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The magazine of the NSW Nurses and Midwives’ Association

volume 69 no.11 December2012 — January 2013


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

Volume 69 No.11 December 2012 — January 2013

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


NSWNMA Communications Manager Janaki Chellam-Rajendra T 8595 1258

12 | Rural hospitals fight for safe staffing


A Local Health District’s refusal to spend $40 a day to re-establish an on-call roster at a small but busy rural hospital, has forced nurses to limit bed numbers.

Produced by Hester Communications T 9568 3148

Cobar RN Genie McMullen

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

PHOTOGRAPH: Gerrit Fokkema



5 6 8 33 34 37 39 41 42 44 50

Editorial Your letters News in brief Ask Judith Social media Nursing research online Crossword Books Obituary Movies of the month Diary dates


16 | The fifth nurse

Nurses at two South Coast hospitals worked together to successfully prevent dangerous staff cuts at Bega Hospital.


Editorial Committee • Brett Holmes, NSWNMA General Secretary • Judith Kiejda, NSWNMA Assistant General Secretary • Coral Levett, NSWNMA 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 F 9662 1414 E Records and Information Centre – Library To find old articles in The Lamp, or to borrow from the NSWNMA nursing and health collection, contact: Jeannette Bromfield, RIC Coordinator T 8595 2175 E

The Lamp ISSN: 0047-3936

24 | Another big year

21 | Award talks begin on a respectful note NSWNMA General Secretary Brett Holmes reports on initial talks with the state government to kick start negotiations.



28 | A healthier nurse

30 | Christmas giveaway

Merry M y Ch Christmas hristmmas fr from om th the he NSWN NSWNMA NMA

NSWNMA wishes all members a Mer r y Christmas and of fers you the chance to be par t of this year’s Christmas giveaway. í˘“ SYDNEY FESTIV VA AL AND AC CCO OMMOD DATTION P ACKA C GE FESTIVAL ACCOMMODATION PACKAGE Winner of this wonderful prize will receiive tickeets for two to see the performance of Rian, on 18 January at 8pm at the Theatre Royaal, and a two o-nigght stay for two at the Mercure Syd dney. Rian is a higgh-en h ergy mix of music and dance and is the latest creation from Dublin’’s Fabullous Beast Dance Theatre. Mercure Sydney is conveniently located in the city, within walking distance of the best attractions, shopping, eating spots and with public transport links on the doorstep providing easy access to everything Sydney has to off ffeer. Visit

We also have a double pass to see Urban, on 17 January, 7.30pm at the River e side Theatres. The visceral rawness, brazen attitude and high-voltage energy of Circolombia’s Urban has put a rocket under contem mporary circus. Following a sellout run in London and New York, and extended seasons in Paris, Urban comes to Australia for an exclusive season at Riverside Theatres. See www.sydneyfestival. www.sydneyfestival. fo or more infformation and performances.

í˘” SUMMER VIEWING The Lamp has a three speed Papillionaire Sommer bicycle valued at $648 to give away, as featured in the Call the Midwife series. And the lucky winner will also get the Call the Midwife DVD. There is an extra copy for a second prize winner. Tra raveerse the ciity streets in stylle. Sommer is a harmony of vintage aesthetics and modern parts. With an uprigght sitting posiitioning and sw wooping step-througgh frrame, it is built for a smooth and easy ride. For more inffo visiit www The six-part Call the Midwife series is a fascinating portrayal of birth, liffe, death and a community on the brink of huge social change. We also have five copies of Hysteria and The Sapphires to give aw way, both available on DVD now. Hysteria is a deligghtful comedy set in 19th Century London. The Sapphires is an inspirational and heart-warming tale, set in the late 60s, about a quartet of young, talented singers f t Ab i i l i i h


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í˘– If y acti this to t Sixxe T20 Ch 201 to li The Syd Syd so d The Syd 9 Ja tick pas two rese Bec Sixxe tod det www sixe sixe

Little is known about the health and wellbeing of the 280,000 nurses working in Australia and how that might impact on patient care.

General disclaimer The Lamp is the official magazine of the NSWNMA. Views expressed in articles are contributors’ own and not necessarily those of the NSWNMA. Statements of fact are believed to be true, but no legal responsibility is accepted for them. All material appearing in The Lamp is covered by copyright and may not be reproduced without prior written permission. The NSWNMA takes no responsibility for the advertising appearing herein and it does not necessarily endorse any products advertised. Privacy Privacy statement: The NSWNMA collects personal information from members in order to perform our role of representing their industrial and professional interests. We place great emphasis on maintaining and enhancing the privacy and security of your personal information. Personal information is protected under law and can only be released to someone else where the law requires or where you give permission. If you have concerns about your personal information please contact the NSWNMA office. If you are still not satisfied that your privacy is being maintained you can contact the Privacy Commission. Subscriptions for 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 DECEMBER 2012 — JANUARY 2013 | 3

Go Direct Debit & Win

a fabulous South Coast holiday Start paying your NSWNMA fees by Direct Debit for the chance to win a two-night stay at the Bannisters in Mollymook, worth over $1,000!

The prize includes a two-night midweek stay in an Ocean Deluxe room, with deck and stunning ocean views; hot breakfasts for two; a picnic hamper for two; a day spa voucher to the value of $120; a $200 Rick Stein at Bannisters Restaurant dinner voucher; and a signed copy of Rick’s latest cookbook. Spring is fabulous on the NSW south coast – uncluttered, very laid-back and the locals are friendly and welcoming. Think of long sandy beaches, fresh clean air, fantastic seafood dining and award winning luxury accommodation and you have all the ingredients that makes Bannisters as a ‘must do’ on your getaway list. This boutique hotel is home to international chef Rick Stein’s only restaurant outside of the UK. Understandably it features the seafood that has become his hallmark, and celebrates the wonderful fresh fish from local south coast waters. This is a dining experience not to be missed, and one that many avid foodies make the pilgrimage to enjoy. Deluxe guest rooms enjoy panoramic sea views, and in season this means you can whale-watch from your private balcony! Spoil yourself with an coastal getaway at Bannisters. To find out more visit or phone (02) 4455 3044 Conditions: valid midweek shoulder season, from 1 September 2012 – 30 April 2013, excluding school and public holidays.



Direct debit is not only the easiest and most convenient way to pay your membership, but switching over could win you a luxury holiday! Don’t risk your membership lapsing from changing workplaces. W With ith direct debit you are always protected on the job.

Membership Application forms or Dir Direct rect e Debit forms can be downloaded fr from om our website www Alternatively Alternatively call the NSWNMA on 8595 1234 (metr (metro o ar area) ea) or 1300 367 962 (non-metr (non-metro o ar area) ea) for mor moree information.


Evidence mounts for the value of ratios There is now a very strong body of research coming out of the United States and Europe, that gives a glowing assessment on health outcomes resulting from improving nurse-to-patient ratios.

The US Department of Health report cites impressive health outcomes that are a consequence of the implementation of ratios.

When we won ratios in our last public health system pay and conditions campaign we were following in the pioneering footsteps of our nursing colleagues in California and Victoria. Minimum staffing ratios have been operational in California since January 2004. Since their implementation there has been a growing body of academic research that has measured their effectiveness. According to a report by an agency of the US Department of Health and Human Services, the news is spectacularly good for both nurses and patients. “The (ratios) legislation has increased staffing levels and created more reasonable workloads for nurses in California hospitals, leading to fewer patient deaths and higher levels of job satisfaction than in other states without mandated staffing ratios,” the report says. “Despite initial concerns from opponents, the skill mix of nurses used by California hospitals has not declined since implementation of the mandated ratios.” The US Department of Health report cites impressive health outcomes that are a consequence of the implementation of ratios: Nursing-hours-per-patient-day in California hospitals grew from 6.03 in 2003 (before the implementation of mandated ratios) to 7.11 in 2008. This is a half hour more than in comparable hospitals in Florida, New York, Pennsylvania and Texas. A comparison of outcomes in California, Pennsylvania and New Jersey hospitals found that 30-day mortality rates were 10 to 13% lower in California than in the other two states. After the implementation of mandated ratios, nurses in California had on average 4.1 patients per shift compared to 5.4 patients in states that didn’t have ratios. A survey of 22,000 nurses in California, New Jersey and Pennsylvania showed Californian nurses reported they had significantly better workloads, adequate staff to ensure high quality care and the capacity ‘to get work done’.

In the same survey, California nurses reported much less burnout and higher levels of job satisfaction. More than two-thirds of nurses in California agreed they were more likely to remain in their jobs as a result of ratios. Higher staffing levels, fewer patient deaths, better care, less burnout, higher retention of nurses – all the things we said ratios could deliver – have been delivered for the undoubted benefit of Californian patients. This research has been backed up by numerous other studies that now extend to Europe and Asia. A 2007 US “meta analysis”, which analysed 94 separate pieces of research on patient outcomes and levels of nurse staffing, found that a decrease from five to four patients per RN on a shift was associated with: • 18% less deaths from in-hospital complications • 28% less cases of sepsis • 24% less cases of hospital-acquired pneumonia • 20% less cases of surgical wound infection. THE CASE FOR IMPROVING AND EXTENDING RATIOS As we prepare for our 2013 public health system pay and conditions campaign it is timely and appropriate to look at how ratios have improved patient care in places like California, where there has been sufficient time to analyse their impact. While some in Australia may think that the jury is out on the benefits of ratios, the evidence from California is that they work very, very well for better and safer patient care. It strengthens our case that not only should the current ratios be consolidated, they should be extended and improved in clinical and geographical areas where they are still to be fully implemented. I would like to wish all members of the NSWNMA a safe and restful festive season as we all prepare for a busy year in 2013.




Thank you for your apology This week I received The Lamp (November 2012). Thank you to the Nurses’ Association for apologising to us unwed mothers from the 50s, 60s and 70s who had our babies taken from us. Back then it was a horrific time, and one I will take to my grave. I still get very upset after all this time when I talk about it, which is not very often. Once our time in hospital was over we were chucked out into the workforce to survive the best way we could, without any counselling, and our best way to survive was to lock it away. So once again I would like to say thank you for your apology to us. I am a member of the NSW Nurses’ Association. M V Davies, AiN

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

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

Seeking volunteer mentors Wesley Aunties & Uncles is a long–term mentoring program that has been caring for children for 39 years. We are seeking new volunteer mentors. Are you an adult who: • Has experience in caring for children with medical needs or behavioural needs? • Is willing to travel to Penrith or lower Blue Mountains area? • Is willing to spend time with a child one day a month?

Phone (02) 9638 2480 for further information or an application package. “Building a better life for children.”

Wesley Aunties&Uncles


De-skilling of the registered nurse I write in support of Barry Watt’s letter to The Lamp, October 2012, re the de-skilling of the nursing workforce, and echo his concerns about the nurse no longer being a “portable nurse”. In the past, nurse education was very much exposure and “hands on”, with the student nurse spending a full two months in each area of medicine and hence feeling competent enough to function in every area of patient care. This style of education, combined with a solid pharmacology paper at the end of your second year, gave you a sense of real achievement and a confidence in your clinical ability. We now have classroom-based education and university curricula that directs the nurse to specialise in one area. Indeed “electives” are there for the student to choose from. This education could best be described as an introduction to health/nursing care. The new graduate nurse now needs to condense three years of exposure and supervision under the old system, into one year’ ad-hoc supervision and exposure. The added blight to this education format is that any supervision is for 25% of the time only, and even that may not eventuate; the other 75% of the time, (outside of office hours) the new graduate has to identify that there is a problem and hope the supervisor has the time to come asap. Add again, that this novice nurse, if working on a ward and not a “unit”, will most probably have nine patients to oversee, possibly more, and quite probably an AiN to oversee as well, and it does not need too much imagination to see how our workforce is being divided and de-skilled. The nurse who has gained a position in a specialised unit area, i.e. ITU/AE, will be particularly de-skilled, not having honed her time management skills, juggling doctors’ rounds with patient needs, not to mention medication needs and no monitor on the patient to alert this new grad to a pending clinical problem. There have been many calls to modify this education and, in today’s IT age, it makes no sense to have nurses so clinically deprived. I agree wholeheartedly with Barry Watts. AHPRA (the Australian Health Practitioner Regulation Agency) has failed us and nursing education is now a political bureaucracy loaded with vested interest groups that have little to no momentum to change an education style that has, and continues to, decimate nursing knowledge and hence the profession itself. Jennifer Tuckwell, RN The NSWNMA responds While we acknowledge that there is no single, “perfect” undergraduate program for nurses, the Association remains committed to university-based education for nurses.We do not believe that a return to an apprenticeship model for training of nurses is in the interest of the profession, nor is it in the interest of the wider health sector. Indeed, the entire health workforce reform agenda in this country is predicated on the existence of a robust, degree-qualified nursing workforce, capable of critical thinking and higher-level skills not previously required of nurses.We agree that many aspects of nursing preparation can be improved and that work does need to be done to develop better structures to support novice practitioners.We also believe that experienced nurses should be aware of their roles and professional responsibilities in this regard.

Uniform confusion I’m just a little concerned about this whole uniform thing. We here in the rural areas are only just hearing about it and we are not receiving a whole lot of information. Do the new “scrub” uniforms affect us, and if so why did we not get to voice an opinion? To be honest, many of the people I work with are not in favor of the scrub style; we don’t feel we work in an American TV show. They are not practical for every setting and I feel that everyone should have the choice of a corporate-style uniform. I really cannot imagine turning up to a function where I represent the Health Service dressed in “scrubs”. I do not however fit into a category that gives me a corporate choice. I would appreciate much more information than I can find on the net. Margaret Ross, CNS

The Lamp responds We apologise if you feel that you have not been kept informed or consulted.While the NSWNMA has made all effort to consult with its members, there is, unfortunately, no consensus about the so-called scrubsstyle uniforms – some want it and some do not.The Ministry made the decision some time ago that all clinical nurses would wear tunic top and pants-style uniforms, as these are internationally recognised as clinical garb. In the past, there have been many complaints from nurses who felt that patients could not distinguish between clinical nurses, and clerical or hotel services personnel. A distinctly clinical uniform is also supported by the recommendations of the Garling Inquiry. You don’t say what type of role you are in, however, broadly, the uniforms will be as follows: • For clinical nurses, tunic-style top teamed with trousers or skirt. • Community health nurses will wear a corporate-style uniform. • NUMs, MUMs, CNCs, CMCs, CNEs and CMEs will wear corporate-style uniform. • Mental health staff members are expected to maintain the status quo – if they have not been wearing a uniform then they will continue not to wear a uniform, unless their LHD or service revises its policy. Currently there is wide variation in what inpatient mental health nurses wear.

Letter of gratitude I am writing to express my huge gratitude towards the NSWNMA. After stopping work to raise my family for approximately five years, and living overseas for a period of that time, I found myself in a position where I was unable to regain my midwifery registration. This was due to the introduction of the recency of practice standard that was introduced in July 2010, while I was overseas. AHPRA denied my application for registration and advised me that I needed to complete a refresher course. The problem was, there was no course in New South Wales. I researched the courses that AHPRA had advised were available and found only one course currently running in Melbourne for a period of approximately 12 weeks, full time. Having three small children under five, this was not possible for me. I could not believe that there was no refresher course available in Sydney. After having my own three children I was determined that if I was to return to work I would return to where my passion lies, and this was midwifery; so I decided to fight the battle. I appealed the


Send your letters to: Editorial Enquiries email fax 9662 1414 mail 50 O’Dea Avenue, Waterloo NSW 2017. Please include a high resolution photo along with your name, address, phone and membership number. Letters may be edited for clarity and space.

More information can be found on the NSWNMA website, including the roll out strategy. Health Support Services (HSS) has also been distributing regular bulletins and placing information on the NSW Health Intranet. With respect to consultation: • All delegates have been receiving updates via the Committee of Delegates reports. • Information has been placed on NSWNMA website as it comes to hand. • Earlier this year all rural delegates were invited to attend a meeting to speak with HSS and supplier representatives about their concerns and needs. Forums were also held at two metropolitan facilities. • HSS had a stall at NSWNMA’s Annual Conference of Delegates in order to consult with nurses and showcase the proposed designs. • Different styles and fabrics were trialled. Rural as well as metropolitan nurses from different LHDs participated. • Arising from feedback provided by members, uniform designs were adjusted and the most popular fabric chosen. More recently, after being approached by NSWNMA, the Ministry agreed to provide a variation in the uniform for ENs so that they will be instantly recognisable by a light blue edge on their sleeves.

decision that AHPRA had made and my case was taken to the Nursing and Midwifery Tribunal. When speaking with a person from the tribunal they warned me that if I were to continue with the appeal, and lost my case, I would be responsible for all costs. He advised that most people tended to withdraw their application at this point, which I almost did. Luckily I was advised by an associate to contact the NSWNMA for advice and assistance. I am so glad that I did. With the Association’s help I was able to build a very strong case to appeal against AHPRA’s decision. My case did not end in court. AHPRA granted me my unrestricted midwifery registration. I was over the moon with the result and cannot thank the Association enough. I am writing this letter to show my gratitude and to voice to others how wonderful the Association is. My future has certainly changed direction thanks to some wonderful people who helped me along the way. Brook Jordan, RN


there are more than



Europe rocked by austerity strikes

General strikes swept through a host of European countries on November 14 as trade unions led a coordinated action against austerity measures.


There are more than 25 million unemployed Europeans – about one in every eight people in the eurozone is now jobless. Millions of workers in France, Spain, Italy, Greece, Portugal and Germany stopped work and marched against government cutbacks that have seen unemployment skyrocket. In Spain, it was the second general strike this year to protest at budget cuts. “The sacrifice is not being shared by the whole of society: the economic and financial elites are spared and some even benefit from it, protected by the government. This is why we will be striking,” said Fernando Lezcano from the Spanish trade union confederation. Italian unions led a four-hour general strike to protest against labour reforms instituted by Prime Minister Mario Monti’s government. The five main French unions organised around 100 protests across the country to protest at “shock treatments” in Greece, Spain and Portugal. Unemployment in France has been on the rise for 17 months. In Greece, unions say there have been continuous wage and pension cuts and attacks on labour, social security and social rights. Purchasing power has dropped 35%. “Extreme neoliberal policies limit the rights of all workers and vulnerable social groups in favour of bankers and lenders. They are leading our people to poverty and misery,” said Tania Karayiannis from Adedy, the Greek public sector workers’ union. “The common and coordinated struggle of the trade unions in all European countries is necessary more than ever. This is our only hope for exiting the crisis.”


United States

NY nurses hailed as heroes President Obama praised a group of New York nurses as the “brightest in America” after they evacuated a ward of babies during Hurricane Sandy. As the hurricane whipped the Neonatal Intensive Care Unit at New York University’s Langone Medical Centre, the power failed and respirators and monitors keeping the infants alive lost power. The nurses were horrified to learn that the hospital’s generator had failed, and that the East River was flooding the hospital. America’s ABC News reported how “one by one, each tiny infant, swaddled in blankets and a heating pad, cradled by one nurse and surrounded by at least five others, was carried down nine flights of stairs. Security guards and secretaries pitched in, lighting the way with flashlights and cell phones.” As the nurses felt their way down they squeezed bags of oxygen into the babies’ lungs. “We literally synchronized our steps going down nine flights,” one of the nurses, Nicola Zanzotto-Tagle, said. “I would say ‘Step, step, step’.” The nurses and 20 babies emerged to a line of waiting ambulances and the tiny patients were evacuated to various New York hospitals. Despite the high drama of the situation the nurses demonstrated calm and selfcontrol. “We take care of (the babies) every day,” said nurse Sandra Kyong Bradbury. During the storm, she said, “… it was in extreme circumstances.”

Medical workers assist a neonatal patient into an ambulance during an evacuation of New York University’s Tisch Hospital, on October 29, 2012. (AP Photo/ John Minchillo)


United States

Study links soft drinks to violence A Harvard study has linked soft drinks to aggressive or violent behavior according to the online news source Slate. Based on 1800 interviews with Boston teens, researchers found that 59% of the heaviest consumers of soft drinks – those who consumed five or more cans a week – reported an incident with a peer, as opposed to 35% of the lowconsumption group. The “heavy drinkers� were also nearly twice as likely to carry a weapon. Researchers said they controlled for other factors like alcohol and tobacco use and weight. The Harvard study didn’t go so far as to say that soft drinks cause violence. But it did track with two other studies in the past five years that have linked declining mental health and anti-social behavior to soft drink consumption.

United Kingdom

Sick days soar as cuts compound stress The number of National Health Service staff off work due to stress or depression has quadrupled in three years. Figures from one NHS network (Dumfries and Galloway in Scotland) showed that 2475 working days were lost in 2011, compared to 632 in 2009. Unions believe the surge in sick days is due to recent staffing cutbacks. There are 89 fewer nurses and midwifes in Dumfries and Galloway than there were three years ago. Royal College of Nursing Scotland director Theresa Fyffe said: “With cuts, and people living longer, pressure on staff to deliver quality care with fewer resources is increasing.� Theresa Fyffe




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Privatisation walk out

Sayonara to the cap

More than 1000 Filipino government health workers staged a walkout last month to protest against a plan to privatise stateowned hospitals, according to the Philippine Star. The health workers left their workplaces during a lunch break to stage a rally in front of their hospitals, denouncing the privatisation of the Research Institute for Tropical Medicine in Muntinlupa and the Philippine Orthopedic Center in Quezon City. Lovely Tanghal, media officer of the Alliance of Health Workers, said they would not be pacified by pronouncements by the Department of Health that the privatisation of hospitals would lead to the improvement of services and benefit patients. “They are claiming that hospitals will not be privatised but some of its services, like laboratories, will be passed on to the private sector. Whichever way, it won’t be good for patients,” she said. Tanghal added that the private sector would not invest in hospitals unless there was a financial gain. Health Secretary Enrique Ona warned the government health workers that they could be suspended or dismissed from the service if they disrupted hospital operations. “They cannot do that, they are government employees,” Ona said. He denied that hospitals were being privatised. “They just don’t understand. This is not privatisation. This is bringing certain private practices to improve efficiency and availability of public services that otherwise will take a long time or, maybe, we will not have that kind of resources at all.”

“Although there are no figures, we believe nurses’ caps have disappeared from most hospitals over the past 10 years.”

The nurses’ cap, an icon of Japanese nursing, is disappearing under the pressures of modernity. The Japanese newspaper Yomiuri Shimbun reported that Nagaileben Co, a Tokyo-based manufacturer of medical uniforms, had only sold 14,000 caps this year – less than oneseventh of what it sold 10 years ago. Experts put the decline down to hygiene and gender equality, with the growing number of male nurses apparently a significant reason for the cap’s demise. “The move was partially due to the idea of realising gender equality,” Rika Shimada, an associate professor at Nagoya City University’s School of Nursing told Yomiuri Shimbun. The Seibo Byoin hospital in Shinjuku Ward, Tokyo, abolished nurses’ caps last year. The cap had graced the heads of nurses at the hospital for about 80 years. The hospital decided to get rid of the caps following a spate of complaints from nurses, who said the headpiece impeded their jobs by catching on medical instruments such as drip infusion sets. About 90% of nurses at the hospital supported the decision. “Although there are no figures, we believe nurses’ caps have disappeared from most hospitals over the past 10 years,” a Japanese Nursing Association official said.


ACTU calls for expansion of super profits tax

Tim Lyons


The ACTU has called on the Gillard Government to “seriously examine” an economy-wide super profits tax and has asked for modeling to be done on the proposal. “The movement towards a system that taxes economic rents more heavily, and normal rates of return to capital more lightly, may bring substantial economic benefits to Australia,” ACTU Assistant Secretary Tim Lyons told the Business Tax Working Group Secretariat, which is part of Treasury. “We do not pretend that such a reform would be easy, nor that the case for the change . . . has been comprehensively made out. It has not,” he said. “Instead, it is an idea that is meritorious and deserving of further investigation.” The ACTU proposal predictably met with strong opposition from the Minerals Council of Australia and the Australian Bankers Association.



Mental health mentoring grants still open The Bob Fenwick Memorial Mentoring Grants Program 2012/13 is currently open for Expressions of Interest from applicants.

United States

Nurses design their workplace Utopia Nurses have been included as part of a team to design a new orthopaedic and spine treatment unit at one of Pennsylvania’s leading hospitals, Harrisburg. Nurses with more than 25 years experience, two that had been patients during knee replacements, were involved. “It’s going to be state of the art,” Courtney Trulear, a permanent charge nurse on the unit told the local newspaper the Patriot-News. Trulear was part of a five-person team of nurses that met every two weeks for six months, sitting at a table with the construction crew, poring over blueprints for the new unit. “We talked about everything from where we wanted stuff located to the equipment we’d need,” she said. Trulear said the nurses told the construction crew what they wanted, and if they couldn’t do it, they’d explain why, “but for the most part, they just did it,” she said. The result is a nursing suite that emphasises

patient comfort and nursing efficiency. All rooms are hotel-style private suites with natural lighting, spacious bathrooms, flatscreen cable TVs, customised furniture for joint-replacement and spine patients, and a pullout sofa bed for family and visitors. In addition to added comfort, the new rooms have built-in bedside vital signs monitors, reducing the need for nurses to haul carts. “It’s going to be a timesaver for the staff, and that gives more time for patient care,” Trulear said. She said the direct involvement of nurses in planning the facility was a pleasant surprise for her. “To have an actual voice is incredible,” she said, “to really be heard is an incredible thing. It’s a good change in health care.”

Bob Fenwick was a mental health nurse who tragically died in a work-related incident in 2011. The Bob Fenwick Memorial Mentoring Grants Program was developed in recognition of Bob’s long service to mental health nursing and his role in mentoring less experienced mental health nurses. Following the success of the first program round in 2011/12, a further two rounds have been funded by the New South Wales Ministry of Health, Mental Health Drug & Alcohol Office. The NSWNMA will administer these next rounds. NSWNMA will be assisting with the placement of up to 20 successful RN applicants, currently working in public mental health services in NSW, for up to five days. During this time they will be mentored by an experienced mental health nurse/clinician at the host mental health service. By popular demand, the closing date has been extended until 21 December 2012. Please see the NSWNMA website ( for more information regarding eligibility to participate in the program and application forms.

Do you want to improve nurses’ wellbeing? This is your chance to make a contribution to nurses in Australia. Participate in an anonymous survey that aims to evaluate the health and wellbeing of nurses. Enrolled and registered nurses are encouraged to participate in this survey. This project at Southern Cross University received funding from the Australian Government.


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It’s all about U CRICOS Provider: NSW 01241G, QLD 03135E, WA 02621K



Cobar nurses close beds A Local Health District’s refusal to spend $40 a day to re-establish an on-call roster at a small but busy rural hospital, has forced nurses to limit bed numbers.


has forced Cobar Hospital nurses to limit bed numbers in support of an oncall roster. Cobar Hospital nurses capped inpatient numbers at five, plus two emergency admission beds, in October, after the Western New South Wales LHD refused to act on low nursing numbers, despite 14 months of trials and negotiations. Cobar nurses have gathered statistics to show that an on-call roster, at an annual cost of less than $15,000, would actually save the LHD money by reducing its overtime bill. The decision to close beds won strong support from local doctors and the general public. Cobar hospital has 21 in-patient beds and an emergency department and averages about 10 in-patients a day. It services a town of 5000 as well as outlying farms and a substantial mining industry. Both sectors have significant workplace injury risks.

NSWNMA General Secretary Brett Holmes said the LHD has been staffing the hospital with 52 nursing hours per day. This provides the basic 4.8 hours per patient for an average of 10 in-patients, with only four hours nursing work left for the emergency department. “Cobar nurses have been arguing for more than a year that this is unsafe – especially without an on-call roster – and a number of recent clinical incidents and near misses confirm their concerns,” Brett said. “Based on the current award rates, we estimate that one on-call nurse, between 11am and 11pm each day, will cost the government just under $15,000 a year or about $40 a day. “We don’t understand why such an isolated but busy place like Cobar is being denied the protection of a basic level of safe hospital services.” The hospital previously had two, eight-hour nursing shifts and one sixhour nursing shift for both day and

evening shifts – 2.75 FTE staff – until district management scrapped the two six-hour shifts in July 2011. Management claimed admissions data did not justify 2.75 FTE staff, but nurses said the numbers did not reflect the acuity of the patient load and other factors. Concessions were made after nurses threatened to cap bed numbers and ban some duties. Nurses accepted a three-month trial of new arrangements, including partial restoration of nursing hours, with an escalation plan and on-call roster. Cobar Hospital RN Genie McMullen said the trial worked well but management insisted on a second trial. This included an escalation plan and on-call roster but no six-hour shifts. After the second trial management decided to abolish six-hour shifts and the on-call roster, though the escalation plan would stay. “Losing the on-call roster was a huge blow and we were very disappointed.

…Continued page 15


Cobar RN Genie McMullen on her way to meet Member for Barwon, and state government minister, Kevin Humphries.


…From page 12

We lost the security of knowing that there was a particular person available to come in to work in an emergency,” Genie said. “We reluctantly accepted because the trials and discussions had been dragging on for 14 months and we were sick of it, so we thought we would give it a go. “But it is just not working.There have been emergency situations where it has taken us 40 to 50 minutes to find someone to come in. “That is unsafe and staff are no longer prepared to continue working without an on-call roster.” She said it was a difficult decision to close beds. “When bed closures were first brought up there was silence in the room. Nobody wanted to close beds. But when we discussed it we realised it was the only option left.” Genie said an escalation plan without an on-call roster meant that when patient numbers unexpectedly increased, nurses had to waste time on the phone, searching for colleagues who were available and willing to come in on their day off. “The nurses on duty should be able to get help immediately, but now we can’t,” she said. “Management are banking on the fact that in a small community people will come in to work at a moment’s notice, on their days off, because of dedication to their community and colleagues. “The expectation is you will come in at any time for as long as is needed.That is an abuse of the relationship that nurses have with their employer and with each other. “There are 19 nurses on staff, with six rostered on every 24-hour period. Some have jobs outside the hospital or have young children so they are not available. “This means the pool of nurses who can potentially come in to work in an emergency is tiny, and the same few people are being asked to come back in to work. And because nursing hours are so low we have to escalate more than 50% of the time. “If you are on your day off and still in town, you feel guilty if you say you can’t come in.

STOP PRESS SMALL IMPROVEMENT BUT BIG ISSUES REMAIN As The Lamp goes to press the NSW IR Commission has ruled that: • The Cobar Health Service Manager is responsible for the contacting of additional staff and not the nurses • The escalation plan is to be revised to include who, how and when additional staff will be called NSWNMA General Secretary Brett Holmes says that is a small improvement but nurses and patients in the Cobar ED or hospital, still need the professional skills of that additional nurse – who should be on-call. “Our members are considering their response but remain committed to continuing the fight for safe patient care for the people of Cobar,” he said.

Support Cobar nurses went

“I have had to turn the oven off, with the dinner half cooked, drive my children with me into the hospital and leave them in the tea room waiting for my husband to pick them up when he finishes work.” Genie said an on-call roster, made up mostly of casuals and permanent parttimers, would actually save money through reduced overtime payments. “A full timer is not put on the oncall roster unless it is absolutely unavoidable. But with no on-call roster, during an emergency, you don’t look at who is the cheapest option to bring in; you just get the first person you can find. “We have told the district, if you give us the on-call we can give you savings and we have the stats to prove it, but for whatever reason they are not listening. “They are wasting taxpayers’ money for reasons we can only guess at.”



met the Member for Barwon, and state government minister, Kevin Humphries in November, to explain why Cobar nurses are concerned about staff numbers. The delegation, including Cobar RN Genie McMullen, met Mr Humphries in Sydney to show him data relating to patient admissions and staff numbers that had been collected by the nurses. “We wanted to show him evidence that district management had got things wrong, and that an on-call roster would actually save them money,” Genie said. Mr Humphries told the NSWNMA that he subsequently phoned the chief executive of Western NSW Local Health District, Dr Pim Allen, who undertook to examine the nurses’ data.


strong for Cobar nurses public and won strong public support for their actions “Hospitals like ours cannot be staffed by rostering models used by large teaching hospitals or bigger city hospitals.”

A rally by hospital staff and supporters in the main street of Cobar, following the meeting with Mr Humphries, drew strong support from the public and was the lead story on Prime 7 nightly TV news. While nurses at Cobar Hospital are being put under pressure, the Cobar local government area is making the state’s fourth biggest contribution to government coffers by way of royalties from its copper, gold, silver and lead mines, according to government figures. Cobar mayor Lilliane Brady urged the public to attend the rally and show support for the nurses. “The present government is slowly withering away all our services at the hospital,” she said.

The nurses also got the backing of Cobar Hospital’s three doctors, who wrote to NSW Health Minister Jillian Skinner warning that “an adverse patient outcome is only waiting to happen” unless the rostering dispute is settled. The letter said inadequate staffing during emergencies had forced nurses to “run around trying to manage the emergency while still trying to find colleagues who might be able to come in (sometimes this may take several calls), while a critically unwell patient’s care is also requiring attention. “Hospitals like ours cannot be staffed by rostering models used by large teaching hospitals or bigger city hospitals. The bare minimum of staffing at any time has to be at least three,” the doctors wrote.



The fifth nurse Nurses at two South Coast hospitals worked together to successfully prevent dangerous staff cuts at Bega Hospital. CONFIRMATION OF A DANGEROUS

cut to nurse numbers on the medical ward of Bega District Hospital came via a new roster posted on the ward noticeboard one Monday morning. Nurses arriving at work were stunned to read that the busy morning shift would lose one of its five nurses.The decision had been made without any negotiation with the NSWNMA. The Bega branch of the Association called an urgent meeting where members condemned management for “the appalling lack of consultation”. They unanimously decided to start closing beds within a fortnight, unless the published roster was withdrawn and nursing hours reinstated. “It’s hard enough to adequately care for patients on morning shift with five nurses. Having only four nurses would clearly be unsafe and left us no choice but to close 16 | THE LAMP OCTOBER 2012

beds,” branch secretary Amanda Gillies, a clinical nurse specialist on the medical ward said. The branch also condemned the introduction of Assistants in Nursing without consultation, called for talks on a planned restructure of nursing management and endorsed a community campaign to oppose the cut in nursing hours. Bega nurses rallied outside the hospital during their lunch break, carrying placards alerting the public to the safety risks posed by staff reductions. “Less Nurses = Money Saved and Lives Lost” warned one sign. “Cuts to Nurses Don’t Heal” said another. Meanwhile, nurses at Pambula Hospital, 35 kilometres away but part of the same Local Health District (LHD), were also staging a public protest in support of their Bega colleagues. “Pambula wanted to show their support

for us because the two hospitals are closely connected. For example, we get patients from them after hours because they don’t have doctors overnight,” Amanda said. “Pambula have their own staffing issues and hopefully we will be able to support them when they need it.” District management claimed the reduction in nursing hours was justified because the morning shift was overstaffed according to award staff ratios. However, the award provisions they referred to were a minimum requirement that should be adjusted upwards, if necessary, to ensure safe patient care and staff welfare, NSWNMA Assistant Secretary Judith Kiejda said. “A whole range of issues needs to be taken into account at the local level when determining nurse numbers, including the level of support and back-up available to

Questions raised on AiNs Southern New South Wales Local Health District has guaranteed that AiNs will only be used at Bega District Hospital in accordance with NSW Health policy, such as “specialing” dementia and delirium patients who need watching. NSWNMA Assistant Secretary Judith Kiejda said the introduction of AiNs raised serious questions. “Skill mix is an important determiner of the number of nurses that should be on duty,” she said. “There is a place for AiNs, and many are already employed in our health system, but not as a cheap replacement for RNs and ENs. “NSW Health’s own research proves that using RNs increases patient safety by reducing bed sores, patient falls, gastrointestinal bleeding, sepsis, shock, physiologic/metabolic derangement, pulmonary failure and ‘failure to rescue’ before cardiac arrest or death.”

the nurses,” Judith said. “Management had not accounted for extra work performed by nurses, and types of patients at Bega, outside the medical ward parameters for the nursing-hours-per-patient-day ratio. “There aren’t enough nurses on this ward to do everything that needs to be done now, with current staffing levels,” she said. “Backup support for the Bega nurses, such as cleaning and administration, is inadequate. At the moment there is only one wards person, on each shift, for the entire 77-bed hospital.” Amanda Gillies explained that Bega nurses regularly have to escort patients for tests, including MRIs, outside of the hospital; they routinely clean beds, including terminal bed cleans; they help out in the children’s ward; empty garbage bins and linen skips after hours; and order and unpack stock. “Morning shift is usually the busiest time of the day, with doctors doing their rounds and ordering tests and people being discharged and admitted. Most of our patients are elderly, and they need to be showered in the morning. Plus we have to make our own beds.” Amanda said the wide range of patients in the medical ward added to the workload. “There are always one or two in palliative care, plus morbidly obese patients, sometimes psychiatric patients and drug and alcohol patients.There are always two or three in isolation who are very time consuming because you have got to dress up and dress down every time you go in and out of their room.” District management withdrew the cut to nursing hours the day before nurses were due to close beds. It also withdrew the planned change to the nursing management

structure. Management and the NSWNMA agreed the medical ward would continue to have five nurses on mornings for the next three months, while both sides carried out an investigation of the hospital’s staffing needs. A few weeks later, district management agreed to maintain the fifth nurse in the medical ward, provided occupancy levels did not fall below a set level. If occupancy fell to 18 or lower, the fifth nurse could be redeployed to another clinical area, Heather Austin, Acting General Manager of Bega Valley Health Service, wrote in a letter to the NSWNMA branch. She said terminal bed cleaning would be transferred to non-nursing staff, a casual wards person would be trialed for patient transfers to medical imaging, and creation of a pool of casual nurses would be examined. “Please convey my thanks to your colleagues for a great job in caring for our patients,” she also wrote. Amanda described it as a good outcome. “People are very happy and there is a sense of achievement that they have stopped an undesirable change. Losing that fifth nurse would have made the ward completely unmanageable and unsafe. “Our action achieved its purpose of getting the message across that nurses and the community weren’t going to be happy if they took that fifth position away.” Amanda said the branch would now turn its attention to getting more nurses on the understaffed surgical ward. “With our achievement up here the surgical floor nurses feel that the branch as a whole can help them achieve an outcome.”

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Warning on maternity care plan Nurses point to potential health risks to mothers and newborns. A PLAN TO PARTIALLY RESTORE maternity services at Pambula Hospital may jeopardise the health of mothers and babies, nurses warn. The 30-bed hospital on the New South Wales far south coast comprises an emergency department, operating theatre and general ward that also provides palliative care services. It was marked for closure by the previous state government and lost its obstetrics service in 2008. Maternity services were centralised at Bega Hospital 35 kilometres away. The current state government has promised to keep Pambula Hospital open, and Southern NSW Local Health District (LHD) management want to introduce a post-natal service there. While the local community has welcomed the news, the Pambula branch of the NSWNMA warns the proposal may be risky because it attempts to offer a partial maternity service with one-hour-per-day midwifery support. Two post-natal beds are to be designated at Pambula Hospital. New mothers who live in and around Pambula will be discharged from Bega Hospital following birth and must make their own way to Pambula Hospital for readmission to the general ward. Drew Barr, president of the Pambula branch of the NSWNMA, said LHD management did not intend to employ any midwives at the hospital to support this new service. Instead, community midwives will visit inpatients for about an hour per day leaving nurses, rostered to care for patients on the general ward, responsible for providing midwifery-based care for the other 23 hours. “We don’t believe this is the safest option, and it contradicts the NSW Health policy Maternity – Towards a Normal Birth in NSW,” Drew said. “Birthing women deserve to be looked after by qualified midwives who are an

“We don’t believe this is the safest option, and it contradicts NSW Health policy.” — Drew Barr

integral part of antenatal, intrapartum and post-natal care. “Pambula Hospital nurses welcome a return of maternity services, but we are wary of this plan because it may not be the best way of providing safe patient care. “The proposal could be improved either by employing a midwife on each shift at Pambula Hospital, as was done before maternity services were removed, or employing more midwives in the domiciliary midwives program, so birthing women in the Bega Valley can be discharged home from Bega and adequately supplied with skilled midwifery care during their post-natal period. “If a new mother is well enough to be discharged from Bega Hospital she should

be well enough to go home to a properly funded and fully supported domiciliary outreach program.” Drew said that under the proposed plan, if post-natal or neonatal problems arose outside the domiciliary midwife’s scheduled one-hour-per-day visit, the patient would be transferred, by ambulance, back to Bega Hospital. He said the LHD could be misleading the community by presenting its plan as a restoration of maternity services at Pambula Hospital. “Mothers and babies discharged from Bega Hospital will be admitted to Pambula Hospital under the VMO (visiting medical officer) of the day. Apparently they will be classified as social or respite admissions not maternity patients. “Pambula Hospital no longer has a nursery area or baby bath or change facilities, even for the public, so there will be nowhere to bath a baby except in the plastic neonatal cot.The proposal may not include dedicated maternity beds. “The nurses are concerned that, while health and hygiene standards at Pambula Hospital are excellent, risks to the newborn infant in this proposal remain unknown.” Drew said that, under the LHD plan, maternity patients discharged from Bega Hospital and sent to Pambula would be new admissions not transfers, so NSW Health would not have to provide transport. “New mothers will have to use their own vehicles on the 30-minute drive to Pambula on the busy Princes Highway, at their own risk, because of the proposal to discharge and re-admit rather than transfer with a midwifery escort.” The state government recently promised that Pambula Hospital would remain open after the new $170m South East Regional Hospital opens at Bega in 2016. The Pambula Hospital catchment contains about 20,000 residents, forecast to rise to 28,000 by 2030. About 25,000 tourists visit the region over the Christmas-New Year period until Australia Day.


Previous films can be viewed on our we website bsite gallery.html g .html Authorised by B.Holmes, General Secretary Secretary,, NSW Nurses and Midwives’ Association


Award talks begin on a respectful note NSWNMA General Secretary Brett Holmes reports on initial talks with the state government to kick start negotiations for the 2013 Public Health System Award. THIS MONTH I, ALONG WITH THE Association’s negotiating team, held preliminary talks with the New South Wales Treasurer, Mike Baird, and the Minister for Health, Jillian Skinner, regarding our new Award, due to be renegotiated in mid2013. I’m pleased to report that both ministers were receptive to our representations on behalf of nurses and midwives and the meetings were courteous and professional. The discussions were a constructive start to the negotiations for our new award. The Treasurer – as might be expected – was keen to show us that his budgetary “cupboard” was bare. Nonetheless, he listened carefully to the messages we delivered on behalf of members, particularly that better nurse/patient ratios are critical to nurses. We clearly pointed out to both ministers that there was international evidence to show that better nurse-to-patient ratios not only save money in the long term, they boost the quality of patient care and clinical outcomes for patients. We also communicated unequivocally that NSWNMA members expect an improvement in their working conditions and will not settle for less. Jillian Skinner did not dismiss these arguments. She was quick to emphasise that the newly elected Coalition Government had honoured the agreement on nursing hours, struck with the former government by increasing nurse numbers and meeting the nursing hours implementation schedule mandated by the Award. I acknowledged this in a Lamp editorial (February 2012 issue). It said, in part: “After the last NSW state election, the O’Farrell Government agreed to abide by the Memorandum of Understanding negotiated

Cupboard not so bare The Auditor-General has revealed that the New South Wales government had made a $1 billion mistake in its calculations, and the budget is actually in surplus. Peter Achterstraat’s audit of the state’s finances found that “data entry errors, mistakes in spreadsheets and poor reconciliations” were responsible for much of the errors in projections. He said there were 37 mistakes of more than $20 million each. When Treasurer Mike Baird delivered the budget in June, he forecast a deficit of $337 million. The government used the deficit to rationalise a “tough” budget, with $1.24 billion in cuts and thousands of job losses in the public sector. The Auditor-General was scathing about the quality of the financial accounts coming from government departments into Treasury. “The New South Wales government is a billion-dollar business, it’s not a school tuckshop,” he said.

“I am happy to report that these initial meetings were a cordial opening…” —Brett Holmes

between the NSWNA and the previous Labor government. We welcomed that announcement and acknowledge that, so far, they have stood by their word ...” I am happy to report that these initial meetings were a cordial opening to what will be many long months of negotiations toward winning a new award with the government. The Association will maintain a spirit of constructive engagement for as long as we judge that it is being reciprocated and our discussions are being conducted in good faith. We prefer to negotiate the agreement by discussion, but will never be deflected from our primary aim: to see pay and conditions — especially ratios — improved for nurses and midwives in New South Wales’ hospitals.


Consulting for The NSWNMA has conducted focus groups with nurses and midwives as part of the consultative process in the lead up to next year’s Public Health System Award campaign. The face-to-face research explored a wide range of issues of relevance to the campaign and nurses and midwives were

“I had an accident on the way home from work the other day – two blocks from the hospital and not my fault. I have to fill in an IIMS (Incident Information Management System) report but there is now no WorkCover – I’ve had to use my sick leave to recover.” — Nurse Educator from Nepean Hospital “After finishing, driving home is always hard because you’re so tired and accidents are a big problem. Taking away the rights of workers comp for these situations might make people not want to work night duty anymore.’ — RN from Royal North Shore Hospital “Our employers expect us to work crazy hours, with strict break times, and no compensation on our way home.” — RN from Hornsby 22 | THE LAMP DECEMBER 2012 — JANUARY 2013

“We will have the worst workplace laws in the country and always open for further attack on our workplace conditions.” — RN from Tamworth Hospital “I am extremely angry about these changes. I think it is dangerous to workers for the government of the day to have so much vested power on these issues. Having the industrial relations [commission] hearing cases of wage and condition disputes ensured that a fair and just hearing occurred.” — RN from Shoalhaven “I think they see the purpose of the unions very clearly and are acting to change that, to take away the power the unions have had to improve wages and conditions!” — CNS from Grafton Base Hospital “What is the point negotiating with the government when they have passed laws giving them all the power to decide what workers have to get?”— RN from RPA

“I am not expecting the current government to support our rights. For O’Farrell it’s more important to improve the M5 and M4 and make new roads, but nothing to support the health of the Australian nation.” — RN from Bankstown Hospital “I become tired of hearing how public servants must cut back while big business gain obscene pay rises and politicians give themselves more than their 2.5% rise.” — EN from Nepean “The government approach to the public health system is very disrespectful. The public health system is not valued or a priority.” — RN from Prince of Wales Hospital

the year ahead forthright in their condemnation of laws enacted by the O’Farrell Government that reduce public sector workers’ rights. In particular, the 2.5% wage cap and the reduction in workers compensation protection dismayed them. Here are some of their comments.

“I believe ratios have seen an improvement in patient care overall. I really appreciate the opportunity to be able to spend the majority of my shift time in one room with patients. The fact that I can be in the room attending to medications, and at the same time observing how my patients may be eating breakfast or walking or interacting with visitors, enables me to constantly be making assessments about patients.” — RN from Wollongong “I think in the 28 years I have been doing this job patient care has declined regardless of who was in government. Patient ratios are a great way to start, but as all nurses know, not all patients are created equal. The acuity of patients is much higher now than years ago and I think nurses work harder because of this.” — RN from Coffs Harbour “Quite frankly I rarely see any difference on the clinical floor when a change of government or policy happens. Our clinical loads remain the same or get heavier and we still need to go through the same process for change. We are the ones that can make a difference to workloads when it comes to fighting for ratios, changing our service delivery or working as a team in improved ways.” — CN/ME from Port Macquarie

“I often think that there are unrealistic expectations on us as workers. I call it the super nurse syndrome. We are well educated and trained and know what is a good balance between service delivery and patient outcomes. That’s why the patient to nurse ratios are such a good health care delivery initiative.” — RN from Manning Rural Referral Hospital “I love my job. That is why I am still doing it after 20 years spent in public hospitals. However, I wish nurses had more time to spend hands-on, rather than doing paper work.” — RN from Bankstown Hospital “I’m only a few years into education but feel I’ve found yet another passion in nursing. It is the diversity that I love.” — Nurse Educator from Nepean Hospital “I must agree about the diversity. Just today for example I spent a couple of hours on the pain round, some time getting ready for the canulation program, I taught all afternoon, and the time in between being on one of the wards, I gently reminded staff about the ‘5 moments for hand hygiene’ before they move to the auditing stage of the process. Tomorrow will be different again. Always something new to learn, which I find fascinating, and then the opportunity to teach it to someone else!” — RN/M from the Centre for Education and Workforce Development






year in review

It has been another big year and in trying circumstances – but despite the obstacles nurses, midwives and their union made plenty of progress in 2012. The Lamp takes a look at some of the highlights.

nurse-to-patient ratios

“I strongly believe that we need to raise community awareness about ratios.These are hard fought for changes to the public health system and the people of New South Wales should know how ratios improve the care they receive.” — Eleanor Romney RPA RN


Winning them was just the beginning! After the hard-fought win came the hard-fought implementation.The year started tardily, with Local Health Networks slow to meet targets set for the recruitment of nurses to fill vacancies for the new positions. But with sustained pressure from nurses, and with more than a little help from the community, by year’s end the implementation of nurse-topatient ratios was well on track to the timetable set out in the Award. Early in the year a powerful lesson came to us via our Victorian colleagues. Having fought tooth and nail for 10 years to win ratios, and fill them, they had to take to the barricades to defend them against a well-organised and sustained attack by the Victorian state government. As the year came to an end the NSWNMA was laying the groundwork for the 2013 award campaign, in which improving and extending ratios will be a high priority.

industrial relations

“The underlying assumption is that injured workers are lazy or are fraudulently claiming higher workers compensation benefits. The Association utterly rejects this line of reasoning.” — NSWNMA General Secretary Brett Holmes

The O’Farrell Government carried on where it had left off in in 2011: rolling back the rights of New South Wales workers and maintaining their attack on the public service. Last year it was an institutionalised pay freeze at 2.5% for public sector workers, the emasculation of the Industrial Relations Commission and heavy penalties for unions, which, well, did their job. This year the government’s main focus was an attack on the Workers Compensation scheme. Nurses and midwives were particularly angered by the abolition of cover for journeys to and from work, so the NSWNMA stepped in with its own insurance to cover such situations. The government has also flagged that staffing arrangements within awards (nurses: read ratios), penalty rates and leave loadings remain in their hairline sights.

aged care In May, the Because We Care campaign, conducted by the NSWNA and the ANF for three years, had a stunning victory with the announcement by the Gillard Government of a $3.7 billion aged care reform package. The package foresaw a massive injection of funds into the sector from 2013. Importantly for aged care nurses, a key component of the package was $1.2 billion to address the wages gap, and training. As with ratios, winning the funding was just the beginning.The big challenge will be ensuring that aged care providers honour the intent of the reform, and address the wages gap between the private and public health sector.

“I’ve said very clearly to providers, we are not just going to provide additional funding to the system if we don’t have the confidence that the additional funding will go to wages.” — Minister for Mental Health and Ageing, Mark Butler



historic moment for midwives History was made at the Association’s 2012 Annual Conference with a change in name to the NSW Nurses and Midwives’ Association. The name change was recognition of the evolution of the nursing and midwifery professions over the years.The Annual Conference – our policy making body – decided it was time to be more inclusive and reflect this modern reality in our name.

“The Association has been around now for 80 odd years and this is a significant, historical change.” — Jan Dilworth, midwife

international Australia may have come through the Global Financial Crisis relatively unscathed, with what, in retrospect, looks like an inspired economic intervention by the federal government. Arrogant and profligate bankers may have been the cause of the crash but, as usual, it was workers throughout the world, particularly public sector workers, who bore the brunt of the financial meltdown. In June we were alerted to a cautionary tale playing out in the US state of Wisconsin, where public employees, including nurses, were battling an extreme antiunion administration. The British National Health Service has been under relentless attack this year, under the guise of “austerity economics”. More than 30,000 National Health Service workers have lost their jobs and the service has been opened up to sweeping privatisation. Similar rollbacks on workers’ rights and health care funding have been taking place throughout Europe and the Americas during 2012.

“The governor is now trying to remove 64,000 needy children from our state health care program. It’s been a yearlong battle to get our human rights back but we’re not giving up.”


— Jeff Weber, US psychiatric nurse

nurses and culture “What a show to be involved in and what a night.” — Matthew House, London primary care liaison nurse

From the London Olympics to MasterChef, nurses, midwives and their families made their mark on popular culture this year. Hundreds of British nurses danced their hearts out at the London 2012 Olympic opening ceremony, as part of a glittering tribute to the British National Health Service. Westmead Children’s Hospital RN Amina Elshafei reached the top 12 on the television cooking show MasterChef, and RN and NSWNMA member Nia Beaman (and 56,000 colleagues) barracked for Nia’s daughter Prinnie, as she battled it out on the popular Channel 9 show The Voice.

anf advertising The Australian Nursing Federation launched a national campaign promoting positive attitudes towards nurses, in August. The campaign aims to address poor community perceptions and frustration with the health system, by building public support for nurses and putting pressure on political parties to improve conditions for nurses and midwives.

“It’s always good to have positive messages about nurses out there.” — RN Jenna Fanning, Westmead Children’s Hospital



A healthier nurse

Little is known about the health and wellbeing of the 280,000 nurses working in Australia and how that might impact on patient care. The first comprehensive survey of nurse health and wellbeing is set to find out.


It is expected that around 70,000 nurses and midwives will complete the survey that runs until March at The research is being funded by the Department of Health and Ageing.

EARLY RESPONSES TO AN ONLINE survey of Australian nurses show they are stressed, some wish they were healthier, and they believe shift work and heavy workloads are impacting on their health and wellbeing. The survey, by Southern Cross University (SCU) on the Gold Coast, is looking at what nurses themselves have to say about the state of their health and the issues they believe are affecting it. “It’s early in the survey but we are getting responses that we are not really surprised by,” Kay Ross, lecturer in the SCU’s School of Health and Human Sciences told The Lamp. “This is a first step towards gaining valuable information on how nurses feel about their health, as well as determining the extent of chronic illness among nurses and midwives. “I’ve been a nurse for 30 years and one thing I’ve noticed in that time is that nurses are really good at looking after everybody else but they don’t tend to look after themselves as well.” One survey respondent commented:

“If we don’t support nurses in their own health and wellbeing we’re going to get to the stage where we don’t have a good nursing workforce.” —Kay Ross

“I’ve been a nurse for 50 years and this is the first time anyone has ever asked me about my own health.” “Weight is an issue with some nurses and that needs to be addressed,” Kay said. “Most people who are overweight, whether nurses or not, are aware and want things to be different. There’s plenty of information out about weight, obesity, hypertension, type 2 diabetes and all the other chronic illnesses. With this survey we want to take a positive look at what can be done differently in nursing and come up with some strategies.” As well as asking for details such as weight and waist measurements, the survey will look at diet and lifestyle issues such as how many nurses are smoking or not eating well or not getting enough physical activity, and whether these issues are in response to shift work and workloads. “Thirty five per cent of nurses are aged over 50 and 45% are aged around 45,” she said. “So we are an ageing work force and the older we get the more likely we are to develop chronic illness; and if we are not looking after ourselves we are at more risk

of chronic illness. We want to look at whether respondents have a chronic illness or are likely to develop one in the next couple of years. Kay said there was already a lot of available information about weight problems in the general community and the survey would establish evidence about the nursing workforce in particular. “We know some nurses are overweight, as are sections of the community. We want to get the evidence to find out how many and what we can do about it,” Kay said. “How much does shift work impact on nurses’ food choices? We know some cafeterias are better than others. A lot of nurses know about the 3am munchies. On night shift are there any choices other than vending machines?” The survey website features forums where nurses can share their experiences, as well as resources such as links to information on a wide range of health issues, from nutrition to alcohol, smoking, obesity and stress. “Obviously a lot of healthy nurses are doing things well and we’d like to provide their feedback,” Kay said. “Nurses have said that just doing the survey got them thinking and we don’t want to leave them in the lurch until we have all the results. “Whatever we find about nurses’ health is going to apply to other industries and other people in the health profession. We can say to employers ‘this is what we’ve found out, these are easy strategies that can be put in place and they don’t have to be time consuming or money consuming’. “We are also conscious of the fact that part of a nurse’s role is talking to patients about stopping smoking, getting more active and eating well. We do that well but are we good role models?” Once the survey analysis is complete, researchers will make recommendations for change where it is necessary. “If we don’t support nurses in their own health and wellbeing we’re going to get to the stage where we don’t have a good nursing workforce. We’ve really got to put in place some strategies to look after nurses. To me that is the major thing.”


M y Christmas Merry Chhristmmas from from the th he NSWNMA NSWN NMA

NSWNMA wishes all members a Merr y Christmas and of fers you the chance to be par t of this year’s Christmas giveaway. í˘“ SYDNEY FESTIV VAL A AND AC CCO OMMOD DATTION P ACKA C GE FESTIVAL ACCOMMODATION PACKAGE Winner of this wonderful prize will receiive tickeets for two to see the performance of Rian, on 18 January at 8pm at the Theatre Royaal, and a two o-nigght stay for two at the Mercure Sydn d ey. Rian is a higgh-en h ergy mix of music and dance and is the latest creation from Dublin’’s Fabullous Beast Dance Theatre. Mercure Sydney is conveniently located in the city, within walking distance of the best attractions, shopping, eating spots and with public transport links on the doorstep providing easy access to everything Sydney has to off ffeer. Visit

We also have a double pass to see Urban, on 17 January, 7.30pm at the Riveerside Theatres. The visceral rawness, brazen attitude and high-voltage energy of Circolombia’s Urban has put a rocket under contem mporary circus. Following a sellout run in London and New York, and extended seasons in Paris, Urban comes to Australia for an exclusive season at Riverside Theatres. See www.sydneyfestival. www.sydneyfestival. or more fo infformation and performances.

í˘” SUMMER VIEWING The Lamp has a three speed Papillionaire Sommer bicycle valued at $648 to give away, as featured in the Call the Midwife series. And the lucky winner will also get the Call the Midwife DVD. There is an extra copy for a second prize winner. Trraaveerse the ciity streets in style l . Sommer is a harmony of vintage aesthetics and modern parts. With an uprigght sitting posiitioning and sw wooping step-througgh fra r me, it is built for a smooth and easy ride. For more inffo visiit www The six-part Call the Midwife series is a fascinating portrayal of birth, liffe, death and a community on the brink of huge social change. We also have five copies of Hysteria and The Sapphires to give awa w y, both available on DVD now. Hysteria is a deligghtful comedy set in 19th Century London. The Sapphires is an inspirational and heart-warming tale, set in the late 60s, about a quartet of young, talented singers f t Ab i i l i i h


We have two, six-pack book gift packs from Penguin: The House of Memories by Monica McInerney ; Lola Benskyy by Lily Jamie’’s 15 Minute Meals by Jamie Brett; Jamie’s Oliver; Montebello by Robert Drewee; Jack of Diamonds by Bryce Courtenay ; and Silent House by Orhan Pamuk.

í˘— HUNTER CHRISTMAS LIGHTS GET TA AWA AY GETAWAY The Lamp is off ffeering members the chance to wiin two tickets e to Hun nter Valley Gardens, Christmas Lig ightts Spectacular and two wo t twin i or double share accommodation nigghts ub & in studio room at Harrigan’s Irish Pu Acco c mmodation including a delicious full hot and cold breakfa f st daily. Our Christmas Lights Spectacular is in its 6th year and has over now has 1.25 million ligghts on display. This multi-aawa w rd nt runs until 26 January 2013. winning even Visit www or m au fo details an uyy your bu express entry ticket.

í˘– BE B OWLED O VER V BOWLED OVER BY CRICKET TICKETS If you’re lookkiing for a fu un-filled nigght o action-packed crickeeting en ntertainmen e alo l ng this summer make sure you get to the SCG to waatch the Sydn d ey Sixxer e s. The Syd dney Sixxer e s are the KFC T20 Big Bash League Season One Champions and the winn i ers of the 2012 Champions League and are ready to ligght up Sydn d ey’s y’s most iconic stadium The SCG will be a sell-out when the Sydney Sixers take on cross-town rivals, Sydney Thunderr, on Saaturday 8 Decem mber so don’t miss out on grabbing your tickeets! The Lamp has four family passes to the Sydney Sixers vs Melbourne Renegades on 9 January 2013 at the SCG! The winning tickets e are for general seating and a family d pass consists of tw d lt two children – th reserved seating. Become a Syd dney Sixxer e s mem mber today or for o more details go to

HOW OW TO ENTER To be in the dra draw w for one of these fabulous prizes, write your your name, address, membership number, numberr, and the prize name and number you you want to win (a separate entry/envelope entr y/envelope is required for each prize), on the back of an envelope envelope and mail to: NSWNA Christmas Giveaway, Giveawayy, 50 O’Dea A Ave, vve, Waterloo NSW 2017 Waterloo a Competition closes ses 16 December 2012. 20 IMPORTANT: NT: Only one entry entr y per member er for each competition competi will be accepted. Entrants must ust indicate which which prize and/performance and/performance they they would would like like to win on the back of the envelope. envelope.

e m i t p f u o r b s 2 u ’ r 01 tI o sc 3! t

Christmas ristmas Closing Dates Total otal al Image will wi close on 21 December b 2012-7 2012 January 2013. December orders will be processed after 7 January 2013

Order your NSWNMA campaign scrub uniforms for conference and rally times, and make an impression!


Over the past few months, NSWNMA and Total Image Group have been working together to create a new fit for purpose scrubs range. The new campaign uniform range endorses a modern appearance and offers both comfort and durable features, while still embracing NSWNMA image.

Sizes range from XS-5XL to ensure various body shapes and sizes are catered. Most importantly, the range has been designed to ensure a comfortable fit every time.

Size (cm)










Half Chest Circumference










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General Guide for Female 8/10 SCRUB PANTS PA ANTS

The new range consists of a Unisex Scrub Top and Unisex Classic Pant. Both made from 65% polyester, 35% cotton. This fabric blend is durable and of superior quality. The scrub campaign uniform also has number of functional features, including jet pockets, pen partition, drawstring front on pants and brushed fabric coating for added comfort.

Half Waist (Relaxed)












20/22 22/24 24/26









Half Waist (Stretched)










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Scrub top and pant are $20 each incl GST. You can place your order by the following methods: 2

Shop online, online, by registering as a user on on our tailored NSWNMA online store. 2 Browse through the customised catalogue, catalogue complete the order form and send back to Total Image by: email Fax: 9569 6200 or Post PO Box 199, Westgate NSW 2048 Total Image accepts credit card payment by Visa, MasterCard, and AMEX (3.5% surcharge on AMEX) or cheque/money order. Delivery by Australia Post within 10-14 working days and charged at $5 incl GST.

For more information please contact TTotal otal Image on (02) 9569 6233 or email


ASK JUDITH Comp claim in dispute

Higher-grade duties

I suffered an injury at work and made a claim for workers compensation but have been informed by the insurer that my claim has been denied. I have sought legal advice and my solicitor is disputing the decision. My doctor has issued a Workcover medical certificate clearing me to work restricted hours and suitable duties. My employer has told me that, as the insurer has denied my claim, they don’t have to give me suitable duties. Is this the case? No, this is not the case. If your claim is in dispute, and your treating doctor has cleared you for suitable duties, then current workers compensation legislation states that your employer has a responsibility to provide you with suitable duties, even though your claim is in dispute. This is explained in section 41A and section 49 of the Workplace Injury Management and Workers Compensation Act 1998.

I am an RN in a public hospital relieving in a higher grade Monday to Friday position. The incumbent took leave from Tuesday, so in the first week I acted up for four days, and then acted up Monday and Tuesday of the next week. When I queried why higher-grade duties (HGD) weren’t paid, I was told I had to work five days in a row to qualify. Is this correct? No, it is not. The relevant part of the Public Health System Nurses’ & Midwives’ (State) Award is clause 24 (i): “An employee who is called upon to relieve and does relieve an employee in a higher classification or is called upon to act and does act in a vacant position of a higher classification for a continuous period of at least five working days shall be entitled to receive for the period of such relief or acting, the minimum payment for such higher classification.The employer shall not rotate the performance of higher grade duty so as to avoid payment for performance of the higher grade duty in this manner.” The relevant words are “for a continuous period of at least five working days”. It does not say “for a continuous period of at least five days”. Days, on which the incumbent is on rostered days off, do not break the five consecutive days. HGD should therefore be paid.

Unreasonable directive I am an RN working in a Psychiatric Acute Care Service Unit in the public health system. Recently, on commencing my morning shift, several co-workers and I were informed by our NUM that we had to take 4.5 hours of time in lieu (TiL). Can you please advise whether this is a reasonable directive? No, this is not a reasonable directive. The TiL should be agreed between management and the employee. The Public Health System Nurses’ & Midwives’ (State) Award 2011 Clause 25 part (iv) provides the relevant information in relation to TiL.

Care for household member I am an RN working in the NSW Public Health System. Would you please clarify whether I am able to take Family and Community Services Leave (FaCS) to care for a member of my household who is not related to me? You may be granted FaCS leave for this purpose as per Clause 32 of the Public Health System Nurses’ and Midwives’ (State)

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

Award 2011. Clause 32 (b) (1) states that family and community services leave may be taken “to provide care and/or support for sick members of the employee’s relatives or household”. Under this clause a household is defined as a family group living in the same domestic dwelling.

Re-entry after six years I am seeking to re-enter nursing in New South Wales after six years away from the profession. What options do I have? Currently, the approved re-entry program in New South Wales is the College of Nursing Assessment of Competence Program, which is an eight-week course in Burwood with a tuition cost of $10,000. This course is designed for Australian Registered and Enrolled Nurses who have not practised for a period of more than five years, but not exceeding 10 years. The program is a Nursing & Midwifery Board of Australia (NMBA) approved pathway to achieve the level of competency required for registration. The Nursing and Midwifery Office (NaMO) is offering full scholarships to nurses who wish to undertake this program. The awarding of a scholarship is linked to employment and recipients must be prepared to accept an offer of permanent employment within the public health system for two years upon successful completion of the course. Applicants should contact NaMO in the first instance. Nurses may undertake approved online courses which also have clinical supervision. NSW Government scholarships are not yet available for these courses.You may work as an Assistant in Nursing in the mean time, until you re-gain your Registered Nurse status with the Australian Health Practitioner Regulation Agency (AHPRA).

REGISTERED NURSING RE-ENTRY PROGRAM NOW AVAILABLE ONLINE Accredited program available via flexible delivery Clinical Placements in your local area Online education allows you to study part-time Scholarships / Government Funding available for eligible students

Institute of Health and Nursing Australia Web:

Tel: 1800 22 52 83







A BLOG FOR AUSTRALIAN NURSES AND MIDWIVES Nurses & Midwives Online. On the frontline of Health Care and at the cutting edge. Sign up for the weekly email newsletter that alerts you to the most recent posts. Nurse Uncut is also on Facebook: And on Twitter @nurseuncut

My first year as a graduate nurse

Anna Scott-Murphy on the stress, nerves, confusion and achievements of her new grad year in a large public hospital.

Report from the International Conference for Emergency Nurses

Jillian Thurlow was exhilarated – and challenged – at an ED conference in beautiful Hobart.

Filmmaking nurses and midwives!

Budding filmmakers prepare for the NSWNMA 2013 Short Film Festival.

Nurses stay calm during mega-storm Sandy

Nurses in a New York hospital had to evacuate the neonatal intensive care unit at the height of Hurricane Sandy.

How do I get into primary health care?

Jessie, a second year RN, seeks advice about moving into public health promotion.

My image of nursing has changed

In Mia Dowling’s first year as a student nurse, her image of nurses has changed – for the better.

Nurse, midwife – a photo essay

Remarkable photos from 1951, of American midwife Maude Callen at work with the poor of rural South Carolina.

Nurses’ films travel to Europe’-films-go-on-a-holiday-to-europe/

Dr Lisa Milner of Southern Cross University took NSWNMA film festival films to Poland and England.

ONLINE Join us


NSW Nurses and Midwives’ Association Aged Care Nurses: One2four the way to safe patient care

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NURSES & MIDWIVES SAID & LIKED on facebook Jobs shortage News from Tasmania and Victoria that large numbers of graduates are not getting places in 2013 was greeted with dismay.

This is disgraceful. I thought there was a nursing shortage? What happens when older nurses retire? We need our new graduates! Get real governments! Only 10 students have secured new grad program in Blacktown Hospital; 30 at Westmead. The rest of the applicants are on a waiting list. I think it is time for a national campaign to increase the number of new graduate nursing positions in public hospitals. If we don’t take action now, the future of our profession is in jeopardy. We need to be training and supporting the next generation of nurses.

Private sector Forster Private Hospital nurses are taking industrial action, having failed to get a fair pay offer in the 14 months since their Enterprise Agreement expired.

Journey insurance News that the NSWNMA has taken out journey insurance for its members.

Car park fees News that Campbelltown Hospital was considering a parking charge for staff provoked high feelings – but some were not bothered.

I’ve signed the petition. But why has the company taken so long to negotiate a new EA? This seems ridiculous. Fabulous news. Well done. Journey accident insurance. Great move to protect members but such a shame that we are not protected under WorkCover ... very sad day. This is unfair to workers, patients and families and must not be allowed to happen. This will only stop people going to hospital or instead calling for assistance from our already overstretched ambulance service. Macarthur must just say no! Most hospital workers pay to park at work. Unfortunately resistance is futile.

I loved Vicki’s speech. She was very passionate about nurses in the aged care sector. Well done!

Launch Vicki Partridge, DoN of Yagoona Nursing Home, spoke at the launch of Bankstown Community Unions.

Questions Facebook can also be a sounding board for questions and opinions.

As a newly graduated EEN, how do you get a position within the industry if you have no experience? All jobs want experience – how do you get that if you can’t get a job? Confused! Paramedics are our colleagues, what affects them affects us. Proposed changes to rosters for rural paramedics will increase the burden on rural emergency departments, and nurses, and put communities at risk. Can someone explain to me the reasoning behind the need to prove that you have been taught for five years in institutions that teach in English in order to register as a nurse? I can see how it would matter if you were born and/or educated overseas, but I’ve never even left the country!


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MASTER OF NURSING (COURSEWORK) GRADUATE CERTIFICATE IN NURSING Students have a choice from four areas of study: UÊ ˆ˜ˆV>Ê Ê UÊ ˆ˜ˆV>Ê/i>V…ˆ˜} Ê Ê ÕÀȘ}ÊÊ Ê Ê Ê UÊi>`iÀň«Ê>˜`Ê>˜>}i“i˜ÌÊÊ UÊÊ}i˜iÀˆVÊVœÕÀÃiÊ܈̅œÕÌÊ>ÊëiVˆ>ˆÌÞ Ê Ê Ê ÊÊ Ê Ê Ê Ê Ê Ê

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Graduate Certificate in Nursing UÊ{ÊÃÕLiVÌÃÊ̜Ì>ˆ˜}ÊÓ{ÊV«Ã Ê Ê Ê Ê Ê

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Win an iPad and save a bundle Buy a home or garden product through our Purchasing Service and you’ll go into the draw to win an Apple iPad 3* Entries close 30/11/2012 * For T’s & C’s, visit .c .



The Australian Institute of Health and Welfare (AIHW) is a major national agency set up by the federal government to provide reliable, regular and relevant information and statistics on Australia’s health and welfare. The aim is to improve the health and wellbeing of Australians through better health and welfare information and statistics. The Institute collects and reports information on a wide range of topics and issues, ranging from health and welfare expenditure, hospitals, disease and injury, and mental health, to ageing, homelessness, disability and child protection. A picture of Australia’s children 2012 This report provides the latest information on how Australia is faring according to key indicators of child health, development and wellbeing. Deaths rates for infants and children have declined since 1986, rates of risky drinking and smoking among children aged 12-14 are down, and most children achieve above the minimum standards for reading and numeracy. Yet there is room for improvement. Almost one-quarter of children are developmentally vulnerable at school entry, and Aboriginal and Torres Strait Islander children and children in socioeconomic disadvantaged areas are likely to fare worse across a broad range of indicators.

Food for thought: what do short questions on food habits tell us about dietary intakes? Short questions on food habits, such as “How many serves of fruit do you usually eat each day?” are often used to assess dietary behaviours. This report presents analysis of the 2007 Australian National Children’s Nutrition and Physical Activity Survey, to assess how well responses to short questions compare with more comprehensive tools, such as keeping a diary of all food

eaten over two 24-hour periods. Results show that short questions may be a reasonable proxy for type of milk usually consumed, and a reasonable approximation of fruit and vegetable intake, but are of limited value for predicting sodium or iodine intakes.

Medications prescribed for people with obstructive airways disease. Antibiotics and inhaled corticosteroids — AIHW Access no. 34, 2012 Access is a quarterly newsletter published by the Australian Institute of Health and Welfare, profiling the Institute’s work and its people.

This report focuses on the appropriate use of certain medications for the management of obstructive airways disease, including asthma and chronic obstructive pulmonary disease (COPD). Appropriate use of medications is important in maximising health benefits for patients, minimising the negative effects of medications, and controlling health costs. Data in this report suggest that antibiotics are commonly used among patients with asthma and COPD, and that supply patterns for inhaled corticosteroids are often not consistent with treatment guidelines for the management of these conditions.

Recruit a new member and go in the draw for A Wonderful Holiday of a Lifetime Travel from Sydney to Perth in the classic Gold Service on the mighty Indian Pacific. The Indian Pacific is an epic journey that spans a continent. Over 3 days and 3 nights guests experience some of the most diverse scenery on earth – from the stunning Blue mountains with lush tree canopies and spectacular valley views, through the great Dividing Range, the salt lakes and sand dunes of South Australia and over the longest straight stretch of rail track in the world across the Nullarbor Plain.

Prize includes one way journey to Perth for two on the Indian Pacific, airfares for two from Perth to Sydney and five-night’s accommodation in a Novotel Perth Langley’s Superior King Room, including full buffet breakfast for two*.

Thomson Bay, Rottnest Island. Credit: Tourism Western Australia

Remember for every new member you recruit/have recruited from 30 June 2012 to 30 June 2013 means you will have your name submitted to the draw. RECRUITERS NOTE: Nurses and midwives can now join online! If you refer a new member to join online, make sure you ask them to put your name and workplace on the online application form. You will then be entitled to your vouchers and draw/s in the NSWNMA Recruitment Incentive Scheme.

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Across 1. The passage of blood through blood vessels 6. Any compound derived from ammonia by substitution of an acyl radical for hydrogen 9. Oil of vitriol (9.4) 11. Pascal (Abbrev.) 12. Fifth letter of the Greek alphabet 14. Excessive salivation 15. Syngraft (10.5) 20. Having four similar parts 22. Genu 23. A receptor of smell stimuli] 25. Isopropyl alcohol (1.1.1) 26. Cuspid tooth


27. Having resistance to infection by a specific pathogen 28. Symbol for element calcium 29. Marks created during the healing of damage to the skin or tissues 32. Clotted blood that lodges in a blood vessel, obstructing the circulation 33. A pustular eruption

Down 1. Alteration or loss of species characteristic 2. Congenital absence of the tongue and the mouth opening 3. An infant’s repetition of the sounds made by others 4. The organ of hearing 5. Hypertonic 7. Any soft marrowlike structure 8. Sediment or dregs 10. Immunoglobulin 13. Normal respiratory secretions (1.1.1) 16. A genus of coccidia chiefly parasitising mammals

17. Any disorder of pregnancy 18. Fontanelle 19. Oily, fatty 21. Ectopic pregnancy 24. Nasal 26. Not agitated 30. Rapid eye movement (1.1.1) 31. Dysprosium


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BOOK ME Baby Care: Nurturing Your Baby, Your Way Rhodanthe Lipsett, edited by Dr Jenny Brown, RM, Med, PhD, Finch Publishing


RRP $34.99 j ISBN 9781921462306 j An ideal book for first time parents who need to explore all the options available to them when trying to understand the needs of the tiny individual who has entered their lives. The author has drawn together her knowledge, experience and wisdom, gained over a lifetime of caring for babies, and explains that there is no set or hard and fast rules that need to be followed.

The Psychological and Social Impact of Illness and Disability (6th ed.) Edited by Irmo Marini, PhD and Mark A. Stebnicki, PhD, Springer Publishing Company

RRP $90.00 j ISBN 9780826106551 j Almost two thirds of the chapters in this latest edition of The Psychological and Social Impact of Illness and Disability are new or updated. The book also contains insightful, empirically based research articles, and the contributions of international researchers to present a more global and richer perspective on the psychosocial aspects of disability and illness. There is an increased focus on the negative impact of societal attitudes and treatment of disabled individuals, on their psychological adjustment to disability. The addition of objectives at the beginning of each chapter, and review questions and personal perspectives at the end of each chapter, further facilitate in-depth learning.

Current Medical Diagnosis and Treatment 2012 (51st ed.) Edited by Stephen J. McPhee, MD, Maxine A. Papadakis and Associate Editor, Michael W. Rabow, MD, McGrawHill Medical

RRP $90.00 j ISBN 9780071763721 j Focusing on internal medicine, this edition of Current Medical Diagnosis and Treatment delivers coverage of more than 1000 diseases and disorders. It offers insight into symptoms, signs, epidemiology, and treatment for these diseases and disorders. It places emphasis on the practical aspects of clinical diagnosis and patient management in various fields of internal medicine. It can be considered as a single source reference for practitioners in hospital and ambulatory settings, as well as a resource for patients and their families who seek information about the nature of specific diseases and their diagnosis and treatment.

When Reason Screams NO and Intuition Screams YES: An Amazing and Inspiring True Life Story of Courage and Faith. Vtec Janus, IDS Publishing (available at Gleebooks and Dymocks, Sydney)

RRP $26.95 j ISBN 978098711780 j Set amid the chaos of war and invasion, this is the true story of Stanley Janus’s brush with death, and of how a miracle saved him from a terminal illness. At the same time, it is the distillation of his wisdom and a guide for living from the heart. The book is an adventure story and an eyewitness account of a time when Nazi Germany and Soviet Russia allied to tear Europe apart. It also tells the story of his wife who performed the duties of a nurse while caring for her husband. In the end, his recovery against all odds inspired them with both faith and courage to care for their newborn grandson, the author, at a later time. The style is unpretentious, conversational, and accessible.

More than Bombs and Bandages: Australian Army Nurses at Work in World War I Kirsty Harris, Big Sky Publishing

RRP $34.99 j ISBN 9780980814057 More Than Bombs and Bandages exposes the false assumption that military nurses only nursed. Far removed from the “devotion to duty” stereotype, it offers an intriguing and sometimes gut-wrenching insight into the Australian Army Nursing Service (AANS) during World War I. Both evidence-rich and personal, More Than Bombs and Bandages focuses on the individuals, using their own words and recollections to illustrate the vast array of roles and skills the AANS had during the Great War.

All books can be ordered through the publisher or your local bookshop. NSWNMA members can borrow the books featured here, and many more, from our Records and Information Centre (RIC). Contact Jeannette Bromfield or Cathy Matias 8595 2121 All reviews by NSWNMA RIC Coordinator/Librarian Jeannette Bromfield. Some books are reviewed using information supplied and have not been independently reviewed. THE LAMP DECEMBER 2012 — JANUARY 2013 | 41


Cynthia Joan Williams OAM (née Manuel) 20 January 1935 — 28 November 2012

[e\ Cynthia Joan Williams, mother, grandmother, nurse, community advocate, and friend to many, was born in Armidale to Wes and Marg Manuel.Their only daughter, she was older sister to Richard, who has also passed away. Cynthia married Don Williams and together they had four children, two girls and two boys. Cynthia was happiest serving others: she had a true servant’s heart. The day she was diagnosed with cancer, four months prior to her passing, she kept saying, “I’m not ready to go yet, I have much more to give.” What a perfect profession she chose in nursing. She began her nursing training 30 June 1953, at Armidale Hospital, and made many lifelong friends throughout her career. She completed her training in 1957 and went on to do general nursing at the Guyra Hospital until 1965. She then worked at the doctor’s surgery for three years until the birth of her two boys, after which she returned to nursing doing night duty so she could be with her family in the day.

In 1973 she started community nursing with the assistance of the Lions Club, who donated the first car. She loved community nursing and was on call 24/7. It was no effort for her to get up at midnight to visit a client in need; the phone never seemed to stop some days. In reading her memoirs she has seen and done some wonderful and varied things for so many people. She found herself in some very dangerous situations at times but was always there for those who called. As with all nurses, the training never ends and Cynthia continued to upgrade and learn new skills in renal nursing, HIV, cardiac rehab and palliative care, to name a few. In 1990 she became a clinical nurse specialist in palliative care, plus a preceptor for aged and palliative care for University of New England. She worked tirelessly for the Cancer Council and represented her nursing community on many committees and programs Her Medal of the Order of Australia (OAM) was a great honour and she dedi-

Graduate Certificates Including Acute Care, Aged Care, Cancer, Child and Family Health, Critical Care, Neonatal, Paediatric, Perioperative and more.

cated her medal to all nurses saying: “As a community nurse I have had many joys, tears and challenges. The OAM to me is very special for all nurses who gain the love, trust and respect of the community through their tireless work.” Cynthia also set up and coordinated home care for six years and instigated the running of a community bus. Another great love was music and she played at many hospital functions and the Bundy Bush Band raised many hundreds of dollars for equipment for the hospital and the community of Guyra. Cynthia was honoured with many awards such as Rotary Citizen of the Year, Australia Day Citizen of the Year and received many certificates of appreciation for her endless work. In fact she was given an award by the RSL the week before she died. Cynthia will be greatly missed and the legacy that she leaves behind will not be forgotten and will serve as an inspiration for nurses throughout Australia.

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Filming in progress Budding filmmakers are set to shine at the next NSWNMA Short Film Festival.


the next NSWNMA Short Film Festival, with the help of experts from the National Institute of Dramatic Art (NIDA). A NIDA filmmaking workshop was held earlier this month to assist nurses and midwives who are producing films for the 2013 International Nurses’ Day Short Film Competition. The session gave NSWNMA members the chance to ask a NIDA expert about any issues they were struggling with during the film making process. Intensive beginner and advanced filmmaking workshops were also held in March, covering the importance of screen writing, camera angles, lighting and camera operation and the elements required to create a visual story. Mental health nurse Julie Millard has been an avid contributor to the NSWNMA Short Film Festival since it’s inception in 2009. “I did a documentary talking to a woman that lives with schizophrenia and it was a fantastic experience for me,” Julie recalled. “In 2009, I did a NIDA filmmaker’s workshop, where the NSWNMA subsidised, encouraged and supported us, and then I did another five day intensive this year. “This time it will be slightly different because now there’s more of a focus on nursing for the film that I’m putting in for next year’s festival,” Julie said. The RN told The Lamp her enthusiasm for filmmaking and entering the short film

“As a mental health nurse I think it’s important that we tell stories.” — Julie Millard

competition was about “having some fun”. “It’s more about the experience of putting together the film and going from a creative idea to actually seeing it on film; it’s never going to be about winning,” Julie explained. “I’m just doing it myself, I’m not doing it with a cast of thousands or anything so it’s more about having some fun.” For those looking to enter a film in next year’s competition, Julie recommends calling on family and friends for added support. “Give it a go and call on all your friends and family to help you,” Julie advised. “Some friends will happily be in it and

other friends will say ‘definitely not’, but then they’ll be very useful as a boom operator or to do props. “Seek out people with their own skills who will help you in their own different ways,” Julie added. The focus of Julie’s new film is once more mental health nursing, a field she works in and is passionate about. “As a mental health nurse I think it’s important that we tell stories,” Julie explained. “Life is about sharing stories and I think film is a way to do that, which I think reaches more people.” NIDA 2 day and 5 day workshops will be held in February. Dates to be advised.



movies of the month SAMSARA

Nestling into the same genre as Koyaanisqatsi made in the 80s, and Baraka made in the 90s, Samsara is a sumptuous sensory experience, writes Anni Cameron. All films have in common Ron Fricke as cinematographer or director and Mark Magidson as producer, as well as no dialogue but a visual smorgasbord, contrasting images of breathtaking natural beauty alongside confronting images of overfed folks shopping at Costco, and the destitute of South America sifting for scraps out of a garbage dump. Fricke’s filming of Samsara, which comes from the Sanskrit word meaning “the ever turning wheel of life”, took five years and spanned 25 countries on five continents. For those who have seen the earlier

films there could be a sense of déjà vu, as many of the places look remarkably like places visited in those. However, the images are as compelling as they are mesmerising and the editing seamless as we are swept along the carved rock city of Petra, to a frenzied intersection in Tokyo, to the smouldering red black lava of an enormous volcano and ever onwards. It could be argued that it is the resounding rhythms of life on this planet that the filmmakers want us to understand, as they search for the elusive currents of interconnection that run through our lives. The sonorous music score and visuals are their way of trying to find a more direct link to the subconscious. Part of the film’s appeal is that you never know what achingly beautiful or hypnotically transfixing image will appear next; displaying our planet’s cyclical journey through civilisation and back again, or the ways we humans alter our natural world and our natural selves. Fricke uses time-lapse photography at regular intervals, depicting with startling clarity the mind-

MEMBER GIVEAWAY the lamp has 15 in-season double passes to give away to Samsara, thanks to hopscotch films. the first 15 members to email their name, membership number, address and telephone number to will win.


numbing drudgery of factory workers, or the fascinating bejewelled patterns of night time traffic and cityscapes. Whether the images before you are of almost comical dancing Filipino convicts, or serenely dedicated monks creating an exquisite mandala from billions of grains of coloured sand, or disturbing images of slums, or a gun factory where guns and bullets are assembled by the thousands, the film is hypnotic. It would seem that Samsara is not just showing a planet in trouble but that the planet is still beautiful. The political and environmental messages are there for the viewer to embrace if they wish to, or you may simply choose to take time out from the hustle and bustle of life and be lost in the film’s dazzling visuals. Anni Cameron, RN, BHA MEd, is a Teacher of Nursing at St George TAFE, Sydney Institute.



˜ Manhattan This is film has lots going for it: romantic comedy, set in Paris, the wisdom of Woody Allen and quite a few, rather interesting, family members, writes Sue Miles. Debut writer/director Sophie Lellouche’s delicious comedy centres on Alice (Alice Taglioni), an idealistic pharmacist who dispenses medicine and doses of Woody Allen, in the form of DVDs, to alleviate her customer’s ailments. Taglioni has a playfulness that is reminiscent of Audrey Tatou, which makes the film easy to watch. Alice spends her life fixated on Woody Allen and his philosophies. Why? Alice responds: “He makes me laugh.” She surrounds herself with images of Allen, continually quotes lines from his films and so it’s perhaps not surprising that she’s still single! Alice’s increasingly concerned Jewish parents hope to cure her fixation by setting her up with a handsome alarm installer (Patrick Bruel). He struggles to compete with the man of her dreams, the one, to whose poster she confides all her secrets. The genre is light and self-deprecating, the film makes fun of itself and doesn’t take itself too seriously, despite the fact that it is well made, and beautifully shot. Paris-Manhattan affectionately refers to many of Allen’s classic movies. Even if you only “just like” Woody Allen, maybe it’s being in Paris, maybe it’s the French or maybe it’s all of it put together, I’m sure you will leave this film in a good mood. I loved it. Sue Miles is a Mental Health Nurse at the RPA


MEMBER GIVEAWAY the lamp has 20 in-season double passes to give away to Paris–Manhattan, thanks to palace films. the first 20 members to email their name, membership number, address and telephone number to will win.



movies of the month

LOVE IS ALL YOU NEED Although billed as a romantic comedy about new beginnings, the humour in this film is darker than usually found in a rom-com, writes Sharon Ketelaar. Love Is All You Need is a Danish movie about two families who come together for a wedding and is set in both Italy and Denmark. Pierce Brosnan plays Philip, a Copenhagen-based fruit and vegetable mogul who demands his employees put business before family, as he does. Philip’s son, Patrick, is about to marry his sweetheart, Astrid, at their huge abandoned villa in a lemon grove in Sorrento. The preparations for the wedding bring together a dysfunctional and comedic collection of relatives, but not before a disastrous coincidental meeting between Philip and Ida, Astrid’s mother. Ida is at a low point in her life, having just completed disfiguring treatment for cancer and then discovering, in the worst possible scenario, that her husband has a lover. Just when the capers in the lemon grove border on ridiculous, the story becomes sombre. It reflects on lives changed by death and misfortune, sexuality, body image after cancer surgery, fear of disease returning, and the effect of these on trying to live a full life. Ida (Trine Dyrholm) has spent her life focussing on her husband and family, always putting herself last. Now, her cancer and her husband’s self-centred behaviour force her to re-evaluate her future. Philip has immersed himself in the high pressure world of business since the death of his wife.

He hides his grief behind a prickly temperament that suggests a raging anger, simmering below the surface. Philip struggles to connect with his son, who seems to be desperately seeking approval from his father. Soon we start to suspect that Patrick’s wedding is more about chasing the ideal of family and a wish that his father will enjoy life again. Philip must also tolerate his wife’s sister, Benedikte, a grating character who treats her own daughter appallingly and who, under the guise of helping the family and the motherless Patrick, barely conceals her desire to feature large in Philip’s life, and indeed his bed. The use of sub-titles in the early scenes and occasionally throughout the movie is a tool that accentuates the sense of place and the different nationalities of the two families. However, in heated exchanges between Ida and her husband, Leif, the viewer is left wondering who said what. The inclination to watch the characters’ expressions and body language trumps attempting to read the words that flick by so quickly. Love Is All You Need has a plot some will find predictable, but if you enjoy a feel-good movie where the loose ends are neatly tied in a bow by the end, then you’ll find this a pleasant European escape for a couple of hours. Sharon Ketelaar is an RN and freelance editor of medical texts.



MEMBER GIVEAWAY the lamp has 15 in-season double passes to give away to Love Is All You Need, thanks to madman entertainment. the first 15 members to email their name, membership number, address and telephone number to will win.

Save your Legs

An enjoyable Aussie crowd pleaser for cricket fans and appreciative newbies alike, writes Murray James.

MEMBER GIVEAWAY the lamp has 20 in-season double passes to give away to Save Your Legs, thanks to madman entertainment. the first 20 members to email their name, membership number, address and telephone number to will win.

Lazy hot days watching cricket are an ideal summer pastime for many Australians. For some, like Edward “Teddy” Brown (Stephen Curry), playing cricket is more than a sport – it’s a way of being. As president of his local cricket club, he has revered cricketing heroes, particularly Indian ones. Essentially a Peter Pan figure, he lives in a mate’s garage and laments the lack of commitment of many of the club members. He and his best friends, Rick (Brendan Cowell) and Stavros (Damon Gameau), are all in their mid-thirties. But whereas his friends have moved on to marriage and other interests, Teddy has not. To revitalise their friendship and commitment to the game, Teddy encourages his friends to fulfill their boyhood dream of playing cricket for Australia in India. Despite their amateur club being a mediocre D-grade, he successfully persuades local sportswear owner and tournament organiser Sanjeet (Darshan Jariwala), to sponsor them on a threematch Indian tour. Stumps fly and friendships come under pressure as the amusing tale unfolds. Different diets and cultural celebrations are all milked for their comedy potential along the way. Teddy in particular learns to cross the cultural

divide, becoming smitten with Anjali, (Pallavi Sharda) the sponsor’s daughter, and in one hilarious scene passes himself off as Ricky Pointing. This movie is loosely based on a real-life club tour of India by the Abbotsford Anglers of Melbourne, in 2001, which was made into a documentary. Save Your Legs is essentially a mateship-bonding story about men’s reverence and love of cricket. It has a convincing cast of Curry, Cowell (who wrote the screen play) and Gameau as the trio of best mates. Statistics-spouting teammate Colin (Darren Gilshenan) also entertains with a dry wit. Photographer Mark Wareham’s filming of the ancient atmospheric cities of Kolkato, Mumbai and Varanasi is excellent, as are the cricket action shots. Setting the movie in India was a definite plus for me, as it brought colour and excitement that would not have existed had it all been filmed locally. A touch of Bollywood, although predictable, adds to the fun. I was surprised to learn that Australian cricket teams have been touring India since 1945. Sharing our passion for cricket, inherited from our shared British heritage, has often helped bind our two cultures together, a fact that this movie highlights. Murray James is a RN in the Mood Disorders Unit at St John of God Health Services, Burwood, NSW.




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conferences, seminars, meetings


Choices & Challenges with Central Venous Access Workshop 5 December, Newcastle Ashley Hayes 0419 993 312 Improving Facility Design in Health 7 December, Sydney NSWNMA Pauline Pertel 02 9680 9026 Nepean Midwives Conference: Taking Midwifery to the Future 1 March 2013, Windsor Council for Children’s Nurses NSW Biennial Conference: Winds of Change - Thinking into Action March 14-15, 2013, Sydney   Natural Health Summit 2nd International 3-5 May, 2013, Sydney 7th Australian Women’s Health Conference   7-10 May 2013, Sydney   02 9254 5000


Tackling Asthma in Australia National Asthma Conference 2013 19-20 March 2013, Canberra


Working together. 7th Annual conference of the Australasian Cardiovascular Nursing College 23-24 February 2013, Auckland, New Zealand 0416 049 825 2013 World Congress for Psychiatric Nurses 2-4 May, 2013, Winnipeg, Canada


Royal Melbourne Hospital January 1973 PTS reunion Claire Jenkin (nee Furlong) 0420 810 544 RAHC March 1973 PTS reunion 17 March 2013 Bronwyn Exley: Jenny Elliott: Sherran Alexander (nee Peck): Allandale Hospital Cessnock 50-year reunion 23 March, 2013 Cessnock Supporter Club • 02 4993 2655 • Tickets $45

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Lamp December 2012-January 2013  
Lamp December 2012-January 2013  

In this issue: rural hospitals fight for safe staffing, nurses at two South Coast hospitals worked together to successfully prevent dangerou...