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lamp The

magazine of the NSW Nurses’ Association

Print Post Approved: PP241437/00033

volume 69 no.2 March 2012

TIME TO ACT FOR BETTER PAY


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CONTENTS

The

CONTACTS

lamp

NSW Nurses’ Association For all membership enquiries and assistance, including Lamp subscriptions and change of address, contact our Sydney office. Sydney Office 50 O’Dea Avenue, Waterloo NSW 2017 (all correspondence) T 8595 1234 (metro) 1300 367 962 (non-metro) F 9662 1414 E gensec@nswnurses.asn.au W www.nswnurses.asn.au

Volume 69 No.2 March 2012

Hunter Office 8-14 Telford Street, Newcastle East NSW 2300 NSWNA Communications Manager Janaki Chellam-Rajendra T 8595 1258

COVER STORY

12 | Time to act for better pay A fairer deal for nurses working in for-profit nursing homes is at the heart of the NSWNA’s latest aged care campaign.

5 6 8 9 23 42 43 44 45 46 48 49

Editorial Your letters News in brief What’s On Ask Judith Nurse Uncut Dedication Nursing research online Books Movies of the Month Diary dates Crossword

RATIOS IN NSW

18 | Extra nurse breathes life into Hornsby ED Newly implemented nurse-topatient ratios are enabling Hornsby Ku-ring-gai Hospital emergency department to deliver better patient resuscitation care and student training.

COMPETITION

SUPERANNUATION

6 | Win a set of stylish suitcases

26 | Super holds up

33 | Midwives fight to keep joint services together

Editorial Committee • Brett Holmes, NSWNA General Secretary • Judith Kiejda, NSWNA Assistant General Secretary • Coral Levett, NSWNA President • Roz Norman, Tamworth Base Hospital • Elsie May Henson, Barraba Multi Purpose Service • Peg Hibbert, Hornsby & Ku-Ring-Gai Hospital • Michelle Cashman, Long Jetty Continuing Care • Richard Noort, Justice Health Advertising Patricia Purcell T 8595 2139 or 0416 259 845 or 9662 1414 E ppurcell@nswnurses.asn.au Records and Information Centre – Library To find old articles in The Lamp, or to borrow from the NSWNA nursing and health collection, contact: Jeannette Bromfield, RIC Coordinator T 8595 2175 E gensec@nswnurses.asn.au

The Lamp ISSN: 0047-3936

Despite a battering from the global financial crisis, and its still rumbling aftermath, industry super funds are holding their own compared to the share market and property. MIDWIVES

Produced by Hester Communications T 9568 3148 Press Releases Send your press releases to: T 9662 1414 E gensec@nswnurses.asn.au

Raj Gangadharan and Norma Bukalan REGULARS

FOR ALL LAMP EDITORIAL ENQUIRIES, LETTERS AND DIARY DATES: T 8595 1234 E lamp@nswnurses.asn.au M 50 O’Dea Avenue, Waterloo NSW 2017

AGED CARE

30 | Nepean nurses bring smiles to Bangladesh A group of Nepean nurses and doctors have donated their skills and experience to patients in Bangladesh, one of the most impoverished countries in the world.

General disclaimer The Lamp is the official magazine of the NSWNA. Views expressed in articles are contributors’ own and not necessarily those of the NSWNA. 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 NSWNA takes no responsibility for the advertising appearing herein and it does not necessarily endorse any products advertised. Privacy Privacy statement: The NSWNA 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 NSWNA office. If you are still not satisfied that your privacy is being maintained you can contact the Privacy Commission. Subscriptions for 2012 Free to all Association members. Professional members can subscribe to the magazine at a reduced rate of $50. Individuals $78, Institutions $130, Overseas $140.

THE LAMP MARCH 2012 | 3


Do by p h Fr ot to n’ id og g t f ay r et or 16 aph yo ge t M in ur ar to ch u 20 s 12

2012 IINTERNATIONAL NTERNA ATIONAL NUR NURSES’ SES’ DAY DAY

Nurses & Midwives Photographic Competition P t Pho Photogr Ph

‘Nurses & Midwives at Work’

We know a lot of nurses and midwives are keen photographers, and this coupled with your creativity, passion and sensitivity means that we will be able to celebrate nursing and midwifer y from your unique perspective. The theme of this competition is Nurses and Midwives at Work. We are looking for ward to seeing the wonder ful work of you and/or your colleagues through the creative medium of photography. Photographs can also include your patients and clients taken at, but not limited to, workplaces such as hospitals, aged care, community health, clinics, air ambulance or out on the road. The photographs selected for exhibition will be on display at the Association on Saturday 12 May and the winners announced that evening at the Cocktail Par ty. The prizes are sponsored by First State Super.

FIRST PRIZE $2000 2XR RUNNER UNNER UP PRIZES P RIZES O OF F $500

Pr Proudly oudly sponsor sponsored ed by

Authorised by B. Holmes, H General Secretary, Secretar y, NSWNA

A fur ther $500 will be awarded to the photographer of the most popular photograph selected by delegates at the Association’s 2012 Annual Conference. For more infor mation see www www.nswnurses.asn.au w..nswnurses.asn.au .nsw


EDITORIAL BY BRETT HOLMES GENERAL SECRETARY

It’s time to act for better pay Our campaign to improve pay and conditions in for-profit aged care facilities is now well under away.

Over the past few years our union has committed significant resources to try and improve the lot of aged care nurses.

It is a big challenge and it will require commitment and determination from all our members in this area to achieve good outcomes. There is a lot of leeway to make up. The wage gap between aged care nurses and the public health system has been well documented. Aged care nurses in NSW earn up to $205 a week less than their colleagues in the public health system. There is a shortage of RNs working in aged care and workloads are difficult. AiNs who go to great lengths to improve their skills by obtaining Certificates III and IV are often unrewarded for that effort in their pay packets. Over the past few years the NSWNA has committed significant resources to try and improve the lot of aged care nurses. Our strategy has been two pronged. On the one hand we have lobbied hard to ensure the Federal Government adequately funds the sector. And we have campaigned vigorously at the workplace and continue to campaign to ensure an appropriate amount of that funding is directed towards improving the pay and conditions of aged care nurses. We have commissioned research to underpin our campaigns, run high profile TV ads and allocated considerable organising resources. We have had some success. The Federal Government allocated $130 million for nursing initiatives in aged care in the 2010 budget. 50,000 aged care workers became eligible for incentives to improve their skills. The Federal Government has indicated that there are still major funding initiatives to come in aged care. It has been hard work but incrementally we are making progress. In the not-for-profit sector effective workplace campaigning delivered a template agreement that markedly improved pay and conditions in that area of aged care. Nurses in for-profit aged care now have their opportunity to improve pay and conditions in their facilities. The first model agreement that the NSWNA negotiated with ACAA two years ago expires at the end of June.

A log of claims was compiled, after widespread consultation, and is currently being voted on. The preparations have been meticulous but now comes the hard part. We say it at the beginning of every pay and conditions campaign and it remains true: the quality of the outcome will depend on the participation and commitment of our members in the campaign. It is paramount that for-profit aged care nurses talk to their colleagues and convince them how important it is to be a member of the Association and to get involved in this campaign. We got a good result in the last round of enterprise bargaining but we want to dramatically improve on that solid foundation. It’s time to act for better pay! IMPLEMENTATION OF RATIOS PROGRESSES The implementation of the ratios won in our last public health system campaign continues apace. In The Lamp we have profiled some of these wards where ratios have been implemented and the feedback has been excellent. Nurses in these wards tell us that it has made a big difference to the level and quality of care they can give. The implementation was always going to be done in stages and we will continue to monitor that it is being done as agreed. As The Lamp goes to print the NSW government has flagged a new wave of attacks on public sector workers’ workplace rights. This includes a a new interim report commissioned by the state government that raises a direct and real threat to safe patient care in the NSW public health system. The report recommends that the NSW Public Sector Wages Policy be amended to include a provision that workforce management policies (such as nurse to patient ratios) should not be included in industrial agreements. We will look at this threat in more detail in next month’s Lamp.

THE LAMP MARCH 2012 | 5


LETTERS LETTERS

LETTER OF THE MONTH

Don’t break up the team! I’ve been a midwife at Manly Hospital for more than 10 years and I’m furious about Mrs Skinner [minister for health] and the political “tug of war” with our maternity service! We had a meeting yesterday with our local newspaper, midwives and union representatives. What the reporter is going to write, we don’t know yet. But I’m sure it will not 100% reflect what we said. I wrote the following letter as a response to an article in the Manly Daily on 14 February. It was suggested I send you my letter to be published in The Lamp, as all MP’s get a copy of the magazine. I would appreciate it if you would print my contribution.

Yvonne Halter-Wehrli, RN, RM Yvonne’s Letter to the Manly Daily Dear Manly Daily, I’m writing to you in response to the article “Nurses change their tunes”, published on 14 February, 2012. I’ve been a midwife at Manly Maternity for over 10 years and have so far restrained myself from responding to any articles regarding Manly Maternity in the past. Well not anymore. When the decision was made in 2009 to combine the two maternity units in Manly, no one was happy. Midwives from the Mona Vale site were devastated; there was a big sense of loss, anger and frustration. The midwives at the Manly Maternity Unit; none of the midwives were involved in the process of making that decision. With the combined Maternity Unit came a higher activity in births. This 6 | THE LAMP MARCH 2012

means we are busier, therefore we are using our various skills more frequently and with more confidence, which greatly benefits the women and their families. Learning opportunities for less experienced midwives are increased; it presents a better skill mix of the midwives during a shift which all enables us to provide a SAFE maternity service. The addition of more junior doctors also contributed greatly to the safety and improvement in clinical outcomes for women and their families.

“If Mrs Skinner had taken the time to seek the opinions of the midwifery and medical team who actually work in the combined maternity service, before making an announcement, she wouldn’t be confused today.” It took us, the midwives who work for the Northern Beaches Maternity Services located at Manly Hospital, one-and-a-half to two years to form a strong team, create stability and be happy in our work environment again. Then we read in the Manly Daily that Mrs Skinner was going to re-open Mona Vale Maternity by April this year. Once again, the midwives were not involved in that

decision or had asked if we want to be split up as a team! We – and I know I can speak for the majority of the team – don’t want to be separated again. We provide a great service and most importantly, the women and their families who choose to come to our Maternity Unit are happy! If Mrs Skinner had taken the time to seek the opinions of the midwifery and medical team who actually work in the combined maternity service, before making an announcement, she wouldn’t be confused today. Both Mona Vale and Manly branches of the Nurses’ Association (nurses and midwives) voted to support the retention of Northern Beaches Maternity Service on one site. As to the question of where the service should be located; I say keep it at Manly, use the $1.7 million on upgrading other worthwhile services – surgical beds or aged care services and finally get going with the long promised Frenchs Forest Hospital. At the end of the day, that’s what we all want and deserve on the Northern Beaches!

From EEN to RN I have been working as an EN/EEN in a public hospital for 20plus years. I am currently studying via distance education to complete my RNs. One of the requirements as a student is to have a national criminal record check, which is $52 and is valid for three years. I purchased this. But now my uni’s requirement is to have it renewed every 12 months. Their reasoning was that we could commit a criminal act and it would not be identified for three years. For EENs currently working in the public system I find this more of a revenue raising exercise. Jenny Hedley, EEN

SAY

SOMETHING Send your letters to: Editorial Enquiries email lamp@nswnurses.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.

Confidence in our profession Amanda Mason-Jones, thank you.You made me cry, you made me smile. But most of all, you made me proud. Proud of your wonderful prose, proud of your powers of clinical observation, proud of your ability to reflect critically on your practice, proud of your intellect and proud of your compassion. And very, very proud that you and I belong to the same profession. Mary Chiarella, Professor of Nursing, Sydney Nursing School, University of Sydney

Every letter published receives a $20 Coles Group & Myer gift card.


COMPETITION

Knock down the needless hurdles I am an EN and have been in the nursing workforce continuously for more than 20 years, so the “needless hurdles” discussed in the February Lamp do not apply to me. However, I am appalled at the plight of all of the skilled RNs who have been out of nursing for a few years, attending to families and other duties, being so discriminated against, after all the hard work and financial sacrifices they have been through to become nurses in the first place. This is truly a soul-destroying act. Five or six years is not even that long [to be out of the profession]. I understand a refresher course – but $10,000! Is this how we solve the nursing shortage? How many of these nurses already spent large amounts of money to gain their degree in the first place? I was aware of the fact that we need to do the competencies to keep our registration going. I don’t really remember hearing or reading about the cost for RNs to renew their registration. None of the RNs I work with were aware of it either and they are shocked. We had a huge public campaign going with regard to Work Choices. I really think this is needed again; we need to get the media and public behind us on this one. The media reported that Jillian Skinner said she couldn’t see what the problem was. Well we need to show there is a problem with this “needless hurdle”. Pauline Fallshaw, EN In support of all nurses being discriminated against.

IMPORTANT

NOTICE Displaced Excess Staff If you have been displaced or declared excess in the public health system and are currently enjoying provisions of salary maintenance or priority of employment status provided by PD 2007_085 Managing Displaced Employees then this notice is extremely important. The NSW Ministry of Health is introducing a new policy for managing excess staff which has provisions that will reduce the current entitlements regarding salary maintenance to three months only. It is important you contact the NSWNA Information Department to advise them of your details and an Officer of the NSWNA will then contact you to advise you of the differences applicable to you. The contact with the NSWNA should be made as soon as possible as the implementation of the new policy is intended to commence on 30 April 2012.

LETTER OF THE MONTH The letter judged the best each month will be awarded a $50 Coles Myer voucher courtesy of Moore Equipment. ‘Clever carts to help clever nurses.’ For details on the range of clax carts please call (02) 9519 5540 or visit www.mooreequipment.com.au

Win a set of stylish suitcases

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NEWS IN BRIEF

Australia

Recency of practice petition

We need your help to gather

10,000

signatures

Many nurses and midwives who interrupted their careers to have children and now want to return to work have found they are unable to, due to new Recency of Practice Standards introduced by APHRA. Since publication of our article Needless Hurdles in the November 2011 issue of The Lamp, there has been considerable media interest in the issue. Nurses and midwives have also been articulating their frustration in online forum discussions at Nurse Uncut (www.nurseuncut.com.au) and on Facebook. Now we need your help to gather 10,000 signatures on a petition to have this issue heard in the New South Wales Legislative Assembly. Please help us to gather as many signatures as you can between now and the end of March. Forms need to be returned by March 31 2012 to: Lisa Kremmer, 50 O’Dea Ave, Waterloo NSW 2017 Petition documents and a background information sheet can be downloaded from the NSWNA website (www.nswnurses.asn.au). In order for the petition signatures to be admissible to the Legislative Assembly, certain rules must be followed: • Each page of signatures must be headed with the words of the request (these are printed on the form you will download from the website). • Every signature must be in original handwriting. Signatures must not be pasted on, photocopied or transferred in any other way. • The petition must be signed by those people whose names are listed on it using their own signature, or mark if they are unable to write. • Every person signing a petition must write their address after their signature. Thank-you and good luck gathering as many signatures as you can. Let’s get our nurses and midwives back to work!

United States

United States

Party drug may lift depression

Caffeine and oestrogen

US medical researchers believe the popular, but illegal, party drug ketamine could provide quick relief to severely depressed patients, especially in the early days of a crisis. Researchers at the NueroPsychiatric Centre at Ben Taub hospital in Houston, Texas have been trialing the drug, which has been used for decades as an anaesthetic. Following reports that it could make depression vanish almost instantly, researchers have begun examining the wider use of ketamine. They are hopeful its efficacy will be an advance on traditional antidepressants, like Prozac, which can take weeks or even months to have an impact. Anu Matorin, Ben Taub’s medical director, says some patients could avoid hospital altogether if the drugs were as quick and as effective as painkillers. ‘I think it would transform psychiatric care and eliminate the fear and concern about treatment,’ she said.

8 | THE LAMP MARCH 2012

A study published in the American Journal of Clinical Nutrition has found that Asian women who consumed an average of 200 milligrams or more of caffeine a day (equivalent to about two cups of coffee) had elevated oestrogen levels compared to Asian women who consumed less. But white women who consumed the same amount of caffeine had slightly lower oestrogen levels than white women who consumed less. Black women who consumed 200 or more milligrams of caffeine daily had elevated oestrogen levels, but this finding was not found to be statistically significant, according to the US National Institutes of Health researchers. The caffeine consumed during the study came from either coffee, black tea, green tea or caffeinated soda. About 89% of American women aged 18 to 34 consume the caffeine equivalent of 1.5 to two cups of coffee a day, according to the authors of the study. The researchers say that in the short term, these variations in oestrogen levels among different groups do not appear to have any pronounced effects but further studies are required to measure the long-term impacts.


NEWS IN BRIEF

Important NSWNA Notice

Wollongong office sold The NSW Nurses’ Association office at 63 Market Street Wollongong has been sold. The property, which had been on the market for more than two years, was closed as an NSWNA office in February. The change does not affect the information service and support for Illawarra members and branches. To contact the Association you should continue to phone 1300 367 962 or email us at gensec@nswnurses.asn.au.

Australia

Climate change threatens human survival A leading Australian disease expert says the health impacts of climate change are a threat to the survival of humans. Epidemiologist Tony McMichael, from the Australian National University, has been examining the impact of climate change on population health for 20 years. “We haven’t really grasped the fact that a change in climate presents a quite fundamental threat to the foundations of population health,” he told Australian Associated Press. Professor McMichael conducted a historical study that suggests food shortages, disease and unrest, caused by natural climate change, have destabilised civilisations across thousands of years.

warming also leads to an increase in infectious diseases as a result of better growth conditions for bacteria and the proliferation of mosquitoes. “These things have happened before in response to fairly modest changes to climate … within a band of about plus or minus three-quarters of a degree centigrade. “Yet we are talking about the likelihood this century of going beyond 2°c and quite probably, on current trajectory, reaching a global average increase of three to four degrees.” Professor McMichael’s study states that the greatest recurring health risk over the past thousands of years has been from food shortages, mostly caused by drought. Drought can also result in greater contact with rodents searching for scarce food supplies. Warming also leads to an increase in infectious diseases as a result of better growth conditions for bacteria and the proliferation of mosquitoes. Professor McMichael said it was difficult to raise health implications in the broader climate change debate. “Most of the attention has been of a more limited shorter-term kind, relating to things around us like the economy, our property, infrastructure and risks to iconic ecosystems and species.”

EDUCATION@NSWNA

WHAT’S ON MARCH 2012

Are you meeting your CPD requirements – ½ day 9 March, Ballina 16 March, Penrith 18 May, Wagga Wagga Seminar is suitable for all nurses and midwives to learn about CPD requirements and what’s involved in the process. Members $40 • Non-members $85

——— • ——— Appropriate Workplace Behaviour – 1 day 22 March, Port Macquarie 3 May, Shellharbour Topics covered include understanding why bullying occurs; anti-discrimination law and NSW Health policies; how to behave appropriately in the workplace; identifying behaviour that constitutes unlawful harassment and bullying; what to do if subjected to unlawful harassment and bullying; how to use workplace grievance procedures; identifying, preventing and resolving bullying. Members $85 • Non-members $170

——— • ——— Legal and Professional Issues for Nurses and Midwives – ½ day 30 March, Griffith 20 April, Shellharbour 26 April, Gymea, Sydney Topics covered include the Nurses and Midwives Act 1991, potential liability, importance of documentation, the role of disciplinary tribunals and writing statements. Members $40 • Non-members $85

——— • ——— Computer Essentials for Nurses and Midwives– 1 day 4 April, Prince of Wales Hospital, Randwick 19 April, Prince of Wales Hospital, Randwick Seminar is suitable for all nurses and midwives. Members $85 • Non-members $170

——— • ——— To register or for more information go to www.nswnurses.asn.au/education or phone Carolyn Kulling on 1300 367 962

THE LAMP MARCH 2012 | 9


NEWS IN BRIEF

1428 EMPLOYEES

50 to70

aged

were asked how they felt they had been treated on the basis of their age.

44

%

experienced medium levels of stereotype threat.

Australia

United States

Retiring from despair, not desire

Redefining clinical depression

Stereotypes of older workers – portraying them as frail, inflexible and with a fear of technology – are pushing them towards premature retirement, according to research commissioned by National Seniors Australia. The study, conducted by Queensland University, asked 1428 employees, aged 50 to 75, how they felt they had been treated on the basis of their age. A high number (44%) experienced medium levels of stereotype threat. A minority (14%) experienced high levels of stereotype threat and 42% experienced low stereotype threat. Many of the comments collected in the survey picked up on the frustration of older workers and confirmed that many retire out of despair, not out of desire. “I’m constantly overlooked in favour of younger people, I’m starting to think I’m hopeless and useless,” said one. “My co-workers seem to think that because I’m over 50, I am inept with computers,” said another. “This isn’t true. My job deals constantly with computers and their breakdown.” National Seniors’ chief executive Michael O’Neill says it is vital to incorporate the report findings into official moves to keep the over-50s gainfully employed. “Unfounded assumptions around the energy, potential or job suitability of older workers only serve to undermine their confidence, work performance and, ultimately, commitment,’’ he said. National Seniors is calling for more positive older role models, stronger anti-discrimination policies, increased training opportunities and greater recognition of mature age staff.

World

Early signs of autism in babies

“…direct brain measures may predict the future risk of autism, from as young as six months old.”

10 | THE LAMP MARCH 2012

A new international study, including an Australian component, may pave the way for the earlier diagnosis of autism. A team of researchers, led by Professor Mark Johnson from the University of London, studied 104 babies at six to 10 months and again at three years. They found that those who went on to develop autism had unusual patterns of brain activity in response to eye contact with another person. The findings, published in the journal Current Biology, suggest direct brain measures may predict the future risk of autism, from as young as six months old. “Because there are no good behavioural signs at this young age, we wanted to see whether, by measuring the activity of the brain in a more direct way, we might be able to pick up earlier warning signs,” Professor Johnson said. The researchers used passive sensors, placed on the scalp, to register brain activity as the babies viewed faces that switched from looking at them to looking away. Most of the babies who went on to develop symptoms of autism showed much less difference in brain activity when someone made eye contact with them and then looked away. This compared to babies, who were later found to be typically developing children, who showed a clear difference in brain activity in response to a face looking towards them compared to a face looking away.

Mental health experts in the United States are considering pairing depression and bereavement together in the new diagnostic manual of mental disorders – but the proposal has been given short shrift in Australia.

The American Psychiatric Association is updating its classification system, known as the Diagnostic and Statistical Manual of Mental Disorders, or DSM. It has been proposed that severe symptoms of grief and loss now be considered as a diagnosis of a major depressive disorder. Professor Ian Hickie, of the Brain and Mind Institute at Sydney University, says some people who have experienced a loss may go on to develop something like a depressive illness over time, and may even become actively suicidal and need psychological care. “I think however, at the wider level, people will see it as a nonsense to mix up understandable normal mood states that are best supported by family and support and normal mechanisms, from those that require specific professional intervention,” he told ABC radio. “I think common sense will prevail in Australia no matter what route the Americans choose to go down.”


NEWS IN BRIEF

Australia

ASU wins equal pay for community workers In a historic decision, representing a great union victory, Fair Work Australia has awarded community services workers equal pay. The Australian Services Union (ASU), which represents the rights of community workers, had been campaigning for two years for equal pay for its members. The ruling will see pay rises of between 19 and 41% for workers in the not-for-profit sector during the next eight years. The decision will have an impact on about 150,000 workers, 80% of them women. Following a 4-1 ruling of its full bench, Fair Work Australia said the pay rises would “provide an ongoing remedy for the part gender has played in inhibiting wages growth in the social, community and disability services industry.” The Gillard Government will contribute $2 billion towards the pay rises and has called on state governments to match its funding. ACTU President Ged Kearney says the decision has put an end to decades of undervalue of the work of women in the sector.

“This is a historic decision on the path to pay justice for women,” she said. “This shows the equal remuneration provisions in the Fair Work Act are delivering on the promise of equal pay, which is a workplace and a human right.’’ Australian Nursing Federation’s Federal Secretary Lee Thomas said the wage rise for community sector workers could also pave the way for Australia’s underpaid aged care workforce to achieve pay equity.

“While the ANF welcomes the decision to order pay increases, we are asking the Gillard Government to be consistent and also address the wage disparity experienced by workers in aged care.” The ANF is urging the government to inject $500 million to close the wages gap in aged care – with an extra 20,000 nursing staff required to meet the demand of Australia’s rapidly ageing population.

ST CH AU NTNS W EIA NE RNM AL HEME R E T V US T SC GO A W EN NE RNM VE GO

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COVER STORY

AGED CARE

Aged care talks get underway A fairer outcome for nurses working in for-profit nursing homes is at the heart of the NSWNA’s latest aged care campaign. T H E C A M PA I G N F O R N E W enterprise agreements for nurses working in the for-profit aged care industry begin this month, when the NSW Nurses’ Association opens talks with the Aged Care Association of Australia. This follows workplace meetings across the state where strong support is being shown for the union’s aim to achieve higher pay, greater recognition of qualifications and safer workloads. The union seeks to extend and improve the current enterprise agreements. The minority of employers still paying their nurses under the “safety net” Nurses Award will be asked to sign an enterprise agreement. The union’s claims are based on extensive research and consultation with members, including a detailed survey of more than 1000 nurses. An elected Log of Claims Committee, consisting of six nurses working in a range of for-profit nursing homes, has helped draft the recommended claims. NSWNA General Secretary Brett Holmes said the union had concentrated on visiting as many for-profit aged care workplaces as possible in recent months, to talk to members about the upcoming agreement. Brett says it is vital that as many aged care nurses as possible join the NSWNA and take part in the campaign. “The more members you have in a workplace the better the outcome you can achieve.” The NSWNA campaign seeks greater recognition of the skills, qualifications and experience of aged care nurses. This includes higher pay and allowances, updating 12 | THE LAMP MARCH 2012

classifications to recognise qualifications and experience, and an increase in the in-charge allowance. Workloads and job security are also a focus of the campaign.The union is calling for a fairer, safer way of managing workloads, more access to paid training and more rights for casuals. The claim is also designed to make it easier for nurses to balance life and work. That includes better leave entitlements and the option to choose more flexible working arrangements.


Safety net is full of holes Nurses from at least 33 facilities in NSW are missing out on the benefits of a union-negotiated enterprise agreement. These nurses work under the “safety net” of the national Nurses Award – but the NSWNA believes that safety net is full of holes. Award workers can only get a pay rise through Fair Work Australia’s national minimum wage review. This happens every year but the outcome is uncertain and not always fair. In 2009, the highly paid members of the then Fair Pay Commission refused to grant any increase at all because of the “global financial crisis”.

“Nurses deserve better pay and conditions than the bare minimum offered under the award system.”

WHAT YOU CAN DO

Become a workplace contact and get involved in the campaign

Talk to your colleagues about the campaign and if they aren’t members of the NSWNA ask them to join. The more members you have, the better outcome you can achieve.

Look out for more updates and activities in The Lamp, Twitter, YouTube or the NSWNA website www.nswnurses.asn.au

Buy a campaign t-shirt from NSWNA Merchandise 02 8595 1234

This meant an effective wage cut for all workers not on an enterprise agreement – people who did nothing to cause the debt crisis and were least able to afford to make a sacrifice, were forced to do so “in the national interest”. Award workers also lose out when the Commission awards a flat dollar, rather than a percentage, increase. An increase of, say, $15 or $20 to the weekly minimum wage may represent a 3% or 4% wage rise if you are paid the minimum wage. However, for most award workers, who get more than the minimum wage, the percentage value of such a flat dollar increase would be much less. Assistant General Secretary of the NSWNA Judith Kiejda points out that awards are only designed to support people who don’t benefit from an enterprise agreement. “Nurses deserve better pay and conditions than the bare minimum offered under the award system,” she says.

THE LAMP MARCH 2012 | 13


COVER STORY

AGED CARE

Norma: “We have to give nurses more time to interact with residents.”

Survey finds better pay is top priority Understaffed, can’t take meal breaks and paid less pay than their public sector colleagues, aged care nurses in the for-profit sector want better pay and reduced work assignments. More than one-third of aged care nurses working in the for-profit sector find it impossible to complete their work assignments and say they do not have enough time to give quality care. This was just one finding of a recent survey of more than 1000 aged care nurses working across 180 different for14 | THE LAMP MARCH 2012

profit workplaces, conducted on behalf of the NSWNA. The survey also found that, despite the enormous loyalty nurses in this sector feel toward their residents and the aged care sector, many have thought about moving across to the public health system for the better pay. Forty per cent of participants had considered moving in the past 12 months. The main reason was to get public health system pay rates, although many also cited professional

development and career reasons. This finding suggests that many are approaching the end of their tether, as they have, till now, been generally loyal to their workplace. More than half of the survey respondents (53%) had been at their current workplace for more than five years. A further 11% had been there for between four and five years. 22% had been at their current workplace between two and three years. The study also found that nurses don’t


Focus on pay, workloads Nurses at Columbia Aged Care Services want to build on the benefits delivered by their first enterprise agreement, with a decent pay rise and reduced workloads their priority. NORMA BUKALAN REMEMBERS how pleased she and her fellow nurses at Columbia Aged Care Services were when they won their first enterprise agreement almost two years ago. “It meant we were no longer stuck on minimum award wages,” said Norma, an Assistant in Nursing at Columbia’s Acacia Centre in the Sydney suburb of Marrickville. “Everyone was so pleased we finally had an agreement that delivered us a pay rise followed by a guaranteed increase the next year. Also the casuals got an increase in their shift loadings.” Columbia’s enterprise agreement expires in June and staff – like those at many other for-profit nursing homes – are preparing to campaign for a new agreement with better working conditions. “Our pay is still really low compared to the public sector so a reasonable pay increase should be our top priority,” said Norma, the local NSW Nurses’ Association delegate. “Our next priority is to reduce workloads, which have definitely increased since 2010.” Norma says there are not enough staff members to allow nurses to spend adequate

time with residents or to deal with unpredictable events. “Management only looks at the numbers of residents and doesn’t take into account the time nurses need to respond to residents’ individual conditions and their families’ concerns. “As a result staff have to stay back to finish work and are not being paid for it.” Norma also points to a rise in the number of patients with dementia, meaning staff must more often deal with difficult and challenging behavior. “When residents are uncooperative and aggressive you need time to sit down with them and calm them down. We have to give nurses more time to interact with residents to gain their confidence and reassure them.” Norma said union membership at Columbia more than doubled as a result of the NSWNA campaign two years ago, meaning that nurses enter into this year’s campaign in a potentially stronger position. “This time we need to involve the community and families of residents more. We should try to get our message across through the media as well.”

Top 5 priorities of for-profit aged care nurses

1

A generous pay rise and recognition for qualifications

2

Increased staffing

3

A continuing education allowance

4

An improved skill mix

5

believe they are being adequately rewarded for their level of education.

said the workplace was understaffed most days.

Ninety-seven per cent of survey respondents had a nurse qualification and almost half held qualifications that related to their aged care work. One in four had a Certificate III or IV but only 16% received additional pay for their qualification.

Unpaid overtime was a concern for two thirds of participants with a fifth (20%) saying they were normally unable to take meal and tea breaks. Only 14% of RNs said they took their meal breaks every day. More than a third had done two hours or more of unpaid overtime in the previous week. Half worked in workplaces that did not pay overtime.

NOT ENOUGH NURSES Understaffing and its consequences are a big issue for nurses in this sector. Twenty-four per cent of for-profit aged care nurses said their workplace was understaffed every day. Another 24%

Respondents showed a high level of awareness of the ‘Because We Care’ campaign and a majority believed it had helped raise the profile of those working in aged care.

Improved penalty rates or compensation for unsocial hours

Only 14% of RNs surveyed take their meal breaks every day. THE LAMP MARCH 2012 | 15


COVER STORY

AGED CARE

Nurses should grab new chance for better agreement Aged care nurses stuck on basic award conditions have an opportunity to go for an enterprise agreement with guaranteed pay rises. REGISTERED NURSE RAJ Gangadharan sees the NSWNA’s current aged care campaign as a new opportunity to get higher wages and better conditions under an enterprise agreement. Raj works at Sir Thomas Mitchell Aged Care Facility, a 125-bed nursing home in the southern Sydney suburb of Illawong. It is one of 30 for-profit employers in NSW that still employ staff under the national Nurses Award 2010. This award is a basic “safety net” that pays less than an enterprise agreement. About 50 for-profit employers have replaced the award with a model enterprise agreement negotiated by the NSWNA, which guarantees annual wage rises and pays other, above-award, benefits. “Under the Nurses Award 2010 there are no guaranteed pay rises,” Raj told The Lamp. “With an enterprise agreement we know we will get a pay rise every year and exactly how much that increase will be. “Also, we lost some conditions when the national nurses’ award replaced the old state-based aged care award. “If we move to an enterprise agreement we can get these conditions back.” Under the award, the public holiday penalty rate transitions from 250% to 200% over five years (currently it is 230%). In the model enterprise agreement it remains at 250%. The enterprise agreement also allows nurses to choose a reduced penalty rate with more annual leave – for example, to be paid a 150% penalty rate with extra annual leave. Enterprise agreements provide an additional public holiday – the August bank holiday – and other allowances not in the award, such as the on-call allowance.

16 | THE LAMP MARCH 2012

Raj:“It is important that all of us, RNs and AiNs, join together in this campaign.”

Raj says aged care nurses should support the union campaign to narrow the gap between private sector and public sector pay. “All the nurses here know that public sector pay is much higher and there is a risk of staff leaving the aged care sector for public hospital jobs. “It is important that all of us, RNs and AiNs, join together in this campaign so we can move towards equal pay for equal jobs.” Raj also wants the NSWNA to do

more to explain the aims of the campaign and encourage nurses to support it. “We need more frequent visits from union representatives and more information about what the union is doing,” he said. “This will help more people to get involved in the union. “RNs need to take the lead in their workplace to explain things to workers with a lower level of education and recent migrants, who sometimes do not understand the industry and the profession.”


Lucille passes the baton After six years of sterling service as president of the Quality Aged Care Action Group (QACAG), Lucille McKenna is optimistic about the future for this “small but vibrant” group.

Lucille McKenna

Lucille: “There is still work to be done to move the government but the politicians are aware of the issues.”

AFTER MORE THAN 40 YEARS working in aged care, with the past six as president of QACAG (the Quality Aged Care Action Group), Lucille McKenna is an authoritative voice in the sector. Now preparing to retire from the presidential role, Lucille says the sector has a much higher profile than it did when QACAG was formed. “QACAG has been useful in spreading an understanding about all aspects of aged care, not just nursing and wages but also the perspective of family members and how they feel,” Lucille told The Lamp. “We’ve made some impact. QACAG has been a serial contributor to all inquiries into aged care. The Productivity Commission definitely knows who we are. QACAG gave us the opportunity to contribute to inquiries and government select committees. It is a vehicle to give people a voice about aged care.” Lucille says that while there is still work to be done to move the Federal Government to support aged care, the group’s achievements should not be underestimated. She said QACAG’s work had been complementary to the Australian Nursing Federation’s (ANF) Because We Care campaign.

“The campaign has been reasonably successful from an awareness point of view. There is still work to be done to move the government but the politicians are aware of the issues.” She said the goal had always been to bring aged care out of the shadows and into the light. “We wanted to form an organisation that was to engage members of the public on aged care issues. That was the catalyst for starting QACAG.” Lucille says she is impressed by the energy and savvy of QACAG’s committed membership. “It’s an important organisation. There are a few nurses who are still working who are involved but there are also retired aged care nurses and members of the public whose lives come into contact with aged care through their parents or partners. It’s a vibrant group even though it is relatively small,” she says. Of the challenges that remain for QACAG Lucille says: “Skills mix is still an issue.Wages parity is still an issue.There still aren’t enough people to do the job in aged care. Standards are not as good as they should be. But I’m always optimistic.”

Tony Windsor asked to support aged care funding Prominent Federal Independent MP Tony Windsor will be the focus of activities in the Because We Care campaign in March. The ANF has identified one key Federal MP in each state who will be urged to support funding in the 2012 federal budget of $494 million to close the wages gap between nurses in aged care and the public health systems. Tony Windsor has been broadly supportive of the campaign’s aims. Aged care members in the New England electorate will be conducting street stalls and letterbox drops, talking to local media and collecting signatures on a petition. These actions will culminate in an ‘Aged Care Can’t Wait’ public meeting in Tamworth on 7 March. Tamworth aged care nurse Jan Howard will be speaking at the meeting about the day-to-day reality of working in aged care. “We will not only be looking to get the support of Tony Windsor but also the support of the local community including health workers, community groups and organisations, and local businesses,” she said. To become involved or find out more contact Stella Topaz, Professional Officer NSWNA on 02 8595 1234 or stopaz@nswnurses.asn.au

THE LAMP MARCH 2012 | 17


RATIOS IN NSW

HORNSBY HOSPITAL

Extra nurse breathes There was a hard fight to win them but now newly Hornsby Ku-ring-gai Hospital emergency department to de

THE EMERGENCY DEPARTMENT (ED) at Hornsby Ku-ring-gai Hospital on Sydney’s upper North Shore treats more than 30,000 patients a year, many arriving acutely ill and needing resuscitation. With 52 permanent nursing staff in the ED, equivalent to 40 full time nurses, the nurse-to-patient ratio has enabled new rosters to swing into action for the fast-paced needs of a busy emergency department, with more staffing for peak patient arrivals. “The nursing staff are very happy with the enhancement; it provides an improved career pathway in acute nursing. It also recognises the demanding and complex 18 | THE LAMP MARCH 2012

Jessica Silverstone and Rosetta Stipo


life into Hornsby ED implemented nurse-to-patient ratios are enabling liver better patient resuscitation care and student training.

Jess:“The ratios have improved the quality of care I can give my patients” Jessica Silverstone, Rosalyn Ferguson and Bridget Jelfs

Rosalyn: “Ratios are the biggest enhancement I’ve seen in 20 years of emergency nursing.”

work a resuscitation nurse does in the co-ordination (of patient care and treatment),” said Hornsby ED’s Nursing Unit Manager (NUM), Rosalyn Ferguson. Rosalyn was one of several NUMs that helped the NSWNA explain the operational needs of emergency departments to NSW Health, during our ratios campaign. These NUMs represented country hospitals, city teaching hospitals and major metropolitan hospitals, such as Hornsby. “It’s very difficult to work ratios out in a clinical area like an emergency department,” Rosalyn said. But the result, she

added, “is the biggest enhancement I’ve seen in 20 years of emergency nursing.” The gains include one-on-one nursing time for patients in the resuscitation room, which is critical, as these patients require intensive nursing care immediately on arrival. “As soon as we had the funds allocated by the NSW Ministry of Health, the Director of Nursing discussed how to implement the ratios,” Rosalyn said. “At Hornsby we have very good recruitment and retention. People like to work here. “We need a dedicated resuscitation nurse for facilities like Hornsby, one every …continued page 21 THE LAMP MARCH 2012 | 19


RATIOS IN NSW

HORNSBY HOSPTIAL

Tony: “I especially like the extra team member during the very busy evening duties.”

Gosia Nizik, Anthony Baker, Rosalyn Ferguson 20 | THE LAMP MARCH 2012


Jessica Silverstone and Bridget Jelfs

Bridget: “The extra nurse is such a relief as we now have more time to care for our patients. …from page 19

shift.The history [at Hornsby] was that the resuscitation nurse was also required to help with the rest of the patient workload,” Rosalyn said. “It’s exciting that NSW Health adopted this proposal for a dedicated resuscitation nurse. We looked at our patient acuity, analysed the data for the main time frames resuscitation patients presented, and then rostered the first dedicated resuscitation nurse according to patient activity and workload. Staff members were very happy to see this change, and look forward to the next step in the implementation.” The emergency department team,

includes a Clinical Nurse Educator, two full time equivalent clinical NUMs, a Nurse Practitioner, six Clinical Nurse Specialists, Registered Nurses, Endorsed Enrolled Nurses and an undergraduate Assistant in Nursing. “This enhancement has given us the scope to take a transitional Registered Nurse (new graduate) for 2012. We also have a second year Registered Nurse critical care program.The Hornsby emergency department has a dedicated senior group of Registered Nurses who are looking forward to training resuscitation nurses for the succession planning for our district.” THE LAMP MARCH 2012 | 21


GO DIRECT DEBIT AND WIN

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Q&A

ASK JUDITH On call on day off I work in a public hospital and everyone in the unit is required to do their share of on call. However, when I am placed on call after my last shift, before proceeding rostered days off, I only get paid the regular on-call allowance, not the on-call-onrostered-day-off allowance. I think I should be entitled to a higher allowance. Yes, you should be paid the higher rate. The Public Health System Nurses’ & Midwives’ (State) Award sets out the two on-call allowances at clause 12 (ii) (a) for the lower allowance of $3.17 per hour with a minimum of $25.34 and at (b) for the higher allowance of $6.34 per hour with a minimum of $50.68. Two questions immediately arise: what happens when on call from end-of-shift to start-of-day-off, and what happens on the day rostered back-to-work, but before start-of-first-shift? In the first instance, the on-call on-day-off allowance is paid and this is why, in the example you describe, you should be paid the higher rate. In the second instance, the lower rate is paid from midnight to the commencement of first shift back. This is set out in Department of Health Information Bulletin 2004/17, “Public Hospital Nurses’ (State) Award — On Call and Call Back” issued 18 May 2004.

Family and community service leave I am an RN working in a public hospital. I have accrued some annual leave. I would like to take some single annual leave days for family reasons, but my NUM refused to approve it, saying that annual leave has to be taken by weeks and not days. Is this correct? While the award does provide for the taking of single days, this is by agreement between the employer and the employee and can be dependant on service provision and the requirements of the employer. The Public Health System Nurses’ and Midwives’ (State) Award 2011 states in clause 30 “Annual Leave”: (vi) Annual leave shall be given and taken either in one consecutive period or two periods, or if the employer and employee so agree, in either two, three, or four separate periods but not otherwise. Provided that up to five single days per year may be taken at times convenient to both the employer and the employee. What this means is, you are entitled to take your annual leave in two lots. However, if you do want to break it up into more than two lots, this can only occur where the employer agrees. Rather than using your annual leave you should consider applying for Family and Community Service (FACS) leave days. FACS leave is an award provision under clause 32 and covers a variety of family and carer responsibilities that employees may have from time to time.

When it comes to your rights and entitlements at work, NSWNA Assistant General Secretary JUDITH KIEJDA has the answers.

Long service in private practice

Nursing during meal break

I have worked full time in a permanent position in a private practice for 20 years. I have never taken long service leave. Do I have an entitlement and if so how much? You need to check your local Enterprise Agreement or Union Collective Agreement for the Long Service Leave (LSL) entitlement. If the agreement draws the entitlement directly from the NSW Long Service Leave Act 1955, the provisions of the Act apply. The Long Service Leave Act provides at section 4 (2) (a) (i) an entitlement of two months for 10 years’ service and one month for each five years thereafter. So, for 20 years’ service the entitlement is four months LSL. Service means “service of a worker with an employer”. This is defined at 4 (11) (a) as “continuous service, whether on a permanent, casual, part-time or any other basis, under one or more contracts of employment”. That is, the service must be continuous with the one employer.

I am an EN working in a nursing home. I recently returned to work following maternity leave and like to go home in my meal break to nurse my baby. My DoN is saying that I must stay within the facility, even on my meal breaks, which are unpaid. Is this correct? You should be able to go wherever you like in your meal break if it is unpaid. If there is any requirement for you to stay in the facility during unpaid meal breaks, you are entitled to be compensated by way of an oncall-during-meal-break allowance. This does not remove your entitlement to a meal break, it just means that you cannot leave the facility while taking your break. If your DoN insists on you staying in the facility, you should receive this allowance.

NSWNA protection while working away I have decided to undertake a six-week assignment in a remote Aboriginal settlement in the Northern Territory. Will I be fully covered by my Association membership while I am away? Any member going to work in another state must notify the Association prior to starting the new assignment, regardless of the duration. Whether you are going on a short, medium or long term work assignment, you must contact the Association to keep cross-border protection in place.

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DIRECT DEBIT

Sonya says, make the Concord Hospital’s NSWNA branch is encouraging members to make the switch from paying their union fees by payroll deduction to direct debit. NOTICING THAT THERE WERE 228 members at Concord Hospital still paying their union fees through payroll deduction, NSWNA Concord Branch Secretary Sonya Jones began a campaign to get them to make the switch. As a Nursing Manager and RN at Concord Hospital for more than 35 years, Sonya understands the need for nurses to convert to paying their union fees by direct debit. In Victoria, automatic payroll deductions were banned, practically overnight, when the Kennett Government prohibited public service departments from making automatic payments of union dues. This left thousands of union members vulnerable to becoming non-financial members, in the process losing the protection of their membership. To ensure NSWNA members at Concord Hospital stay protected, Sonya and other branch officials decided to directly approach each nurse that was still paying their fees by payroll deduction. The team distributed information packs explaining the need for NSWNA members to change to direct debit or cash payment options, and highlighting the difference between payroll deductions and direct debit. CNC and RN Anne McDade, who also took part in the campaign, said she found that there was confusion among some nurses, who thought they already were having their union fees collected through direct debit. “A lot of nurses think they’re already doing it because it’s coming out of a payroll deduction,” Anne said. “They also thought that it would be difficult to switch. “That’s why in our campaign the forms were all laid out and an individual letter went out, addressed to the member by name, complete with return envelopes. A direct debit form and a letter with instructions for the HR department were also provided. “We put everything in the package and all they had to do was put in their bank details and fill everything out, then put it in the envelopes and send it off,” Sonya told The Lamp. “We put a box in the staffing office, which most people pass in and out of going 24 | THE LAMP MARCH 2012

If you would like to run a direct debit campaign like the nurses at Concord Hospital, we can help. Simply call your Branch Organiser at the Association on (02) 8595-1234.

From left to right: Sally Woodburne, RN; Mary Palme, RN and Peta MacFarlane, Public Relations/Marketing at Concord Hospital


switch!

Sonya:“Payroll deductions could be taken away without warning, as happened inVictoria which was absolutely disastrous.” NSWNA Concord Branch Secretary Sonya Jones

to work, so they just had to drop it in there. Basically it was all about bringing it to their attention individually and making it as easy as possible,” Sonya said. Through her campaign experience at Concord Hospital, Sonya learnt that having a contact person in each ward was the best way to approach nurses to help them to make the change to direct debit. “All you have to do is stop a nurse for five minutes and say, ‘fill this out and we’ll do the rest’. All they have to do is supply their bank details and the rest is so simple,” Sonya said. “It’s not that nurses don’t want to do this. They just need to have the paperwork right there in front of them.” Although Sonya and Anne know how

hard it is for nurses to find the time to change their NSWNA payment options – between work and family nurses don’t have a lot of spare time – they urge all nurses to consider switching from the old payroll deduction system to direct debit payments. “The union is only as strong as its collective membership,” Anne says. “We can’t have a strong Association if you don’t have the numbers. That’s the only way our Association stays strong and through that, the membership is protected. “Payroll deductions could be taken away without warning, as happened in Victoria which was absolutely disastrous. We can’t think that it won’t happen here in NSW, so I really do think it’s a campaign that we should continue.” THE LAMP MARCH 2012 | 25


SUPERANNUATION

Super holds up Despite a battering from the global financial crisis, and its still rumbling aftermath, industry super funds are holding their own compared to the share market and property. FIRST STATE SUPER HEALTH Division, take a bow! Last year the super fund for health workers ranked second of all balanced super funds with a 1.7% positive return. Over three years it averaged 8% making it the most successful super fund in Australia. While 1.7% growth might not seem like much, it was a very good performance compared to the average –1.9% of the top 20 super funds (according to Super Ratings). It was a stellar performance compared to the share market, which experienced a 15% drop (as measured by the S&P/ASX index). And it compares very favourably to the housing market: house prices Australia-wide fell by 4.8% during 2011, according to the Australian Bureau of Statistics. HESTA was also one of the top 10 performing super funds for 2011, with its core pool fund registering a 0.1% decline. Last year was the first year of negative performance by super funds since the annus horribilis of 2008 when the global financial crisis broke. 26 | THE LAMP MARCH 2012

WHAT DO LABOR’S SUPER CHANGES MEAN FOR ME? The increase in the superannuation guarantee and the super tax cuts will mean a $500 billion boost to workers’ retirement funds by 2035: • An 18-year-old worker on average wages will be $205,000 better off. • A 30-year-old worker will be $108,000 better off. • A 40-year-old worker will be $56,000 better off. • Women on lower incomes will be particularly better off, with the changes boosting the superannuation of 2.1 million women earning less than $37,000 by $550 million in 2012-13 alone. • A 30-year-old woman on average wages will have an extra $108,000.


Super gives Pauline a secure retirement For recently retired nurse, Pauline Roebuck, superannuation is all about security. She considers it an extremely important outcome from her working life and told The Lamp that it had prepared her for her retirement.

Pauline Roebuck

Pauline: “If there’s an aspiration to increase the levy I think they should be doing it.”

“Without super I couldn’t afford to live. It’s allowed me to maintain a lifestyle that I was used to and I could not have done that without super.” With superannuation Pauline is still able to travel and has enough saved away to live comfortably. “Super has contributed to the re-building of a new home and it has given me enough backup to plan regular holidays every year and big trips. I can still have an annual holiday and also go on large trips every two to three years,” Pauline said. Even after Pauline took time off to have children, her State Super fund was in good shape when she returned to work. “When I got back into the workforce, which was when I was just 40, super was

The Gillard Government has flagged the introduction of significant changes to further bolster workers’ retirement incomes in these volatile economic times, with the biggest beneficiaries to be low-paid workers and women. MOVES TO INCREASE SUPER Superannuation for all has been a feature of Australian life following campaigns fought by unions and their members more than two decades ago. The greatest triumph of these campaigns was the establishment of industry super funds — low cost, not-for-profit superannuation funds dedicated to the interests of members. These funds are now the envy of the world. The Gillard Government has changes in the pipeline that will take superannuation to the next level. Among those changes are: • Increasing the compulsory superannuation guarantee from 9% to 12% over six years, from 1 July 2013 to 1 July 2019.

there for me,” Pauline explained. ”Once you commence paying into it, it is there for the perpetuity of your working life until you retire. If you’re going to leave work and have children then there’s still a maintained investment portfolio to keep the growth going.” Pauline believes the Federal Government’s plan to increase superannuation payments from 9% to 12% is a good step forward. “We’re lucky that we had compulsory contributions from the employer and it’s got to be built on. If there’s an aspiration to increase the levy I think they should be doing it. “I think it’s well overdue and should’ve been done before. As far as I’m concerned it should’ve happened 30 years ago.”

WHAT YOU CAN DO Send a message to all members of the House of Representatives asking them to pass the laws needed to boost the super of all Australian workers. Go to www.standupforsuper.com.au and sign the petition

• Cutting taxes on super contributions for low-income workers. • Banning commissions on financial advice and forcing improvements to the management of super, so that workers, especially those in commercial super funds, pay less fees. • More flexible superannuation contribution rules for people aged over 50 and removing the age limit on guaranteed contributions, to deliver older workers more income. General Secretary Brett Holmes says the NSWNA and other unions are supporting these changes. “We support these changes because they will deliver greater financial security for our members,” he said. “There are also broader benefits for the country as they address the problems we have with an ageing population – something many of our members have first hand experience of – and they will support the national economy with investment in national infrastructure and jobs.”

OBSTACLES TO IMPLEMENTATION These changes to superannuation are still only proposals by the Gillard Government and are yet to be passed by parliament. A major obstacle to their implementation is the position of Tony Abbott and the Liberal-National coalition. The cost of the superannuation increase is being met by the new mining tax. So, the increase in super will depend on parliament passing the mining tax package, something Abbott and the Coalition are vehemently opposed to. This is consistent with previous Coalition policy on super. Under John Howard’s government there was no increase in the superannuation guarantee after 1992. The ACTU is calling on the Independents and the Greens to join with the Labor government to support the changes in the parliament. The ACTU has an online petition that can be found at www.standupfor super.com.au (see above).

THE LAMP MARCH 2012 | 27


NHS

BRITAIN

NHS fight back A broad alliance of practitioners, including nurses and midwives, and the British public are standing up and saying No! to the Cameron Government’s attack on their National Health System.

IT IS A REVOLT WITH INCREASING momentum that has been compared to the poll tax backlash that brought Margaret Thatcher down in 1990. David Cameron’s conservative government has spent months trying to crash a radical bill, which would effectively privatise large swathes of the British National Health System (NHS), through the British Parliament. Even before the legislation has been passed, radical surgery on the NHS is being conducted. A private company, Circle Health, has been contracted to take over the Hinchingbrooke Public Hospital in Cambridgeshire, and the government has been in talks with international health corporations about taking over 20 more. The Royal College of Nursing (RCN) warns that the NHS is heading for crisis point with 56,058 positions due to be cut. In England, the pace of job cuts has risen 28 | THE LAMP MARCH 2012

by more than 50%, with 48,029 NHS posts set to be, or already lost, since the RCN began tracking losses in April 2010. Less than a year ago, the figure was 30,873. An RCN analysis revealed that clinical posts make up almost half of the total workforce cuts, with nursing posts accounting for more than a third of those earmarked to be cut. The new bill not only allows privatisation, it drives it. The government has said it will raise the cap on the proportion of income British hospitals can make from private work from 2% to 49%.While existing law allows private involvement in the public system, the government’s bill will insist upon it. BROAD COALITION ARISES The broadest possible coalition has come together to oppose the bill. Health unions, the Royal College of Nurses, the Royal

College of Midwives, the British Medical Association and the Chartered Society of Physiotherapists, have all called for the bill to be scrapped. Ninety-eight per cent of the Royal College of General Practitioners support a call for the bill to be abandoned. Its chair, Clare Gerada, called the government’s plan “unsafe for patients”. In a letter to The Lancet medical journal, 150 members of the Royal College of Paediatrics and Child Health said “… if passed, we believe that the bill will have an extremely damaging effect on the healthcare of children and their families, and their access to high quality, effective services. In our view, no adequate justification for the bill has been made.” Even at managerial levels there are major concerns about the bill. The Institute of Healthcare Management, representing NHS managers, published the results of a survey


“The government’s plans are fatally flawed. They must listen to hard-working NHS staff and we will fight to protect this national treasure and one of the most cost effective systems in the developed world.” UNISON Head of Health, Christina McAnea (UNISON is the major union in the health service representing more than 450,000 healthcare staff).

“Cutting staff numbers by up to a quarter and axing a third of nursing posts will undoubtedly have a deep and potentially dangerous impact on patient care.” Dr Peter Carter, chief executive, Royal College of Nursing

“Breaking up what we have, embracing the private sector, and injecting full-blown competition and market forces is not what the NHS needs or what health professionals and patients want. We join the growing chorus of voices calling for the bill to be withdrawn, and the proposed reforms stopped in their entirety.” Cathy Warwick, chief executive, Royal College of Midwives

showing that 87% of members say the bill is ‘fundamentally flawed’ and leaked internal NHS reports warning that the reforms run a high risk of reducing levels of safety and patient care. Public opposition to the government’s plan is also escalating. An e-petition against the bill collected more than 100,00 signatures in four days. Among those who signed the petition were celebrity chef Jamie Oliver, England footballer Rio Ferdinand and TV star and author Stephen Fry. PRODUCTIVITY: THE SAME TIRED ARGUMENT The government’s health secretary Andrew Lansley has underpinned the argument for change with claims that the productivity of the NHS has fallen by 15%. However an analysis by Nick Black, professor of health services research at the London School of Hygiene and Tropical Medicine,

published in The Lancet, contradicted this. While Lansley argued that productivity in NHS hospitals had dropped by 1.4% a year despite the budget swelling from £60bn in 2000 to £102bn in 2010, Black said productivity had “almost certainly” risen in the past decade, with taxpayers getting more value out of the NHS. “Despite such confident statements, rather than declining, the productivity of the NHS has probably improved over the past decade,” Black wrote. “To justify the reforms to the NHS that the Conservative party wanted to introduce, the claim of declining NHS productivity was necessary.” Black listed substantive improvements in the effectiveness of the NHS: A baby born in 2009 could expect to live three years longer than one born in 2000. Far fewer people were dying in specialist procedures. Declines occurred in adult

critical care (2.4% a year), dialysis (3.3% a year), and coronary artery bypass surgery (4.9% a year). There were annual relative increases in the proportion of patients treated within four hours in accident and emergency departments (2.5% a year) and in the numbers operated on within 28 days of their operation having been cancelled for non-clinical reasons (10.4% a year). These improvements saw a corresponding leap in the popularity of the NHS. In the annual British Social Attitudes survey, 70% of respondents reported they were overall satisfied with the NHS. This was the highest figure ever recorded – the lowest was 34% in 1997, at the end of the Conservatives’ previous period in office.

THE LAMP MARCH 2012 | 29


NEPEAN NURSES OVERSEAS

Nepean nurses bring smiles to Bangladesh Since 2007, a group of Nepean nurses and doctors have donated their skills and experience to patients in Bangladesh, one of the most impoverished countries in the world.

THE DEDICATION OF SOME nurses knows no bounds. In November last year, a team of six theatre nurses and four doctors from Nepean Hospital in Sydney took annual leave to perform cleft palate, cleft lip, and post-burns surgery on patients in Bangladesh. They paid their own airfares and accommodation, having raised the money to cover patient costs. All of their clinical services were provided free. The venture was a product of the Aussi Bangla Smile Project, created in 2007 by senior theatre nurse Barbara Mitchell and Bangladesh-born doctor Hasan Sarwar, along with senior teammates Judy Barlow and Angela Brady. The Nepean Rotary Club now supports the project. Barbara Mitchell told The Lamp it was the group’s fourth trip to Bangladesh, one of the most impoverished countries in the world. “We successfully completed 115 surgeries bringing our tally to a total of 421 “smiles on faces” since 2007,’ she said. EXPERIENCE OVERCOMES TOUGH CONDITIONS Barbara’s colleague, Judy Barlow, the 2010 team leader, says that while the experience can be grueling it is also immensely rewarding. “Conditions are tough and there are many hours of travelling to the remote health facilities and, once there, we work from 8am till 11pm some nights. We are so motivated by these beautiful, brave little children and adults. The surgeries give dramatic improvements, enabling them to fit into society, to learn, communicate and even swallow their food normally,” she said.“Intra-operatively, patients receive oxygen, N2O, halothane and fentanyl, are hand-ventilated and monitored with just a pulse oximeter and our trained eyes. 30 | THE LAMP MARCH 2012

Sandy Burrow, Clinical Nurse Specialist “We were greatly rewarded by the sweet faces of the brave Bangladeshi children, the gratitude of their parents and carers and the generosity, support and friendship of the local hospital staff.” Pia Buckingham, Scrub and Scout Nurse “I have difficulty in measuring the amount of self-fulfillment and pride that I feel. It was incredible that we could change a person’s life forever, and for the better, in the space of a couple of hours. I feel humbled by my experience in Bangladesh. It was an experience that I will never forget.” Annie Vincent RN “This experience was a privilege, and one I will never forget. It gave me great pleasure and pride that I contributed so little and made a life long change to all the cases. After I came back it gave me a totally different outlook on life.” Dr Hasan Sarwar, Team Surgeon “This could be a role model for another group to start some international charity work on a small scale with their expertise. All it needs is some dedicated members, honesty, sincerity and commitment and hard work to take up the challenge.”

“Each surgery on average takes one and three quarter hours and we run two and sometimes three operating tables in one big room. “We have no issues with sterility as we are all senior staff with years of experience. Each case is treated as though we are in separate rooms, maintaining hygiene and infection control constantly. This is good for any little airway challenges that may arise on induction and emergence.” THE WHOLE NINE YARDS Members of the group not only give up their annual leave to go to Bangladesh, they also give up their spare time to raise the funds needed to finance the project. “We have two major fundraising events a year. We host a Trivia Night in St Mary’s, which brings in more than 450 people and raised more than $15,000 last year. We also hosted a benefit concert in the Blue Mountains, which raised just over $3,800. Johnson and Johnson have donated sutures and Koala have donated anaesthetic consumables,” said Judy. With companies donating supplies, each $200 raised is used to fund a surgical procedure. Judy’s most recent trip was her third and the second for Pia Buckingham and Sandy Burrow. Linda Mee, Kim Merceica and Annie Vincent were fellow team members. “Some of us had never travelled to the Far East, but we coped incredibly well together, forming a bond in sharing a wonderful lifetime experience,” Judy said.


All donations to the Aussi Bangla Smile Project are tax deductible. For more information visit www.aussibangla.org.au

Annie Vincent with patient Marium, after the operation. Inset: Marium pre-operation. THE LAMP MARCH 2012 | 31


PALLIATIVE CARE

Regrets – I’ve had a few An Australian palliative nurse, who found that the words of wisdom from her dying patients had great inspiration for the living, has released a book, The Top Five Regrets of the Dying.

BRONNIE WARE, WHO IS ALSO A singer songwriter, first recorded the wisdom of her dying patients in a blog called ‘Inspiration and Chai’ (www.inspirationandchai.com). Among the top regrets, from men in particular, was the wish that they hadn’t worked so hard. Here are the top five regrets of the dying, as recounted by Bronnie Ware: 1. I wish I’d had the courage to live a life true to myself, not the life others expected of me. This was the most common regret of all. When people realise that their life is almost over, and look back clearly on it, it is easy to see how many dreams have gone unfulfilled. Most people had not honoured even a half of their dreams and had to die knowing that it was due to choices they had made, or not made. Health brings a freedom very few realise, until they no longer have it. 2. I wish I hadn’t worked so hard. This came from every male patient that I nursed. They missed their children’s youth and their partner’s companionship. Women also spoke of this regret, but as most were from an older generation, many of the female patients had not been breadwinners. All of the men I nursed deeply regretted spending so much of their lives on the treadmill of a work existence.

Bronnie Ware

“All of the men I nursed deeply regretted spending so much of their lives on the treadmill of a work existence.”

32 | THE LAMP MARCH 2012

3. I wish I’d had the courage to express my feelings. Many people suppressed their feelings in order to keep peace with others. As a result, they settled for a mediocre existence and never became who they were truly capable of becoming. Many developed illnesses relating to the bitterness and resentment they carried as a result. 4. I wish I’d stayed in touch with my friends. Often they would not truly realise the full benefits of old friends until their dying weeks and it was not always possible to track them down. Many had become so caught up in their own lives that they had let golden friendships slip. There were many deep regrets about not giving friendships the time and effort that they deserved. Everyone misses their friends when they are dying. 5. I wish I’d let myself be happier. This was a surprisingly common one. Many did not realise, until the end, that happiness was a choice. They had stayed stuck in old patterns and habits. The so-called “comfort” of familiarity overflowed into their emotions, as well as their physical lives. Fear of change had them pretending to others, and to their selves, that they were content, when deep within, they longed to laugh properly and have silliness in their life again.


Midwives and mothers are in support of maintaining a single-site Northern Beaches maternity service, formed three years ago when Mona Vale midwives were relocated to Manly Hospital while asbestos was removed from their hospital.

MANLY AND MONAVALE MIDWIVES are locked in a battle with the NSW Health Minister Jillian Skinner over plans to split the joint maternity services that have been operating in the Northern Beaches for the last three years. Three years ago Mona Vale midwives were relocated to Manly Hospital while asbestos was removed from their hospital. A year later they wanted to return but were denied. They then set about creating a viable and first-rate maternity service for the women of the Northern Beaches. Now the Minister is pushing to divide, once again, the maternity services between the two hospitals. Midwife Unit Manager Deirdre Breen says midwives have looked at the evidence and are advocating for the option that delivers a superior model of care and improved clinical outcomes. “Midwives believe there is more support, more staff and a better 24 hour medical cover with the single site service,” she said. Deirdre says the combined service has tangible benefits for the women who use it. “The statistics say they are more likely to have a normal birth. We have been able to introduce a midwifery group practice model of care for women since the amalgamation of the services. This option of care cannot be expanded if the service is split. The staff are more confident and happier. There are more medical staff on site to consult with which is important particularly in an emergency situation. We receive many cards and letters of thanks from the women who use the service. There has been no increase in babies born on route to hospital”.

Midwives fight to keep joint services together The evidence is in — women are benefitting from a single-site Northern Beaches maternity service — and local midwives want to retain this safer, more supportive environment. “Historically there was a sense of rivalry between the staff of two maternity units but they’ve grown together in the last three years. Midwives don’t mind where the service is as long as it is together.They are concerned that the service will be diluted if the service is split.”

IT AIN’T BROKE, DON’T FIX IT The current single site service at Manly has 20 beds, over 1300 deliveries per year and bed occupancy of 53 per cent. The amalgamation of Manly and Mona Vale provided more midwives on each shift and 24-hour on-site obstetric registrar coverage. The caesarean section rate dropped to 23 per cent, which is now below the State average. In the year before the move 698 women delivered at the 16-bed Mona Vale unit, with 32 per cent of the deliveries being caesarean sections. The unit only averaged 49 per cent bed occupancy. Under the State government’s proposal some shifts will only have one midwife rostered in the birthing unit at Mona Vale. Full on-site, around-the-clock obstetric registrar coverage will be lost at both sites. Instead the registrar will be on call between 10.00pm and 8.00am. NSWNA Assistant General Secretary Judith Kiejda says maintenance of a single-site service is a better use of scarce health funds and the government should listen to those midwives on the ground. “Since the amalgamation outreach services and clinics have been expanded. Satellite antenatal clinics have been established at Mona Vale, French’s Forrest, Narrabeen and Harbord,” she said. “It is a great credit to this midwifery team that they have looked closely at the evidence and been prepared to change their view on the issue. Now the midwives want the State Government to take notice of the evidence and change its policy.’’ THE LAMP MARCH 2012 | 33

© Newspix / News Ltd / Braden Fastier

MIDWIVES


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FILM FESTIVAL

Nurses focus on 2013 film festival NURSES ARE ALREADY GEARING up for the 2013 International Nurses’ Day Film Festival by taking part in a series of filmmaking workshops offered through NIDA (National Institute of Dramatic Art) and the NSWNA. Beginner and advanced workshops were held last month, for budding filmmakers looking to further their skills in the art of visual story telling.The workshops were so popular that more are being planned for later this year. The second, two-day course, scheduled for 8 March, sold out within weeks of its announcement. In the workshops nurses learn about the entire film production process, from screen writing through to camera angles, lighting, camera operation and all the elements required to create a visual story. Nurse educator at Concord Repatriation Hospital, Distan Bach, teamed up with his mental health colleagues at the NIDA workshops and is hoping to make a submission to the film festival next year. “The course the Association ran for us was fantastic,” Distan said. “I was really impressed and that was the sentiment from all of us at the end of a couple of days. We were all keen to get out and do something.” As president of the mental health branch of the NSW Nurses’ Association, Distan plans to use the skills he learned in the NIDA workshops to create e-Learning materials for the mental health unit at Concord hospital. Distan has already started working on videos that can be used as supplementary material by mental health nurses who are still in training. “Part of our 12-month transition program has an online component,” Distan explained. “We could put videos online so that they appear on the website and stream across from Vimeo or YouTube.” With a Masters degree in e-Learning, Distan also hopes to create a video library for nurses who are new to the mental health department. 40 | THE LAMP MARCH 2012

Nurse educator at Concord Repatriation Hospital, Distan Bach

“I’ve been wanting to build up a collection of videos that might help people to understand the psychotic experience,” Distan said. “It’s very important that nurses identify quickly and understand what the experience to be psychotic is like.” Distan believes there is also potential to create videos for friends and families of patients who may need more detailed information or other forms of support. “I certainly see the opportunity to do things that would be directed towards them,” he said. Distan told The Lamp he joined the NIDA workshops not only to advance his video skills, but also to find new ways to construct a compelling narrative while learning new interviewing techniques. He said his main priority was to apply the interviewing, escalation, engagement and

Distan:“The course the Association ran for us was fantastic.” questioning techniques that he learned to create videos of about 10 minutes in length. “I shot a video with some colleagues here last week, just some interview pieces,” Distan said. “The bigger library of media you have, the more opportunity you have to assemble something or re-film something for different audiences.”


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NURSE UNCUT

What’s HOT on Nurse Uncut? The negative stereotypes affecting older workers, nurses migrating to Australia, one nurse’s story of medical outreach in Northern Thailand and how aged care nurses, doing the same work for less pay, are starting to walk away. Read all the latest happenings at www.nurseuncut.com.au.

Hot topics Nurse Uncut iPad winner loves her prize Florey Ang completed her Bachelor of Nursing in the Philippines, graduated in 1995, and has been nursing ever since. She worked in the Middle East for three years before coming to Australia in 2004 and completing her conversion course at the College of Nursing. She is currently working at Blacktown Hospital-Acute Medical 2. Florey read about Nurse Uncut in The Lamp and started browsing the site. She thought there was no harm in entering the contest, though she didn’t expect to win when she saw there were already around 140 entries. “My colleagues and friends were asking how I won it so I have since encouraged them all to visit Nurse Uncut and join in!” www.nurseuncut.com.au/nurse-uncut-christmas-contest-winner-thrilled Older workers, technology, and stereotyping Perceived long-held stereotypes, such as frailty, inflexibility and a fear of technology, are pushing older workers towards premature retirement, research shows. According to the National Seniors Australia report, Stereotype Threat and Mature Age Workers, older employees who experience “stereotype threat” – a belief that they’re the target of demeaning stereotypes – lose enthusiasm for the job to the point of quitting. We are asking some mature nurses if they have experienced this – check out what Paul Hanrahan had to say at Nurse Uncut. Are you interested in talking to us? If so email admin@nurseuncut.com.au www.nurseuncut.com.au/older-workers-technology-and-stereotyping-part-1 Nurses migrating to Australia In conjunction with Public Service International, the NSWNA is carrying out research as part of a global project on the international migration of health and social care workers. The NSWNA would like to improve the experience of nurses who migrate and we are gathering evidence from health and social care workers about their experience of migration. Check out the survey at Nurse Uncut. www.nurseuncut.com.au/migrating-nurses-we-want-your-thoughts/

42 | THE LAMP MARCH 2012

A story of medical outreach in Northern Thailand In our two-part blog series, Bronwen Griffiths, a Clinical Nurse Specialist tells us about her recent trip with the MOSAIC programme (Medical Outreach and Social Aid in Communities) to Northern Thailand. She tells us about the programme and her experiences in the village of Ban Khunsuay. Read the series at Nurse Uncut. www.nurseuncut.com.au/a-nurses-story-of-medical-outreach-in-northern-thailand-part-1-of-2/ www.nurseuncut.com.au/a-nurses-story-of-medical-outreach-in-northern-thailand-part-2-of-2/ Same work for less pay may see nurses walk away Aged care nurse Terri Burrell, who is in charge of 59 patients, is paid $12,000 less per year than a nurse with a similar job in a public hospital. While hospitals and child care centres have staff-patient ratios, Ms Burrell said Australian nursing homes did not. This meant that a night shift at her facility saw two nurses and two assistants overseeing 59 residents. This is the reality for Australia’s aged care nurses, who work just as hard and have just as much responsibility but are paid much less than their hospital counterparts. The situation is putting pressure on an already stretched aged care system. Read the full story at Nurse Uncut. www.nurseuncut.com.au/same-work-for-less-pay-may-see-nurses-walk-away/

What nurses are talking about? On the ‘I Support Nurses’ Facebook page: What do you think about the Nursing and Midwifery Board’s response? Do you think the re-entry competency course is justified? www.facebook.com/NurseUncutAustralia “Re-entry competency is insulting. Hospital trained nurses do not ‘forget’ how to nurse. They need a pharmacology and technology update. Half the nurses in hospital are on temporary work visas and Australian nurses who want short shifts to be able to keep skills can’t get work!” “It’s a damn joke. APHRA have recently taken away my career. It should be illegal!”


DEDICATION

Patricia Danks 20 July 1934 — 8 August 2008 [e\

many nurses attended a service in the chapel of saint luke the physician at sydney hospital, last year, marking the considerable career of nurse patricia danks, matron of sydney hospital for nearly 15 years. susan lang of the nsw ministry of health spoke at the service, during which a plaque, dedicated to matron danks, was unveiled. this is an edited version of her speech.

Contemporary health care policies and protocols urge health care professionals to place the patient at the centre of all we do – but this concept is not new to people who have worked for a time at Sydney Hospital. For Sydney Hospital people, the patient has always been central and Pat was renowned and highly respected for her unwavering advocacy for the welfare of the patient by ensuring the delivery of safe, high standards of nursing and clinical care.

Patricia Danks was the consummate teacher, teaching by example and working with her students and alongside her staff, never teaching at them. I was fortunate to be one of Sister Danks’ student nurses and I now know just how much I learned from this firm, intuitive, sometimes tough, often black and white, but always fair, generous and encouraging woman.

Improving management systems was another area that benefited from Pat’s knowledge and skill. In the 1970s and 1980s, under Pat’s drive and stewardship, the need for ward and unit managers to have financial responsibility if they were to effectively manage and control their patient care area, was eventually recognised.

Pat undertook her General Nurse Training at Sydney Hospital from 1952 to 1958, followed by midwifery, and first returned to Sydney Hospital in 1964, becoming Charge Sister of Ward 5 in 1966. In 1970 she gained the Diploma of Nursing Administration through the Royal College of Nursing Australia. Her career encompassed a diversity of roles such as planning and implementation of the Newcastle Regional Nurse Training Council in 1974 (a role that depended upon Pat’s ability to coordinate input from the Directors of Nursing from 11 hospitals); Director of Nursing at Liverpool Hospital in 1975 and then, in June 1977, returning to Sydney Hospital to take up the position of Director of Nursing – a position she held until her retirement in 1991. There were a number of areas that were of particular, strategic importance to Pat during her time at Sydney Hospital: nursing education, improving management systems to support the delivery of outstanding patient care services, and championing the growing professional and industrial standing of nurses and midwives. Her dedication to continuing nurse education was well known and under her leadership the role and functions of the Clinical Nursing Services Department were extended and expanded. Many hospitaltrained nurses were actively encouraged to pursue academic qualifications – myself included.

While some might think the pendulum has swung too far in this respect, I don’t think Pat would agree. Pat believed that a good nurse could (and should) do just about anything and she encouraged and supported her nurses to do just that. Although Pat’s ideas were visionary, and light years ahead of her time, she did not seek high profile or prominence. Instead, she taught the value of solid, well-reasoned argument, of researching your subject, of being sure of your facts, of persistence and consistency and knowing your audience: valuable lessons then and no less valuable now. To many, Pat was a friend, a teacher beyond par, and a life-long mentor. She shared her knowledge with good humour and a dry, wicked wit. She created opportunities for us, while ensuring we knew the importance of continuing our education and keeping the lines of communication always open. Pat and her achievements remain an inspiration for the many Sydney Hospital graduates who work in many fields of health – her teaching and collaborative guidance provided a sound professional framework that still supports and influences what we do and how we do it today. Destiny smiled on those of us whose good fortune it was to have been a student nurse, staff member, friend or colleague of Pat Danks. — Susan Lang

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THE LAMP MARCH 2012 | 43


NURSING RESEARCH ONLINE

The case of dismissed Arizona RN Amanda Trujillo explores some interesting tensions for nurses seeking to fulfil professional responsibilities to patients, while balancing the demands of the workplace. While the case raises interesting professional and ethical issues for Australian nurses, what is also of interest is the way nurse bloggers in the US raised the profile of the case, bringing it to the wider attention of the public and the media.

This blog post purports to be an email from Amanda Trujillo, describing the events that led to her dismissal. http://vdutton.posterous.com/94287821 “Back in April of this year I was caring for a dying patient whom I had discovered had no clue about what they were about to participate in when they agreed to get a major invasive surgery.When I properly educated the patient using the materials allowed by my employer they became upset that the physician never explained details of the surgery or what had to be done after the surgery (complex lifetime daily self care). The patient also had no idea that they had a choice about whether they had to get the surgery or not or that there were other options. They asked about hospice and comfort care and I educated the patient within my nursing license and the nursing code of ethics. The patient requested a case management consult to visit with hospice to explore this option further in order to make a better decision for their course of care. I documented extensively for the doctor to read the next day and I also passed the info on to the next nurse taking over, emphasizing the importance of speaking with the doctor about the gross misunderstanding they had about the surgery.The doctor became enraged, threw a well-witnessed tantrum in the nursing station, refused to let the patient visit with hospice, and insisted I be fired and my license taken. He was successful on all counts.”

The case of Amanda Trujillo — American Journal of Nursing Shawn Kennedy, AJN editor-in-chief

http://ajnoffthecharts.com/2012/02/02/the-case-of-amanda-trujillo/ Amanda Trujillo, MSN, RN, is a nurse who until recently worked at Banner Del Webb Hospital in Sun City, Arizona, until she was fired for, as she claims, just doing what she’s obligated to do as a nurse—specifically, providing informed consent to a patient about a surgical procedure.

44 | THE LAMP MARCH 2012

Ms Trujillo says that, when the patient had a change of heart about the surgery, she requested a hospice consult. After a physician complained that Trujillo had overstepped her scope of practice, the hospital filed a complaint with the Arizona Board of Nursing, which has launched an investigation.

Those emergency blues http://torontoemerg.wordpress.com/2012/02/07/why-nurses-are-furious-about-the-amanda-trujillo-case/ We are also angry that Trujillo apparently was penalised for acting as her patient’s advocate and for attempting to ensure her patient could act with autonomy.This has serious implications for all nurses, because hobbling any nurse’s ability to act as advocate seriously jeopardises patient care and safety. But first, the word “advocate” has been bandied about so much I want to inject a little clarity as to what exactly nurseas-advocate means in the context of end-of-life care. This is what my own regulatory body, the College of Nurses of Ontario, says: “Nurses advocate for their clients and help implement their treatment and end-of-life care wishes. However, a client’s request to receive a treatment does not automatically bring with it the obligation for the nurse to provide the treatment. A nurse is not obligated to implement a client’s treatment wish if it has been determined that the treatment will not benefit the client and is therefore not a part of the plan of care.” I think this is fairly standard nursing practice anywhere, and how all of us understand advocacy, whatever the stage of life. It is needful to point out the College phrases its language as nurses “must” not “may”. In other words, advocacy is not an optional part of nursing practice. And what about patient autonomy? One of the four pillars of health care ethics, patient autonomy is the right of all patients to make informed decisions about their care and treatment, and necessarily implies [that] outcomes matter most importantly for the patient, not the health care team. Nurse advocacy, it hardly needs to be said, is an important part of ensuring a patient can act in an informed autonomous way.


BOOKS

BOOK ME Nurse/Carer and Patient Language Helper, with Midwife Supplement

SPECIAL INTEREST

Hand Picked Diaries RRP $35.00 ISBN 9780980522280

Nurse/Carer and Patient Language Helper has been specifically written to assist nurses and carers to communicate with patients who do not speak English, while attending to them at their bedside. The most common migrant languages have been chosen and the book includes translations in paired sentences, so that the carer and patient can point to the related phrase in order to understand each other. Simple and easy to use, this text would be a valuable asset to any health care professional. Gerontological Nursing (7th ed.) Charlotte Eliopoulos, Lippincott, Williams and Wilkins RRP $94.60 ISBN 9780781753449

www.lww.com This 7th edition of Gerontological Nursing is a comprehensive textbook that details how to care for older adults in a manner that will provide them with the quality of life that they need and want. It is simple and easy to use and focuses on the integration of holistic concepts and practices, and places an emphasis on the emotional and spiritual aspects of aging and gerontological care.

Emergency and Trauma Care for Nurses and Paramedics Kate Curtis, Clair Ramsden and Bill Lord, Elsevier Australia RRP $149.95 ISBN 9780729539821

www.elsevierhealth.com.au This book is intended to provide a practical and evidence-based resource for pre-hospital care providers, rural and urban emergency and trauma nurses, students, or those with an interest in these specialisations. Cross-references are made throughout the 54 chapters to further information within other areas of the book. More than 500 figures and 275 tables further support the “hands on” clinical approach of the book.

Compact Clinical Guide to Acute Pain Management: An Evidence-Based Approach for Nurses

Treating Complex Trauma in Adolescents and Young Adults

Yvonne D’Arcy, Springer Publishing Company RRP $45.00 ISBN 9780826105493

John N. Briere and Cheryl B. Lanktree, Sage Publications (available through Footprint Books) RRP $58.95 ISBN 9781412981446

www.springerpub.com This guide covers the topics of acute pain assessment, both pharmacologic and non-pharmacologic treatment options, current information from national guidelines, along with regional anaesthesia techniques, patient-controlled analgesia, and epidural pain management. This is an essential reference for primary care providers in clinics, hospitals, specialty care, and critical care, to assess pain in general populations and provide tips for performing pain assessment on patients with acute pain.

www.footprint.com.au This book claims to be the first practical and research-based manual to guide students and practitioners to evaluate and treat adolescents and young adults who have experienced repeated, extended, and/or severe traumatisation. The book covers the following areas: problems and symptoms, assessment, treatment overview, relationship building, psycho-education, training and regulation, interventions with adolescents and their families, and group therapy.

Australia’s Controversial Matron: Gwen Burbidge and Nursing Reform Judith Godden, The College of Nursing RRP $30.00 ISBN 9781921375491

www.nursing.edu.au/Home This is a compelling account of Gwen Burbidge, (1904-2000), one of the first Australian nurses to write a nursing textbook and a controversial nursing reformer. She improved nurses’ working, living and educational conditions and helped introduce visiting hours for infectious patients. She played a major role in implementing Manpower for nurses during World War II and ensuring that Nurses’ Aides were recognised and received training. Her professional life reflected the major struggles of nurses to receive appropriate education and to regulate their various roles. This fascinating biography of her life shows Gwen Burbidge as an exemplary leader, whose challenges are all too familiar to those who nurse today. The book can be regarded as an outstanding contribution to Australian nursing history.

All books can be ordered through the publisher or your local bookshop. NSWNA members can borrow the books featured here, and many more, from our records and information centre (RIC). Contact Jeannette Broomfield gensec@nswnurses.asn.au or Cathy Matias 8595 2121 cmatias@nswnurses.asn.au. Reviews by NSWNA RIC Coordinator Jeannette Broomfield. Some books are reviewed using information supplied and have not been independently reviewed. THE LAMP MARCH 2012 | 45


MOVIES

MOVIES OF THE MONTH

Only at the movies March 1ST CINÉ FILES

Like Crazy was inspired by the real life experience of director Drake Doremus and his now ex-wife, Austrian-born Desiree Pappenscheller, who was sent back to Europe when her student visa expired.

MEMBERS GIVEAWAY The Lamp has 15 double passes to give away to A Dangerous Method thanks to Paramount Pictures. The first 15 members to email their name, membership number, address and telephone number to lamp@nswnurses.asn.au will win. 46 | THE LAMP MARCH 2012

While this film spoke directly to her heart, CHRIS BENELLIE LADERA believes it has an honesty and unique voice that will speak to all romantics. Like Crazy tells the story of a young couple who embark on a seemingly impossible long-distance relationship. The film introduces us to a young British student living in California, Anna, who falls in love with Jacob, a furniture design student. Jacob is equally smitten by the intriguing and confident Anna. The story of how they come to be together is uncomplicated and in every sense romantic. They meet, they fall in love, and they part. The parting, of what seems to be a perfect match, is heartbreaking. We are then taken across the globe through a whirlwind of rendezvous, from romantic to disastrous. As they continue on with their separate lives, the complexities of being apart become apparent in the relationship. The film shows the constraints of time, the obsessive nature of young love and the awkwardness of stopping and restarting the relationship each time the pair separate and then reunite. The film stars promising newcomers Anton Yelchin and Felicity Jones, who are relatable and captivating as Jacob and Anna. The director, Drake Doremus, shot the film using an inexpensive and commercial

MEMBERS GIVEAWAY

LIKE CRAZY

The Lamp has 15 in-season double passes to give away to Like Crazy, thanks to Paramount Pictures.

The first 15 members to email their name, membership number, address and telephone number to lamp@nswnurses.asn.au will win. Canon 7D DSLR and the result is a film both intimate and dynamic. Like Crazy is a story that has been told before. It’s a story that we’ve heard many times. Films tend to do that. It could be the story of your life, and for this film, it was mine. And that’s what I loved about it. The premise is simple; love with all its ups and downs is, simply crazy. If you have loved, lost and found love again, then there is something in this movie that you will ultimately connect with. There is honesty in how the story is told. The film has a unique voice that is both smart and genuine. It is beautifully made and poignant. The narrative uniquely leaves it up to the audience to connect the puzzle pieces that the film presents. Chris Benellie Ladera, is an RN at Saint Vincent’s Hospital, Darlinghurst

Keira Knightly (Pirates of the Caribbean, Bend it Like Beckham) plays a young woman who captures the professional and romantic attention of both Dr Carl Jung (Michael Fassbender) and his mentor Sigmund Freud (Viggo Mortensen). Directed by David Cronenberg (Naked Lunch, Crash) the film is a look at how the intense relationship between Jung and Freud gave birth to psychoanalysis, and of Sabina Spielrein (Knightly) one of the first female psychoanalysts and a pioneer in the field of child psychology.

Only at the movies March 29TH www.ADANGEROUSMETHOD.com.au Facebook.com/ADANGEROUSMETHODAU © 2012 Lago Film GmbH Talking Cure Productions Limited RPC Danger Ltd Elbe Film GmbH. All Rights Reserved.


HEADHUNTERS Hold on to the edge of your seat for a ride through this dark and twisted plot, writes ANNI CAMERON. This film is based on the bestselling novel of the same name by the Norwegian author, Jo Nesbo. It is an action thriller with a dark, twisted plot peppered with comedic moments reminiscent of something the Coen brothers would employ.

“One of the breathtakingly bizarre scenes will remain imprinted on your brain for a long time to come.�

Only at the movies March 8TH CINÉ FILES Former stockbroker, pop star and now best selling crime writer (and children’s author) Jo Nesbø, has established The Harry Hole Foundation to provide reading and writing classes for children in the developing world.

IPS RSHIP SCHOLA ES IVES DWIV AND MIID S ES SE RS NUR FO FOR NU

  

         



 

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freecall 1800 117 262 freecall scholarships@rcna.org.au scholarships@rcna.org.au w ww.rcna.org.au www.rcna.org.au

ealth SScholarship cholarship and and Support Support Scheme Scheme N Nursing ursing and and Allied Allied H Health ((NAHSSS) NAHSSS) iiss ffunded unded b he A ustralian G overnment. byy tthe Australian Government. R CNA, Australia’s Australia’s p eak p rofessional nursing nursing organisation, organisation, RCNA, peak professional iiss p roud tto op artner tthe he A ustralian G overnment aass tthe he proud partner Australian Government fund administrator administrator ffor or tthis his program. program. fund

The central character, Roger Brown, played by Aksel Hennie, is not particularly likeable. A successful and wealthy executive headhunter, he lives in an expensive house complete with all the designer accessories and a beautiful wife with whom he is totally besotted. He seems to have it all yet director Morten Tyldym has skilfully underlined Roger’s various insecurities. Roger isn’t particularly good looking and is shorter than his wife, Diana, and you can sense him doubting the strength of her love for him, which in turn pressures him to anxiously try to anticipate and indulge her every whim. Spending more and more on indulging Diana, his credit card juggling has become so extreme that it necessitates an urgent stream of income. This leads him to burgle the home of a hopeful executive he has lined up for a prestigious position and who, during a preliminary interview, discloses the location of a family heirloom, a priceless Rubens painting. Roger bungles the burglary, setting in motion a series of events from which escape appears increasingly dubious. Nonetheless, Nesbo has managed to generate a certain amount of sympathy for Roger and the extreme situations in which he finds himself. The twists and turns of this complex plot are both clever and unthinkable, keeping you on the edge of your seat and in confusion as to who is fooling who and who will come out on top. One of the breathtakingly bizarre scenes will remain imprinted on your brain for a long time to come. Well worth a look. Anni Cameron, RN, BHA, MEd, is a Teacher of Nursing at St George TAFE, Sydney Institute, NSW

MEMBERS GIVEAWAY The Lamp has 10 in-season double passes to give away to Headhunters, thanks to Madman Entertainment. The first 10 members to email

their name, membership number, address and telephone number to lamp@nswnurses.asn.au will win. THE LAMP MARCH 2012 | 47


DIARY DATES

CONFERENCES, SEMINARS, MEETINGS SYDNEY, HUNTER & ILLAWARRA Tenterfield Hospital Fete 4 March 2012 Karen Holley 02 6739 5223 or Bradholleycontracting@hotmail.com

NSW Operating Theatre Association 2012 Annual Conference Perioperative Nurses Out in Front 8-10 March 2012 Grand Pavilion, Rosehill Gardens Racecourse Registrations closed 9799 9835 or info@nsw-ota.asn.au

Australian Wound Management Association 2012 Conference 18-21 March 2012 Sydney Convention and Exhibition Centre awma2012@arinex.com.au 9265 0700 www.awma2012.com

Mental Health Problems in Non-Psychiatric Care Settings: Part two 22 March 2012 Shalom Centre 157-163 Balaclava Rd, Marsfield Nurses Christian Fellowship 9888 5842 or ncfansw.org

2nd Whole Person Care National Symposium

The Australian Pain Society 32nd ASM Integrated Perspective of Pain 1-4 April 2012 Melbourne Convention and Exhibition Ctr www.dcconferences.com.au/aps2012

14th National Nurse Education Conference 2012 11-13 April 2012 Pan Pacific Hotel, Perth WA nnec@iceaustralia.com www.iceaustralia.com/nnec2012

Australia and New Zealand Urological Nurses Society & USANZ Annual Scientific Meeting 21-24 April 2012 Darwin Convention Centre, Darwin urological_nurses@hotmail.com 9990 4148 www.anzuns.org

Union of Risk Management for Preventative Medicine Seminar for Risk and Emergency Management for HealthCare 2012 2-4 May 2012 University of London, London, UK www.eventsforce.net/urmpm

International Conference on Integrative Medicine

21-22 March 2012, Sydney 9368 1200 or wholepersoncare@iceaustralia.com www.iceaustralia.com/wholeperson12

13-15 May 2012, Jerusalem +41 22 5330 948 Skype +41 22 5330 948 rlevy@paragon-conventions.com www.mediconvention.com

Nurse Practitioner Professional Development Day

STTI European Conference 2012

Hand in Hand Enhancing Health Care 17-18 May 2012 Coffs Harbour Showgrounds Sue Trotter 6562 2688 suetrotter@eastwest.net.au

Diversity Across Europe: Implications for Nursing 12-14 July 2012 Cardiff, Wales, UK www.sttiec2012.net

The Children’s Hospital at Westmead

STTI 23rd International Nursing Research Congress

Spring with the Kids — Paediatric Perioperative Seminar 15 September 2012, The Sebel Parramatta Claudia Watson 9845 2112 claudiw2@chw.edu.au

Australasian College for Infection Prevention and Control (ACPIC)* National Conference 2012 8-11 October 2012 Sydney Exhibition and Conference Centre 8204 0770 conferenceinfo@ashm.org.au *formally Australian Infection Control Association (AICA)

REGIONAL INTERSTATE & OVERSEAS Discharge Planning Masterclass 23 March 2012, Manchester bookings@mkupdate.co.uk 017687 73030 Book online to receive a 10% discount www.mkupdate.co.uk

Assisting with Medical Procedures for HCA’s 17 May 2012, London 13 June 2012, Manchester 26 November 2012, London bookings@mkupdate.co.uk 017687 73030 Book online to receive a 10% discount www.mkupdate.co.uk

48 | THE LAMP MARCH 2012

Creating a Legacy through Nursing Research Innovation and Global Collaboration 30 July-3 August 2012 Brisbane Convention and Exhibition Centre, Brisbane www.nursingsociety.org

13th International Mental Health Conference Positive Change: Investing in Mental Health 6-8 August 2012 Call for Abstracts Outrigger Inn (formerly Holiday Inn) Gold Coast, Qld www.anzmh.asn.au/conference

9th Tri-National Psychiatric Nursing Conference (German Language) Health promotion and health competency 4-5 October 2012, Vienna Call for abstracts (German only) until 30 March 2012 info@oudconsultancy.nl

10th International Conference for Emergency Nurses New Frontiers in Emergency Nursing 10-13 October 2012 Hotel Grand Chancellor, Hobart TAS info@cdesign.com.au www.cdesign.com.au/cena2012

REUNIONS

Basic Foot Care for AiNs — 1 day

PAM Hospital Tenterfield 150–year celebration

Target group: AiNs 25 May 2012, Port Macquarie

3 March 2012, 6pm Tenterfield Golf Club Karen Holley 02 6739 5223 Bradholleycontracting@hotmail.com

Basic Foot Care for RNs & ENs — 2 days

Manly Girls High School 1967–1972 reunion

Computer Essentials for Nurses and Midwives — 1 day

3 March 2012 Lyn 07 3869 1936 or 0409 691 936 Jill 9938 1220 or 0413 709 424 mghs67to72@gmail.com

Target group: all nurses and midwives 4 April 2012 18 April 2012 9 May 2012

RPAH PTS January 69 Reunion Lunch

Leadership Skills for the Aged Care Team — 4 days

Target group: RNs and ENs 9-10 May 2012, Lismore

24 March 2012, Sydney Venue: TBA Jan O’Dea (Parsons) 0402 800 046 janodea@hotmail.com Jenny Smith (Sinclair-Harris) 0427 016 822, jennifer.smith@det.nsw.edu.au

Sutherland Hospital 1973 reunion March 2012 Marianne Beuzeville marianne@upsidedowninsideout.com.au

RPAH April 1979 graduates’ reunion 28 April 2012, 5.30 pm Helm Bar, Darling Harbour Jane Howland 6580 1119 page 0050 jane.howland@ncahs.health.nsw.gov.au

2012 NSWNA Education Calendar

Target group: all aged care nurses 21 March 2012 23 April 2012 30 May 2012

Legal and Professional Issues for Nurses and Midwives — ½ day Target group: RNs, RMs and ENs 30 March 2012, Griffith 20 April 2012, Shellharbour 26 April 2012, Gymea 11 May 2012, Tweed Heads 31 May 2012, Penrith

Practical, Positive Actions in Managing Conflict and Disagreement — 1 day Target group: all nurses and midwives 18 April 2012, NSWNA offices, Waterloo

Check venues with Lyn Stevens 02 8595 1234 or 1300 367 962

Aged Care Seminar Series – 1 day

Practical, Positive Leadership — 3 days

Target group: RNs, ENs, AINs 20 April 2012, Penrith 24 May 2012, Bathurst

Target group: All N/MUMs, CNS, CNC, Educators 4 April 2012, NSWNA offices, Waterloo 16 May 2012, NSWNA offices, Waterloo

Appropriate Workplace Behaviour — 1 day

Practical, Positive Ways in Managing Stress and Burnout — 1 day

Target group: all nurses and midwives 22 March 2012, Port Macquarie 3 May 2012, Shellharbour

Target group: all nurses and midwives 14 March 2012, Penrith

Are you meeting your CPD requirements? — ½ day Target group: all nurses and midwives 9 March 2012, Ballina 16 March 2012, Penrith 18 May 2012, Wagga Wagga 25 May 2012, Armidale

EDUCATION DATES For more information on NSWNA Education Courses contact Carolyn Kulling (02) 8595 1234 • Free call 1300 367 962 • www.nswnurses.asn.au/topics/2761.html



RCNA NURSING & HEALTH EXPOS HELD ON SUNDAYS FROM 10AM–3PM NSW – 25 March 2012 Sydney Convention & Exhibition Centre QLD – 15 April 2012 Brisbane Convention & Exhibition Centre WA – 29 April 2012 Perth Convention & Exhibition Centre

RCNA

ACT – 6 May 2012 tre National Convention Cen SA – 3 June 2012 tre Adelaide Convention Cen VIC – 8 July 2012 g Royal Exhibition Buildin 2 201 July TAS – 15 Hotel Grand Chancellor

www.rcna.org.au


CROSSWORD

TEST YOUR KNOWLEDGE

Across 1. Third molar tooth (6.5) 9. Colour of skin affected by jaundice (6) 10. Lack of equality between opposing forces (9) 11. The chest area (6) 12. Any outgrowth from a surface (11) 14. Nursing classification (1.1) 16. Prefix meaning scar (3) 17. Arcus senilis (10) 19. Pregnancy (9) 21. Inflammation of the ear (6) 22. Treatment of infectious disease by the injection of antitoxin (11) 25. One thousandth of a second (abrev. 4) 28. Contusion (6) 29. Primary coccidioidomycosis (6.5) 31. Any broken-down material (8) 32. An inhabitant (6)

Down 1. Inflammation of the lung following exposure to corrosive toxins (5.4) 2. Oily, fatty (9) 3. A thin split-thickness graft, usually in small pieces (6.5) 4. Stimulating physical, mental, or emotional vigor (5) 5. A single thing (3) 6. Surgical incision of the uterus (11) 7. An element existing in two or more physical forms (11) 8. The amount so administered (6) 13. Not penetrating the body or disturbing the tissue (3,8) 15. An individual whose saliva does not contain antigens of the ABO blood group (11) 18. To elevate (5) 20. Lacking teeth (8) 23. Relating to the eye (6) 24. Indistinct; vague (4) 26. Relating to the vertebral column (6) 27. Operating room (abrev. 1.1) 28. Forehead (4) 30. Seasonal viral infection (3) THE LAMP MARCH 2012 | 49


Nursing career opportunities exist now with Ageing Disability and Home Care (ADHC) to provide services to people with an intellectual disability. Large residences and specialist supported living facilities exist across the state of New South Wales. These facilities provide supported accommodation and specialist services to people who have an intellectual disability. Ageing Disability and Home Care have vacancies in Newcastle, Central Coast, Western Sydney and Western New South Wales. Expand your nursing knowledge and take up an exciting nursing opportunity in disability nursing.

Our large residential and specialist supported living facilities have full time, part time and casual positions available now for: • Registered Nurses (Salary package up to $78685) • Medically Endorsed Enrolled Nurses (Salary package up to $56525)

Successful applicants can expect to be provided a paid comprehensive work place induction. Learning and development staff provide ongoing education and support to large residence and specialist supported living staff. Vacancies and other details can be confirmed by contacting the nurse managers below: NEWCASTLE/HUNTER Helen Winning 02 492 80844 CENTRAL COAST Bill Learmouth 02 439 43702 WESTERN SYDNEY Sing Ting 02 9842 2314

• Enrolled Nurses (Salary package up to $53780)

ORANGE Michael Herbertson 02 636 27153

• Assistance in Nursing (Salary package up to $44128)

SUMMER HILL Yvonne Turiano 02 9798 1100

Interested in finding out more about Careers in Nursing with Ageing, Disability and Home Care (ADHC) visit www.adhc.nsw. gov.au/careers/discover_career_paths/career_in_nursing

Crossword solution

I S E M B A X C E L O U E S D S E R N T V A L T D E T

W H I T E L U N G

50 | THE LAMP MARCH 2012

D O L A L I R E R G R T A F O T C U L E A R I

M T O O T N O A N C E I S C E N C O E R O N T I A T I O N V S H E R A P S A I Z Y F E V E E L D T U S

H Y S T E R O T O M Y B R O W

D L O W E S R A X H G E N O N X N T I S T E S E C R P O R U I S E T N O A E L L E R A L L O T R O P I S M


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Can you tick all the boxes? Yes, my super fund: Has the best fee deal for superannuation open to the public1 Won Money magazine’s Best of the Best lowest cost super fund award five years in a row2 Is one of the ten largest funds in Australia3 Offers access to great value financial planning4 and pension products Is a not for profit fund that does not pay commissions to advisers.

If you can’t tick ALL the boxes, then maybe you should talk to First State Super today. To find out more about First State Super, visit www.firststatesuper.com.au or call us on 1300 650 873.

1 SelectingSuper, a company of Rainmaker Information Pty Limited ABN 86 095 610 996, describes the best overall fees payable for super funds open to the public where overall fees are calculated for a member earning around $50,000 pa who has had $50,000 in their super fund’s default investment option. Research dated August 2011. 2 The funds in Money magazine’s Best of the Best Lowest-Cost Super Funds were chosen from SuperRatings’ platinum-, gold- and silver-rated balanced funds and ranked on their annual costs associated with a $50,000 balance. First State Super was the winner in 2008, 2009, 2010, 2011 and 2012. 3 In Rainmaker’s Benchmarking Report, June 2011, First State Super was ranked 5th in the ‘Top 50 Super funds by assets’. 4 Financial planning services are provided by Health Super Financial Services Pty Ltd (HSFS) (ABN 37 096 452 318, AFSL 240019) trading as FSS Financial Planning (FSSFP). FSSFP is wholly owned by the FSS Trustee Corporation (ABN 11 118 202 672, AFSL 293340), Trustee of the First State Superannuation Scheme (ABN 53 226 460 365). January 2012.

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Consider the applicable First State Super ABN 53 226 460 365 Product Disclosure Statement before deciding whether becoming a member or continuing your membership is right for you. To obtain a copy visit the website or call us. Issued by FSS Trustee Corporation ABN 11 118 202 672, AFSL 293340. January 2012.


The Lamp March 2012