Staffing gains at John Hunter
Mums matter, babies count
Seclusion and restraint forecast to decline
Your rights and entitlements at work Nurse Uncut – your stories What nurses and midwives said Nursing research online
THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION VOLUME 75 NO. 2 MARCH 2018
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2 | THE LAMP MARCH 2018
CONTENTS Contacts NSW Nurses and Midwives’ Association For all membership enquiries and assistance, including Lamp subscriptions and change of address, contact our Sydney office. Sydney Office 50 O’Dea Avenue, Waterloo NSW 2017 (all correspondence) T 8595 1234 (metro) 1300 367 962 (non-metro) F 9662 1414 E email@example.com W www.nswnma.asn.au
VOLUME 75 NO. 2 MARCH 2018
Hunter Office 8-14 Telford Street, Newcastle East NSW 2300
NSWNMA Communications Manager Janaki Chellam-Rajendra T 1300 367 962
Maitland Hospital to stay public Nurses win five out of five in battle to defend regional public hospitals
For all editorial enquiries letters and diary dates T 8595 1234 E firstname.lastname@example.org 50 O’Dea Avenue, Waterloo NSW 2017
Produced by Hester Communications T 9568 3148 Press Releases Send your press releases to: F 9662 1414 E email@example.com Editorial Committee Brett Holmes, NSWNMA General Secretary Judith Kiejda, NSWNMA Assistant General Secretary Coral Levett, NSWNMA President Peg Hibbert, Hornsby Ku-ring-gai Hospital Michelle Cashman, Long Jetty Continuing Care Richard Noort, Justice Health Advertising Danielle Nicholson T 8595 2139 or 0429 269 750 F 9662 1414 E firstname.lastname@example.org Information & Records Management Centre To find archived articles from The Lamp, or to borrow from the NSWNMA nursing and health collection, contact: Jeannette Bromfield, Coordinator. T 8595 2175 E email@example.com The Lamp ISSN: 0047-3936 General Disclaimer The Lamp is the official magazine of the NSWNMA. Views expressed in articles are contributors’ own and not necessarily those of the NSWNMA. Statements of fact are believed to be true, but no legal responsibility is accepted for them. All material appearing in The Lamp is covered by copyright and may not be reproduced without prior written permission. The NSWNMA takes no responsibility for the advertising appearing herein and it does not necessarily endorse any products advertised.
COVER STORY Nurses drive united hospital campaign
The battle to save Maitland Hospital brought unions and the community closer together. SAFE STAFFING Staffing gains at John Hunter Nurses and midwives at John Hunter Hospital in Newcastle win a breakthrough in a long-running staffing dispute
SAFE STAFFING Mums matter, babies count
Midwives at Royal North Shore Hospital have run an innovative campaign to educate the public about the need for appropriate staffing levels in birthing wards.
Privacy Statement The NSWNMA 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 the NSWNMA office. If you are still not satisfied that your privacy is being maintained, you can contact the Privacy Commission.
Subscriptions for 2018 Free to all Association members. Professional members can subscribe to the magazine at a reduced rate of $30. Individuals $84, Institutions $140, Overseas $150.
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Editorial Your letters Competition News in brief Ask Judith Nurse Uncut Facebook Nursing Research Online Crossword Book Club At the Movies Diary Dates
HOUSING AFFORDABILITY Solutions sought on nurses’ housing
The NSWNMA is pushing for an affordable housing development levy, charged to developers in the City of Sydney, to be extended to five other local government areas.
TAX JUSTICE Turnbull pressures ABC on tax coverage
Staffing gains at John Hunter
Mums matter, babies count
Seclusion and restraint forecast to decline
Your rights and entitlements at work Nurse Uncut – your stories What nurses and midwives said Nursing research online
p.31 p.36 p.37 p.39
THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION VOLUME 75 NO. 2 MARCH 2018
Under pressure, broadcaster censors reports on proposed company tax cuts.
TPP Zombie TPP hurts Australian job seekers
Malcolm Turnbull’s new TPP trade agreement gives six countries unlimited access to Australian jobs.
MENTAL HEALTH Seclusion and restraint forecast to decline
NSW government vows to implement findings of mental health care review.
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OUR COVER: Liz Featherstone, Anne Hazell, Kate Mathews and Sharon Lawler Photographed by Sharon Hickey THE LAMP MARCH 2018 | 3
The Edith Cavell Trust is now able to receive non-tax deductable donations/bequests. The Trust – named in honour of Edith Cavell – assists in the advancement of NSW nurses, midwives and assistants in nursing/midwifery through further studies and research, made available through scholarship. The knowledge and expertise gained by nurses, midwives and assistants in nursing/midwifery, supported by the Edith Cavell Scholarships, is an asset to the care of their patients and clients. Bequests to the Trust continue to support this important work. Edith, a British nurse serving in Belgium in WW1, is a hero to most nurses and midwives. She helped some 200 Allied soldiers escape from German-occupied Belgium. Her actions saw her arrested, accused of treason, found guilty by a court-martial and sentenced to death. Despite international pressure for mercy, she was shot by a German firing squad. NAME ADDRESS
BEQUEST/ DONATION AMOUNT
PREFERRED METHOD OF PAYMENT Electronic Fund Transfer Bank: Commonwealth Bank
Account name: Edith Cavell Trust BSB: 062-017 Account no: 10017908
Credit Card I authorise the Edith Cavell Trust (processed via NSWNMA) to debit my credit card for the amount of Mastercard
Name on Card Expiry Date
Signature of Cardholder
ALWAYS CURRENT. ALWAYS EVIDENCE-BASED.
Wolters Kluwer is honoured to partner with the Australian College of Nursing to localise the Lippincott Procedures content specifically for the Australian health care market. “We decided to partner with the ACN on this project because we share similar missions in seeking to provide health care professionals with the best available evidence to inform their practice. By using Lippincott Procedures Australia at point of care for clinical decision support, nurses and other health care professionals can provide the highest quality, evidence-based care to their patients, which means improving patient outcomes.” Anne Dabrow Woods, DNP, RN, CRNP, ANP-BC, AGACNP-BC, FAAN Chief Nurse of Wolters Kluwer, Health Learning, Research and Practice
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Visit our site and request a free trial http://lippincottsolutions.com/landing/procedures-aus Scan the QR code with your smartphone camera or APP 4 | THE LAMP MARCHaccess 2018 to our website. for instant
Holmes GENERAL SECRETARY
Let’s keep fighting for a better public health system Our successful campaign to stop the privatisation of five regional hospitals provides us with the inspiration to push on and improve our public health system. Maitland Hospital is to stay in public hands. Just like Wyong, Goulburn, Shellharbour and Bowral hospitals. How sweet that sounds! Sixteen months ago it looked like a very big mountain to climb when the then health minister Jillian Skinner announced the privatisation of those regional hospitals. But all credit to local nurses and midwives, other health staff and their unions and their local communities. They never took it lying down. Unity, commitment, hard work, perseverance, creativity: all were in abundance over the last 16 months as they fought tooth and nail to keep their hospitals public. Nurses and midwives’ engagement with the public and, in return, their wholehearted support was instrumental in the win. This is a critical lesson for us to absorb as we step up our efforts to extend and improve ratios throughout the public health system. Polls always show the public rank health among their most important issues. The last sixteen months has shown us they are prepared to go further and participate in our campaigns. Clearly, they cherish our public health system as much as we do. The community turned out in droves at all our anti-privatisation rallies. At our first rally at Wyong over 3000 packed the local football ground. There was also large public participation at Shellharbour and the other targeted hospitals. Over 35,000 people in Wyong signed
‘The public is our most powerful ally. The community’s willingness to stand together with us obviously had a powerful impact on the NSW government.’ our petition. More than 25,000 in Maitland did the same. The public is our most powerful ally. The community’s willingness to stand together with us obviously had a powerful impact on the NSW government which lead directly to the government backing down. I acknowledge Brad Hazzard, the current Minister, for his preparedness to listen to our members and the community. Stopping the privatisation of regional hospitals is a significant achievement and victory. But there are now other battles we must turn to if we are to maintain a world-class public health system. We need to maintain and build on this relationship with the public in our other campaigns, including for better ratios in the public health system and aged care. Of course the NSWNMA will be doing its utmost to inform the public of the importance of ratios to safe patient care. But there is also an important role for all nurses and midwives to play. Many, many people in the community know a nurse either as a friend or as family. We cannot underestimate how powerful and effective it is for nurses and
midwives to engage the people we know about our issues and how they impact on them as patients.
NEW OFFICE ACCOMMODATION UNDERWAY FOR THE ASSOCIATION In other news, for the past 14 months we have been exploring nearby sites to relocate our head office in order to best serve you and our growing membership into the future. Our current Waterloo premises now sit in an area which has been re-zoned by City of Sydney for high density residential redevelopment. Therefore, I am delighted to announce 9,000 square metres of new office space to be built within a new mixed-use commercial complex at 342 King Street, Mascot. Spanning four levels, the space is proposed to include a 500 seat auditorium, a library, member education rooms and meeting rooms. The project relates to a stratum above a hotel and will also comprise one level of basement parking in a multistorey carpark. A development application for the project is expected to be lodged this month with Bayside Council and I will continue to keep you informed as progress is made. ■ THE LAMP MARCH 2018 | 5
RELAX AND UNWIND WITH A THREE-NIGHT STAY AT
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SPECIAL OFFER – exclusive to NSWNMA! Make a booking during the month of March for a time of your choice (excluding NSW school holidays and public holiday long weekends) and you will receive 10% off your accommodation rate. Bookings can be made by contacting Mantra Aqua, Nelson Bay directly on (02) 4916 4777 or firstname.lastname@example.org. Mention the promotion code LAMP when making your booking.
WIN! The Lamp is offering NSWNMA members the chance to win three nights’ accommodation (Sunday to Thursday) in a selfcontained 2-bedroom pool-view apartment, valued at over $1,400. To enter the competition, simply provide your name, address and membership number and email your entry with the subject: Mantra Aqua, Nelson Bay to email@example.com
A little understanding goes a long way It seems to me that not enough facilitators are aware of mental health issues in students. I’ve seen a number of students on placement nearly in tears because facilitators are yelling at them and not listening. We need thick skins in our job, no doubt, but you never know what someone is going through and a little understanding goes a long way. I’ve had some great nurse educators and facilitators during my studies and I am hugely thankful for their help. I think the answer might be more awareness training around mental health issues that affect nurses as a whole group. Or maybe some students are just unlucky. Taylor Bradford, Student nurse
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6 | THE LAMP MARCH 2018
If there’s something on your mind, send us a letter and have your say. The letter of the month will WIN a gift card Membership essential to employment I would like to thank the NSWNMA for the recent discount to see the Carole King Musical, Beautiful. For $70 we sat in the second row of the musical. My non-nursing friends were impressed. This is the 2nd time I have seen it so, you can guess what I thought of such a beautiful musical. I have been working as a nurse since 1986. Now that I am a casual employee of NSW Health, I endeavour to follow correct policies but I get more complaints than compliments. My membership with NSWNMA has always helped me whenever I needed to write a statement. So while some people may think that the NSWNMA fees are expensive... I have always considered the membership essential to my employment. Jenny Yee, RN
SEND YOUR LETTERS TO: Editorial Enquiries EMAIL email@example.com fax 9662 1414 MAIL 50 O’Dea Avenue, Waterloo NSW 2017. Please include a high-resolution photo along with your name, address, phone and membership number. Letters may be edited for clarity and space. Anonymous letters will not be published.
More respect for ENs
Step it up, AHPRA
I know I’m not the first one to raise the issue of disrespect towards ENs, but it continues to be an issue. Hearing “TAFE isn’t as good as university” is disheartening, especially since I do a lot of the same basic care. My parents both work in healthcare and were a large influence in my decision to become an EN. I chose this career for the same reason many other nurses do: because I care a lot and honestly love helping patients. I’m looking forward to finishing my studies and I hope this perception of ENs being ‘lesser’ is done away with sooner rather than later. Brett Sutherland, Student nurse
Why is the AHPRA registration process so slow? I’m about to start as a new grad and first submitted my application in November to only just receive confirmation from AHPRA in mid-February. And only after I called them several times! There are other new grads who are in the same boat as me, but there are probably a lot of new grads who left it a little later and might not hear back in time before they need to start. Not to mention the horror stories I’ve heard where nurses have to jump through countless hoops to get reregistered. I appreciate it’s important to be thorough, but something needs to be done to speed up the process. My advice to anyone graduating is to submit your forms to AHPRA as early as possible. Emma Mees, Student nurse
Member Benefits THE LAMP MARCH 2018 | 7
Maitland Hospital to stay public Nurses win five out of five in battle to defend regional public hospitals
From left: Kate Mathews, Liz Featherstone, Anne Hazell and Sharon Lawler
lmost 18 months after it vowed to privatise five regional public hospitals, the NSW government quietly conceded the last facility – Maitland Hospital – would stay in public hands. In a news release on 25 January, Health Minister Brad Hazzard said: “After much consideration, we have decided on a public health-led approach for the brandnew Maitland Hospital at Metford.” “Some $5 million has been allocated in the 2017/18 State Budget and planning for construction will commence immediately.” His announcement marked the final victory of a union-led, community campaign that forced the government to abandon – hospital by hospital – its plan to have the five facilities privately built and operated. In 2016, former Health Minister Jillian Skinner said the government would call for private tenders to build and run more than $1 billion in hospital projects at Wyong, Goulburn, Shellharbour, Bowral and Maitland. Nurses and other health workers warned that privatisation would limit public access to care, degrade the quality of service, reduce staff conditions and restrict staff training opportunities. Labor and the Greens also strongly opposed any privatisation. 8 | THE LAMP MARCH 2018
OUR CAMPAIGN SWAYED THE GOVERNMENT Mr Hazzard acknowledged that community and staff opposition helped sway the government. ”It was put to me strongly that the community wouldn’t embrace a [non-public] hospital,” he told Fairfax Media. “Staff have to love where they are,” he added. Acting general secretary of the NSWNMA Judith Kiejda described the Maitland win as “a five from five victory. Five hospital privatisation backflips from the NSW Liberal–National Coalition”. “This is a very sweet victory for hundreds of nurses and midwives who work and live in Maitland and the surrounding areas. “It signifies the collective power of local workers, community members and health sector unions to achieve the best possible outcome when common sense prevails.
‘It was put to me strongly that the community wouldn’t embrace a [non-public] hospital.’ — Health Minister Brad Hazzard
‘This is a very sweet victory for hundreds of nurses and midwives who work and live in Maitland and the surrounding areas.’ — Judith Kiejda “From the outset, our members were steadfast in their opposition to a ‘public–private partnership’ or anything other than a publicly owned and operated new hospital to service their rapidly growing community. “We recognise the contribution of private health care and our members who work in it. But we are strongly opposed to our public health system being handed over to private operators.” Judith said branch members never wavered despite former Maitland MP Robyn Parker and former Health Minister Jillian Skinner continually ignoring their concerns about patient safety and the delivery of public health services under a hybrid model. “As advocates for safe patient care and a robust public health system, local nurses and midwives knew they had a professional obligation to speak up on behalf of the Maitland community. “They continued to lobby for a publicly built and run, new state-of-the-art hospital.”
PETITION COLLECTS 25,000 SIGNATURES Labor MP for Maitland Jenny Aitchison said she never doubted the campaign to stop privatisation would succeed. “We had a petition with 25,000 signatures . . . 25,000,” she told The Maitland Mercury. “Everywhere I went people were telling me to keep fighting, so I did. “Besides, when a hospital isn’t government funded, so many grey areas arise. What happens to things like assisted dying – whatever your views are on that – or IVF, or sterilisation … suddenly you have a bottom line, profits and losses that come into the equation. “And what about staffing levels? The public sector has set nursing ratios that must be adhered to, but the private sector just says staffing must be ‘adequate’. Who determines adequate?” She said the new hospital would be “a resource that everyone in the community owns; it will work better for the whole Hunter–New–England Health system”. “We won’t lose those government-backed jobs, we’ll be able to maintain ratios for staffing, we’ll have accountability in terms of reporting. It’s a really good outcome.” ■
How the privatisation dominoes fell It took a lot of hard campaigning but after sixteen months the state government’s move to gift five regional hospitals to private operators has been decisively stopped in its tracks. 15 SEPTEMBER 2016 Health Minister Jillian Skinner announces an Expression of Interest (EOI) process for non-government hospital operators to build and operate five regional hospitals: Wyong, Goulburn, Shellharbour, Bowral and Maitland.
14 OCTOBER 2016 EOI submissions close. Mrs Skinner
describes the response from private operators as “excellent”.
21 OCTOBER 2016 As Goulburn nurses and community members plan a big public protest, Mrs Skinner announces that Goulburn Hospital will remain public. Privatisation plans for the other four hospitals will “progress to the next stage”. 6 JULY 2017 New Health Minister Brad Hazzard says Wyong Hospital will also stay in public hands with a $200 million redevelopment. The announcement follows months of community campaigning. About 35,000 people sign a petition and more than 3000 attend rallies, forums and vigils. “There has never been a local issue that has galvanized our community so much,” says the Labor MP for Wyong, David Harris. 7 JULY 2017 Bowral Hospital is the next privatisation
domino to fall. Mr Hazzard announces it will stay public with a $50 million upgrade. “After consultation with representatives of the local community and medical staff, we have decided on a government-led approach for this significant upgrade,” he says.
27 OCTOBER 2017
Shellharbour Hospital becomes the fourth facility to be saved from privatisation thanks to a powerful joint campaign by the NSWNMA, other unions and community groups. Minister Hazzard says a $251 million redevelopment will begin in 2018 and thanks Shellharbour Hospital staff and the local community “for working with us as we considered redevelopment plans”.
25 JANUARY 2018 It’s five out of five as the government drops its plan to privatise the last remaining regional hospital, at Maitland. “After much consideration, we have decided on a public health-led approach for the brand-new Maitland Hospital at Metford,” Mr Hazzard says.
THE LAMP MARCH 2018 | 9
Nurses drive united hospital campaign The battle to save Maitland Hospital brought unions and the community closer together.
ane Burton and Liz Featherstone were on afternoon shift in Maitland Hospital’s surgical ward when a NSWNMA text message told them they had won the fight to keep their public hospital. “We were excited and elated,” said Liz, the hospital’s NSWNMA branch delegate. “The whole ward knew within a few seconds and all the patients were rapt too.” Jane, the NSWNMA branch president, said the news “lifted the mood throughout the whole hospital. Everyone was so excited and relieved that we will be able to continue our careers and care for our local community in a public hospital”. “It was fabulous news after a long, hard battle to get what our community needs and deserves.” Jane said it had been a privilege to work with other unions and community members in the campaign, which collected 25,000 signatures on an antiprivatisation petition. “Our joint work has set a precedent for closer cooperation between union and community groups on health care issues down the track. “I think the nurses’ passion for providing decent health care for our community helped drive everyone forward.”
GREAT SUPPORT FROM OTHER HOSPITALS She said Maitland nurses received “great support’ from nurses in other hospitals – in particular, Wyong, Goulburn, Shellharbour and Bowral hospitals. 10 | THE LAMP MARCH 2018
‘I think the nurses’ passion for providing decent health care for our community helped drive everyone forward.’ — Jane Burton “ W he n t ho s e ho s pit a l s s uc c e e de d in stopping privatisation it helped to propel our own campaign. “Nurses from those hospitals helped us with ideas for actions that had worked for them in their communities and quite a few attended our rallies and meetings. “We never felt as if we were standing alone.” Jane says the campaign’s success has empowered locals to get more involved in community groups. “It has helped to unite the community and brought people in who were not very active in the community. “It has also strengthened our ties with outlying areas that send patients to Maitland – places like Cessnock, Dungog, Kurri Kurri, Muswellbrook, and Taree.”
Maitland community members celebrate the retention of their local hospital in public hands with local nurses and midwives and NSWNMA Acting General Secretary Judith Kiejda. Jane said nurses would continue to work to ensure that the new Maitland Hospital is adequate for the expanding community. “A new clinical services plan is being developed and we want to ensure we get an opportunity to have some input.” Liz said the people of Maitland now “feel more secure in their health needs”.
COMMUNITY VITAL TO SUCCESS She said a campaign highlight was the combined union delegation to meet Health Minister Brad Hazzard at parliament house. “We came armed with facts and we were able to counter the minister’s arguments,” she said. “We pointed out that our community is one of the poorest in the state and also the fastest-growing. New subdivisions are being built and young families are moving to the area every day because there is now easier road access to Sydney and land is cheaper. “The new hospital will be built two blocks from an existing private hospital and it didn’t make sense that you would duplicate private services while abolishing a public facility. “We were due to meet for 45 minutes but the minister extended the meeting and listened to what we had to say. “I walked out thinking, we’ve got this. We all felt we had done a good job to convince him of our case.” Liz said the community element of the campaign was
‘We came armed with facts and we were able to counter the minister’s arguments.’ — Liz Featherstone
vital to its success. “Community members came to all our rallies and meetings, helped us to collect signatures and came with us to Sydney to present the petition. “Local businesses were happy to put our notices in their windows.” She said the campaign has “revitalised” Maitland’s NSWNMA branch. “A lot more people are coming to branch meetings and speaking out more. At the same time, we have stronger relations with other unions in the hospital.” ■
THE LAMP MARCH 2018 | 11
Staffing gains at John Hunter Nurses and midwives at John Hunter Hospital in Newcastle win a breakthrough in a long-running staffing dispute.
MANAGEMENT AGREE TO LIKEFOR-LIKE REPLACEMENTS
he NSWNMA and Hunter New England Local Health District management have reached consensus on several staffing and policy issues following four months of discussions overseen by the NSW Industrial Relations Commission. Acting General Secretary of the NSWNMA, Judith Kiejda, said the outcomes were “a win for hundreds of nurses and midwives who have been hammered by safe staffing and workload concerns for many months”. Dav id P fa n ner, NSW NM A bra nch v ic e pre sident a nd delegate at John Hunter, said the branch had developed a good working relationship with the hospital executive. “Management appear to be making a serious effort to settle outstanding issues,” he said. “We were holding week ly meet ings of t he Rea sonable Workloads Committee to sort things out. “We have now reverted to monthly meetings but management say they are happy to meet more often if we think it’s needed. “The chief executive of the LHD is now on board with what we are doing and Commissioner Stanton (from the Industrial Relations Commission) said it was great to see management and union working together to solve problems.” He said management had abandoned its policy of prioritising 12 | THE LAMP MARCH 2018
He said management had also changed its policy on replacing unplanned leave. “Too often in the past an absent registered nurse would be replaced by someone of a lower classification such as an assistant in nursing. “This practice puts a lot of pressure on senior nurses who are trying to manage their own clinical workload while assisting lower-classification nurses with their patients.
‘Management appear to be making a serious effort to settle outstanding issues’ — David Pfanner follow-up phone calls to discharged patients over the care of inpatients. “The new procedure is that if we can’t reach a discharged patient after two attempts we do not have to keep calling. Also, follow-up calls no longer take precedence over urgent patient care or when we have a heavy workload. “Follow-up phone calls are important but they should not be allowed to reduce the alreadylimited time available to care for in-patients.”
“Management have now agreed to make every effort to achieve ‘like for like’ replacements including use of overtime. “If they cannot do so they must fill out forms to show what steps they have taken to find a like-forlike replacement.” David said the branch hoped to soon reach agreement on the staffing of close observation beds and the use of ‘specials’, or one-toone nursing care, which has often left wards effectively short staffed. He said management were making genuine efforts to fill vacancies but experienced staff were often hard to find. “We have had a lot of problems finding experienced staff to fill vacancies especially in areas like theatre and midwifery.” The branch wrote to management in June last year outlining concerns relating to patient and staff safety
More than 200 nurses and midwives attended a protest meeting outside the hospital late last year and more than 250 staff voted almost unanimously in favour of a ban on follow-up discharge phone calls. across the facility. Concerns included the opening of unfunded and understaffed beds, forced excessive overtime, sick leave not being replaced, an excessive use of under-qualified staff, missed meal breaks and unpaid overtime. After trying unsuccessfully to resolve issues through the Reasonable Workloads Committee the union took action under the Industrial Relations Act to obtain hospital data that would reveal the extent of understaffing. The data showed that the LHD repeatedly failed to staff wards and units according to the minimum six nursing care hours per patient, per day, as set out in the Public Health System Award. As a result, John Hunter patients missed out on 6,695 hours of nursing care from late December 2016 to July 2017.
‘A win for hundreds of nurses and midwives’ — Judith Kiejda More than 200 nurses and midwives attended a protest meeting outside the hospital and a secret ballot of more than 250 staff voted almost unanimously in favour of a ban on follow-up discharge phone calls. David said the branch had to agree to lift the ban in order for the commissioner to hear the union’s case. “However, the ban had an enormous impact in terms of showing management how serious we were about getting a solution to the problems.” He said John Hunter members had “terrific support from union
head office staff, organisers and officials” who spoke at meetings, argued the nurses’ case in the media, took the issue to the commission and negotiated with top management. “General Secretary Brett Holmes had a big impact when he went on TV to explain how the LHD deliberately breached the award by not rostering and recruiting the necessary staff. “He explained to the public how patients were being cheated out of the nursing hours they were legally entitled to and how nurses had to work harder as a result.” David said the branch came out of the dispute in a stronger position. “Some of our branch meetings attracted 150 people and we picked up quite a few new members. ‘The hospital recently had its biggest ever intake and almost all of them joined the union.” ■ THE LAMP MARCH 2018 | 13
Mums matter, babies count Midwives at Royal North Shore Hospital have run an innovative campaign to educate the public about the need for appropriate staffing levels in birthing wards.
orrine Cakebread has worked as a midwife for more than 15 years. Over that time she has seen increased numbers of mothers and babies with complicated health needs coming into the wards. “We get a lot more women with complex health issues now. More women are being induced earlier,” she says. There are a number of factors that have changed the birthing environment: the rising numbers of older mothers, more IVF births to women with complex health histories and higher rates of gestational diabetes. Babies being born at 35 weeks are now being cared for in regular maternity wards, rather than in intensive care. But these increasingly complex care needs haven’t been matched with increased staffing levels says Corrine, a registered nurse and midwife at the Royal North Shore Hospital. “We have the same level of staffing, the same hours as when I started,” she said.
FIGHTING TO GIVE MOTHERS BETTER CARE After a couple of near misses last year, Corrine and other midwives worked with the union to create a campaign called ‘Mums Matter, Babies Count’. The campaign slogan highlights both the staff’s desire to give every mother the best possible care, and to improve Birth-rate Plus®, which currently doesn’t count babies as patients, a key issue for calculating appropriate staffing levels. NSWNMA Acting General Secretary Judith Kiejda says, Birth-rate Plus®, can be a clunky tool for calculating appropriate staffing numbers.
‘Babies need to be cared for too, and embedded in Birth-rate Plus® is the assumption that babies don’t count as patients.’
The RNSH’s birthing ward – which also takes referrals for complicated cases from surrounding regions – averages 220–230 births per month. “We don’t get the time to help everyone who needs help,” Corrine says.
Compounding the problem is the pressure to “discharge babies earlier than ever means that many are coming back and being treated for jaundice”. As a long-time union member, Corrine was happy to pay her fees knowing the union was representing nurses and midwives in the workplace. But last year Corrine’s growing concerns about patient safety led her to become active in the union for the first time. 14 | THE LAMP MARCH 2018
“At the end of the day, if something happened to one of our patients it comes down to the midwife looking after the mother and baby and the team leader. And that is a huge responsibility. I was concerned that something would have to happen before something changed.”
“When our organisers f i r s t s at dow n w it h RNSH staff to discuss staffing levels and workload pressures, midw ives were crying. They were devastated they couldn’t provide the kind of holistic, woman-centred care they would like to,” she said. Corrine explains that unlike nurses, who can have a four-to-one patient-nurse ratio, midwife loads can be much higher. “On a good day you have five women to look after. On occasions there can be one midwife for up to eight mothers. But babies need to be cared for too, and embedded in Birth-rate Plus® is the assumption that babies don’t count as patients.” She says management have been making up staffing shortfalls with assistants in midwifery (who are usually student midwives) but they are
still learning and can’t be expected to do observations. “Some babies [born pre-term or to diabetic mothers] need their blood sugar levels monitored for at least 24 hours,” Corrine says. “The only people who can do that are midwives.”
Corrine has seen some small improvements in staffing levels since their action started, but more needs to be done. “We would like at least five midwives on the maternity ward and at least five on the birthing unit every night.”
For Corrine, the bottom line for safe staffing levels is that “anyone who walks onto that ward should be able to resuscitate a neonate or a mother”.
As part of the campaign, RNS midwives counted missed meal breaks: they found 96 missed meal breaks on the birthing unit over two weeks.
In the post-natal ward, midwife shortages are being filled with RNs, who can’t be expected to have the expertise to get a woman breastfeeding correctly, Judith says.
“Midwives will work through their lunch; we are not going to leave a birthing mother,” Corrine said.
“When baby and mother thrive, readmissions rates are lower.”
TALKING TO THE COMMUNITY Last year Corrine and other midwives, with NSWNMA support, met with the hospital’s reasonable workload committee to discuss possible solutions, including increased ward clerk hours and changes in ward layout. While the committee was sympathetic, when the midwives’ concerns were put to management they “fell on deaf ears”. As part of the campaign, they also held a rally outside the hospital last October. “Some of the doctors came and supported us,” Corrine says. “We’ve also been wearing ‘Mums Matter, Babies Count’ badges, and talking to mothers and visitors when they ask us about it.”
Judith Kiejda says midwifery shortages are impacting maternity units everywhere, with the units at the RNSH down the equivalent of 15 FTE, while at least 40 FTE positions are missing at Westmead. She says long-term issues still remain unresolved in Wollongong Hospital maternity unit. Corrine is a lso concerned that the work pressures are making it harder to retain new midwives coming through. “We have at least 10 student midwives coming through every year. We don’t get the chance to educate them the way we should educate them. My fear is so many of our midwives are going to leave because they don’t get the support they need.” She’s worried she doesn’t have time to sit long enough with mothers either as she bounces between patients. “The main thing for me is trying to make sure we are working in a safe environment for staff and patients. That is our aim in having babies count.” ■ THE LAMP MARCH 2018 | 15
Solutions sought on nurses’ housing The NSWNMA is pushing for an affordable housing development levy, charged to developers in the City of Sydney, to be extended to five other local government areas.
he NSWNMA is working on a number of fronts to tackle the growing problem of hou si n g affordability for nurses. These initiatives aim to link nurses on moderate incomes to high quality housing developments at below market rents. At our la st t wo a nnua l conferences, members passed resolutions asking the NSWNMA to lobby government to improve renters’ rights, rental security and affordability, and to work with councils and community groups to work towards solutions to the housing affordability crisis in NSW. NSW NM A Act ing G enera l Secretar y Judith Kiejda says the NSWNMA has been acting on these resolutions. Earlier this year the Association wrote a submission to the NSW government supporting a plan to expand an affordable housing development lev y charged to developers in the City of Sydney area to five more local government areas. It has also been working to link nurses and midwives up to housing providers such as City West Housing that rent properties fixed at 25 per cent to 30 per cent of a tenant’s income. As well, the Association has also been working closely with NSW Federation of Housing Associations, an organisation which represents 16 | THE LAMP MARCH 2018
‘Government needs to see housing as something that is as important as transport, and put money into subsidising building so rents can be lower for a wide range of workers, including nurses and midwives.’ Wendy Hayhurst, NSW Federation — of Housing Associations community housing providers and advocates for greater government support of community housing. “The demand for health workers is growing all the time, and new developments such as the Northern Beaches Hospital will only add to the need for nurses in areas where housing has become increasingly unaffordable,” said Judith. A recent analysis of census data conducted by The Sydney Morning Herald found that, on average, nurses live 27 km from the CBD. While Randwick is home to the largest group of nurses and midwives (628), large numbers of nurses are also living in areas further from the CBD, such as Blacktown, Baulkham Hills and Castle Hill.
The health and social assistance sectors are the biggest employers in NSW, accounting for one in eight jobs, but wages in the sector aren’t keeping up with the increasingly high cost of housing, Judith said. “Last year we conducted a survey of members and found that 36 per cent have changed jobs and relocated because of housing affordability. Almost half of the members who responded to the survey indicated they are prepared to change jobs to live in a more affordable area.”
COMMUNITY HOUSING IS NOT A HAND OUT Wendy Hayhurst, the CEO of the NSW Federation of Housing A ssociations told The Lamp that while community housing
Community housing properties are of an extremely high quality, equivalent to some of the best properties available on the commercial market. in Australia was still “relatively small in scale compared to some other countries”, the organisations they work with provide homes of high quality. “It just looks like ordinary housing and is often in developments where other tenants own or pay market rental rates.” “It is not a hand out. It is the kind of housing that should be available for different points of your life, for example when you are a woman who suffers a relationship breakdown or retires from work.” Wendy says government needs to “see housing as something that is important as transport, and put money into subsidising building so rents can be lower for a wide range of workers, including nurses and midwives”. Government needs to support infrastructure for workers who have “skills that are in demand that they can take elsewhere,” she added. Wendy says that by 2020 the stock of community housing will increase by 2,700 new homes across NSW. This will add to the 38,000 community housing properties currently owned and managed by registered providers. Judith says the NSWNM A will continue to work closely with providers such as City West Housing and advocacy group’s such as NSW Federation of Housing Associations to ensure that nurses have access to many of these properties. ■
What does social, community and affordable housing mean? The terms ‘social’, ‘community’ and ‘affordable’ housing are often confused and are sometimes used interchangeably, but they usually mean different things. Housing is generally considered to be affordable if the household members are not in housing stress after they have paid for their housing, irrespective of whether they are renting or buying. There are a number of measures of affordability. One of the most widely used is that a low-income or moderate-income household should not pay more than 30 per cent of their gross income on housing. Affordable rental housing is rental housing and refers to a form of housing for low–moderate income households where the rent is set at a proportion (e.g. 75 per cent or 80 per cent) of the rent that would normally be charged for the property in the private rental market. This distinguishes it from social housing which is targeted to very low-income households and where the rent is usually set as a proportion of the tenant’s income.
Community housing provides affordable rental housing to people on low to moderate incomes. In some developments, community housing can exist alongside properties where tenants own or pay market rent, and the community properties will look indistinguishable from these other kinds of properties. Community housing can cater to a range of different people, from those with high needs, to people on moderate incomes. A ‘moderate income’ can be defined as anything up to 120 per cent of the median income. For more information visit: https://shelternsw.org.au/
Tell us your housing story We want to hear from nurses and midwives about how the cost of housing is impacting on you personally and how it affects your professional roles. Send your story to: firstname.lastname@example.org
THE LAMP MARCH 2018 | 17
NSWNMA backs affordable housing for essential workers Nurses need affordable housing close to where they work in order to deliver healthcare where it is needed.
n January this year the NSWNMA made a submission to the NSW state government supporting the extension of an affordable housing policy to five new councils: Randwick City, Inner West, Northern Beaches, City of Ryde and City of Canada Bay. The Department of Planning and Environment is currently reviewing its SEPP 70 scheme, a policy that operates in the City of Sydney local government area. The proposed changes would ensure new residential developments in these council areas include affordable housing. The scheme works by charging developers a levy which is then used to help fund a range of affordable housing options. “The NSWNMA strongly supports a draft proposal to extend the policy to these five new councils,” said Judith Kiejda. The NSWNMA’s submission says a lack of affordable housing close to workplaces is impacting on nurses’ and midwives’ ability to be available to deliver healthcare where it is needed. Long commuting times are also impacting nurses’ health and relationships. “There are many public and
18 | THE LAMP MARCH 2018
‘Moderate income earners in key occupations, like nurses and midwives, are also priced out of many of these areas.’ — Judith Kiejda private hospitals and aged care facilities in the councils to be included in proposed new SEPP 70 policy. We know that many of our members are struggling to find affordable housing in these areas,” Judith said. The NSW NM A submission notes that: • Randwick City Council’s research has found the Children’s Hospital and the Royal Hospital for Women in Randwick have difficulty filling specialist nursing vacancies due to nurses being priced out of living in the area. • The Northern Beaches Council has found that the health and social assistance job sector will be the fastest growing sector across the Northern Beaches over the next 20 years, and the opening of the
Northern Beaches Hospital will significantly increase demand. • C oncord Hospital is the highest employer in the local government area, and the council anticipates an increase in the number of health care, education and social service sector jobs in Sydney over the next 30 years. “The changes proposed to the SEPP 70 rightly supports affordable housing policy for low and very low income earners,” Judith said. “But the NSWNMA’s submission also strongly supports including moderate income earners as eligible for affordable housing, recognising that moderate income earners in key occupations, like nurses, are also priced out of many of these areas.” ■
Nurses and midwives can be eligible for community housing The NSWNMA has been working to connect eligible nurses and midwives with City West Housing, an awardwinning community housing provider that provides affordable rental housing in the City of Sydney Local Government Area. CWH owns and manages over 700 apartments of between one to three bedrooms. To be eligible to apply, you need to: • live or work in the City of Sydney LGA • have a household income of under $101,400 • n ot own assets that could solve your housing needs •b e a permanent resident of Australia and • be currently living in inadequate housing – this includes unaffordable housing. CWH charges rents that are set at between 25 per cent and 30 per cent of your household income. The properties are of an extremely high quality, equivalent to some of the best properties available on the commercial market. Their aim is to provide access to housing at a price level that is affordable to low-to-moderate income earners. City West Housing’s priority is to match working households with affordable rental housing, thereby enabling tenants to sustain employment. The properties are funded by a levy charged to private developers and are based in Pyrmont, Ultimo, North Eveleigh and the Green Square precinct, with five new projects in the pipeline due for completion by 2023.
Living in a share house at 61 Affordable housing should be a part of a safety net that protects people from life’s vagaries and misfortune. Nurse Lou Housego owned three different properties during her marriage, but when domestic violence led to her divorce a decade ago she was left without assets and a $100,000 debt. Lou is now living in a share house and she thinks she will have to work and live in insecure rental accommodation “forever”.
Although she would prefer to work in palliative care or theatre, Lou is now working as an outpatient nurse at John Hunter Hospital and living in a share house, which she says is “far from ideal”. Lou has found renting an incredibly insecure option, with most leases lasting “six months”. If they extend the lease, landlords often raise rents. As she ages and deals with health issues, getting permanent part-time work “is getting harder and harder”. There are fewer work options in rural areas, but it is “out of the question to rent in Sydney”. “I hear of people travelling
‘I have got nursing friends who house sit while they take jobs around the country.’ “I got here by way of a domestic abuse situation which left me homeless,” says Lou, who raised three children while working as a nurse from 1974. “We had three properties, my husband was an accountant and the Family Court saw fit to leave him with all the assets. “Twelve months after I left I found that he put a tax debt in my name and I had to pay this off too. You don’t have any money to fight these things.” Sixty-one-year-old Lou has been taking contract jobs in Tasmania, Victoria and in rural NSW, “which sometimes give you accommodation as part of the contract”.
two hours to get to their jobs in Sydney because they can’t afford to get any accommodation nearby.” Lou says she sees many other nurses in the same situation as her. “I have got nursing friends who house sit while they take jobs around the country.” Lou wants to see more done to ensure affordable housing for essential services workers. “You also need security of tenure in rental accommodation”, she adds. “Secure leases of up to five years, as in some other countries, would be good.” ■
THE LAMP MARCH 2018 | 19
Turnbull pressures ABC on tax coverage
Under pressure, broadcaster censors reports on proposed company tax cuts.
BC management censored a news report and analysis criticising the Coalition government’s proposed company tax cuts after complaints from Malcolm Turnbull and three government ministers. The articles by the ABC’s chief economics correspondent, Emma Alberici, cast doubt on the government’s plan to give $65 billion in tax cuts to Australia’s biggest companies. Turnbull, communications minister Mitch Fifield and treasurer Scott Morrison all wrote letters of complaint to ABC managing director Michelle Guthrie. Fifield’s letter to Guthrie said Alberici’s coverage was “neither fair, balanced, accurate nor impartial. It fails to present a balance of views on the corporate tax policy”. Turnbull and his finance minister, Mathias Cormann, also attacked Alberici’s coverage during question time in parliament. Her news report revealed that one in five of Australia’s top companies paid zero tax for the past three years. The ABC rewrote and reposted the report following the government’s complaints.
ONE IN FIVE COMPANIES PAY ZERO TAX In her analysis accompanying the news report, Alberici said there was no case for a corporate tax cut when one in five companies did not pay tax. She warned that a major company tax cut would “blow a massive hole in the government’s revenues and push the budget and national debt further into the red.” “It’s been 10 years since the Australian budget was last in surplus. With a debt of more than $600 billion, many are questioning the merits of prioritising a $65 billion giveaway to big business in the form of a tax cut.” The ABC said it removed this analysis from its website because it “did not meet editorial standards”. The Guardian Australia newspaper reported that ABC News management was in “crisis meetings” for two days after the government’s attack. The ABC claimed however, that, “Any suggestion the ABC is responding to outside pressure over these stories is incorrect.” Tax cuts for big business are the centrepiece of the government’s economic policy. It argues that lower company tax will lead to more investment, more jobs and higher wages.
20 | THE LAMP MARCH 2018
FOREIGN COMPANIES THE WINNERS FROM TAX CUTS In the article taken down from the ABC website, Alberici noted that government ministers repeatedly claim that Australia’s “headline” or top corporate tax rate of 30 per cent will push companies to invest in other, lower taxing countries. However, “the facts don’t bear that out” Alberici wrote. “Business investment in Australia has been at historically high levels over much of the past decade despite our comparatively high headline corporate tax rate.” “In truth, businesses make decisions about where in the world to park their money based on myriad reasons, possibly least of which is the headline corporate tax rate. “The principal beneficiaries of a cut in Australia’s corporate tax rate are overwhelmingly foreign companies and foreign shareholders in Australian companies. “There is no guarantee at all that cutting the tax they pay in Australia will lead them to increase the level of business investment in Australia.” Alberici said investment decisions were driven by the effective tax rate not the headline rate. She noted that according to a report published last year by the US Congressional Budget Office, Australia’s effective tax rate, at 10.4 per cent, is among the lowest in the world. Effective tax rates take account of what companies actually pay once deductions, depreciation and other tax minimisation strategies are considered. Few companies pay anything like a 30 per cent tax rate “thanks to tax legislation that allows them to avoid paying corporate tax”. ■
Make up your own mind You can still read Emma Alberici’s censored article online: There’s no case for a corporate tax cut when one in five of Australia’s top companies don’t pay it https://johnmenadue.com/emma-alberici-theres-no-casefor-a-corporate-tax-cut-when-one-in-five-of-australiastop-companies-dont-pay-it/ Why many big companies don’t pay corporate tax http://www.abc.net.au/news/2018-02-14/why-many-bigcompanies-dont-pay-corporate-tax/9443840
Tax cuts won’t flow to workers
Shareholders and CEOs will pocket the benefits from lower corporate taxes.
The Turnbull government claims that giving the country’s biggest companies a tax cut will lead to higher wages for employees. However, there is “no compelling evidence” for this claim, wrote Emma Alberici in her censored ABC analysis. “Since the peak of the commodities boom in 2011–12, profit margins have risen to levels not seen since the early 2000s, but wages growth has been slower than at any time since the 1960s,” she said. Qantas chief executive Alan Joyce is a leading advocate of the government’s tax cut plan. But Qantas has not paid any tax for 10 years and “has already indicated an intention to invest $3 billion across 2018 and 2019 regardless of where the corporate tax rate sits”. Alberici said the overwhelming benefit of higher profits flows to shareholders, not the bulk of employees. “A zero corporate tax bill at Qantas has certainly seen one significant wage rise at the company – the chief executive’s. The benefit to workers has been less pronounced. “According to the Australian Services Union, representing just under half of all Qantas workers, the average pay rises for staff since the airline has returned to profitability have barely kept pace with inflation. “Alan Joyce, on the other hand, has seen his total salary close to double from $12.9 million in 2016 to $24.6 million last year, thanks to a huge jump in the value of shares provided as part of a bonus scheme.”
STEALING FROM THE PUBLIC PURSE
Pre-tax company profits and wages In Australia, excluding bank, insurance, education, training, healthcare and social assistance sector profits
Has corporate tax avoidance led to a culture which poses the question: “Can we get away with it?”
Pre-tax profits* % change from year earlier 70
Revelations of corporate greed have fuelled growing public anger over company tax dodging in recent years. Almost two years ago, The Lamp reported that Australia lost $5.37 billion to corporate tax dodging by just 76 foreign multinationals in 2013 and 2014. According to researchers at the University of Technology, Sydney, these corporations paid an average effective tax rate of just 16.2 per cent, compared with 24 per cent paid by the average nurse. “To put this in perspective, these 76 corporations stole enough money from the public purse to restore $650 million ripped from Medicare, $1 billion from aged care, $500 million from Indigenous services, $240 million from the Rental Affordability Scheme – with $2.4 billion in spare change,” said GetUp, an independent community campaign group, that commissioned the research. “Corporate tax dodgers have been robbing our local schools, hospitals and communities for decades.” In May last year The Lamp reported that multinational gas producers are paying minimal tax while our hospitals are starved of funds. We quoted a report by the McKell Institute revealing that under the Petroleum Resources Rent Tax (PRRT), offshore gas producers pay minimal tax on the profits they make. Major petroleum companies “poorly compensate the Australian public for the publicly owned resources they are extracting and selling for profit,” the report said. ■
Wage cost index** % change from year earlier 5.0
35 3.0 18 2.0
01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17
Source: ABS business indicator and wage price index *Pre-tax profits on 4-quarter moving average. ** Wage cost index is lagged 3 quarters.
Poll results from Thomson Reuters Financial Crime Conversation (Tax: The Final Frontier)
THE LAMP MARCH 2018 | 21
CALLING ALL RUNNERS, WALKERS & VOLUNTEERS JOIN US ON SUNDAY 13 MAY FOR THE
Early bird rates until 17 April Save up to $10 per registration
The Mother’s Day Classic, held on Sunday 13 May, is a national fun run raising money for the National Breast Cancer Foundation. The NSWNMA will be showing its support by once again sponsoring the water stations at The Domain and Parramatta Park, Western Sydney and by entering an NSWNMA Team. You can come along and be part of the team by volunteering to hand out water and refreshments on the day at The Domain or Parramatta Park events or by joining the NSW Nurses & Midwives’ Association team as we make our way around The Domain, Parramatta Park or any of the events held across NSW. We would love to see as many members and their families join our team either running, walking or volunteering at the water stations.
VOLUNTEERS NEEDED 22 | THE LAMP MARCH 2018
JOIN THE NSWNMA TEAM Register and nominate the NSWNMA as your team by Thursday 12 April and receive an NSWNMA team running shirt for the day. TO REGISTER: 1 Go to www.mothersdayclassic.com.au/register 2 Enter your details and select the event and race 3 When prompted with the page asking if “you would like to join a team” select YES 4 Search and select our team name – NSW Nurses & Midwives’ Association using team password NSWNMA if prompted. * To be eligible for the team running shirt, please register by 12 April.
Volunteer to assist at the NSWNMA Sponsored water stations. If you are keen to volunteer handing out water and refreshments on the day at the Domain or Parramatta events, please contact Miriam Galea at email@example.com to register your interest.
Zombie TPP hurts Australian job seekers Malcolm Turnbull’s new Trans-Pacific Partnership trade agreement gives six countries unlimited access to Australian jobs.
he Turnbull government has agreed to a revived Trans-Pacific Partnership (TPP) trade deal that will allow employers to import “temporary” workers from at least six countries without first advertising jobs to Australians. The TPP will allow unlimited access to workers from Canada, Mexico, Chile, Japan, Malaysia and Vietnam in 435 occupations. The peak union body, the ACTU, has strongly criticised the move. “This agreement will allow employers to overlook local workers for good steady jobs like nurses, engineers, electricians, plumbers, carpenters, bricklayers, tilers, mechanics and chefs,” said former ACTU President Ged Kearney. “In regional areas where youth unemployment is at crisis point this is simply unacceptable.” She said the failure to make companies test whether local workers were available for jobs would permit the “wholesale exploitation of migrant workers, while also tearing the bottom out of the domestic labour market”. Labor’s shadow trade minister, Jason Clare, told The Guardian newspaper that Australians “hate” jobs going to migrants “without first checking if there is an Australian who can do that job”. “Turnbull should put Australian workers f irst a nd reinstate labour market testing in the TPP for those countries.” Labor policy is that, if elected, it would conduct independent modelling of the costs and benefits
‘Turnbull should put Australian workers first and reinstate labour market testing in the TPP for those countries.’ — ALP spokesman Jason Clare of every new trade agreement before signing, including the effect on jobs.
A SECRET TILL IT’S SIGNED The TPP was thought to be dead after President Donald Trump pulled the United States out of the agreement last year. But the Turnbull government lobbied to keep the TPP alive and 11 countries agreed to a new deal without the US last November. However, the text of the agreement has remained secret. The Sydney Morning Herald’s economics editor, Peter Martin, highlighted this secrecy when he asked: “What’s in the revised Trans-Pacific Partnership deal for Australia? There’s no way to tell until we’ve seen the text, and we won’t see it until after it’s signed, in Chile on 8 March.” Martin said the TPP would allow foreign companies to sue Australian governments in extraterritorial tribunals if they took decisions that harmed their commercial interests – “as Philip Morris did over Australia’s tobacco plain-packaging laws using the terms of an obscure Hong Kong investment agreement”. “John Howard successfully resisted having them in the US-Australia agreement and the Abbott government managed to
avoid them in the Australia–Japan agreement, but we have apparently agreed to them now, for Japan, Korea and eight other nations. “The best guess as to what the trade and investment concessions do for Australia financially, from the respected Peterson Institute, is ‘not much’. Australia’s national income would eventually be 0.5 per cent higher, a gain of less than half of onetenth of a per cent per year.” The new TPP also contains a “state-owned enterprises” provision, which allows foreign companies to take legal action for damages if public enterprises present “unfair competition”. Dr Patricia Ranald, convener of the Australian Fair Trade and Investment Network (AFTINET) says the TPP would also restrict Australian governments from re -reg ulat ing essent ia l services like energy or financial services, despite demonstrated market failures. “As usual, the government has released only positive information about possible market access gains from the deal, but the full text of the changes is not available for public scrutiny. The full text will only be released in March at the time of the signing of the deal,” she said. ■ THE LAMP MARCH 2018 | 23
Seclusion and restraint forecast to decline NSW government vows to implement findings of mental health care review.
he state government expects the use of seclusion and restraint in acute mental health units and emergency departments (EDs) to decline after it implements a review panel’s recommendations. The government has accepted all 19 recommendations aimed at preventing the “inappropriate” use of seclusion and restraint. The review was led by the state’s chief psychiatrist, Dr Murray Wright. Other members of the review panel were: • Ms Karen Lenihan, Principal Official Visitor • Dr Kevin Huckshorn, CEO, Huckshorn and Associates, a US a behavioural health consulting business • M s Julie Mooney, Executive Director, Nursing and Midwifery, Southern NSW LHD • Dr Robyn Shields, Deputy Commissioner, NSW Mental Health Commission • T he late Ms Jackie Crowe, Commissioner, Australian Mental Health Commission (consumer representative). “Seclusion and restraint incidents have been gradually declining since 2011 and once we begin implementing the review’s recommendations, we expect this trend to accelerate,” said Minister for Health Brad Hazzard and Minister for Mental Health Tanya Davies in a joint statement. They said the death of Miriam Merten from injuries sustained in a seclusion room in Lismore in 2014 was the catalyst for the review. The Ministry of Health is expected to deliver a plan to implement the recommendations this month. “Whilst the government will need to work with our local health districts to bring about change in practices and procedures, the message from the review is loud and clear – seclusion and restraint of mental health patients should be a last resort,” the statement said. “The NSW government will immediately invest $20 million, so hospital managers can work with their staff to improve the therapeutic environment inside acute mental health units.” 24 | THE LAMP MARCH 2018
A REVIEW OF EMERGENCY DEPARTMENTS TO COME In accepting the review’s recommendations, the ministers said the government would also review the use of safe assessment rooms in emergency departments (EDs). The review panel said they witnessed examples of “positive leadership and constructive collaboration with mental health staff in caring for mental health consumers” in EDs. There were “noteworthy examples of emergency department leaders who displayed concern and compassion for mental health consumers, and who made constructive efforts to improve the environment and the processes”. However, “There were also examples of stigmatising, discriminatory and hostile behaviour towards consumers and mental health staff” the panel said. “At multiple site visits, emergency department staff displayed unprofessional attitudes and openly discussed people presenting with a mental illness differently from those presenting with a physical illness. “In some emergency departments, all mental health consumers were only seen in a safe assessment room and there was a low threshold for using security guards. “The use of inappropriate language such as referring to mental health consumers as ‘taking up emergency beds’ and ‘distracting our services from looking after patients who are more in need of emergency services’; referring to ‘your mental health patient’ as a way of disowning any responsibility for the delivery of care; or mentioning that ‘mental health patients are dangerous, and disturb the other patients with legitimate medical problems’ was a common issue.”
WORKFORCE SHORT ON MENTAL HEALTH EXPERIENCE AND SKILLS The panel found that most mental health staff “are motivated to provide quality care in a challenging environment.”
‘Many staff were recruited to work in mental health inpatient settings with little or no previous mental health experience or skills.’ — Review panel
However, “The review team heard repeatedly that many staff were recruited to work in mental health inpatient settings with little or no previous mental health experience or skills. “Some staff working with mental health consumers knew little about trauma-informed care or its relevance in restrictive practices, and in some cases expressed views and opinions that reflected stigmatising attitudes towards consumers. “Training in systemic, multifaceted and evidencebased strategies to prevent seclusion and restraint was uncommon but, where it was implemented and supported, it was clearly beneficial.” The review said “discriminatory and stigmatising behaviour and attitudes” were observed at all levels of the workforce. “NSW Health should ensure that recruitment and performance-review processes include appraisal of values and attitudes of all staff working with people with a mental illness.”
LEADERSHIP IS IMPORTANT The review team “witnessed some notable, although infrequent examples of positive and active leadership. These provided hope and showed what can be achieved by determined and strategic leadership, within existing resources”.
However, “The tolerance of leaders for outdated, discriminatory and damaging attitudes and behaviours among staff was a matter of considerable concern, and was at odds with some of the submissions by professional groups emphasising the importance of leadership”.
INADEQUATE OVERSIGHT During site visits, the review team heard that “decisions about the use of seclusion and restraint were often left in the hands of the nurses on the mental health inpatient unit, with limited external scrutiny or available supervision”. “This was an indication of the unreliability of on-site clinical supervision and support to safeguard good practice, assist in complex decision making, and ensure all staff are both supported and accountable. “Services lacked explicit guidelines for delegation and escalation in preventing seclusion and restraint.” The review team were “disturbed to discover that some mental health inpatient units very rarely received visits from the on-site, after-hours senior nurse managers. “Senior managers were said to be too busy ‘running the business’. This was despite the likely role that a lack of external after-hours scrutiny played in the deviation from acceptable practice on the unit where Ms Merten was secluded (in the opinion of the review team).” ■ THE LAMP MARCH 2018 | 25
Review dodges vital issues Seclusion and restraint report is vague on workforce improvements.
he review of seclusion and restraint in acute mental health units and emergency departments makes no mention of vital workforce issues raised by the NSWNMA. These include the lack of clinical nurse educators, the statewide shortage of psychiatric intensive care (PICU) beds, excessive workloads and inadequate skill mix. Some of the review’s positive recommendations lacked substance. For example, the review said all mental health inpatient services “must have 24-hour, everyday on-site supervision from accountable management representatives. This supervision must include inperson rounding on every shift”. Mental health nurses point out that units attached to public hospitals may already be supervised by a person doing rounds every shift. However, that person often has no mental health qualification and no understanding of what they are supervising. Some nurse unit managers of acute mental health services have no mental health experience, yet are expected to understand the complex management of mental health patients and lead the nursing team effectively. The review recommended that NSW Health develop and implement minimum standards and skill requirements for all staff working in mental health. However, as Jack Schwartz, a veteran of 40 years mental health nursing, points out, the review does not say what those minimum standards should be.
26 | THE LAMP MARCH 2018
SECLUSION IS ALREADY A LAST RESORT Jack is president of the Coffs Harbour mental health branch of the NSWNMA and delegate to the union’s mental health reference group. “The inquiry did not sufficiently recognise the implications of a lack of qualifications, training, and experience,” he says. “On my unit fewer than half of the nurses working have been trained in prevention and management of aggression, or sensory modulation, and de-escalation techniques. “No one likes to seclude anyone – if only because of all the paperwork involved. “If someone is secluded it is pretty much done as a last resort. “The ministry wants trauma-informed care but nurses working in mental health often do not have the expertise in counselling to do this appropriately. “The review fails to recognise that 80 per cent or more of nurses in mental health units are not psychiatrically trained and therefore don’t know how to deal with a lot of behavioural problems. “The health system did away with psychiatry as a nursing specialty because general nurses were paid less. “NSW Health does not train mental health nurses any more. They train List A nurses who may later gain a mental health endorsement. “By then they are already working in a mental health ward and are usually not equipped with the knowledge they need. “Often they don’t have the experience and skills to cope without the need for seclusion.
‘The inquiry did not sufficiently recognise the implications of a lack of qualifications, training and experience.’ — Jack Schwartz
“Because of this lack of training they often take the easy way out of situations, which creates problems for nurses who stick to protocols.”
USE OF UNSKILLED STAFF IS PROBLEMATIC Jack says the use of enrolled nurses and assistants in nursing has added to the problems facing RNs. “AiNs are unregulated and have minimal training; they have no skills to complete a mental health assessment and therefore cannot do a risk assessment of the patient. “This puts the patient and the AiN at risk. It robs the patient of the quality of care that an RN, can provide and creates more work for the RN who has to closely supervise the AiN. “This takes away valuable time that the RN should be spending with their own patients. AiNs have a place in health, but not in acute mental health.”
SMOKE-FREE POLICY PUTS PATIENTS AND STAFF AT RISK The inquiry called for “an immediate reinvigoration” of the implementation of the NSW Health smoke-free policy, “which includes increasing the knowledge and use of nicotine replacement therapy”. However, Jack says patient reaction to the policy has put patients and staff at risk while funding for nicotine replacement has declined. “Easily half our ‘aggro’ happens because we don’t allow people to smoke. As far as most patients are concerned, nicotine replacement is not the same. “Cigarettes get smuggled in and problems arise when we have to take away their lighters and cigarettes. No matter how we try to stop patients from smoking they
will find a way to smoke. “The review report was obviously written by people who don’t actually work in a mental health unit and are taking a pie-in-the-sky view of things. “For example, they recommend a staff member sit outside the seclusion window and monitor the patient visually for at least an hour immediately following seclusion. “If you put someone in there because they have just attempted to assault you and your fellow workers, that patient is irate as can be. “Now you are going to stare at them through a window for an hour? That would just be a red rag to a bull. “The abuse you would get for that hour would give you post-traumatic stress. “It is a ridiculous suggestion.” The review says all mental health units should have “a multidisciplinary team with the skills to deliver a therapeutic program and environment on an extendedhours basis”. However, budget constraints have eroded day programs and evening programs in mental health facilities. The review was critical of nurses having to make decisions about seclusion “with limited external scrutiny”. Jack says the nurse often knows more about the patient’s mental and physical state than the on-call psychiatrist. If the ministry wants more supervision of nurses it must employ more resident psychiatrists and resident psychologists, he adds. ■ THE LAMP MARCH 2018 | 27
NEWS IN BRIEF
“Intolerable” compromise of patient safety in British EDs Doctors running 68 emergency departments (EDs) in Britain’s NHS have sent a “letter of unprecedented alarm” to the prime minister warning that people are dying in corridors because staff are overwhelmed.
Nursing crisis predicted in NSW NSW Ministry of Health figures uncovered by an ABC Freedom of Information investigation predict a shortage of up to 8,000 registered nurses and midwives across NSW in the next decade. The analysis predicts that by 2030, 82,000 full-time registered nurses and midwives will be needed, but only 74,000 will be available – a gap of 8,000 workers. The outlook for enrolled nurses is equally dire. This year alone, the ABC reports: “NSW will need to find 2,000 full-time enrolled nurses to meet demand, and on current trends, the shortage will continue to grow”. “The current workforce of 9,000 full-time staff will plummet to 7,500 by 2030, while at the same time demand will sky-rocket to about 13,000.” According to the ABC the official data predicts a “catastrophic” shortage of staff in south-west Sydney. Acting General Secretary of the NSWNMA, Judith Kiejda, said the predicted nursing workforce shortages were not a huge surprise; however, the key concern was ensuring the Berejiklian Government and the Ministry of Health took the modelling seriously. “We have been lobbying this government for the past seven years to urgently improve and expand nurse-to-patient ratios to address the current shortfalls we already have in the delivery of safe patient care across the state’s public hospital system,” Ms Kiejda said. “It’s imperative the government doesn’t play these figures down but instead, actually starts planning to meet the predicted demand of our growing population.”
‘The official data predicts a “catastrophic” shortage of staff in south-west Sydney.’ 28 | THE LAMP MARCH 2018
The letter outlined how some hospitals had become so overloaded that they were looking after as many as 120 patients a day in corridors, with “some dying prematurely” as a result. The letter bluntly warned that the crisis in EDs was caused by severe and chronic underfunding and that some care was not safe. Treatment was taking 10–12 hours from the decision to admit, to finding a bed; people were dying on trolleys, and patients were sleeping in clinics. “The current level of safety compromise is at times intolerable, despite the best efforts of staff,” the letter said. “Our emergency departments are not just under pressure, but in a state of emergency,” said Dr Taj Hassan, President of the Royal College of Emergency Medicine. Prime Minister, Theresa May responded by saying that flu was the key factor putting strain on emergency departments. The Guardian newspaper was scathing of this assessment in an editorial. “This is not the flu: it is a system-wide crisis brought about by seven years of mounting austerity,” it said.
‘Our emergency departments are not just under pressure, but in a state of emergency.” — Dr Taj Hassan, President of the Royal College of Emergency Medicine.
NEWS IN BRIEF
Human Rights Watch slams misuse of antipsychotics American nursing homes are misusing antipsychotic drugs to control the behaviour of residents with dementia, according to a new report.
Carillion’s collapse exposes PPP folly The implosion of the outsourcing giant Carillion is a “watershed” moment for the “rip-off” privatisation of British public services. Carillion was one of the British government’s “go-to” outsourcing and building companies, which managed hundreds of public sector projects as well as vital public services. It had been entrusted with the building and operation of a number of high profile hospitals, including the Midland Metropolitan hospital in Birmingham and another in Liverpool.
In the report – “They want docile” – Human Rights Watch (HRW) says: “In an average week, nursing facilities in the United States administer antipsychotic drugs to over 179,000 people who do not have diagnoses for which the drugs are approved”. HRW suggested that antipsychotics were used to “make it easier for understaffed facilities, with direct care workers inadequately trained in dementia care, to manage the people who live there”. “In many facilities, inadequate staff numbers and training make it nearly impossible to take an individualised, comprehensive approach to care. Many nursing facilities have staffing levels well below what experts consider the minimum needed to provide appropriate care,” it said. HRW cited studies that found antipsychotic drugs almost double the risk of death in older people with dementia. “When the drugs are administered without informed consent, people are not making the choice to take such a risk.” US Federal regulations require individuals to be fully informed about their treatment and provide the right to refuse treatment. “Yet nursing facilities often fail to obtain consent or even to make any effort to do so. Such non-consensual use and use without an appropriate medical indication are inconsistent with human rights norms,” said HRW.
Both were substantially delayed and over budget and were seen as central to the company’s failure. The company’s collapse has cost thousands of jobs, which will be exacerbated by the financial stress put on more than 30,000 small firms owed money by Carillion. Opposition leader, Jeremy Corbyn, called Carillion’s collapse a “watershed moment”, adding that it was “time to put an end to the rip-off privatisation policies that have done serious damage to our public services and fleeced the public of billions of pounds”. Carillion’s Chairman, Philip Green, was an adviser to the Prime Minister David Cameron on corporate responsibility until December 2016. The company’s former Chief Executive Richard Howson is still currently entitled to a £660,000 salary, even though he quit the company last year over the company’s tanking performance.
‘(It’s) time to put an end to the rip-off privatisation policies that have done serious damage to our public services and fleeced the public of billions of pounds.’ — Jeremy Corbyn
‘Such non-consensual use (of antipsychotics) and use without an appropriate medical indication are inconsistent with human rights norms.’ THE LAMP MARCH 2018 | 29
NEWS IN BRIEF
‘Diseases such as cancer, diabetes, dementia and depression will become far more common among over-65s in their later years.’
Big achievements in global health In 2017, there were many reasons for celebration in the field of global health. In an assessment of global health in 2017, the online website Project Syndicate outlined the successes that led to the eradication of many diseases and millions of lives saved. Among some of the best achievements were: • India announced it had eliminated active trachoma – a leading infectious cause of blindness. Last year, trachoma was also eliminated in Mexico, Cambodia, and the Lao People’s Democratic Republic. • The World Health Organization announced substantial progress towards elimination of onchocerciasis, which causes blindness, impaired vision and skin infections. WHO said: “In 2016, almost 133 million people living in areas at risk of onchocerciasis received treatment as compared with 46 million in 2005.” The main areas of risk were Africa, the Americas and the Eastern Mediterranean. • Guinea worm disease was pushed to the brink of eradication. Only 26 cases were recorded worldwide in 2017, down from 3.5 million cases in 1986. Nigeria, the most endemic country, had 650,000 cases at its peak. It now has zero. • New vaccines were developed for typhoid and shingles. • Four countries – Bhutan, the Maldives, New Zealand and the United Kingdom – were all declared measles-free. • Thanks to coordinated global efforts, most people in Latin America and the Caribbean are now immune to the mosquito-borne Zika virus. • Polio is on the cusp of being eradicated. As recently as 1988, there were 350,000 cases of polio each year. Fewer than 20 new cases were reported globally in 2017.
‘Polio is on the cusp of being eradicated.’
30 | THE LAMP MARCH 2018
We’ll live longer but with more medical conditions New research finds we’ll live longer but with more medical conditions, putting a greater strain on public health systems. The study, by researchers at Britain’s Newcastle University, found that the number of older people with four medical conditions would double by 2035. Diseases such as cancer, diabetes, dementia and depression will become far more common among over-65s in their later years, they found. The study found that men will live an extra 3.6 years and women an extra 2.9 years by 2035, but for two thirds of that extra time would suffer from four or more diseases. “These findings have enormous implications for how we should consider the structure and resources for the NHS in the future,” said Carol Jagger, professor of epidemiology of ageing, who led the study. “Multi-morbidity increases the likelihood of hospital admission and a longer stay, along with a higher rate of readmission, and these factors will continue to contribute to crisis in the NHS.” The increase in the number of people with four or more medical problems will largely come from an expected sharp rise in the number of people living until at least 85.
NEWS IN BRIEF
Private health insurers get 3.95 per cent increase and still want more Private health fund premiums will rise by 3.95 per cent in April while inflation and wage growth remain below two per cent. The average family will pay an extra $143 a year for private health insurance from April after the federal health minister Greg Hunt announced a 3.9 per cent increase in premiums. Single people will pay an average of $73 a year more. Private insurers, through their representative body Private Healthcare Australia, had earlier argued high-income earners should be penalised at a higher rate through the Medicare levy for failing to take out private health insurance. Both measures drew the ire of doctors, academics and the ALP. Opposition leader Bill Shorten said the government should not be “running around saying they’ve had some marvellous win because our health insurance premiums will go up just under four per cent this year”. “For Australians who’ve got historic low wage rises, this is another kick in the guts. Inflation’s barely at two per cent. Wages are moving at two per cent,” he said. Premiums have increased by an average of 5.6 per cent every year since 2010. The AMA, representing doctors, said the fact that people were prepared to pay more tax rather than take out health insurance was an indictment on the industry’s products. “Too many Australians find out only when they are sick that their health insurance policy is not what they expected and, in some cases, is nearly entirely useless,” said AMA President Michael Gannon.
‘Last year there was an increase in total billionaire wealth in Australia of about $38 billion.’
Australian inequality continues to rise It’s a great time to be an Australian billionaire; less so if you are on wages.
‘The government should not be running around saying they’ve had some marvellous win because our health insurance premiums will go up just under 4 per cent this year.’ — Bill Shorten
A report released by Oxfam in January, using data supplied by Credit Suisse, shows that the share of wealth concentrated in the hands of the top 1 per cent of Australians has increased to 23 per cent – up from 22 per cent in 2016. The top 1 per cent of Australians continue to own more wealth than the bottom 70 per cent of Australians combined. Australia’s income inequality compares poorly with other OECD member countries. The latest OECD data shows Australia ranked 22nd for inequality – well behind most of the 35 OECD countries. Oxfam says that income shares for all income groups outside the top 20 per cent have fallen over the decade to 2015. This, it says, is because “Australian workers’ wage growth has largely stagnated since the GFC in 2008, despite strong economic and labour productivity growth in this period”. Meanwhile the rich keep getting richer. Last year saw an extra eight Australian billionaires and an increase in total billionaire wealth of about $38 billion. Australian billionaire wealth increased by 140 per cent to $115.4 billion in the decade to 2017. Over the same period, average wages of ordinary Australians increased by just 36 per cent and average Australian household wealth grew by just 12 per cent. “Australian wage growth has slowed to record lows over the past few years, which has barely kept up with the cost of living,” Oxfam said. THE LAMP MARCH 2018 | 31
Dementia Management Training
Monday 12 March, Waterloo $ Members $95 / non-members $190 This new course covers a range of topics regarding dementia such as its effects, changed and difficult behaviours, strategies in approaching clients behaviours, assessments, documentation and self-care. Increasing Resilience in Stressful and Changing Times – FACE TO FACE AND SELF-DIRECTED CPD
6 Wednesday 14 March, Waterloo Members $95 / non-members $190 The goal of this workshop is to provide you with tools and strategies to help you get your mojo back and put you in the best position to deal with stress, strain and change. $
How to be an effective Preceptor / Mentor
6 Thursday 22 March – Waterloo $ Members $95 / non-members $190 Learn how to be an effective preceptor / mentor. Understand the differences between precepting and mentoring in an effort to appreciate the contribution such relationships can make to the novice nurse / midwife. Environmental Health Forum
Legal, Ethical and Professional Issues for nurses and midwives All
5.5 Friday 6 April, Waterloo $ Members $60 / non-members $120 This year’s forum will focus on a range of topics, including the impact of environmental events on healthcare. Professional Comprehensive Documentation All
Tuesday 10 April, Waterloo $ Members $30 / non-members $60 This workshop is designed to revisit the principles of documentation within the healthcare setting. Wound Care: Pathophysiology, Skin Tears and Pressure Injury Prevention
Evening Series CPD
Wednesday 11 April, Waterloo $ Members $95 / non-members $190 A suite of wound care courses has been added to the 2018 education calendar.
CPD Made Easy
4 Wednesday 18 April, Gymea Thursday 3 May, Newcastle $ Members $50 / non-members $100 This seminar is designed to assist nurses and midwives to better understand the key concepts and relevant information to ensure effective recording and completion of CPD that meets NMBA standards. RN EN MW
Medication Safety, Professional Obligations, Professional Comprehensive Documentation and the NMBA Decision-Making Framework
Cultural Competence in Healthcare
4 Thursday 19 April, Wagga Wagga $ Members $50 / non-members $100 The concepts of culture and multiculturalism, cultural and linguistic competence, strategies to enhance cultural competence and more. All
The Influential Thought Leader at Work
6 Friday 20 April, Gymea $ Members $95 / non-members $190 This program will provide you with the skills and tools to build your confidence in becoming an inspiring and motivational thought leader. All
Prepping for Interviews
4 Thursday 26 April, Newcastle $ Members $20 / non-members $40 To prepare nurses, midwives and undergraduates for interviews. All
8595 1234 (METRO) • 1300 367 962 (RURAL)
All nurses, midwives & assistants in nursing
Attendance at NSWNMA education sessions may count towards your Continuing Professional Development (CPD) hours. The number of hours noted beside each course is the maximum amount of claimable CPD hours assuming that as an attendee you remain for the entirety of the course and complete any extra activities as may be required. All
Thursday 19 April, Kempsey $ Members $95 / non-members $190
REGISTER ONLINE bit.ly/NSWNMAeducation CPD
Friday 13 April, Waterloo Friday 27 April, Hornsby Wednesday 2 May, Newcastle $ Members $95 / non-members $190 Learn about potential liability, disciplinary tribunals, NMC and HCCC complaints and Coroners Court, identify the fundamental ethical standards and values to which the nursing and midwifery profession is committed.
Judith Breaking News A new ‘Occupational Assessment Screening and Vaccination’ PD on the way The Ministry of Health recently approached public health unions with an amended draft policy directive ‘Occupational Assessment Screening and Vaccination Against Specified Infectious Diseases’. The key changes originally proposed were as follows: (i) r ecategorisation of positions to include a Category A High Risk position for workers employed in high risk clinical areas; (ii) mandatory annual influenza vaccination program for workers employed in Category A High Risk positions; (iii) t he inclusion of termination as a possibility where reassignment to a non–high risk clinical area was not feasible; and (iiii) compliance monitoring and reporting. The Association gave immediate feedback. The Ministry has adopted a collaborative approach, which has been pleasing and will lead to a superior framework. The Association succeeded in having the draft amended to squarely deal with an identified ambiguity. It is now clearly understood that NSW Health staff who have a medical contraindication to vaccination etc will be risk managed, and will not be the subject of any action to terminate their employment. It has also been highlighted that mandatory flu vaccinations will need to be made available during a range of shifts and days to maximise access and ensure ready compliance.
Working with Children Check I work at a public hospital as an EN. We were recently told that all nursing staff will be required to get a Children’s Check. Is that right? In short, no. A ‘blanket approach’ is not to be adopted and is contrary to the legislative schema and PD2016_047 (Employment Checks – Criminal Record Checks and Working
When it comes to your rights and entitlements at work, NSWNMA Assistant General Secretary Judith Kiejda has the answers.
with Children Checks). Obtaining a Working with Children Check is a requirement if one’s employment is in child-related work, which is defined as follows: “Child-related work is work in a child-related role or in paid or unpaid work, involving face-to-face or physical contact with anyone under the age of 18 years, in an area prescribed as child relatedwork.” Check out Section 2 of the policy directive, which provides a number of examples to assist in this determination.
Can ADOs be ‘banked’? I am a registered nurse working in a public hospital. I was recently approached to ‘bank’ my ADO for this month due to shortages. Can that happen? Clause 4(vi) and (vii) of the Public Health System Nurses’ and Midwives’ (State) Award 2017 makes clear that once set, an ADO should not be changed except for genuine unforeseen circumstances. However, an employee and local nursing management can agree to an employee accumulating their ADOs to a total of three.
Healthscope sabbaticals I work as a registered nurse in a hospital operated by Healthscope. I am looking to take a break to complete some studies full time. Is there an alternative to using up my paid leave? Clause 44 (Sabbatical Leave) in the Healthscope and NSWNMA/ ANMF – NSW Nurses and Midwives’ – Enterprise Agreement 2015–2019 sets out that an employee with five or more years’ service may request a period of unpaid sabbatical leave. Unless agreed, this request should be made at least six months in advance and should state the proposed duration and commencement date. Healthscope is obliged to consider the request and respond promptly. All requests for unpaid sabbatical leave will be considered subject to operational needs.
Reporting criminal charges I work at a public hospital. What
are my requirements to report criminal charges against me? Section 4.3.18 of PD2015_049 (NSW Health Code of Conduct) requires employees to report criminal charges and convictions against them involving offences punishable by imprisonment for 12 months or more to the chief executive. Any charge or conviction involving an under 18-year-old should be notified immediately (Section 4.3.19).
Probation at RSL LifeCare I have just started work at an aged care facility run by RSL LifeCare. I have been told I will be on a six- month probationary period. Is that right? Clause 12.1 of the RSL LifeCare, NSWNMA and HSU NSW Enterprise Agreement 2015–2017 sets out that “Employees (other than casual employees) will be on a period of probation for the first six months of engagement (12 months for small business) for the purpose of determining the employee’s suitability for ongoing employment.”
SCR and future employment Does a Service Check Register record mean I cannot get a job elsewhere in NSW Health? Section 6.4 of PD2013_036 (Service Check Register for NSW Health) sets out the obligations on a health organisation if a preferred applicant has a SCR record, which “… does not necessarily preclude a person from being engaged or employed.” If the risks previously identified are not relevant to the new role, the recruitment process should proceed. If, however, it is identified that the previous risk is relevant, the preferred applicant must be provided an opportunity to submit additional information and any other material (i.e. references, courses attended etc.), which must be assessed by the health organisation prior to arriving at a final determination. A similar process is established in Section 6.5 for those instances where the preferred applicant was previously terminated from NSW Health and has a SCR record as a result. THE LAMP MARCH 2018 | 33
Registered and Enrolled Nurse members of the Association are invited to apply for an OPWC Aged Care Scholarship The NSW Nurses and Midwives’ Association is pleased to announce a new round of the Old People’s Welfare Council (OPWC) Scholarships, opening for application on 1 March 2018.
WHO MAY APPLY 1 Registered or Enrolled Nurses; 2 You must be currently registered with the Nursing and Midwifery Board of Australia; 3 A financial member of the NSWNMA; 4 You must be currently working in aged care; 5 The scholarship is open to Australian citizens and permanent residents.
OPWC Scholarships are available under the following categories: CATEGORY 1: Scholarships for a short course (duration less than 6 months), not necessarily leading to an award or an additional formal qualification. CATEGORY 2: Scholarships for extended study (duration over 6 months) leading to the award of a formal qualification at a recognised tertiary institution in Australia or overseas.
Please note, applications are for studies being undertaken in the academic year 2018.
TO APPLY 1 Read the Scholarship Information and Terms at www.nswnma.asn.au/education/ scholarships 2 Complete the official OPWC Scholarship application form 3 Your application must be received by the NSWNMA by the scholarship closing date 5pm, Friday 13 April. FAX 02 9662 1414 MAIL M. West, NSWNMA EMAIL firstname.lastname@example.org 50 O’Dea Avenue, Waterloo NSW 2017 FOR ENQUIRIES, please contact the Association on 1300 367 962 or (02) 8595 1234
The Scholarship program is due to a generous grant by the Old Peoples Welfare Council Ltd to the NSW Nurses and Midwives’ Association. The Scholarships aim to enhance the care of older people by supporting the undertaking of further studies by nurses who would then apply their learning in their aged care work.
Great deals for members at
The Good Guys As a valued Union Shopper member you can now get exclusive access to a new online shopping site with The Good Guys Commercial. You will be able to see ‘live’ discounted pricing on the entire The Good Guys range – that’s great deals on over 4,000 products! And you will be able to make your purchases online – saving you time and money.
To register for online access to The Good Guys Commercial website, visit www.unionshopper.com.au/the-good-guys/ or phone 1300 368 117
1300 368 117 unionshopper.com.au 34 | THE LAMP MARCH 2018
Do you have a story to tell? An opinion to share? Nurse Uncut is a blog written by everyday nurses and midwives. We welcome your ideas at email@example.com
New on our Support Nurses YouTube channel Australia voted Yes, this nurse got married and the wedding was beautiful!
WHY JOIN THE NSWNMA We’ve put together a video with the help of Samantha, giving you the best reasons to join the NSWNMA. bit.ly/whyjoinnswnma
There’s been some wonderful stories of same-sex weddings across the country since Australia voted Yes, but none better than this one from a nurse and her partner! https://www.nurseuncut.com.au/ australia-voted-yes-this-nursegot-married-and-the-weddingwas-beautiful/
Australia day or invasion day? A nurse’s perspective There’s no doubt Australia is an incredible country but it’s important we don’t ignore the worst parts of our history. Eliza is a nurse who has shared her thoughts on what 26 January means to her. https://www.nurseuncut.com.au/ australia-day-or-invasion-day-anurses-perspective/
Listen to our podcast Environmental Health Forum – The Green Line bit.ly/GreenLineProgram
Connect with us on Facebook Nurse Uncut www.facebook. com/NurseUncutAustralia New South Wales Nurses and Midwives’ Association www.facebook.com/nswnma Ratios put patient safety first www.facebook.com/ safepatientcare Aged Care Nurses www.facebook.com/ agedcarenurses Look for your local branch on our Facebook page www.facebook.com/nswnma Follow us on twitter @nswnma / @nurseuncut Share on Instagram by tagging @nswnma and don’t forget to use the hashtag #nswnma!
Rural and regional nursing for city new grads: more benefits than you might think Rural and regional nursing for city new grads: more benefits than you might think. https://www.nurseuncut.com.au/ rural-and-regional-nursing-for-citynew-grads-more-benefits-than-youmight-think/
Alison Bush: The story of an incredible Australian midwife There are quite a few nurses and midwives who have huge impacts on the lives of those around them and our professions in general. While there are many unsung heroes, here’s one we’d like to remind you of. https://www.nurseuncut.com. au/alison-bush-the-story-of-anincredible-australian-midwife/
‘We are the carers’ – an aged care nurse’s story This is one aged care nurse’s experience about a day at work. Is it similar to your day? https://www.nurseuncut.com.au/ we-are-the-carers-an-aged-carenurses-story/
Working with the best gets me through aged care Everyone you know will have at least one complaint about something they do at work. And even though the job isn’t exactly what she expected, how good is the optimism from this nurse working in aged care? https://www.nurseuncut.com. au/working-with-the-best-gets-methrough-aged-care/ THE LAMP MARCH 2018 | 35
JOURNEY ACCIDENT INSURANCE Your journey injury safety net
DID YOU KNOW THAT
your membership fees cover you for travel to and from work? If you are involved in an accident while travelling to or from work, NSWNMA’s Journey Accident Insurance provides you with peace of mind. As a financial member of the NSWNMA you are automatically covered by this policy. Make sure your membership remains financial at all times, so you’re covered.
Unsure if you are financial?
It’s easy! Ring and check today on 8595 1234 (metro) or 1300 367 962 (rural). Change your payment information online at
It was nice to know that the Association was there to provide that assistance. I am so impressed and indebted to them for it. RN Alexis Devine
bit.ly/NSWNMA-alexis Watch Alexis talk about Journey Accident Insurance
The Association has been absolutely marvellous, helping me step by step throughout the whole process. They also organised and helped me go back to work on restricted duties. RN Shari Bugden
bit.ly/NSWNMA-shari Watch Shari talk about Journey Accident Insurance
36 | THE LAMP MARCH 2018
What nurses and midwives said and liked on Facebook www.facebook.com/nswnma
people can’t poke my face. Hahaha!! That initial reaction reminds me of you Jason! I don’t look that good!
Poor priorities lead to missed care
Stand proud Maitland!
Aged care nurses discussed inadequate staffing numbers as the most common reason for missed care.
Maitland Hospital was saved from privatisation thanks to you! Here’s what you said.
For operators it’s about profit; they don’t give a rat’s a*** about poor service and care. They don’t set up facilities to look after aged folk! They do it to maximise profit and work staff to the bone. Deskilling of staff, poor wages – what do you expect? It takes special people with expertise to look after the elderly. It’s all about money. Greed does not belong in an industry where “care” is the main priority. Management need to stop being so money hungry and ripping off the elderly, and provide enough staff to give adequate care to every member of their facility. After all, it is the residents’ home! They pay so much to be there and only get so little back. Last night an elderly lady came into ED. She split her top lip right open from falling out of a low bed. She needed a specialist on her at every breathing moment as she was gcs 11 and a scary risk of getting up and falling off our ED beds. We wondered how on earth she would be looked after back at the aged care facility; there is no way they could leave her alone even for a split second. Staffing ratios suck. This could have been avoided I believe, if someone was close to her bedside watching out for her.’
Still happens to me!!! Kind of like the other night but not so friendly
Oh, thank goodness that common sense has prevailed! This is great news for our community, patients and all the staff who fought hard for this! The best news ever for our community and for the hard-working nurses who deserved an answer a lot sooner. Congratulations to everyone involved in fighting for this outcome. Best outcome for the Community! Be proud!!! Good news; now wait for the cuts! Your work is not over! People power wins again.
Reasons to be grumpy You reacted to what it’s like to be woken up after night shift. Can be a struggle for some and you tagged your friends! I’ve actually just woken up and wondered where the hell I was. It took a few seconds to realise. Very realistic. But I keep my door locked so errant
The impersonal touch
There’s technology out there where robots can take blood samples! Not the best according to some. I would rather see the robot clean the toilets I would love a robot who would get my vein first time, rather than people who have to attempt multiple times, then get sent away because no one can find a vein. Technology is going to be part of our future; we will have to embrace it. Maybe for the calm, cooperative, alert, not confused, nonanticoagulated patient with good skin integrity and trust for new technology, but I just don’t imagine this population makes up a great deal of those needing blood tests... also you still need a nurse to draw the sample and put pressure on the puncture site? Seems like they didn’t really think this through all that well.
1/ M anly Hospital nurses and midwives standing together to show why they need job certainty 2/ Fighting for equality at the Women’s March in Sydney 3/ NSWNMA staff wearing loud shirts to promote awareness of mental health issues 4/ Union summer interns experiencing life in the NSWNMA 5/ Marching for Indigenous rights on Australia Day
THE LAMP MARCH 2018 | 37
Upgrade your NSWNMA membership & you could win a relaxing 5-NIGHT ESCAPE in
LEGIAN, B ALI!
ARE Y OU AN ASSOCIATE, AIN OR EN MEMB ER?
Any member who upgrades their membership by 31 March 2018 will be entered into the draw to win
. . ..
5 nights’ accommodation (for two guests) at the Astagina Resort Villa & Spa in a deluxe room Daily breakfast for two 2 x dinners for each guest 1 x 60-minute massage each Return airport transfers. The NSWNMA will arrange and pay for return f lights for two to Denpasar. You will experience a traditional Balinese escape in Legian — a short stroll to the beaches and restaurants of Seminyak. Astagina Resort Villa & Spa is perfectly situated close to the famous Cocoon Beach Club and Double Six Beach, and all the trendy boutiques and cafes and bars Seminyak has to offer. Or choose to relax by the pool and be pampered at the Anjali Spa, where you will be left feeling relaxed and rejuvenated.
E VERY MEMB ER WHO UPGRADES THEIR MEMB ERSHIP WILL B E ENTERED INTO THE DRAW!
PRIZE DRAWN 1 APRIL 2018 38 | THE LAMP MARCH 2018
Conditions apply. Prize must be redeemed by 1 April 2019 and is subject to room availability. Block out dates 1 July to 31 August 2018 and 20 December 2018 to 10 January 2019. Booking to be made directly through Astagina Resort Villa & Spa on firstname.lastname@example.org. Competition opens on 1 October 2017 and closes 31 March 2018. The prize will be drawn on 1 April 2018. Must be a financial member of the NSWNMA at time of travel. If a redraw is required for an unclaimed prize it must be held up to 3 months from the original draw date. NSW Permit no: LTPM/17/01625
NURSING RESEARCH ONLINE It’s ten years since the Australian Parliament apologised for the Stolen Generation and established the campaign to Close the Gap. The results have been mixed and generally disappointing. Every Australian health professional should consider how they can contribute to improving the health outcomes of Australia’s First Peoples. Closing the Gap Prime Minister’s Report In 2018, Closing the Gap remains a shared commitment. It is the story of a shared journey to continue to work together and enable and empower Aboriginal and Torres Strait Islander people to live healthy and prosperous lives. This journey continues to draw on the enduring wisdom, strength and resilience learned over thousands of years of Aboriginal and Torres Strait Islander civilisation. The past 10 years of Closing the Gap have also provided governments with valuable lessons. One of the key lessons learned is that effective programs and services need to be designed, developed and implemented in partnership with Aboriginal and Torres Strait Islander people. Governments have also recognised the importance of taking a far more holistic approach involving agencies from across government to develop policies and deliver services to First Australians. The Closing the Gap framework was established in 2008 to address Indigenous disadvantage. Ten years on, the lives of Aboriginal and Torres Strait Islander people have improved but more gains need to be made. It is clear that continued effort and action is required. The Closing the Gap framework provides an annual national snapshot of progress made against the targets – and helps maintain our collective focus. While acknowledging this, it is important to recognise the success and achievements of many Aboriginal and Torres Strait Islander people, demonstrating that when equal opportunities are provided, disadvantage can be overcome. https://closingthegap.pmc.gov.au/
To close the health gap we need programs that work. Here are three of them. Neale Cohen, Jonathan Carapetis, Sue Kildea
The tenth Closing the Gap report to be tabled in Parliament is expected to show progress in the two health targets – to close the gap in life expectancy by 2031 and halve the child mortality (death) gap by 2018. But only the latter is on track. The gap in life expectancy between Indigenous and non-Indigenous Australians won’t be closed by 2031. The Indigenous death rate has dropped by 15 per cent (from 1998–2015), but we’re not on track to meet the deadline. Chronic diseases such as diabetes, heart
disease and cancer are responsible for the majority of this gap. While death rates from heart and kidney disease have dropped among Indigenous people, death rates from cancer are on the rise, and the gap here is widening. The child death rate has dropped by 33 per cent for the 1998–2015 period, and is reportedly on track to meet the target. But overall, progress is slow. As governments talk about “refreshing” targets, three experts – in diabetes, maternal and infant health care, and rheumatic heart disease – provide evidence for how giving more support, funding and control to the Indigenous community leads to actual results. https://theconversation.com/to-close-the-health -gap-we-need-programs-that-work-here-are-three -of-them-91482
Australia’s health 2016 – Main contributors to the Indigenous life expectancy gap Australian Institute of Health and Welfare
Life expectancy is an important measure of the health status of a population: it indicates how long a person can expect to live, based on current mortality patterns. Indigenous Australians tend to die at younger ages than non-Indigenous Australians. Life expectancy is affected by a range of factors, including disease incidence and prevalence; health behaviours such as smoking; social determinants such as education, income and employment; and access to health services (AHMAC 2015). This article presents estimates of the contribution of different age groups and causes of death, to the current gap in life expectancy between Indigenous and non-Indigenous Australians. This analysis will assist policymakers by showing where interventions are best targeted to reduce the gap. It is important to note that the gap in life expectancy is a relative measure and, as such, the size of the gap is not just influenced by changes in Indigenous life expectancy, but also by changes in the life expectancy of the non-Indigenous population. All mortality data in this article relate to the five jurisdictions for which the quality of Indigenous identification is considered to be of acceptable quality for reporting: New South Wales, Queensland, Western Australia, South Australia and the Northern Territory (AIHW 2015a). https://www.aihw.gov.au/ THE LAMP MARCH 2018 | 39
e m S i l n a y a t i k R w O y ha F a st aw RECENTLY I!
r! fe oo
Be A TRI sw P ep t
AL B O OT
CHANGED YOUR EMAIL? CLASSIFICATION CHANGED?
Log on to ONLINE.NSWNMA.ASN.AU and update your details to be automatically entered in the draw to win
5 nights in your very own one-bedroom pool villa at the luxurious Villa Kayu Raja. YOU AND A FRIEND WILL ENJOY:
• 5 nights’ accommodation in a 1-bedroom pool villa for two • Return airport transfers for two • Return flights for two to Denpasar • Breakfast daily for two • 2 x dinners for two • 2 x 60-minute massages. Spend your time relaxing and recharging at the resort, a tropical oasis surrounded by palms, or take the complimentary shuttle into Seminyak and experience all the region has to offer – boutique shopping, cafes and chic bars.
40 | THE LAMP MARCH 2017
Log on and update your details from 1 October 2017 – 30 June 2018 and you will automatically be entered in the draw to win.
m sa nd co nd it
at www .nswnma.asn.au/nswnm
st s nte o c / bers amem
ot m ro p d- an
19 21 22
ACROSS 1. Passage of blood in the smallest vessels (16) 9. A poultice (9) 11. Infectious hepatitis (1.1) 12. Strange or unusual; odd (8) 13. Absence of milk in the breasts after childbirth (9) 15. Rejoin (8) 16. A person who makes artificial eyes (9)
19. A symbol of a value (6) 20. Inosine 5’-monophosphate (1.1.1) 21. The point on the Earth’s surface directly above the focus of an earthquake (9) 22. Endorsed Enrolled Nurse (1.1.1) 23. To have a high fever (4.3) 24. Aspirator (7)
26. The plotted path of an object through space (10) 30. An anti-inflammatory drug used to treat arthritis and bursitis (9) 32. Symbol for aluminium (2) 33. A person’s individual speech pattern (8) 34. An athlete who plays for pay on a parttime basis (16)
DOWN 1. Specialised sensory end organs that respond to mechanical stimuli such as tensions, pressures, or displacements (16) 2. Chip, nip, chop (3) 3. Children’s home (9) 4. Not fitting; inappropriate (5) 5. To divide into categories (16) 6. A muscle which moves a part away from the mid-line (8.6) 7. An inflammatory reaction of a bodily part (10) 8. Relating to the posterior portion of the pituitary gland (16) 10. Be ill or unwell (3) 14. Violent, vicious, harmful (7) 17. Skin chafing that occurs in or under folds of skin (10) 18. Certain (4) 25. A reinforced covering for the toe of a boot or shoe (6) 27. Remove (3) 28. A disease of recurrent heamorrhage into the retina and vitreous (5) 29. Frequently (5) 31. A fixed ideal or standard (4)
THE LAMP MARCH 2018 | 41
Do you have a story to tell? INTERNATIONAL MIDWIVES’ DAY & INTERNATIONAL NURSES’ DAY
2018 Short Story & Poetry Competition Nurses and midwives have always talked about the amazing, uplifting and special moments they experience in their work. These stories inspire the nurses and midwives who hear them, as well as some who, after hearing such poignant stories, decide to take up the profession. So without breaching confidentiality, let’s celebrate International Midwives’ and International Nurses’ Days 2018 by sharing our stories in prose or poetry. First State Super is once again proud to help celebrate this short story and poetry competition by sponsoring the FIRST PRIZE OF $2000, and the 2 RUNNER-UP PRIZES OF $500. These prizes will be awarded to members or associate members of the NSWNMA who can tell an entertaining and inspiring story that promotes the wonderful work of nurses and midwives.
. Conditions of Entry • Entrant must be a financial or associate member of the NSWNMA • Entry must be original and the work of the entrant • Entry must not have been published previously • Stories/poems to be no longer than 2500 words • Confidentiality must not be breached, patient’s/ client’s names must not be used. And the facility in which your story takes place must not be identifiable • Please keep a copy of your story as your entry/entries will not be returned • The NSWNMA reserves the right to retain and publish copies of the entries, in The Lamp and on NSWNMA online (including nurseuncut.com.au) • Copyright remains with the author • Judges’ decision will be final • Failure to meet the conditions above will render entries ineligible.
e z i r st p
r-up e n n u Two prrizes of m 5 p 018 e n s clo rch 2 ced o s trie Ma noun En y 16 an da ill be 018 i r F w y2 ers 4 Ma n in
. How to enter • There is no limit on the number of entries, but each entry must have its own entry form • Complete the online entry form • Number and title each page of your story or poem • Do not include your name and address anywhere on your story/ poem copies • Keep within the word limit • 3 copies of the story to be included for the judges and to be double spaced on one side only with a 2cm margin. 42 | THE LAMP MARCH 2017
REVIEWS DISCOUNT BOOKS FOR MEMBERS The Library is pleased to announce that McGraw-Hill Publishers are now offering members a 25% discount off the RRP! The offer currently covers medical as well as a range of other professional series books. Please see the online Book Me reviews for a link to the promotion code and further instructions, or contact the Library directly for further information.
Patrick K S Poon MPG Printgroup Ltd: https://www.amazon.com/ RRP $9.00 ISBN 9780957558915
Tales from a Male Nurse
All the latest Book Club reviews from The Lamp can be read online at www.nswnma.asn.au/libraryservices/book-reviews.
Paediatric Nursing Skills for Australian Nurses Elizabeth Forster and Jennifer Fraser
Cambridge University Press: https:// www.booktopia.com.au/ RRP $79.35 ISBN 9781316628195
Paediatric Nursing Skills for Australian Nurses is the first Australia-focused, dedicated paediatric skills text for undergraduate students. Integrating the theoretical and clinical components of nursing knowledge, the authors outline the clinical skills needed in the care of children and young people. The journey begins with an introduction to communication – an essential skill for any paediatric nurse – before exploring crucial topics such as mental health, nutrition and medication. These discussions are presented in connection with the latest national competency standards for registered nurses to help equip readers with these necessary abilities.
Oxford Textbook of Communication in Oncology and Palliative Care David W. Kissane, Barry D. Bultz , Phyllis N. Butow, Carma L. Bylund, Simon Noble Oxford University Press: https://www. booktopia.com.au/ RRP $256.75. ISBN 9780198736134
Written by an international team of authors the Oxford Textbook of Communication in Oncology and Palliative Care integrates clinical wisdom with empirical findings. It draws upon the history of communication science, providing the reader with a comprehensive curriculum for applied communication skills training. In focusing on cancer and the end-of-life, it deals with the existential and spiritual challenges found across all of medicine, providing deep insights into what is at stake and how clinicians might optimally respond.
All books can be ordered through the publisher or your local bookshop. NSWNMA members can borrow the books featured here via the Library’s Online Catalogue: visit http://www.nswnma. asn.au/library-services. Call 8595 1234 or 1300 367 962, or email email@example.com for assistance with loans or research. Some books are reviewed using information supplied and have not been independently reviewed.
CI No book has ever been written from a male nurse’s AL IN T E perspective about general nursing in the UK. Every nurse has a tale to tell but Patrick has a few tales like no others. He was a trainee nurse, staff nurse, young charge nurse and nursing officer in the acute general hospitals in the NHS for almost 30 years. Unique tales include: a man in agony who did not pass urine for four days: a qualified surgeon was caught stealing chicken from a supermarket … You will be feeling sad, happy and moved when you read these tales. Vividly written and a gripping read.
Nursing Diagnosis Handbook: An Evidence-Based Guide To Planning Care Betty J. Ackley
Elsevier - Health Sciences Division: www.amazon.com RRP $52.74. ISBN 9780323322249 https://www.bookdepository.com RRP $51.99 ISBN 9781848135932
This handbook helps practising nurses and nursing students select appropriate nursing diagnoses and write care plans with ease and confidence. It shows you how to correlate nursing diagnoses with known information about clients on the basis of assessment findings, established medical or psychiatric diagnoses, and the current treatment plan. Extensively revised and updated with the new 2015-2017 NANDA-I approved nursing diagnoses, it integrates the NIC and NOC taxonomies, evidence-based nursing interventions, and adult, paediatric, geriatric, multicultural, home care, and client/family teaching and discharge planning considerations, to guide you in creating unique, individualised care plans. THE LAMP MARCH 2018 | 43
Do you want to escape to
i! l w a r a r e n d b d g a o e i h n t t o m e B m u, ew g n g n a a C n i t to win a 5-night holiday rui
The 2017–2018 NSWNMA Member Recruitment scheme prize The winner will experience their very own private oasis in two luxurious villas, with the following inclusions (for two): g Five nights’ accommodation at two super luxe properties located in Canggu, Bali (three nights at Sandhya Villa and two nights at Lalasa Villas) g Return airport transfers and transfers from Sandhya Villa to Lalasa Villas g Breakfast daily g One dinner for two guests at Lalasa Villas g One 60-minute massage for two guests at Unagi Spa g The NSWNMA will arrange return flights for two to Denpasar. You will experience a serene and peaceful holiday away from the hustle and bustle, with Seminyak’s fabulous restaurants and shopping just a stone’s throw away. Relax by your private pool, take a free shuttle service to Berawa Beach or explore the village of Canggu. Recruiters note: Join online at www.nswnma.asn.au. If you refer a member to join online, make sure you ask them to put your name and workplace on the online application form. You will then be entered in to the NSWNMA Member Recruitment scheme draw.
Every member you sign up over the year gives you an entry in the draw! Conditions apply. Prize must be redeemed by 30 June 2019 and is subject to room availability. Block out dates 1–30 August 2018 and 24 December 2018–5 January 2019. Competition opens on 1 August 2017 and closes 30 June 2018. The prize will be drawn on 30 June 2018. If a redraw is required for an unclaimed 44it must | THE LAMP prize be held up toMARCH 3 months2018 from the original draw date. NSW Permit no: LTPM/17/01625
Prize drawn 30 June 2018
at the movies
Cathie Montgomery, CNS, Operating Theatres, CRGH and Greg Kennedy, RN, Sydney Dental Hospital are this month’s reviewers. If you would like to be a movie reviewer, email firstname.lastname@example.org
THE SQUARE OV
I E GIV
The Square is a proposed utopian, art installation by the main character, Christian (Claes Bang) the curator of a contemporary art museum in Sweden.The artworks mandate, presented on a brass plaque states: “The SQUARE is a sanctuary of trust and caring. Within it, we all share equal rights and obligations.” A clipboard wielding person asking, ‘Do you want to save a life?’ juxtaposed to the beggar lying near death, as well-attired office workers pass by, oblivious. The dramatic theft of Christian’s wallet and mobile lead to a ludicrous plan to retrieve the items, with far reaching consequences. Freedom of speech versus political correctness is questioned. The museum’s PR ‘millennials’ who are engaged to promote The SQUARE, describe the project as naïve. Concerned for their own ability to make a project viral, they create a campaign that appears to miss the entire meaning, providing shock value. Staged fund-raising events for Friends of the Museum take place. They make you laugh, they make you feel intensely uncomfortable and they make you question, when is art, art?
Ann (Elizabeth Moss, The Handmaid’s Tale) provides a sexual component for this movie, as well as some intensely amusing conversational scenes. Without giving too much away, the chimpanzee and the monkey man scenes force multiple unexpected emotions to surface. This movie has an almost sketchlike feel, with Christian’s power and position linking each segment, developing and reducing his authority with equal clarity. As a social commentary on Swedish life, it ‘satirically targets art, taste, sex and money’. Many parallels can be drawn with the choice of contemporary art works here in Australia, the prohibitive costs, the patrons who view them privately, and the increasing complacency of the public to everyday suffering. Funny, dark, provocative, and complacent, where political correctness abounds at the cost of humanity. It is definitely worth the 142 minutes viewing time.
Email The Lamp by the 12th of the month to be in the draw to win a double pass to The Square thanks to Sharmill Films. Email your name, membership number, address and telephone number to email@example.com for a chance to win!
LOVE, LIES & RECORDS From the pen of BAFTA award-winning writer Kay Mellor (Band of Gold, Fat Friends, The Syndicate, In the Club), Love, Lies & Records follows Registrar Kate Dickenson as she tries to juggle her personal life with the daily dramas of births, marriages and deaths and the impact they have on her. After a dream promotion to the top job of Superintendent, Kate finds herself increasingly torn by the endless responsibilities of being a modern working mother. Her daughter’s hiding suspicious messages on her mobile, her son hates her because she’s bought him the wrong trainers and now her stepson’s turned up unannounced to stay. As Kate tries to hold her work, life and relationship together, things go from complicated to impossible when a disgruntled colleague threatens to expose a secret from her past. This series explores how women in particular have to juggle their lives. Kate has reached the top of her profession but with everything she’s worked for in jeopardy, can she sustain herself when it’s not just her job that’s on the line?
Email The Lamp by the 15th of the month to be in the draw to win a DVD of Love, Lies & Records thanks to Acorn Media. Email your name, membership number, address and telephone number |to firstname.lastname@example.org for a chance to win! THE LAMP MARCH 2018 | 45
make a date
Diary Dates for conferences, seminars, meetings, and reunions is a free service for members. email@example.com
Australian Diabetes Educators Association NSW/ACT Branch Conference 10 March 2018 8.30am–4.30pm Sydney Olympic Park https://www.adea.com.au/
Sleepless in Sydney Study Day 16 March 2018 The Children’s Hospital at Westmead Carol.firstname.lastname@example.org 0477763935
Workshop – Living with Anxiety 28 April 2018 9.00–11.00am Macquarie Park, Sydney followed by NCFA AGM 11.30am–1.00pm www.ncfansw.org Mobile: 0412 862 776
DECLARED 2018 – Delirium Clinical and Research Days 4th Biennial Conference 6–7 September 2018 Melbourne Convention Exhibition Centre Melbourne, Victoria, Australia www.delirium.org.au/2018-Conference
4th Commonwealth Nurses and Midwives Conference 12 March 2018, London, UK
3rd Asian Conference in Nursing Education 18–20 April 2018 Yogyakarta, Indonesia.
The Wellness Show 25–26 June 2018 International Convention Centre Sydney www.wellnessshow.com.au
17th National Nurse Education Conference 1–4 May 2018 Crown Promenade, Melbourne www.dcconferences.com.au/nnec2018
NCFA professional meeting 5 May, 2018 9.00am Melbourne, Victoria
EVENTS: REUNIONS West Metropolitan Group School of Nursing – Westmead: all years 24 March 2018 Castle Hill RSL, Luxe Room email@example.com St. Vincent’s Hospital March 1975 PTS Group Reunion 24 March 2018, Sydney Anne Roth firstname.lastname@example.org
Crown Street Women’s Hospital Graduates March 1968 50-year Reunion Lunch 1 June 2018 The Royal Sydney Yacht Club Wendy Wooller email@example.com
RNSH Hospital July 1977 Intake 40-year Reunion
12th PACEA CONFERENCE: Pre conference training courses 4–6 June 2018 Taipei, Taiwan
Ann Fincher (Wyllie-Olson) firstname.lastname@example.org Linda Tebbutt email@example.com
NCFI PACEA Conference ‘Christian nursing in a troubled world’ 7–11 June 2018 Chientan Youth Activity Center, Taipei, Taiwan ncfi.org/conference/ ncfi-pacea-regional-conference
Sandra Cox: firstname.lastname@example.org Sean O’Connor: 0408 349 126 Gerard Jeffery: 0417 664 993
While you look after those who need it most, we’re looking out for you. Contact us to register today.
02 9965 9456
www.ncfansw.org Mobile: 0412 862 776
46 | THE LAMP MARCH 2018
Please send event details in the format used here: event name, date and location, contact details – by the 5th of each preceding month. Send your event details to: email@example.com Fax 02 9662 1414 Post 50 O’Dea Ave, Waterloo NSW 2017. All listings are edited for the purposes of style and space. Priority is given to non-profit professional events.
Tamworth Base Hospital February 1976 intake 40-year reunion
Camden District Hospital PTS February 1978 Reunion Gay Woodhouse 0438 422 069 Gay.firstname.lastname@example.org
Winner. Outstanding value Superannuation.
firststatesuper.com.au/feelfutureready | 1300 650 873 Winner of the Canstar award for the Personal Super product. Consider our product disclosure statement before making a decision about First State Super. Call us or visit our website for a copy. FSS Trustee Corporation ABN 11 118 202 672 ASFL 293340 is the trustee of the First State Superannuation Scheme ABN 53 226 460 365. 48 | THE LAMP MARCH 2017
In this issue of the Lamp: Mass closure at St Vincent's Hospital causes concern; Mental health 'scary' for new nurses; Nolan house battles t...