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Japara wields the axe

The power of speaking out

Prescribing is the future

page 12

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REGULARS Your rights and entitlements at work Nurse Uncut – your stories What nurses and midwives said Nursing research online



p.33 p.35 p.37 p.39


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CONTENTS Contacts NSW Nurses and Midwives’ Association For all membership enquiries and assistance, including The 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 W


Hunter Office 8–14 Telford Street, Newcastle East NSW 2300


NSWNMA Communications Manager Janaki Chellam-Rajendra T 1300 367 962 For all editorial enquiries letters and diary dates T 8595 1234 E 50 O’Dea Avenue, Waterloo NSW 2017

Press Releases Send your press releases to: F 9662 1414 E 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

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 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. 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 2019 Free to all Association members. Professional members can subscribe to the magazine at a reduced rate of $30. Individuals $84, Institutions $140, Overseas $150.


AGED CARE Japara wields the axe

Aggressive cost-cutting at Japara nursing homes shows why aged care needs nurseto-resident ratios laws.

16 18

AGED CARE Rally for ratios leads to staff improvements

Bupa initially tried to dissuade staff from attending a rally in support of ratios but later responded with small measures to alleviate workload pressure.

AGED CARE Bupa nurses 'cry for help'

Nurses and relatives tell local paper why facility needs more staff.

20 22

AGED CARE Parliament starts the vital conversation


5 6 6 28 32 33 35 37 39 41 43 45 46

Editorial Your letters Competition News in brief NSWNMA Education Ask Judith Nurse Uncut Facebook Nursing Research Online and Professional Issues Crossword Book Club At the Movies Diary Dates

on aged care Our federal politicians have been debating a series of bills that will establish the Royal Commission into Aged Care, recently announced by the Prime Minister. The Lamp looks at what some of them had to say about the state of the sector. ios tios

NSWNMA PROFESSIONAL DAY The power of speaking out

Discrimination and harassment are a plague on the workplace, says Tracey Spicer.


NSWNMA PROFESSIONAL DAY Prescribing is the future

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Private hospital nurses win ratios Macquarie University Hospital (MUH) in Sydney’s north, becomes the first private hospital in NSW to agree to shift-by-shift ratios for nurses.

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Our first shift-by-shift ratios victory A well-organised, hard-working branch along with an enlightened employer has delivered an agreement with NSW’s first shift-by-shift ratios.

Hats off to our Macquarie University Hospital branch. After months and months of negotiations and perseverance as part of the bargaining team they have achieved a memorable enterprise agreement which delivers shift-by-shift ratios for the first time in NSW (see pp 8-11). This is a major breakthrough – not just for the staff at Macquarie – but for nurses and midwives throughout the state. Management at Macquarie recognised our arguments that implementing such ratios are better for patient care. Interestingly, they are also good for the hospital’s business model. Macquarie competes with a number of other private hospitals within a small radius and this agreement will allow it to attract the high quality staff and provide them with the resources they need to deliver high quality care that will make the hospital competitive in a crowded market. This is a salient lesson for other private hospitals, those running our public hospital system as well as providers in aged care. Ratios should be seen as an investment that will enhance the quality of health delivery rather than as an expense. There are other notable achievements in the Macquarie University Hospital agreement: a good pay rise, 12 weeks paid parental leave, five days paid family and domestic violence leave and improved qualification and on-call allowances.

‘This is a win-win outcome that we would like to see other employers pursue.’ Our members at Macquarie believe this will give them a better worklife balance. The employer will get a more contented and motivated workforce. Patients will get safe, high quality care. This is a win-win outcome that we would like to see other employers pursue.

AGED CARE NEEDS A SEA CHANGE Enlightened isn’t how you would describe many of the large aged care providers. Blinkered would be more apt. Blinkered by the bottom line of their financials. You would think that after the barrage of recent negative media coverage that has ranged from the ABC’s Four Corners to the Daily Telegraph over the poor staffing, poor care and outlandish profiteering that plagues the aged care sector that providers would take stock and show some humility and remorse. But not so. As we outline in this month’s Lamp some of the country’s biggest providers continue to pursue a business model that is underpinned by staff cuts despite the clear evidence of what the consequences of that will be. As the NSWNMA and ANMF have been saying for some time, now vindicated by media exposure, these

cuts inevitably lead to poor care. Taxpayers would have good reason to feel aggrieved knowing that billions of dollars in government money going into aged care is being channelled into profits and executive bonuses rather than for care for Australia’s elderly. This money needs to be accounted for more vigorously. The last federal Labor government, in its final days, tied extra government funding to wage increases for aged care workers. Unfortunately, the incoming Abbott government – in one of its first acts on gaining office – reversed this innovative policy. But the idea that aged care providers should be made accountable for how government funding is allocated remains a strong one. The media revelations and the ongoing behaviour of aged care employers give little confidence that providers will allocate this government funding responsibly towards more staff, better skill mix and adequate care without being forced to do so. There is a mountain of empirical evidence that shows ratios enhance safe patient care. Nurse to resident ratios enforced in law should be a vital cog in ensuring accountability in the aged care sector. ■



Have your


Empathy is as important as science A letter by Angela Pridham and her sister Elizabeth Murphy, (Lamp September 2018), resonated with my sentiments entirely, and I reply as follows: Angela Pridham, you have expressed perfectly what I have thought for some years, and had some experience of recently, when my husband spent a week in hospital. Yes, I am of the ‘old school’, hospital trained, 10 years retired. We were expected to treat everybody with equal kindness, care and consideration, never to be judgemental, and would not have gained our registration doing otherwise. It does appear that nowadays, even taking understaffing into consideration, science, technology and administration are allabsorbing and consuming, and many (most definitely not all) fail to realise there is a person (at times a very vulnerable and frail human being) inside every patient. Real nursing is still very important on the road to recovery, from any minor or major illness. Karen Rudd, Retired RN

A grateful patient I recently had two heart attacks – one admission was to Concord Hospital and the other to the Blue Mountains Hospital. I can honestly say the nursing care was excellent. Our nursing staff need to be praised and I would like to extend a big thank you.

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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 I know what conditions they work under, and believe me it’s time to give thanks for the hard work they do. I am talking of my own admission where the staff were excellent. Thank you Concord and Blue Mountains for everything. Let’s give our nurses more praise. Robert Southcombe

Staff happiness adds to better patient care Overall, I also agree that if the aged care sector is adequately staffed, more personal attention can be extended to residents and this will significantly boost quality of care. For staff, adequate staff ratios will make the work lighter, reduce absenteeism – especially relating to fatigue, and generally, this would increase staff morale. Happiness has a rub-on effect on others, especially our residents who need motivation and reassurance on a daily basis, as most are far away from home and know that they will never go back home on a permanent basis. Keep up the good work. Lily Jijita, AIN

Finding and keeping nurses The shift-by-shift ratios plan from the NSW opposition sounds terrific, but I would like to know where the NSW government is going to find the extra 950 nurses from? If they were out there, we would have been using them over the last 10+ years!

SEND YOUR LETTERS TO: Editorial Enquiries EMAIL 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.

Also, we have nursing students graduating from universities who can’t get a new graduate placement. Is there anything we can do about that, so we don’t lose these wonderful people from our profession? Patrick Tracey, RN Editorial response: To introduce ratios there will be a need for more nurses. In 2011–13, due to the NSWNMA’s successful campaign for nurse-to-patient ratios, 1800 FTE were hired to the system to implement the first phase of ratios, many of whom were newly graduated RNs. If there are more positions and ratios, evidence shows nurses will come. New positions would create employment opportunities for the hundreds of new graduate RNs that are missing out on new graduate positions in our Public Health System.

More starch in The Lamp? I happened to come across a Byron Shire Echo and see that they come in compostable corn starch bags… would the NSWNMA consider the same for The Lamp? Kate Johnson, RN Editorial response: Thanks for reaching out and looking to make positive changes to help protect our environment. The NSWNMA made the switch to bio-degradable plastic wrap in December 2016 which is indicated by the bio-degradable logo on the wrap of each issue.

Advertise in The Lamp and reach more than 66,000 nurses and midwives. To advertise please contact Danielle Nicholson 02 8595 2139 / 0429 269 750



Private hospital nurses win ratios Macquarie University Hospital (MUH) in Sydney’s north, becomes the first private hospital in NSW to agree to shift-by-shift ratios for nurses.


he NSW Nurses and Midwives’ Association has negotiated minimum nurse-to-patient ratios in Macquarie University Hospital’s latest enterprise agreement (EA). Staffing ratios for wards and units will be 1:5 for morning shifts, 1:6 for afternoons and 1:10 at night. Registered nurses must make up at least 75 per cent of staff on every shift in the wards.

‘Putting ratios in the agreement ensures that patient safety can’t be compromised by poor staffing’. — Jenny Gilchrist

The EA also mandates ratios for ICU/CCU (1:1 for ventilated and other critically ill patients), Day Oncology (1:4) and Perioperative Services (as per 2017 ACORN staffing standards).

times. But management are pretty good at staffing to acuity, using casuals, existing staff and agency staff when required.

Members have won pay increases totalling 6.3 per cent over 2.5 years from 1 January 2018 to 1 July 2020. From July 2018, a Year 8 registered nurse at the 182-bed MUH will be paid $1710.55 per week – 1.5 per cent more than the public health system rate of $1685.10. The MUH’s NSWNMA branch has unanimously endorsed the agreement. Members were due to vote on it when this edition of The Lamp went to press. MUH branch president Jenny Gilchrist, a nurse practitioner, said winning mandated ratios was a major breakthrough. “Putting ratios in the EA gives us a minimum standard for safe practice. It ensures that patient safety can’t be compromised by poor staffing,” she said. “Like most hospitals, we are short of staff at 8 | THE LAMP NOVEMBER 2018

“If the hospital wants to recruit staff they know they have got to offer competitive working conditions – there are two other private hospitals within 10 km of MUH.”

BRANCH MEMBERS HAPPY WITH GAINS She said nurses also welcomed increases in pay and allowances which would also help to recruit staff. “The hospital is at the end of the M2 tollway in northern Sydney and a decent rate of pay is particularly important to attract and retain those nurses who might have to pay tolls of up to $20 a day to get to and from work.” Jenny was a member of the NSWNMA team that negotiated the EA between February and September. “We met with management for three hours every week. It was a significant burden for everyone involved



but branch members are very happy with what we’ve achieved,” she said. Other improvements won at MUH include 12 weeks paid parental leave, five days paid family and domestic violence leave and improved qualification and on-call allowances. Jenny said 10 weeks paid parental leave had been hospital policy in the past, but management had refused to formally include it in the EA until now.

AGREEMENT DELIVERS BETTER PAID PARENTAL LEAVE In the previous policy, parental leave was paid in two parts – half on commencement of parental leave and the other half on return to work. Under the newly negotiated EA, it is to be modernised and paid as full pay weekly for 12 weeks, or half-pay weekly for 24 weeks. “It was significant to get parental leave recognised as our right under the EA,” she said. “The agreement includes other measures to improve work–life balance for nurses. “Staff no longer have to be on call for 24 hours to receive the on-call allowance; they can be on call for eight-hour or 12-hour periods. “Nurses must now get a 10-hour rest break after overtime and work performed on recall.

“Our director of nursing, Deborah O’Neill is very keen to make sure that nurses have a good work–life balance and she strongly supported these measures.” Jenny said a new clause on prevention of bullying and harassment in the workplace “shows the hospital want their staff to work in an environment conducive to their physical and mental health”.■

How member leaders at MUH organised to win • They arranged regular Branch meetings • Ensured good member participation at Branch meetings, particularly from perioperative staff • Attended bargaining meetings with management • Reviewed and amended draft clauses • Reported back to members • Directly sought feedback from members and passed this on to the bargaining team. THE LAMP NOVEMBER 2018 | 9


Ratios should help recruit staff


heatre nurse Verita Roach, a member of the NSWNMA negotiating committee at MUH, said winning guaranteed ratios was a “fantastic achievement”. “Before now, we could never be certain we would have adequate staffing on a shift. Hopefully, mandatory ratios will help to recruit more nurses so we can reduce the reliance on overtime,” Verita said. “In theatre, we have been expected to work long hours to cover shifts. Getting ACORN staffing standards will give us something to fall back on if we feel that staffing arrangements are not satisfactory. “Nurses are generally very pleased with the agreement and keen to see it in place and up and running. Hats off to the union officers and branch officials – they did a great job. “Ward nurses are particularly pleased about getting the ratios. They have been under a lot of stress due to short-staffing and want to be able to give their best for the patients.”

‘Ward nurses are particularly pleased about getting ratios. They have been under a lot of stress due to short-staffing and want to be able to give their best for the patients.’ — Verita Roach Verita said theatre nurses welcomed the new EA provision for 10-hour breaks after overtime shifts. “Overtime is very common in theatres and our nurses sometimes have to drive an hour and a half to get to and from work. “The change to the on-call allowance is another improvement. Staff no longer have to be on call for 24 hours to get the allowance, they can go on call for eight hour or 12 hour periods. “That means you don’t have to lose your entire weekend when you go on call.” ■ 10 | THE LAMP NOVEMBER 2018


Macquarie University Hospital agreement: main outcomes > Shift-by-shift ratios • Minimum ratios to be included in the enterprise agreement for the first time • Minimum ratios for wards/units are 1:5 AM, 1:6 PM and 1:10 ND • Ratio for ICU/CCU: 1:1 for ventilated and other critically ill patients • Ratio for Day Oncology: 1:4 • Perioperative Services: staffing as per the 2017 ACORN staffing requirements • 75 per cent RN skill mix • Like-for-like replacement of absences • Support for NUMs in working with staffing ratios

> Pay increases (for the 2.5-year period from 1 January 2018 to 1 July 2020):

>Improved On-call Allowance: • Increase on-call allowance rates by 10 per cent on 1 January 2018 and a further 10 per cent on 1 July 2019 • Introduce hourly rate model

> Incharge Allowance to increase by 2.8 per cent on 1 July 2019 • New classification levels added to enterprise agreement: • New CNS Grade 2 • New CNE Grade 2 • New CNC Grade 2 and 3 • Nurse Managers included in EA

>A  iN classifications linked to student nurses’ year of study:

• 1.2 per cent back paid to 1 January 2018 • 2.4 per cent back paid to 1 July 2018 • 2.7 per cent on 1 July 2019

• Year 2 student nurse working as an AiN will be classified as a 3rd year AiN • Year 3 student nurse working as an AiN will be classified as a 4th year AiN

> Allowances will increase as per the pay increases above, except as follows:

> 1 0-hour rest break after overtime and after work performed on recall

> Improved Qualifications Allowance:

> Improved parental leave:

• Level 1: $38 per week (relevant post-registration hospital certificate, postgraduate certificate) • Level 2: $50 per week (relevant postgraduate diploma or additional degree) • Level 3: $62 per week (relevant masters or doctorate)

• 12 weeks primary caregiver and adoption leave • 2 weeks secondary caregiver leave • a modernised parental leave clause

> Improved rights for casuals: • Casual loading to be paid on weekends in addition to the penalty rate • Casual loading to be paid in addition to the penalty rate when casuals work overtime • Option of casual conversion after 26 weeks of regular and systematic employment

> I ntroduction of lactation breaks: 30 minutes paid break > New family and domestic violence leave clause including 5 days paid leave and 5 days unpaid leave > New continuing professional development (CPD) clause including 2 days paid CPD leave >C  onfirmation that the in-charge allowance is payable to nurses below the level of NUM who are designated in-charge > New limits on the use of temporary employment and fixed term employment > Improved workload management clause, including time frames for addressing issues > New bullying and harassment clause > Enterprise agreement has been significantly re-drafted to made it clearer and more accessible to members



Japara wields the axe Aggressive cost-cutting at Japara nursing homes shows why aged care needs nurse-to-resident ratios laws.


ged care nurses are resisting aggressive job cuts by Japara Healthcare under a company-wide roster-restructuring program. Nursing hours have been cut at Japara facilities nationwide over the past 12 months. In NSW they include South West Rocks, Coffs Harbour, Forest View, Henley Manor, Wyong and Albury. NSWNMA General Secretary Brett Holmes said the cuts are further proof that many aged care providers will not provide adequate care unless they are legally obliged to. Brett said Japara is changing roster times to reduce staffing – for example, by increasing night shift hours that involve fewer staff. Japa ra Hea lt hca re’s chief financial officer, Christopher Price, boasted that the new rosters would boost profits. Price told an investors’ conference in Aug ust that “operationa l initiatives largely related to the roster optimisation program ... are running across all of our homes”. He said 14 initiatives were completed in the first half of 2018 financial year and 15 in the second half, with the rest to be completed during the first half of the 2019 financial year. He added: “This program is a key initiative for Japara, which should enable a further reduction in our wages-to-revenue ratio in FY ’19. “Staff cost as a percentage of revenue has reduced in the last 12 | THE LAMP NOVEMBER 2018

‘Japara told the gathering in Albury that the “minimum” is being met. Surely we can aim for better than that.’ — Albury Border Mail two halves to 69.5 per cent in the second half of FY ’18, versus 70.7 per cent in the second half of FY ’17, as the roster restructure program is progressively implemented.”

THREATENED WITH DISMISSAL FOR SPEAKING PUBLICLY At Japara’s Albury and District nursing home, staff said they were threatened with dismissal if they “brought the company into disrepute” by speaking publicly about the cuts. However, they received welcome support from NSWNMA public hospital members who attended a rally outside the nursing home to call for mandatory ratios in aged care (see story page 14). A meeting of residents and family members at the Albury facility unanimously called on the company to abandon proposed staff cuts and instead employ more nurses. In an editorial, Albury’s Border Mail newspaper said the fears of residents and their family members were not allayed when Japara Healthcare addressed the meeting. The paper said: “Japara staff told the gathering in Albury that the ‘minimum’ is being met. Surely we can aim for better than that.”

“Here are some questions and issues we would like to see addressed: Are staff numbers in nursing homes sufficient since there is no minimum legal ratio of staff to residents, no minimum training requirement and no statutory requirement to have a nurse on duty at all times? “Should there be minimum requirements, since nurses now make up only 24 per cent of staff (and this is shrinking), and personal care assistants are now almost three-quarters of all staff? “ T he on ly cu r rent lega l requirement is the unenforceable rule that staff numbers are ‘adequate’.” The strength of local opposition in Albury appears to have forced Japara to partially back down from its aim to cut two staff members on day and night shifts. When this edition of The Lamp went to press, it seemed the company was instead seeking to reduce staffing from one registered nurse (RN) and five assistants in nursing (AiN) to one RN and four AiNs on a night shift. Nurses said even this would leave one nurse to care for a section of 30 residents, including a locked dementia facility, and with two


residents in that facility needing to be lifted by two staff.

CUTS AT WYONG FACILITY TOO Proposed roster changes at Japara’s Wyong aged care facility amount to a cut in nursing hours of about 309 hours per week. The cuts cover the roles of AiN, registered nurse and clinical nurse consultant. In a letter to Japara, Brett Holmes said the Wyong cuts would adversely affect nurses’ capacity to provide quality care to residents and asked that Japara conduct a risk assessment of the impact on nurses. He noted the Wyong facility failed a “significant number” of aged care quality standards set by the regulator in April this year. “Whilst this was not under Japara’s management, we are concerned that a further reduction of staffing is ill advised.” Brett said changed shift times would increase the length of night shift, when traditionally skeleton staffing was provided and many residents remained awake and active. “The reduction of the afternoon shift length in particular will have a real impact on a number of our members’ contracted hours and incomes,” he said. ■

Japara CEO’s big payday Japara was named in a report by the Tax Justice Network as one of the big six providers posting enormous profits while taking advantage of $2.17 billion in taxpayer subsidies. The company took around 70 per cent of its revenue from government funding. In an article headed “Time to justify expenses in industry littered with neglect, abuse”, Sydney’s Daily Telegraph reported that “Japara handed CEO Andrew Sudholz $2.09 million in pay and perks, including $990,000 in bonuses in the 2017 financial year”. “At the same time as the company reported a profit of $29 million, it ordered staff to not check on residents overnight in a move that was criticised as a way to reduce staffing,” The Telegraph said. “In the annual report Mr Sudholz set out just how bright the outlook was to make more money: ‘The fundamentals of the residential aged care industry remain favourable given Australia’s ageing population and increasing prevalence of entering residential care at a later age, with more chronic and complex health conditions, including dementia’.”

STOP PRESS As The Lamp goes to print Japara announced the proposed changes were no longer to go ahead. The staffing at all Japara facilities is an ongoing concern to the ANMF. The residents’ families say staffing is still inadequate to ensure safe resident care and wish to continue fighting with the nurses. THE LAMP NOVEMBER 2018 | 13


Public hospital members step up in support When Albury and District nursing home staff were threatened with dismissal if they went public about looming hours cuts, NSWNMA members at Albury Base Hospital stepped into the breach.


even Albury Base Hospital members, including six from mental health unit Nolan House, joined a rally outside Japara’s Albury nursing home to support their aged care colleagues. They waved placards alongside the busy road and collected signatures on a nationwide nurses’ petition calling for mandatory ratios in aged care. Catherine Winchester, NSWNMA branch president at Nolan House, said members believed the public deserved to be told about the threat to nursing hours and resident care. “We are a strong group and one of our biggest bugbears is management not allowing staff to have free speech,” she said. “When we found out that aged care workers were not allowed to have a voice because their jobs were threatened, we decided to stand up and support them.” Catherine reported a positive response to the rally from passersby and family members arriving for a meeting inside the nursing home. 14 | THE LAMP NOVEMBER 2018

‘When we found out that aged care workers were not allowed to have a voice because their jobs were threatened we decided to stand up and support them.’ “Most people k now from personal experience or friends of friends that there is understaffing and that nursing home staff were really pushed. “They were appalled that staff numbers could be cut even further. “Most of them could relay stories to you about someone they know in a poor state in a nursing home. They were disgusted to hear that it would get worse as a result of nursing hours being cut.”

MANAGEMENT BLOCK OUT RALLY Inside the nursing home, management pulled down the window blinds – presumably so people inside could not see the rally. They also called the police, who sat in a van nearby.

“After a while the police drove off, giving us a toot and thumbs up,” she said. “Talk about wasting police time – we were loud and vocal, but we were not dangerous. “We knew as long as we didn’t go onto nursing home land we weren’t breaking any law.” Catherine worked in aged care for more than three years until a resident’s sad passing prompted her resignation. It was dinnertime and Catherine was scrambling to care for 14 residents by herself. One of them, an old lady, was dying. “I wanted to sit with her and hold her hand, so I rang the manager and asked him to send someone to assist me with the other residents,” she said.


‘I thought, this is the last thing I can do for this woman; make sure she’s clean before they come and take her.’ — Catherine Winchester

“He told me to leave the old lady and do my job. “It took four hours for her to pass, which is not a long time – four hours when someone could have sat with her and held her hand. “She was a country and western fan and all I could do was put on one of her cassette tapes, a Charlie Pride album. “During that time, I was trying to toilet and feed the other residents and all I could think of was that old lady. “Now and then I ran back to her room and checked on her and I kept the doctor updated. When I heard the music stop, I’d run back in and change it. “After she passed, I had 45 minutes to wash her, change her nightie and lay her out, ready for the undertaker. “I thought, this is the last thing I can do for this woman; make sure she’s clean before they come and take her. “The residents didn’t get their evening showers that night because there wasn’t time. “That night I decided to walk away from aged care and I never went back.” Catherine says the experience “will live with me forever. I don’t believe anyone should leave this earth on their own. Management could have prevented that if they had been prepared to authorise another nurse to come in.” She describes her experience of working in aged care as “like being on a production line”. “I was going home feeling guilty because I hadn’t had time to properly care for someone.”■

‘A disgraceful breach of trust’ The daughter of a resident of Japara’s Albury nursing home told The Lamp she had seen increasing pressure on “good and caring nurses who are distressed that they are no longer able to give the quality of care that is needed for the well-being of the residents”. “The decrease in staff work conditions and resident happiness has been very obvious over these last months,” she said. “When I visit, the residents openly talk of Japara not really caring about them. They say Japara is only interested in making more money for their shareholders and for their executive bonuses.” She said it was sad to know that her father and many other Australians from the “silent generation (1925–1945)” are seen as “a source of greedy profit by a company that could do more”. In a letter to the management of Japara Aged Care Australia, she and her family described the proposed cuts to night shift staff as “a disgraceful breach of trust and duty of care”. They said the nurses and carers aimed to care for residents with “professionalism and compassion”, but this care could not be sustained with fewer workers. “The residence building is large and so it is difficult for staff to move from one section of the building to respond to residents’ calls. Response times to resident needs are presently inadequate and will be totally compromised if further staff cuts are made,” they warned. They said they were shocked by a Japara management directive reportedly issued in May that staff no longer check on residents overnight. They described the practice of not employing temporary staff when permanent staff are sick or away as “barbaric, further putting staff under incredible stress and potential injury”. In a subsequent letter to Japara, they urged the company to “be bold, brave and ethical and act to increase your staff ratios before the Royal Commission demands you do so”. ■



Rally for ratios leads to staff improvements Bupa initially tried to dissuade staff from attending a rally in support of ratios but later responded with small measures to alleviate workload pressure.


ged care owner Bupa indicated that any employee who attended a brief rally while on duty would be docked four hours’ pay. Bupa issued the warning to staff at its Pottsville nursing home on the NSW far north coast. Nurses say the company also sent Sydney-based, human resources staff to Pottsville who observed the rally and photographed nurses who took part. However, nurses refused to be intimidated and gathered on the footpath in front of the home. They displayed a banner and placards and handed out leaflets calling on the company to urgently employ more staff and for aged care staffing ratios to be made law. Family members and friends of residents joined the rally. To date, it appears no nurse has had their pay docked for attending the protest in their own time on 27 September. Branch delegate and secretary 16 | THE LAMP NOVEMBER 2018

‘At least Bupa is listening to us, which they were not doing before.’ — Sue Wilson Sue Wilson said management put a notice on the staffroom wall warning that any employee who took part in the rally would be docked four hours’ pay.

staff and residents. At least Bupa is listening to us, which they were not doing before.


“We need extra staff – AiNs, ENs and RNs – on all three floors because every nursing category is having more and more work put on them.”

She said conditions had slightly improved since the rally as a result of management introducing staggered start and finish times for some shifts. “Some staff now start an hour earlier to help shower and dress those residents who are awake and can eat breakfast earlier,” she said. “Also, a staff member comes in an hour earlier in the afternoon and they are bringing back the recreation officer for the dementia unit on weekends. “These steps seem to have alleviated a bit of the pressure on

“However, we still need more staff, especially at night.

Sue said workload pressures intensified after management cut nursing hours earlier this year. “We can have an EN looking after as many as 50 low-care and dementia residents across two floors and an AiN trying to care for up to 22 residents.” In a letter to Bupa management, NSWNMA General Secretary, Brett Holmes, said cuts to nursing hours on rosters in March, April and May this year coincided with an increase in residents’ falls. ■


Bupa’s multiple safety issues Association urges company to act on security, manual handling and training concerns.


upa breached the WHS Act by failing to protect nurses at its Pottsville facility from risks arising from exposure to violence and aggression, NSWNMA General Secretary, Brett Holmes informed the company. In a letter to Bupa management, Brett urged it to act on the findings of a n NSW NM A hea lt h a nd safety inspection of the Pottsville workplace in the Tweed region of northern NSW. The union inspection found there were not always enough staff on duty to appropriately move residents who require two or three staff to assist them. The inspection report called on the company to review rosters and ensure relevant staff have manual handling competency. T he repor t sa id re sident aggression made up the largest group of reported incidents in the previous 12 months. Personal duress alarms were not provided and staff were not given de-escalation training. Nurses could be trapped by

‘Staff are placed in designated work areas without the appropriate education or skills to manage challenging behaviour, and told to attend training in their own time.’ — NSWNMA safety report

aggressive patients or visitors at nurses’ stations that did not have a second exit. The inspection report called for second exits to be created where possible, installation of swipe card access to station doors and installation of hardwired duress buttons in all stations. It said staff were placed in designated work areas without the appropriate education or skills to manage challenging behaviour, and told to attend training in their own time. The report recommended that all staff be trained to manage aggressive incidents, be trained in dementia and/or mental health and receive de-escalation training.

It said NSWNM A members raised concerns about bullying and harassment and called on the company to implement systems to deal with those issues. Complaints should be mediated by an external authority not a facility manager. The Pottsville branch of the NSWNMA wrote to the facility m a n a ger ab out m i s si n g or inadequate equipment, including a lack of overhead lifters. The branch said there were not enough commode chairs for showering residents and it took too long to get equipment repaired. New equipment was introduced without staff being trained in how to use it, thereby exposing staff and residents to potential injury. ■ THE LAMP NOVEMBER 2018 | 17


Bupa nurses’ ‘cry for help’ Nurses and relatives tell local paper why facility needs more staff.

Bupa Pottsville nurses are “crying out for help, calling for more staff to be urgently appointed to help them take care of residents” the Tweed Daily News reported. Here is what staff members and residents’ relatives told the newspaper on the day of the rally and earlier:

Assistant in Nursing Gill West: “We were told not to come down (to the rally) or we would be docked; even if we came down for 10 minutes on our meal break we would be docked four hours’ pay. “A lot of staff are feeling threatened and they’re really scared they’re going to lose their job. “(Management) don’t listen to our concerns; we’re constantly run off our feet.” Assistant in Nursing Georgia Meredith: “I’m in the dementia wing and we’ve only got three people to look after 22 residents who are all high care; none of them can look after themselves or shower themselves. “It also puts a lot of stress on residents because they’re uncomfortable and that causes more behaviours for them because they don’t know how to fix the problem. “We’ve only got one staff member on at night who has to try to look after them and change pads by themselves. And it’s not just the AiNs that are stressed; the cleaners and kitchen staff are also stressed. We’re all trying to do our jobs.” Assistant in Nursing Elanor Bilbie: “As it stands, with one nurse to nine residents it’s completely unsafe and on some occasions it can be one-to-23, depending on what shift you’re on. “(Residents are) not getting the care they need. We want to make it safe for all the nursing staff and all of the residents as well. “Some residents who can semi-care for themselves may not see a nurse for six hours and that’s just entirely unfair. It can lead to



isolation and a higher falls risk; just because they can do a few things doesn’t mean they can’t trip over. They could lie there for a few hours and no-one would know.” Shane Thompson, son of a 93-year-old resident: “There’s a lack of quality care because the guys are trying to do way too much; they’re trying their hardest but it’s not fair on them and there’s no management support for them at all. “The flow-on from that is mistakes in medication and quality of care ... I’ve addressed management half a dozen times this year about it and it’s actually just got worse. Nothing has been done. “It’s very stressful for the family; there’s no peace of mind when you leave and you’re always just constantly worried.” James Lees, husband of a resident: He said staff are “pulled in every direction”, which left residents unattended for hours. “It doesn’t look good when I walk into my wife’s bathroom to find faeces all around the toilet bowl. “The hallways are empty because staff are just flat out. It can take 20-40 minutes for a call-out. The nurses are working extremely hard and have to be everywhere.” ■

Income up, costs and care down Bupa’s Australian aged care business made over $663 million in 2017 and over 70 per cent ($468 million) of this was from government funding, a report by the Tax Justice Network found. While revenue increased by $27 million last year, BUPA slashed costs, paying suppliers and employees $3 million less. The Sydney Daily Telegraph reported the Tax Justice Network’s findings on Bupa and other aged care providers under the headline, 'Time to justify expenses in industry littered with neglect, abuse’. A company spokesman told The Telegraph that the salaries of Bupa aged care managing director Jan Adams and chairman, Nicola Roxon – a former federal health minister and attorney-general – were not disclosed by the UK parent company.



Parliament starts the vital conversation on aged care Our federal politicians have been debating a series of bills that will establish the Royal Commission into Aged Care, recently announced by the Prime Minister. The Lamp looks at what some of them had to say about the state of the sector. DR MIKE FREELANDER

Susan Templeman – Macquarie, NSW (ALP)

Luke Howarth – Petrie, QLD (LIB)

“I want to take a moment to talk about three aged-care workers in my community who have for many years been arguing for workforce issues to be addressed. Nurses and Midwives Association members Jocelyn Hofman, Annette Peters and Shirley Ross-Shuley have been fierce advocates for improvement in aged-care nurse wages and conditions and for quotas, and I support them in that call. They know what they’re talking about. They have experienced appalling situations of having to look after too many people, with not enough qualified staff.”

“The message is clear: Any person or organisation doing the wrong thing will be found. We won't stand for substandard care, and we have included the option to shut down an operator who is doing the wrong thing as part of the broader reforms.”


Chris Hayes – Fowler, NSW (ALP)  “Staff are increasingly working in unsafe workplaces, doing increasingly demanding work and spending longer time at work. Many of them are getting less pay than people who are working in our fast-food outlets. Can you imagine? Nurses are looking after older Australians – changing their nappies, regrettably, and doing all that

work, trying to show dignity and care – and many of them are getting paid less than the people who work at McDonald’s!”

Dr Mike Freelander – Macarthur, NSW (ALP)   “Adequate pay and having enough qualified people are essential to getting things right. The Australian Nursing and Midwifery Federation, representing one of Australia’s most respected callings, agrees.”

Keith Pitt – Hinkler, QLD (LIB) “If you live in a regional area, you are linked to that community, and it is important that those communities are provided with the opportunity that services provide in the





capital cities. You should not have to move to a capital city simply to be provided with aged-care services. So I commend the bill to the House.”

improve the conditions of some of our least appreciated workers. The Royal Commission can’t be an excuse for inaction by this government.”

Patrick Gorman – Perth, WA (ALP)

Bert Van Manen – Forde, QLD (LIB)

“Firstly, the staff do not get paid properly. We’ve got to be honest about that if we are going to grow and build this sector for the future. Secondly, we need adequate ratios of qualified staff, qualified carers, qualified nurses and all of the other health and professional workers who engage with the sector.”

“It’s disappointing, in some respects, that we seem regularly in this place to have to legislate for entities and organisations in our communities to do the right thing by their fellow Australians. Be that as it may, when we do identify these issues it is our responsibility to put in place legislation and regulation to deal with the shortcomings we are seeing in our community.”

Lisa Chesters – Bendigo, VIC (ALP) “There are regular reports of there not being qualified nurses on, that people who are sick aren’t replaced and that programming has been cut, and there are questions about the quality of the food.  I do support ratios. We need to look at making sure that we’ve got ratios where we are reaching the complex care that’s required.”

Peter Khalil – Wills, VIC (ALP) “I support their campaign around funding, as to increasing the ratios in the system and the staffing issues generally. Fixing these issues will undoubtedly improve quality of care for some of the most vulnerable members of our society and concurrently

Joanne Ryan – Lalor, Vic (ALP) “The Royal Commission will shine a light on things, but we know now what many of the issues are. We know that there are issues in terms of staff ratios. We know that there are issues in terms of the quality of care. These things need to be addressed immediately.”


Brian Mitchell – Lyons, TAS (ALP) “This is a matter of priorities, and I know that my priority as a parliamentarian is to ensure that elderly Australians live out the final years of their lives with dignity. We need more staff, better wages and better conditions for those who undertake the important work of caring for our elderly.”

Things you can do The NSWNMA and the ANMF continue to campaign to Make Ratios in Aged Care Law. You can help join the campaign and: Like us on Facebook https://www. MoreStaffForAgedCare

Anne Stanley – Werriwa, NSW (ALP)

Go to timeforruby. to tell your politician that you want aged care staff ratio laws

“Given the revelations of Four Corners, it seems that the quality of aged care has not improved and this just isn’t good enough. There has been report after report about the situation.”

Download resources ( au/pages/ratios-foraged-care-campaignresources) and help spread the word about the campaign. THE LAMP NOVEMBER 2018 | 21


The power of speaking out Discrimination and harassment are a plague on the workplace, says Tracey Spicer.


‘Unions are an incredible port of call for anyone experiencing discrimination and harassment. In fact they are the best.’

At the Channel 10 Christmas party that night, “he got up on stage and said to Angela Bishop ‘nice tits Ange’,” Tracey told an audience of nurses and midwives at the NSWNMA’s professional day.

the power of unions when, as a young journalist, she went to work in Traralgon in the 1990s, and covered news about a “plague of white asbestos at the power station”.

hen Tracey Spicer was at the height of her television newsreading career, she attended a workshop led by a Channel 10 executive on workplace policies, including on sexual harassment.

Later that night, Tracey felt someone groping her bottom. When she turned around to slap the offender she realised it was the man who’d led the workshop earlier that day. “I realised it was one of the big bosses and slowly lowered my hand.” The executive was nicknamed “The Groper”, Tracey says, and that evening she contemplated whether to risk her job by raising it, or to “walk away”. She ended up approaching her union delegate, Jason Thompson. “I said, ‘You’re never going to believe what’s happened’, and Jason responded, ‘I know, it’s bloody dreadful; let’s do something about it’. So we joined together to try to change the culture at Channel 10.” Tracey had already experienced 22 | THE LAMP NOVEMBER 2018

— Tracey Spicer

Tracey recalls interviewing “a guy called Dave, who said when he was a kid he used to go and sit on his father’s knee as he worked on the lathe. Dave’s dad died of mesothelioma, and then Dave died a couple of years later of asbestosis.” Tracey worked in conjunction with the unions in the area to make a documentary that helped the workers to agitate for a payout, which they got some years later.

FIGHT THE GOOD FIGHT! Back at Channel 10, Tracey and Jason not only fought against sexism at Channel 10, they fell in love and married. Then, after 14 years with the network, Tracey’s contract was terminated weeks after she returned from maternity leave after the birth of her second child, Grace. Jason again backed her when she sued for

unfair dismissal. Previously the station had tried to sideline her after the birth of her first child, Taj. Six months into the pregnancy she was diagnosed with the life-threatening condition placenta previa, and doctors ordered her to stay on her back for the last three months of pregnancy. Thanks to the “incredible midwives and nurses at the North Shore Hospital”, Taj survived despite being born at 36 weeks, but he was tiny and suffered two lifethreatening lung complications. While Taj was fighting for his life, her producer called offering her a “lower paid, lower profile role”. Tracey, who describes herself as a “bogan from Brisbane”, met with her bosses and said, “What you are suggesting is illegal and immoral and I will take you to court”. With the help of the Media, Entertainment and Arts Alliance she was “invited back to my old job, while he was sidelined”, Tracey said. She learned the lesson that



it’s “always worth fighting the good fight”. It is never easy, though, she warned. “We know in one of two cases you will get a black mark against your name.” Tracey was asked to return to work early after Gracie was born too, but she later realised it was a ruse to create a “technical separation from the maternity leave”.

SACKED FOR BEING A MUM Tracey was famously sacked when she returned after Gracie’s birth. Rather than “sign a press release saying I’d chosen to leave for family reasons”, Tracey decided to speak out about an industry notorious for judging women on their age and appearance and for discriminating against mothers. “I have had hundreds upon hundreds of emails from people saying ‘this had happened to my wife, my aunt, my daughter, my mother’. It is a plague on workplaces, and I take my hat off to anyone who takes action because it is incredibly difficult.”

my daughter said, ‘Why do women wear make-up and men don’t?’ I said there is a long history of women being judged on their appearances and not what is in their hearts.” In a recent TedX talk that has had more than 5 million views, Tracey, who has been told to lose weight and “stick out her tits” at work, stripped away her newsreader’s clothes, wiped off her make-up and took off her high heels. “Women spend a third of their income on their appearance in customer-facing professions,” she said. “That is an industrial issue for me.” More recently, Tracey has become the figurehead of the Australian arm of the #MeToo movement, initially helping expose men such as Don Burke, host of Burke’s Backyard. “We are in a tremendous time of change at the moment,” she said. “We will look back on this period and it will be equivalent to the civil rights movement of the 1960s.”

Sky News soon contacted Tracey and offered her family-friendly shifts, but she didn’t stop agitating for equality.

To date, Tracey has received 2000 disclosures from women of sexual harassment and abuse at work, but Australia’s defamation laws prevent the vast majority of them from becoming public.

“I was putting on make-up and

She has founded the organisation

NOW, a non-profit that connects people with legal and counselling help. While the focus of the #MeToo movement has been on famous and wealthy women, Tracey grew up in a poor working-class family and says she is particularly concerned about the most powerless workers, such as cleaners and hospitality workers. “Unions are doing incredible work in this area. Unions are an incredible port of call for anyone ex p er ienci ng d iscr im inat ion and harassment. In fact, they are the best.” Her final message was for women to keep speaking out. “How bloody good does it feel when you do it? It really is very cathartic.” n

WATCH Tracey Spicer on TEDx Talks: https://www. watch?v=PENkzh0tWJs THE LAMP NOVEMBER 2018 | 23


Prescribing is the future With the right training and competencies, nurses could take on a much bigger role in medicine prescribing says Professor Lisa Nissen.


peaking at the NSWNMA’s Professional D a y, Professor Nissen, Head of the School of Clinical Sciences at Queensland University of Technology, said nurses and midwives are already handling and administrating medicines as part of their day-to-day practice and are in an excellent position to expand their practice to prescribing. “You already touch medicines everywhere, you have roles in administration, you are already in prescribing [environments].” Nurses, she said, are “ethical, you’re excellent communicators, you work in collaborative teams with other people, you communicate across different boundaries”. Currently prescription medicines cost the Pharmaceutical Benefits Scheme (PBS) 11 billion dollars a year. But not all of that money is well spent, she said: “In 10 to 20 per cent of cases [medicines] hurt people”. One issue is that “the space around medicine is getting much more complex,” she said. In her own lifetime, assessment and care of patients “has gone from being one or two people to now being myriad different health practitioners”. Nurses can play a central role in prescribing in an environment where care is increasingly fragmented, she said. And there are also growing issues around patient access to complex information. Nurses have a particular strength in patient communication, and “I do think engaging patients in their care in this age of digital technology is going to be really important. “Taking a history, working out whether medication is appropriate,


‘I do think engaging patients in their care in this age of digital technology is going to be really important.’ — Professor Lisa Nissen communicating that to the people that are relevant, and making sure you review it where it is required,” are key skills nurses can bring to prescribing, she said. Professor Nissen has been an expert adviser for the National Prescribing Service on prescribing comp etenc y st a nda rd s, a nd she’s been closely involved in the training and development of nurse

practitioners, who have been able to prescribe for more than 15 years. She spoke about the different prescribing models that could be used for professions such as nurses, pharmacists, podiatrists, physiotherapists and optometrists, from independent prescribing practitioners to those who are closely supervised.


Current nurse and midwife prescribing in Australia

PRESCRIBING IS NOT MYSTERIOUS What is needed though is an overarching “super model,” she said. “We want to have a consistent way we do this for people, making sure people are safe and have the right knowledge to work.” There is nothing mysterious about prescribing, she told the conference. “We often think it is special, but prescribing is a tool like any other clinical tool, that you use and you teach at your universities to graduates.” “We as pharmacists like to lay claim to medicines as being special, just because we spend four years doing it. Yes, there are things around the clinical decision making that involve drugs that you need to know about, but the rest is very generic.” “We don’t spend enough time in the curriculum on confidence for prescribing. Most of our training programs prepare health practitioners to take excellent clinical histories. We learn lots about our patients, and we understand our patients. We have a reasonable understanding of treatments and we are really good at communicating with other people, but when we have particular decisions about prescribing, we are not so great [at teaching this].” Research from Professor Nissen’s own university shows that when prescribing competencies are taught and assessed in programs that do involve medicine, not surprisingly graduates’ confidence in prescribing is very high. Prescribing is the “future” for nurses, Professor Nissen said. “You don’t want to be in the situation where 10 years from now or 20 years from now you have three or five per cent of profession involved in prescribing.” “We are trying to put prescribing on top of your core training, whether you are an NP or whether you are an eligible midwife. [And] I would say to you, when you are doing your next standards, please put prescribing in the undergraduate program for midwifery.” Professor Nissen ended by encouraging nurses to take ownership of prescribing spaces. “We need to revolutionise health care … and to do that we need major system change. You’ve got to think about scope of practice, and it is about optimising the skills that you bring to the system. “You can do more. I would say to you this opportunity is rare, but it is the right one now for nursing and midwifery going forward.” ■

Nurse prescribing was first introduced in Australia in 2000 with the creation of nurse practitioner (NP) roles. Now prescribing is established practice for midwives with an endorsement for scheduled medicines; other health professions in areas such as dentistry, podiatry, pharmacy, and optometry now hold varying authorisations to prescribe. Nurses and midwives who prescribe and manage medications are subject to Nursing and Midwifery Board of Australia (NMBA) regulatory requirements, and they must complete an approved postgraduate education program. Since 1 November 2010, NPs and midwives with a scheduled medicines endorsement have been able to prescribe medicines subsidised by the Pharmaceutical Benefits Scheme (PBS). Medicines that NPs and midwives may prescribe independently within the PBS are listed and others are identified as medicines NPs may prescribe for ‘continuing therapy only’ after a medical officer makes the first prescription.

Listen to the podcast You can listen to all of Prof Nissen’s presentation at http:// THE LAMP NOVEMBER 2018 | 25


Stolen, now suffering A new federal government report finds that members of the Stolen Generations suffer chronically poor levels of physical and mental health.


hen Australian authorities removed generations of Indigenous children from their families between 1910 and 1970, they justified their actions by arguing Indigenous children would have better lives and opportunities in white society. If anyone still needed evidence this official argument was nonsense, a new report from the Australian Institute of Health and Welfare has found members of the Stolen Generation are suffering chronically poor levels of physical and mental health. The 17,000 members of the Stolen Generations living across Australia today have “higher levels of adversity  in relation to most of the 38 key health and welfare outcomes analysed in the report,” said Professor Steve Larkin, chair of The Healing Foundation Board, the organisation that commissioned the report. “Even compared to Aboriginal and Torres Strait  Islanders in the same age group,  who are already at a disadvantage, Stolen Generations members are suffering more,” said Professor Larkin,  a former social worker. The report found that compared to Aboriginal and Torres Strait Islanders in the same age group, members of the Stolen Generations  are  three times more likely to have been incarcerated in the last five years. They are also almost twice as likely to rely on government payments, and 1.5 times more likely to experience poor mental health. And they are more likely to suffer chronic health conditions such as cancer, diabetes and heart disease. “For the first time, we have comprehensive data to illustrate a direct link between poor health and This report provides estimated numbers and demographic characteristics of the Stolen Generations and descendants using a series of ABS surveys. It also presents range welfare outcomes and the forced removal of atens of health and socioeconomic outcomes for the Stolen Generations and descendants, and differencessaid with of thousands of children from their families,” Indigenous and non-Indigenous comparison groups, the effects of removal from families. Professor Larkin. “We can alsotoTheexamine see the ongoing impact findings in the report will be useful to assess on subsequent generations.” the needs of the Stolen Generations and their families. Professor Larkin said the level of disadvantage outlined in the report was appalling but should not come as a surprise. “The Stolen Generations were denied a proper education or a decent wage, which put them at a financial loss right from the start. But more fundamentally, they endured significant childhood trauma when they were taken from their families, isolated, institutionalised and often abused.


Stronger evidence, better decisions, improved health and welfare

‘For the first time, we have comprehensive data to illustrate a direct link between poor health and welfare outcomes and the forced removal of tens of thousands of children from their families.’ “If people don’t have an opportunity to heal from trauma, it continues to impact on the way they think and behave, which can lead to a range of negative outcomes, including poor health, substance abuse, suicide and violence.” The report is the first step in The Healing Foundation’s Action Plan for Healing project, which the federal government funded last year. ■

Aboriginal and Torres Strait Islander Stolen Generations and descendants Numbers, demographic characteristics and selected outcomes

Read the report https://www.

WHAT’S ON at Family Planning NSW in 2019 Calendar for Nurses and Midwives Well Women’s Screening Course*

Reproductive and Sexual Health Clinical Accreditation Program Designed to prepare nurses and midwives to function in an extended clinical role as a practitioner in the specialty of reproductive and sexual health. Includes pre course online activities, a two day workshop, 21 weeks online learning and assessment and up to 32 hours of clinical placement at a Family Planning NSW clinic. Workshop dates 13 & 14 February (Ashfield), 5 & 6 September (Newcastle)

Nurse Education Day & Clinical Forums Update your knowledge of contemporary reproductive and sexual health topics. Nurse Education Day 24 May (Ashfield), 13 September (Newcastle) Clinical Forum 9 February (Dubbo), 30 March (Port Macquarie) 23 November (Wollongong)

Reproductive and Sexual Health for Midwives Aims to increase midwives’ ability to provide holistic care for women and their families during the reproductive continuum. Includes pre course online activities, 16 weeks online learning and assessment and a two day workshop. Workshop dates 10 & 11 April (Ashfield) 30 & 31 October (Ashfield)

Designed to help registered nurses, midwives and enrolled nurses develop confidence and competence in the provision of cervical screening, breast health education and history taking. Includes pre course online learning and assessment, one day workshop and up to 14 hours of clinical training. Workshop dates 28 March (Newcastle), 9 May (Ashfield), 22 August (Tamworth), 16 October (Penrith), 21 November (Liverpool)

Cervical Screening Upskilling* A practical workshop for health professionals wanting to improve their knowledge, refresh skills and gain clinical experience in cervical screening. Includes pre course online activities and a 4 hour workshop. Various dates – see for details

IUD Insertion Training This clinical competency based training develops skills and techniques in IUD insertion. Content includes IUD types, pre-insertion assessment of patients and management of IUD related problems. Includes pre course online activities, three hour workshop and up to 16 hours of clinical placement. Workshop dates 20 February (Ashfield), 9 May (Newcastle) 29 May (Ashfield),18 September (Ashfield)

Cervical Screening Program Update Webinars Following the implementation of changes to the National Cervical Screening Program (NCSP) on 1 December 2017, these webinars include up-to-date information on the NCSP, followed by case studies and a Q&A session. Various dates – see for details

Please check our website for full details, course fees and to register at We are proud to offer a series of scholarships as part of our commitment to the health professionals of NSW. * These courses are fully funded by the Cancer Institute NSW. All dates correct at the time of printing.




Ten minutes of exercise a day improves memory Exercise not only benefits your body but also improves your memory, according to a new study. The research by scientists at the University of California found that short bursts of activity – such as 10 minutes of slow walking, yoga or tai chi – led to increased connectivity between parts of the brain responsible for memory formation and storage. The researchers asked healthy volunteers in their early 20s to do 10 minutes of light exercise – at 30 per cent of their peak oxygen intake – before assessing their memory ability. The memory test was then repeated on the same volunteers without exercising. In the brains of those who had exercised they discovered enhanced communication between the hippocampus – a region important in memory storage – and the cortical brain regions, which are involved in vivid recollection of memories. The people who had exercised were better at separating or distinguishing between the different memories, the scientists wrote in the Proceedings of the National Academy of Sciences (September 2018). “An evening stroll is sufficient to get some benefit,” Michael Yassa, a neuroscientist at the University of California and project co-leader told The Guardian. Yassa said that the frequency and exact amount of exercise will depend on the person’s age, level of mobility, potential disability and other lifestyle factors.

‘An evening stroll is sufficient to get some benefit.’


India launches massive healthcare initiative A new health reform called ‘Ayushman Bharat’ (Healthy India) aims to deliver free health care for the poorest 40 per cent of the population or 1.25 billion people. According to Indian government estimates, more than 60 per cent of an average family’s current spending goes on medicines and healthcare. A private consultation can cost 1,000 rupees ($US15) – an enormous amount in India. A recent report in The Lancet found that substandard healthcare was responsible for an estimated 1.6 million deaths a year in India – the highest in the world. The new initiative – dubbed the world’s biggest health insurance scheme – will provide low-income families with 500,000 rupees ($US7,100) in annual health insurance to treat serious illnesses. The government also plans to open 150,000 ‘health and welfare’ centres staffed by nurses, traditional medicine healers and other health workers, by 2020. However, the scheme has its critics. Some experts say the scheme focuses too heavily on hospitalisation and not enough on primary health care. “Putting a high emphasis on expanding inpatient care does not seem appropriate when so many of India’s health priorities – eg, increasing immunisation rates and tackling infectious and non-communicable diseases – would be better dealt with in primary care settings,” the former Director-General of WHO, Gro Harlem Brundtland, wrote in The Lancet. Political opponents called it an “election gimmick”. “This is going to be another scam. It will only benefit private insurance companies,” said Sanjay Nirupam, from the country’s opposition, the Congress Party.

‘So many of India’s health priorities would be better dealt with in primary care settings.’ — Gro Harlem Brundtland, former Director-General of WHO 28 | THE LAMP NOVEMBER 2018



HIV down overall, but on rise in straight Australian men HIV diagnoses have hit a seven-year low in Australia, but the trends among heterosexual men are less encouraging. A report by the Kirby Institute at the University of NSW found that among gay and bisexual men, new diagnoses fell by 15 per cent in one year from 2016 to 2017. The decrease was even more marked among Australian-born gay and bisexual men at 25 per cent. New HIV diagnoses attributed to heterosexual sex rose 10 per cent over the past five years and 14 per cent between 2016 and 2017, according to the Kirby report. Heterosexual sex accounted for one in four new HIV diagnoses in 2017 (238 people: 145 men and 93 women). New HIV diagnoses in men that were attributed to heterosexual sex (rather than injecting drugs) rose 19 per cent over the past five years.

MEMBERSHIP FEES 2019 NSW Nurses & Midwives’ Association – in association with the Australian Nursing & Midwifery Federation Year



Enrolled Nurse: $649.00 $162.25


Assistant in Nursing+ & Assistant in Midwifery: $535.00 $133.75 $44.58 $20.56 Undergraduate Bachelor of Nursing /Midwifery or Diploma of Nursing^: $267.00 $66.75 $22.25 $10.26 Membership fees are tax deductible Trainee AIN’s have fees waived for the duration of their traineeship Students working in a nursing role while undertaking an Undergraduate Bachelor of Nursing/Midwifery or Diploma of Nursing for the duration of the bachelor/diploma. *All membership fees include GST




‘(The drop among gay and bisexual men) is a fantastic achievement for Australia.’

ABN 63 398 164 405


“This is a fantastic achievement for Australia, and reflects strengthened clinical and public health initiatives, and the leadership of people living with HIV,” Professor Guy said.



The drop among gay and bisexual men is the result of an increase in HIV testing and treatment, and the rise of preexposure prophylaxis (PrEP), all of which reduce the risk of individuals transmitting the virus, the report said.


Registered Nurse & Midwife: $764.00 $191.00 $63.66

The rise in HIV among heterosexuals was small but concerning, the head of the Kirby Institute’s Surveillance, Evaluation and Research Program and co-author of the report, Professor Rebecca Guy, told the Sydney Morning Herald. Overall the number of HIV diagnoses fell to 963 new cases in 2017 – the lowest number since 2010 and a 7 per cent drop in the past five years.


BUY THE DIARY THAT SAVES LIVES Every dollar raised from this diary goes to clinical trials research that saves and improves the lives of people with breast cancer. Buy the diary and help to save lives today, tomorrow and forever. LISA WILKINSON Host, Channel Ten’s

The Sunday Project, mum and wife.



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Coalition called “dishonest” over $8 million aged care TV campaign The federal government spent $8 million on an advertising campaign promoting home-care packages it knew many elder Australians would not be able to access for years.


Amazon: “Unions are lying, cheating rats” “We are not anti-union but we are not neutral either”, an Amazon training video begins. What follows is a 45-minute-long, aggressive assault on the rights of its workers to organise. The video was produced by the Amazon subsidiary Whole Foods – bought by the parent company for $US13.7 billion last year – for its “team leaders” and leaked to the US technology website Gizmodo. “We do not believe unions are in the best interest of our customers, our shareholders, or most importantly, our associates. Our business model is built upon speed, innovation, and customer obsession – things that are generally not associated with union,” the video claims. The animated video gets to the guts of its message in the section titled “Warning signs”. Examples given to indicate worker “disengagement, vulnerability to organising, or early organising activity” include: • use of words like “living wage” • workers raising concerns on behalf of their co-workers •w  orkers “who normally aren’t connected to each other suddenly hanging out together” •w  orkers showing an “unusual interest in policies, benefits, employee lists, or other company information” • increased negativity in the workplace. The video warns managers against threatening employees, but advises that personal opinions that have the same impact are within their rights. “Opinions can be mild, like, ‘I’d rather work with associates directly,’ or strong: ‘Unions are lying, cheating rats.’ The law protects both!” it says. Amazon is the United States’ second-largest employer. It has opened two giant warehouses – called “fulfillment centres” – in Australia in the last year.

‘Warning signs of union activity include the use of language like “living wage”.’ 30 | THE LAMP NOVEMBER 2018

The comprehensive online, print, radio and TV advertising campaign told seniors they should start planning for the future and living independently. It advised them the federal government had provided “20,000 extra high-level home-care packages to help you stay at home … for longer”, reported The Australian. At the time of the campaign the waiting list for home care packages was 108,000 and rising fast. The latest figures show the national priority queue has grown to more than 121,000 people. Labor aged-care spokesperson Julie Collins told The Australian the government should have been honest with voters instead of “trying to deceive them with taxpayerfunded advertising’’. “The Liberals have misled vulnerable older Australians and given them false hope about accessing care at home as the waitlist grew significantly,” she said. “What’s worse – they have wasted millions of taxpayer dollars on this expensive exercise.” Council on the Ageing (COTA) chief executive, Ian Yates, told Sky News that the government’s policy was inadequate and called for it to fund another 30,000 packages immediately. “The government put 20,000 extra home-care packages into the system last year and in this year’s budget, but we are still well short,” he said. According to COTA $1.5bn would be needed to close the gap in support for older Australians who needed serious help to remain at home.

‘They have wasted millions of taxpayer dollars on this expensive exercise.’



ICN calls for nursing leadership on climate change Climate change has the potential to undermine the past 50 years of public health gains, says the International Council of Nurses (ICN).


WHO recognises Traditional Chinese Medicine for first time The World Health Organization will include information on Traditional Chinese Medicine (TCM) in its influential global medical compendium. According to Nature magazine, the global reach of the compendium is “unparalleled”. “The document categorizes thousands of diseases and diagnoses and sets the medical agenda in more than 100 countries. It influences how physicians make diagnoses, how insurance companies determine coverage, how epidemiologists ground their research and how health officials interpret mortality statistics,” it said in its September 2018 edition. Chapter 26 of the compendium will feature, for the first time, a classification system on traditional medicine. WHO has been avidly supporting traditional medicines, especially TCM, as a step towards its long-term goal of universal health care. According to the agency, traditional treatments are less costly and more accessible than Western medicine in some countries. However, many Western-trained physicians and biomedical scientists view TCM practices as unscientific, unsupported by clinical trials, and sometimes dangerous. In response, WHO told Nature that its Traditional Medicine Strategy “provides guidance to Member States and other stakeholders for regulation and integration, of safe and quality assured traditional and complementary medicine products, practices, and practitioners”. It stressed that the goal of the strategy “is to promote the safe and effective use of traditional medicine by regulating, researching and integrating traditional medicine products, practitioners and practice into health systems, where appropriate”.

‘According to WHO, traditional treatments are less costly and more accessible than Western medicine in some countries.’

The ICN – representing 130 nursing associations worldwide – has called on governments, health system leaders, national nursing associations and nurse leaders to “take immediate action to mitigate climate change and to support people and communities around the world to adapt to its impacts”. The ICN President Annette Kennedy said: “As the nursing profession is committed to protecting health and wellbeing and to promoting social justice, it has a duty to work to mitigate the effects of climate change and help people and systems to adapt.” “Nurses have a shared responsibility to sustain and protect the natural environment from depletion, pollution, degradation and destruction.” “There is a clear relationship between climate change and health, with people in low- and middle-income countries facing disproportionate effects,” said Dr Isabelle Skinner, ICN’s Chief Executive Officer. “Nurse leaders can empower individuals, families and communities to make healthy lifestyle choices; work with communities to build resilience to the impacts of climate change; and advocate for policies that promote the reduction of healthcare waste.” In a position statement, the ICN: • u rges countries, that have not yet done so to ratify the Paris Agreement without further delay • c alls on governments to invest in climate change and public health research.

‘There is a clear relationship between climate change and health.’



Enrolled Nurses Forum







Friday 9 November, Gymea $ Members $95 / non-members $190 Learn about potential liability, disciplinary tribunals, NMC and HCCC complaints, Coroners Court and identify the fundamental ethical standards and values to which the nursing and midwifery profession is committed.

Transitioning to the Workplace


New Grad RN New Grad EN New Grad MW


Monday 12 November, Waterloo Wednesday 12 December, Newcastle $ Members $20 / non-members $40 The objective of the training is to ensure that newly registered nurses and midwives are provided with some basic skills to start their professional journey transitioning into the workforce.

NEW! Diabetes Management for Clinical Staff All $


Wednesday 14 November Members $95 / non-members $190




Friday 9 November, Wollongong Members $60 / non-members $120 Program: Wound Care; Measuring a GCS; Culturally Appropriate Healthcare; Professional Obligations and the NMBA Decision Making Framework; Mindfulness. $

Legal, Ethical and Professional Issues for Nurses and Midwives

CPD Made Easy: Are you prepared if you were audited?


Friday 16 November, Hornsby $ 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.

How to be an effective Preceptor and Mentor

Wednesday 28 November, Taree Thursday 6 December, Waterloo $ Members $95 / non-members $190 Learn how to be an effective Preceptor and Mentor. Understand the differences in an effort to appreciate the contribution such relationships can make to the novice nurse / midwife.

Finding Evidence and Implementing into Practice

Thursday 15 November, Griffith Members $95 / non-members $190 This course focuses on what we do as individuals to increase safety for our patients. $




Friday 30 November, Wollongong Members $95 / non-members $190 This interactive workshop is designed to give nurses and midwives the tools to find evidence to support and appraise guidelines and policies. $







Bullying: Let’s put an end to it

Medication Safety, Professional CPD 6 Obligations, Professional Comprehensive Documentation and the NMBA Decision Making Framework (DMF)


Friday 7 December, Gymea Members $95 / non-members $190 This seminar covers topics such as anti-discrimination law, identifying unlawful harassment and bullying, understand what can be done if subjected to harassment and bullying and also assists managers and supervisors to identify, prevent and resolve bullying and harassment. $

Look out for January to March courses in the December-January Lamp and go online for more courses throughout 2019!


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 nurses, midwives & assistants in nursing










Grad RN

Graduate RNs

Grad EN

Graduate ENs

Grad MW

Graduate midwives



Judith Breaking News Consultation on employment check policies The Ministry of Health has begun consultation with public health unions on a proposed reworking of the Working with Children check policy and other related police checks. The proposal does not seem to seek significant change but it does accommodate some changes arising from legislative requirements, as well as administrative processes. The Association is reviewing the proposal and providing feedback as part of this process. Office accommodation The Association, (and other public health unions), continues to try to prevent a slavish adoption of the NSW government approach to office accommodation of “… agile, active and/or flexible models” (i.e. no offices). The Association provided significant feedback to the Ministry based on member comments and thoughts. Legislative Council inquiry into the rollout of the NDIS in NSW The NSW Legislative Council, via Portfolio Committee No 2, has begun an inquiry into the implementation of the National Disability Insurance Scheme (‘NDIS’) and the provision of disability services in New South Wales. The Association provided a comprehensive submission, and gave further oral evidence before the Committee last month. The report is now being developed. Overtime and part-time employees Following representations from the Association, the Ministry has issued PD2018_033, a revised PD which better clarifies the payment of overtime to permanent part-time employees and notes the action of pay averaging over a roster period to mitigate the payment of overtime is not acceptable.

Rectifying underpayments I am a registered nurse working in a public hospital. My pay was recently short changed. Now I have been told I won’t get the missed amount till the next pay run. Is this right? Under Clause 27(v)(a)(i) of the Public Health System Nurses’ and Midwives’ (State) Award, if the amount not paid is equal to or greater than one day’s gross base pay then the underpayment must be

When it comes to your rights and entitlements at work, NSWNMA Assistant General Secretary Judith Kiejda has the answers.

rectified within three working days. Anything less than that outstanding amount will be processed in the next normal pay.

Break between shifts at Ramsay

I work in a hospital operated by Ramsay Health. What is the minimum break between rostered shifts? Under Clause 4 of the Ramsay Health Care Australia Pty Limited, and NSW Nurses & Midwives’ Association /ANMF Enterprise Agreement 2015–2018, rosters will provide for a minimum of eight hours’ break between the finish of ordinary hours on one day and the commencement of ordinary hours on the following day.

Meal breaks at RSL Lifecare

I work in a facility operated by RSL LifeCare. When do I get an unpaid meal break? Clause 16 of the RSL LifeCare, NSWNMA and HSU NSW Enterprise Agreement 2017–2020 sets out that employees shall not be required to work more than five hours’ without an unpaid meal break. Such a meal break will be between 30 and 60 minutes in duration.

plan to withdraw, notice equivalent to the roster period is required. In the case of demonstrated pressing necessity, this notice period can be reduced.

Leave for Aboriginal ceremonies I am a registered nurse who works in a rural area and covered by the Nurses Award 2010. Occasionally I attend traditional Aboriginal ceremonies. What are my rights to be released from work under the Award? Clause 33 of the Nurses Award 2010 provides that an employee who is legitimately required by Aboriginal tradition to be absent from work for Aboriginal ceremonial purposes will be entitled to up to ten working days unpaid leave in any one year with the approval of your employer.

Waiver form for breaks between shifts

I am a former Mona Vale AiN now working at the new Northern Beaches Hospital. When will I receive my transfer payment? It is still anticipated that this will occur in (mid) November, and in conjunction with any leave cashed out (if this has been requested by transferring staff).

I am a registered nurse at a public hospital. We have recently received a waiver form about the 10-hour break between rostered shifts. Do I have to sign this? In short, no. There is no compulsion for you to waive your entitlement under Clause 4(iv)(a) of the Public Health System Nurses’ and Midwives’ (State) Award to have a ten-hour break between your rostered shifts. Further, if you do not agree to waive this right, you cannot be subject to detrimental treatment in seeking to retain an Award right. Equally, however, if you and your colleagues believe an advantage accrues from agreeing to a waiver, then that is permitted under the Award.

Opting out of 12-hour shifts

Extra public holiday

I work in a public hospital ICU and we do 12-hour shifts. I am starting to feel that this is not the best way for me to work. Can I opt out? Under Clause 5(v)(l) of the Public Health System Nurses’ and Midwives’ (State) Award, an individual employee has the right to withdraw from the 12-hour shift system. If you

Just wondering if the extra public holiday has been decided for NSW Health yet? Yes, the nominated date for the extra public holiday in the NSW Health Service over Christmas/New Year in public hospitals is Monday, 31 December 2018.

Northern Beaches Hospital transfer payments


Recently changed your email? Classification changed? online. nswnma.

Log on Update details Go into the draw

WIN AN APPLE WATCH online. nswnma.

Log on and make sure all your details are up to date. You can easily update your address, workplace or credit card details as well as pay fees online, print a tax statement or request a reprint of your membership card – it’s simple! Everyone who uses our online portal from 1 July – 30 November 2018 to update their details will automatically be entered in the draw to win.

* The winner must be a financial member of the NSWNMA. 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/18/02955.


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

New on our Support Nurses YouTube channel

RALLY FOR RATIOS AT NSW PARLIAMENT Nurses and midwives from across the state gathered outside the New South Wales Parliament to voice their concerns on ratios in our public health system and the need for more nurses and midwives.

I’m taking a ‘dignified exit’ From Aged Care A former aged care nurse manager speaks of the incredible issues abounding in the sector, and why she decided to take a ‘dignified exit’. https://www.nurseuncut.

Excellence in Nursing and Midwifery Awards – Winners and Finalist List NSW 2018 Congratulations to all the winners and finalists! Check out the full list here. https://

BOB FENWICK MENTORING PROGRAM 2012-2018 A recap of the Bob Fenwick Mentoring Program since it began in 2012. Connect with us on Facebook Nurse Uncut www.facebook. com/NurseUncutAustralia New South Wales Nurses and Midwives’ Association Ratios put patient safety first safepatientcare Aged Care Nurses agedcarenurses Look for your local branch on our Facebook page Follow us on Twitter @nswnma / @nurseuncut Share on Instagram by tagging @nswnma and don’t forget to use the hashtag #nswnma!

Sexual harassment must be prohibited under industrial law NSWNMA Assistant Secretary, Judith Kiejda, outlines why sexual harassment at work should be considered a safety issue in order to make real change. au/sexual-harassment-must-beprohibited-under-industrial-law-todrive-real-workplace-change/

Poor women who use midwives have healthier babies A study published in the British Medical Journal Open reports that midwifery patients were 41 per cent less likely to have a small-for-gestational-age baby compared to patients of obstetricians. https://www.

Diabetes in Practice for Nurses – Online Course With diabetes the fastest growing chronic condition in Australia, nurses play a pivotal role in supporting people living with diabetes. Diabetes Qualified has developed a course specific to the educational requirements of nurses. diabetes-in-practice/

Listen to our podcast Self-care and resilience in stressful and changing times – dot yam & tiffany baxter. THE LAMP NOVEMBER 2018 | 35

Australian Nursing and Midwifery Federation New South Wales Branch Summary of Financial Information for the Year Ended 30 June 2018


he financial statements of the Australian Nursing and Midwifery Federation New South Wales Branch have been audited in accordance with the provisions of the Industrial Relations Act, 1991 and the following summary is provided for members in accordance with Section 517(2) of the Act, as applied by section 282(3) of the Industrial Relations Act, 1996.

A copy of the Financial Statements, including the independent Audit Report, will be supplied free of charge to members upon request. Certificates required to be given under the Act by the Accounting Officer and the Committee of Management have been completed in accordance with the provisions of the Act and contain no qualifications.

SUMMARY STATEMENT OF PROFIT OR LOSS OR OTHER COMPREHENSIVE INCOME FOR THE YEAR ENDED 30 JUNE 2018 Service fee – NSW Nurses and Midwives’ Association (NSWNMA) Interest income Other income Total income Less total expenditure Result for the year Remeasurement of retirement benefit obligations Total comprehensive income for the year SUMMARY BALANCE SHEET AS AT 30 JUNE 2018 Total equity Represented by: Current assets Non-current assets Total assets Current liabilities Non-current liabilities Total liabilities Net assets INFORMATION TO BE PROVIDED TO MEMBERS OR REGISTRAR In accordance with the requirements of the Industrial Relations Act, 1991 [NSW] the attention of members is drawn to the provisions of Sub-Sections (1) and (2) of Section 512 which read as follows: (1) A member of an organisation, or the Industrial Registrar, may apply to the organisation for specified information prescribed by the regulations in relation to the organisation. (2) An organisation must, on the making of such an application, make the specified information available to the member or the Industrial Registrar in the manner, and within the time, prescribed by the regulations. 36 | THE LAMP NOVEMBER 2018

2018 ($)

2017 ($)



164,607 46,332 21,249,575 (21,106,604) 142,971 52,265 195,236

70,735 8,440 13,697,611 (13,614,586) 83,025 (146,265) (63,240)



8,548,790 8,548,790 7,674,682 708,736 8,383,418 165,372

7,395,968 7,395,968 6,542,478 883,354 7,425,832 (29,864)


The summary financial statements, which comprise the summary balance sheet as at 30 June 2018 and the summary statement of profit or loss and other comprehensive income for the year then ended are derived from the audited financial report of Australian Nursing and Midwifery Federation New South Wales Branch for the year ended 30 June 2018. In our opinion, the accompanying summary financial statements are a fair summary of the audited financial report.

Summary Financial Statements

The summary financial statements do not contain all the disclosures required by Section 510 of the Industrial Relations Act, 1991 [NSW] or Australian Accounting Standards. Reading the summary financial statements and the auditor’s report thereon, therefore, is not a substitute for reading the audited financial report and the auditor’s report thereon.

The Audited Financial Report and Our Report Thereon

We expressed an unmodified audit opinion on the audited financial report in our report dated 9 October 2018. Our Independent Auditor’s Report to the members on the Financial Report did not contain any particulars of any deficiency, failure or shortcoming as referred to in the Industrial Relations Act 1991 [NSW], as applied by Section 282(3) of the Industrial Relations Act, 1996.

Committee of Management’s Responsibility for the Summary Financial Statements

The Committee of Management is responsible for the preparation of the summary financial statements.

Auditor’s Responsibility

Our responsibility is to express an opinion on whether the summary financial statements are a fair summary of the audited financial report based on our procedures, which were conducted in accordance with Auditing Standard ASA 810 Engagements to Report on Summary Financial Statements.

Daley & Co

Chartered Accountants

Stephen Milgate


9 October 2018, Wollongong Liability limited by a Scheme approved under Professional Standards Legislation

A copy of the Financial Report, including the Independent Audit Report, may be found on the Members page of the website www. or can be obtained upon written application to: Brett Holmes, Branch Secretary Australian Nursing and Midwifery Federation NSW Branch 50 O’Dea Avenue, Waterloo 2017



Say Let’s promote ratios on the Opera House! Following the decision by the NSW government to allow a horse race to be advertised on the Opera House, we had our own suggestions. Yep, for sure. If they can promote gambling, then why not promote health care? It’s about time the government took care of things that really matter. Yes, gold. Make this country account for this atrocious treatment of our aged taxpayers living worse than people in third world countries. Well it’s our ICON not the politicians’ or corporations’. So if it is to become a billboard then let’s have it display the people’s views and messages. Omg this is awesome... And the bridge too!

Standing up for aged care Aged care nurses working at Bupa facilities were warned they could have their pay docked for attending a rally on ratios. It’s about time the

What nurses and midwives said and liked on Facebook

government took back control of the aged care system. I hope that one day the politicians and CEOs of these aged care facilities get to suffer in these facilities as our loved ones do today. See how long they would last with three pads a day or sedated so heavily that they can’t even speak or swallow. We are all going to be old someday, so wake up, Australia and start trying to fix the problem. I work as a carer with another company. We have posters everywhere encouraging us to ring the aged care complaints line if we see/hear anything not right. But I only see caring staff and happy residents... not all facilities are bad. Whilst the issue is front and centre in the media, this is the time that nurses need to stand together for what is best for themselves in relation to working conditions and patients in relation to their welfare. The worst condition is NOT paying nurses enough to stay. It is a very demanding profession. Clearly, here we see the value of unions, not only for the good they do for workers, but the good they do for society, yet constantly the Liberal party along with the right-wing media attack unions. Why? Is it so greedy corporations can carry on in this manner? Join your union. Make them work for you. That’s what unions do. It’s what they want to do. Companies like Bupa and their ilk will divide and conquer you. You’ll never have the strength, unorganised, on your own.

the gallery

It is their duty to speak out. Multinationals like Bupa are clearly interfering with the proposed inquiry and should be called to account. /1

An outpouring of love


Last month included Emergency Nurses Day, Perioperative Nurses Week, Neo-natal Nurses Day and Mental Health Month. There was an outpouring of love to our friends and family who don’t get the appreciation they deserve. The ED nurse who took care of my son at Hawkesbury Hospital about 6 weeks ago was fabulous! She went above and beyond to help settle him and try and make it as calm as possible for everyone. I distinctly remember the mental health nurse whom I met during a short involuntary stay at Concord psychiatric hospital. Even in that horrible moment she gave me hope that I would recover and re-join my family. Thanks to all our mental health nurses. You do such a great job. Happy Perioperative Nurses Week to all my amazing co-workers at RDS! Hope you guys get maybe one day off this week. Thanks to the most helpful and most compassionate, especially the ones at Wollongong public hospital.



/5 1/ M  ental health nurses who are a part of the Bob Fenwick Mentoring Grants Program 2018 2/ U  K nurses and members of Unison supporting the ANMF Aged Care Ratios campaign! 3/ N  SWNMA members from the Illawarra Shoalhaven region on the rally train to NSW Parliament 4/ Grafton NSWNMA showing their support for ratios 5/ Bombala NSWNMA Delegates at morning tea


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NURSING RESEARCH AND PROFESSIONAL ISSUES The NSW Nursing and Midwifery Council has recently updated its Drug Screening Policy to bring it into line with the rest of Australia. Details are available in the following links along with a link to the relevant ANMF policy. The NSWNMA is committed to a non-punitive, supportive approach to nurses and midwives with hazardous and harmful use of alcohol and drugs.

Nurses and midwives and hazardous and harmful use of alcohol, drugs and other substances Hazardous and harmful use of alcohol, drugs and other substances has the potential to compromise performance at work and adversely affect the health and safety of self and others, including people receiving nursing and midwifery care and co-workers. Where the hazardous and harmful use of alcohol, drugs and other substances is identified, all staff including nurses, midwives and assistants in nursing should be assisted to participate in programs of assistance, support, education and/or rehabilitation. Each workplace should provide accessible, non-punitive and confidential assistance and support programs for nursing and midwifery employees when necessary. Nurses_midwives_AINs_hazardous_drugs.pdf

Nurse and Midwife Support Nurse and Midwife Support (NM Support) is the first national telephone and online service to offer health support to nurses and midwives in Australia. It is free, confidential and available 24/7. Its goal is to contribute to better health and wellbeing for nurses and midwives, and safer care for the public. Nurses and midwives who call the telephone service (1800667877) have 24/7 access to an experienced team who can assist with a wide range of health and wellbeing related issues that may be affecting their practice. The service also provides support to nursing and midwifery students, educators, employers and concerned family members. A website has been designed for nurses and midwives so that they can find health services and information and access to email support. NM Support is a Nursing and Midwifery Board of Australia (NMBA) initiative and is run by Turning Point, a leading addiction treatment, research and education organisation. NM Support is independent of the NMBA and the Australian Health Practitioner Regulation Agency.

Drug screening policy Nursing and Midwifery Council, 1 June 2018 This policy and its related procedure outline how to comply with conditions requiring a practitioner or student to undergo urine and hair drug screening and the consequences of any non-compliance. The Council uses urine and hair drug screening to monitor practitioners and students where there is a history of, or concerns about, substance misuse or dependence. The Council understands that sample collection can be inconvenient, intrusive, and expensive. However, negative drug screening results are an effective way for the Council to protect the public, by knowing that a practitioner or student is not affected by substances and can continue safely in practice or training. https://www.nursingandmidwiferycouncil. nmc_-_policy_-_drug_screening_policy_-_01_ june_2018_0.pdf

Australia’s recreational drug policies aren’t working, so what are the options for reform? The Conversation, March 2016 Some of the greatest harms from using illicit drugs are because they are illegal. Illegal drug production is unregulated and many drugs are manufactured in backyard labs. Users cannot be sure what’s in them or how potent they are, so the risk of adverse reactions, including overdose and death, is high. A large proportion of the work of the justice system – police, courts and prisons – is occupied with drug-related offences. Many people have a criminal record for possessing drugs intended for personal use, which can affect their work prospects. Drug busts have little impact on the availability of drugs and, as we continue to see more harms including overdoses and deaths, it is clear we need a new approach to illicit drugs. -so-what-are-the-options-for-reform-55493



Fabulous holiday offers Aitutaki Lagoon Private Island Resort – Cook Islands The ultimate in South Pacific indulgence, the only overwater bungalows in the Cook Islands! A twominute ride by private ferry from the main island of Aitutaki, this 4-star resort offers a restaurant, bar, day spa and beachfront pool.

Overwater Bungalow – 5 nights $2756* (2 ADULTS) • Free return airport-resort transfers in Aitutaki • Free daily tropical breakfast • Free car rental for 1 full day • Bottle of fine wine (per stay) • One NZ$100 Spa Polynesia credit (per stay) • Free daily activities and use of nonmotorized water sport equipment

Ziva, A Boutique Villa – Seminyak, Bali Nestled in a Balinese tropical garden, this 4.5-star accomodation exudes peace and tranquility. Take a stroll on a pristine beach, soak up the lush surroundings while stretching out by the private pool or sample Seminyak's unique cuisine and nightlife.

One Bedroom Villa with private pool – 5 nights $1406* (2 ADULTS) • Daily breakfast • Daily afternoon tea or coffee • Return airport transfers • 1 x 2-hour massage • 1 x cooking class (lunch) • Butler service on arrival • 10% discount room service • Personalized check in and out • Seasonal tropical fresh fruit arrangement upon arrival • Complimentary coffee and tea in villa • Shuttle service within Seminyak square and Seminyak based on schedule^ • Unlimited WiFi in villa and lobby *Aitutaki Lagoon Private Island Resort: valid for low season 1 Nov – 19 Dec 18 and 11 Jan – 31 Mar 19. Crusoe’s Retreat: valid until 31 Mar 20 (from 1 Feb 19 the resort will be exclusively adults only, 16 years or older). Ziva: valid until 20 Dec 19. Carnival Legend: limited time sale valid until sold out . Other room categories available. #Choice of alternative dining at extra charge. ^Subject to availability. Full T&C at 40 | THE LAMP NOVEMBER 2018

Crusoe’s Retreat – Coral Coast, Fiji Fiji’s best kept secret. A two hour drive from Nadi but a world away. Relax on Crusoe’s sandy beach, enjoy a full array of complimentary activities, visit a traditional Fijian village, indulge in a relaxing massage at Coco’s Spa, and enjoy a tropical cocktail while witnessing a breathtaking Fijian Sunset.

Sea view Bungalow – 5 nights $440* (2 ADULTS)

• Tropical buffet breakfast • Daily Fiji cultural activities • Complimentary resort activities including snorkel gear, sea kayaking, beach volleyball and village tour. Bonus for stays from 1 Oct 18 – 31 Mar 19: RECEIVE ONE FREE 30 MINUTE MASSAGE in Coco’s Spa per adult.

Carnival Legend: 12 Day New Caledonia, Fiji & Vanuatu DEPART SYDNEY 1 NOV 2018

Cruise the pristine blue seas of the South Pacific where sunshine and smiles meet.

FLASH SALE – Inside Twin Room 12 nights $899pp* (2 ADULTS) • All main meals on-board 24-hours • Sit-down or anytime dining# • Use of ship facilities: indoor and outdoor entertainment, live music and/or shows, movies, activities, kids to teen programs (2-17 yrs) • Ship-shore-ship transfers • Gratuities when on Australia-based ship.

Can’t find what you’re looking for? Contact the Member Concierge desk to discuss the world on sale. To book email or call 1300 959 550. For all other packages, head to


test your

Knowledge 1









10 11


15 13

14 16





21 22




31 26





ACROSS 1. The surgical correction of defects in the nasal septum (16) 9. Capable of being passed from one generation to the next (9) 11. Basic, elementary (10) 12. The capital city of Kenya (7) 13. Relating to nutritional qualities of food or drink (7) 14. A compound of oxygen with An element or radical (5) 16. Diindolylmethane (1.1.1) 18. To remove the ions from (8)

20. Without life (9) 21. A section of a hospital to treat injured people and those afflicted with sudden, severe illness (1.1) 22. Symbol for samarium (2) 23. Symbol for germanium (2) 24. Severe subjective distress caused by a child's inability to achieve an integrated sense of self (8.8) 26. Investor (11) 29. Containing silicon (7) 30. Blastomere (12.4)

DOWN 1. 1. Various diseases characterised by abnormal sphingolipid metabolism (16) 2. Take part (11) 3. A doctor specialising in treatment of the skeletal system (11) 4. A tumor of hybrid cells used in the in vitro production of specific monoclonal antibodies (9) 5. A sharp instrument used for suturing, for puncturing, or for the guiding of ligatures (6) 6. Infiltrations, saturations (11) 7. An organisation providing a specific service (6) 8. A severe infectious disease caused by flavivirus (6.5) 10. The symbol for lutetium (2) 15. Assist, support (3) 17. Inserting something (9) 18. Antiperspirant (9) 19. Relating to pain occurring to a nerve (9) 23. Not local (7) 25. Dwarfism (6) 27. Hepatitis C (1.1) 28. Under, or deficient (4)


Develop and assess your medication dosage calculation skills with the world's leading resource for healthcare practitioners and students. safeMedicate comprises 3 modules: • Essential Skills • Pediatric Bodyweight-Based Calculations • Injectable Medicine Therapies Meet your CPD requirements • Certificate of Completion • Reflective Account • Up to 21 CPD hours (7 per module) Scan the QR code or browse to our website to visit our secure online store and be up and running with your new safeMedicate account in minutes!

safeMedicate is brought to you in partnership with

NSW Nurses and Midwives’ Association

PROFESSIONAL EDUCATION For more information contact the NSWNMA on 1300 367 962 or Niki at the email address below. COPYRIGHT © 2018 AUTHENTIC WORLD LTD


This program is endorsed by ACN according to our Continuing Professional Development (CPD) Endorsed Course Standards. It has been allocated 7 CPD hours per module according to the Nursing and Midwifery Board of Australia – Continuing Professional Development Standard.




1 NSWNMA Navy Polo Shirt with embroidered logo $20.


Quantity: Ladies size 14 (to fit sizes 8-10) Size: Ladies size 16 (to fit sizes 12-14) S M L XL 2XL 2 Madrid Sunhat $25. Quantity:

Size: 1


S/M (one size)

L/XL (one size)

3 NSWNMA Royal Blue Cap $10. Quantity:

Postage and Handling $5 per item. Total cost of order $ Name Address Postcode Phone H Sizes: Ladies size 14 (to fit sizes 8-10); 16 (to fit sizes 12-14); and Unisex S, M, L, XL, XXL, XXXL. 2 Madrid Sunhat $25. Sizes: S/M and L/XL (one size). 3 NSWNMA Royal Blue Cap $10. 100% cotton; one size fits all; crossover velcro at back.


FAX (02) 9662 1414 POST NSWNMA, 50 O’Dea Ave. Waterloo NSW 2017 42 | THE LAMP NOVEMBER 2018



1 NSWNMA Navy Polo Shirt with embroidered logo $20.

Email Method of Payment Cheque



Name of card holder Card number Expiry date



Money Order

REVIEWS All the latest Book Club reviews from The Lamp can be read online at





Diana Gabaldon Book Depository: Cornerstone: RRP $16.00 ISBN 9781784751371





book club

Medical-Surgical Nursing – Two-Volume Set: Assessment and Management of Clinical Problems 10th Edition Sharon Lewis, Linda Bucher, Margaret Heitkemper, Mariann Harding, Jeffrey Kwong, Dottie Roberts Elsevier: au RRP 101.88 ISBN 9780323355933

Completely revised and updated content explores patient care in various clinical settings and focuses on key topics such as patient safety, evidence-based practice, and teamwork. A variety of helpful boxes and tables make it easy for you to find essential information and the accessible writing style and building-block approach make even the most complex concepts easy to grasp. Best of all – a complete collection of learning and study resources helps you learn more effectively and offers valuable, real-world preparation for clinical practice.

The Body Keeps the Score: Brain, Mind, and Body in The Healing of Trauma Dr Bessel A van der Kolk Elsevier

Penguin Books: fishpond. RRP $23.89 ISBN 9780143127741

Trauma is a fact of life. Veterans and their families deal with the painful aftermath of combat; one in five Americans has been molested; one in four grew up with alcoholics; one in three couples have engaged in physical violence. Dr Bessel van der Kolk, one of the world’s foremost experts on trauma, has spent over three decades working with survivors. In The Body Keeps the Score, he uses recent scientific advances to show how trauma literally reshapes both body and brain, compromising sufferers’ capacities for pleasure, engagement, self-control, and trust. He explores innovative treatments – from neurofeedback and meditation to sports, drama, and yoga – that offer new paths to recovery by activating the brain’s natural neuroplasticity. The Body Keeps the Score exposes the tremendous


IA It’s 1946, and Claire Randall goes to the Scottish Highlands L IN T E with her husband, Frank. It’s a second honeymoon; a chance to learn how war has changed them and to re-establish their loving marriage. But one afternoon, Claire walks through a circle of standing stones and vanishes into 1743, where the first person she meets is a British army officer – her husband’s six-times great-grandfather. Unfortunately, Black Jack Randall is not the man his descendant is, and while trying to escape him, Claire falls into the hands of a gang of Scottish outlaws, and finds herself a Sassenach – an outlander – in danger from both Jacobites and Redcoats. Marooned amid danger, passion and violence, her only chance of safety lies in Jamie Fraser, a gallant young Scots warrior. What begins in compulsion becomes urgent need, and Claire finds herself torn between two very different men, in two irreconcilable lives.

power of our relationships both to hurt and to heal – and offers new hope for reclaiming lives.

Nurse’s Pocket Guide Diagnoses, Prioritized Interventions, and Rationales 14th Edition Marilynn E Doenges, Mary Frances Moorhouse and Alice C Murr F.A. Davis Company: $36.98 ISBN 9780803644755

This quickreference tool has what you need to select the appropriate diagnosis to plan your patients’ care effectively. The 14th Edition features all the latest nursing diagnoses and updated interventions. A laminated “pocket minder” bookmark makes diagnosis even easier. All books can be ordered through the publisher or your local bookshop. Call 8595 1234 or 1300 367 962, or email for assistance with loans or research. Some books are reviewed using information supplied and have not been independently reviewed. THE LAMP NOVEMBER 2018 | 43


For NSWNMA Members


your membership fees cover you if you are injured travelling to or from work? If you are injured in an accident while travelling to or from work, NSWNMA’s Journey Accident Insurance provides you with peace of mind with a Weekly Bodily Injury Benefit of up to 85% of your average gross weekly salary for a period of up to 104 weeks (after 7-day waiting period). 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 44 | THE LAMP NOVEMBER 2018



















If you would like to be a movie reviewer, email



at the movies



White Dragon At Eternity’s Gate A mad and brilliant Van Gogh Julian Schnabel’s ravishingly tactile and luminous new film, At Eternity’s Gate, takes a fresh look at the last days of Vincent van Gogh, and in the process revivifies our sense of the artist as a living, feeling human being. Schnabel fuses the sensual, the emotional, and the spiritual. The pulsing heart of At Eternity’s Gate is Willem Dafoe’s shattering performance: his Vincent is at once lucid, mad, brilliant, helpless, defeated and, finally, triumphant. Also starring Oscar Isaac as Gauguin, Rupert Friend as Theo, Mathieu Amalric as Dr Gachet, Emmanuelle Seigner as Madame Ginoux, and Mads Mikkelsen as the Priest. In cinemas 20 December 2018. Email The Lamp by the end of November to be in the draw to win one of ten adult passes to At Eternity’s Gate thanks to Transmission Films. Email your name, membership number, address and telephone number to for a chance to win!

University lecturer Jonah Mulray’s world is turned upside down when his wife, Megan, a high-ranking international development worker, is killed in a car accident on a mountain road outside Hong Kong. Overcoming his fear of flying, Jonah jets out from London to identify her body. Alone in an unsettling, alien environment, given the runaround by overworked and underpaid local cops and haphazardly assisted by the British Consulate, Jonah discovers that the accident is not all it seems. Megan had been living a dangerous double life that left her exposed to sinister business interests. A web of conspiracy deepens as the evidence points to murder. White Dragon is a character-driven emotional thriller. There are elements of Lost In Translation coupled with The Descendants, underpinned by a propulsive hook-laden serial narrative. Our setting is the neon-suffused hypermodern island of Hong Kong, a place in constant motion, and the perfect metaphor for the series. Available in stores 21 November 2018. Email The Lamp by the end of November to be in the draw to win a DVD of White Dragon thanks to Acorn Media. Email your name, membership number, address and telephone number to for a chance to win! THE LAMP NOVEMBER 2018 | 45


make a date

Diary Dates for conferences, seminars, meetings and reunions is a free service for members.

EVENTS: NSW NSW Society of Vascular Nursing Annual Professional Development Day Infection in Patients with Vascular Dysfunction Friday 23 November 2018, Burwood RSL Omnicare Alliance: The RED Conference A Regional Experience in Practical Dementia Care 28–29 March 2019 Sails Port Macquarie, Port Macquarie 42nd Australian Association of Stomal Therapy Nurses Conference: Power of Connections – Coming Together 19 –22 May 2019, SMC Conference and Function Centre Sydney. http://www.stomaltherapyconference. com/ EVENTS: INTERSTATE 8th Biennial Australian and New Zealand Falls Prevention Conference 18–20 November 2018 Hotel Grand Chancellor, Hobart, Tasmania 2018 STOP Domestic Violence Conference 3–5 December 2018 QT Gold Coast, Surfers Paradise 15th National Rural Health Conference 24–27 March 2019, Hobart, Tasmania Lowitja Institute Indigenous Health and Wellbeing Conference 17–20 June 2019, Darwin, NT


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: 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. INTERNATIONAL World Congress of Cardiology and Cardiovascular Health 5–8 December 2018 Dubai, United Arab Emirates wcc-2018/ EuroSciCon Conference on Clinical Pathology and Bacterial Diseases 2019 27–28 February 2019 Prague, Czech Republic International Council of Nurses 2019 Congress 27 June–1 July 2019 Marina Bay Sands Expo and Convention Centre, Singapore ICN-Congress-Singapore-June-2019/ International Council of Nurses (ICN) 21st International Conference on Nursing 25–26 September 2019 London, United Kingdom EVENTS: REUNIONS Lewisham Hospital Graduate Nurses’ Association Annual Lunch Saturday 3 November 2018, Ryde Chris Majewski 0401 866 377 Balmain Hospital Graduate Nurses Reunion Saturday 10 November 2018 Balmain Hospital Conference Centre All past and present staff welcome Contact: Merril 0419 221 762

Prince Henry Hospital PTS 75 REUNION Saturday 24 November 2018 from 6:30pm Harbourview Hotel, Dawes Point near The Rocks Partners welcome Conrad: WWBH PTS 1979 40-Year Nursing Reunion 2 February 2019 Alison Meek (Giese) 0402612240 Sharyn Wellham (Noonan) 0432416419 Steph Taggart (Heenan) 0457414503 Hornby Ku-ring-gai Hospital Reunion Orange group 40–Years 1976–79 Saturday 9 February 2019 Helen Sim (Anderson) 0418 654 757 Gillian Linton (Frame) 0403 430 989 NEC Group February 1976 Intake Reunion – 40-years since Graduation Possibly March 2019 Marie Sansotta-Allen 0408 979 465 CROSSWORD SOLUTION

Dreaming of Fiji?

Recruit a new member and go into the draw to win a 5-night holiday at the Sofitel Fiji Resort & Spa, Denarau THE 2018–2019 NSWNMA MEMBER RECRUITMENT SCHEME PRIZE The winner will experience a luxurious holiday at the Sofitel Fiji Resort & Spa, with the following inclusions (for two adults): • 5 nights’ accommodation in a Luxury Oceanside King Room • VIP Meet & Greet welcome at Nadi Airport along with return airport transfers provided by Rosie Holidays • Full buffet breakfast daily • 1 x Salt Sensations Beach Bure Dinner for two inclusive of arrival cocktail • 1 x 60-minute full body massage for 2 guests at SO Spa, including a glass of bubbles at the end of the treatment The NSWNMA will arrange return flights for two to Nadi International Airport Escape to the South Pacific and retreat to a Fiji beach resort, merging luxury hotel facilities with the destination’s natural beauty, vibrant culture and an elegant French touch. Experience a holiday in paradise. Relax and unwind.

Every member you sign up over the year gives you an entry in the draw!

Recruiter’s note: Join online at 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. PRIZE DRAWN 30 JUNE 2019

Conditions apply. Prize must be redeemed by 30 June 2020 and is subject to room availability. Block- out dates include all Australian and NZ school holidays and Christmas / New Year period. The prize will be drawn on 30 June 2019. 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/18/02955


Profits that go to members, not shareholders. The right support and advice to help you

feel future ready

1300 650 873

Consider our PDS before making a decision. FSS Trustee Corporation ABN 11 118 202 672, AFSL 293340, trustee of the First State Superannuation Scheme ABN 53 226 460 365.

48 | THE LAMP MARCH 2017

Lamp November 2018  

In this issue of the Lamp: Macquarie University Hospital nurses win ratios; Japara wields the axe on Aged Care staffing; Rally for ratios le...

Lamp November 2018  

In this issue of the Lamp: Macquarie University Hospital nurses win ratios; Japara wields the axe on Aged Care staffing; Rally for ratios le...