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Midwives warn Minister over maternity staffing

Aged care gains traction in parliamentary reports

Introducing our new councillors

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


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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 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




Privatised Northern Beaches Hospital a dangerous shambles The state government promised a smooth transfer to the new Northern Beaches Hospital. But several weeks after opening the facility was in disarray.

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 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: Jeannette Bromfield, 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  ‘Sorry, we can’t help you’

An emergency involving their young daughter has given an Avalon couple a frightening insight into the loss of local public health services.

SAFE STAFFING  Midwives warn Minister over maternity staffing

Maternity unit staffing levels are too low to provide safe care and overworked midwives don’t have enough time to educate new mums.

SAFE STAFFING Town backs nurses’ ratios campaign


Aged care nursing at Manilla MPS sacrificed to plug gaps in emergency and acute staffing.

AGED CARE Aged care gains traction


in parliamentary reports A Liberal-led parliamentary committee has recommended the mandatory disclosure of staffing ratios in Australia’s nursing homes.ios

AGED CARE Staffing aged care safely makes

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Midwives warn Minister over maternity staffing

Aged care gains traction in parliamentary reports

Introducing our new councillors

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page 28

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

p.37 p.39 p.41 p.43


economic sense Better staffing and higher wages in nursing homes won’t cost the health system any more – and may well save money. ios tios

NSWNMA ELECTIONS Introducing our new councillors

In this month’s Lamp, our new councillors introduce themselves and tell us about their aspirations for our union.

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OUR COVER: Chris and Mila Sadrinna Photographed by Guy Finlay THE LAMP FEBRUARY 2019 | 3






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Chronicle of a fiasco foretold Normally it takes a bit of time before the flaws and inadequacies in service provision from a privatised public service become obvious but at the Northern Beaches Hospital it has been on show from the beginning. The privatisation of the Northern Beaches Hospital was undertaken without any serious public debate. The tendering process was shrouded in secrecy. The public was lied to about what it would cost. Now the hospital has opened in a state of chaos due to completely inadequate planning and preparation. This is largely due to a failure to engage with staff and a management that lacks experience in running public hospitals. It was arrogant to think that private corporations would do a better job of running a public hospital. The government responsible for this debacle deserves to be made accountable. The opening six weeks for the hospital was a shambles as we detail in this edition of The Lamp and as was heavily reported in the media. The Government and Healthscope were obviously embarrassed but tried their best to spin it as “normal teething problems”, despite the large number of problems exposed. Nurses, midwives and other health staff have done their very best to deliver a service to their community against almost impossible odds. Privatisation was the wrong decision and we said so loud and clear from the beginning. The Baird/Berijiklian Government has locked in this privatisation for the next 20 years at least. Unwinding this would cost a lot of money and we have to make sure this mistake is not repeated.

‘Since it was elected to office in 2011 this NSW Liberal-National government has made the privatisation and outsourcing of public services, including health, its signature policy.’ Healthscope needs to deliver on its contract and meet its obligations to deliver appropriate staffing and maintain the entitlements of the transferred nurses. It needs to negotiate nurse-to-patient ratios in the next round of bargaining. I am advised that Healthscope at Northern Beaches is currently pulling out all stops to recruit new staff and in the interim is relying on more than a hundred agency RNs per day to fill the rosters. Interestingly, many are travelling from Western Sydney and pass public hospitals like Nepean, Blacktown, and Westmead – all of whom swear on a bible they can’t find RNs to fill their vacancies and that agencies can’t help them. Northern Beaches Healthscope is obviously more successful than our public hospitals when it comes to the supply of agency RNs! Since it was elected to office in 2011 this NSW Liberal-National government has made the privatisation and outsourcing of public services, including health, its signature policy. Electricity, ports, housing, land and property information, recreation facilities, museums and court operations are just

a small sample of the many services that have been subject to its sweeping privatisation program. And, of course, health services have not been exempt. On top of the Northern Beaches Hospital there was the privatisation of disability services and the attempt to privatise five regional hospitals. The privatisation of public hospitals and health services was undertaken without any consultation or discussion with the community about what it wanted. The NSW public was denied the facts they needed to make an informed choice on this issue at the last state election. Very soon they will have the opportunity to rectify that, better armed with the facts, including the facts on the ground. The Labor leader Michael Daley has pledged that if his party is elected to government: “There will be no privatisation of NSW hospitals, water, electricity or public transport services”. Nurses and midwives, along with the community, will have a clear choice on this and other critical issues for public health when the NSW state election rolls around this March.




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The case for pill testing Harm minimisation works! The “war on drugs” and a reactive government do not! Why do we have a government that has its head stuck in the sand, ignoring the success of pill testing in the Netherlands and Portugal? And now, Norway has decriminalised possession of all drugs for personal use and treats substance use and abuse as a health issue, not a crime issue. • Pill testing has been shown to change the black market with products publicly identified as dangerous being withdrawn from the market. • Pill testing changes behaviour, with research suggesting that negative results would deter a majority of people from consuming drugs and spur them on to warn their friends. John William Waterhouse The Lady of Shalott 1888, Presented by Sir Henry Tate 1894, Tate, © Tate, London 2018

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• Visits to pill-testing booths create an opportunity for providing support and information over and above the testing itself. • Pill testing enables the capture of long-term data about substances in the drug market and the potential for a warning system against new, unexpected, or very dangerous drugs, and consumption trends. Take note Gladys Berejiklian and Scott Morrison and get your heads out of the sand! Skye Romer

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NSWNMA members the chance to win a two-night stay in a one bedroom apartment including breakfast at the Forrest Hotel & Apartments and entry for two to see Love & Desire: Pre-Raphaelite Masterpieces from the Tate at the National Gallery of Australia, Canberra. This world-exclusive exhibition features artworks of breathtaking beauty, brilliant colour and exquisite detail, inspired by the great love stories of history and literature. To enter the competition, simply provide your name, address and membership number and email your entry with the subject: Canberra to lamp@nswnma.asn.au *Conditions apply. Rooms subject to availability and valid for stays Sunday to Thursday nights. Prize must be redeemed by 28 April 2019. Not valid during long weekends, NSW school holidays, Public Holidays or major event periods. Voucher is not transferrable, non-exchangeable and not redeemable for cash. The offer is valid for 2 people only. Voucher must be presented on arrival. Competition entries from NSWNMA members only and limited to one entry per member. Competition opens 1 February 2019 and closes 28 February 2019. The prize is drawn on 1 March 2019. If a redraw is required for an unclaimed 6 it| must THEbeLAMP 2019 prize held upFEBRUARY to 3 months from the original draw date. NSW Permit no: LTPM/18/02955.

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LETTER OF THE MONTH Another grateful patient I recently had an admission to hospital. On returning home, I opened my Lamp and was so inspired by Robert Southcombe’s letter as to echo his sentiments. I don’t think it matters that my admission was also to Concord Hospital, as I’m sure that his comments and mine are reflected throughout the state and indeed the country. The care I received from all clinicians was second to none but most of that care was determined and provided by nurses. The quality of education nurses receive is, of course, vitally important. There is something else however, something that leads a person to decide that they want to be a nurse in the first place, something that you can see in the faces and hear in the voices of nurses and, thankfully, in students too. That something is of course compassion – a need to make a meaningful contribution to the health and welfare of others. My life experiences, especially those derived from over three decades of employment in the health system, confirm that this is true of nurses and midwives working in all fields of practice. Also, I am proud of the small contribution I made over that time to the work of the union that constantly has to strive so hard to protect and improve the pay and conditions of nurses and midwives. I am sure that grateful appreciation of what nurses do is widespread and deeply felt among us. Yet it is so rarely and grudgingly shown in the behaviours of their employers. Charles Linsell

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.

More thought needed on drugs There is always the comment put forward that people should not take illicit drugs. My question would be: Why not? We need to critically think about why some substances are legal and others are not. Alcohol and nicotine are far more harmful to self and others than mushrooms, LSD and ecstasy. We, as a society, are very quick to say: “It’s illegal. Don’t do it” when we actually need to think much more about this. The evidence for pill testing is widespread. Pill testing is a very effective way to minimise harm. Annie Elizabeth Smoker

Substance abuse is a health issue I cannot believe the opposition to pill testing on a number of levels. Irrespective of society’s views on the use of substances, people will continue to use them. Unlike alcohol (which in terms of financial and social costs is far more damaging), substances require purchase via illegal means. It is the potential for contamination that poses such a threat and testing allows users to make informed decisions about the drug they are thinking of taking. Having such vital information determines whether the effects of the drug will be as expected or have a potentially dangerous outcome instead. No one deserves to die by taking something that could be easily avoided through testing. According to the National Drug and Alcohol Research Centre (NDARC), testing could also force black markets to improve the quality of substances sold. Current evidence supports harm minimisation and testing is a part of this process. The risk of overdose or individual reactions to substances will still occur; however, the awareness of the substances’ contents can only

contribute to reducing these adverse events. Testing also provides access to drug and alcohol services and workers and access to assistance with substance use if it is an issue, or awareness and education for others. The University of NSW (UNSW) has an excellent article from findings of the NDARC. Our children and community members do not deserve to die through use or ingestion of something that is not what it is claimed to be, especially when such an easily validated alternative exists. Although it is another issue, all alcohol prohibition did was create an illegal, lucrative and violent black market. Substance use needs to be a public health issue (with an associated framework) not a law and order issue for users. Glenn Edmond Hayes

Accreditation should be linked to ratios I left the private hospital system 12 months ago due to bullying and unsafe ratios. While the hospital, during workplace agreement negotiations with the NSWNMA, stated that the hospital did not and would not partake in shift-by-shift ratios, it worked on the nurse:patient ratios of AM 1:5, PM 1:6, ND 1:10. As a registered nurse, I worked under these ratios for many years, on many occasions being in charge of a 40-bed unit and still having a nurseto-patient ratio of one to 10. From experience I can say that these ratios are unsafe! The minimum safe ratios for any NSW hospital, public or private, should be AM 1:4, PM 1:5, and ND 1:7 – and this should be legislated. This is not a political issue. This is not an election winning issue. This is patient safety! This is nurse safety! If hospitals do not comply with these ratios, they should lose their accreditation.  Patrick Tracey



Privatised Northern Beaches Hospital a dangerous shambles The state government promised a smooth transfer to the new Northern Beaches Hospital. But several weeks after opening the facility was in disarray.


n 2015, the then NSW Health Minister, Jillian Skinner, accused the NSW Nurses and Midwives’ Association of running an advertising “scare campaign” against the state government’s hospital privatisation plans. We predicted privatisation would bring about a decline in the quality of care, patient satisfaction and staff morale, and make health services more expensive. Members of the Coalition state government repeatedly called our campaign a lie. Fast forward to the opening of the privatised Northern Beaches Hospital (NBH) on 30 October 2018. Within a fortnight of receiving its first patients it was obvious the hospital was a “shambles” with patients and staff reporting “chronically understaffed” units, as the Sydney Morning Herald put it.

‘The hospital currently fails completely in its primary objective of patient safety.’ — Senior anaesthetist

well as Mona Vale to replenish the new hospital’s stockrooms,” the Herald reported. There was a bed shortage due to lack of staff and ED patients waited up to 17 hours for treatment. A patient needing a half-hour operation for a cut hand was bumped off the surgery list for five days in a row and a child had to wait eight hours in paediatrics for antihistamine. Relatives were forced to buy meals and even bottled water for patients due to food shortages.


The hospital repeatedly ran out of essentials such as insulin, adrenaline, antibiotics, drugs for heart failure and hypertension, d ia lysis f luids a nd cent ra l int ravenous nut rit ion. Unit s also ran out of syringes, IV lines, medical swabs, saline bags, needles, wash cloths and alcohol rub and maternity pads.

NSWNMA General Secretary, Brett Holmes, described the situation this way: “Emergency response teams unable to access patient areas because their swipe cards are not granting access during a critical incident; nurses and midwives running from one ward to another to find basic stores and drugs, inadequate training of staff to use new equipment, along with unsafe understaffing.”

“Nurses have filled their own car boots and back seats with basic medical equipment from the now-closed Manly Hospital as

NBH CEO, Deborah Latta, described these as “teething problems” but conceded that patient demand was “greater than


anticipated”. Health Minister, Brad Hazzard, dismissed concerns, saying: “Whenever you build big new hospitals there are always some challenges.” However, a senior NBH specialist told the Herald: “The problems are not just teething problems. They just don’t have enough staff to run the operating theatres.” T he Au s t r a l i a n Me d ic a l Association NSW complained of a lack of junior and senior medical staff “across the board”. President of the Australian Salaried Medical Officers Federation, Tony Sara, said NSW Health needed to force Healthscope to comply with its contract obligations, and ensure safe care for patients and junior doctors and nurses before staff were overwhelmed or someone died as a result. “It is just being done on the cheap. The dollar is the primary motivator and it is inevitable that patient care will be compromised,” Dr Sara said. “The hospital management are thinking about the money – they are not thinking about the patient care.” He


Hea lthscope


management as “arrogant, ignorant and probably incompetent in terms of its capacity to run a public hospital”.

PROFITS BEFORE MOTHERS AND BABIES Staff, led by doctors and anaesthetists, began to expose life -t h reaten ing f laws in NBH management. The ABC reported that an email from a senior anaesthetist detailed a case where a mother undergoing an emergency caesarean survived “against the odds”. “Let me be clear these are NOT ‘teething problems,’ he wrote in the email to the head of his department, adding that the emergency caesarean was a nightmare for clinicians.

‘It’s well known that people have to mortgage their home or take out loans to pay for their medical bills even when they are insured. — Britta Houser, ED Nurse, America

“The hospital currently fails completely in its primary objective of patient safety.” “There was inadequate supply of equipment, insufficiently trained staff, poor protocols for simple requests such as a blood transfusion, and a complete lack of a cohesive plan for (a) worst-case scenario.” T he gove r n me nt a lw ay s claimed that NBH would treat public patients the same as at any public hospital. The first indication that this was false came 12 days after opening, with media reports of a patient refused an angiogram because NBH would not accept his private insurance with NIB. John Whitehead was also told that if he entered the hospital as a public patient it would cost him $4,945. Mr Whitehead was forced to book into Royal North Shore Hospital, a move that delayed his treatment. After a social media outcry and intervention by Mr Whitehead’s local MP, NBH relented and promised his angiogram would go ahead.

WAY BACK IN 2013 WHEN THE THEN LIBERAL HEALTH MINISTER, JILLIAN SKINNER, ANNOUNCED THE PRIVATISATION OF THE NORTHERN BEACHES HOSPITAL, THE NSWNMA BROADCAST TV ADS THAT WARNED THE COMMUNITY THAT THIS WAS THE FIRST STEP BY THE NSW GOVERNMENT TOWARDS THE AMERICANISATION OF OUR PUBLIC HEALTH SYSTEM. Richard West, a retired Royal Prince Alfred Hospital Professor of Surgery called on the NSW government to ensure public and private patients receive the same treatment at NBH. Meanwhile, a mothers’ group, Friends of Northern Beaches Maternity Services, said NBH was putting profits before mothers and babies because of its refusal to expand midwife-led birth services. “We’re worried NBH is not going to deliver good public maternity services because they want women to go with private obstetricians, which is more profitable,” a spokesperson said. ■

‘The hospital management are thinking about the money – they are not thinking about the patient care.’ — Dr Tony Sara, ASMOF

Serial resignations at NBH The disastrous start at Northern Beaches Hospital led to a string of high-profile resignations, starting with CEO Deborah Latta three weeks after the hospital opened. Ms Latta was soon followed out the door by NBH’s director of medical services, Louise Messara. The Medical Staff Council had unanimously supported a vote of no confidence in Dr Messara. Two senior anaesthetists then quit, with one warning management that the facility “fails completely in its primary objective of patient safety”. NBH’s head of anaesthetics, Alistair Boyce, also resigned on 5 December .



‘Sorry, we can’t help you’ An emergency involving their young daughter has given an Avalon couple a frightening insight into the loss of local public health services.


ctor Chris Sadrinna and screenwriter Mahalia Rimmer are determined to fight for the restoration of services at Mona Vale Hospital (MVH) after their two-yearold daughter Mila was sent home from Northern Beaches Hospital (NBH) undiagnosed despite presenting with a very high temperature. Later that week, Mila spent three days on intravenous antibiotics at Royal North Shore Hospital (RNS) to treat a urinary tract infection that had spread to her kidneys. Chris and Mahalia had a very different experience with publicly operated MVH when their son Asher, 5, was operated on for an inguinal hernia shortly before MVH services and staff were transferred to Healthscope’s NBH in November. “It was all so fast and efficient and smooth sailing from the moment we realised there was a problem until he was rushed into surgery,” Mahalia said. “We were dealt with very well.” On a Monday in December, with MVH now closed, Chris called an ambulance to take a feverish Mila to NBH. Chris said an NBH doctor told him Mila probably had a stomach bug and there was no need for blood or urine tests which would be “too traumatic” for her. Mila was sent home after double doses of Panadol and Nurofen 10 | THE LAMP FEBRUARY 2019

‘The community and staff have had their lives and careers affected for the sake of making something private and making a buck.’ — Mahalia Rimmer brought her temperature down. Two mornings later, as Chris changed Mila’s nappy he noticed her lips were turning black and her body blue and she was “slightly crosseyed”. He quickly got Mila and Asher into the car where Mila passed out. Chris drove six kilometres to the nearest facility, Mona Vale, now branded an “Urgent Care Centre” but was turned away.

Chris and Mahalia drove Mila to RNS where she spent the next five days before being discharged. Mahalia says if NBH had tested and diagnosed Mila when she first presented, her infection might have been successfully treated with an oral course of antibiotics – thus avoiding an IV and a hospital stay. “Maybe they (NBH) were busy but due diligence wasn’t done,” she says.

“They said sorry, we can’t help you, we don’t have the facilities and can’t take blood,” Chris said.

Mahalia says she doesn’t know what they will do if one of the kids needs hospital treatment again.

However, MVH staff called an ambulance. It drove Mila to Sydney Children’s Hospital, Randwick because Chris refused to allow them to return her to NBH.

“We don’t know when we will get increased services at MVH and what level they will be at.

A LOSS OF TRUST Sydney Children’s Hospital tests showed a high white cell count in Mila’s urine and very high CRP level in her blood. Her heart rate reached 170. The hospital administered antibiotics but had no free beds, so

“Do I risk the (22 kilometres) drive to NBH or do I go (6 kilometres) to MVH and risk having to wait for an ambulance if they can’t do anything? “That’s a really hard call to make if you’ve got a small child. “With Mila, it initially wasn’t a life-in-the-balance emergency but it did escalate to that – or what felt like that – very quickly.


“As soon as you’re faced with a challenge like that suddenly, the whole world begins to unravel before your eyes. “If that can happen here, what’s happening in regional and remote areas of Australia?”

NSWNMA CAMPAIGN JUSTIFIED Mahalia says losing two public hospitals – Mona Vale and Manly – and getting a private hospital in return is “totally and utterly crazy”. “It’s not fair on the community and staff who have had their lives and careers affected for the sake of making something private and making a buck.” Chris describes Mila’s hospital experience as a “debacle”. “I also have two teenage daug hter s f rom a prev ious relationship and I’ve been through hospitals a lot with kids. I’ve always been really well looked after. “We’ve lost Mona Vale, we’ve lost Manly, we’ve been given a substandard hospital as a replacement that’s not even a proper 100-per-cent public hospital. “We’ve lost faith in the only hospital we’ve been given … even GPs are suggesting you don’t go to that hospital.” Chris says t he NSW NM A campaign against privatisation of NBH has proven to be “absolutely justified in retrospect.” “I don’t think privately-run hospitals should be running an emergency department when things are based on money. “The government needs to be accountable. It can’t be palmed off on to a private company that isn’t accountable or doesn’t want to be accountable.” Following Mila’s hospitalisation, Premier Gladys Berejiklian told Channel 10 News: “I think the people of northern beaches are served extremely well.” But Chris Sadrinna asks, “If you can’t be accountable for problems and mistakes then how do they get fixed?” ■

‘I don’t think privately run hospitals should be running an emergency department when things are based on money.’ — Chris Sadrinna CHRIS SADRINNA AND MAHALIA RIMMER WITH THEIR CHILDREN, ASHER AND MILA THE LAMP FEBRUARY 2019 | 11


Healthscope in ‘daily breach’ of commitments Northern Beaches nurses flood the Association with complaints about new hospital.


orthern Beaches Hospital was opened before it was ready and Healthscope was breaking it’s commitment to uphold staff-to-patient ratios “on a daily basis”, NSWNMA General Secretary, Brett Holmes, told ABC Radio. Brett was interviewed on November 20 – three weeks after the hospital received its first patients. He said the hospital was suffering from stock shortages, insufficient staff to handle the patient load and inadequate training on new equipment. “I’m sitting in front of 40 pages of emails from my members which detail [problems in] the first 10 days of operation,” he said. “I think Healthscope operators completely underestimated the impact of opening a new hospital and the surge of patients they would experience.” He called on the state government to insist that Healthscope honour its commitment to staff who transferred from Manly and Mona Vale hospitals concerning their working conditions, including staff-to-patient ratios. “[These commitments] are being breached on a daily basis. “This is a shocking situation where Healthscope has contracted to deliver these services and they are simply not showing that they can do it.”


‘[The people of the Northern Beaches] should be looking to their local members of parliament and saying, what’s going on here, this is not the hospital you promised us.’ — Brett Holmes ALREADY LOSING STAFF He said some Healthscope nurses had already decided to quit the hospital. “They were sceptical about transferring from the public system into the private system and the experience has been such they are already resigning and going elsewhere ... Hopefully [more] people won’t be forced into that situation. “But what we saw in the buildup to the opening was four years of Healthscope and Northern Sydney Local Health District failing to really engage with staff and tell them what the future would look like.” Brett was asked: “Is it just a matter of waiting for [the hospital] to hit its stride?” He replied: “Well, I really feel for all the patients and staff who have been in that waiting period because staff have done their very best to

keep patients safe but the stories being told really do not give you much confidence. We hope that it will improve. “The people of the northern beaches may have been asleep when this was being forced upon them but they should be awake now. They have now got a hospital they should have high expectations of, given that the government is paying billions of dollars to a private operator to run it. “They certainly should be looking to their local members of parliament and saying, what’s going on here, this is not the hospital you promised us.” The manager of NBH is now reporting that the hospital is meeting it's obligations to provide the original nursing hours with large numbers of agency RNs and overtime and extra shifts from part-time staff. ■


Community battles to restore public services Residents angry about hospital privatisation are carrying on the fight to restore public health services on Sydney’s northern beaches.


‘Every single bit of privatisation has been an economic and servicesdelivery failure.’

eplacing Mona Vale and Manly public hospitals with the privately-run Northern Beaches Hospital (NBH) at Frenchs Forest has been a “disaster” for northern beaches residents, says the Save Mona Vale Hospital committee. Mona Vale Hospital (MVH) was downgraded to an Urgent Care Centre with a focus on geriatric and palliative care in 2018. However, campaigners are fighting to restore some of MVH’s public health services. They have organised several lively protests, including a rally that drew thousands of concerned residents, and run a vigorous social media and letter boxing publicity campaign. One of their leaflets says that by closing emergency, surgical, maternity and other acute services at MVH, “politicians are playing with our lives”. In December, campaigners had a partial win when the government agreed to restore equipment it claimed would upgrade the Urgent Care Centre to emergency department level. Health Minister, Brad Hazzard, said the hospital would now retain its CT scanner and ultrasound as well as antivenene to treat spider, tick and snake bites. Save Mona Va le Hospita l chairman, Parry Thomas, says the

— Parry Thomas measures fall way short of community demands for a restoration of onsite pathology, intensive care beds and surgical theatres. The northern beaches area incorporates Sydney’s northern coastal suburbs from the harbour north to Broken Bay.

AN IDEOLOGICAL DECISION Parry says replacing nearby public hospitals with a distant private hospital was never about delivering better health services for the people of the northern beaches. “It is all about privatising health on the northern beaches. “If you live at Bondi you are almost as far from the Northern Beaches Hospital in Frenchs Forest as people living at Avalon. And it takes almost the same amount of time to get there. “At the moment, we consider the situation is fundamentally unsafe.”

operator as “absolutely ideological”. “It’s a weird view of the world, that party embraces at the moment, which says private is always going to do things better. “Of course, every single bit of privatisation has been an economic and services-delivery failure.” Northern beaches health services may suffer further privatisation if the Coalition government is returned at the 23 March state election. In 2016, the government sought expressions of interest from private providers to design, build and operate “health related services” on the Mona Vale site without any public consultation. Options included day surgeries, primary care services, residential aged-care facilities and carer accommodation, the government said. ■

Parry describes the government’s decision to hand NBH to a private



Countdown to chaos How the Northern Beaches Hospital bungle unfolded. 30 October

11 November

NBH receives its first patients in what Health Minister, Brad Hazzard, calls “a smooth, safe transfer”. The opening “went off without a hitch” 7 News reports.

Pittwater Online News reports a patient has been refused an angiogram because NBH would not accept his private insurance with NIB. John Whitehead was also told that if he entered the hospital as a public patient it would cost him $4,945.

November 9 The Manly Daily says it has received complaints from “a string of unhappy staff and patients” about a shortage of drugs and other essentials such as bandages, syringes, IV sets and body bags. The paper also reports a bed shortage due to lack of staff and long delays for surgery. Hospital CEO, Deborah Latta, says patient demand is “greater than anticipated”.

10 November 10 News reports a patient could not be given a tetanus shot because the hospital had no vaccine.


of care, only 15 per cent of women at NBH will have access to the model. A mothers’ group, Friends of Northern Beaches Maternity Services, says NBH is putting profits before mothers and babies because of its refusal to expand midwife-led birth services.

12 November The Sydney Morning Herald (SMH) reports that while NSW Health aims to provide 35 per cent of mothers-to-be with a midwife-led continuity model

18 November

17 November NBH staff tell The SMH the new hospital is a “chronically understaffed shambles” with ED patients waiting up to 17 hours for treatment. Wards have repeatedly exhausted their stocks of insulin, adrenaline, antibiotics, drugs for heart failure and hypertension, dialysis fluids and central intravenous nutrition. Units have also run out of syringes, IV lines, medical swabs, saline bags, needles, wash cloths and alcohol rub and maternity pads. The 488-bed facility has only six wheelchairs. CEO Deborah Latta admits to “teething problems”.

ASMOF, the union representing salaried doctors, calls on NSW Health to intervene, saying Healthscope appears to be indifferent to inadequate staffing and the plight of public patients at NBH. ASMOF says that, contrary to the NSW government’s contract with Healthscope – which says junior doctors are to care for public patients – the young doctors had been “instructed” to look after private patients in the private wards.

19 November The Australian Medical Association NSW says a lack of junior and senior medical staff “across the board” at the hospital has forced the cancellation of some elective surgeries. The association’s president, KeanSeng Lim, said: “The lack of staff has been one of the primary concerns. Complex procedures require not just operating staff but nurses and the follow-up in the postoperation phase.”


‘Astrid McCrank was forced to wait on a gurney outside the operating theatre for more than an hour while staff “frantically tried to source the blood and equipment they would need to operate safely”.’ — Sydney Morning Herald, 25 November 21 November

December 3

December 6

Deborah Latta resigns as NBH CEO. The Manly Daily says Health Minister Brad Hazzard has given Healthscope a three-week deadline to fix problems at NBH. And the minister has sent a public service “flow team” to help the private operator find solutions.

A senior anaesthetist has resigned from NBH and warned management that the facility “fails completely in its primary objective of patient safety”. ABC News reports the anaesthetist, in an email to management on November 23, criticised the hospital for shortages of staff, equipment and training. The ABC says several anaesthetists have refused to sign hospital contracts. The SMH reveals NBH’s medical director Louise Messara has also resigned.

NBH’s head of anaesthetics Alistair Boyce resigned on 5 December, The SMH reports.

22 November NBH’s Medical Staff Council, representing senior doctors, unanimously supports a vote of no confidence in the hospital’s director of medical services, Louise Messara.

24 November A 98-year-old ‘nil-by-mouth’ female patient goes 24 hours without food or water before being put on a drip, The Manly Daily reports. NBH visitors are having to go out to buy bottles of water for other patients, the paper says.

25 November A new mother needing an emergency caesarean at NBH came close to death and the experience left staff “deeply shaken” The SMH reported. Astrid McCrank was forced to wait on a gurney outside the operating theatre for more than an hour while staff “frantically tried to source the blood and equipment they would need to operate safely” the paper said. After she was transferred to ICU Ms McCrank’s airways were compromised, her oxygen levels dropped dangerously

low and she turned blue, staff said. They blamed “systemic failures, including poor rostering”. Ms McCrank was eventually sent home with no discharge papers. She said she was never informed of the “life-threatening near miss”.

December 8 The Manly Daily describes Healthscope’s NBH management team as “a bunch of faceless men and women” and says no one from the company is prepared to speak to the paper. “It does not help that, after five and a half weeks, Healthscope has just brought in its third new PR person, a crisis management specialist, which says everything,” The Manly Daily says.

December 1 Doctors’ union, ASMOF, says Healthscope and NSW Health appear committed to resolving issues raised by doctors, including staffing, workload management, resuscitation trolley stocking and checking, improvements to the paging system and communications, better switchboard performance, improved admissions and allocation of patients to senior doctors.

December 5 The Manly Daily says a second anaesthetist has resigned from NBH. The paper says Health Minister Brad Hazzard has told doctors to stop criticising the hospital and “get on with the job”.

‘Brad Hazzard has told doctors to stop criticising the hospital and “get on with the job”.’ — Manly Daily, 5 December THE LAMP FEBRUARY 2019 | 15


Midwives warn Minister over maternity staffing Public hospital maternity unit staffing levels are too low to provide safe care and overworked midwives don’t have enough time to educate new mums.


idwives at 10 public hospitals have warned the state government they can no longer rely on understaffed maternity services to deliver a safe level of care to mothers and their babies. In an open letter to NSW Health Minister Brad Hazzard, the midwives urged the government to commit to mandated ratios in maternity services. “It is dangerous and unsafe when our hospitals are operating understaffed. Mistakes can be made,” the letter said. The letter was endorsed by NSWNMA members at Blacktown, John Hunter, Lismore, Liverpool, Nepean, Royal North Shore, Royal Prince Alfred, Tamworth, Tweed and Wollongong hospitals. “We stand united as midwives who can no longer rely on our current system to deliver a safe level of care to mothers and their babies,” they wrote. “Currently, there are no ratios of midwives to mothers. This means some of us can be caring for up to 12 mothers plus their babies at any one time.” Such ratios would “provide a clear and accountable system that patients can rely on and midwives can trust at all times.” “The staffing system in NSW public hospitals as it currently stands is broken. It is not being delivered on a shift-by-shift basis and we have found management is able to short-staff wards because they can balance the hours over a week. “We need better ratios of at least one midwife to three mothers in postnatal wards to provide a clear and accountable system that patients can rely on and midwives can trust at all times. “Many of us are parents and will no longer stand by while mothers and their babies miss out on much needed midwifery care. All mothers in NSW, regardless of where they live, should have access to safe, quality care.”



INSUFFICIENT TIME FOR EDUCATION OF MOTHERS The letter said nothing is being done to improve working conditions to encourage more midwives into the sector and there is a lack of support for young midwives. “High vacancies and overtime mean educators and midwifery managers are constantly having to work on the floor. “Without the ability for educators to provide adequate training, midwives are failing to obtain the skills needed to support junior midwives.” The midwives’ letter linked the current staffing system with a decline in breastfeeding rates, which have dropped 8.4 per cent since 2011, according to NSW Health statistics. It said: “An important part of our job is to educate mothers and provide physical and emotional support to women and their babies. Yet, under the current staffing system, there is not enough time for us to provide the level of support and education new mothers need during these vital days.” ■


Rallies put understaffing of midwives in the spotlight The public are increasingly aware of the need for ratios to overcome a statewide shortage of midwives.


idwives have held lunchtime rallies outside many of the state’s public hospitals in support of ratios of at least one midwife to three mothers in postnatal wards. At the Wollongong Hospital rally, NSWNMA members were joined by former maternity patients who spoke to the media about their birth experiences. Wollongong councillor Cath Blakey – who brought her one-month-old daughter Jedda to the rally – told the Illawarra Mercury she had complications with pre-eclampsia so had to spend two weeks in the maternity ward prior to Jedda’s birth. “I had my baby by emergency caesarean and when we were moved back to the ward, we were counted as one patient even though I’d had major abdominal surgery. “It’s a sneaky way to understaff hospitals – by not counting babies as patients. “While the care I received from the nurses and midwives at Wollongong was fantastic, they were restrained by lack of staff.” NSWNMA branch president, Sarah Morton, said midwives received strong support from “women who understand what is going on and want to help change it.” “We are very lucky to have amazing community support. People are starting to understand that we need increased funding statewide because every single maternity unit in the state is understaffed.”

MIDWIVES WOULD WORK MORE HOURS WITH RATIOS At Wollongong Hospital, two midwives look after as many as 28 women during night shift. Sometimes, only one midwife and one registered nurse or enrolled nurse are rostered on overnight. “The staff are just too busy to give women all the breastfeeding support they need, which is a serious public health issue,” Sarah said. At the end of 2018, the maternity unit was shortstaffed by about 18 full-time equivalent midwives, including permanent and temporary staff.


“During one recent four-week roster period there was a total of 56 hours of overtime worked in the birth unit and only 19 hours of that was sick leave – the rest was to cover gaps in the rosters. “People have had to come off the floor to fill educators’ positions that haven’t been replaced so there has been lots of overtime recently. “Hospital management are working hard to get recruitment happening and using casuals but unfortunately there are just not enough midwives available. “Management are doing what they can – we just need legislated ratios in order to safely provide this care.” Sarah said midwives work a 20-hour week on average and many would work more hours if the workplace was not severely understaffed. “People who work in short-staffed situations tend to reduce their hours. The NSWNMA has done a survey where at least half of respondents would increase their midwifery hours if we had adequate ratios.” ■ THE LAMP FEBRUARY 2019 | 17


Town backs nurses’ ratios campaign Aged care nursing at Manilla MPS sacrificed to plug gaps in emergency and acute staffing.


he small northern NSW town of Manilla has come out strongly in support of nurses who are battling to get more staff for the local health service. About 250 of the town’s 2,500 residents attended a rally in support of nurses at Manilla’s 53-bed multipurpose service (MPS). The Manilla facility is the biggest MPS in NSW with 40 aged care (high care) beds, 13 acute beds, three emergency beds and an overnight room. Nurses say the facility is seriously understaffed and the community is not getting the care it needs. Manilla’s NSWNMA branch has called for the employment of six more nurses to give afternoon and night shifts two additional AiNs and one more RN. However, after long negotiations, management of Hunter New England Local Health District has only conceded the employment of an additional part-time clinical nurse specialist.

The branch rejected a further offer to settle the dispute with the employment of an additional endorsed enrolled nurse on evening shift because it would not have improved overall staff numbers.

SAFETY CONCERNS FOR PATIENTS AND STAFF Manilla has a large number of elderly patients at high risk of falls. However, aged care units are left dangerously understaffed when nurses rostered to aged care beds are required to work in the ED and acute ward during busy periods. Staffing often falls short of award requirements, which are themselves inadequate, nurses say. Nurses are also concerned that understaffing sometimes forces them to work alone in old buildings not designed to meet modern security needs. Manilla aged care nurses have told the NSWNMA there are not enough staff to cover meal breaks, absentees and rostered leave. In one 20-bed aged care unit, there is no RN or CNS to help with medication checks and no specialist

‘We had a palliative patient who hadn’t had personal care properly attended to for a full week because there were not enough people on the floor. That’s not good enough.’ — Crystal Costello 18 | THE LAMP FEBRUARY 2019

aged care RN. In the second aged care unit, there is sometimes no RN on the morning roster, no RN on the afternoon shift to oversee medications and no AiN to help bed down residents. Some leave vacancies are unfilled. In the acute ward, a RN taken off the ward to assist triage is sometimes replaced with an AiN and most shifts are working with only two staff members. Manilla branch secretary, Crystal Costello, said staff were “pretty stressed out and at breaking point.” “We can’t do what we are trained for – we can’t adequately care for people if we don’t have the staff on the ground,” she said. “Things are getting missed through no fault of the staff. It’s a big thing if you’re not getting your breakfast until 10 or 11 am due to understaffing. “We had a palliative patient who hadn’t had personal care properly attended to for a full week because there were not enough people on the floor. That’s not good enough. “People a re not get t i ng continence aids changed and medications are late.” The NSWNM A branch has condemned management attempts to “bully and intimidate” nurses who have raised issues relating to patient and resident safety. A branch resolution said the branch was "deeply concerned that



‘We feel disappointed when we walk out the doors and we feel we haven’t given the care we should.’ — Tanya Rogers our members are targeted for making our service safe ... If this continues, we will demand the NSWNMA take all measures, including legal avenues, to stop this behaviour.”

WEAK RESPONSE FROM LOCAL MP Two candidates for the seat of Tamworth at the forthcoming state election, Labor’s Stephen Meares, and Jeff Bacon of the Shooters, Fishers and Farmers Party, spoke in support of the nurses’ demands at the Manilla rally. Sitting National Party member, Kevin Anderson, declined an invitation to attend. In 2017, Anderson and his National Party colleagues voted down a bill to mandate one registered nurse in nursing homes at all times. Manilla branch president, Tanya Rogers, said Anderson did agree to meet with a delegation of branch members.

“Mr Anderson did listen to our concerns but we asked him if he would support our ratio rally and he declined in signing a pledge because currently he doesn’t feel ratios are the answer. He thinks management is where the issues are,” she told the Northern Daily Leader. “Mr Anderson is the only person in Tamworth as the MP that can help take it to the Minister of Health to get more funding in the budget to be passed down to us. She told the paper staff had no time to properly attend to tasks such as putting makeup on patients, having difficult conversations with grieving families and taking the time to give patients a quality shower. “We feel disappointed when we walk out the doors and we feel we haven’t given the care we should,” Tanya said. “At the moment the patients don’t feel they matter.” ■

Health is Tamworth’s top poll issue Manilla is not the only multipurpose service in the Hunter New England LHD facing serious staffing pressures. Nurses from several facilities in the LHD’s Peel District – Barraba, Bingara, Gunnedah, Manilla, Qurindi, Tamworth Rural Referral hospital and Werris Creek – staged a combined rally in support of nurseto-patient ratios last month. About 100 people attended the rally outside Tamworth council chambers where all candidates for the state seat of Tamworth addressed the crowd. Health is the number one concern of voters in the Tamworth electorate for the upcoming state election, according to the latest polling by the Northern Daily Leader newspaper. More than 300 people took part in The Leader’s online survey, which asked voters to choose one of six prominent issues as their biggest priority for the 23 March election. Health was the clear favourite, attracting more than a quarter of the votes. THE LAMP FEBRUARY 2019 | 19


It’s not safe to work alone Country hospital flouts NSW Health policy despite safety risk.


eeton District Hospital is breaching NSW Health policy by rostering nurses to work alone, a NSWNMA inspection has found. The current staffing level makes it impossible to provide a safe environment for nurses and patients in the ground floor emergency department and upstairs medical ward at the same time, the inspection report says. NSWNMA officers inspected the hospital after a patient assaulted a nurse and another patient. Later, another patient threatened a nurse with physical harm. A single nurse is rostered to work in the ED on day and afternoon shifts and three nurses cover the ward and ED at night. “Rostering a sole nurse to work in isolation is in breach of NSW Health policy as set out in chapter 26 of the Protecting People and Property Manual,” the report says. It says nurses often have to answer the ED door on their own and retrieve medical records after hours and on weekends on their own. “There is clear potential for a serious injury to staff or patients to occur,” the report warns. The 76-bed hospital has poor perimeter security and only one security guard employed for five 8-hour days. The guard is not replaced when on leave and Leeton does not have a 24-hour police presence. The report calls for an additional nurse and a security guard to be rostered on afternoon and night shifts. It says safety risks are aggravated 20 | THE LAMP FEBRUARY 2019

‘Design changes will help but won’t resolve the issue of nurses working in isolation.’ — Robyn Whittaker by a lack of appropriate location finding duress alarms with persondown capability. The current duress alarm system fails to meet minimum standards in place since 1998. The alarm alerts a distant security company which then telephones the ward. Ward staff then have to investigate – including finding the source of the alarm – and call the security company for help if needed. Since the 1998 standards were introduced, new systems have become available that provide “allin-one functionality including connectivity to telephone, duress alarm, pager, nurse call, fire alarm and door alarm systems.” T he se a l l-in- one system s enha nce sa fet y, productivit y and communication and are particularly suited to smaller facilities, the report adds. The NSWNMA’s Leeton Hospital branch president, Robyn Whittaker, said management representatives declined to attend the past two workloads committee meetings. As a result, they could not be held due to the lack of a quorum. However, Robyn, and ED nurse Kerrie Maguire, met management representatives in October to

discuss security issues raised in the NSWNMA report. Robyn said management reps talked about possible “structural and physical” improvements to security but said they had no authority to discuss nurse staffing levels or employment of a security guard. “The meeting was the first sign of progress but we’d really like to see progress on our staffing levels,” she said. “Design changes will help but won’t resolve the issue of nurses working in isolation when the hospital is on two levels. “On a night shift, the ward can have anywhere from three to 24 patients. When one nurse is working in ED the other two nurses can’t be watching the monitor all the time to check on her welfare.” In a letter to NSWNMA General Secretary Brett Holmes, the acting Chief Executive of Murrumbidgee Local Health District, Maurice Ahern, said the LHD had taken steps to improve security following the union’s inspection. They included an upgrade of CCTV cameras, advertising a casual security position to backfill planned leave and installation of swipe card access in the ED and other clinical areas. ■


Rights won to a leave that saves lives NSW unions achieve a significant win on domestic and family violence leave.


urses, midwives and other public servants in NSW now have the right to 10 days of paid domestic and family violence leave each year. The right to paid leave was won after years of campaigning by the NSW Nurses and Midwives’ Association and other public sector unions in the state. From the first of January this year, over 300,000 public sector workers are able to access t 10 days of domestic and family violence leave without having to use other leave, such as carers leave or personal leave, first. NSW Nurses and Midwives’ Association General Secretary Brett Holmes said the right is critical to helping nurses maintain employment and financial stability while escaping a violent and abusive relationship. “This win by the union movement will make it easier for survivors of domestic and family violence to remain in paid employment while managing stressful and timeconsuming tasks, like finding a new home or attending court,” he said. Victims of abuse will be able to use the paid leave to attend police inter views a nd cour t proceedings, seek legal advice and make alternative schooling and accommodation arrangements. One in three nurses and midwives said they had experienced family and domestic violence when the association surveyed members about

the issue in 2011.

National Employment Standards.”

The decision for NSW public servants is a vast improvement on a Fair Work Commission decision last year which gave victims of abuse just five days unpaid domestic violence leave.

Dr Kate Farhall, a postdoctoral research fellow at RMIT University, says “research shows that finances a nd dome st ic v iolence a re inextricably linked”.

Brett Holmes praised the nurses and midwives who have advocated for this reform in NSW, along with unions such as the ASU. He added that the Association will continue to support the ACTU campaign to extend the right to all workers. “Nurses are not just affected by family and domestic violence in their own lives, at work they are at the frontline caring for victims of abuse. Our members see the devastating impact it has on individuals, families and communities.”

CAMPAIGN CONTINUES TO EXTEND LEAVE TO ALL WORKERS On average one woman a week dies in Australia at the hands of an intimate partner or an ex-partner. According to ABS figures, two thirds of women who are subjected to family violence are in paid work. The ACTU President Michele O’Neil says extending the right to paid leave to all workers will help save lives. “We have to change the rules for people experiencing family and domestic violence. No one should be forced to choose between their income and their safety. “We need 10 days of paid family violence leave included in the

Financial hardship “can bind women to abusive relationships”, while ongoing employment can be critical in supporting women to leave abusive relationships. Employment can “also serve to psychologically bolster victims,” she says. Unfor t unately, v ict ims of domestic violence experience higher rates of part-time and casual work, lower retirement savings and a lack of job stability, Dr Farhall says. “Many lose their jobs as a direct result of violence. Victims of domestic violence are also more likely to experience food insecurity, to struggle to find affordable housing and cover the basic essentials like utility bills.” ■

How to get help If you’re experiencing family and domestic violence or are concerned for a friend or colleague, phone NSW Rape Crisis Centre (Sexual Assault and Domestic Violence) CONTACT nswrapecrisis.com.au

1800 424 017



Aged care gains traction in parliamentary reports A Liberal-led parliamentary committee has recommended the mandatory disclosure of staffing ratios in Australia’s nursing homes.


he federal parliament’s Standing Committee on Health, Aged Care and Sport, chaired by the Liberal MP for North Sydney, Trent Zimmerman, has recommended the passing of a bill that would see the mandatory disclosure of staffing ratios in Australia’s nursing homes. The Committee also recommended that the Austra lian Government: • Legislate to ensure that residential aged care facilities provide for a minimum of one registered nurse to be on site at all times. • Specifically monitor and report on the correlation between standards of care (including complaints and findings of elder abuse) and staffing mixes to guide further decisions in relation to staffing requirements. A NM F Federa l Secret a r y, A nnie Butler, welcomed the committee’s decision. “The Committee has acknowledged the urgent need to increase transparency in the aged care sector, particularly around staffing levels and the use of taxpayer funding,” she said. “It’s equally encouraging that the committee recognised the need for registered nurse staffing to be available 24 hours a day for every nursing home resident in the country.” Ms Butler also commended independent MP Rebecca Sharkey after she introduced a Private Member’s Bill that would “increase 22 | THE LAMP FEBRUARY 2019

‘Residents and their families can’t wait for up to two years for a Royal Commission. They need the government to act now to stop their suffering.’ — Annie Butler, Secretary, ANMF transparency and accountability for billions of taxpayer funds provided to the sector”. In another development in Canberra, a Senate Committee also recommended greater transparency in the financial practices of for-profit aged care providers. The ANMF welcomed these developments and the overall recommendation that for-profit providers are subject to greater transparency and accountability as “a positive first step” but stressed that immediate implementation of t he recommendations by the government was essential, independent of its Royal Commission into Aged Care. “We don’t believe that politicians should avoid ma k ing toug h decisions about the practices of for-profit providers by deferring the most difficult issues to the Royal Commission.” “Residents and their families can’t wait for up to two years for a Royal Commission. They need the government to act now to stop their suffering,” said Annie Butler. ■

We want to hear from aged care members The Royal Commission into Aged Care has begun proceedings as The Lamp goes to print. ANMF Federal Secretary, Annie Butler, has been invited to present to the Commission in mid-February. The ANMF will also present a submission that will outline our analysis of the sector and our recommendations for change. Further, you can also make your own submission to the Commission. All relevant information is available on the Royal Commission website: https:// agedcare.royalcommission.gov.au/ submissions/Pages/default.aspx The federal legislation that created the Royal Commission contains provisions to protect any aged care worker who appears as a witness, gives evidence, or produces a document for the Commission. An employer who dismisses or “prejudices any employee” for contributing to the Royal Commission is liable to penalties including up to one year’s imprisonment.


Clinicians unite for ratios in aged care A key alliance of nurses and national medical groups has called on all political parties to legislate and fund minimum staffing ratios in aged care. The ANMF, Australian Medical Association, Royal Australian College of General Practitioners and Australia New Zealand Society of Geriatric Medicine, published a joint open letter to Prime Minister Scott Morrison in The Australian newspaper in December, calling on him to introduce and fund minimum staffing ratios to aged care. Professor John Pollaers, Chair of the 2018 Aged Care Workforce Strategy Taskforce, also added his support to their position.

Authorised by Annie Butler, Australian Nursing and Midwifery Federation, 1/365 Queen Street, Melbourne THE LAMP FEBRUARY 2019 | 23


Staffing aged care safely makes economic sense Better staffing and higher wages in nursing homes won’t cost the health system cost any more – and may well save money.


ncreasing staff numbers, improving skill mix and raising wages in nursing homes would not cost the overall health system more financially, according to a Flinders University economic analysis. In fact, the analysis suggests that not making these improvements will cost Australia more. Economists at Flinders University Australian Industrial T ra nsformat ion Institute, looked at the implications of improving staffing to the safe levels recommended by t he Australian Nursing and Midwifery Federation (ANMF). The economists also tested a separate scenario incorporating a 10 per cent wage increase for aged care workers. The ANMF recommendations were set out in its national staffing and skills mix report in 2016. It found that care is currently at 2.84 hours of direct care per resident but needs to be 4.3 hours on average. The ANMF report outlined three central issues in aged care with remedies that Flinders University subjected to cost analysis: • t hat nursing homes are under24 | THE LAMP FEBRUARY 2019

‘For the first time, the analysis has quantified previously unrecognised benefits of the implementation of mandated minimum staffing and care levels.’ — Annie Butler, Secretary, ANMF resourced and staffing levels need to be significantly increased from 2.84 hours per resident to 4.3 on average • that the sector is under-skilled and the minimum skill mix to ensure safe residential care would be 30 per cent registered nurses (currently 14.8 per cent), 20 per cent enrolled nurses (currently 10.2 per cent) and 50 per cent assistant in nursing/ personal care worker (currently 70.3 per cent) • that the sector is under-valued with wages at least 10 per cent below the public health system.

BENEFITS OUTWEIGH THE COSTS T he F linder s re sea rcher s measured the direct wage costs from an increase in staffing and skills mix along with the indirect costs required to support these workers.

They also factored in the direct benefits including cost savings from such a restructuring and indirect benefits including savings for the public hospital system. “The modelling shows that while there is an increase in costs of $4.8 billion, this is offset by indirect benefits to the value of $2.1 billion thereby reducing the pressure on government’s budgets,” they said. “There is an estimated value of further intangible benefits of $2.8 billion. The total figure of $4.9 billion in other benefits accrued clearly offsets the increase in costs incurred by implementing the ANMF recommendations. “Importantly, this conclusion is based on the assumptions used in the analysis, which could reasonably be considered conservative.”


Study results at a glance Implementing the recommendations of the ANMF staffing and skill mix report would raise base wages and other costs in the residential aged care sector by $5.3 billion. This amount would be offset by:


’The report shows that ’aged care ratios make economic sense’

Improved efficiencies such as reduced attrition and improved operational effectiveness estimated at $0.5 billion

— Annie Butler, Secretary, ANMF

NOT IMPLEMENTING THE REPORT WILL BE COSTLY T he rep or t wa r n s t hat not implementing the ANMF recommendations would carry significant costs. “If the recommendations are not pursued the stresses already existing in the system (the ageing of the population and the increased demand for services) will intensify at a considerable cost to the sector. “Moreover the benefits of implementing the recommendations will grow over time to an estimated $9.4 billion in 2036.” Additional modelling by the Flinders University researchers found that a wage increase of 10 per cent for aged care workers “would be expected to produce some additional financial offsets and indirect and intangible benefits”. “The narrowing of the relativity gap in wages between the aged care sector and the rest of the health system will likely lead to the attraction of more qualified and experienced people into the sector.

delivery due to a more positive workplace culture and improved retention of experienced staff.” A NM F Federa l Secretar y, Annie Butler, said the report shows that ’aged care ratios make economic sense’. “Significantly, and for the first time, the analysis has quantified previously unrecognised benefits of the implementation of mandated minimum staffing and care levels. “The Morrison government must address this before the next federal election. The Aged Care Royal Commission is important and necessary but it should not mean a delay in reforms, the most critical of which is the urgent need for improved staffing levels. “If we continue to delay doing what we know is right it means at least another 18 months of pain and suffering and, potentially, too many undignified deaths.” ■


 educed costs in the public R hospital system and an increase in taxation revenue (from an increased wages bill) amounting to $2.1 billion


 ocial/quality of life benefits S valued at $2.8 billion.

The report concludes that implementing the recommendations would, at least, “break even in a cost benefit context”. But it is more likely, considering the conservative assumptions used that there would be a “net benefit overall”.

READ THE REPORT http://anmf.org. au/documents/ reports/ANMF_CBA_ Modelling_Final_ Report.pdf

“It will reduce staffing attrition and improve effectiveness of service THE LAMP FEBRUARY 2019 | 25


Nurses control of drugs in aged care weakened The Berejiklian government has opened the doors to drugs of addiction being controlled by employees who are not registered health practitioners.


ew state government regulations give aged care facility managers – who do not need to be a registered nurse – total control over medications. This includes drugs of addiction that need to be locked away for public protection.

‘This signals the end of nursing oversight of dangerous medication for many thousands of vulnerable people.’

Previously, directors of nursing were given this responsibility. They have to be a RN and comply with professional guidelines.

oversight of dangerous medication for many thousands of vulnerable people.

As registered nurses, directors of nursing have been educated in the safe and quality use of medicines. The changes are outlined in the Poisons and Therapeutic Goods Amendment (Residential Care Facilities) Regulation 2018 issued by NSW Health Minister, Brad Hazzard, on 7 December. They also increase by 600 per cent the amount of dangerous medicines that nursing homes can store. NSWNMA Assistant General Secretary, Judith Kiejda, said the changes were potentially harmful to the public. “They afford very little safeguard against the mismanagement and potential diversion of dangerous drugs of addiction,” she said. “This signals the end of nursing 26 | THE LAMP FEBRUARY 2019

— Judith Kiejda

“The safest option would have been to extend the legal requirement so that a DoN was employed in every facility where high-care residents are accommodated.”

A RETROGRADE STEP In a letter to Brad Hazzard, Judith Kiejda said giving increased authority over medications to people not professionally licensed was “an ill thought-out and retrograde step.” “You will be aware that there is no current legal provision requiring residential facility managers to have minimum competencies in regard to the management of medicine. Nor are they professionally accountable for their actions in the same way that a Director of Nursing would be,” Judith said. She said managing medications required “specialist knowledge and skills in pharmacokinetics

and pharmacodynamics and a sound understanding of the ethical-legal implications related to medication management.” Western Sydney GP A line Smith said she did not understand how this “appalling” change could be justified. She said the change was not in keeping with the practice in hospitals and in general practice where S8 drugs remain under the control of a RN. “Our accreditation standards clearly prohibit staff who are not registered nurses or GPs from managing the drug register,” she said. “In general practice, our practice manager or facility manager cannot hold the key to the S8 safe unless they are a RN.”■


Medication errors more likely RN Angelin Maharaj, who manages medications at a western Sydney nursing home, said she was concerned the new regulations would give facilities another reason not to employ RNs. She said medication management is incorporated into pre-registration education of RNs, and nurses at her facility undertake a drug calculation quiz every year “to see whether we still have the knowledge.” “Also, as RNs we must follow, and are held accountable to, professional codes of practice.” Angelin said that until now, every nursing home had one RN who held the key to Schedule 8 medications on each shift. “However, if a manager is not a qualified RN, they won’t know how to accurately calculate the doses to be dispensed and residents could be given the wrong doses. “I think there will be a lot of errors by unqualified staff holding the S8 key and dispensing medications such as morphine. “Also, giving unqualified staff control over much greater quantities of medicines makes it more likely medicine will go missing.” ■

’I think there will be a lot of errors by unqualified staff holding the S8 key and dispensing medications such as morphine.’ — Angelin Maharaj



Introducing our new councillors

A number of members joined the NSWNMA and ANMF NSW Branch Councils after elections late last year. The councils are an important part of our democratic structure. It acts as the Committee of Management responsible for:

Diane Lang, RN

Erin Francis, RN

South East Regional Hospital, NSWNMA Branch Delegate since 2011

Mental Health/Kiloh Observation Unit, Prince of Wales Hospital, NSWNMA POW Mental Health Branch Secretary/ Alternate Delegate

Since becoming a RN nine years ago I have worked on a surgical ward in a regional hospital. Before that I worked as an AiN in a local nursing home and for eight years was the NSWNMA branch delegate. I represented aged care members. Aged care is still a passion and I will continue to fight for safe, quality care and improved funding. As an activist, I was introduced to a new world of workers’ rights by the 2007 Your Rights at Work campaign. Since then, I have been passionate about protecting those rights and have proudly represented and supported members and continue to do so as a hospital delegate. I will continue to fight for the expansion of ratios in our public health system and their introduction into aged care and for the retention of 24/7 RNs in our nursing homes.


I am an RN working in an acute adult mental health unit and Branch Secretary/Alternate Delegate for Prince of Wales Hospital Mental Health Branch of the NSWNMA. I have been a passionate and enthusiastic NSWNMA/ANMF member since becoming involved with the Union in my new graduate year in 2014. Throughout the last year I have assisted with the rejuvenation of an inactive branch and doubling the number of our branch members. Since then I have been able to re-engage members and management to see some great success with local efforts. My vision for the NSWNMA/ANMF is to be a world-class union and a leading advocate for safe patient care, through the continuing campaign for safe nurse-to-patient ratios.


• the oversight of day-to-day management (which is undertaken by the General Secretary and Assistant General Secretary)

In this month’s Lamp our new councillors introduce themselves and tell us about their aspirations for our Union.

• ensuring the implementation of policy as determined by Annual Conference

The full list of NSWNMA/ANMF Councillors can be found at https://www.nswnma.asn.au/about-us/ councillors/

• ensuring the deliverance of the Rules and Objectives of the NSWNMA.

Jocelyn Hofman, RN

Jill Telfer, RN

NSWNMA Branch Delegate, Bodington Aged Care Service

NSWNMA member since 1987, previous NSWNMA Branch Secretary and delegate, Tamworth Rural Referral Hospital

I am a registered nurse and have worked in the aged care sector since 1987. I have witnessed the impact of changes in government policy affecting the care given to our elderly in residential aged care facilities and the drastic effect on aged care workers. Registered nurse numbers are dwindling in aged care. The relentless push for privatisation of government services, the march towards the Americanisation of our health system, our beloved Medicare being chipped away and these ongoing frustrating changes in aged care are the reasons I decided to become a more active NSWNMA/ANMF member and delegate. Through the NSWNMA, I received education, support and encouragement to drive our local campaigns like Save Medicare and RN 24/7. I, with fellow members, continue the fight to mandate ratios in aged care – a fight that we must win, in the name of older Australians in residential aged care facilities! As an NSWNMA and ANMF councillor, I will fiercely fight on behalf of aged care nurses to maintain our ability to provide the best possible care for our residents.

I have been nursing in the public health system for 38 years, mostly in rural settings. I am a NUM in the dialysis unit at Tamworth Hospital and have assisted our branch with improving staffing in ED and maternity. I am a branch representative on our Reasonable Workloads Committee. I am committed to improving patient safety and the working conditions for all staff. Patients, city or country, deserve the same amount of nursing care. We need mandated nurse- and midwife-to-patient ratios on every shift on every ward to deliver safe, patient centred care. I support the campaign for ratios made law in aged care and support nurses and midwives’ working rights in the public or private sector. We must continue to fight against the privatisation of public health services and for keeping Medicare. NSWNMA and ANMF have been vital in keeping pressure on both state and federal governments through these campaigns and I am committed to continuing to keep up this good work.



Introducing our new councillors

Lauren Lye, RN

Meg Pendrick, EN

Acting CNE, Intensive Care Unit Dubbo Health Service, NSWNMA Branch Secretary 2014-2018, Alternate Delegate 2016-2018

Gosford Hospital, NSWNMA Branch Delegate and President

I grew up in Tamworth, completing my Bachelor of Nursing at the University of New England, Armidale, in 2011. Since then I have been working as a RN in ICU at Dubbo Health Service. I completed a Graduate Certificate in Critical Care/Acute Care in 2015 and currently Acting CNE in ICU. I have stood up as an NSWNMA branch official on behalf of members across my hospital to fight for better staffing and skills mix in ED, maternity and on wards. We need enforceable shiftby-shift ratios across all our public hospitals. I am passionate about delivering quality care to regional and remote communities and believe everyone is entitled to the same level of care regardless of their postcode. It is critical for our communities that we continue to fight for ratios to be law in aged care and that patients in private hospitals also benefit from enforceable staffing arrangements.


I am an enrolled nurse with my experience in acute surgical wards on the NSW Central Coast. I have been actively involved in our NSWNMA branch over this time as secretary, president and delegate. I have stood up to be part of our statewide campaigns against privatisation, and to fight cuts to penalty rates for all workers. My passion is nurse advocacy, professionally and individually, with a strong desire to strengthen, support and improve the nursing profession. I am committed to strive for a safe, realistic, enduring and professional work place for all nurses and midwives. I actively promote the benefits of union support and educate on the advantages of unity and endeavour to maximise available assistance. I sought election to the NSWNMA and ANMF NSW Branch Councils so I can support the continuing campaign for ratios across all sectors to fight for fairer pay, to retain and improve our current work conditions and to ensure every nurse and midwife has a voice every time by listening and engaging all nurses and midwives.


WELCOME NEW COUNCILLORS AND FAREWELL TO RETIRING COUNCILLORS In this edition of The Lamp we welcome Diane Lang, Erin Francis, Jocelyn Hofman, Jill Telfer, Lauren Lye, Meg Pendrick, Wing Besilos and Sylvia Moon who join re-elected Councillors O’Bray Smith (President), Lorna Scott(Vice President), Michelle Cashman (Executive Member), Gary Clark (Executive Member), Edward Makepeace (Executive Member), Liz McCall (Executive Member), Kerry Rodgers (Executive Member), Sue White (Executive Member), Julie Goss, Lyn Hopper, Richard Noort, Michelle Straub and Gil Wilson on the Council of the ANMF NSW Branch

Liwayway (Wing) Besilos, RN Intensive Care Unit, Westmead Hospital, NSWNMA Branch Delegate 2016-2018, NSWNMA Branch Secretary and Alternate Delegate 2018 I have been a registered nurse in Australia for 21 years and have been working in critical care units (cardiothoracic and general ICU) for the past 15 years. I have been a member of the NSWNMA/ANMF since I became a registered nurse, except for the years when I worked overseas, as I believe that the power of nurses and midwives is achieved through unionism. The goal for nursing is safe patient care. With safe patient care, the welfare of the nurses and midwives should also be taken into consideration. Nurses and midwives need a healthy environment in order to deliver care that is not only safe but also holistic. I support the NSWNMA’s campaign for ratios on a shift-by-shift basis across city and country, in all specialties, in aged care and the private sector. Patients in the whole of New South Wales deserve to be safe and to be given holistic care.

and NSWNMA Council. I pay tribute to the retiring Councillors Coral Levett, Annette Alldrick, Sue Brazil, Natalie Ellis, Peg Hibbert, Debbie Lang, Lucille McKenna and Debra Smith. Each of these Councillors deserve the membership’s gratitude for the thousands of hours they have given to managing the affairs of the NSWNMA and ANMF NSW Branch making sure that both your unions have always been focused on the best interests of the membership. Councillors play a critical role as the Committee of Management of the union and with that comes a high level of responsibility and accountability. I thank all of the Councillors for their contribution and commitment to our union. Brett Holmes, General Secretary

Sylvia Moon, RN Interventional Services Unit, NSWNMA WWBH Branch, Branch delegate/secretary Since 2000, Wagga Wagga Base Hospital I have been an RN at WWBH for 24 years, working in every department except theatre. I commenced work in the new ISU in Oct 2017. Over the years, I have been actively involved with numerous local and state campaigns to improve nursing and patient care including, strikes, rallies and just recently, a ratios campaign at the Relay for Life. I have met and advocated strongly for nurse-to-patient ratios, shift-by-shift, city and country with the Health Minister, the Leader of the Opposition and my local independent member of parliament. I know we need better staffing in our maternity units throughout the state but we especially need them in our regional hospitals like Wagga Wagga. I have seen firsthand the amazing changes to nursing and patient care over the years and hope to see more in the future, particularly ratios for those in the country and for aged care.




US health professionals speak out on gun violence US nurses and doctors launch campaign after National Rifle Association (NRA) tell them to ‘stay in their lane’. The campaign started when the NRA told clinicians to mind their own business after the American College of Physicians released a position paper calling for a public health approach to firearmsrelated violence. Soon after a doctor, a pharmacist and a police officer were shot dead in the emergency department of Mercy Hospital and Medical Centre in Chicago. The NRA’s callousness and the shootings led to #ThisIsOurLane – a vehicle for an avalanche of personal stories, gun violence statistics and calls for action by health professionals. Among the statistics tweeted: “100 Americans are killed and 200 injured by firearms each day. Most of those people are white men in rural America who use firearms to kill themselves. About one-third of gun violence is concentrated among minority men in inner cities. Firearms deaths are the second-leading cause of death for American youths.” A forensic pathologist Dr Judy Melinek tweeted: “Do you have any idea how many bullets I pull out of corpses every week?” Dr Mark Seamon, a professor of surgery at the University of Pennsylvania said there was a new “willingness to take on politically charged topics” by health professionals. “Previously many physicians were hesitant to speak out about the horrors of what they saw on a daily basis. No more,” he said. The campaign has seen nearly 40,000 healthcare workers sign a letter calling for clinicians to come together to address the gun violence epidemic.

’Previously many physicians were hesitant to speak out about the horrors of what they saw on a daily basis. No more.’

Member Benefits 32 | THE LAMP FEBRUARY 2019



On average men earn $25,700 a year more than women The gender pay gap is narrowing but at a glacial pace.


ACTU seeks Fair Work Commission control over workplace harassment An ACTU survey finds 60 per cent of Australian women have experienced sexual harassment at work. In the survey, a total of 3,612 respondents (60 per cent) reported experiencing sexual harassment at work. The most common forms were crude or offensive behaviour – experienced by 69 per cent of people who reported sexual harassment; unwanted sexual attention (46 per cent) and inappropriate physical contact of a sexual nature (34 per cent). The survey found that 64 per cent of people had witnessed sexual harassment at work. Two thirds of those who had witnessed sexual harassment in their workplace did not make a formal complaint and 40 per cent did not tell anyone at all. More than half said they feared negative consequences if they spoke up. The President of the ACTU, Michele O’Neil, said: “Everyone should go to work free from the fear of harassment and unwanted sexual attention. “For many people – mainly women – today in Australia, this is not the reality. Our workplace laws have failed women who are experiencing harassment at work.” The ACTU’s Change the Rules campaign calls for the Fair Work Commission to have jurisdiction over sexual harassment, which currently requires litigation in courts. “Sexual harassment is a workplace issue and people who experience it should be able to take it up through the workplace umpire,” said Michele O’Neil.

’Our workplace laws have failed women who are experiencing harassment at work.’

The gender pay gap has dropped by 1.1 per cent from last year but men still take home, on average, 21.3 per cent more than women. The analysis by the Workplace Gender Equality Agency, using Australian Bureau of Statistics data found women earn less at every stage of their lives – including when they first enter the workforce – when they are on par with work experience and history. Women get paid 5.7 per cent less from their very first job. In their 40s and 50s, they receive on average 20 per cent less pay then their male colleagues. Where you work plays a major role in the wage gap. Women working in the financial and insurance services sector are paid an average 30.3 per cent less than a male colleague. In real terms, that’s a massive $48,800 less in total remuneration. Women who work in the construction sector face a 29.4 per cent wage gap – an increase of two per cent in the last 12 months. The average difference now sits at just under $40,000. Public servants have the smallest pay gap at 4.9 per cent, or around $4,400. That’s gone down significantly since last year, from 9.2 per cent. Women make up just over half of the workplace – 50.1 per cent – but are still seriously under-represented in leadership positions. They make up just over a third of senior managers, and just 17.1 per cent of CEOs or company heads.

’Public servants have the smallest pay gap at 4.9 per cent, or around $4,400.’

ARE YOU A REGISTERED NURSE WITH A REFUGEE BACKGROUND? I would like to talk to you about your resettlement journey and experiences becoming an RN in Australia To be a part of this research study please contact Harrison Ng Chok (PhD candidate) PHONE: (02) 4734 3180 EMAIL: h.ngchok@westernsydney.edu.au TWITTER: #Refugee2RNStudy This study has been approved by the Western Sydney University Human Research Ethics Committee. Approval no H12410. For complaints or reservations about the ethical conduct of this research, contact the Ethics Committee (Office of Research Services) on 4736 0229 or humanethics@westernsydney.edu.au




ANMF calls for a ban on nuclear weapons Nurses and other health professionals take a stand to prevent nuclear catastrophe. The Australian Nursing and Midwifery Federation, the Public Health Association of Australia, the Rehabilitation Medicine Society of Australia and New Zealand and the Royal Australasian College of Physicians, have signed a Healthcare Organisations Statement, initiated by the Medical Association for the Prevention of War (MAPW, Australia), calling on the Australian Government and ALP to sign the UN nuclear weapons ban treaty. The Australian Medical Association (AMA) has also called for Australia to sign the treaty.


SEATO nurses still waiting for their Gold Card Australian nurses who served in the war in Vietnam have won the right to the Department of Veterans Gold Card but will have to wait until 1 July 2020 to access it. From 1964 to 1972, over 200 civilian volunteers answered the Australian Government’s call to serve in surgical and medical teams providing care under the South East Asia Treaty Organization (SEATO) aid program. Decades after Vietnam, many returned civilian nurses began experiencing the same health conditions suffered by military forces such as cancers and Post Traumatic Stress Disorder. It sparked a campaign in the mid-90s, strongly backed by the Australian Nursing and Midwifery Federation (ANMF), seeking recognition for civilian nurses and the same health entitlements afforded the military under the Veteran’s Entitlement Act 1986 (VEA), where eligible individuals receive a Department of Veterans’ Affairs (DVA) Gold Card that covers the cost of medical treatment for all conditions. In December last year Federal Treasurer Josh Frydenberg announced that the SEATO nurses would finally be entitled to the card. But he delayed eligibility to the card until July 2020. ANMF Federal Secretary, Annie Butler, said there were no excuses why the nurses couldn’t access the card immediately. “The Government shouldn’t make them wait another 18 months to access medical treatment and other assistance and support they so urgently need,” she said.

’Many returned civilian nurses began experiencing the same health conditions suffered by military forces, such as cancers and Post Traumatic Stress Disorder.’ 34 | THE LAMP FEBRUARY 2019

The statement says nuclear weapons represent an overwhelming threat to human and environmental health and that the only way to avoid widespread destruction is to abolish them. “As an organisation of healthcare professionals, we call on the Australian Government to sign and ratify the Treaty on the Prohibition of Nuclear Weapons, and we call on all parliamentarians to work to achieve this essential goal, as we believe it is a key step toward the abolition of the world’s most terrifying devices,” it reads. ANMF Federal Secretary, Annie Butler, said the country’s largest union felt it was important to take a stand on nuclear weapons. “With millions of colleagues around the world, including the International Council of Nurses and the World Medical Association, we strongly support the Treaty on the Prohibition of Nuclear Weapons,” Ms Butler said. “The Treaty represents a significant step towards eliminating the most destructive weapons ever created. We call on all governments, including our own, to sign and ratify the Treaty.”

’We call on all governments, including our own, to sign and ratify the Treaty.’



Non-communicable diseases account for three-quarters of deaths worldwide Poor diet is a factor in 20 per cent of global deaths. The Global Burden of Disease study found that noncommunicable diseases such as cancer and diabetes now account for nearly three-quarters of the 55.9 million deaths worldwide. The leading cause of death is cardiovascular disease, with abnormal tissue growth including cancers in second place, and chronic respiratory conditions in third. Among cancer deaths, lung cancer was the most common cause. Experts say the latest findings reflect an accelerating shift away from deaths relating to infections and problems around birth and towards diseases such as cancer and diabetes. High blood glucose – which can lead to diabetes – was the fourth biggest risk factor for an early death, while almost nine per cent of deaths worldwide – about five million – were attributable to air pollution, putting it in fifth place. The opioid epidemic was a major killer, with the number of deaths from substance use disorders up by almost 24 per cent since 2007, with a 77 per cent jump for opioid deaths: about 110,000 people are thought to have died from the use of such drugs in 2017. Poor diet was the greatest risk factor for death from noncommunicable disease. A bad diet was behind more than 19 per cent of all deaths worldwide in 2017 and almost 70 per cent of coronary heart disease deaths. Diet was a risk factor in one in five of all deaths worldwide in 2017 % Diet




High blood pressure Tobacco High blood glucose Air pollution High body mass index High LDL cholesterol Child and maternal malnutrition Alcohol Source: Global Burden of Disease Study. Note: deaths can be linked to multiple risk factors

READ MORE The Global Burden of Disease study’s findings can be found at: https://www.thelancet.com/journals/lancet/ article/PIIS0140-6736(17)32154-2/fulltext


Percentage of global deaths in which poor diet is a factor

Professional Issues Committee (PIC) The NSWNMA seeks expressions of interest from financial members of the Association to join the Professional Issues Committee (PIC). The aim is to provide expert advice, opinions and recommendations to the NSWNMA and ANMF NSW Branch Councils on professional issues relating to nurses, midwives, nursing and midwifery. We have current vacancies for representatives from: • the aged care sector (1 position) • the private sector (1 position) • mental health (1 position) • undergraduate students in nursing or midwifery (1 position) To join the following reference groups: • Midwifery • Drug and Alcohol • Mental Health • Education • Climate Change Action • Community Nurses and Midwives Each reference groups consists of members with experience and expertise in their specialty. They provide advice and make recommendations to the NSWNMA Council through the PIC and assist the Association to accurately represent member’s interests. The meetings take place every second month with teleconference facilities for those that cannot attend in person.

Please direct enquiries to: gensec@nswnma.asn.au and include the reference group that interests you in the subject line. THE LAMP FEBRUARY 2019 | 35

PROFESSIONAL EDUCATION February to April 2019 Education


Foot Care: A Nurse’s Role, Wed 20 February, $95 / $190, 6 CPD Hours

Know where you stand with Law, Ethics and Professional Standards in Nursing and Midwifery, Thurs 28 March, $95 / $190, 6 CPD Hours


Wound Care: Negative Pressure Wound Therapy, Fri 15 March, $95 / $190, 6 CPD Hours

How to get that dream job (Portfolio/CV, Job Application & Interview Skills), Mon 15 April, $95 / $190, 6 CPD Hours


Alcohol and Other Drugs: The Current Situation – an update for all nurses and midwives, Thurs 21 March, $95 / $190, 6 CPD Hours



The Deteriorating Client, Wed 13 February, $95 / $190, 5 CPD Hours

The Influential Thought Leader at Work, Thurs 28 February, $95 / $190, 6 CPD Hours Ageing and Disability: New Challenges in Service Delivery, Fri 8 March, $95 / $190, 6 CPD Hours Clinical Supervision, The Role Development Model, 8-day course commencing Wed 13 March – see ad on page 38

Understanding the Four Human Behavioural Styles, Thurs 21 February, $95 / $190, 6 CPD Hours Diabetes for Clinical Staff, Wed 6 March, $95 / $190, 5 CPD Hours

Environmental Health Seminar, Fri 5 April, $60 / $120, 6 CPD Hours

Dementia Management Training, Thurs 21 February, $95 / $190, 7 CPD Hours Your Annual CPD Obligations, Thurs 21 March, $50 / $100, 4 CPD Hours, RN, EN, MW


Clinical Communication and Documentation, Thurs 11 April, $95 / $190, 6 CPD Hours


Standard Mental Health First Aid, 2-day course, Mon 8 and 29 April, $190 / $380, 12 CPD Hours


Medications: How we do it better, Wed 3 April, $95 / $190, 6 CPD Hours

Alcohol and Other Drugs: The Current Situation, an update for all nurses and midwives, Fri 5 April, 6 CPD Hours

Clinical Communication and Documentation, Thurs 4 April, $95 / $190, 6 CPD Hours


Dementia Management Training, Thurs 28 March, $95 / $190, 7 CPD Hours

Wound Care: Understanding Wound Care Products, Mon 15 April, $95 / $190, 6 CPD Hours


Practical, Positive Leadership Series, 4-day course, Mon 8 April, 6 May, 3 June and 8 July, $340 / $600, 24 CPD Hours

Foot Care: A Nurse’s Role, Wed 13 March, $95 / $190, 6 CPD Hours

Medication Administration for Clinical Staff, Fri 15 March, $95 / $190, 5 CPD Hours

Increasing Resilience in Stressful and Changing Times, Mon 29 April, $95 / $190, 6 CPD Hours

Wagga Wagga


Discovery of Self for the Practising nurse/midwife: Visioning and selfcare workshop, Tues 19 February, $95 / $190, 6 CPD Hours

Transitioning to the Workplace, Mon 18 February, $30 / $60, 6 CPD Hours, New Grad RN, EN, MW Medications: How we do it better, Wed 20 March, $95 / $190, 6 CPD Hours


The Deteriorating Client, Mon 8 April, $95 / $190, 5 CPD Hours

Byron Bay

Medications: How we do it better, Wed 20 February, $95 / $190, 6 CPD Hours Clinical Communication and Documentation, Thurs 21 February, $95 / $190, 6 CPD Hours


Medications: How we do it better, Mon 4 March, $95 / $190, 6 CPD Hours Clinical Communication and Documentation, Tues 5 March, $95 / $190, 6 CPD Hours

WESTERN NSW Coonabarabran

Clinical Communication and Documentation, Wed 27 February, $95 / $190, 6 CPD Hours Your Annual CPD Obligations, Thurs 28 February, $50 / $100, 4 CPD Hours, RN, EN, MW

For full details of courses including course content, venue & times, please go to www.nswnma.asn.au CPD


Attendance at NSWNMA education sessions may count towards your Continuing Professional Development (CPD) hours. The number of hours noted beside each course is the maximum amount of claimable CPD hours. Unless otherwise noted, our courses are suitable for all Nurses, Midwives and Assistants in Nursing/Midwifery.




Judith Breaking News More options for long service leave in public health It is a source of confusion and frustration for members working in public health, whose contracted working hours have changed during their employment, to find they are subjected to an averaging calculation to determine the payment to be used when taking long service leave (LSL). This can result in a payment that does not equate to your contracted hours when taking LSL. For example, a nurse who has worked several years parttime and then becomes full-time will not receive the full-time rate when taking LSL. That is, their varying contracted work hours are subjected to the averaging calculation to determine the LSL payment figure. Following extensive discussions between the Ministry of Health and public health unions, the Ministry released IB2018_059 at the end of 2018, which sets out some additional options. In short, if you want to be paid at your current rate (which is higher than the calculated averaged rate) you can but you will use up more accrued LSL. This is not dissimilar to the principle involved in taking LSL at double pay. Equally, if your current rate is lower than the calculated averaged rate, you can remain on your current rate and use up less of your LSL accrual. It is entirely voluntary and you are free to nominate the option you wish, or have some calculations done prior to making a final decision. In addition, if you elect one option this year, it does not mean you have to do the same next time.

Higher Grade Duty in public hospitals I am a Registered Nurse working in a public hospital. Recently I acted up as the NUM for a few days on either side of a weekend. Am I entitled to be paid higher grade duties?

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

Clause 24(i) (Higher Grade Duty) of the Public Health System Nurses’ and Midwives’ (State) Award sets out that higher grade duty is payable when undertaken for a continuous period of at least five working days. As your period acting up was a minimum of five continuous working days, albeit straddled on either side of days off, payment should be forthcoming.

Complaint from the HCCC

I am a registered nurse working in a private hospital. The Health Care Complaints Commission has notified me of a complaint they have received about me. Can the Association be of assistance? The Association has a team of legal officers who advise, provide assistance and, in appropriate instances, represent members in relation to problems or complaints concerning their alleged conduct or performance as a registered health practitioner. You should contact the Association without delay and send through any documentation you may have received from the HCCC.

On call during break

I work in a facility operated by Opal. What should I be paid if I have to be on call during my meal break? Under Clause 30.1(b) and Schedule D of the Opal Aged Care (NSW) Enterprise Agreement 2016, an employee required to remain available for duty during a meal break will be paid an “on call during meal break allowance”, which is currently $11.83 (provided that only one allowance shall be payable in any period of 24 hours).

On call on days off

What are the rules about being on call over days off? I work in a public hospital. Under sub clause 4(xvii) (Hours of Work) of the Public Health System Nurses’ and Midwives’ (State) Award, no employee will be required to remain on call on a rostered day off or on the completion of a shift prior to a rostered day off. The

only exception is in “extreme circumstances” (as agreed to by the employer and the Association) to enable the provision of services by a public hospital, A higher allowance is payable as set out in sub clause 12(ii) and Table 2 of the Award if on call does occur on your days off.

Changes to domestic and family violence leave I am a Registered Nurse working in FACS. Has there been a change to family violence leave entitlements? Yes. From 1 January 2019, via a Premier’s Memorandum, all fulltime government sector workers will have access to 10–days paid domestic and family violence leave per calendar year (non-cumulative). The leave will be available pro rata for part-time employees. It can be taken in part days, single days, or consecutive days. This leave can be accessed without exhausting other existing leave entitlements first (for example, sick leave). The leave can be used by workers experiencing domestic and family violence for things like: seeking safe accommodation; attending medical, legal, police or counselling appointments; and attending court and other legal proceedings, relating to such violence. It can also be used for organising alternative care or education arrangements for children. The agency will, however, need to be satisfied on reasonable grounds that domestic and family violence has occurred.

Next pay increase at Healthe Care I work in a private hospital run by Healthe Care. When is the next pay increase due? Under the Healthe Care Pty Ltd (New South Wales Hospitals) and the NSWNMA/ANMF NSW Branch Enterprise Agreement 2017, the next pay increase is due in the first full pay period on or from 1 April 2019.




Clinical Supervision for Role Development Training 8-DAY COURSE IN 2019 CPD


13, 14, 15 March; 4, 5, 6 June; 3 & 4 September 2019 9 am – 4.30 pm 50 O’Dea Avenue, Waterloo All $

$3,300 (inc. GST) or $375/day + GST Pay as you go negotiable/ invoice available for organisations supporting staff to attend. Lunch & refreshments provided.

CONTACT Paul Spurr, 0410 033 342 paul@spurrcsc.com Provided in partnership with

Clinical Supervision is a regular, dedicated time for reflection on all aspects of professional practice. Clinical supervision aims to improve care and support the professional development and wellbeing of staff. This eight-day foundational training equips potential clinical supervisors with a variety of techniques and approaches to conduct quality individual and group clinical supervision. For many professions, clinical supervision is now a mandatory condition of registration and ongoing practice and forms an integral part of Continued Professional Development (CPD). COURSE CONTENT: The training provides clinical supervisors with an understanding of the Role Development Model of clinical supervision, the supervisor role and a framework for clinical supervision practice. The learning includes utilisation of role theory, role analysis, concretisation techniques, actionlearning techniques and role training as clinical supervision interventions. Other innovative interventions such as “this year/next year” are included. LEARNING OUTCOMES: • Appreciate the benefits of clinical supervision in participant’s work area • Identify other models of clinical supervision and the theories informing the Role Development Model • Understand and explore concepts and techniques used in clinical supervision • Conduct effective individual and group clinical supervision sessions within the framework • Demonstrate confidence and competence in applying advanced clinical supervision techniques.

Dot & Tiffany’s Workshops 2019

THE INFLUENTIAL THOUGHT LEADER AT WORK 28 February | 29 August • Waterloo

Dot Yam and Tiffany Baxter are leadership specialists and facilitators.

PRACTICAL, POSITIVE LEADERSHIP (4-day course) 8 April, 6 May, 3 June, 8 July • Waterloo

Dot Yam has been working with the Association for many years educating nurses and midwives. Dot is an acknowledged leader in healthcare education with a background in nursing, education, management, counselling and coaching.

The goal of this 4-module program is to equip and empower you in your leadership role with knowledge, tools and strategies in the most practical, positive ways, to enable you to fulfil your role with confidence, pride, credibility and integrity. Each module is conducted as a full-day workshop at monthly intervals.


Tiffany Baxter is a Professional Development Strategist, Coach and has a background in complimentary medicine. Those who attended her workshops and coaching sessions find them motivating, encouraging and life changing.



6 CPD Hours $ $95 / $190

The goal of these one-day workshops is to provide you with the skills and tools to build your confidence in becoming an inspiring and motivational thought leader. The methodologies you will learn will ultimately go towards creating unity and partnership within teams, improving family dynamics and personal relationships and helping to advance your future career.


24 CPD Hours $ $340 / $600

6 CPD Hours $

$95 / $190

The goal of these one-day workshops is to provide you with practical tools and strategies to help you get your “mojo” back and put you in the best position to deal with stress, strain and change. EMOTIONAL INTELLIGENCE TRAINING 13 June • Waterloo | 17 October • Campbelltown

6 CPD Hours $ $95 / $190

These one-day workshops will take you beyond your IQ and into a deeper understanding of yourself and others and how to navigate difficult situations at work and in life.


Do you have a story to tell? An opinion to share? Nurse Uncut is a blog written by everyday nurses and midwives. We welcome your ideas at nurseuncut@nswnma.asn.au The NSWNMA has partnered with The Ethics Centre with this free, independent helpline to assist with life’s toughest challenges. https:// www.nurseuncut.com.au/ethi-callbecause-the-human-experiencecan-be-complex/

New on our Support Nurses YouTube channel

MARY’S STORY Mary, whose daughter is a nurse, tells why she supports a new shiftby-shift nurse-to-patient ratios system. http://bit.ly/MaryRatios

We’ve had 20 aged care reviews in 20 years – will the Royal Commission be any different? Jane Phillips, Deborah Parker and Michael Woods question whether the upcoming Aged Care Royal Commission will yield new results. https://www.nurseuncut.com. au/weve-had-20-aged-carereviews-in-20-years-will-the-royalcommission-be-any-different/

Researchers from Monash University invite you to take part in this study to identify nurse-initiated environmental sustainability interventions. https:// www.nurseuncut.com.au/ nurse-initiated-environmentalsustainability-interventions-inacute-hospitals/

BOB FENWICK MENTORING PROGRAM CEREMONY 2018 A recap of the Bob Fenwick Mentoring Program for 2018. http://bit.ly/bobfenwick18 Connect with us on Facebook Nurse Uncut www.facebook. com/NurseUncutAustralia New South Wales Nurses and Midwives’ Association www.facebook.com/nswnma Ratios put patient safety first www.facebook.com/ safepatientcare Aged Care Nurses www.facebook.com/ agedcarenurses Look for your local branch on our Facebook page www.facebook.com/nswnma

Christmas holidays can be a compromising time for nurses A nurse reflects on what Christmas means for her: having to compromise time with family and friends, and to reconsider her beliefs and values. https://www.nurseuncut.com. au/christmas-holidays-meancompromise-for-nurses-2/

Follow us on Twitter @nswnma / @nurseuncut Share on Instagram by tagging @nswnma and don’t forget to use the hashtag #nswnma!

Nurse-initiated environmental sustainability interventions in acute hospitals

Ethi-call – helping with the complexity of human experience

Confession of an imperfect nurse Nurse Carolyn shares her story of committing a drug error and navigating her way through the ethical minefield that it raised. https://www. nurseuncut.com.au/confession-ofan-imperfect-nurse-2/

Listen to our podcast

Garling After 10 – Jeff Furolo and Judith Kiejda. http://bit.ly/ garlingjeffjudith THE LAMP FEBRUARY 2019 | 39


y d a e R r 2019 e b o 19 Oct

Wellness, resilience and building the skills needed for future workplace success

Be inspired

Be Financially Be healthy Be mindful Fit

Kurt Fearnley

Paralympian & Disability Rights Advocate

Kathryn Hawkins

Dietitian , Nutritionist & Presenter

Ready for a change? 40 | THE LAMP FEBRUARY 2019

Lucinda aka The Mindful Nurse

RN, Life Coach, mindfulness & meditation teacher


More details in the next Lamp

Learn about investment strategies, budgeting, debt management and retirement income strategies to understand your options and make informed decisions about your financial future


Yoga & meditation



Say It’s time for improvements to maternity services! Midwives and nurses took action in December to demand safer staffing in maternity wards. Sadly, this is why I choose not to work in midwifery any more. I was lucky to never have seven, eight or nine mums and bubs to look after, but still felt I couldn’t spend enough time with the new mums. Too caught up in paperwork, policies, check lists. I totally agree with these midwives that you’d go home worrying about what you had or hadn’t done, and knowing you’d given inadequate care where needed. These are such accurate comments describing our maternity services. We’ve had the same problems continue over the years: lack of midwifery staff, lack of auxiliary staff, unsafe skill mix and poor staff-topatient ratios. Babies must be counted as patients! When will our concerns be heard? Twelve years ago the maternity unit I retired from last year had an external review around staffing. A senior midwife consultant was asked by the then DON about the place of ENs in the maternity unit. The emphatic reply was that “there is no place for ENs in maternity units. They were deployed to other areas within the hospital.

What nurses and midwives said and liked on Facebook www.facebook.com/nswnma

This last few months they have been working again on the post-natal wards! Why are we repeating past mistakes? The universities should offer more places for midwifery students, and the hospitals should offer more post-grad students jobs. I used to work as one midwife and an EEN to 12 or 13 patients. It was ridiculous and unsafe.

People before things The Government’s new baby bundle is being rolled out from this year. You were outraged that money was being poured into the hamper ahead of midwifery care. Pollies are in love with objects – hospital buildings, bundles, advertising campaigns. My theory is that is takes an individual with a very low level of imagination and little empathy to be a successful politician. So naturally it will be beyond them to imagine humans staffing buildings, mothers needing emotional support or truly looking after people properly. This government wants to bribe us and buy our votes with this waste-ofmoney baby bundle. I’m an ICU nurse and I have a CCU nurse friend who was thrown into work in Maternity Units with zero

the gallery

experience with mothers and babies. It was really scary! Hospitals should hire or train more midwives to safely look after mums and bubs. Services are so much more vital to birthing and new mothers than “things”. I was so lucky to have more than adequate birth services and also parenting and baby health services for my Australian birth back in 1992. There were Labor governments at both levels then.



I’m wondering how many companies did under the table deals just to get brand exposure in these hampers! The one thing I thought might be great (the Grug book) is not even the proper story of Grug! That’s outrageous!

The right groove for CPR



A hospital made a Spotify playlist of the best songs to help you perform CPR. Here were your hot takes. Haha. Imagine designating jobs in an emergency – “and you – grab my phone, open Spotify and grab my playlist please”. When I had to renew my first aid cert, I was doing the compressions to “Baby Shark” and it actually works. My favourite is “Too Good at Goodbyes” by Sam Smith. Mine will always be “Work It” by Missy Elliot. Put my thang down flip it and reverse it. Needs “ The Imperial March” added to it, in my opinion. I think I’d ask Alexa to play Lady Gaga’s “Just Dance”.

/5 1/ N  urse Nadia Rodriguez campaigns for ratios with her two kids in the Illawarra 2/ N  epean Branch visits Penrith MP, Stuart Ayres, to convince him of the need for safer nurse-topatient ratios 3/ S  anta shows his support for nurse-to-patient ratios in Ballina 4/ Central Coast MPs, David Mehan and David Harris, join nurses and midwives to show their commitment to safe patient care 5/ Assistant Secretary, Judith Kiejda, joins RPA branch to call for ratios in NSW maternity wards. THE LAMP FEBRUARY 2019 | 41

We are currently reviewing how the NSWNMA communicates with members via The Lamp and online to ensure we remain relevant and easily accessible to all nurses and midwives. Please take the time to complete a short 3-minute survey, the results will help shape the future direction of The Lamp. Everyone who completes the survey will go into the draw to win an Apple Watch Series 4. The survey will close Thursday 28 February 2019. SURVEY LINK:




Lamp survey.indd 1

23/1/19 8:53 am

“I want a super fund that’s an expert at managing money.” Vindhya Mendis, HESTA member

We’ve been awarded a 15 year platinum performance rating from Australia’s most respected super research company, SuperRatings. That means we’re not only one of the largest super funds in the country, we’re also one of the best.

Product ratings are onlyone factorto be considered when making a decision. See hesta.com.au/ratings formore information. Issued byH.E.S.T.Australia LtdABN66006818695AFSL235249, theTrustee of Health Employees SuperannuationTrustAustralia (HESTA) ABN 64 971 749 321.This information is of a general nature. It does not take into account your objectives, financial situation or specific needs so you should look at your own financial position and requirements before making a decision. You may wish to consult an adviser when doing this. Before making a decision about HESTA products you should read the relevant product disclosure statement (call 1800 813 327 or visit hesta.com.au/pds for a copy), and consider any relevant risks (hesta.com.au/understandingrisk).


NURSING RESEARCH AND PROFESSIONAL ISSUES A number of young people attending summer music festivals have died this year in circumstances associated with illicit drug use. Sadly the Berejiklian Government remains wedded to a ‘Just say no’ approach despite the growing prevalence of drug use among young people. There is a consensus among drug experts that a failure to embrace harm reduction policies is costing young lives. Here’s why doctors are backing pill testing at music festivals across Australia Martin Lloyd Jones and Paul Komesaroff For many years experts in the field of drug policy in Australia have known existing policies are failing. Crude messages (e.g. calls for total abstinence: “just say no to drugs”) and even cruder enforcement strategies (harsher penalties, criminalisation of drug users) have had no impact on the use of drugs or the extent of their harmful effects on the community. Whether we like it or not, drug use is common in our society, especially among young people. In 2016, 43 per cent of people aged 14 and older reported they had used an illicit drug at some point in their lifetime. And 28 per cent of people in their twenties said they had used illicit drugs in the past year. The use of MDMA (the active ingredient in ecstasy) is common and increasing among young people. In the last three months alone five people have died as a result of using illicit drugs at music festivals and many more have been taken to hospital. The rigid and inflexible attitudes of current policymakers contrast dramatically with the innovative approaches to public health policy for which Australia was once renowned. Since the 1970s many highly successful campaigns have improved road safety, increased immunisation rates in children and helped prevent the spread of blood-borne virus infections.


Drug use at music festivals Tom Gotsis Drug use at music festivals has become a public safety concern in NSW, one that has led to a number of fatalities in recent years. The latest death occurred after a 19-year-old man attended the Knockout Games of Destiny music festival on 7 December 2018. That music festival also saw three people taken to hospital in a critical condition; 13 people taken to hospital for treatment and 130 people seeking medical treatment during the event. This e-brief provides an overview of the main recommendations of the expert panel report titled Keeping People Safe at Music Festivals, released by the NSW Government on 23 October 2018. Those reforms, all of which were accepted by the NSW

Government in principle, embrace a multifaceted approach of regulatory reform, increased criminal sanctions as deterrents and harm reduction. The recommendations relating to deterrence include a new on-the-spot fine for drug possession at music festivals and a new offence of supply drug causing death. Those two reforms are examined in detail. In light of ongoing calls for a trial of pill testing at music festivals, this e-brief also presents recent evidence on the efficacy of pill testing.

https://www.parliament.nsw.gov.au/ researchpapers/Documents/Drug%20use%20 at%20music%20festivals_final.pdf

NSWNMA Position Statement on Harm Reduction Endorsed by Annual Conference 2018 The NSW Nurses and Midwives’ Association (NSWNMA) is an advocate for interventions that promote harm minimisation in relation to substance use. The NSWNMA supports the exploration and investigation of alternative models for control of drug use. The NSWNMA acknowledges that adequate resources for drug and alcohol treatment, management and preventative education are required, with a commitment of recurrent funding to ensure treatment options and ongoing support is readily available and able to be maintained. Harm Reduction International defines harm reduction as the “policies, programmes and practices that aim to reduce the harms associated with the use of psychoactive drugs in people unable or unwilling to stop. The defining features are the focus on the prevention of harm, rather than on the prevention of drug use itself, and the focus on people who continue to use drugs.” It is well known that a blanket ban on illicit drugs and the application of criminal law to control substance use in Australia is an approach that is failing. According to the National Drug Strategy Household survey, in 2016, around 3.1 million Australians reported using an illicit drug. There is a need to explore alternative models that can assist in the control of drug use and reduce the occurrence of adverse events relating to illicit drug use.

http://www.nswnma.asn.au/wp-content/ uploads/2018/10/NSWNMA-PositionStatement-on-Harm-Reduction.pdf THE LAMP FEBRUARY 2019 | 43



Joanne Robertson


1968 – 2018

It is with enormous sadness that we share the news of the unexpected and sudden passing of our dear midwifery colleague and friend, Joanne Robertson. Joanne worked at Westmead Hospital for more than 10 years. She commenced her nursing career as an AIN, came to Westmead to complete her Graduate Diploma of Midwifery and never looked back. After completing her Grad Dip, she became a core staff member of Maternity care. Joanne completed her IBCLC – Lactation Consultant and developed a true and lifelong passion to help women navigate through their breastfeeding journey. She was an active delegate for the NSWNMA, Parenthood Educator and a trainer in the PROMPT program. She was instrumental in the implementation of her Bereavement Midwife position, a role which was close to her heart and which she was very passionate about. Joanne was a highly regarded midwife and well known for her compassionate nature, energy and dedication to the profession. She was highly respected by all staff for her leadership skills and commitment to women-centred care. Jo was also known for her love of dancing, partying and her wonderful sense of humour. She was a dedicated wife and a mother to 3 beautiful daughters. As a valued staff member of the Women’s and Newborn Health team, Joanne will be greatly missed. ■



test your

Knowledge 1











10 12








21 23

17 24




26 28






34 35




39 40



ACROSS 1. Absence of or decreased ability to exercise willpower or initiative, or to make decisions 5. To decay; to putrefy 10. Chimney, vent 11. Stertor 12. Hernia of the bladder 14. Auris 15. Relating to the belly area 18. Set afire or burning 19. Versatile, resilient 22. Dilation of a tubular




structure 23. Symbol for indium 24. An edge or a margin 25. The sensation of sparks before the eyes 28. Dose equivalent (1.1) 29. Penetrable, porous 32. A section or a part of an organ or other structure 34. A large vase 35. Human growth hormone (1.1.1) 36. Relating to

biotransformation 38. Replication – competent retrovirus (1.1.1) 39. Diabetes insipidus (1.1) 40. Group, set, lot 42. Work together, cooperate 44. Ethanol 45. Capable of withstanding stress without injury

DOWN 2. Sticking plaster 3. Interferon (1.1.1) 4. Chilly; cold 5. Lying down; lying flat 6. The portion of the nervous system consisting of the brain and spinal cord (1.1.1) 7. An amine containing only one amino group (1.1.1) 8. Facet of the compound eye of an insect 9. Asthenopia 13. A warming drink that contains antioxidants 15. Immune serum 16. Hypodermic syringes 17. Sluggish, inactive, inert, drowsy 19. An abnormal fear of being in crowded, public places 20. Medicine that causes a loss of feeling, especially of pain 21. Thread made from fibres of the flax plant 26. Exactly equal and alike 27. Make intoxicated 30. Produced offspring 31. Resembling a table 33. Torture 37. Guides 41. Used to express surprise 43. Slippery liquid


Registered Nurses working in NSW Public Mental Health Services



The Program aims to encourage less experienced mental health nurses to take the opportunity to be mentored by a more experienced colleague, assisting them to achieve their mental health professional practice goals.

Who can apply?

Any registered nurse currently working in NSW public mental health services is eligible to apply. Mental health nurses with less than two years’ experience or working in NSW rural and remote areas as well as Aboriginal or Torres Strait Islander nurses currently working in mental health are all strongly encouraged to apply.

What will each mentoring grant include? n Matching with a mentor in a Local Health District (LHD) other than their own for up to five consecutive days to pursue their mental health areas of interest. n Being provided with travel, accommodation and meal allowance, while remaining a fully paid employee of their regular mental health service during their placement.

Seeking mentors for the Program


Applications are open to registered nurses who want a unique opportunity to further their mental health nursing career by participating in this innovative Program.

If you are a senior mental health nurse, you can help build the specialty of mental health nursing by nominating yourself to become a mentor. Simply use the Mentor Details Form or contact the Program Manager for more information.

How do I apply?

More detailed information about the Program (including a video interview of past participants) can be found on the NSW Nurses and Midwives’ Association website www.nswnma.asn.au 2019 EXPRESSION OF INTEREST FORMS WILL BE AVAILABLE FROM 1 FEBRUARY 2019. If you require more information contact the Program Manager by email: mhmgrant@nswnma.asn.au or contact Matt West on 1300 367 962.

Bob Fenwick-advert half.indd 1

20/11/18 11:09 am

The Edith Cavell Trust is now able to receive non-tax deductable donations/bequests. The Trust – named in honour of Edith Cavell – assists in the advancement of NSW nurses, midwives and assistants in nursing/midwifery through further studies and research, made available through scholarship. The knowledge and expertise gained by nurses, midwives and assistants in nursing/ midwifery, supported by the Edith Cavell Scholarships, is an asset to the care of their patients and clients. Bequests to the Trust continue to support this important work. Edith, a British nurse serving in Belgium in WW1, is a hero to most nurses and midwives. She helped some 200 Allied soldiers escape from German-occupied Belgium. Her actions saw her arrested, accused of treason, found guilty by a court-martial and sentenced to death. Despite international pressure for mercy, she was shot by a German firing squad. NAME ADDRESS


Cavell Edith




PREFERRED METHOD OF PAYMENT Electronic Fund Transfer Account name: Edith Cavell Trust Bank: Commonwealth Bank BSB: 062-017 Account no: 10017908 Credit Card I authorise the Edith Cavell Trust (processed via NSWNMA) to debit my credit card for the amount of Mastercard


Card no Signature of Cardholder 46 | THE LAMP FEBRUARY 2019



Name on Card Expiry Date


REVIEWS All books can be ordered through the publisher or your local bookshop. Call 8595 1234 or 1300 367 962, or email gensec@nswnma.asn.au for assistance with loans or research. Some books are reviewed using information supplied and have not been independently reviewed.







Lesley Potter, Anchor Books Australia (available through Angus & Robertson) www.angusandrobertson.com.au RRP $34.95. ISBN 9780648061601


Mistress of her Profession: Colonial Midwives Of Sydney 1788 – 1901


book club

All the latest Book Club reviews from The Lamp can be read online at www.nswnma.asn.au/ library-services/book-reviews.


Before any official midwifery training was instigated in New South Wales numerous women worked as midwives. Many were untrained and practised independently but a few had overseas midwifery qualifications that gave them prestige in the practice of their craft. This book tells the stories of nine midwives and their account of the development of midwifery training in New South Wales.

Fundamentals Of Nursing And Midwifery Research: A Practical Guide For Evidence-Based Practice Lisa McKenna and Beverley Copnell

Allen & Unwin Pty Ltd: https:// www.allemandunwin.com RRP $69.99 ISBN 97817606310939

An accessible and practical reference for undergraduates in nursing and midwifery explaining the principles and value of health research. This book represents a unique approach to teaching the principles of health research using practical case studies that students can identify and engage with.

Mosby’s Guide to Nursing Diagnosis 5th Edition Gail Ladwig, Betty Ackley and Mary Makic Elsevier: https://www. elsevierhealth.com.au RRP $62.95. ISBN 9780323390200

Updated and easy to use, this book is ideal for use in clinics, classes and at the bedside. This pocket-sized reference book is a condensed version of Ackley’s Nursing Diagnosis Handbook 11th edition that helps you diagnose

and formulate care plans with confidence and ease. Includes approved nursing diagnoses based on more than 1,300 specific symptoms and a step-by-step guide to creating care plans, featuring desired outcomes, interventions and patient teaching. Alphabetic thumb tabs allow for quick and easy access to specific symptoms and nursing diagnoses.

Critical Care Emergency Medicine 2nd Edition David Farcy, William Chiu, John Marshall and Tiffany Osborn McGraw Hill Education: https://www.mheducation. com.au RRP $189.95. ISBN 9780071838764

Critical Care Emergency Medicine has become the standard reference for all clinicians who wish to understand the overlap between emergency medicine and critical care. This book is unique in incorporating both perspectives into the practice of emergency medicine and critical care. It teaches emergency physicians everything they must know and do to better care for critically ill patients in an emergency department or to provide care in an ICU. Also includes important information on the use of ultrasound, fluid management,

nutritional support, pediatric considerations, patient transportation and end-of-life issues.

Skills For Midwifery Practice Ruth Johnson, Wendy Taylor, Sally de-Vitry Smith and Sara Bayes Elsevier: http://www. elsevierhealth.com.au RRP $62.95 ISBN 9780729542777

Endorsed by the Australian College of Midwives, this text provides instruction and guidance on more than 200 clinical skills for midwifery students and midwives who wish to perfect their practice. Each clinical skill is presented logically in a step-by-step format, providing a clear sequencing of information. Theory and evidence precedes each skill to thoroughly explain the underlying physiology of the scenarios encountered in midwifery practice. Key features: womancentred approach; structured to follow the logical progression from pregnancy through to labour and birth and finally to postnatal care, and Australian and New Zealand guidelines, policies, standards, statistics, terminology and cultural considerations are included throughout. THE LAMP FEBRUARY 2019 | 47


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 48 |

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 Indemnity Insurance: the limit per claim is now $5 million THE LAMP FEBRUARY 2019

REVIEWS If you would like to be a movie reviewer, email lamp@nswnma.asn.au






Stan & Ollie














at the movies



Laurel and Hardy, the world’s favourite comedy double act, set out on a variety hall tour of Britain in 1953. Diminished by age and with their golden era as the kings of Hollywood comedy now behind them, they face an uncertain future. As they start crisscrossing the country, attendances are disappointingly low. But they’ve always been able to make each other laugh and as the charm and beauty of their performances shines through, their audiences laugh too and they reconnect with legions of adoring fans, old and new. The tour becomes a hit but Stan and Ollie can’t quite shake the spectre of Laurel and Hardy’s past; and long buried ghosts, coupled with Oliver’s failing health, start to threaten their precious partnership. A portrait of the most tender and poignant of creative marriages begins to unfold as the duo, aware that they may be approaching their swan song, try to rediscover just how much they mean to each other. Directed by: Jon S Baird Starring: Steve Coogan, John C Reilly, Nina Arianda, Shirley Henderson, Danny Huston and Rufus Jones Email The Lamp by 16 February to be in the draw to win one of 10 double passes to Stan & Ollie thanks to Entertainment One. Email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

A Discovery of Witches Adapted from Deborah Harkness’ bestselling trilogy of novels, A Discovery of Witches is a bold and romantic thriller that uncovers a secret underworld of extraordinary beings hiding in plain sight for fear of persecution by humans – they are vampires, witches and daemons. Brilliant historian Diana Bishop is a witch denying her own heritage. But when she unexpectedly calls up an ancient, bewitched manuscript from Oxford’s Bodleian Library, a manuscript that was thought by the creatures to be lost and could answer the mysteries of their existence, she finds herself thrown into the heart of a dangerous mystery – and into the path of the enigmatic geneticist and vampire Matthew Clairmont. Matthew is driven to solve the looming threat of the creatures’ decline and extinction but their unlikely alliance to find the book before it falls into the wrong hands and their deepening relationship – threaten to violate age-old taboos and shake the fragile peace that exists between the species. Starring: Teresa Palmer (Hacksaw Ridge, Light’s out, Berlin Syndrome), Matthew Goode (Downtown Abbey, Ordeal by Innocence, The Crown), Alex Kingston (ER, Doctor Who), Owen Teale (Game of Thrones, Stella), Valarie Pettiford (The Blacklist, Being Mary Jane). Email The Lamp by the end of February to be in the draw to win one of 5 copies to A Discovery of Witches thanks to Acorn Media. Email your name, membership number, address and telephone numberto lamp@nswnma.asn.au for a chance to win! THE LAMP FEBRUARY 2019 | 49


make a date

Diary Dates for conferences, seminars, meetings and reunions is a free service for members. lamp@nswnma.asn.au


The RHW Midwifery Conference: Working Local – Thinking Global 22 February 2019 Royal Hospital for Women, Randwick www.royalwomen.org.au/rhwmidwifery Omnicare Alliance: The RED Conference A Regional Experience in Practical Dementia Care 28–29 March 2019 Sails Port Macquarie, Port Macquarie red.omnicare.org.au 42nd Australian Association of Stomal Therapy Nurses Conference: Power of Connections – Coming Together 19–22 May 2019, SMC Conference and Function Centre Sydney. http://www.stomaltherapyconference. com/ 2nd Women’s and Newborn Health Conference 3–4 May, 2019, Westmead Hospital Marjan.Khajehei@health.nsw.gov.au EVENTS: INTERSTATE

15th National Rural Health Conference 24–27 March 2019, Hobart, Tasmania www.ruralhealth.org.au/15nrhc/ Lowitja Institute Indigenous Health and Wellbeing Conference 17–20 June 2019, Darwin, NT http://www.nirakn.edu.au/ event/2019-lowitja-instituteinternational-indigenous-healthand-wellbeing-conference/


EuroSciCon Conference on Clinical Pathology and Bacterial Diseases 2019 27–28 February 2019 Prague, Czech Republic https://clinicalpathology.euroscicon. com/ Council of International Neonatal Nurses Conference Enriched family – enhanced care 5–8 May 2019, Auckland, New Zealand www.coinn2019.com 7th World Congress on Nursing and Healthcare Recent Innovations for Better Healthcare and The Facets of Nursing 17–18 June 2019 London, UK https://www.scientificfederation.com/ wcnh-2019/ International Council of Nurses 2019 Congress 27 June–1 July 2019 Marina Bay Sands Expo and Convention Centre, Singapore http://www.icn.ch/events/ ICN-Congress-Singapore-June-2019/ International Council of Nurses (ICN) 21st International Conference on Nursing 25–26 September 2019 London, United Kingdom www.icn.ch/ EVENTS: REUNIONS

WWBH PTS 1979 40-Year Nursing Reunion Saturday 2 February 2019 Alison Meek (Giese) 0402 612 240 Sharyn Wellham (Noonan) 0432 416 419 Steph Taggart (Heenan) 0457 414 503 Hornby Ku Ring Gai Hospital Reunion Orange group 40-Years 1976–79


Please send event details in the format used here: event name, date and location, contact details – by the 5th of each preceding month. Send your event details to: lamp@nswnma.asn.au Fax 02 9662 1414 Post 50 O’Dea Ave, Waterloo NSW 2017. All listings are edited for the purposes of style and space. Priority is given to non-profit professional events.

Saturday 9 February 2019 Helen Sim (Anderson) 0418 654 757 Gillian Linton (Frame) 0403 430 989 RPAH – February 1984 PCB 35 Year Reunion Saturday 16 February 2019 Venue: TBH Rebecca Burke (Hartwell) beckburke@ bigbond.com 0408430662 NEC Group February 1976 Intake Reunion – 40 Years since Graduation Possibly March 2019 Marie Sansotta-Allen tealhealthsolutions@gmail.com 0408 979 465 Royal Canberra Hospital PTS March 1979 40-Year Nursing Reunion Saturday 16 March 2019 Canberra Ruth Snowball: 0417062019 ruthsnowball@outlook.com Kerry Taliaferro (Hockley): Kerry.Taliaferro@act.gov.au St Vincent’s Hospital Darlinghurst March 1979 PTS Group 40-Year Nursing Reunion Saturday 4 May 2019 6 pm Polo Lounge, Darlinghurst Mary Norman (Anderson) mary_norman@me.com CROSSWORD SOLUTION

Dreaming of Fiji?

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

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

Recruiter’s note: Join online at www.nswnma.asn.au If you refer a member to join online, make sure you ask them to put your name and workplace on the online application form. You will then be entered in to the NSWNMA Member Recruitment scheme draw. PRIZE DRAWN 30 JUNE 2019

Conditions apply. Prize must be redeemed by 30 June 2020 and is subject to room availability. Block- out dates include all Australian and NZ school holidays and Christmas / New Year period. The prize will be drawn on 30 June 2019. If a redraw is required for an unclaimed prize it must be held up to 3 months from the original draw date. NSW Permit no: LTPM/18/02955

Welcome to


Improved communication channels and engagement Seamless access to membership details

Functionality at your fingertips

Unique NSWNMA member login with email

Create your new member login account & you could win a trip to Bali! Log on to online.nswnma.asn.au and create your login to be automatically entered in the draw to win a 5 night holiday to THE TRANS RESORT BALI, SEMINYAK You and a friend will enjoy: • Five nights’ accommodation in a Premier Room • Return airport transfer • Breakfast daily for two • One x Friday night buffet or set dinner for two • One x Sunday Yum Cha for two • One x 30 minute massage for two • 20% off Food & Beverage.

The NSWNMA will arrange and pay for return flights for two to Denpasar, Bali


log on and create your login from 1 Feb 2019 – 31 Jan 2020 and you will automatically be entered in the draw to win.

Prize drawn 1 Feb 2020

Full terms and conditions are available at www.nswnma.asn.au/nswnmamembers/contests-and-promotions Conditions apply. Prize must be redeemed by 31 January 2021 and is subject to room availability. Block out dates: 23 – 29 January 2020 , 21 – 31 May 2020, 1 June – 31 July 2020 and 23 December 2020 – 6 January 2021. Competition opens on 1 February 2019 and closes 31 January 2020. The prize will be drawn on 1 February 2020. If a redraw is required for an unclaimed prize it must be held up to 3 months from the original draw date. NSW Permit no: LTPM/18/02955

Profile for NSW Nurses and Midwives' Association

Lamp February 2019  

In this issue of the Lamp: Northern Beaches Fiasco; Midwives wan Minister over maternity staffing; Aged care gains traction in parliamentary...

Lamp February 2019  

In this issue of the Lamp: Northern Beaches Fiasco; Midwives wan Minister over maternity staffing; Aged care gains traction in parliamentary...