The Lamp August 2020 by NSW Nurses and Midwives' Association

PHS WAGE FREEZE

COVID-19

NURSE EDUCATION

REGULARS

Stores happy to support nurses

Nurse death toll soars

Jobs the big issue for new grads

page 10

page 22

page 28

Your rights and entitlements at work Nursing research online Crossword Reviews

THE MAGAZINE OF THE NSW NURSES AND MIDWIVESâ&#x20AC;&#x2122; ASSOCIATION VOLUME 77 NO. 4 AUGUST / SEPTEMBER 2020

PUBLIC SECTOR WAGE FREEZE

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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 gensec@nswnma.asn.au W www.nswnma.asn.au

VOLUME 77 NO. 4 AUGUST / SEPTEMBER 2020

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 lamp@nswnma.asn.au 50 O’Dea Avenue, Waterloo NSW 2017 Produced by Hester Communications T 9568 3148 Press Releases Send your press releases to: F 9662 1414 E gensec@nswnma.asn.au Editorial Committee Brett Holmes, NSWNMA General Secretary Judith Kiejda, NSWNMA Assistant General Secretary O’Bray Smith, NSWNMA President Michelle Cashman, Long Jetty Continuing Care Richard Noort, Justice Health Liz McCall, Byron Central Hospital Diane Lang, South East Regional Hospital, Bega Valley Printed by Ovato Print Pty Ltd 37-49 Browns Road, Clayton VIC 3168 Advertising Danielle Nicholson T 8595 2139 or 0429 269 750 F 9662 1414 E dnicholson@nswnma.asn.au Information & Records Management Centre To find archived articles from The Lamp, or to borrow from the NSWNMA nursing and health collection, contact: Adrian Hayward, Coordinator. T 8595 2175 E gensec@nswnma.asn.au 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.

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COVER STORY

Wage freeze makes no sense The government’s wage freeze will worsen the recession in NSW, according to several economic analyses.

COVER STORY

From heroes to zero Nurses in the southern NSW town of Albury are pointing to the hypocrisy of the state government’s simultaneous praise for, and punishment of, nurses during the pandemic.

COVER STORY

In the thick of the campaign Demonstrating outside state parliament and meeting face-to-face with the Treasurer of NSW are some of the actions taken by nurse Cindy Bulaon in the campaign to overturn the public sector wage freeze.

REGULARS

5 6 28 31 34 38

Editorial Your letters Nurse Education Ask Judith News in brief Nursing Research Online and Professional Issues 41 Crossword 43 Book Club 45 At the Movies

COVER STORY

Sacrifice and betrayal The NSW Industrial Relations Commission is hearing a case against the wage freeze brought by Unions NSW and public sector unions, including the NSWNMA.

SUPERANNUATION

Don’t delay the Super increase Nurses and midwives stand to lose thousands of dollars a year in retirement income if the Morrison government freezes the superannuation levy.

DISCLAIMER: Aboriginal and Torres Strait Islander people are warned the following pages contain images of deceased persons. COVID-19

NURSE EDUCATION

REGULARS

Stores happy to support nurses

Nurse death toll soars

Jobs the big issue for new grads

page 10

page 22

page 28

Your rights and entitlements at work p.31 Nursing research online p.38 Crossword p.41 Reviews p.43

PHS WAGE FREEZE

THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION VOLUME 77 NO. 4 AUGUST / SEPTEMBER 2020

COVID-19

Coronavirus: Nurse death toll soars Healthcare workers are paying a high price in the global battle against COVID-19.

COVID-19

Increasing number of Victorian COVID-19 outbreaks linked to healthcare sites Nearly 400 Victorian healthcare workers have caught the coronavirus since the beginning of the pandemic.

PUBLIC SECTOR WAGE FREEZE

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OUR COVER: Skye Romer and Cindy Bulaon Photographed by Sharon Hickey THE LAMP AUGUST / SEPTEMBER 2020 | 3

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EDITORIAL

BRETT

Holmes GENERAL SECRETARY

Essential but not valued The Berejiklian government plays a sly hand when it effusively praises nurses for their role in containing COVID-19 while effectively reducing their real wages. Politicians have a habit of treating health as a sideshow somehow subservient to the main game of economics and the power that flows from that discipline. This year has exposed the hubris of that worldview. The COVID19 contagion has devastated economies around the world, including Australia’s, just as we were coming to grips with the consequences of climate change after a summer of apocalyptic bushfires. The natural world has delivered a massive reality check in 2020 and posited with crystal clarity the centrality of health – of the human population and of the planet. For nurses and midwives this year started with significant recognition as the World Health Organization declared 2020 the Year of the Nurse and Midwife. This is a year in which we should be celebrating the nurses and midwives who dedicate their lives to the health of others. Instead, it has turned into a time of mourning for the hundreds of nurses and other health workers who have fallen victim to the coronavirus across the world (see pp 20-21). As The Lamp goes to print, the pandemic shows no signs of abating as infections accelerate worldwide, and with nearly 15,000,000 confirmed cases and more than 600,000 deaths. Every day of this pandemic nurses have fronted up despite the risks and at great personal sacrifice. Each nurse that has caught COVID19 is one too many and highlights the danger they face keeping the public safe.

‘ Every day of this pandemic nurses have fronted up despite the risks and at great personal sacrifice.’ In NSW it is easy to understand then their sadness and anger as their state government targets them to carry, not just the responsibility of saving people’s lives in the world’s worst pandemic since 1913, but also the economic burden in the aftermath of the epidemic. It is morally disgraceful, callous, and it makes no economic sense.

ECONOMISTS RAISE THE ALARM Numerous economists have raised the alarm over the government’s public sector wage freeze. Even the Treasury has proffered advice that “reducing public sector wage growth in the short-run would deepen the recession”. Dr Andrew Charlton, who was a key economic adviser for the Rudd government when it crafted its stimulus package in response to the Global Financial Crisis says the pay freeze is “precisely the opposite direction economic policy needs to be headed to achieve the government’s goal of supporting economic recovery (see pp 17). This is damning criticism from a widely respected economist with a strong track record in charting recovery from an epic-level financial crisis. The wage freeze also sits uneasily with the public. Since the freeze was announced our members have engaged tirelessly with their communities. Their message that the wage freeze will adversely

impact local businesses and jobs has resonated especially strongly in rural and regional areas still recovering from the hammer blows of drought and fires. The policy finds few friends in parliament outside of the Liberal Party. A regulation to impose the freeze was disallowed in the NSW Parliament. A majority of the NSW Upper House did not agree with a freeze to public sector wages. The NSW government also finds itself alone in the Commonwealth with this financial folly. Victoria, South Australia and Tasmania have all committed to wage increases for their nurses and midwives this year and for the following years. Queensland is to delay payment for this year but has promised two increases next year. The truth is, in NSW, the wage freeze is not a one-off as a consequence of the coronavirus. It sits on a continuum of policy that has been implemented since 2011. The Liberal government since its election 9 years ago, under several different leaders, has unilaterally capped the wages of nurses and midwives and obstructed improvements to ratios. It loves to sing the praises of nurses and midwives when it suits it and has done so regularly during the COVID-19 outbreak. But what is clear is the government doesn’t really value their essential work. n THE LAMP AUGUST / SEPTEMBER 2020 | 5

COMPETITION

YOUR LETTERS

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I just wanted to say a BIG thank you for the Historical Heroes posters! What a treat! I love our nursing history, especially the military nurses’ history. In 2015, I was lucky to embark on the nurses’ study tour: “In the Wake of the ANZAC Nursing Sisters”. We went to the historical places of Moudros in Lemnos and Gallipoli, where our nursing sisters served during WWI. As a Nursing Officer in the Royal Australian Army Nursing Corps (RAANC), it was a great honour to walk in the footsteps of these remarkable women. I am passionate about the nursing profession. No other profession would have given me such enormous achievements and acknowledgements for looking after my fellow human beings and where I am able to put my values in action. As the RAANC’s motto says “Pro Humanitate”. Thank you again for the wonderful motivational posters. Eva Ballai, RN

Australia has a good track record in vaccine development I believe it’s true what Dr Craig Rayner said: “It is a little naive to think because the United States is doing a lot of the vaccine development, that they are going to put us right at the front of the queue”. (‘COVID19 vaccine in the making’, June-July issue The Lamp) However, we certainly have the good science, as the development in Australia, many years ago, of the vaccines against rotavirus and the human papillomavirus testify. Of course, we have Emeritus Professor Peter Doherty, Nobel Laureate The Doherty Institute has been awarded AU$3.2 million by the Jack Ma Foundation to expedite the creation of a vaccine against COVID-19. This is in collaboration with Melbourne University. Currently, only the annual influenza vaccine and the one against Q fever are manufactured in Australia.

^ Excluding NSW School Holidays & Public Holiday long weekends. *Conditions apply. Rooms subject to availability. Prize must be redeemed by 31 August 2021 & is valid for stays Sunday to Thursday nights (not valid during School Holidays, Public Holidays or Long weekends). Competition entries from NSWNMA members only & limited to one entry per member. Competition opens LAMP 1 August AUGUST & closes 30 September 2020. The prize is drawn on 1 October 2020. If a redraw is required 6 | THE / SEPTEMBER 2020 for an unclaimed prize it must be held up to 3 months from the original draw date. NSW Permit no: LTPM/20/05518.

SEND YOUR LETTERS TO: Editorial Enquiries EMAIL lamp@nswnma.asn.au 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.

Vaccines to protect against COVID-19 are also being developed in both Brisbane (Queensland University and QIMR Berghofer Medical Research Institute) and Melbourne (Monash University and biotechnology company Vaxine). Human trials began in Melbourne in May, with six volunteers injected with a recombinant vaccine created by US company Novavax. It will require a total number of 131 volunteers and first results are expected in July. COVID-19 has brought many countries to their knees, but Australia has been fortunate as our politicians have been listening to the health and infectious diseases experts, and we have been compliant (on the whole). There is, however, little education concerning vaccines provided to the general public, apart from the specialist researchers, primary health and NSW Authorised Nurses' knowledge bank. Lack of literature on this subject, except from expert and anecdotal evidence offered by general practitioners and nurse immunisers highlights the need to advocate for education programs on the science of immunisation. Georgina Hoddle, RN

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LETTER OF THE MONTH Blown away by community support When we heard that the NSW Liberal-National government were trying to freeze our wages it felt like a kick in the guts. With all we have been through with COVID it was truly a low blow. This government continues to deny nurses and midwives anything more than the bare minimum. After denying us nurse-to-patient ratios for over 10 years, we now face a pay freeze! This is how they thank their nurses and midwives. On 2 June parliament sat to push through the pay freeze. Members from across the state rallied in front of their local MP offices and outside Parliament House to collectively demonstrate that we meant business. Due to social distancing regulations, 10 Liverpool nurses and midwives met outside the Holsworthy MP’s office. Since this rally we have been busy meeting with all our local MPs. Liverpool has many neighbouring electorates. All of our local Labor MPs were more than willing to meet with us and pledge their support of a pay rise for nurses and midwives. Thank you, Liverpool MP Paul Lynch, Cabramatta MP Nick Lalich and Macquarie Fields MP Anoulack Chanthivong for

your support! Liberal MP for Holsworthy, Melanie Gibbons, has ignored members’ emails and requests to meet. We have turned to the community for support, knowing that by paying public sector workers we can boost our local economies and create jobs. Many of our local small businesses have agreed to display our poster in their windows, informing the community that nurses and midwives shop with them. This has been such a positive experience! We have been blown away by the community support. Nurses and midwives will continue to support their local small businesses, shopping local, buying coffees, going to the pub for a meal, getting our hair done at the local hairdresser. We are calling on the Liberal government to change their mind and support the pay rise we were due! Stop adding to this Pink Recession! Heidi McNamara, RN

Advertise in The Lamp and reach more than 68,000 nurses and midwives. To advertise contact Danielle Nicholson 02 8595 2139 / 0429 269 750 dnicholson@nswnma.asn.au

THE LAMP AUGUST / SEPTEMBER 2020 | 7

COVER STORY

Wage freeze makes no sense The government’s wage freeze will worsen the recession in NSW, according to several economic analyses.

reasury advice has come to light that acknowledges a wage freeze for NSW public sector workers, including nurses and midwives, would worsen the state’s economic recession. The advice is contained in an email from Sam Walker, director of the Treasury’s budget division. The Sydney Morning Herald obtained the email under Government Information (Public Access) Act 2009. In the email, Walker says he is attaching a pack containing “economic advice that reducing public sector wage growth in the short-run would deepen recession”. This analysis supports a report by Dr Andrew Charlton of Equity Economics that was submitted to the NSW Industrial Relations Commission (IRC). The report found the wage freeze was “precisely the opposite direction economic policy needs to be headed to achieve the government’s goal of supporting economic recovery” (see p 17). Dr Charlton was a key economic adviser for the Rudd government when it crafted its stimulus package in response to the Global Financial Crisis. That stimulus was widely credited with keeping the Australian economy stable and growing while 8 | THE LAMP AUGUST / SEPTEMBER 2020

‘The increased productivity of nurses and midwives is evident in the government’s own hospital data.’ — Brett Holmes most other countries throughout the world fell into recession.

met the challenge by increasing their productivity.

A recent study, The Same Mistake Twice: The Self-Defeating Consequences of Public Sector Pay Freezes, published by the Centre for Future Work at the Australia Institute also questions the wisdom of the wage freeze. It found that freezing pay for essential workers was “not just morally questionable – it’s also a major economic mistake”.

Over the last nine years “the increased productivity of nurses and midwives is evident in the government’s own hospital data”, he said.

“The motivation for public sector wage austerity seems more ideological than fiscal or economic. Our research shows these arbitrary pay freezes are both unfair and economically counterproductive,” said the report’s lead author, Dr Jim Stanford.

HOSPITAL PRODUCTIVITY IS UP NSWNMA general secretary, Brett Holmes, says even before COVID-19 put added strain on the NSW public health system, demand was on the rise and nurses

“Bureau of Health Information reports over the period from 2011 to 2020 indicate significant increases in throughput of patients cared for by nurses and midwives in NSW hospitals, and highlight initiatives such as new models of care to meet service objectives, which also represent cost savings such as reducing length of hospital stays.” Even before COVID-19 the highest ever number of patient presentations in EDs occurred between October and December 2019. “Yet, here in NSW we have a state government wanting to penalise nurses and midwives by freezing their wages, to their short– and long– term financial detriment,” he said.

COVER STORY

What economists have to say about the wage freeze ‘ Reducing public sector wage growth in the short-run would deepen (the) recession’ — NSW Treasury NSW IS AN OUTLIER

state economies generally”.

NSW stands alone in the Commonwealth in targeting nurses and midwives to carry the brunt of the economic fallout from the coronavirus.

He said that in addition to pay increases the state government s i n V ic tor i a a nd Queensland had significantly improved their nurse-to-patient ratio systems since 2015.

In Queensland, government legislation is pending to delay a 2.5 per cent pay rise for the public sector this year. But unlike NSW, Queensland is proposing to catch up by paying two increases next year. In South Australia, nurses and midwives recently reached agreement on two per cent increases per year over the next three years. In Victoria, nurses and midwives will receive a three per cent increase in December 2020. In Tasmania, public sector nurses and midwives received a 2.3 per cent pay rise from 1 December, 2019 to be followed by a 2.3 per cent, a 2.35 per cent, and a 2.35 per cent increase in the following years to 2023. Brett Holmes says although these governments had a weaker fiscal position than NSW prior to COVID-19, they are “recognising their public sector nurses and midwives and the stimulus their incomes provide to spending in their local economies and their

“They have made substantial investments in higher nursing staffing and patient outcomes.” T he NS W gover n ment argues that the $3 billion in “savings” from the public sector wage freeze will be spent on infrastructure projects to create jobs. But Brett Holmes says the government has indicated it would simply fast track projects already committed but pay for them out of public sector wages. Very few of these are spread across rural NSW. “The immediate effect of a pay rise stimulus would be felt statewide as soon as it hits the pockets of nurses and midwives, when the economy needs it, as opposed to infrastructure projects that take time to deliver stimulus. Spending in local communities will be immediate.”

The pay freeze is ‘precisely the opposite direction economic policy needs to be headed to achieve the government’s goal of supporting economic recovery’ — Dr Andrew Charlton, Equity Economics

‘ These arbitrary pay freezes are both unfair and economically counterproductive’ — Dr Jim Stanford, Australia Institute

THE LAMP AUGUST / SEPTEMBER 2020 | 9

COVER STORY

Stores happy to support nurses Wollongong nurse Eddie Barry is heartened by local business support for the campaign to overturn wage cuts.

urse Eddie Barry says s h o p ke e p e r s in t he Wollongong area have responded “positively and without exception” when asked to display the NSWNMA’s “Stop the Wage Freeze” posters.

of 2007–08 showed, the economies that emerge quickest from an economic downturn are those that stimulate spending.”

NURSES ARE IMPORTANT CUSTOMERS “Euromoney magazine gave Kevin Rudd’s treasurer, Wayne Swan, the title of finance minister of the year

The posters, which encourage people to patronise stores that support the union campaign, have “gone over really well with the public,” Eddie says. “It’s actually been a pleasurable experience going around speaking to shopkeepers and the general public.

Eddie is a mental health nurse and vice-president of the Illawarra Shoalhaven mental health branch of the NSWNMA. He says the state government “is relying on the fact that a lot of nurses are big hearted and don’t put their own interests first”. “The government’s line is that we need to forgo a pay rise for the sake of the economy and because lots of other people have lost their jobs. “But as the Global Financial Crisis 10 | THE LAMP AUGUST / SEPTEMBER 2020

IMAGE: ALEX RAY

“People love to support people who are supporting them. They understand it must be extremely stressful for us as we work to keep them safe during COVID. And if they don’t understand, I tell them.”

EDDIE BARRY WITH 'STOP THE WAGE FREEZE' SUPPORTER KATHERINE KOSTANTINIDIS, OWNER OF THE COAST CAFE IN THE WOLLONGONG SUBURB OF CORRIMAL.

‘People love to support people who are supporting them. They understand it must be extremely stressful for us as we work to keep them safe during COVID.’

YEAR OF TH EN 20 20 UR

COVER STORY

“The last thing we need is a government that won’t learn from the past and follow the lead of previous Labor governments in stimulating the economy. “If the government needs more money and wants to be fiscally responsible, it could tax some of the companies making super profits – as Kevin Rudd wanted to do with the mining companies.” He says shopkeepers understand that public employees such as nurses are important customers who will have less money to spend in their stores if wages are cut. “Don’t buy into the government’s line that asking for the wage increase we were ‘guaranteed’ is being selfish. “It’s not selfish to protect local businesses that need us to keep spending. “It’s not selfish to ensure our kids see nursing as a financially viable vocation to enter. “People aren’t going to go into nursing unless they feel it is remunerated as a tertiaryqualified profession. “If we go down the path of America, where wages are always ground down, then nursing will be seen as the poor cousin of the other health disciplines.”

IFE DW MI

in 2011 because the government kept Australia out of recession by stimulating spending.

Annual THURSDAY, 23 JULY 2020

THANK YOU

NSW Nurses and Midwives’ Association gratefully acknowledges the sponsorship provided by the following companies for our Annual Conference on 23 July 2020

NO GUARANTEES IT IS A ONE-OFF Eddie notes that Premier Berejiklian has refused to say when the pay freeze will be lifted and refused to guarantee that this year’s 2.5 per cent will be paid next year. “Even if this freeze was for one year, I wouldn’t be banking on Gladys giving us five per cent next year,” he says. As a mental health nurse, Eddie is not directly caring for COVID-19 patients, however, the pandemic has indirectly raised levels of anxiety and stress in his unit because patients, who have a diminished capacity for social distancing, are prevented from leaving hospital for short breaks. “They really look forward to a half-hour break, so missing out makes it hard for them and hard for us. “It makes for a lot of anxiety and creates tensions among patients, and between patients and staff. “Nurses will bear the brunt of increased tension. “When a duress alarm in a mental health unit goes off, nurses are the only discipline who actually respond. “We the only tertiary-qualified professionals expected to deal with those situations on our own. “And on top of dealing with those risks they now want to freeze our wages.” n

THE LAMP AUGUST / SEPTEMBER 2020 | 11

COVER STORY

From heroes to zero Nurses in the southern NSW town of Albury are pointing to the hypocrisy of the state government’s simultaneous praise for, and punishment of, nurses during the pandemic.

o guard against COVID1 9, theatre nurse Charlotte Todros wears a mask, gog gles and visor throughout every long shift – an experience she describes as “suffocating”. “One moment, P rem ier Berejiklian tells us we are doing a fantastic job putting ourselves at risk on the front line,” says Charlotte, president of the Albury Base Hospital branch of the NSWNMA. “The next minute the Premier is saying the state can’t afford to honour its commitment to pay our annual wage increase – while giving huge pay rises to some ministers and top bureaucrats. That’s abhorrent. “Nurses I work with – and their families – are going through a lot of mental anguish and stress. We band together every day and ask each other, are you okay? “However, the people being rewarded by the government are already highly paid and are not the ones on the front line.” The Albury branch’s first action against the wage freeze was a rally outside the hospital supported by NSWNMA branches at Nolan House mental health service and Albury community health. “We had a fantastic turnout

12 | THE LAMP AUGUST / SEPTEMBER 2020

‘ The people being rewarded by the government are already highly paid and are not the ones on the front line.’ — Charlotte Todros

and got positive coverage on the front page of the Border Mail and a live feed on the ABC website and breakfast radio that morning. “Albury being a regional town, everyone knows a nurse, fire fighter, ambulance officer or police officer – so our campaign has had strong public support. “Yes, a lot of people have lost their jobs, but we are the local breadwinners and our wages keep the local economy going. “In the current economic climate it’s even more vital that we do get that 2.5 per cent increase as promised by legislation.”

POUNDING THE PAVEMENT Charlotte has “pounded the pavement” to enlist Albur y’s shopkeepers in the campaign. “Small businesses are mostly happy to put our signs up; they know nurses and midwives will spend their money in shops that show support for the campaign.

“The closure of the border has limited Victorians from crossing the border to shop in Albury, which means it’s now even more important for Albury people to be able to patronise local stores. “It’s harder to get the big chains to display our signage but Platypus shoes, which is part of a very popular chain, did agree. They also need locals to keep spending in order to keep their doors open.” Albury branch held a second rally outside the office of local Liberal MP Justin Clancy. “His position was to support the wage freeze but he said he would present our views to the government,” Charlotte said. She keeps branch members up to date with a weekly email and via social media. “It’s important to keep members and supporters informed and not let the campaign fizzle out.” n

IMAGE:JAMES WILTSHIRE, THE BORDER MAIL

COVER STORY

NURSES AND MIDWIVES PROTEST AGAINST THE PAY FREEZE OUTSIDE ALBURY BASE HOSPITAL. CHARLOTTE TODROS IS SECOND FROM RIGHT.

Survey: nurses and midwives will slash spending if freeze proceeds The impact of the pay freeze will ripple out to industries such as hospitality, entertainment and travel as well as having consequences for superannuation, according to a YouGov survey. The survey of nurses and midwives found that a staggering 83 per cent of respondents were stressed by existing day-to-day expenses and more than three quarters (77 per cent) felt underpaid. If hit with a wage freeze, results show nurses and midwives would curb monthly expenses by an average of $350, which would have economic consequences for NSW communities. Meanwhile, 82 per cent of respondents indicated spending would drop significantly on eating out, gym membership and shopping. More than half (56 per cent) of respondents indicated their

household had already suffered employment impacts due to the COVID-19 pandemic. Domestic and international holidays was one area that respondents said they would cut back, with travel spending estimated to fall by $2624. “This is likely to have a devastating impact on the travel industry, which is already struggling,” commented YouGov. Of the 28 per cent of members who make voluntary contributions to super, 48 per cent would cut back on their contributions. 93 per cent worry about having enough to be able to afford a comfortable retirement. The vast majority of members (92 per cent) admitted to worrying about the potential for contracting COVID-19 at work and potentially passing it on to their friends and family.

Key findings

92%

of respondents were worried about contracting COVID-19

83%

were stressed by existing day-to-day expenses

82%

indicated spending would drop significantly on eating out, gym membership and shopping

77%

felt underpaid

THE LAMP AUGUST / SEPTEMBER 2020 | 13

COVER STORY

In the thick of the campaign Zoom conferencing with the Opposition leader, demonstrating outside state parliament and meeting face-to-face with the Treasurer of NSW are some of the actions taken by nurse Cindy Bulaon in the campaign to overturn the public sector wage cut.

s the NSWNMA’s assistant bra nch secret a r y at Concord Hospital, (she has since left Concord) Cindy Bulaon found herself in the thick of the anti-wage freeze campaign. One of the branch’s first actions was to set up an online meeting between state Labor leader Jodi McKay and branch members Alison Brannelly, Mavi Giacomello (branch steward) and Cindy.

‘ It was nerve wracking, but I wanted Mr Perrottet to know how strongly I felt about the wage freeze.’ — Cindy Bulaon on television, and sent a strong message against the wage freeze. Our general secretary, Brett Holmes, also attended and spoke to the media.

support from Christian Democratic Party leader, Fred Nile, who had not indicated his position on the legislation.

“The branch had worked with Jodi during the ratios campaign and we wanted to make sure she would continue to support the nurses and midwives by campaigning to stop the wage freeze,” Cindy said.

“We had to limit the numbers in attendance because of COVID social distancing.

“I thought that maybe I could get through to Fred Nile as a fellow Christian,” Cindy said. “He replied within 24 hours to say he did support the nurses and would vote against the wage freeze.

“Jodi pledged to continue to support us and arranged to attend a media conference with the Shadow Minister for Health, Ryan Park, and Concord nurses in front of the hospital.

“The next day, Jodi and Ryan Park joined our branch meeting online to thank us for our work during COVID and assure us we had their support.”

“Alison, Mavi, branch delegate Stephen Mansfield and I got together to make placards and posters for the media conference. “It got a lot of coverage, with Alison and Mavi both interviewed 14 | THE LAMP AUGUST / SEPTEMBER 2020

“But those who did attend were senior nurses with long service at Concord.

PUTTING OUR CASE TO TREASURER PERROTTET With the pay freeze legislation due to be voted on by parliament’s Upper House, Cindy decided to write a personal letter seeking

“I wrote back to say it was fantastic to have his support and I would love to see him at the forthcoming nurses’ rally outside Parliament House. “I didn’t speak to Reverend Nile at the rally but he did come outside and indicate support for nurses – only to turn around and vote with the Liberals on the day. “I was really angry, because he’s supposed to be a Christian minister.

COVER STORY

‘ This pay freeze was a slap in the face and to do it on International Nurses Day was horrendous.’ — Cindy Bulaon But a lot of politicians will say one thing and do the opposite.” During the protest, Treasurer Dominic Perrottet agreed to meet three NSWNMA representatives in his Parliament House office. So Cindy joined a NSWNMA organiser and RN Lisa Barr y, Branch Secretary, POW at the meeting. “It was nerve wracking, but I wanted Mr Perrottet to know how strongly I felt about the wage freeze,” Cindy said. “I told him we deserve this pay increase because we work very hard for it in very difficult conditions – and not only during this pandemic. The money will go back into the economy through our local shops and to pay our bills. “For instance, on 1 July the government introduced a toll on the M5 East tunnels, which my husband uses to get to work every day. That’s

$6.95 for a one-way trip. “Mr Perrottet obviously wasn’t open to changing his mind; it felt like he just wanted to show that he was willing to listen to us.”

A SLAP IN THE FACE Cindy says the pay freeze had made her feel “very undervalued” by the state government. “They don’t understand what we face every day, especially in trying to keep ourselves and the public safe during COVID. “This pay freeze was a slap in the face and to do it on International Nurses Day was horrendous.” “We should also remember the cleaners who have had a big increase in their workload. They were already short-staffed and then had to clean to a higher standard twice a day.

“Cleaners work just as hard as nurses and doctors and don’t get the accolades they deserve.” Cindy says she is particularly upset by Premier Berejiklian’s decision to freeze nurses’ wages while awarding huge increases to some politicians and top public servants. In July, it was revealed that Ms Berejiklian had quietly handed a $17,000 pay rise to her finance minister, Damien Tudehope, and a $90,000 pay rise to police commissioner, Mick Fuller. She did this despite saying “The only way NSW will come out of this crisis in a strong position is if we all make sacrifices, and that’s what we’re asking our own workforce to do.” n

THE LAMP AUGUST / SEPTEMBER 2020 | 15

COVER STORY

Minister dodges wage freeze questions The Liberals have shown how little they value the public health service by cancelling a scheduled pay increase for health workers.

uring a NSWNMA rally against the wage freeze outside Parliament House in Sydney, nurse Skye Romer spotted health minister, Brad Hazzard, and took the opportunity to introduce herself. Skye told the minister she had just watched his video thanking nurses and midwives for striving to keep the public safe during COVID-19. She asked him if he would t herefore b e opp o si n g h i s government’s decision to freeze nurses’ wages. “He didn’t want to answer any of my questions and said it was a matter for Cabinet,” she told The Lamp. As secretary of the Association’s Prince of Wales Hospital mental health branch, Skye has spoken to many nurses about the wage freeze. “Almost all of them are outraged,” she said. “Some have said things like, why would we continue to work under extreme pressure for the community while the government continues to slap us in the face? “In mental health, nurses are frequently spat on, assaulted and abused. Why would we continue to do that work for less money?” She points out that the state government has not even guaranteed to pay the 2.5 per cent increase next year. 16 | THE LAMP AUGUST / SEPTEMBER 2020

‘ In mental health, nurses are frequently spat on, assaulted and abused. Why would we continue to do that work for less money?’ — Skye Romer “How will this affect nurses’ earnings over the long term a nd supera nnuation payouts on retirement?

“The 2.5 per cent was supposed to keep us in line with cost of living increases, so what will the wage freeze mean for our purchasing

COVER STORY

power? Especially if you are the only person paying the mortgage?” An NSWNMA survey of members shows the freeze will initially cost nurses and midwives, on average, $160 in lost wages per month. “The 2.5 per cent was the result of a government decision in 2011 that saved billions,” Skye said. “It’s okay for the Premier’s Liberal Party friends to line their pockets with massive wage increases – the rest of us are told to just suck it up. “Well, we have already sucked it up by going to work during a pandemic – because it’s our job and we care – and this is how we’re thanked.” In July, federal health minister, Greg Hunt, said the relatively high survival rate of COVID-19 patients in Australia was due to hospitals having ample ICU capacity and surge capacity and “arguably they have the best doctors and nurses and systems in the world”. However, the wage freeze in NSW shows the state government doesn’t really care about public health, Skye said. “L ib era l p ol it icia n s shou ld understand that if they end up in hospital and are sick enough, they won’t stay in the private system, they will come across to the public. “Most people would want their hospital to be funded properly and staff paid properly so they are happy to come to work and do a good job. “How will that be achieved by cutting nurses’ wages?” Skye has joined other nurses in handing out leaflets outside the offices of two Liberal MPs. “Almost every member of the public I’ve spoken to has been extremely supportive of our campaign,” she says. “A lot of people ask to have their photos taken with us to put on social media. “They are thankful for the work of nurses and other essential services workers who have helped to keep society functioning through the pandemic, regardless of the dangers.” n

Economist: pay freeze takes economy in wrong direction NSW public sector workers would lose $56,000 from the NSW pay freeze, according to economic evidence presented to the IRC. Dr Andrew Charlton, who served as Kevin Rudd’s economic adviser during the 2008 Global Financial Crisis, said “freezing public sector salaries is not warranted” in NSW in a report tendered to the IRC. The report, co-authored with Angela Jackson from Equity Economics, says “the macroeconomic benefits of a pay rise to the 400,000-strong public workforce would substantially outweigh the costs”. “A 2.5 per cent increase in the average public servant’s income for 2020–21 equates to $2198 in 2020–21, but an increase of $56,150 in future income over the next 20 years. “A freeze in public sector wages would represent a real cut in incomes for 407,999 employees across the state. This will have a direct impact on the spending by these employees, due to a reduction in disposable income and borrowing capacity. “This is precisely the opposite direction economic policy needs to be headed to achieve the government’s goal of supporting economic recovery,” it says. The Equity Economics analysis points out that the current position of the NSW government to cut the real wages of all public sector employees regardless of their role or their level of pay is not consistent with advice given by the International Monetary Fund (IMF). The IMF recommends any pay freeze: • exclude priority areas like health, social workers; security workers; transport, and other employees involved In ensuring the continuation of essential services; and • be progressive in its design, with lower paid public sector workers sharing less of the burden.

‘(The pay freeze) will have a direct impact on the spending by these employees, due to a reduction in disposable income and borrowing capacity.’ — Dr Andrew Charlton

THE LAMP AUGUST / SEPTEMBER 2020 | 17

COVER STORY

Sacrifice and betrayal The NSW Industrial Relations Commission is hearing a case against the wage freeze brought by Unions NSW and public sector unions, including the NSWNMA. Two NSWNMA members, Angela Gittus and Gary Clark explained to the Commission the contribution of nurses in the battle against COVID-19 and the impact of the coronavirus – and the pay freeze – on their colleagues, family and communities.

The impact of COVID-19 on nurses: more work, more flexibility, more risk The coronavirus has seen nurses increase their skills, broaden their responsibilities and improve their productivity, Angela Gittus told the IRC. Angela, who is a CNS in emergency at a regional hospital, said “since COVID-19 was declared a pandemic our ED has been very busy preparing for all the potential issues that we might have to deal with, being the front door to healthcare in uncertain times”. She said nurses have had “to learn completely new ways of doing things, and practice these new skills frequently to ensure we get it right when it matters”. “We have worked together as a team to train in new ways of doing procedures such as intubation or management of severe shortness of breath.” She says nurses have “waded through mountains of new information, policy and procedures, sometimes changing daily how we conduct our core business”. “Infection control procedures for anyone with fever, cough or shortness of breath plus the donning and doffing of PPE with a buddy required to observe has put a strain on resources within the ED.” Angela says ED nurses have also helped nursing staff from the operating theatre to orientate and learn how to be emergency nurses. “The mentoring and education has grown a much more flexible and mobile workforce, while providing meaningful work for nurses whose regular work was abruptly stopped due to COVID-19.”

Angela told the Commission that the pay freeze was “bad for nurses, bad for communities but also bad economics”. Losing the 2.5 per cent pay rise would be devastating for rural communities, she says. “My money is spent locally and on supporting my family. It stays in my community and supports local businesses. “In many of the small towns, around the state, it’s the wages of nurses and midwives and other public service workers that keep the town afloat. “In many of these towns nurses and midwives now find themselves the sole breadwinner. Drought and fire and high unemployment in the bush have meant job losses for many. Those nurses and midwives struggling to keep a family going, are also being counted on to keep their town going.”

‘Those nurses and midwives struggling to keep a family going, are also being counted on to keep their town going.’ 18 | THE LAMP AUGUST / SEPTEMBER 2020

COVER STORY

A life put on hold Regional nurse manager, Gary Clark, told the IRC about the inspirational role nurses have played behind the scenes to construct a barrier to COVID-19 in NSW correctional services. Gary told the Commission that working in prisons “is not a glamorous area of health”, however, it is an area where nurses can make a significant impact on patients and the lives of their families. While it may not be glamorous, overseas experience shows nurses in prisons play a critical role during a pandemic. As of 3 July, the five worst outbreaks of COVID-19 in the United States have occurred in prisons. The hardest hit institution is Marion Correctional Institution in Ohio with 2439 cases. There had been 40 outbreaks of COVID-19 in the United States that involved clusters of 500 or more people. Of those, 31 occurred at correctional facilities. Gary says incarcerated patients are at significant risk of contracting COVID-19 as they are housed in large dormitories or close-contact cells. “Bathrooms are communal and social distancing is almost impossible to maintain,” he says. Away from the public eye there have been thorough preparations to pre-empt COVID-19 outbreaks in Australian jails, with nursing staff at the forefront. These include: • quarantining and testing of all new patients • isolating all patients with symptoms • screening all staff on entry to work • minimising all movements of patients.

‘ Every area of the nursing community contributed to ensure the commissioning of the field hospital was achieved within four weeks.’

Gary was seconded to work with a superintendent from Corrective Services to develop and build a ready-for-operation field hospital should COVID-19 levels become a major issue. There is a contingency to build up to nine field hospitals across NSW, aligned to isolation hubs at regional jails. Gary says staff worked tirelessly, seven days a week over the four weeks, with collaboration with Corrective Services to ensure they were prepared for the COVID-19 pandemic and its possible impact on the correctional system in NSW. “Every area of the nursing community contributed to ensure the commissioning of the field hospital was achieved within four weeks – infection control, HR, educators, unions, management, work health and safety, infrastructure and procurement,” he said.

“My family and friends took a back seat for close to six weeks to ensure the field hospital was built and all the staff were properly trained and educated. “I was proud of what an expert job my colleagues did to work so closely and collaboratively with Corrections to ensure the safety of our patients and staff.” The pay freeze, he said, would have consequences for the retention of nurses who had proven themselves as a bulwark against the coronavirus. “Having no pay rise this year would mean I would have to make difficult decisions such as decreasing the level of my private health coverage and decreased spending on entertainment, takeaway food, dining out and holidays,” he said. “The long-term impact on my superannuation is also of concern after a career of almost 40 years.”

THE LAMP AUGUST / SEPTEMBER 2020 | 19

SUPERANNUATION

Don’t delay the Super increase Nurses and midwives stand to lose thousands of dollars a year in retirement income if the Morrison government freezes the superannuation levy.

s the Morrison government about to take an axe to the retirement savings of workers, including nurses and midwives?

A group of 10 Coalition federal MPs has urged the government to delay or cancel scheduled increases to the compulsor y superannuation levy. They claim employers cannot afford an increase due to the coronavirus pandemic. Those MPs get superannuation of 15.4 per cent on top of their parliamentary pension and other post-parliamentary benefits. For the rest of us, superannuation is due to rise from 9.5 per cent to 10 per cent in July 2021 and 12 per cent by 2025. Freezing the levy at its current rate would cost a 30-year-old worker earning $40,000 a year about $10,000 less each year in retirement, according to former Labor prime minister Kevin Rudd. Rudd said the Liberal Party was “softening the electorate up” for a superannuation freeze even before COVID-19 struck. He pointed out that the government commissioned a former Liberal government staffer, Mike Callaghan, to head an inquiry into retirement incomes. Callaghan’s 20 | THE LAMP AUGUST / SEPTEMBER 2020

‘Using the bushfires and pandemic as political cover, Morrison is determined to fulfil the Liberal Party’s long-held desire to freeze the compulsory super guarantee levy.’ — Kevin Rudd report was due in late July.

political profiteering”.

The public intervention by 10 Liberal MPs “dispelled any doubt as to the strategy” Rudd wrote in the Sydney Morning Herald.

“If the Liberal Party’s only solution to the problems of the pandemic is to raid people’s super, then they’ve clearly run out of ideas,” Connolly said.

“You simply do not get onein-five backbenchers speaking in unison like that unless it has been authorised by the leader, especially when the group includes a gaggle of ministerial aspirants,” he said. “Using the bushf ires and pandemic as political cover, Morrison is determined to fulfil the Liberal Party’s long-held desire to freeze the compulsory super guarantee levy at its current 9.5 per cent rate.”

PANDEMIC POLITICAL PROFITEERING ACTU Assistant Secretary Scott Connolly described Liberal attacks on superannuation as “pandemic

“These backbenchers need to be put in their place by the Morrison government, and workers need to be given reassurance that their retirement savings will go up as currently legislated.” Until the late 1980s, only highincome earners and public servants enjoyed decent superannuation. Most workers – including almost all women – had no super at all. From the late 1980s, unions began to win superannuation as a part of enterprise and award bargaining. Unions set up industry super funds such as HESTA to look after the

SUPERANNUATION

‘ If the Liberal Party’s only solution to the problems of the pandemic is to raid people’s super, then they’ve clearly run out of ideas.’ — Scott Connolly, ACTU

retirement savings of their members. In 1992, the Keating Labor government introduced a compulsory superannuation levy as part of a tripartite agreement between the government, employers and the unions. The Liberals opposed any levy. Labor planned for the levy to reach 15 per cent but the Howard government halted it at 9 per cent. In 2010, the Rudd governme nt a n no u nc e d it wou ld incrementally raise the rate to 12 per cent by 2020 but Tony Abbott froze the rate at 9.5 per cent in 2014, citing a “budget emergency”. According to former prime minister Kevin Rudd, this was “classic Abbott bullshit to advance a long-standing, ideological agenda”. Rudd disputes the current claim by many Liberal MPs that businesses cannot afford a super increase. He said labour productivity had risen about 9 per cent since the Abbott freeze, easily outstripping the stalled 2.5 per cent rise in contributions. “They also conveniently ignore that (Rudd’s announced increase to 12 per cent) was coupled with business-friendly measures including a company tax cut, phased implementation and an instant asset write-off.” n

Fund members face Super ‘double whammy’ About 2.4 million people have applied to withdraw funds from their super accounts under the government’s “early access scheme” put in place during the pandemic. By July, about 500,000 people had already accessed the scheme, which allows members to withdraw up to $20,000 from their super fund. Industry super funds have warned that people who make withdrawals under the scheme face a double whammy if the planned increase in employer contributions from 9.5 per cent to 12 per cent is cancelled. According to Industry Super Australia modelling, if the increase is abandoned, a typical man who draws down the maximum $20,000 allowed under early release rules will lose $180,000 in retirement savings. To make up the difference, he would have to work an extra 6.5 years past retirement age, to 73 and a half.

A woman would lose $150,000 and have to work eight years longer, until she was 75, to make up the difference. Experienced business analyst Glenda Korporaal, an associate editor of The Australian newspaper, says the early access scheme has set a dangerous precedent. “The danger for the super industry is that if easier access conditions are continued or not well monitored, they will be seen as a handy ATM to draw down funds for all events of future hardship,” she wrote. “Another severe bushfire season? Allow those affected to draw down their super. People affected by severe flooding or cyclones? Allow them to draw down their super. The list goes on. “Allowing early access to super simply means that there will be no money, or a lot less money, for people – sadly, the more vulnerable in society – once they get to retirement age.” THE LAMP AUGUST / SEPTEMBER 2020 | 21

COVID-19

Nurse death toll soars Healthcare workers are paying a high price in the global battle against COVID-19.

r it i sh nu r s e A nd rew Nwankwo spent the last five weeks of his life on a ventilator in intensive care – a victim of coronavirus. Described as a “big friendly giant”, 46-year-old Andrew worked at Bloomfield Hospital in Chelmsford, north-east of London. A lack of personal protective equipment at the hospital reportedly forced Andrew to try to buy his own online. “He was being sent to face the danger without being given the adequate protection – that’s the bottom line, and he told me as much,” his brother told the BBC. A hospital spokesperson denied there had ever been a lack of PPE. Andrew was among 101 nurses to die after contracting COVID-19 in England and Wales between 9 March and 25 May, according to the Office for National Statistics. The ONS confirmed that nurses had “statistically significantly higher rates of death involving COVID-19” compared with the general population. A lack of PPE remains a serious problem for nurses and other healthcare workers (HCWs) in many countries, according to the International Council of Nurses. It called on governments to systematically record infection rates and deaths amongst HCWs and report the results to the World Health Organization, in order to promote preventative measures. ICN CEO, Howard Catton, said partial and preliminar y f ig ures raised a number of questions, including: What contributes to the wide 22 | THE LAMP AUGUST / SEPTEMBER 2020

‘Nursing is looking like one of the most dangerous jobs in the world at the moment.’ — Howard Catton, International Council of Nurses variation of HCW infection rates between countries, e.g. between 1 per cent in Singapore and more than 30 per cent in Ireland?

Lost on the Frontline aims to count, verify and memorialise every US healthcare worker who dies during the pandemic.

Why are some countries that have high numbers of cases recording low numbers of deaths among HCWs? For example, Germany and Spain.

They include nurses like Helen Gbodi, 54, who worked at MedStar Washington Hospital Center in Washington DC.

How do HCW infection rates vary between different clinical settings, such as hospitals, and long-term care facilities, such as care homes?

Helen, a single parent, was known for helping elderly neighbours and fellow churchgoers, picking up their medications and groceries and accompanying them on walks.

“Nursing is looking like one of the most dangerous jobs in the world at the moment,” Catton said. “We need to get this data for every country and work out exactly what is going on that explains the variations that are evident with even a cursory glance at the figures. “Only then will we be able to learn how best to keep our nurses safe and prevent any repeat of these terrible statistics in the future.” In the United States, which has the world’s highest number of COVID-19 infections, inadequate access to testing among the general population, a nationwide shortage of protective gear such as N95 masks, and lack of basic supplies like hand sanitiser are driving up the death toll among health workers. By 1 July, the pandemic had taken the lives of 735 frontline HCWs in the US, according to Lost on the Frontline, a project launched by The Guardian newspaper and Kaiser Health News (KHN).

Rebecca Gbodi said her mother worked long hours to put her three children through college and helped pay school fees for other relatives. Though Helen did not actively care for patients who had been diagnosed with COVID-19, such patients were being treated on her floor, Rebecca said. By t he t ime Helen wa s hospitalised with COVID-19, she was too weak to lift her arm for a virtual handshake with her daughter on FaceTime. In addition to tracking deaths, Lost on the Frontline reports on the challenges healthcare workers are facing during the pandemic. It says many have been forced to reuse masks countless times amid widespread equipment shortages. Others had only garbage bags for protection. “Some deaths have been met with employers’ silence or denials that they were infected at work,” it says. n

COVID-19

Key findings According to statistics collected by the International Council of Nurses (as at the beginning of June):

‘Little flu’ kills 60,000 and counting

of the world’s COVID-19 cases are among healthcare workers (450,000 out of 6 million cases)

600

nurses had died of the virus worldwide

101

nurses died from COVID-19 in England and Wales (between 9 March and 25 May)

735

frontline healthcare workers had died in the US (up to 1 July)

More information Visit Lost on the Frontline https://www.theguardian. com/us-news/series/ lost-on-the-frontline)

Before being admitted to intensive care with coronavirus in the Brazilian city of Manaus, a 46-year-old nurse named Nicolares Curico wrote to his wife, Deizeane: “Take care of our daughters. I love them.” A week later, Nicolares was dead. Deizeane said her husband loved his profession, but a lack of PPE and staff because so many colleagues were falling ill, had left him overworked and exposed. “He felt unprotected because he didn’t have an N95 mask,” she said. “He was seeing more than 100 patients a day.” Earlier this year, Brazil’s president Jair Bolsonaro described coronavirus as “a little flu” but the country now has the secondworst death toll in the world, behind only the US.

With no social distancing and few lockdown measures in place, it is feared that the death toll – almost 60,000 by 1 July – will continue to spiral. The pandemic is having a particularly devastating impact on Brazil’s nurses. A video from the Rio Nurses Union shows hospital staff sleeping in corridors and bodies covered in bin bags in wards where people are recovering from the virus. Nurses recently assembled in the capital, Brasilia, to mourn the lives of their colleagues and protest a lack of PPE and lack of training in how to use available supplies. During the vigil, they lit candles and laid crosses in memory of those who died from Covid-19. THE LAMP AUGUST / SEPTEMBER 2020 | 23

COVID-19

Increasing number of Victorian COVID-19 outbreaks linked to healthcare sites Nearly 400 Victorian healthcare workers have caught the coronavirus since the beginning of the pandemic.

hen Victoria reached a new height of 428 new COVID-19 cases on 17 July, Victoria’s Chief Health Officer Brett Sutton said positive cases among aged care and health care workers were driving some of the outbreaks. Just three days earlier, an article in the Medical Journal of Australia repor ted that hea lth worker infections represented six per cent of all infections to date. In m i d - J u l y, V i c t o r i a ’s Department of Health and Human Services announced that 388 Victorian hea lthcare workers had caught the virus since the pandemic began, and 150 of the cases were still active. While the department said the “vast majority” of the workers testing positive had been infected outside their workplaces, increasing numbers of Victorian outbreaks have been linked to healthcare sites, including the Northern and Alfred public hospitals, the Brunswick Private Hospital, and the Royal Children’s Hospital. At the time of writing, 27 clusters had been linked to aged care homes in Victoria. Lisa Fitzpatrick, the Victorian branch secretary of the Australian Nursing and Midwifery Federation, told The Lamp increased community 24 | THE LAMP AUGUST / SEPTEMBER 2020

‘ One little break in our PPE and we could become the next source of community transmission.’ — Lisa Peters transmission meant that Victorian nurses, midwives and carers are dealing with uncertainty. However, she said, “It’s important to remember nurses and midwives are well educated in infection control and know how to protect themselves against the risks at work. “The Victorian health department’s close-contact tracers are working on understanding the source of infection for each healthcare worker who has tested positive with COVID-19.” Lisa said that while healthcare workers are contracting the virus in the community and at work, significant numbers are self-isolating and awaiting results of tests. In the meantime, she said Victoria is well prepared in the event a surge workforce is needed. “There are more than 4000 nurses on the health department’s pandemic surge workforce register, and the federal government has funded critical care education for more than 20,000 nurses, plus refresher education for registered

and enrolled nurses who were no longer in clinical practice.”

THE IMPORTANCE OF PPE The surge in infections occurred as the Medical Journal of Australia published a paper by University of NSW infectious diseases expert Raina MacIntyre and co-authors, calling for all health workers treating COVID-19 patients to be provided with respirators. They write that a “growing body of scientific evidence around tra nsmission a nd prevention of SARS-CoV-2 infection” was challenging beliefs that droplet and airborne transmission were distinct modes of transmission. “Newer studies show that droplets and aerosol particles exist in a continuum,” they write. “Even a single large droplet may reduce in diameter and become airborne during its trajectory, because of evaporation.” T hey propose t hat “N95 respirators offer significantly better protection (96 per cent) than surgical

COVID-19

masks (67 per cent) against SARS, MERS and SARS-CoV-2”. The authors add: “Our health workers are a precious asset and warrant the highest protection – not simply for their occupational health and safety, but for a functional and resilient health system.” In mid-July the federal health minister, Greg Hunt, announced five million masks from the national medical stockpile to support Victoria’s response. Lisa Fitzpatrick says the “state health department has confirmed that delivery of masks and PPE from the national stockpiles to private aged care nurses, carers and other aged care workers will be coordinated through existing Vic tor ia n mecha n ism s once approved for release by the Commonwealth Government”. “Ninety per cent of deliveries are occurring within 24 hours of being ordered.”

‘ It’s important to remember nurses and midwives are well educated in infection control and know how to protect themselves against the risks at work.’ — Lisa Fitzpatrick ANMF (VIC) The crucial importance of PPE was highlighted by Victorian nurse Lisa Peters, who wrote about her experience testing residents of the Flemington and North Melbourne public housing towers for the ABC online. Going into the towers, Lisa writes: “We were assembled in teams of two nurses and two police officers, and each of us had a trolley containing everything we needed. “When each floor was completed, we went back downstairs to ‘doff’ — remove our PPE in a particular way so as not contaminate ourselves

or others. “Teams of paramedics were on hand to assist with every step. They possibly thought their job was insignificant, but it was just as important as ours. “One little break in our PPE and we could become the next source of community transmission.” Lisa wrote that with both her own safety and that of her immediate family weighing on her mind, “she had never felt so anxious about doffing in all my decades of nursing”.

Scholarship

Activism • Campaign • Advocacy Roz Norman was an outstanding activist, branch official and Councillor of the NSWNMA and ANMF. In honour of her outstanding contributions, the Roz Norman Scholarship was created to further humanitarian, social or community causes.

The scholarship covers fees for an approved course promoting activism and the development of campaigning skills or public advocacy, including ongoing financial support for reasonable costs associated with campaigning for a period of one year, up to a maximum of $5,000. NSWNMA Branch Officials or highly active members who can demonstrate leadership qualities are encouraged to apply. Successful recipients are required to report back to Committee of Delegates (COD) at the end of the scholarship period.

Applications open 1 July, closing 30 September 2020

To apply go to bit.ly/RozNormanScholarship

further enquiries: email /gensec@nswnma.asn.au THE LAMP AUGUST SEPTEMBER 2020 | 25 METRO: (02) 8595 1234 • RURAL: 1300 367 962

WORKPLACE SAFETY

Co-operative approach delivers safer workplace Enhanced dialogue and co-operation between management and staff is bringing improvements to a violence-plagued mental health service.

he NSWNMA’s Illawarra Shoa lhaven mental health branch says a joint m a n a g e m e n t– union approach is bringing about a safer workplace and better staff representation in the district’s mental health service. A combined committee of NSWNMA and Illawarra Shoalhaven Local Health District representatives has overseen the introduction of capital improvements, better equipment and more training this year. In 2019, after several serious assaults by patients on other patients and staff, SafeWork NSW found the LHD had breached the Work Health and Safety Act and issued it with an improvement notice. SafeWork said staff were “at risk of psychological injury” due to the way misconduct allegations were handled, which included “potentially intimidating correspondence” sent to workers. SafeWork directed the LHD to develop, “in consultation with workers, a system to control the risk of psychological injury arising from the process of investigating allegations of misconduct.” Also in 2019, the NSWNMA launched its own health and safety inspection of the service’s Eloura 26 | THE LAMP AUGUST / SEPTEMBER 2020

‘ The union and mental health executive are implementing changes which are leading to a safer workplace.’ — Branch delegate, Chris Scott

East Acute Unit, Eloura West High Dependency Unit and Mirrabook Acute Unit. The inspection found the LHD had failed to take reasonable steps to protect nurses from exposure to violence from patients and management bullying. Sixty-two per cent of members in the service said they had been bullied at work in the previous 12 months, mostly by “management or a supervisor”. NSWNMA Assistant General Secretary, Judith Kiejda, said the inspection found “multiple safety issues that put nurses at significant risk of serious injury”.

PHYSICAL ENVIRONMENT NOT FIT FOR PURPOSE The inspection report said the physical environment of all three units was not fit for purpose, with poor lines of sight and an inability to separate patients. CCTV cameras were inadequate,

units lacked spaces for de-escalation and separation, windows were made of breakable glass and back-up power supplies were insufficient. Nurses worked in isolation yet there was a shortage of personal duress alarms. Regarding patient care, there was a shortage of doctors, poor medical management and a lack of continuity of care. Understaffing was rife and low rates of anti-violence training were “extremely concerning”. Management had failed to address serious issues raised by nurses through consultative mechanisms, including assaults on staff resulting in injury, sexual harassment of female staff, high levels of fatigue and low morale. In a letter to The Illawarra Mercury newspaper titled “Help”, published in November 2019, staff members said “urgent action is critical to instil professional

IMAGE: ALEX RAY

WORKPLACE SAFETY

CHRIS SCOTT, ILLAWARRA SHOALHAVEN MENTAL HEALTH BRANCH DELEGATE

management, systems and procedures” in the mental health service. The Mercury reported there had been at least six serious assaults on staff by patients between December 2018 and November 2019. In November, NSWNMA general secretary, Brett Holmes, told ABC News the lack of trained staff was deeply concerning. “If they can’t recruit sufficient staff then they need to manage the level of service that they can provide otherwise they’re putting the lives of patients and their staff at risk,” Brett said. He said a shortage of staff was very dangerous for a facility with such a history of violent incidents. “There need to be adequate numbers of staff to intervene in critical situations and that’s a minimum of six people needed to restrain someone who's physically violent towards themselves or others.” Brett said a shortage of trained staff gave rise to a high risk of nurses of being involved in a potentially violent incident and then being accused of not practising properly. “Then staff get investigated, and suspended during that investigation, which only adds to the staffing issues.” n

Catalyst for change During 2020, there has been “a marked shift in management’s attitude and the issues are being taken seriously and being addressed,” said Chris Scott, a delegate of the NSWNMA’s Illawarra Shoalhaven mental health branch. Chris told The Lamp the union health and safety inspection was “a catalyst for significant change”. Management agreed to close several beds, which was “a relief to staff on workload and safety grounds”, he said. “Previous workloads were unrealistic and unsuited to caring for people with challenging presentations. “The LHD has committed to working through matters with the union including regular joint meetings to implement improvements. “An external HR organisation was brought in to review the culture of the mental health service. That

allowed staff to express their concerns without fear of repercussions. “The union and mental health executive are implementing changes which are leading to a safer workplace.” This year has seen improvements to patient access to medical care and staff access to, and sight of areas within units. CCTV coverage and lighting has improved and faulty duress alarms have been replaced. Violence prevention training has significantly improved and patients have more therapy activities and more and safer exercise equipment. Units have been supplied with new weighted chairs and tables that cannot be thrown as weapons. There is also more support for nurse unit managers.

THE LAMP AUGUST / SEPTEMBER 2020 | 27

NURSE EDUCATION

Jobs the big issue for new grads The nursing sector welcomes proposals to reduce higher education fees for nursing students, but the real issue is the lack of quality graduate positions.

s a final year nursing s t ude nt at C h a rle s Sturt University, Kate L aw r enc e won’t be eligible for a 50 per cent reduction in nursing fees, part of the recent higher education reforms the federal government claims will encourage students to study joboriented degrees. She told The Lamp that while a fee reduction “would have been lovely, I don’t think the fees are what deters people”. Kate says the biggest concern for graduating nursing students is finding practical placements during your degree, juggling paid work, and transitioning to a quality job at the end of your degree. The federal government has proposed reforms to the tertiary sector, which lower the cost of nursing and many STEM degrees (Science, Technology, Engineering and Mathematics) while increasing fees for social science and humanities degrees. Professor Tracey Moroney, Chair of the Council of Deans of Nursing and Midwifery, said these changes were announced without consultation with the nursing profession, and without any consideration of workforce data. 28 | THE LAMP AUGUST / SEPTEMBER 2020

‘ We are pleased that the government is talking about nursing students, but it is time that the government started talking about us as a profession.’ Professor Tracey Moroney, Chair of the — Council of Deans of Nursing and Midwifery

“While there are shortfalls in some parts of the practice environment, such as mental health and regional nursing, there is no evidence of a shortfall in nursing graduates across the board. We actually have an oversupply of graduate nurses. We have to look at the opportunities to get our graduates into practice.

graduate positions and “consolidate theoretical knowledge to practice”.

“We are pleased that the government is talking about nursing students, but it is time that the government started talking about us as a profession,” Professor Moroney said.

Universities currently receive $21,929 per year for each nursing student, made up of a Commonwealth contribution of $15,125 and a student contribution of $6804.

She said investments were needed to ensure that nursing students can move speedily into

CHANGES CREATE A SHORTFALL FOR UNIS Professor Moroney is also concerned that the proposal will see universities struggling to maintain the highest teaching standards and learning environments.

Under the new Job-ready Graduates Package, student fees drop to $3700 per year but Commonwealth contributions only increase by

NURSE EDUCATION

‘ The big issue is that we need to get (graduates) into secure, meaningful employment’ Annie Butler, Federal — Secretary ANMF

$1375, leaving universities with a shortfall $1729 less per student. P r o fe s s o r Moroney said nursing deans are already stretched running laboratories and budgeting for items such as IV fluids and equipment for environments that mirror “small hospitals”. Universities also need to cover 800 hours of clinical placements, which can cost up to $150 per student, per day. “Getting less money per student will place additional pressure on us,” she said. Annie Butler, federal secretary of the Australian Nursing and Midwifery Federat ion, agrees. She say s gover n ment investment needs to be directed to creating quality placement s a nd longterm employment. “We don’t have any problem with people wanting to get into the courses. We continue to see an increase in graduates every year.

The big issue is that we need to get them into secure, meaningful employment,” she told the Sydney Morning Herald. Bruce Chapman, the architect of the Higher Education Contribution Scheme for the Hawke government, now an Australian National University economist, has criticised the government’s proposa l, say ing t hat ch a n g i n g c ou r s e fe e structures will do little to change student demand. Chapman said students made “study choices based on their interests and earning potential”. His system of deferring payment through HECS loans was always designed to blunt the impact of course fees on student course decisions. The fee changes will commence from 2021 if t he leg islat ion pa sses parliament. While current students in courses where fees are set to increase will have their current fees grandfathered, in courses such as nursing, the fee reductions will apply immediately to existing students. n

Fierce competition for graduate positions Third year nursing student Kate Lawrence’s biggest concerns as a nursing student has been securing placements to cover the compulsory 800 hours of practical experience, and then finding a graduate position when she completes her degree. “When we come out there are only a certain number of graduate positions available, and they are very competitive. You can put eight preferences in your application, but that doesn’t necessarily mean you will get one of those.” “I applied to Tamworth, thinking it might be the only placement I’d get.” She added that the current COVID-19 pandemic is adding to student anxiety. “A lot of people are having their placements cancelled. But if you don’t get a placement, you don’t graduate.” Kate says that the compulsory weeks of placements while studying can also play havoc with students’ ability to maintain paid work. “Sometime students get an email on a Friday to start a placement five hours away. They have to work out accommodation, and negotiate time off paid work if they are employed, making it hard to earn income while studying.”

KATE LAWRENCE

THE LAMP AUGUST / SEPTEMBER 2020 | 29

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YOUR RIGHTS

Ask

Judith When will it end? Drought, fires, injury, evacuation, smoke, unprecedented, death, forced handshakes, economic loss, blame, Wuhan, mystery virus, pandemic, COVID-19, surge, National Cabinet, lock down, PPE, ventilators, self-isolation, recession, Ruby Princess, hospitalisation, closed borders, death, flatten the curve, grief, easing restrictions, second wave, blame, heroes. Words. Just over 40 of them and yet each is so instantly recognisable and so descriptive of the untold suffering that this country and all its people have endured over the last eight or so months. Elsewhere the world has paid, and continues to pay, a colossal price in lost or shattered lives, communities and economies broken. It is a cost that will endure for many years, if not generations. Not surprisingly, wherever the need of the community has been at its greatest, when it has required someone to set aside their own fears and uncertainties, nurses and midwives have been there, at the absolute centre of any response, of any care or support being provided, of any pain or suffering endured. To be your elected representative and a voice for the professions of nursing and midwifery has always been a privilege, but never more so than in this, our own very special International Year, marred as it has been by above events. And yet, despite the hero status applied liberally (and quite rightly so), members have on a daily basis still been short-changed on staffing levels, pushed to breaking point, investigated, disciplined or sacked, bullied or rebuffed, not paid enough. How can this be? I am not sure, sadly. But what I do know is that by working together, members and Association, we can persist, we must demand and we must prevail in having the best system of health and care possible, in all settings, for young and old. It cannot be otherwise.

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

Continuing Education Allowance For some time I have been trying to get paid the continuing education allowance for my postgraduate qualifications, without success. I work in a public hospital as an RN. Clause 13 of the Public Health System Nurses’ and Midwives’ (State) Award sets out the circumstances and criteria of eligibility for the payment of this allowance. If a dispute arises regarding the eligibility for the allowance and it is not resolved locally with the assistance of the Association (on the basis that we form a view that the allowance should be payable), Clause 13(xiii) requires the matter to be the subject of discussions between the Ministry of Health and the Association in an attempt to resolve the matter (and prior to any possible escalation to the Industrial Relations Commission of NSW). Flu vaccination allergy I work in aged care and can’t have the flu vaccination for medical reasons. Where does that leave me? On 17 March 2020, the Australian Health Protection Principal Committee, which advises the National Cabinet, recommended that from 1 May 2020, you must not work at or visit an aged care facility in you have not had the

influenza vaccination. However, whilst Public Health (COVID-19 Aged Care Facilities) Order (No 2) 2020 reflects that requirement, it does permit a person to provide a medical certificate certifying that they have a medical contraindication to the influenza vaccination. In these situations, a reliance should be made on ensuring appropriate infection control is in place, and having PPE available as required. Running out of sick leave I work at a public hospital and was recently sent home prior to commencing my shift because of a high temperature. I am running out of sick leave. What happens next time if I am sent home and asked to get tested for COVID-19? This scenario has been the topic of considerable debate. The Association and other public health unions have been pressing for an enhanced paid special leave entitlement, both in access and quantum. Those discussions continue and now include the Department of Premier and Cabinet. However, the Ministry has, in its latest Workforce Advice, indicated that: “Where sick leave is exhausted, Health agencies may grant additional sick leave on a case-bycase basis.” Wages at Opal I work at a nursing

home run by Opal. What is happening with my wages? The last pay increase in the Opal Aged Care (NSW) Enterprise Agreement 2016 has come and gone. Opal has confirmed a 2.25 per cent administrative increase to wages and allowances effective from the first full pay period in July 2020. My workplace has no agreement. Am I covered? I work as a midwife in a private hospital, and no workplace agreement is in place. I am paid under the Nurses Award 2010 but can’t work out where I fit in. In the absence of any federal enterprise agreement, the Nurses Award 2010 would apply (the default safety net). Under Clause 4 – Coverage, the Award covers “a nurse/midwife, principally engaged in nursing/midwifery duties comprehended by the classifications listed in Schedule B - Classification Definitions”. Section B.2 then states: “For the purposes of this award nursing care also includes care provided by midwives.” Accordingly, for practical purposes, the reference to nursing duties in the classification structure should be read to mean midwifery duties for midwives. This should assist in determining where your duties and responsibilities fall, and in turn what you should be paid.

THE LAMP AUGUST / SEPTEMBER 2020 | 31

PROFESSIONAL EDUCATION

Due to COVID-19, much of the Associations face-toface education program has regrettably been cancelled. In response to this, we have developed a series of webinars. Each webinar will be held across 2 sessions and also involve some self-directed learning.

Medications How we do it better This webinar series will assist you to formulate an understanding of medications in practice and what we, as individuals, can do to increase safety of the people in our care. To explore the various causes of medication errors, and provide you with the understanding and abilities to help prevent medication errors from occurring.

Search for upcoming dates of these webinars under TOPIC for ONLINE EDUCATION / WEBINARS

4 bit.ly/educationNSWNMA

COVID-19 MODULE SUPPORTING YOU AT A TIME OF NATIONAL CRISIS

As a healthcare professional led team, we are pleased to offer safeMedicate free of cost to colleagues during the COVID-19 pandemic. Our COVID-19 Education Support module is our contribution to supporting healthcare competence updating in COVID-19 related drug dosage calculations. It’s presented as part of our international suite of safeMedicate authentic learning and assessment environments which you will also have free access to during this 3 month period (June to September). The wider safeMedicate Future Nurse Suite (FNS) includes the following modules and all their learning support resources: • Essential Skills • Bodyweight and Body Surface Area Calculations • Injectable Medicines Therapy These can be used to further support your updating in the COVID-19 domain of practice, and also in the more generic areas of drug dosage calculation practice that may be relevant if your staff are returning to practice or are working towards revalidation. CONTACT: Niki McCartney niki@safemedicate.com

www.safemedicate.com PROFESSIONAL EDUCATION

32 | THE LAMP AUGUST / SEPTEMBER 2020

Clinical Communication & Documentation How to maintain high quality clinical conversations and transfer of information. This webinar series will assist you to develop the knowledge and resources to communicate professionally and comprehensively. This will include recognising that good communication is essential for quality care and patient safety. Understand the real purpose behind communication and the exchange of information.

NSWNMA

CPD SESSIONS

CPD

MAbit.ly/NSWN The Association has developed extracts from a number of our face to face courses and recorded them into short videos with additional accompanying learning resources. Co-Regulatory Model in NSW An overview of how the co-regulatory model works in NSW, explaining the role of the Nursing and Midwifery Council (NMC) and the Health Care Complaints Commission (HCCC). It also outlines the process for managing notifications and complaints in NSW.

Your Annual CPD Obligations This session will provide you with a clear understanding of your CPD requirements, explain what activities could form part of your CPD and outline your professional obligations in relation to CPD.

Reflection in Practice Following from our ‘Your Annual CPD Obligations’ video, it outlines what refection in practice is, provides examples of how you can use reflection in relation to CPD, and how to write reflectively, when considering your learning and development needs.

Professional Obligations An overview of the professional obligations relating to nursing and midwifery and provide you with a better understanding of professional accountability.

NMBA Code(s) of Conduct An understanding of the NMBA Code(s) of Conduct and the principles of professional behaviour that guide safe practice. It gives an overview of the standards expected of nurses and midwives within their practice.

Coronial Inquests An overview of the role of the Coroner, and the coronial process in NSW. It also looks at how coronial inquests can improve practice and prevent future deaths.

Documentation This session discusses the importance of documentation, the Standards for Practice, and how to ensure you document clearly and effectively.

Ethics in Practice Ethics in Practice discusses how nurses and midwives make ethical decisions in their practice, how to maintain professional boundaries, and case studies where professional boundaries have not been maintained.

Law in Practice This session discusses some of the laws that are relevant to nursing and midwifery practice, and discusses the legal and professional obligations outlined in the Standards for Practice and the Code(s) of Conduct.

Social Media Social media is becoming increasingly popular – if you are using social media, it is important you are aware of your professional obligations relating to this.

Assertive Communication An overview of the benefits of assertive communication, and outlines how you can use assertive communication in your workplace.

CPD hours for these courses can be calculated by the time you spend actively learning. This will vary between individuals, as further selfdirected learning can be included (e.g. – reviewing the associated resources and completing the reflective questionnaires).

Access FREE NSWNMA CPD sessions videos from:

bit.ly/NSWNMA-CPD PROFESSIONAL EDUCATION THE LAMP AUGUST / SEPTEMBER 2020 | 33

NEWS IN BRIEF

UNITED STATES

US officially notifies WHO of its withdrawal The move is widely condemned as COVID-19 continues to rage around the planet. The US administration has formally notified the World Health Organization of its withdrawal from the UN body despite widespread criticism. When he flagged the move in late May, President Trump, accused WHO of helping the Chinese government in a cover up in the early stages of the coronavirus epidemic in Wuhan. The New York Times said this accusation was baseless. “There is no evidence that the WHO or the government in Beijing hid the extent of the epidemic in China, and public health experts generally view Mr Trump’s charges as a way to deflect attention from his administration’s own bungled attempts to respond to the virus’s spread in the United States,” it said. “In fact, the agency issued its first alarm on Jan 4, just five days after the local health department of Wuhan announced a cluster of 27 cases of an unusual pneumonia at a local seafood market. The WHO followed up with a detailed report the next day.” Public health experts in the United States reacted to the move to withdraw from WHO with dismay. “Turning our back on the WHO makes us and the world less safe,” said Dr Thomas Frieden, the former director of the Centers for Disease Control and Prevention. The Infectious Diseases Society of America “stands strongly against President Trump’s decision,” said its president, Dr Thomas M. File.

‘ Turning our back on the WHO makes us and the world less safe.’

34 | THE LAMP AUGUST / SEPTEMBER 2020

WORLD

Many more men are dying from COVID-19 than women In many countries, male fatalities are twice those of women. In Italy and China, deaths of men due to COVID-19 are more than double those of women. In New York City, men constitute about 61 per cent of patients who die. Australia is showing signs of similar results. Clearly, the major variable in severity of COVID-19 is age. But experts say the other major factor is the presence of chronic diseases, particularly heart disease, diabetes and cancer. These are all more common in men than women, which might account for some of the bias. Writing in The Conversation, Jenny Graves, Professor of Genetics at La Trobe University, says “the sex bias in COVID-19 deaths is part of a much larger picture – and a very much older picture – of sex differences in genes, chromosomes and hormones that lead to very different responses to all sorts of disease, including COVID-19”. “We’ve known for a long time that women have a stronger immune system than men. It gives women an advantage when it comes to susceptibility to viruses.” In China, the marked differences in death rates between men and women mirrors the extreme differences in smoking rate. Almost half of Chinese men smoke compared with only 2 per cent of women. Not only is smoking a severe risk factor for any respiratory disease, but it also causes lung cancer, a further risk factor.

‘We’ve known for a long time that women have a stronger immune system than men.’

NEWS IN BRIEF

AUSTRALIA

The Australian public’s regard for unions is rising A poll finds a majority of people think Australia would be better off if unions were stronger. The poll, conducted by Essential for The Guardian found that 50 per cent of Australians indicated we would be better off with strong unions. Only 25 per cent disagreed. This is a marked increase in the positive perception of unions since the early 2010s when support was less than 40 per cent. NEW ZEALAND

NZ aged care nurses campaign for pay parity Nearly 14,000 New Zealanders have signed a petition calling for an end to the pay disparity between the country’s registered nurses who work in aged care and their counterparts in public hospitals. “Registered nurses who work in aged care in New Zealand earn on average at least $10,000 a year less than nurses who work in public hospitals,” says the petition to Dr David Clark, New Zealand’s Minister of Health. “That’s not because they are any less skilled or important, but because of years of underfunding of rest homes by successive governments and undervaluing of the care of older people.” There are more than 5000 aged care registered nurses in New Zealand. The push for better pay comes as the skill and leadership of the country’s aged care nurses have been credited as an important reason for New Zealand’s low fatality rate from COVID-19. Only 21 people have died from COVID-19 in New Zealand. Most of the deaths were concentrated in two aged care facilities. The overwhelming majority of homes had no casualties. Experts say that staffing issues were an important factor in the facilities that experienced outbreaks and low staffing levels must be an important part of any review into coronavirus outbreaks in New Zealand rest homes. “Quality care requires more staff and more time. Higher staffing ratios will also provide more room for flexibility when crises occur,” said Dr Katherine Ravenswood, from Auckland University of Technology.

The poll also found that: • 7 4 per cent of respondents agreed that unions provide essential services to their members to ensure they are paid appropriately and have safe working environments • 7 4 per cent agreed that unions give workers more power with employers through a collective voice •6 7 per cent agreed unions are vital to stop businesses taking advantage of their employees. Sally McManus, ACTU Secretary, said the research shows that Australians know “who has their back”. “Unionised workers have steered the country through this pandemic and will continue to play a leading role in the economic rebuild,” she said. “Pay cuts and cuts to workers’ rights will not help Australia recover. We are working to win more secure jobs and fairer wages.” The poll came as the Australian Bureau of Statistics released new figures showing unemployment climbing to nearly 1 million people; 227,000 jobs were lost between April and May.

‘Unionised workers have steered the country through this pandemic and will continue to play a leading role in the economic rebuild.’ — Sally McManus, ACTU Secretary

‘Quality care requires more staff and more time.’ THE LAMP AUGUST / SEPTEMBER 2020 | 35

NEWS IN BRIEF

AUSTRALIA

HESTA divests from coal The industry super fund for health workers has announced a new climate policy that commits to net zero emissions across its investment portfolio by 2050. HESTA says its climate plan will reduce absolute carbon emissions across its investment portfolio by 33 per cent within the decade and 100 per cent by 2050. This would bring its investment strategy in line with the goals of the Paris Climate Agreement. “Climate change is probably the single most important issue that we’ll be facing over the next century and really, for us, it’s so important because it’s a material financial risk for our portfolio,” said HESTA chief executive ,Debby Blakey. “We are the generation that needs to address this and we really do need an urgent response.” HESTA has faced criticism in the past for retaining investments in companies like Coal India, one of the largest coal producers in the world.

AUSTRALIA

GDP will fall by 25 per cent without climate action A failure to act urgently on climate change will have dire economic consequences according to a report commissioned by 60 of the world’s central banks, including the Reserve Bank of Australia. The report warns that global GDP could fall by 25 per cent by 2100 if the world does not act to reduce global greenhouse gas emissions. It outlines three different scenarios to guide bankers and financial regulators when assessing the climate risks to the economy and financial sector: • An “orderly scenario” where climate policies would be introduced soon and gradually tightened, limiting the risk of physical damage and the impact of the transition to low emissions. It would be expected to lead to a “relatively small” economic impact of about 4 per cent of global GDP by 2100. • A “disorderly” scenario where climate policies would not be introduced until 2030, and the emissions reductions needed would be more abrupt. It would lead to a nearly 10 per cent reduction in global GDP. • A third scenario, described as a “hot house” world, where action to deal with the climate crisis would be limited to current policies only. The report estimated that the physical damage caused under this scenario could wipe out up to a quarter of annual global GDP by the end of the century. Frank Elderson from the Netherlands’ central bank said the report was important as “climate change leads to financial risks and therefore remains a vital issue for central banks and supervisors to address”.

Read the report https://www.ngfs.net/en/communique-de-presse/ 36 | THE LAMP AUGUST / SEPTEMBER 2020

HESTA’s new climate policy will apply to all thermal coal companies, including Coal India as well as its holding in Whitehaven Coal, a company running four coal mines in NSW and Queensland. “We have a view that thermal coal is in structural decline and we are concerned about stranded assets,” Ms Blakey said. “This idea that coal can continue to provide base load energy in the long term is really inconsistent with what’s needed to meet the goals of the Paris Agreement.”

‘Climate change … is a material financial risk for our portfolio.’ — Debby Blakey, HESTA chief executive

NEWS IN BRIEF

AUSTRALIA

Pacific Island economies face collapse over COVID-19

The Pacific region is almost COVID-19-free but economies have been devastated. Strict border closures have devastated tourism, a crucial revenue earner and restricted much-needed imported foods in Pacific Island states. “COVID-19 is clearly the job-killer of the century,” Fiji Prime Minister Frank Bainimarama said. “You can’t suddenly work from home when you earn your pay cheque as a scuba instructor, or in a garment factory dependent on regional supply chains, or as a handicraft maker who usually sells to tourists.” Cook Islands Deputy Prime Minister Mark Brown said the pandemic lockdowns were an “economic tsunami”. Tourism makes up 65 per cent of the islands’ economic activity. A report published by the Hawaii Journal of Health and Social Welfare, says some measures taken to fight Covid-19 are likely to increase the long-term risk of non-communicable diseases common across the Pacific, such as hypertension, diabetes, and heart disease. “For example, trade and movement restrictions within and between countries has reduced availability and accessibility to healthier foods, and increased reliance on unhealthy processed foods,” the report said. “In addition, there is potential for individuals becoming less physically active as a result of curfews and restricted movement; abuse of tobacco and alcohol while being isolated at home; and an increase in domestic violence.” Small Pacific Island states typically produce less than 65 per cent of their country’s dietary energy supply domestically.

CROSS

WORD SOLUTION

‘ COVID-19 is clearly the job-killer of the century.’ — Frank Bainimarama, Fiji Prime Minister THE LAMP AUGUST / SEPTEMBER 2020 | 37

NURSING RESEARCH AND PROFESSIONAL ISSUES The Clinical Communiqué (www.thecommuniques.com) is an electronic publication containing narrative case reports about lessons learned from Coroners’ investigations into preventable deaths in acute hospital and community settings. The Clinical Communiqué is written by clinicians, for clinicians. The goal is to improve the awareness of health care professionals, clinicians and managers about the nature and circumstances of the systems failures that contributed to patient adverse events.

Editorial Dr Nicola Cunningham

In this edition we explore two cases where death occurred in secure settings – a correctional facility and a mental health facility. As the details unfolded at inquest, it became apparent that the usual layers of complexity that exist in providing care to patients with multiple physical and mental health co-morbidities in acute hospital settings were magnified. Major logistical issues included access to the facility, use of multiple providers, and personal safety concerns for the staff.

Case #1 A series of very unfortunate events Dr Rohit D’Costa

Ms AW was a 19-year-old woman with a diagnosis of impulsive personality disorder and chronic alcohol and cannabis abuse. Due to her drug and alcohol misuse and mental health issues, she was deemed to have a chronic high risk of suicide. On one occasion where she had been drinking spirits and using cannabis, she attempted to harm herself, but was quickly found and taken to an emergency department (ED) for assessment. There she was uncooperative, swearing at the staff and eager to leave, but was kept in the department overnight to sober up. The next morning, a decision was made that her risk to herself was not increased and she was subsequently discharged from the ED. That night however, she 38 | THE LAMP AUGUST / SEPTEMBER 2020

again attempted to harm herself, and was found and transported by police to the ED. Once more, she was intoxicated and combative so was sedated and kept in hospital overnight. On review the next morning, she refused a voluntary admission to the hospital’s mental health unit, so the psychiatrist made a decision to admit her to an authorised hospital as an involuntary patient. Patients under involuntary status were generally sent to that hospital via the Royal Flying Doctor Service (RFDS). The patient reacted angrily to this decision and both sedation and physical restraint in the High Dependency Unit (HDU) were necessary to facilitate ongoing care and safe transfer. The RFDS crew, comprising Dr D and RN J, arrived to retrieve Ms AW but first attended the bedside of an intubated patient with a neck injury in ED who they were also transferring. DR D remained with that patient while RN J went to the HDU to see Ms AW. While in the HDU, RN J asked one of the nurses to prepare two 50ml syringes for their flight, one containing midazolam and the other haloperidol. RN J then returned to the ED. The HDU nurse contacted the nurse unit manager (NUM) to access more haloperidol from stock to complete the request. The NUM queried whether 50mg or 50ml of haloperidol was required by the RFDS crew, and was told by the HDU nurse that the request had been for 50ml. The NUM discovered that

the remaining hospital stock of haloperidol was 50 ml, so she contacted Dr D to confirm that 40 ml would suffice. The syringes were then labelled (haloperidol 200mg/40ml, midazolam 50mg/50ml) and provided in a bag for the flight. This case illustrates the common issue of how serious adverse events usually occur as the result of a series of unfortunate events, each equally critical, but equally likely to fall under the radar of a busy clinician. The challenges of maintaining patient and staff safety during care and transport of an agitated patient are significant, and very often will require judicious use of chemical and physical restraint, but the specific risks of medications and tools used need to be fully appreciated by all involved in the patient’s care.

Case #2 A twist in the list Dr Nicola Cunningham

Mr EH was a 37-year-old man who was six months short of his release date from prison when he died in the cell he occupied. He had already served 15 years of his custodial sentence. His medical diagnoses included mental health problems (including posttraumatic stress disorder and bipolar disorder), chronic back pain, drug dependence, hepatitis C, early cirrhosis, and morbid obesity. While in prison, Mr EH was on a methadone program and was being treated by a psychiatrist and general practitioner for his

NURSING RESEARCH AND PROFESSIONAL ISSUES

mental health and chronic pain issues. His management plan also included regular reviews by nursing staff to screen for his risk of metabolic syndrome (a cluster of cardiovascular risk factors including insulin resistance, hypertension, central obesity and dyslipidaemia that result in significantly increased risk of cardiovascular disease and death).

In his finding, the coroner explained that it is ‘sometimes easy to forget that there is a single person at the centre of the inquest’ when the investigative focus is on ‘systems and processes and how they may be improved for the community at large’.

The coroner then prefaced the documentary evidence about the circumstances of Mr EH’s death, The screening would involve with a thoughtful account of measurements of weight, girth, Mr EH’s troubled life. Mr EH was blood pressure, cholesterol level, described as a man who loved body mass index, and insulin his family, and had a passion resistance. However, he declined for rugby and music, whose life to attend most of the screening was severely changed after he sessions that were scheduled suffered significant burns in a for him. On the day before his house fire. He developed mental death, Mr EH was last seen alive health and drug addiction issues at 5:45pm when he was given and became involved in criminal his prescribed medication. At activity, eventually culminating 7:15am the following morning, in his convictions for multiple he was found in his bed indictable offences and unresponsive and not breathing. sentences that were to be served An emergency call was made concurrently. Throughout his for immediate assistance. life, Mr EH had been like a best Cardiopulmonary resuscitation friend to his father, who spoke was unsuccessful, and he was at the inquest of how much he COMMUNIQUÉS pronounced deadTHE at 7:35am. missed his son.

Learn more Download the publication www.thecommuniques.com

THE COMMUNIQUÉS

VOLUME 7. ISSUE 2. JUNE 2020 Edition ISSN 2204 - 0099

Clinical Communiqué

Next Edition: September 2020

THE LAMP AUGUST / SEPTEMBER 2020 | 39

There are some things you shouldnâ&#x20AC;&#x2122;t handle alone. Contact the NSWNMA if you are: Asked to attend a disciplinary or fact finding interview with your employer Threatened with dismissal Instructed to provide a statement for any reason Contacted by the Health Care Complaints Commission or the Nursing and Midwifery Council of NSW Contacted by police or solicitors in relation to a Coronial Inquest

Call us on 8595 1234 (metro) or 1300 367 962 (non-metro) Email gensec@nswnma.asn.au www.nswnma.asn.au 40 | THE LAMP AUGUST / SEPTEMBER 2020

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22 24

27 28

ACROSS 1. Obstruction to the blood flow and bleeding into an abdominal organ (9.8) 10. A chronic, progressive anaemia of older adults due to failure of absorption of vitamin B12 (10.7) 11. Horripilation (9) 14. Any material inserted or grafted into the body (7) 16. Make free from bacteria (11) 17. Nuclear magnetic resonance (1.1.1)

18. A muscle in a state of contraction (7) 19. Compliance (9) 22. A single unit (3) 23. A dye used in microscopy as a biological stain and in medicine as a bactericide, fungicide, and anthelmintic (7.6) 25. Progeny (9) 27. A discharge (8) 28. Contribution, donation (8) 29. A life-threatening manifestation of an allergic reaction (12.5)

DOWN 1. Spontaneous pain in a body area that lacks sensation (9.8) 2. Double immunodiffusion (1.1.1) 3. Spellbinding, hypnotising (11) 4. Non-invasive neoplasia (1.1.1) 5. Plumbism, saturnism (4.9) 6. Regulating so as to be synchronised (7) 7. A portable enclosure for a baby (7) 8. Erythema chronicum migrans (1.1.1) 9. Vulvovaginal candidiasis (5.9) 12. Laborious; industrious; diligent (7) 13. Not deliberate, inadvertent (13) 15. Suprarenal, near kidney (7) 20. A gas burner used in laboratories (4) 21. A large muscle group arising from the inside of the back wall of the pelvis and lower abdomen (9) 24. Numb (6) 26. Very small (5) 27. Revise (4)

THE LAMP AUGUST / SEPTEMBER 2020 | 41

INSURANCE BENEFITS

For NSWNMA Members

Insurance protection when you need it most The NSWNMA is committed to protecting the interests of nurses and midwives by purchasing a range of insurances to cover members.

Journey Accident Insurance provides cover for members who are injured as a result of an accident while travelling between their home and their regular place of employment. Professional Indemnity Insurance provides legal representation and protection for members when required. Make sure your membership remains financial at all times in order to access the insurance and other benefits provided by the NSWNMA.

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 www.nswnma.asn.au

www.nswnma.asn.au 42 |

IMPORTANT NOTE From 1 December 2018 the insurance benefits have changed as follows: • Journey Accident Insurance: the waiting period for benefits is now 14 days • /Professional THE LAMP AUGUST SEPTEMBER 2020 Indemnity Insurance: the limit per claim is now $5 million

REVIEWS

book club

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COVID 19: What you need to know about the coronavirus and the race for the vaccine

SPE C

All books can be ordered through the publisher or your local bookshop. Call 8595 1234 or 1300 367 962, or email library@ nswnma.asn.au for assistance with loans or research. Books are not independently reviewed or reviewed using information supplied by the publishers.

Where the Crawdads Sing Delia Owens Little Brown Book Group: RRP $17.90 ISBN 9781472154668

For years, rumours of the ‘Marsh Girl’ have haunted Barkley Cove, a quiet town on the North Carolina coast. So in late 1969, when handsome Chase Andrews is found dead, the locals immediately suspect Kya Clark, the so-called Marsh Girl. But Kya is not what they say. Sensitive and intelligent, she has survived for years alone in the marsh that she calls home, finding friends in the gulls and lessons in the sand. Then the time comes when she yearns to be touched and loved. When two young men from town become intrigued by her wild beauty, Kya opens herself to a new life – until the unthinkable happens.

The Bush Telegraph Fiona McArthur

Penguin Random House Australia: RRP $32.99 ISBN 9781760894986

It’s been ten years since Madison Locke left her small country town of Spinifex with nothing but her newborn baby in her arms. The gossip about Madison and the man she ran from, sown like seeds by the bush telegraph, has haunted her since. But when the town is in need of someone to steer their medical centre, Maddy, now a midwife and nurse, returns with her daughter, Bridget, determined to prove herself and meet the dark memories of her past head on. Outback nurse Phyllis, ready for retirement, is struggling to keep up with her new boss and the learning curve Maddy’s placed her on. Spinifex is drying up and getting hotter with each year, the drought is driving farmers to the edge and there hasn’t been a baby born in town for years. Why bother trying to teach an old dog new tricks, or revive a town on its last breath?

Dr Michael Mosley: Simon & Schuster: RRP $17.50 ISBN 9781760857592 CI This book charts the trajectory of the COVID-19 virus, from its AL IN T E emergence in China at the end of 2019 to its rapid worldwide spread. Based on the latest scientific discoveries, Dr Mosley gives a detailed understanding of the secrets of this coronavirus, how it spreads, how it infects your body and how your immune system tries to fight back. Armed with the facts you’ll be in a much better position to protect yourself and your family when the world begins to reopen. Dr Mosley also follows the work of leading doctors and virus researchers as they battle to find treatments, and a safe and effective vaccine (ultimately, the only way to defeat the virus). Eating well, sleeping soundly, exercising and managing your stress are all critical for keeping your brain, body and immune system in the best possible shape over the coming months.

Four Weddings and a Festival Annie Robertson

Orion Publishing Co RRP $24.99 ISBN 9781409189992

Four months. Four weddings. One happy ending? Lifelong friends and rom-com fans Bea, Lizzie, Hannah and Kat have curled up with Bridget Jones, sobbed at Love, Actually and memorised the script to Notting Hill. They always joked about getting married in one summer – their own Four Weddings – and it seems like this might just be the year. That is, until Bea turns down her boyfriend’s proposal. Is her own Hugh Grant waiting for her amid the champagne and confetti? Can real-life romance ever live up to a Richard Curtis movie? As the wedding – and festival – season gets into its swing, can all four friends find their happy ever after?

THE LAMP AUGUST / SEPTEMBER 2020 | 43

LIONS NURSES’ SCHOLARSHIP Looking for funding to further your studies in 2021? THE LIONS NURSES’ SCHOLARSHIPS OPEN ON 1 AUGUST AND CLOSE ON 31 OCTOBER EACH YEAR The trustees of the Lions Nurses’ Scholarship Foundation invite applications for scholarships. Nurses eligible for these scholarships must be resident and employed within the State of NSW or ACT. You must currently be registered with the Nursing and Midwifery Board of Australia

and working within the nursing profession in NSW or the ACT, and must have a minimum of three years’ experience in the nursing profession – the last twelve months of which must have been spent in NSW or the ACT. Details of eligibility and the scholarships available (which include study projects either within Australia or overseas), and

application forms are available from: www.nswnma.asn.au/education Administration Liaison Lions Nurses’ Scholarship Foundation 50 O’Dea Avenue Waterloo NSW 2017 or contact Matt West on 1300 367 962 or education@nswnma.asn.au

COMPLETED APPLICATIONS MUST BE IN THE HANDS OF THE SECRETARY NO LATER THAN 31 OCTOBER

44 | THE LAMP AUGUST / SEPTEMBER 2020

REVIEWS

at the movies A

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The Secret Garden

Rams Where there’s a wool, there’s a way. In remote Western Australia, two estranged brothers, Colin (Sam Neil) and Les (Michael Caton), are at war. Raising separate flocks of sheep descended from their family’s prized bloodline, the two men work side by side yet are worlds apart. When Les’s prize ram is diagnosed with a rare and lethal illness, authorities order a purge of every sheep in the valley. While Colin attempts to stealthily outwit the powers that be, Les opts for angry defiance. In cinemas 27 August. Email The Lamp by 15 August to be in the draw to win one of ten double passes to see Rams thanks to Roadshow. Email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

The Secret Garden tells the story of Mary Lennox (Dixie Egerickx), a prickly and unloved 10-year-old girl, born in India to wealthy British parents. When they die suddenly, she is sent back to England to live with her uncle, Archibald Craven (Academy Award® and BAFTA-winner Colin Firth) at Misselthwaite Manor, a remote country estate deep in the Yorkshire moors, under the watchful eye of Mrs. Medlock (BAFTA-winner Julie Walters) and with only the household maid, Martha (Isis Davis) for company. Mary begins to uncover many family secrets, particularly after chancing upon her sickly cousin Colin (Edan Hayhurst), who has been shut away in a wing of the house, and through her discovery of a wondrous garden, locked away and lost within the grounds of Misselthwaite. In cinemas 17 September. Email The Lamp by 15 August to be in the draw to win one of ten double passes to see The Secret Garden thanks to StudioCanal. Email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

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Blood Series 2

EMBER AY

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Series 2 begins when Jim Hogan (Adrian Dunbar, Line of Duty) returns home a year later, stripped of his medical license and determined to make amends and reconnect with his family. He finds that his eldest daughter Fiona Crowley (Grainne Keenan, Victoria) is ailing, slowly succumbing to the same debilitating illness that afflicted her mother, and her husband Paul Crowley (Ian Lloyd Anderson, Love/Hate) is struggling. Jim's determined efforts to make amends and reconnect with his family only seem to add to their grief, and things worsen when he stumbles upon suspicious activity at the farm where Paul works. Released on 8 July.

Schitt’s Creek Series 1–6

Email The Lamp by15 June to be in the draw to win one of five DVDs of Blood Series 2 thanks to Acorn Media. Email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

Email The Lamp by15 June to be in the draw to win one of three sets of Schitt’s Creek Series 1-6 thanks to Acorn Media. Email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

All 80 episodes of the smash hit show in a 12 disc set. Releasing 26 August.

THE LAMP AUGUST / SEPTEMBER 2020 | 45

20 hours of CPE FREE

for NSWNMA members!

FEATURING Meeting your Continuing Professional Development needs is now even easier with this great new offer for NSWNMA members. As a financial member you’ll have access to 61 best practice topics absolutely free.

LOGGING ON

Access to over 20 hours FREE CPE 61 best practice topics including those modules that are deemed mandatory annual competencies by large health organisations and nursing agencies 4/ 3/ Free professional development portfolio to provide evidence to the Nursing and Midwifery Board of Australia (NMBA) of participation in CPD annually.

MEMBERS: New users create a ONE TIME login to the website.

Access free videos and learning resources from a number of face to face courses @ bit.ly/NSWNMA-CPD

NON-MEMBERS: Join the union at www.nswnma.asn.au and receive access to your 20 hours FREE CPE!

Access to ANMJ online – Nursing articles in the ANMJ can count towards your annual CPD.

bit.ly/NSWNMAMemberCentral 5/

46 | THE LAMP AUGUST / SEPTEMBER 2020

Alice Cashin (26 MARCH 1870 – 4 NOVEMBER 1939)

“ It was a terrible and cruel night and one that will stand out in memory all one’s life”

Alice trained as a registered nurse at St Vincent’s Hospital in Sydney, and later moved to England to pursue her career. When WW1 broke out, she signed up with the British Red Cross, and in July 1915 she joined the Queen Alexandra Military Nursing Services Reserve (QAIMNSR). For her work and bravery while serving in Egypt, Alice was awarded the Royal Red Cross 1st Class medal. Later, as Matron on the hospital ship the Gloucester Castle, she defied the Captain’s orders to take to a lifeboat when the ship was torpedoed without warning in the English Channel on the night of 30 March, 1917. Alice refused to leave the sinking ship until all her 399 injured men and 33 nurses were safely on lifeboats. She left on the last lifeboat. On her return to Australia she was crowned the Queen of Marrickville. For her ‘example of coolness and devotion to duty, and rendering invaluable service’ Alice was the first Australian to receive the Bar to her Red Cross Medal. She died on 4 November 1939 from chronic nephritis.

cal histori nurses ingmidwives t a b r nd Cele a

Authorised by B.Holmes. General Secretary, NSWNMA

Join the health fund that’s all about you.

Nurses & Midwives Health is dedicated to caring for the carers. We’re the only health fund exclusively for nurses, midwives and their families. When you’re a member, you’re part of our family. So that’s why your family members are also welcome to join us.

For your free, side-by-side comparison, and our latest offers, visit nmhealth.com.au call 1300 344 000 Eligibility criteria and conditions apply. Nurses & Midwives Health Pty Ltd ABN 70 611 479 237 NMH-NSWNMA-07/20 Authorised by B. Holmes, General Secretary, New South Wales Nurses and Midwives’ Association, 50 O’Dea Ave, Waterloo NSW 2017

The Lamp August 2020

Articles inside

News in brief

Book Club

Increasing number of Victorian COVID 24 COVID-19

Nursing Research Online

Nurse Education

Ask Judith

Editorial