 32 | TQN | APRIL 2015

Under the act, workers can get 8.67 weeks of long service leave for 10 years of service—however, an enterprise agreement may contain better conditions. For instance, QNU members employed by Blue Care are entitled to 10 to 12 weeks of long service leave for 10 years of service. If you are unsure of when you can apply for long service leave, or how much leave you are entitled to, check your enterprise agreement. The most favourable long service leave schemes were won by QNU members collectively bargaining for better conditions. www.qnu.org.au

MIDWIFERY

PII and exemption for intrapartum care extended to end of 2015 The federal government has extended indemnity insurance coverage and exemption for intrapartum care in the home for privately practising eligible midwives until the end of 2015. Since November 2010 midwives have been able to gain recognition to provide pregnancy, labour, birth and post natal care to women and their infants, as well as endorsement as an eligible midwife so long as they are able to demonstrate specified legislated requirements. To provide a Medicare midwifery service, the eligible midwife is required to be working in private practice and have:  professional indemnity insurance (PII)  a medicare provider number and  collaborative arrangements with a specified medical practitioner or be credentialed at a hospital. All privately practising eligible midwives are required to have insurance to cover all aspects of the care they provide, with the exception of intrapartum care in the home. To be exempt from needing insurance for providing intrapartum care for

homebirths, the privately practising midwife must comply with a number of requirements under the National Law s284, including a safety and quality framework. A Commonwealth-subsidised professional indemnity insurance (PII) package is available to privately practising eligible midwives. The PII package can be purchased from the insurer after meeting additional requirements including participation in risk management programs. This product does not cover birth in the woman’s home but does cover private birth care in hospital. The Commonwealth-subsidised PII exemption for intrapartum care in the home had been scheduled to expire on 30 June 2015. However, the federal government has recently extended the exemption to 31 December 2015. This allows time for further opportunities for PII cover to be explored into 2015, while privately practising eligible midwives can continue to practice supported by PII cover during this period.

Midwifery Group Practices on the increase in Queensland In a positive step forward for Queensland midwives and mothers, the number of new Midwifery Group Practices being established in the state continues to increase. Midwives in Hospital and Health Services are embracing the continuity of midwifery care caseload models, expanding the number of MGPs across urban, rural and remote settings. MGP models need to be locally tailored to meet the needs of women and babies in their community. The MGP models require caseload midwives to be available on a flexible 24 hour schedule, with time rostered off call in consultation with other midwives in the group. www.qnu.org.au

Unlike core midwives who work rostered shifts and are paid wages in maternity services, MGP caseload midwives are paid an annualised salary, as outlined in the Queensland Health Nurses and Midwives Award – State 2012 and the Nurses and Midwives (Queensland Health) Certified Agreement (EB8) 2012. The award and EB8 protect the entitlements of caseload midwives by recognising these employment differences and making provision for tailored local agreements. The award requires Hospital and Health Services wishing to establish a new caseload midwifery model to form a working group that includes

representative midwives, midwifery managers, the QNU, and other stakeholders. This ensures the local agreement is tailored to the individual service’s requirements and that all industrial obligations are met. The QNU will continue to work with HHSs to ensure local agreements are put in place when establishing new MGPs, or are reviewed whenever there are significant changes to an existing MGP. You can now visit the ‘members only’ section of the QNU website to find more information about signed local agreements to assist you in identifying your industrial entitlements. APRIL 2015 | TQN | 33

CONTINUING PROFESSIONAL DEVELOPMENT

C ASE S TU DY

Issues for nurses highlighted at the inquest into infection deaths BY JUDY SIMPSON, ROBERTS & KANE SOLICITORS

This inquest was heard on 20-25 November 2014 in Cairns. It related to the deaths of Graeme Gulliver, Joanne Harrison and Aileen Morten, who were in the care of the Cairns and Hinterland Hospital and Health Service (CHHHS) at the times of their deaths. Mr Gulliver, Ms Harrison and Ms Morten died as a result of infections. In each case, the question arose whether they had received timely and appropriate treatment while in hospital. Six nurses were called to give evidence at the inquest, five of whom were members of the QNU. The non-member nurse was represented by the CHHHS, who also acted for the hospitals and three doctors. The five QNU-member nurses were separately represented by Roberts & Kane Solicitors, and we instructed a barrister to advocate on their behalf. The findings of the Coroner were delivered on 8 December 2014, and are published on the Queensland Courts website.

Coroner’s findings The Coroner found that all three deceased died of natural causes. In each case those natural causes were extraordinary infections. Mr Gulliver died at the Mossman Hospital on 20 March 2012. The Coroner found that Mr Gulliver’s death was caused by sepsis, caused by leptospirosis. Ms Harrison died at the Mossman Hospital on 12 January 2012. The Coroner found that Ms Harrison’s death was caused by group A streptococcal meningitis and septicaemia. Ms Morten died at the Atherton Hospital on 23 July 2012. The Coroner found 34 | TQN | APRIL 2015

that Ms Morten’s death was caused by septicaemia due to Escherichia coli. According to the evidence, both Mr Gulliver and Ms Harrison were assigned appropriately as triage category four, on the basis that the triage nurses were not aware of the infections on presentation in both cases. Ms Harrison presented as someone with a fever who had been on antibiotic treatment. Mr Gulliver’s vital signs were good on presentation, and he was alert and active and in no obvious distress. He anecdotally reported having received some concerning pathology results, which the triage nurse promptly followed up. However, both patients were much sicker than they initially presented, and their subsequent deterioration was rapid. In both cases, there was no doctor on shift at the Mossman Hospital overnight, and the seriousness of their conditions was not recognised until it was too late. In Ms Harrison’s case, there was a breakdown in communication where a concerned referring doctor could not contact the hospital. In Mr Gulliver’s case, the concerning pathology results were not communicated directly to the hospital.

...A FAILURE TO DELIVER APPROPRIATE AND TIMELY MEDICAL TREATMENT OCCURRED WITH RESPECT TO EACH PATIENT...

In Ms Morten’s case, she was inappropriately discharged one morning without review and without appropriate consideration of all relevant factors.

Issues which contributed to the deaths The broad issues identified by the Coroner as contributing to the circumstances in which Mr Gulliver, Ms Harrison and Ms Morten died include:  the need for consistent use of tools available to assess and detect patient deterioration and subsequent escalation of a patient’s care  understaffing, particularly of medical staff, in regional hospitals, and subsequent overwork and fatigue  a culture that discourages nurses on night shift from asserting their concerns about a patient’s wellbeing when communicating with on-call doctors  the need for on-call doctors to attend to hospitals when required  haemoptysis (blood in sputum, or coughing up blood) should never diagnostically be attributed to coughing or a burst blood vessel—it must be acted on by doctors and nurses immediately  the need for clear communication channels between pathology testing laboratories, General Practitioners, Medical Centres, and hospital emergency departments, and  the need for around-the-clock access to radiology services. The Coroner concluded that a failure to deliver appropriate and timely medical treatment occurred with respect to each patient and was attributable to several systems and personal failings. www.qnu.org.au

CONTINUING PROFESSIONAL DEVELOPMENT

Lessons from Atherton and Mossman As a result of the Coroner’s finding, the QNU advises the following practical considerations for all nurses and midwives.

Assertiveness Regardless of a doctor’s fatigue, nurses should overcome any reservations to call on-call medical staff. When a nurse has contacted an on-call doctor and raised concerns that are sufficient in the nurse’s mind to compel the doctor to attend, that nurse should articulate they want the doctor to attend. If a doctor fails to attend when required, a nurse aware of the situation should escalate the matter to their line manager or, if there is still no appropriate action, to a Nursing or Medical Director.

Documentation The Coroner criticised the failure to correctly document clinical notes and to consider the patients’ clinical records and history contained in the patients’ charts. Staff should keep thorough documentation of not only relevant observations but also relevant actions undertaken, including of communications with on-call doctors. This reduces the chances of miscommunications and also protects a nurse if there is a later dispute over an exchange of information.

Workload implications The use of available tools to recognise and manage deterioration in patients provides nurses with an evidence-based measure, which they can rely on to escalate the care of a patient. Such tools, including the Adult Deterioration Detection System, provide invaluable assistance to hospitals and nursing staff. They encourage a dynamic approach to recognising the change of patient needs, as well as provide justification for changing the priorities of a patient’s care. Although there is no substitute for adequate staffing, the use of such tools provides a systems-based methodology for the escalation of a patient’s care that nurses can rely on, and goes a significant way towards offsetting any systemic failures. www.qnu.org.au

Reflective exercise for case study over page »

APRIL 2015 | TQN | 35

CONTINUING PROFESSIONAL DEVELOPMENT

C ASE S TU DY

Reflective exercise: Issues for nurses highlighted at the inquest into infection deaths 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 intended to assist your learning from reading and analysing the content of the previous article. This exercise is designed to get you thinking about your current practices and the policies and procedures of the service in which you work and what impact they have on you. Reflect on the following questions and consider what implications they have for enhancing your professional practice. 1. What are the options for immediately addressing the failure of a medical colleague to attend a deteriorating patient? Consider: ◆ policies regarding escalation of the matter and how you would stress the need for the review. ◆ the role of a standardised approach— the use of the Adult Deterioration Detection System in assisting you to describe the changes in the patient’s condition and to argue for an immediate response by your medial colleague. http://www.safetyandquality.gov.au/ wp-content/uploads/2012/01/35981ChartDevelopment.pdf 2. Are the policies of the employer regarding access to on-call or off-site clinicians enough to support professional practice and decision making when a patient’s condition deteriorates? Reflect on the conflicting demands of ensuring the timely review of a patient whose condition is deteriorating with the challenge of preserving collaborative relationships (in this case with the doctor).

Consider how you might contribute to the development of policies which support evidence-based clinical practice, national safety standards and work health and safety legislation. http://www.safetyandquality.gov.au/ our-work/accreditation-and-the-nsqhsstandards/resources-to-implement-thensqhs-standards/ 3. What type of documentation is critical when recording the actions taken to address the needs of a deteriorating patient? Consider the scope of what needs to be recorded, including detailed clinical information. For example, standard observation forms and/or prompts are commonly required, timelines (who was contacted and when), clinical records of the instruction received, and details of the response and escalation process. 4. What is the role of Adult Deterioration Detection System (ADDS) in the context of clinical /professional judgement? Consider the value of a tool/system as a prompt for recognising change in patient needs, particularly for less experienced clinicians and colleagues unfamiliar with the working environment. Consider the view that the use of a standardised system or tool promotes complacency and limits the exercise of clinical judgement versus the view that ADDS provides an evidence-based methodology for escalation that is tested, reliable and assists in addressing the issues that impact on safety.

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

36 | TQN | APRIL 2015

Date

Topic

Description

27-03-14

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

Learning Need OR Objective

Outcome

CPD hours

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

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

www.qnu.org.au

HEALTH REFORM AND GOVERNANCE

New government means new opportunity to balance HHSs In Queensland, the state government is responsible for the governance arrangements of the 16 Hospital and Health Services.

The Hospital and Health Boards Act 2011 sets out the governance functions, powers and decision-making abilities of HHS Boards and Chief Executives. Governance mechanisms in the act— such as committees and links with the Department of Health as state-wide system manager—are intended to maintain balance between individual HHSs. Unfortunately, the reality is there is little balance between the HHSs.

16 separate health systems proving difficult to manage The existence of 16 separate public health systems in Queensland creates difficult challenges. For example, there is a funding inequity, where some HHSs are funded on an activity-based system, while others are funded through a fixed amount arrangement. The danger of this varied funding arrangement is the evolution of a health system that lacks equity and consistency. Annual reports indicate that in the south east corner, some HHSs are generating a substantial surplus—while others in rural areas are struggling to meet budgets. The QNU believes surpluses should be shared statewide to help provide services that are hard to fund in rural and remote areas but are taken for granted in high population areas. For example maternity and mental health services often struggle for funding due to the reduced size of the population. www.qnu.org.au

TORRES AND CAPE

Negative impacts of decentralisation on health service

CAIRNS AND HINTERLAND

NORTH WEST

A fully decentralised model also has a number of negative impacts upon the health service. The wide variation in service provision has a significant impact on nursing and midwifery workloads. This can mean better patient outcomes in some places, and worse in others. The risk of negative patient outcomes is further increased when some HHSs remove their executive leadership in nursing and midwifery positions. Some HHSs have failed to implement the prescribed safety and quality committees—a vital component for improving patient outcomes. One of the objectives of the health reform agenda enacted by the Commonwealth government was to improve both the quality and accessibility of primary healthcare services. Until recently, primary healthcare services took the form of Medicare Locals —however, the federal government has decided Medicare Locals will be replaced by Primary Health Networks (PHNs) on 1 July 2015. The federal health minister Sussan Ley has yet to announce details about this most significant change, and existing

TOWNSVILLE MACKAY

CENTRAL WEST

CENTRAL QUEENSLAND WIDE BAY

SUNSHINE COAST METRO NORTH

SOUTH WEST DARLING DOWNS

WEST MORETON

METRO SOUTH GOLD COAST

Medicare Locals have called for urgent clarification on this matter. In the current setup, the QNU has seen little evidence of co-operation between HHSs and Medicare Locals. In fact, decisions made by the state government to close some community and primary health services in various HHSs has put increased pressure on the private sector to provide these services. When considering the provision of a health service, HSSs should consult with the Department of Health, as well as stakeholders such as Medicare Locals and professional associations. The development of a clinical governance framework that is centralised and shared across all HHSs would improve access, equity, cost-effectiveness, and consistency of all health services provided across Queensland. APRIL 2015 | TQN | 37

HEALTH AND SAFETY

New smoking laws require careful management As of 1 January 2015 new tobacco legislation took effect in all private and public health facilities in Queensland—including residential aged care. Since that time the QNU has been monitoring the effects on members. The change requires that no person— including staff—is allowed to smoke (including E cigarettes) within five metres of a health facility’s boundary, with no exemptions to any areas within the facility ground, as previously existed.

Concerns about implementation While the law is laudable as a public health initiative to reduce smoking rates, the QNU had concerns about its implementation when the proposal was first raised by former health minister Lawrence Springborg in 2013. The QNU believed that were such laws to take effect, a number of issues needed to be worked through prior to commencement. It was clear the new law would have the potential to impact broadly on staff and patient health and safety, professional practice, and workloads and skills mix. Despite this there is little information for nurses and midwives around how these concerns are to be addressed now the laws are in place. For example:  Are nurses expected by the employer to escort patients who wish to smoke outside the boundary of the facility?  How will the employer ensure there is no disruption to clinical treatment when patients leave the facility to smoke?  How will the employer ensure the service boundary of the facility is clearly identified? 38 | TQN | APRIL 2015

 Are resources to be made available for those patients requiring additional clinical interventions if they suffer a complication as a result of excessive time beyond the facility boundary?  What strategies are in place to curb aggression from patients aggrieved by these new laws? Queensland Health fact sheets on the new laws provide advice on the various clinical intervention strategies on offer for patients such as Nicotine Replacement Therapy—but there is no information on the issues identified above.

Considerations for QNU members who smoke The only concession to employees of Queensland Health who do not wish to cease smoking and will also be affected by these laws—including those working night shift—is to apply “caution”. Members should be aware that if they are injured while on a “recess break” they have the capacity to make a workers’ compensation claim. We strongly recommend they contact the QNU should this occur.

If you are pressured to escort patients off premises If your employer seeks to compel nurses and midwives to escort patients beyond the boundary of the facility, do so only if you are satisfied appropriate resources are made available to allow it. Escorting patients who wish to smoke must not impact on your workload or that of your colleagues.

MEMBERS SHOULD BE AWARE THAT IF THEY ARE INJURED WHILE ON A “RECESS BREAK” THEY HAVE THE CAPACITY TO MAKE A WORKERS’ COMPENSATION CLAIM.

It’s not your job to police this new law While the QNU supports nurses and midwives offering clinical interventions to patients that smoke, nurses must not be asked to police these new laws. This means any direction by managers that nurses and midwives are expected to confront people smoking within the boundaries of the facility is unreasonable, and has the potential to place these staff at risk of conflict. The legislation allows for authorised personnel to perform this task and it should be left to them. The QNU is available to assist members who are impacted negatively by these laws and members should contact the QNU as needed. www.qnu.org.au

SOCIAL

66,000 DOMESTIC VIOLENCE INCIDENTS IN QUEENSLAND LAST YEAR

DOMESTIC VIOLENCE IN QUEENSLAND:  In 2013-14 financial year, there were 66,016 occurrences of domestic and family violence reported to Queensland Police.  17 homicides relating to domestic and family violence occurred in Queensland in the 2012-13 financial year.  The annual cost of domestic and family violence to the Queensland economy is estimated to be between $2.7 billion and $3.2 billion.

www.qnu.org.au

Former Governor General Dame Quentin Bryce has delivered the taskforce report into domestic violence, titled Not Now, Not Ever: Putting an End to Domestic and Family Violence. Dame Quentin presented the taskforce’s findings to Premier Annastacia Palaszczuk at Parliament House in Brisbane in early March. The findings included 140 recommendations, including a specialised domestic violence court and a new criminal offence of non-lethal strangulation. Nursing and midwifery also play a frontline role in this issue. The report contains a number of key recommendations relating to the professions, including:  The Queensland Government should evaluate the frequency and efficacy of ante-natal screening for domestic and family violence, and report to the Audit Oversight Body.  The Queensland Government should commission the Australian College of Midwives to develop training for midwives on asking pregnant women about exposure to domestic violence during ante-natal appointments.

 Hospital and Health Services should ensure all midwives receive appropriate training and that all women attending ante-natal clinics should be asked about their exposure to domestic and family violence.  The Queensland Government and DV Connect should work together to provide specialist domestic and family support and referral services within all maternity hospitals and emergency departments.  The National Code of Conduct for Health Care Workers should include a requirement that the Standing Council on Health must be familiar with domestic and family violence and child harm indicators, and to intervene appropriately. The report also focused heavily on ensuring flexibility in the approaches to combating domestic violence. The state government has since announced it will immediately commit to funding two new domestic violence shelters in Brisbane and Townsville. A response to the report is expected to be handed down by the government in June 2015. APRIL 2015 | TQN | 39

PROFILE

Keeping the heart of both professions “I would give nurses and midwives power to have control over their practice,” Sandra responded when asked to identify something she would change about the profession. And if she could ensure one thing remained the same? “The heart of both professions—being woman-centred care for midwifery, and patient-centred care for nursing,” she said. “Working here at the QNU will just be continuing with my life’s work, really— ensuring nurses and midwives have a safe environment and control over their practice. “We need to have structural empowerment in the system so nurses and midwives do have that authority over their own life and work. That’s a fight— always has been, probably always will be.” A long-time QNU Councillor, Sandra says in her new role she wants to focus on the union’s power source, including member engagement and branch development. “I think there are different ways we can get nurses and midwives involved with understanding their own power.” 40 | TQN | APRIL 2015

With 35 years’ experience working as a nurse and 29 as a midwife, Sandra Eales is looking forward to drawing on her accumulated knowledge and experience in her new role as QNU Assistant Secretary.

A strong advocate for core union values A member of the QNU since 1980, Sandra is a strong advocate for the union movement, particularly when it comes to empowering nurses and midwives. “We’re stronger as part of a collective group, particularly in nursing and midwifery. Nurses and midwives aren’t aggressive in going after their own needs, we look after other people often to our own detriment. “So many of the advances in patient safety and conditions have come about through the QNU advocacy on behalf of nurses and midwives.” It was through her involvement with the QNU that Sandra started to develop her role as a workplace activist and make significant changes at her local level, including campaigning to reopen the Mareeba maternity unit as a rural standalone midwifery service—the first in Queensland, which Sandra helped pilot in 2005. “I’d been a workplace delegate since 1995, and the things I learned through www.qnu.org.au

PROFILE Meeting with HQCC Co mmissioners...

at ... speaking on the floor Annual Conference...

... with fellow QNU Co

uncillors in 2009...

the th he QNU education program certainly increased my skills so we were able in to have some good wins in the local workplace,” said Sandra. w “Then through attending Annual C Conference I understood how I could in influence the bigger picture by putting pr proposals up on the floor and having those professional discussions about th st strategic direction. “G “Going through that very political pr process of the closure of the Mareeba m maternity unit and the active community ca campaign to reopen it politicised me even m more.” “I “It really came home to me during this pr process how important it is to have the Q QNU as my backup when taking local ac action.” www.qnu.org.au www.q

Family, travel and history Family Being the family bread winner and raising two sons as a sole parent for many years, a big part of Sandra’s QNU involvement has focused on advocating for a healthy work/life balance for all nurses and midwives. She has travelled extensively, including to India and Nepal, North and Central America, and the UK and Europe, where she attended midwifery conferences in Germany and Scotland. And who would she like to invite to a dinner party? “If I could talk to people from an historical point of view, it would be the women who aren’t named or recognised as figures in history, because most of history was written by men. I’d like to talk

... with past QNU Secre tary Gay Hawksworth (left) and Pat Nicholls (centre).

to some of those wise women from across the ages who were involved in birth care and politics of the personal, including the midwives who were burned at the stake during the Inquisition.” Other individuals I admire include Ina May Gaskin, Mahatma Ghandi, Nelson Mandela, Rosa Parks (US civil rights activist), the Dalai Lama, and Vincent Lingiari here in Australia, all of whom struggled against oppression in some form. APRIL 2015 | TQN | 41

OPINION

R . E . S . P. BY DR LIZ TODHUNTER, QNU RESEARCH AND POLICY OFFICER

It is unbecoming to dance on the graves of the dead, but in the case of Campbell Newman it is just too easy. There are many opinions on the LNP’s loss of the state election and its own internal review will no doubt identify its failings in key areas. However, a stark reality is that the LNP regime started and ended with Campbell Newman. Along with senior LNP party members, he was the architect of his rise to power and ultimately his own demise. Sadly for those who placed their trust in him, he was the architect of theirs as well. From the outset, Mr Newman was the centrepiece of the government and its electoral campaigns. This may have been brave but it was ultimately a strategy enabled at the expense of others—‘collateral damage’ in military terms—because the main purpose was only ever about winning, crushing their opponents and savouring the spoils of victory. Thus Mr Newman’s war, one for which he was educationally, technically, and financially armed, ended as quickly as it commenced. There were obvious policy factors with which many voters disagreed, but it was Mr Newman’s overriding lack of respect on so many levels and for so many people that allowed his arrogance to triumph at the expense of good government. Those who stood in the way of his over-engineered plan for ‘reform’ spanned numerous professions and interests. 42 | TQN | APRIL 2015

SADLY, IN THE END MR NEWMAN BELIEVED HIS OWN HUBRIS.

Trade unions, other political parties, the judiciary, doctors, nurses, public servants, teachers, community groups, literary groups, the parliamentary process, Fitzgerald’s legacy of good government, and most importantly those who voted for him—the electorate—all suffered at his hands. Unfortunately, the absence of respect came from his lack of knowledge about his opponents and Quee Queensland political history, parti particularly labour history. Most will know that unions will neve never back away from attacks on w workers and their rights, but in i confronting unions, he cond condemned his own constituents and unwittingly brought out the very best in all of us. The Stafford by-election provided the first moment of poll-driven insi insight, but by then it was too late. ‘Op ‘Operation Boring’, a military retr retreat and regroup exercise, cou could not stem the tide of dis disaffection. Sad Sadly, in the end Mr Newman be believed his own hubris. H His acolytes—those who felt leg legislation was the weapon to right perceived wrongs, to bl bludgeon those who opposed and to further personal agendas— w were swept up in his crusade. They too saw no wrong in d demonising and marginalising the very people who had voted th ffor him. www.qnu.org.au

OPINION

E . C. T Belatedly, they realised that workers are the union and personal hatred of individual union officials cannot justify trying to crush the movement as a whole. In that regard, they also failed to appreciate that there is no other organisation that can mobilise the masses like trade unions, even when many are struggling to grow membership. Lack of introspection and selfawareness, a complete disregard for alternative views, and the absolute conviction that he was right led Mr Newman down a narrow, risky path. He created a common enemy by demonising the public service and trade unions, ruled by fear, division, dislike, and distrust, and thereby alienated many public servants from their commitment to serving the common good. What a shame this energy was directed into such nihilism. There are many lessons for those who follow in Mr Newman’s political footsteps. Importantly, they must not respond with spite, aggression, and hatred. To do so makes them no better than the Newman government and displays the very same characteristics for which it was

www.qnu.org.au

lik d and d which hi h hastened h t d it so di disliked its own downfall. Labor must celebrate in its victory but remain humble in government and the people it serves. It must learn from the mistakes of the past and recognise that forming a government is a great privilege that must be done with humility, respect, compassion, and tolerance for differing political and social views. The purpose of government is not only to pursue economic wealth at all costs. We must hold this Labor government to the same high standards and never forget our own responsibilities as voters to bring about effective government.

It w was his own death call when Ca Campbell Newman announced ‘as go goes Ashgrove, so goes the state’. It w was also a clear reflection th that to the very end, his selfob obsession both won and lost the LN LNP office in a very short space of time. T Too late came the realisation th that respect is the cornerstone o of good government. There was, however, one shining sstar, one clear winner in all the rreflections, commiserations, and ccongratulations. IIt was not jjust the ALP and those who worked so hard to overthrow the Newman regime—it was the democratic process and the Westminster system of government. On 31 January 2015, democracy was the victor. This election showed us that the people will not tolerate mistreatment at the hands of ideologues. They have families and feelings and, most importantly, they vote. I wish Mr Newman well in his new life. He performed with energy and commitment, but rather than remembering him for having served with honour, history will recall him as having reigned with fear.

APRIL 2015 | TQN | 43

YOUR LIBRARY

QNU LIBRARY: a world of knowledge at your fingertips 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.

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.

Interlibrary Loans The QNU Library belongs to a network of health libraries (GRATISNET). Requests for photocopies of journal articles or books should be submitted on copyright request forms giving full citations. If requested, books can be supplied outside the GRATISNET network as an interlibrary loan. A fee of $6 may apply.

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.

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. 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 accessing nursing information generally, the QNU librarian can conduct searches to find suitable citations.

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

The QNU’s friendly librarians, Madeleine and Pat. 44 | TQN | APRIL 2015

www.qnu.org.au

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

APRIL Lung Health Promotion Centre at The Alfred 16–17 April, Managing COPD 20-21 April, Spirometry Principles & Practice 29 April–1 May, Respiratory Course (Module A) Ph: (03) 9076 2382 Email: lunghealth@alfred.org.au ACN Nursing and Health Expo VIC Saturday 18 April, Melbourne www.acn.edu.au/expos QNU Meeting of Delegates 21 April, QNU Bundaberg 22 April, Maryborough 29 April, Townsville 30 April, Cairns www.qnu.org.au/mods 33rd Annual Dermatology Nurses’ Association Convention Collaboration. Discovery. Education. 23-26 April, Las Vegas, USA. http://2015.dnanurse.org/ World Day for Safety and Health at Work (ILO) 29 April 2015 www.un.org/en/events/safeworkday/ ACN WA Matters ACN presents the opportunity to hear firsthand and discuss critical issues affecting health care provision in your state or territory. 30 April, Perth www.acn.edu.au/wamatters

MAY ACN Nursing and Health Expo WA 1 May, Perth www.acn.edu.au/expos APNA Continuing Education Workshops for Nurses in Primary Care 1-2 May, Perth 29-30 May, Adelaide https://www.apna.asn.au/ educationworkshops World Press Freedom Day 3 May http://www.un.org/en/events/ pressfreedomday/ International Conference on Nursing 4-7 May, Athens, Greece www.atiner.gr/nursing.htm International Day of the Midwife 5 May 2015 www.internationalmidwives.org/ QNU International Day of the Midwife/International Nurses’ Day Barbeque Breakfast The First Anzac Nurses 6 May, Brisbane www.qnu.org.au/2015_ind

www.qnu.org.au

QNU Meeting of Delegates 6 May, Rockhampton 22 May, Mackay www.qnu.org.au/mods Australian & New Zealand Society for Geriatric Medicine 2015 Annual Scientific Meeting 6-8 May, Perth www.anzsgmconference.org Lung Health Promotion Centre at The Alfred 7 May, Respiratory Update 27–28 May, Respiratory Course (Module B) P: (03) 9076 2382 E: lunghealth@alfred.org.au Nurses & Midwives Wellness Conference Create your healthy footprint 8 May, Melbourne www.anmfvic.asn.au/events-andconferences World Red Cross Day 8 May 2015 www.icrc.org/eng/resources/ documents/misc/57jqz6.htm 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, Copenhagen Denmark www.eapc-2015.org/ Creating Futures 2015 Practice, Evidence and Creativity in Tropical and Remote Settings 11-14 May, Cairns http://cf15.conorg.com.au/ ACN National Nurses Breakfast 12 May www.acn.edu.au/national_nurses_ breakfast International Nurses Day 12 May 2015 www.icn.ch/ 12th Behavioural Research in Cancer Control Conference Bridging the gap 12-15 May, Sydney www.cancercouncil.com.au 7th Australian Primary Health Care Nurses Association National Conference Brave to Bold 14-16 May, Gold Coast www.apna.asn.au/ Australian Dermatology Nurses Association 14th National Conference 16-17 May, Adelaide www.adna.org.au/events/ 2nd Australian & New Zealand Eating Disorders & Obesity Conference 18-19 May, Surfers Paradise

http://eatingdisordersaustralia.org.au/

www.un.org/en/events/refugeeday/

The person centred approach to healthy weight management. If not dieting, then what?® 22-23 May, Hobart 5-6 June, Perth 19-20 June, Adelaide www.apna.asn.au/ifnotdieting

3rd International Conference on Ageing in a Foreign Land 24-26 June, Bedford Park, SA www.flinders.edu.au/ehl/conferences/ ageing/

13th National Rural Health Conference People, Places, Possibilities...for rural and remote Australia 24-27 May, Darwin www.ruralhealth.org.au/13nrhc/ ACN SA Matters ACN presents the opportunity to hear firsthand and discuss critical issues affecting health care provision in your state or territory. 28 May, Adelaide www.acn.edu.au/samatters

JUNE World Environment Day 5 June 2015 www.unep.org/wed/ Lung Health Promotion Centre at The Alfred 11-12 June, Spirometry Principles & Practice 18 June, Paediatric Respiratory Update 24 June, Asthma Management Update Ph: (03) 9076 2382 Email: lunghealth@alfred.org.au 18th Cancer Nurses Society of Australia Annual Winter Congress Cancer nursing: expanding the possibilities 14-16 June, Perth www.cnsawintercongress.com.au/ Renal Society of Australasia Conference Digging deeper: Golden opportunities to advance renal care 15-17 June, Perth http://rsaannualconference.org.au/ 16th Institute of Continuing Education (ICE) meeting (Australian College of Critical Care Nurses) Let’s Get Clinical 19-20 June, Adelaide www.acccn.com.au/events/event/ ice2015-adelaide Medical Imaging Nurses Association National Conference 19-21 June, Sydney www.minanational.com/ International Council of Nurses (ICN) International Conference and Council of National Representatives (CNR) Global Citizen, Global Nursing 19-23 June, Seoul, Republic of Korea. www.icn2015.com/ World Refugee Day 20 June

ACN History Conference Disrupting discourses: new views on nursing history 29 June, Sydney www.acn.edu.au/history 3rd Annual Worldwide Nursing Conference 29-30 June, Singapore www.nursing-conf.org/

JULY ACN QLD Matters ACN presents the opportunity to hear firsthand and discuss critical issues affecting health care provision in your state or territory. 7 July 2015, Cairns www.acn.edu.au/qldmatters ACN NT Matters ACN presents the opportunity to hear firsthand and discuss critical issues affecting health care provision in your state or territory. 9 July 2015, Darwin www.acn.edu.au/ntmatters Lung Health Promotion Centre at The Alfred 14 July, Educating & Presenting With Confidence 15-17 July, Asthma Educator’s Course 23-24 July, Smoking Cessation Course 30-31 July, Creative Behaviour Change Coaching For Chronic Illness Ph: (03) 9076 2382 Email: lunghealth@alfred.org.au QNU Annual Conference 15-17 July, Brisbane Summer Global Nursing Symposium Nursing Practice, Nursing Education, Nursing Management, and Disaster Management 17-18 July. Los Angeles, USA www.uofriverside.com/conferences/ global-nursing-symposium/2015summer-global-nursing-symposium/ International Confederation of Midwives (ICM) Asia Pacific Regional Conference Midwifery care for every mother and their newborn 20-22 July, Yokohama, Japan. www.icmaprc2015.org/en/general_ information.html

SEPTEMBER 2015 QNU Professional Practice and Ethics Seminar 4 September, Brisbane

APRIL 2015 | TQN | 45

YOUR SUPER

Recognising outstanding achievements in nursing and midwifery It’s said that small acts can make a big difference. This is certainly true when it comes to the HESTA Australian Nursing Awards, with each person nominated receiving a certificate of recognition. “This gesture is an important part of the HESTA Australian Nursing Awards,” says HESTA CEO, Anne-Marie Corboy. “Recognition plays a vital role in rewarding professional achievement. “A certificate lets all those who’ve been nominated know their work is appreciated.” A $30,000 prize pool — generously provided by ME Bank — will be shared among the winners in three award categories: Nurse of the Year, Outstanding Graduate and Team Innovation. Members of the public and those working in health and community services can nominate a Nurse of the Year. Nominations for the Outstanding Graduate Award must come from Graduate Nurse Coordinators, while leadingedge nursing teams can self-nominate for the Team Innovation Award. “It’s a great opportunity for patients, their families, colleagues or employers to say ‘thank you’, and to tell the community about Australia’s exceptional nurses and midwives,” Ms Corboy says. “The achievements of Australia’s remarkable nursing professionals are inspirational, courageous and innovative — and our awards are an avenue to share their stories.” HESTA CEO, Anne-Marie Corboy Nominations are now open for the 2015 HESTA Australian Nursing Awards. Winners will be revealed at the Awards dinner, where all finalists will celebrate with their colleagues, friends and family. To make a nomination or find out more about the awards, visit hestaawards.com.au HESTA is the super fund for health and community services, with more than 800,000 members and $29 billion in assets. More people in health and community services choose HESTA for their super. H.E.S.T. Australia Ltd ABN 66 006 818 695 AFSL No.235249 Trustee of Health Employees Superannuation Trust Australia (HESTA) ABN 64 971 749 321. Terms and conditions apply, see hestanursingawards.com.au for details.

46 | TQN | APRIL 2015

Women living on less retirement The superannuation gender gap is not new, but it appears to be widespread with around 90 percent of women predicted to retire with inadequate savings to fund a comfortable lifestyle in retirement1. According to recent information released by the Association of Superannuation Funds Australia, on average, women are retiring with only $112,000 in super savings—$92,000 less than men. Even worse, one in three women will retire with no superannuation at all. Lower pay, time out of the workforce to raise children and shouldering the bulk of unpaid domestic work can make it challenging for women to build a reasonable amount of super for themselves.

What can you do? There are some quick and easy ways to boost your super so you can take control of your future: • Ask your employer to pay some of your pre-tax wage into super. Before-tax contributions (salary sacrifice contributions) can be a tax-friendly way to grow your super. • Make super contributions out of your own pocket. Known as ‘non-concessional’ contributions, these after-tax super contributions aren’t generally subject to the 15% contributions tax because you have already paid income tax on this money. Depending on your income, you may also be eligible for a government co-contribution to your fund. • Find your lost super. The Australian Taxation Office’s free SuperSeeker tool can track down any lost super you may have. Visit ato.gov.au/superseeker or call 13 28 65 and remember to have your tax file number handy. • Think about consolidating your super into one fund. It could be a quick way to boost your super and save on extra fees and charges. Make sure you check any insurance cover you may have first or exit fees! With super, small contributions now can make a big difference over time2. Visit the QSuper website at qsuper.qld. gov.au for some handy calculators to help you keep track of and maximise your super. 1. Association of Superannuation Fund Australia Research Centre. 2. All superannuation savings are preserved until you permanently retire and reach your preservation age, which is between age 55 and 60, depending on when you were born. Please note that contribution caps do apply, more details can be found in the Accumulation account guide. Just quickly, we need to let you know that this information is provided QInvest Limited (ABN 35 063 511 580, AFSL and Australian Credit Licence Number 238274) which is ultimately owned by the QSuper Board (ABN 32 125 059 006) as trustee for the QSuper Fund (ABN 60 905 115 063). All QSuper products are issued by the QSuper Board as trustee for the QSuper Fund. When we say ‘QSuper’, we’re talking about the QSuper Board, the QSuper Fund, QSuper Limited or (QInvest Limited), unless the context we’re using it in suggests otherwise. We’ve put this information together as general information only so keep in mind that it doesn’t take into account your personal objectives, financial situation, or needs, shouldn’t be relied on as legal or taxation advice, and doesn’t take the place of this type of advice. Before you make any decision to acquire a product, or to keep hold of one you already have you should consider the PDS, which you can download at qsuper.qld.gov.au, or call us on 1300 360 750 for a copy. © QSuper Board of Trustees 2015

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From conversation comes knowledge. They can be powerful things, conversations. And they can change your life for the better. We’re here to help you set yourself up for the lifestyle you want in the future. • Talk to us about our range of information and tools. • Create a simple super action plan that you can put in place now. Spend a few minutes with us and see how much you could get out. Start the conversation today.

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