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FIRST Print Post Approved: PP241437/00033

2012 winners, left to right: Brenden Stapleton, Jenny Anderson and Nicholas Ralph

Know w someone some eone in nursing g who o deserves deserv an award? and innovation innovation Recognise their their outstanding leadership leadership and by nominating them in one of three ee categories: Nurse Nurse of the Year Team Team Innovation Outstanding Outstanding Graduate




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in prizes to be won!* Winners announced announced aatt tthe he aawards wards d inner o n Winners dinner on TThursday hursday 9 May May 2013, 2013, in in Melbourne. Melbourne.

*Generously provided by:

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Visit for for more more iinformation. nformation. Visit Issued by H.E.S.T H.E.S.T. T. Australia Aus Ltd ABN 66 006 818 695 AFSL No. 235249 Trustee Trustee of Health Employees Superannuation TTrust rust Australia (HESTA) (HESTTA A) ABN 64 971 749 321.





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 70 No.1 February 2013

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


12 | It’s time to vote on the recommended Public Health System claim Our 2013 pay and conditions campaign in the Public Health System will seek to improve and extend the ratios won in our last campaign and a pay increase of 2.5% per year. Mimi Chu, RN

5 6 8 35 36 39 41 43 44 46 50

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


FOR ALL EDITORIAL ENQUIRIES, LETTERS AND DIARY DATES: T 8595 1234 E M 50 O’Dea Avenue, Waterloo NSW 2017 Produced by Hester Communications T 9568 3148 Press Releases Send your press releases to: F 9662 1414 E

PHOTOGRAPH: Shannon’s Way


NSWNMA Communications Manager Janaki Chellam-Rajendra T 8595 1258


18 | The bush deserves better A lack of funding and staff in country and regional communities means an increase in nursing workloads, with the result that patients suffer.

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

27 | Pay rises at Forster Private

21 | We need safe ratios Despite the vulnerability of their tiny charges, Neonatal Intensive Care Units do not have the same level of mandated nurse numbers as adult ICU equivalents.


6 | Relaxing getaway


30 | Prank call with tragic consequence The day before the apparent suicide of a British nurse, the NSWNMA warned Radio 2Day FM to consider the personal toll on nurses of its prank calls.

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 2013 Free to all Association members. Professional members can subscribe to the magazine at a reduced rate of $50. Individuals $78, Institutions $130, Overseas $140. T H E L A M P F E B R U A R Y 2 01 3 | 3


a wonderful escape to

Norfolk Island

Start paying your NSWNMA fees by Direct Debit for the chance to win a holiday for two to Norfolk Island! The prize includes return airfares for two from Sydney or Brisbane International airport with Air New Zealand; 4 nights accommodation at the boutique Poinciana Cottages; car hire; half-day orientation island tour; sunset cliff top fish fry; breakfast bush walk with NI Touring; Mastering Taste chef school with Hilli’s Restaurant & Wine Bar; Two Chimney Winery platter and bottle of wine; and a welcome pack on arrival for each person. Norfolk Island, the wonderful Island destination, is just a 2 and a half hours short flight away with Air New Zealand. There’s more to Norfolk Island than you may think. Relax over a famous “Vineyard Platter”, enjoyed with a local glass or two, on the Cellar Door verandah at the Two Chimney’s Winery; learn to cook like a chef with Hilli’s Restaurant & Wine Bar Mastering Taste Cooking Tour. Whether you are having a quick bite to eat between activities, or settling in for an extended dining experience, Norfolk Island’s dining experience

is enhanced by the seasonal, homegrown freshness of its produce. Try your best swing at the Norfolk Island Golf Course, dramatically situated along the rugged coastline. Snorkel in Emily Bay, explore around the islands historic salt farms from under the turquoise water or escape for the afternoon at one of the many picnic spots along the cliff tops. We look forward to welcoming you to our 360º of Wonder.

Contact Adventure World on 1300 295 161 or email for more information about Norfolk Island. Conditions: the prize is not transferable or redeemable in cash; prize is valid for 12 months after the draw date; flights and accommodation are subject to availability; times of tours and availability are subject to change without notice.


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

Membership Application forms or Direct Debit forms can be downloaded from our website www Alternatively call the NSWNMA on 8595 1234 (metro area) or 1300 367 962 (non-metro area) for more information.


Ratios put patient safety first The focus of our Public Health System 2013 award claim is to improve and extend the nursing hours/ratios system.

High in our priorities will be the extension of ratios into specialty areas such as community nursing and paediatrics, which missed out in the last award campaign.We will also be making it a priority to improve ratios in country hospitals.

2013 will be a year full of challenges and opportunities for nurses and midwives in New South Wales. Opportunities will come with the renewal of our Public Health System Award. The centrepiece of our recommended claim for a new award will be the improvement and extension of ratios delivered via minimum nursing hours (NH). See page 12. Ratios remain at the heart of our campaigns for a very good reason: ratios put patient safety first. High in our priorities will be the extension of NH/ratios into specialty areas such as community nursing and paediatrics, which missed out in the last award campaign. We will also be making it a priority to improve ratios in country hospitals. No doubt many of you will have seen the latest Association TV ads, now on air. They are the first step in educating the public about our plan to further improve patient care in our public health system. Our 2013 claim is the culmination of many months of consultation with members through surveys, branch meetings, discussion groups and quantitative and qualitative research. Winning ratios in our last campaign was a great triumph for patient care and public hospitals. Since then, the government, to its credit, has fulfilled its commitment to deliver the 1400 extra nurses required to fill the ratios. However, this is not enough. Country and community nurses are struggling to keep their patients safe and are falling behind city hospitals. In areas like paediatrics and neonatal intensive care there is an urgent need to guarantee nurse numbers. Our members working in these areas have been clear that they too need ratios or, in the case of community nurses, an equivalent mechanism to deliver mandated face-to-face nursing hours. There are several resolutions from annual conference that call on the Association to campaign for these improvements.

The big challenge will be to convince the O’Farrell Government that it needs to commit resources to make these improvements. The state government must improve and expand minimum, mandated ratios for all nurses in the public health system. Nurse-to-patient ratios must be improved in all regions of NSW. The Association is aware of budget and recruitment issues, particularly in regional and rural areas. We urge the NSW government to redirect it’s $2.3 billion in “back office” savings to frontline services and better patient care. Our TV campaign will do a lot to alert the public about the issues in our public health system, and to enlist their support for our campaign. But that won’t be enough on its own. To win will require all nurses and midwives to stand united as never before. To win will require the active participation of the whole membership in the campaign. This campaign will not be easy. We have already seen nurses made redundant in NSW and Queensland and there has been a relentless attack on public services since the election of the O’Farrell Government. But we can win. Time and time again NSW nurses and midwives have shown the courage, commitment and resilience to fight for a better public health system, leading to better and safer patient care. We’ve done it before and we can do it again. I would like to thank the nurses who participated in our TV ads, in particular Mimi Chu, Emily Orchard and Katrina Lee, as well as mother Danielle Griffiths, who features in our ad about neonatal intensive care units. They all did a fantastic job in articulating the challenges facing us in these nursing areas and in advocating for achievable solutions that will improve patient care.

T H E L A M P F E B R U A R Y 2 01 3 | 5



Be a member! A couple of weeks ago I was called back into work at 11.30pm. I work in theatres at Prince of Wales, Randwick. I parked my car on Coogee Bay Road and began to cross the road when a pushbike I did not see, (no lights), took me out. I walked to hospital and admitted myself to casualty. They treated me as a trauma case and provided great nursing care. I was treated for a haematoma on my head and suspected broken ribs. Luckily it wasn’t a serious injury. I remember thinking in ED, lucky I’m in the union! I knew the state government had recently ceased our protection cover, to and from work. The hospital in this case will cover my expenses as I was on call. Although it is still to be cleared by the insurance agency, the union has guaranteed protection if this case is not covered by the insurer. So far the hospital and staff have been very good at looking after my care, and I have peace of mind that costs will be covered. Be a member! Lisa Barry, RN

letter of the

month The letter judged the best each month will be awarded a $50 Coles Myer voucher. “Whatever your next purchase, remember Union Shopper. After all, who can think of a reason NOT to save.” u n i o n s h o p p e r. c o m . a u • 1 3 0 0 3 6 8 1 1 7

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

CPD Cruises invites you to join fellow health professionals in combining education, relaxation and all the fun cruising is renowned for. Join us on one of our South Pacific Cruises with seminars in Mental Health, Relationships in the Healthcare Setting and Diabetes Mellitus and Nurses for Nurses Network 2013 Annual Conference. Bookings 0425 301 008 or info@ CPD Cruises Pty Ltd has RCNA Authorised Provider Of Endorsed Courses (APEC) status, subsequently our educational activities attract RCNA CNE points

6 | T H E L A M P F E B R U A R Y 2 01 3

Suicide of English nurse an opportunity for NSW wisdom The Lamp will probably report on the tragic apparent suicide of Jacintha Saldanha, aged 46, after being involved in the 2Day FM radio prank call to the London hospital treating Kate, Duchess of Cambridge. While the exact issue is very unusual and specific, it does address many issues of how to support those colleagues perceived to have behaved incorrectly, despite the many parameters of the real world in which we all live. Jacintha’s children, family and friends will continue to pay a disproportionately huge debt for what seems more an indiscretion than a crime. Though the hospital (and others) have reportedly been supportive, Jacintha seems to have been left with an individual debt that should have been shared corporately, especially by those who profited in reputation and financially from her otherwise excellent standard of work. The tragedy will be further extended if it does not cause us all to reflect upon how we support those perceived to have “broken protocol” and indeed how we support those with valid and sincere concerns such as “whistle blowers” and advocates for improvement. Often those already burdened by perceived grief and desire to further improve are isolated by their colleagues, and reprimanded by bureaucracies far removed from clinical knowledge and reality. The nursing community contains many loyal, humourous friendships, but also much robotic and ignorant lack of support for colleagues. The work environment can be toxic enough without our colleagues and communities adding unnecessary stress. May Jacintha’s death remind us all the value of true respect and empathy for our colleagues, as well as our patients/clients. May it truly encourage us to endorse and enjoy our profession. Liz Abbottsmith, RN Cruel call The death of the London nurse after a hoax call was tragic. I feel for all involved and I believe the station should be accountable, even if it is to financially cover the two children left motherless. Last night at work, I received a call from a “husband” asking about his wife and her condition. I immediately felt uncomfortable just being asked about a patient of mine since the recent incident. Of course I gave no information, but put the call to her, but the point is – the impact of what happened is too close to home for many of us. Robin Young, RN Nursing in a rural area Rural nurses have become the true generalists as we don’t have MET teams, wardsmen, RMOs, ward clerks, OTs etc and as such do our nursing and additional work and manage. Residents, acute and A&E with one RN and two RNs during the day – our NUM works four shifts a week on the floor also – and one RN, one EN at night. There are enormous differences between rural and city nursing and the ability of rural facilities to educate, train, guide and mentor students. Like mothers who work, and those who don’t, sometimes rural nurses feel judged that they are not “specialised” in a specific area. Yet ironically, when roles are reversed, large facility nurses are daunted by what we do and the enormous skills we individually have that make us the backbone of our health system. Sharyn Massey, RN


Scholarship approval Thank you so much to the Association for approving my application for an Edith Cavell Trust Scholarship. I can hardly put it into words my feelings of gratitude and appreciation. The scholarship means that I can now study Chronic Care at Charles Sturt University without the extra financial pressure. The subject fees for next year have risen to $1800 per subject, which means the scholarship will pay for most of my first semester subject fees. I believe this course will further enhance my professionalism in nursing and my ability to provide patient care of a high standard. Thanks again! Lisa Davis, RN Thank you to the Association Recently I was seconded to a NSW Ministry of Health position for just over a year. LHD management, who I had been employed with for over 20 years, approved the secondment. However, the week before I was to return to my substantive position, I was advised that my position had been “deleted” and was subsequently “in excess”. In accordance with NSW Policy my position was “matched” to another nursing management role, which was completely unrelated to the area of specialty I had worked in for the previous 20 years. Naturally I contested the decision to delete my position. The NSW Nurses and Midwives’ Association was extremely supportive of my cause and, despite three separate appearances before the Industrial Relations Commission, and numerous meetings and consultations with nursing staff affected by the deletion, it was finally a mendacious management who were victorious and the position remained deleted. My reason for writing this letter to The Lamp is not only to thank the NSWNMA but also to alert other nurses in NSW to the delusion that all nursing positions are safe – they are not. Next time it could be your position under review. Do not be misled into thinking that senior nurses will be your support; in my case it was the Area DON who represented management at the Industrial Relations Commission hearings. I would sincerely like to thank the NSW Nurses and Midwives’ Association and its delegates for their tireless efforts in the assistance they provided during this time. I cannot thank all those involved enough for their support, work and caring.You are all true nurses. Name withheld to protect the identity of the member


Hunter Valley

The Lamp is offering members a chance to win a wonderful getaway at the Pokolbin Village Accommodation, situated in the heart of Hunter Wine Country (the wino’s and foodies playground). Your spacious accommodation is an ideal spot to switch off and relax away from the pressures of day-to-day life, situated only meters from the shops of Pokolbin Village and minutes from the multi-award winning wineries, such as First Creek Wines. This is made even more interesting during February each year when the harvest is on and the wineries are full of frantic activity with the processing of grapes. The choice of fantastic restaurants is wide and varied. The village restaurant Vittorios is a popular spot for breakfasts whilst a long lunch at the chef hatted Muse Café will be a highlight of any foodies visit to the Hunter. All of this goes with breathtaking scenery that can be enjoyed at Audrey Wilkinson Vineyard and other spots found on tours conducted by The Vineyard Shuttle Service. The prize includes two nights midweek accommodation for two in a Deluxe Queen Suite; cooked breakfast for two each morning at Vittorio’s Restaurant; lunch for two at the chefs hatted Muse Café; a private tasting and tour at First Creek Wines, a half-day tour for two with Vineyard Shuttle Service; discount vouchers at the retail outlets of Pokolbin Village and for wine purchased at Pooles Rock Winery and Audrey Wilkinson Vineyard; a six-pack of wine from Audrey Wilkinson Vineyard; and a bottle of local sparkling wine. To enter the competition, simply write your name, address and membership number on the back of an envelope and send to: Hunter Valley competition 50 O’Dea Avenue, Waterloo, NSW 2017

SPECIAL OFFER For those wishing to indulge in a midweek break, our ‘Take Home the Hunter’ package is for you! You and your guest can stay for one night in a recently refurbished deluxe queen suite, with in room continental breakfast, and take home a six pack of wine for only $199. Mention The Lamp and we’ll throw in a bottle of local sparkling wine as well. PHONE US ON 4998 7670 OR EMAIL RELAX@POKOLBINVILLAGE.COM.AU

Competition closes 28 February 2013. *Terms & Conditions apply.

©Hunter Valley Wine Country Tourism


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.




£424 A YEAR.

United Kingdom

Welfare cuts hit nurses, soldiers, teachers Nurses, soldiers and teachers have been the biggest losers in the latest assault by the British government on that country’s social services, according to a new report. David Cameron’s conservative government has passed new laws – which it says are aimed at “shirkers and scroungers” – that slash welfare benefits. Half a million nurses, soldiers and teachers apparently fall into this category and will have their incomes reduced. Up to 300,000 nurses, 40,000 soldiers and 150,000 primary and nursery school teachers will lose money according to the study by the Children’s Society. It says that by 2015 a loneparent nurse with two children, earning the profession’s average of £530 a week, will lose £424 a year; a second lieutenant in the army who has three children, who earns £470 per week, and whose spouse does not work, will lose £552 a year; and a couple with two children, where the sole earner is a primary school teacher earning £600 a week, will lose £424. The government’s new measures cap a whole range of benefits at 1% until 2015, including child benefit, tax credits, maternity pay and jobseeker’s allowance. In a letter published in the Observer newspaper, 27 organisations, including Barnardo’s, Women’s Aid, Citizens Advice and the Royal National Institute for the Blind, condemned the government’s cuts, claiming they will hurt working families. “This hardship penalty will hurt millions of families across the country. Families already struggling to pay for food, fuel, rent and other basics will see their budgets further squeezed,” it said. 8 | T H E L A M P F E B R U A R Y 2 01 3

A woman wears a placard reading, ‘Their looting is my crisis, without bread there is no peace’ during a demonstration organised by Spanish health workers to denounce budget cuts and privatisations in health services, in Madrid on December 19, 2012. PEDRO ARMESTRE/AFP/Getty Images


Spanish health workers march Thousands of Spanish health workers, who had already been on strike for a month, marched in Madrid in December to protest budget cuts and plans to privatise the management of public hospitals and medical centres, Reuters reported. It was the third time nurses, doctors, and other health workers had rallied since local authorities put forward a plan to place six hospitals and dozens of medical practices under private management. The plan also calls for patients to be charged a €1.00 fee for prescriptions. Health workers have launched an indefinite strike against the plan. They are striking Monday to Thursday each week and seeing patients only on Fridays, and also responding to emergencies. Spain’s 17 autonomous regions control health and education policies and spending. They have all had to implement steep cuts this year as the country struggles to meet tough European Union-agreed deficit targets. Dressed in white scrubs, the protesters shouted slogans such as “Health is not for sale” and “Health 100% public, no to privatisation”. One million Spanish citizens signed a petition rejecting the plan.




Business push to slash penalty rates

Lucky Domain Group draw winners

The ACTU has warned that an employer push to reduce or remove weekend penalty rates in Awards would cut the take home pay of more than 500,000 low-paid workers. In December, Fair Work Australia heard 20 submissions from employer groups who want to remove or reduce penalty rates in awards for workers in retail, hospitality, tourism and other industries. ACTU President Ged Kearney said that employers were launching a co-ordinated attack on penalty rates in the lead up to next year’s federal election. “Twenty different submissions have been made to Fair Work Australia to cut penalty rates with little or no regard for the effect on workers,” Ms Kearney said. “If these employer applications succeed, 500,000 low-paid workers will be out of pocket by anything up to $105 for a six-hour shift on a Sunday. “There is no evidence that reducing penalty rates will create new jobs, and plenty of evidence it will hurt low-paid workers,” she said. IF EMPLOYER APPLICATIONS SUCCEED

500,000 $105




Kathy Toy, of Domain Coffs Harbour, was drawn as the first prize winner of the NSWNMA Domain Principal Group (DPG) Christmas draw on 18 December 2012. Kathy won a two-night, midweekstay, in a 4-star Deluxe Queen Suite (for two people) at the Pokolbin Village in the Hunter Valley. The prize also included a host of other complimentary gifts. Yolanda Gleeson of Domain Florence Towers won the second prize, a Coles Myer gift card valued at $150 dollars. Sharon Haig, also of Domain Coffs Harbour, won the third prize, a Coles Myer gift card valued at $100. The lucky draw ran across DPG facilities in New South Wales in the weeks leading up to Christmas, in support of the 2013 Enterprise Bargaining Campaign. The NSWNMA received more than 200 entries from eligible members.

SEMINAR WITH RULA AL’SAFFAR Rula Al’Saffar, president of the Bahrain Nursing Society, was recently named the 11th most influential person in the Middle East. In 2011, she was incarcerated and tortured by the Bahraini government after treating protestors injured during anti-government uprisings. Over 90 medics were targeted and Vice-President of Bahrain Nursing Society Ibrahim Al-Dimistani remains in jail. In September 2012, Rula addressed the UN Human Rights Council in Geneva and has been travelling the world campaigning for the release of her colleagues and to raise awareness about the ongoing challenges for health professionals in Bahrain. Rula is also Assistant Professor at the Bahrain College of Health Sciences, head of the Emergency Nursing and Critical Care Program and the Head of the International Training Centre. Rula is in Australia to mark the two year anniversary of the crackdown on Bahrain’s ‘Forgotten Arab Spring’ and the presentation of motions to the Federal Parliament of Australia condemning the repression. Join us for an afternoon seminar with Rula and hear her incredible story of survival and how nurses organise in times of political crisis. NSWNMA Auditorium, 50 O’Dea Ave, Waterloo on Monday, 18 February at 4pm. Light refreshments will be provided. RSVP Miriam Galea on 1300 367 962 or email AUTHORISED BY BRETT HOLMES, NSWNMA GENERAL SECRETARY.

T H E L A M P F E B R U A R Y 2 01 3 | 9



International Day for People with Disability NSWNMA members at ADHC (Ageing, Disability and Home Care) sites across New South Wales marked the International Day for People with Disability on December 3, taking the opportunity to draw attention to the current campaign to achieve equal pay for disability nurses. At Summer Hill Accommodation and Respite centre members held a “We Deserve Better Pay ‌ and Cakeâ€? afternoon tea. A mountain of signed petitions were collected and members swapped stories about the high level of community support for the campaign they had found while out and about collecting signatures. Lisa Kremmer from the NSWNMA attended the afternoon tea and presented the centre with a cheque for $339.80, raised by coin donations at the Association’s Disability Morning Tea, held in November. Go to to support ADHC nurses.

From left to right: Dhilay Bhutia, Sejal Patel, Yan Yin, Julia Junsen, Janet Tuckson, President Cheryl Apostol, Lina Leal, Veronica Morrell, Nymia Bayrante, Chinjoop Valsan, Yvonne Tanner, Christian O’Connor, Pat Martinez, Cecelia Llanos, Gary Dunne.

Charles Sturt University’s University’s (CSU) Master of Health Ser Services vices Management is designed for pr practising actising and aspiring managers in health ser services vices who ar aree seeking a for formal mal management qualification to complement their experience experience and/or under undergraduate graduate qualifications.

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Studyy Health Ser Services Stud vices Management with one of Australia’s Australia’s largest largest providers providers of distance education.

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United States

Americans have shorter lives and poorer health The United States spends more on healthcare per capita than almost any other country in the world, yet its citizens are more likely to die early and are sicker than their peers in comparable countries, according to a report by the US National Research Council and the Institute of Medicine. The shocking results appear in a study that compared the United States with 16 other developed nations including Australia, Canada, Japan and Europe. The report looked at data from the late 1990s to 2008 and “uncovered a strikingly consistent and pervasive pattern of higher mortality and inferior health in the United States beginning at birth.” Americans have a shorter life expectancy than people in similar affluent societies and for the past three decades the gap has been widening, particularly for women. It has the highest infant mortality rate of any wealthy country and does poorly on other birth outcomes, such as low-weight babies. Deaths from injuries and homicides are far higher than elsewhere and a leading cause of death in children, adolescents and young adults. US adolescents have had the highest rate of pregnancies of affluent countries since the 1990s and are more likely to acquire sexually transmitted infections. The US has the second highest HIV rate and the highest incidence of AIDS among the 17 countries. The US has the highest obesity rate and, from age 20, one of the highest levels of type-2 diabetes. The death rate from heart disease is the second highest in the 17 countries. “We were struck by the gravity of these findings,” Professor Steven Woolf, chair of the panel that wrote the report, told the Guardian newspaper.

CRITERIA FOR SPONSORING NOT-FOR-PROFIT ORGANISATIONS Delegates at the 2008 NSWNMA Annual Conference voted to allocate an annual amount from the NursePower Fund for the support and sponsorship of not-forprofit organisations, such as sporting clubs, youth and cultural organisations, in order to build on the strong community links established during past campaigns, such as the Your Rights at Work campaign. Such funds shall be allocated according to strict guidelines established by the Association’s Council: • Applications must be in writing from a not-for-profit, community-based organisation focused on youth, sporting or cultural development, health promotion or any other worthy social objective deemed appropriate, from time to time, by the NSWNMA Council. • Applications must have the written support of a NSWNMA member who is prepared to attest to the organisation’s good standing and its positive attitude towards the principles of trade unions. • The applicant must agree to the messaging required by the NSWNMA on sponsored items for at least the period of the sponsorship. • The application must demonstrate relevance to current or future members of the NSWNMA, by providing such things as membership or participant numbers and ages and the expected public exposure opportunities, including estimated numbers, arising from the sponsorship. • The application must demonstrate a commitment to the promotion of a healthy lifestyle and wellbeing. • The application must provide value for sponsorship dollar in comparison to traditional advertising opportunities.


EXPOSURE TO ENVIRONMENTAL TOBACCO SMOKE POSSIBLE CLASS ACTION FOR DAMAGES The NSWNMA has instructed NEW Law to investigate the possibility of a Class Action for damages for personal injury caused to persons who may have been exposed to environmental tobacco smoke while working in the Corrective Services institutions throughout New South Wales. If you believe that you have suffered personal injury as a result of exposure to environmental tobacco smoke as an employee or former employee of Corrective Services, and you are interested in a possible class action for damages for personal injury, would you please send an email containing your full name and all contact details to the email address displayed below and a questionnaire will be sent to you seeking further information. Please forward all enquiries to

T H E L A M P F E B R U A R Y 2 01 3 | 1 1


It’s time to vote on the recommended Public Health System claim Our 2013 pay and conditions campaign in the Public Health System will seek to improve and extend the ratios won in our last campaign and a pay increase of 2.5% per year. A RECOMMENDED NSWNMA LOG OF claims for the 2013 Public Health System Award campaign has been finalised by the log of claims committee and is to be voted on by members at branch meetings during February. Voting will open at 9.00 am on Monday 18 February and close at 4.00 pm on Friday 1 March. The recommended claim is the culmination of months of consultation with members through surveys, branch meetings, discussion groups and focus groups. An elected claims committee of delegates met to debate the possible claims and have recommended a strong package to Branches. Some of the draft claims include the extension of ratios into specialty areas such as paediatrics and neonatal intensive care units, the improvement of ratios in all hospitals to the same level as Peer Group A, and a new mechanism to guarantee face-to-face, nurseto-patient hours in community nursing. The Association’s proposed claim also

seeks a 2.5% pay rise per year for the life of the agreement. NSWNMA General Secretary Brett Holmes says that nurses are telling the Association that patient care and ratios are the most important thing and that wages need to keep pace with inflation. “Let’s be crystal clear: we do not accept the government’s legislation to cap pay and rights – we never will.” RATIOS WORK SO LET’S BUILD ON THEM In research commissioned by the NSWNMA, members were unequivocal that ratios work – as we said they would – where they have been implemented. More staff, members say, has led to better patient care and less stress for nurses. This is consistent with a growing body of international research which shows that increasing nurse numbers and RN skill mix delivers better patient outcomes and avoids adverse events.

Brett Holmes says the outcomes from the implementation of current ratios have been a big success but there is more work to be done so ratios work properly. “Now it’s time to improve and fund ratios for rural hospitals and extend them into more nursing specialties.” Brett says another area where the Association will be aiming to introduce ratios is neonatal intensive care. “Nurses in neonatal intensive care units carry an enormous responsibility with extremely vulnerable premature babies so they need mandated nurse numbers.” Brett says while some country and smaller metro hospitals won ratios in the last campaign they were below the level of metro tertiary hospitals and need to be built on. “We have always been aware that ratios would be achieved in an incremental way. Ratios were established in some country hospitals in our last campaign but their numbers now need to be lifted to those

How we get a new Award activity research – member survey, branch meetings, discussion groups

when 2012

status Complete



By 1 March



When approved by majority of Branches


When government makes an offer and responds to nurses’ claim

From now


vote on proposed settlement


Occurs when members are satisfied with government’s offer

completed new award


When approved by Branches.

draft claim developed branches vote on draft claim claim sent to government & ministry negotiations member support to win a good result

1 2 | T H E L A M P F E B R U A R Y 2 01 3

here are the stages to achieving a new award

Have your say Voting on the proposed 2013 PHS claim will open at 9.00 am on Monday 18 February and close at 4.00 pm on Friday 1 March. All NSWNMA members in the public health system are encouraged to attend their local branch meeting to discuss and vote on the claim.

established in the city. Country people are entitled to a level of patient care afforded to others in the state.” Brett says that community nursing is another important part of the claim. “Community nursing is of growing importance in our health system with the ongoing shift towards primary care. It is in everyone’s interests to resource this area well. Not only will it lead to better patient care in the community it will relieve pressure on our public hospitals,” he said. “We understand that ratios don’t work in community nursing but we want to see an equivalent mechanism that guarantees face-to-face time with patients.” 22 NSWNMA community branch meetings across NSW in 2012 endorsed this model for our campaign claim. MORE CNEs The 2013 claim seeks a funding commitment from the government for a further 275 FTE CNEs/CMEs – working across seven days and all shifts. “Once the 2010 ratios system is completely implemented, there will be a definite improvement in skill mix, as the new graduates recruited in 2012 and 2013 consolidate their clinical practice,” Brett Holmes says. “But achieving this will take more support than is currently promised if it is to genuinely take some pressure off our most experienced RNs. “The government can and must do more to help by funding more CNEs, and not just on day shift. This is the real way to thoroughly and safely develop the clinical skills of beginning practitioners.” OTHER STAFFING ISSUES RAISED IN THE CLAIM • NURSE STAFFING FOR PATIENT SPECIALS – patients requiring specialling shall have that care provided in addition to the minimum mandated nursing hours for the ward/unit that that patient would ordinarily receive.

• USE OF MIDNIGHT CENSUS DATA – the NSWNMA will seek a better system than the current “midnight census” to calculate the occupancy of a ward or unit. Currently this system is used to determine a ward’s average patient number in the calculation of the minimum mandated nursing hours required. • PROTECTING SKILL MIX – two immediate improvements will help protect the skill mix of the nursing workforce: AiNs should only be introduced in accordance with the 2010 Assistants in Nursing working in the Acute Care Environment – Health Service Implementation Package. If this plan is followed correctly then appropriate engagement of AiNs will occur. And more CNEs as per the recommended claim will mean increased retention of new RNs and RMs.

“Country people are entitled to a level of patient care afforded to others in the state.” — Brett Holmes

Seeking a reasonable pay rise The NSWNMA will seek a 2.5% pay increase per year for the life of the agreement. This will be in line with inflation forecasts by the Reserve Bank of Australia. Since our last campaign the environment in which we claim for more pay has changed drastically. We have a different government. Not long after taking office the O’Farrell Government imposed a 2.5% cap on public sector wages. It took away the power of the independent umpire, the NSW Industrial Relations Commission, to arbitrate on pay, leaving the final decision in the hands of the government itself. Effectively, it took away your rights to a fair system for determining your pay and conditions. It also passed a law that insisted thet any award improvements over 2.5% per year must be ‘paid for’ by workers ‘trading of ’ existing conditions. NSWNMA does not accept these laws – and never will. We will have to fight hard to make sure a safer public health system is not at the expense of nurses and midwives! The O’Farrell Government has also relentlessly cut budgets in the public sector. This has led to massive job losses and the rolling back of public sector workplace conditions and protections. The government has gutted the Workers Compensation scheme, which has had major consequences for nurses. All these cuts were justified by a so-called budgetary ‘black hole’ which has been exposed as false. The real agenda has been to reduce fairness in the workplace. Brett Holmes says the Association’s recommended pay claim is responsible and nurses are entitled to a responsible government response on ratios in return. “Our members are telling us that a 2.5% pay increase, that is in line with inflation, would be acceptable if it is accompanied by a a new award that funds the necessary extensions and improvements in ratios, so nurses can deliver safe patient care across the whole public health system,” he said. T H E L A M P F E B R U A R Y 2 01 3 | 1 3


Recommended Draft Ratios / The table shows the minimum nursing hours assigned to different ward types and the equivalent ratios. Only nurses providing direct clinical care are included in the ratios/nursing hours. This does not include positions such as NUMs, NMs, CNEs, CNCs, dedicated administrative support staff and wardspersons. speciality / ward type am

equivalent ratios pm

nursing hours night

Peer Group B (Major Metropolitan and Major Non-Metropolitan Hospitals)1




Peer Group C (District Group Hospitals)1




Peer Group D (Community Acute and Community non-acute Hospitals)1




Peer Group F3 (Multi-Purpose Services – Acute Beds)1




Peer Group F3 (Multi-Purpose Services – Aged Care Beds (DoHA funded)2




Adult – in specialised Mental Health Facilities4




Acute Mental Health Rehabilitation4




Child and Adolescent5

1:2 + in charge

1:2 + in charge


10.5 + additional hours

Long Term Mental Health Rehabilitation5

1:6 + in charge

1:6 + in charge


3.67 + additional hours

Older Mental Health5

1:3 + in charge

1:3 + in charge


7.33 + additional hours





1:3 + in charge + triage

1:3 + in charge + 2 triage

1:3 + in charge + triage

Level 3 Emergency Departments

1:3 + in charge + triage

1:3 + in charge + triage

1:3 + in charge

8.67 + additional hours for in charge and triage

Level 2 Emergency Departments






1:3 + in charge

1:3 + in charge

1:4 + in charge

7.83 + additional hours for in charge


1:4 + in charge

1:4 + in charge

1:4 + in charge

6.5 + additional hours for in charge

general adult inpatient wards

6 (includes some shifts staffed with an in-charge)


inpatient mental health3 6 (includes some shifts staffed with an in-charge)

for in charge

for in charge for in charge

emergency department (adult and paediatric)6 Resuscitation Beds Level 4-6 Emergency Departments

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/ Nursing Hours Claim speciality / ward type am

equivalent ratios pm

nursing hours night

1:3 + in charge

1:3 + in charge

1:3 + in charge

8.67 + additional hours for in charge


1:1 + in charge

1:1 + in charge

1:1 + in charge

26 + additional hours for in charge


1:2 + in charge

1:2 + in charge

1:2 + in charge

13 + additional hours for in charge

Special Care Nurseries9

1:3 + in charge

1:3 + in charge

1:3 + in charge

8.67 + additional hours for in charge


1:1 + in charge

1:1 + in charge

1:1 + in charge

26 + additional hours for in charge


1:2 + in charge

1:2 + in charge

1:2 + in charge


1:3 + in charge

1:3 + in charge

1:3 + in charge

13 + additional hours for in charge 8.67 + additional hours for in charge

paediatrics7 General Inpatient Wards neonatal intensive care units8

critical care, including adult & paediatrics10

community health and community mental health services, except for acute assessment teams

Limit of 4 hours of face to face client contact per 8 hour shift, averaged over a week.11

community mental health services (acute assessment teams)

Limit of 3.5 hours of face to face client contact per 8 hour shift, averaged over a week.11

1 General Adult Inpatient Wards: This minimum staffing claim applies to all Medical, Surgical and combined Medical/Surgical wards in Peer Group B (Major Metropolitan and Major Non – Metropolitan Hospitals), Peer Group C (District Group Hospitals), Peer Group D (Community Acute and Community Non – Acute) and Peer Group F3 (Multi Purpose Service – acute beds). The staffing ratio expressed as nursing hours provides the option of rostering some shifts with a nurse in charge who does not also have an allocated patient workload. This claim is the same as currently legally mandated for Peer Group A city hospitals. 2 General Adult Inpatient Wards: This minimum staffing ratio expressed as nursing hours will apply to Peer Group F3 Multi Purpose Service – DoHA funded beds. 3 Inpatient Mental Health: This claim does not apply to adult acute mental health wards in general hospitals that are not ‘specialised’ mental health facilities, because these wards have legally mandated nursing hours/ratios under the 2011 Award. This claim does not apply to forensic or PECC units. 4 Acute Adult Mental Health – Specialised Facilities and Acute Mental Health Rehabilitation: This staffing ratio expressed as nursing hours provides the option of rostering some shifts with a nurse in charge who does not also have an allocated patient workload.

5 Child and Adolescent, Long Term Mental Health Rehabilitation and Older Mental Health: In addition to the ratios expressed as nursing hours, additional hours must be provided for in charge of shift across two shifts. 6 Emergency Department: This minimum staffing claim applies to adult and paediatric Emergency Departments according to their NSW Health designated level. Each staffing ratio expressed as nursing hours applies to beds, treatment spaces, rooms and any chairs where these spaces are regularly used to deliver care. The claim includes Emergency Departments, Emergency Medical Units, and Medical Assessment Units and other such services however named. In addition to the ratios expressed as nursing hours, additional hours must be provided for in charge of shift and triage nurses across all shifts where specified in the table above. 7 Paediatrics: This minimum staffing claim applies to all paediatric general inpatient wards including medical, surgical and combined medical surgical wards and units across all Peer Groups. In addition to the ratios expressed as nursing hours, additional hours must be provided for in charge of shift across all shifts. Further additional hours must be provided for nurse escorts and work that in general adult hospitals would be described as ‘ambulatory care’.

8 NICU: This minimum staffing claim applies across all Peer Groups. In addition to the ratios expressed as nursing hours, additional hours must be provided for in charge of shift across all shifts. Further additional hours must be provided for work that may be described as discharge nurse, neonatal family support and transport nurse (including retrieval). 9 Special Care Nurseries: This ratios/nursing hours claim does not apply to the following named special care nurseries that perform CPAP, where the HDU claim will apply instead: Blacktown, Campbelltown, Gosford, Lismore, St. George, Tweed Heads, Wollongong, Coffs Harbour, Dubbo and Wagga Wagga. Additional staffing hours specified in note 8 above also apply. 10 Critical Care, including Adult and Paediatrics: This minimum staffing claim applies to Critical Care units, including Intensive Care Units, High Dependency Units and Coronary Care Units across all Peer Groups. In addition to the ratios expressed as nursing hours, additional hours must be provided for in charge of shift across all shifts. Further additional staffing may be clinically required and if so, should be provided. 11 Community Health and Community Mental Health: Work that is not included in ‘face to face hours’ includes travel, meal breaks and administration (eg. phone calls, paperwork), otherwise known as ‘indirect care’. Face to face hours may also be known as ‘direct care’.

T H E L A M P F E B R U A R Y 2 01 3 | 1 5


More community nurses for a better health system More community nurses would relieve the pressure on the public hospital system, says RN Mimi Chu.

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A NURSE OF 14 YEARS, MIMI Chu is passionate about improving the health and lives of her patients in south-west Sydney. Mimi believes community nursing is about promoting wellness, preventing illness and empowering the community to take control of their health. “I run clinics where Mum will come with a sick child for advice. For example if they have problems with their speech or toilet training issues or schooling issues – generally anything they need help with. “My job is promoting healthier lives, linking my patients into other services and giving them the power to be healthy themselves,” she says. A vital part of her job, Mimi says, is giving back control to her patients. “Community nursing is about giving power back to the mother. I might immunize a child or if they don’t want to immunize, that’s up to them. If they have the knowledge they can make the right decisions. “Communication is so important. It’s an important part of being a nurse and being a patient advocate.” While she is proud of the service she and her colleagues provide, Mimi says more community nurses would improve the service and have flow through benefits for the rest of the health system. “It is important we get more community nurses - the more the better. Preventative measures are good for patients. “If we can prevent them getting sick then they won’t have to go into hospital. That will help the hospital system. It will reduce waiting lists.

“If we have more community nurses the health system will run more smoothly.” Mimi supports the NSWNMA claim for a mechanism in community nursing that would mandate face-toface hours with patients. “I definitely think community nurses need something like ratios,” she said. “We’re in their homes and you have to understand that when you are in someone’s home you can’t rush things. They have to feel you’re genuine. If you rush out because you’ve got another six clients you have to visit, they don’t want to see you again because they don’t think you are there for them.” Mimi says community nurses have a multitude of tasks that preclude them from spending sufficient time with their patients. “We have a max of two hours with each visit and that includes travelling time. If we identify a need for it, we book a follow up. Just to do our computer work is one hour, so if they’ve got any issues – bearing in mind we’ve got to look at the baby, find out if the mum’s got feeding issues, sleeping issues – we don’t have the capacity. “When you leave you just hope it’s okay.They might not use our system again and we might miss them. “It’s very important that we have ratios in hospitals but it is important we have them in community nursing as well. “Face-to-face time with my patients is very important. If I could change things it would be to free me up to spend more time with my patients. Our service would definitely be better.”

“If I could change things it would be to free me up to spend more time with my patients.” — Mimi Chu, community nurse

T H E L A M P F E B R U A R Y 2 01 3 | 1 7


The bush deserves A lack of funding and staff in country and regional communities means an increase in nursing workloads, with the result that patients suffer unnecessarily. Katrina Lee, CNS at Orange Base Hospital, tells The Lamp why every patient, in every region and community in New South Wales, deserves the right to safe care.

“We desperately need better ratios across morning shift or the afternoon shift. It’s — Katrina Lee, CNS

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every shift not just the got to be across the board.”

KATRINA HAS WORKED IN ORANGE OR its surrounds for more than 18 years and loves the community mindedness of working in a rural hospital. “I certainly feel rural facilities have extraordinarily dedicated nursing staff. We tend to be very aware of our community and most people that come through the door as patients we would know of them, or of where they live, so there is a real connection. Katrina says working as a nurse in a country environment has its particular challenges, which foster corresponding skill sets. “Nursing staff in country hospitals have more resilience in their everyday practice. We are often stretched to the limit. “We’re at a disadvantage to some of our metro hospitals, where you have a large pool of nursing staff available that could work.We have a static number to draw on in our area. “The bigger facilities do have support services, but certainly in my first job, in a smaller facility – with about 16 beds – you did everything. “You were in charge of the hospital and after hours you were the cook and the cleaner and everything if you had late admissions and all staff had gone home and there was just you and an EN. And that’s kind of nice. You are community-minded.” Katrina acknowledges that the New South Wales government has held up its commitment to deliver 1400 more nurses to the health system, but says this is no longer enough. “Wards have converted to what the government has promised – although it is quite tenuous at times. We often have a lot of sick leave that isn’t catered for. We don’t have agency staff to call on. If nursing staff are off sick you have to increase your workload to cover the shortfalls. “We have lots of ‘surge activity’ with more patients coming through and so our normal allocated bed numbers can fluctuate quite rapidly,” she says. “At the moment there are specialty areas that don’t get adequate ratios.We desperately need better ratios across every shift not just the morning shift or the afternoon shift. It’s got to be across the board. “The workload of my facility, it doesn’t change no matter what shift you are on. There’s no one shift that is quieter or less busy. The patients need that higher level of nursing input. So we are desperate to get better ratios.”

T H E L A M P F E B R U A R Y 2 01 3 | 1 9


We need safe ratios Despite the vulnerability of their tiny charges, Neonatal Intensive Care Units (NICU) do not have the same level of mandated nurse numbers as their adult ICU equivalents. Neonatal nurse Emily Orchard features in a new NSWNMA campaign to inform the community about the need to improve ratios in these wards. “WE TAKE EXTREMELY PREMATURE babies weighing from 450g upwards. We are one of the few hospitals in the state that does that, which is really exciting,” Emily, who works in the Special Care Nursery attached to a NICU in Western Sydney, told The Lamp. “We often have babies with complex syndromes.” It is a fantastic area to work in. It is very rewarding and challenging. “My first day at work was terrifying. You don’t realise how small they are.You’re holding up these little babies and, literally, the length of their torso will fit in your hand. Our babies are a third the size of a newborn. “It’s very busy in an NICU. It is chaos sometimes. It is constantly moving. We do have babies who don’t make it because of their size and the complications that come from their being so premature. “Unfortunately it’s one of the risks that comes with these tiny

bubs. But it’s an amazing feeling when you watch a baby you’ve nursed go out with a very happy mum and dad. “It’s an area I always thought would be brilliant. It’s my dream job. I have to get up at 4am but it doesn’t bother me. I love it. “It’s incredibly important to be resourced. You can’t do your job unless you have the resources to do it. “It’s such a challenging environment. You need that fully stocked ward. You need all the medications to be there. You need all the nursing staff to be able to carry out all the work. You can’t do it without having enough nurses available. “We need safe ratios. We need nurses with less patients. It should be 1:3 but it is usually more like 1:4. If you have three that are very sick and a fourth one as well it is very difficult to manage. To have extra hands would be unbelievable.”

T H E L A M P F E B R U A R Y 2 01 3 | 2 1


Patient care is at the heart of our campaign The story of Danielle Griffiths, whose baby Sam spent 11 weeks in an Neonatal Intensive Care Unit, highlights why the NSWNMA continues to put safe patient care and ratios front and centre in all our campaigns. Our Public Health System 2013 campaign will seek to improve nurse numbers in this and other vital areas.

“The nurses got me through the darkest days.” — Danielle Griffiths.

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DANIELLE GRIFFITHS GAVE BIRTH TO SON Sam at 27 weeks: more than three months premature. Sam was her second baby and his early arrival was a huge surprise as her first pregnancy went full-term and was drama-free during pregnancy and birth. Sam’s dramatic and sudden birth began, without warning, while Danielle was at work. “I was in a meeting. It was about three o’clock and I thought ‘this feels a bit regular, maybe it’s a contraction’. Danielle said she didn’t realise – but her boss did – that she was breathing like she was in labour. “My boss said ‘you’re not okay you have to go! But I still stayed through the whole meeting (like an idiot) and then went back to my desk until my boss said ‘you need to go. Can I call you a taxi?’ “I said ‘no I’ll get the train’! When I

was on the train it started up – full on labour. I was crying and trying to call my husband. Everyone on the train was staring at me.” After being met by her husband at the station Danielle went first to her private hospital but, as they did not have the facilities to deal with such a premature birth, was immediately transported by ambulance to Liverpool Hospital. “I had him at 8.30pm. There were 20 people in the room when I was having him, including doctors and nurses from NICU who were in the corner waiting. “I was so terrified.What would he look like? Would he be fully developed? Would he be alive? I kept saying ‘I’m scared, I’m scared’. I made eye contact with one of the neonatal nurses. I just kept looking at her. She was so focused on me. It was so reassuring.

“Then he came out and we had a little boy and my husband said ‘he’s perfect, he’s just small’.” Sam spent 11 weeks in neonatal intensive care and Danielle says the hardest thing was having to say goodbye to her little boy every day. “It breaks your heart. Your job as a mum is to love them and it’s so hard to leave them every day.” She says the care and attention lavished on Sam by the NICU nurses made the parting tolerable. “They loved your baby when you couldn’t – the way they handle them, touch them, talk to them. They were amazing.You appreciate them so much. “I could go away at night and know he would get a cuddle. That meant so much to me when I couldn’t be there. Their job is to look after babies but the

unofficial part of their job is to look after the mum and dad as well.They put their arm around you, they offer their friendship. “Sometimes you want to forget and talk about anything and they’ll sit down with you and talk about anything you want and have a bit of a giggle.They are patient and tolerant. They handle it beautifully. They carry you through. They got me through the darkest days. Truly.” NURSE NUMBERS ARE CRITICAL Danielle says the stakes are high for all the babies in NICU and nurse numbers and resources are critical. “It’s an hour-to-hour proposition for these babies. It is life and death. The nurses do a great job.”

Danielle said the environment that NICU nurses were working in, physically and emotionally, was unbelievable to her. “I was in there for 11 weeks. At first it was so overwhelming.There are always alarms going off. It’s very stressful – there are 30-something babies. “The days when other people’s babies die is horrible.You form close bonds with their mums. It’s horrible when you see someone lose their baby in front of you. It happens every day for these nurses. Imagine having to go to work and having to deal with that? It’s awful. The nurses are so compassionate. “They shouldn’t be put under that much stress when there is so much at stake. A tiny little mistake like not washing your hands properly can be fatal for a baby only that big.” T H E L A M P F E B R U A R Y 2 01 3 | 2 3


NURSE / MIDWIFE AD ADVOCATE VOCA ATE T – PERMANENT FULL-TIME THE ORGANISA ORGANISATION ATION T The NSW Nurses and Mid Midwives’ wives’ Association (NSWNMA) is a trade union, which which represents the industrial, professional and leg al interest of Nurses and Mid wives legal Midwives in NSW currently looking for a Nurse/Mid wife NSW.. W Wee are currently Nurse/Midwife Ad vocate to work work within our Member Industrial Services Ser vices Advocate TTeam eam e (MIST) on a per manent basis. permanent

THE ROLE The primar primaryy responsibilities of this position are to: 2 Ad Advocate vocate on behalf of NSWNMA members and

specialty and/or discreet ggroups roups of members, 2 Pro Provide vide a central point of contact for NSWNMA management representatives, members and facility manag ement representativ es, 2 Identif Identify, entify, plan and follo follow w through potential w orkplace ce based bas issues, ssues, affecting specific speecific ggroups roup roups workplace of NSWNMA NSW WNMA NMA mem m mbers. mbe mb mbers members. applicant have: The successful succe appli ap ppliicant will hha ve ve: 2 Reco Recognisedd nursin nursing ng and/ and/or d//or mid midwifer midwiferyy qualifications, alifications lifi ations tions,


cur rently registere reg registered with AHPRA currently

2 Extensive Extensive experience in the field of nursing and/

or midwifery midwifer y 2 Demonstrated commitment to the nursing and

mid wifer y profession midwifery 2 Demonstrated commitment to the union movement movement 2 Experience at a senior or clinical management management level level

in nursing and/or midwifery midwifer y 2 Demonstrated ability to manage manage a range range of complex 2 2 2 2 2 2 2

issues simultaneously Demonstrated level level of highly developed developed written and verbal verbal skills (English language) language) Demonstrated commitment to NSWNMA Computer skills ie W Word ord and Outlook Demonstrated negotiation negotiation skills Ability to work work within a multidisciplinary/complex multidisciplinar y/complex team environment environment Demonstrated ability to think analytically Full Fu NSW Drivers Drivers Licence Class 1A.

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Please include postage handling of $5 per order ostage and han Total cost of order $ Name Address (W)

Method of payment

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Name of card holder Card number Expiry date


Please email Emplo Employee yee Relations at jobs@ns w or telephone (02) 8595 1234 to receiv receivee an Emplo Employment yment Application pack w which hich includes an NSWNMA Emplo Employment Form yment Application For m Nurse/Midwife Advocate and an Nurse/Mid wife Ad vocate Position Description. Position ou to be par rt of We invite invite yyou We part an association that fosters a diverse workplace. workplace. diverse ns should be received eiv bbyy receiv Applications Februar y 2013 to: 22 February Emplo oyee Relations Employee NSW Nurses es & Midwives’ Midw idwives’ Associatio tion on Association Avenu enue 50 O’Dea Avenue W ater a looo N NSW 2017 Waterloo or via email: jjobs@ns nsw wn u

information how Pleasee read the infor info mation on ho w to apply pply for fo th thiss accepted position. Applications lications tions will only be acce acc epted from who ca candidates w ho follow folloow this process. proocess

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The ethics of action One of the most confronting issues for nurses has long been whether to engage in industrial action.

“It’s a bit rich when health ministers say nurses are holding patient safety to ransom.”

LEADING NURSE ETHICIST, PROFESSOR MEGANJane Johnstone, believes there are times when nurses need to use industrial action to achieve the best possible safety and care outcomes for their patients. Professor Johnstone is Chair in Nursing and Associate Head of School (Research) in the School of Nursing and Midwifery at Deakin University, and a consultant in ethics and human rights to the International Council of Nurses. She told The Lamp: “Society, and even nurses, have taken a long time to accept [industrial action] as an ethical way to fulfil their professional responsibility to advocate for the needs and moral interests of the individuals, groups and communities for whose health care they share responsibility.” In 1989, when the first edition of Professor Johnstone’s widely acclaimed book, Bioethics: A Nursing Perspective, was published, the subject of nursing ethics was largely invisible. “This made it very difficult for nurses to have their concerns about ethical issues heard, let alone addressed.The first two of the five revised editions took an almost defensive stance on the rightness of industrial action in certain situations. “By the time of the third revised edition much had changed. Nursing ethics had gained legitimacy and respect as a distinctive field of inquiry in its own right,” she said. “And the language had changed from discussion of strikes, to emphasis on industrial action including negotiations, going slow or not performing certain tasks. People started to recognise that nurses were just as entitled to take industrial action as any others.” Professor Johnstone, who is also a Resource Expert for Bioethics Beyond Borders (BBB), a global network of bioethics experts, says despite this nurses still struggle with the idea of industrial action. “The pressure is multifactorial. I have no doubt they feel a big obligation to the people they’re caring for. That’s what they studied for, gained their credentials to do and they are consummate professionals. But while taking industrial action may be the right thing to do, that isn’t to say it would be the easy thing to do. I would worry if nurses didn’t have anxiety about taking it. We try to educate our students to be reflective practitioners. They won’t just sit up one morning and say ‘goodie we’ll take industrial action.’They will think deeply.” Even though nurses may feel betrayed by an employer they often still feel loyalty to their organisation.

“A decision to either withdraw labor or inconvenience family or patients is a really tough call. On the other hand, it’s time people realised that dedication doesn’t pay the rent. “Nurses have studied hard and most have gone on to do postgraduate works because nursing has become very specialised. “Although the media try to paint a different picture, nurses’ organisations run these industrial disputes very responsibly.Withdrawing labor is an absolute last resort. It’s a bit rich when health ministers say nurses are holding patient safety to ransom, when nurses are struggling to maintain their work demands. It’s governments that hold patient safety to ransom. “In a wholesale dispute, people walk off en-masse.Yet nurses never walk off en-masse, never totally abandon patients. Essential nursing services are maintained. The organisers and the nursing body itself, in engaging in this sort of action, ensure it is framed very responsibly and they give authorities notice so that nurse services are maintained.” Professor Johnstone says the relatively recent worldwide patient safety movement has helped to focus attention on the importance of nursing work. “The research is now shining the spotlight on the fact that nurses are absolutely the lynchpin to the safety and quality of health care, that where you have good nursing systems in place you get an equation of good quality care and reduced morbidity and mortality.” Professor Johnstone says nursing and nursing research are highly regarded in the field of public health and in medico legal systems. “The people who are not listening are politicians and bureaucrats and this is extremely frustrating and difficult to address. “It is hard to ignore that, despite the progress that has been made over the past century and more, as has been famously argued ‘the nurse question is and remains the woman question’. Certainly there is room to question that if nursing wasn’t a female dominant profession, would they have to fight the same old battles to get the respect and recognition they deserve? “Even though as a society we have moved forward in terms of equal rights for women, emotionally we’re still stuck in the dark ages. I don’t think we can avoid the gender issue. It’s the elephant in the room. I think people repress the awareness of subtle discrimination. I wonder if nursing was a male-dominated profession whether we would constantly have to fight the same old battles.” T H E L A M P F E B R U A R Y 2 01 3 | 2 5

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Pay rises at Forster Private Nurses engaged in a successful campaign of theatre closures and public engagement to win fairer wages and conditions.

“It was a massive decision to take strike action and it wasn’t taken lightly.” — Jo Stratton, NSWNMA branch president Forster Private Hospital.

ABOUT 90 NURSES AT FORSTER PRIVATE Hospital on the mid-north coast have won pay increases totaling 9.75% after a strong campaign of industrial and community action, including a strike that closed the hospital’s two operating theatres. NSWNMA General Secretary Brett Holmes said the nurses had not had a pay rise since October 2010 and had been asking for a new agreement for 14 months, without getting a fair pay offer. He said the hospital’s owner, Pulse Health, had allowed nurse salaries to fall about 15% behind rates paid at nearby Manning Base Public, and about 13% behind Mayo Private Hospital in Taree. “How can you credibly say you want to be the hospital of choice for staff when you allow that situation to develop and continue?” Brett asked.“Pulse’s refusal to commit to a reasonable plan to start fixing the low pay rates left the nurses with no choice but to take legal industrial action.” Pulse Health owns five private hospitals in New South Wales and Queensland. The president of the NSWNMA branch at Forster Private, Jo Stratton, said the branch initially sought increases of around 15% to achieve parity with the public health system.

Pulse’s counter offer was a 2.75% increase in the first year and an increase of between 1.5% and 5% in the second year, at the company’s discretion. Members rejected this offer but did reduce their claim to 10% over two years.They later rejected Pulse management’s counter offer of 6.25%, finally settling for a compromise of 9.75%, to be paid in three stages over 27 months. “The feeling among the staff is pretty good now,” Jo said.“Everyone is feeling quite happy with what we’ve achieved.” The branch called three, eight-hour stoppages – two on the general ward and the third also covering theatres. “It was a massive decision to take strike action and it wasn’t taken lightly. There was a lot of discussion at the branch meetings,” Jo said. “We are not a huge hospital and we look after patients who we know personally. “But we got to the point where we felt backed into a corner. There was no other way left for us to show the company how serious we were and how upset we were with their offers.” The branch began its campaign with bans on overtime and filling out forms to enable the billing of patients. Nurses wore badges stating “we are seeking a pay rise from Pulse Health” and handed out leaflets to visitors and patients explaining the campaign. They also held a rally and leafleted the town centre. Brett Holmes said the company wrote to every nurse “...inviting them to approach the company as individuals to do an individual agreement.” That attempt to divide the workforce failed to gain traction. He said Pulse management later tried to head off industrial action by initiating a ballot to put the company’s pay offer to all nurses. “However when Pulse saw the determination of nurses, and realised they were united with their branch, they called off the ballot and negotiated an acceptable agreement.” Forster Private nurses overwhelmingly approved the final 9.75% deal in a ballot conducted by the Australian Electoral Commission. T H E L A M P F E B R U A R Y 2 01 3 | 2 7 nursing books


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Danger signs at understaffed ED Bathurst Hospital board deaf to nurses’ plea for help. “We have spent two years raising the issues at the reasonable workloads committee with no result.”

BATHURST HOSPITAL NURSES HAVE ASKED New South Wales health minister Jillian Skinner to visit their emergency department to witness a dangerous staff shortage. The hospital’s NSWNMA branch wrote to Mrs Skinner and Member for Bathurst, Paul Toole, asking them to visit the ED urgently, following the Western Local Health District board’s rejection of the nurses’ appeal for extra staffing. “We have asked Mrs Skinner to come and see for herself the unsafe situations that arise in the ED because of short-staffing,” branch president Tatiana Muller said. Bathurst nurses have also begun a community campaign, holding roadside rallies and calling on motorists to honk their support for more staff. The nurses have also prepared letters to hand to non-urgent ED patients explaining that they may experience delays because of inadequate staff numbers. Tatiana said branch members were frustrated after unsuccessfully seeking an extra ED nurse on each shift, for two years. “We have spent two years raising the issues and presenting data to the reasonable workloads committee with no result.”

ESCALATION PLAN IGNORED Tatiana says the ED has an escalation plan starting at green through amber to red, but extra nurses have never been provided even when the situation reaches red. “Red usually means the situation in ED is reaching a dangerous level because you are on bed block and can’t offload ambulances. We are supposed to get extra help in those circumstances but we never do.” She said the failure of the reasonable workloads process forced the branch to appeal to the board of Western LHD, at a public meeting called by the board, to tell the community how the LHD had performed during the past year. When the floor was opened for questions nurses handed the board a letter calling for an extra ED nurse on each shift, to cope with greater workloads brought about by increased patient acuity, especially in resuscitation, emergency and urgent cases. However the board’s chair, Dr Robin Williams, later wrote to the branch effectively rejecting the request. He claimed the number of presentations had decreased and the ED was meeting the required key performance indicators set by the Ministry of Health for the five triage codes.

PATIENT CARE COMPROMISED The NSWNMA branch met to consider Dr Williams’ letter and carried a resolution “absolutely rejecting” the response. “Not one of the issues has been addressed and we remain extremely concerned that patient care continues to be compromised,” the resolution said. “The board completely ignored the issue of increased acuity, saying everything is okay because we meet our benchmarks each month,” Tatiana said. “Nurses manage to meet their targets through hard work and dedication, but that doesn’t mean it is always done safely or is sustainable.” Patient numbers at Bathurst ED have grown steadily in recent years, from 22,233 in 2008-09 to 23,870 in 2010-11. While non-urgent presentations dropped from 3696 in 2008-09 to 2558 in 2010-11, emergency presentations rose from 1109 to 1472 in the same period. Urgent presentations went up from 4789 to 6117. In 2010, the ED averaged 65 patients a day, with an average of more than 21 being emergencies or requiring urgent attention. To handle all this there are: • 3.5 nurses plus a nurse unit manager on the morning shift. • Five nurses on the evening shift, including the clinical initiatives nurse who is dedicated to non-urgent cases. • Three nurses on night shift. NSWNMA General Secretary Brett Holmes says these figures show the Bathurst ED is being staffed at the bare minimum, with emergencies and urgent cases averaging nearly one an hour. He said that until safer nurse numbers are provided non-urgent patients may face extra delays, as nurses focus on emergencies and urgent cases. “Until now they have been trying their best to juggle both. However, I am advised that has led to a number of near misses and they must now take action to protect patient safety,” he said.

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Prank call with tragic consequence The day before the apparent suicide of a British nurse, the NSWNMA warned Radio 2Day FM to consider the personal toll on nurses of its prank calls

Jacintha Saldanha, 46, took her life in the nurses’ quarters at King Edward VII Hospital.

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A SENIOR NURSE AT LONDON’S KING Edward VII Hospital was found unconscious and unable to be revived at a nurses’ accommodation block, two days after transferring a hoax call from 2Day FM radio DJs, Mel Grieg and Michael Christian. Nurse Jacintha Saldanha transferred the hoax call, which unbeknownst to her or her colleagues was being broadcast, to the duty nurse. Posing as members of the royal family, the DJs were able to elicit confidential details of treatment being given to the pregnant Duchess of Cambridge, who was suffering from hyperemesis gravidarum, or acute morning sickness. The call received widespread, international media coverage, prompting the NSWNMA to write to 2Day FM management asking them to consider the serious professional consequences such a call could have on nurses. The day after the call, and a day before Mrs Saldanha’s death on December 7, NSWNMA General Secretary Brett Holmes wrote to 2Day FM general manager Jeremy Simpson, drawing attention to “the very serious professional consequences such a stunt would have had for a nurse or midwife in the Australian context. “As regulated health professionals, Australian nurses and midwives must comply with strict professional and legal obligations in terms of patient privacy,” he wrote. He added that a nurse working in New South Wales, taken in by such a hoax, could potentially have to respond to three separate disciplinary processes conducted by the employer, the regulating authority and the Health Care Complaints Commission. “In our role as industrial and professional representatives for NSW nurses and midwives, we deal with these processes every day and I can assure you that they are stressful and deeply traumatic experiences for many nurses and midwives, regardless of the level of wrongdoing or the nature of the precipitating incident. “In the future I urge you to consider the personal toll such a prank could exact from a professional caregiver such as one of my members,” Brett wrote. He called on the station to “undertake to never again attempt to jeopardise their professional standing by perpetrating such a deception against another hardworking nurse or midwife.”

Four days after Mrs Saldanha died, Brett Holmes wrote a second letter to 2Day FM – this time to CEO Rhys Holleran – saying that the station’s public response to the tragedy “demonstrates either a reckless indifference or a fundamental misapprehension with regard to the legal and professional framework that governs nursing practice and the principle of patient confidentiality.” His letter described the professional and legal obligations of Australian nurses concerning patient privacy, which, he said, were similar to those applying in the UK. “As we pointed out in our earlier correspondence, this nurse would have potentially been facing disciplinary action conducted by her employer, regulatory authority and health care complaints agency. “On top of these very serious professional and legal repercussions, she had to deal with the shame and humiliation of her mistake being broadcast to a global audience.” In a reply dated January 11, 2013, Day FM general manager Jeremy Simpson wrote: “We have conducted a review of the process undertaken in airing the segment and found that our announcers and producers followed our internal processes and procedures.” He also wrote: “We appreciate your comments regarding the regulation of health care professionals and how such a prank call could cause serious personal and professional ramifications ... We are taking this situation very seriously and have responded by: • Donating all profits from advertising on 2Day FM from 13 December 2012 to 31 December 2012 to an appropriate fund that will directly benefit the family of Jacintha Saldanha with a minimum contribution of A$500,000; • cancelling 2Day FM’s Hot 30 program; and • suspending all ‘prank’ calls across the SCA radio network.” The NSWNMA published a message of condolence to the “family, friends and colleagues” of Mrs Saldanha on its website and urged “all nurses and midwives who are under pressure or feeling stress to seek appropriate assistance and to feel confident they can reach out for help.” If you or someone you know may be at risk of suicide contact Lifeline 13 11 14, Beyond Blue 1300 22 46 36, or Salvo Care Line 1300 36 36 22.

CULTURE OF ‘RECKLESS INDIFFERENCE’ How much responsibility should Radio 2Day FM have taken for the death of British nurse Jacintha Saldanha? In his letter to the NSWNMA, 2Day FM general manager Jeremy Simpson said: “As you know, the content we broadcast is governed by the Commercial Radio Australia Codes of Practice (the Codes). In your letter, you mentioned that the Codes require that an identifiable person should not be broadcast without their permission. With respect, it is our view that no breach of the Codes has occurred. The relevant Code that prevents the unauthorised broadcast of statements by identifiable persons is Code 6. We do not consider that the two nurses whose words were broadcast were identifiable. At no time during the segments did we broadcast (or indeed even know) the name of either of the two nurses.” However, Dr Denis Muller, Honorary Fellow in the Centre for Applied Philosophy and Public Ethics at the University of Melbourne, questioned the station’s claim that no law had been broken, saying the prank call possibly breached laws in New South Wales, Australia and the UK. According to Dr Muller, 2Day FM, its licence holder Southern Cross Austereo, its management and its board of directors had created “a culture of reckless indifference to the welfare of others and contempt for norms of decency.” Dr Muller, a leading expert on media ethics, said: “To obtain private information about a person’s health without that person’s consent is itself a serious breach of ethics. To obtain it by deception makes it worse, and to then broadcast it publicly over the radio makes it beyond all civilised standards of behaviour.” Former 2Day FM presenter Wendy Harmer said she believed the station had broken the Commercial Radio Code of Practice by not gaining the nurse’s permission to broadcast the exchange.

T H E L A M P F E B R U A R Y 2 01 3 | 3 1

NSWNMA EDUCA Basic Foot Care for AiNs – 1 Day TARGET GROUP: c c MEMBERS NON-MEMBERS Basic Foot Care for RNs and ENs – 2 Days TARGET GROUP: c c c c MEMBERS NON-MEMBERS Legal and Professional Issues for Nurses and Midwives – ½ Day TARGET GROUP: c c c c c c c c c c c c MEMBERS NON-MEMBERS

Practical, Positive Ways in Managing Stress and Burnout – 1 Day TARGET GROUP: c c c MEMBERS NON-MEMBERS Practical, Positive Actions in Managing Conflict and Disagreement – 1 Day TARGET GROUP: c c c MEMBERS NON-MEMBERS Aged Care Nurses Forum – 1 Day TARGET GROUP: c MEMBERS NON-MEMBERS Mental Health and Drug and Alcohol Nurses Forum – 1 Day TARGET GROUP: c MEMBERS NON-MEMBERS Enrolled Nurses Forum – 1 Day

Leadership Skills for the Aged Care Team – 4 Days



Men in Nursing Forum – 1 Day




ATION CALENDAR Policy and Guideline Writing – 1 Day

Appropriate Workplace Behaviour – 1 Day



Review and Implementation of Guidelines and Policies – 1 Day TARGET GROUP: c MEMBERS NON-MEMBERS Computer Essentials for Nurses and Midwives– 1 Day TARGET GROUP: c c c c c VENUE: MEMBERS NON-MEMBERS Practical, Positive Leadership – 3 Days



Leadership for DONs and SNMs – 3 Days TARGET GROUP: c MEMBERS

TARGET GROUP: c c c c c c c c c c MEMBERS NON-MEMBERS Aged Care Seminar Series – 1 Day TARGET GROUP: c c c MEMBERS NON-MEMBERS



Are you meeting your CPD requirements? – ½ Day


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

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.

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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.











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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 Pay upon termination? I recently resigned from a position in Community Aged Care having given the required two weeks notice. Am I entitled to two weeks pay at the end of my employment? Having given the required notice of two weeks, and as long as you have worked your required shifts, or taken leave to cover your final two weeks, you are entitled to your final two weeks pay upon termination. The Nurses State Award 2010, clause 11.2 states that: “The notice of termination required to be given by an employee is the same as that required of an employer except that there is no requirement on the employee to give additional notice based on the age of the employee concerned. If an employee fails to give the required notice the employer may withhold any monies due to the employee on termination under this award or the NES, an amount not exceeding the amount the employee would have been paid under this award in respect of the period of notice required.”

Pre-dispensed doses I am an AIN Certificate III working in a private low care facility and want to know if I’m allowed to administer non-packed schedule 4 drugs. My understanding is that I am not, as it has to be in predispensed doses. Is this correct? The answer to your question is covered by the Poisons and Therapeutic Goods Act 1966 Part 4. No 23 Possession and supply of drugs of addiction by carers: “Despite any other provision of or made under this or any other Act, a person

who has the care of, or is assisting in the care of, another person (for or to whom the supply of a drug of addiction has been authorised by the prescription of a medical practitioner, nurse practitioner, midwife practitioner or dentist) is not guilty of an offence in relation to the possession or supply of the drug if the person is in possession of the drug for the sole purpose of administering, or assisting in the self-administration of, the drug to the other person and does so in accordance with that prescription” This means that a person who is caring for, or assisting in the care of another person to whom a drug has been prescribed by a medical practitioner, can administer or assist in the administration of the drug. It is important for staff to receive relevant training and possess an understanding of medications being administered. There should also be a written policy in place covering all staff classifications that administer medication.

Emergency meal allowance I am an RN working in a public hospital in theatres. We sometimes have emergency lists and end up doing anywhere from two to six or more hours overtime. Are we entitled to a meal allowance? Yes, you are entitled to both a paid meal break of 20 minutes after two hours’ overtime and every four hours overtime thereafter and a meal without charge at each meal break. The Public Health System Nurses’ & Midwives’ (State) Award at Clause 25, (vii) (a) states: “Where the employer is unable to provide such meals, an allowance per meal as calculated hereunder shall be paid to the employee concerned.”

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

The rate for the meal allowance is determined as per Department of Premier and Cabinet Circular C2010-28, as amended or replaced.

Cashing out annual leave I work in a public hospital and have an additional week annual leave as a result of working Sundays and public holidays. Am I able to have the leave paid out in cash rather than taking the leave? Yes, you are able to cash out this annual leave. Clause 30 (xi) of the Public Health System Nurses’ & Midwives’ (State) Award 2011 allows for any accrued “additional” annual leave to be paid out. Additional annual leave is the two weeks leave allowed to nurses who work a seven day a week rotating roster and accrue six weeks annual leave per year, or any additional leave accrued for working a certain amount of Sundays and public holidays. The above information is also available in the Ministry of Health Policy directive IB2011_051 Nurses and Midwives Cashing Out Additional Accrued Annual Leave.

Cashing out before 12 months I am an RN in the public health system and I have been employed for less than 12 months. Am I entitled to cash out additional annual leave? Unfortunately you will not be able to cash out your additional annual leave until you have completed at least 12 months employment in the Public Health System as per clause 30 (i) of the Public Health System Nurses’ and Midwives (State) Award 2011.

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:

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Email: T H E L A M P F E B R U A R Y 2 01 3 | 3 5





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 heartbreaking adoption story

Maryanne was pregnant and unmarried in 1970 and had no choice but to adopt out her baby.

Recency of practice: Alice’s story

With three children under five, Alice will be forced back to work before she’s ready — or forced to give up her nursing career — under recency of practice rules.

I said mate, I said luv, I said darl...

One Local Health District has issued a memo banning health workers from using endearments with patients.

Stunt turns to tragedy

A hoax call to a nurse on night shift in London had tragic consequences.

A nurse cycles for fistulas

Bruno Cordier is cycling across Australia to raise funds for women with childbirth injuries.

Sydney midwife’s Bougainville dramas

Coping with haemorrhage, retained placenta, obstructed labour, breech babies, etc, in rugged isolation.

Nursing has its moments!

Jan (nee Rayner) Mills writes about the many highlights of her nursing career, including working in Vietnam during the war.

Walking at work

Some nurses walk kilometres in the course of each shift – but does this make them fit?

ONLINE Join us


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

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United Kingdom A London nurse took her own life after being caught up in a radio hoax call.

Staff cuts ED nurses at Bulli Hospital are furious at cuts to the night shift.

Mind your tongue When one LHD instructed staff to stop using endearments, we asked: is it okay to call patients “love” or “mate”? The response was huge!

Jo Kemp from Gosford Hospital won an iPad for switching her NSWNMA membership from payroll deduction to direct debit.

Why are they wearing that t-shirt? A branch barbeque in Leeton.

Regardless of what caused the nurse to commit suicide, it is never ok for the sick and vulnerable or their carers to be the butt of childish pranks. Hospitals are full of overworked understaffed nurses who should never have to be concerned about being pranked while on duty. How often have we as the smallest link in an enormous bureaucracy been the ones called to answer when the processes of the organisation are at fault? For the nurse and her family, words cannot express the sympathy I feel. For the nurses that lost a co-worker and friend, my most sincere sympathy. As nurses we need to send a message that enough is enough! I trained many years ago at Bulli when it was an extremely busy hospital. Emergency ward was always full and busy at all hours, day and night! What is happening that Bulli is now expecting to have no ED? I have watched this hospital fall from complex training hospital in the 80s to this. Sad!

Absolutely. Also Auntie/Uncle to the Indian and Koori elders. Very polite. Personally I loathe being addressed as sweetheart/darl/luv. I think it is insincere and presumptuous particularly when used by someone of the opposite sex. I have a name and I prefer people to use it. Working in a birth suite I am very guilty of saying “honey” or something like that! I do try to use their name but sometimes in the heat of the moment you forget. Micro management at its finest. When will the real issues be addressed? It was only the other day in ED an elderly patient told me the best part about coming to hospital was being called such lovely terms. The intent makes all the difference; most nurses can differentiate between those who wish to be called Mr or Mrs and those who respond to that little extra friendliness. We are professionals and don’t need memos to tell us how we should or shouldn’t speak. It’s more important to keep them alive than worry about our words isn’t it? Keep doing what you do people! Words like “pet”, “darl”, and “honey” can be viewed as flippant and condescending. Correct and respectful address of patients shows them that we have etiquette and manners in a society that continues to lack both. I use such terms to be tender while dealing with sensitive issues with the patient and when, unfortunately, I have to cause pain doing an intervention. I think we use these terms of endearment with our patients because we treat them like we would our friends and family – with care and compassion. We connect with them on very close personal levels while we care for them. Trust us, we are nurses. Let the professional nurses continue as THEY see fit and call their patients what they think is appropriate.

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Previous films can be viewed on our we website bsite

www2.nswnma gallery.html allery.html html Authorised by B.Holmes, General Secretary Secretary,, NSW Nurses and Midwives’ Association


Data and research on important areas for nursing professionals in New South Wales. Inequalities in bariatric surgery in Australia: findings from 49,364 obese participants in a prospective cohort study Rosemary J Korda, Grace Joshy, Louisa R Jorm, James RG Butler and Emily Banks

Obesity is a major public health challenge for Australia. In the 2007–08 National Health Survey, 24% of Australian adults were reported to be obese and a further 37% overweight. Obesity rates are growing and the continuing increase in severe obesity is of particular concern. It is a major risk factor for type 2 diabetes and a range of other chronic diseases, including cardiovascular, digestive and musculoskeletal disorders, as well as overall mortality. This article investigates the variation, and quantifies socioeconomic inequalities, in the uptake of primary bariatric surgery in an obese population in Australia. This surgery is more effective than non-surgical interventions for the treatment of severe obesity, and is cost-effective. In addition to substantial weight loss, bariatric surgery can lead to improvements in co-morbid conditions including lipid abnormalities, obstructive sleep apnoea and joint disease. Of particular note is its effectiveness in treating type 2 diabetes, with one recent trial showing remission rates of 75–95% within two years of surgery.

Incontinence in Australia: prevalence, experience and cost Australian Institute of Health and Welfare

This paper reports on the 316,500 people who experienced severe incontinence in 2009, according to the Australian Bureau of Statistics’ Survey of Disability, Ageing and Carers. The majority of people (209,000 or 66%) were female. Needing assistance with bladder or bowel control will affect an individual’s life in many ways. The labour force participation rate for people aged 15-64 who always or sometimes needed assistance with bladder or bowel control was 20.4%. For 2008-09, the health care expenditure estimated for incontinence was $201.6 million (not including residential aged care costs). In comparison, the equivalent expenditure for 2003 was $157.9 million (in 2008-09 dollars). The largest share of 2008-09 expenditure was for admitted patient hospital services, which accounted for $145.5 million, or 72% of the total health care expenditure that could be allocated to incontinence. The Continence Aids Assistance Scheme and out-of-hospital medical services were the next largest contributors to the cost, at $31.6 million and $17.7 million respectively. Additional costs, not included in these estimates, were personal costs, such as laundry, clothing and time.

The effect of community interventions on alcohol-related assault in Geelong, Australia Peter G. Miller, Anders L. Sønderlund, Kerri Coomber, Darren Palmer, Jennifer Tindall, Karen Gillham and John Wiggers

Alcohol has consistently been demonstrated to increase levels of aggression and violence, particularly in late night licensed venues. The aim of this study was to assess the individual and collective impact of community interventions on indicators of alcohol-related assaults in the Geelong region. Since 2005, the City of Geelong has implemented a substantial number of interventions to reduce alcohol-related violence, including a liquor accord, increased police surveillance, ID scanners, CCTV, a radio network and an alcohol industry-sponsored, social marketing campaign.

This paper reports stage one findings from the Dealing with Alcohol-related problems in the Night-time Economy project (DANTE) and specifically examines assault rate data from both emergency department presentations, International Classification of Diseases classification codes, and police records of assaults. Community level interventions appeared to have had little effect on assault rates during high alcohol times. It was also possible that social marketing campaigns, without practical strategies, were associated with increased assault rates. The findings also raised questions about whether interventions should be targeted at reducing whole-of-community alcohol consumption.

A guide to understanding and working with General Practice in NSW Carla Saunders, Laura Tierney

A better understanding of the particular ways of working and ethos of general practice will support sustainable partnerships, improve health care integration and eliminate misperceptions about general practice and general practice service delivery. This guide provides an outline of general practice. It considers its uniformity and diversity, its funding arrangements, service delivery, workforce, training, capacity and supporting structures. It provides recommendations for identifying and acting on opportunities for collaboration. The guide draws on published literature as well as the experience of an expert group. The guide is not intended to be exhaustive. It attempts to consolidate in one document key information about general practice. W_Guide_WEB.pdf

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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.

test your

knowledge 1







8 9







16 18






22 24



Across 1. Any dysfunction associated with sleep 8. Parts accessory to an organ or structure 9. Removal of certain parts from a mass 10. Brain death (12.4) 12. The quantity of drug to be administered at one time 14. Highly hepatotoxic compounds formed in the rumen by the combination of amines and nitrite 17. Turning outward, e.g. of an eyelid 18. Having two feet

19. The formation of a neoplasm 20. Mucous secretion from the lungs through the mouth 22. A nurse classification (1.1) 23. Method of giving medication through the trachea 25. A circular muscle that constricts a passage or closes a natural orifice 26. Gas that may be expelled through the anus

Down 1. Plague 2. A backward flow 3. To put aside or postpone from consideration 4. Thin or emaciated 5. One of several soluble proteins involved in the initiation of protein or RNA synthesis (10.6) 6. An agent that counteracts acidity 7. A strip of material wrapped applied to any body part 8. An oily, poisonous liquid used in the manufacture of dyes 11. Syngeneic

13. A patient treated in a hospital dispensary or clinic 15. Below the apex of any part 16. Overdose (1.1) 19. Nostril 21. Mitochondrial Encephalomyopathy with Lactic Acidosis & Stroke-like episodes ( 24. A measure of the acidity or alkalinity of a solution (1.1)

T H E L A M P F E B R U A R Y 2 01 3 | 4 1

Quality legal advice for NSWNMA members 2 Compensation and negligence claims 2 Motor vehicle claims 2 Wage loss claims 2 Industrial and Employment law

2 First Free Consultation for all members 2 Discounted rates for members on all matters 2 Free Standard Wills 2 No win – no charge*

Call the NSWNMA on 1300 367 962 and find out how you can access this great service. Offices in Sydney, Newcastle and visiting offices in regional areas (by appointment). *Conditions apply

Continuing Continuing Professional Professional Development Development with "The The College of Kno Knowledge" wledge wledge" Book your place now 1800 1 80 0 COLLEGE (26 55 343) www

Some CPD courses ffor or Mar March ch and April April include: March Aged care 4M a rc h – A ge d c are llegal egal issues, is su e s , Adelaide SA A d e laid e S A 211 & 2 22 2 2 March March – The The deteriorating deteriorating patient: patient: Clinical Clinical decision decision making, making , Brisbane QLD Brisbane Q LD 2 & 3 April April – Wound Wound management, management, Alstonville NSW Alstonville N SW 9 & 110 0 April April – Urological Urological nursing, nu r sing , Burwood NSW Bur wood N SW

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Comprehensive Systematic Review for Advanced Nursing Practice Cheryl Holly, Susan W. Salmond and Marie K. Saimbert

jSpringer Publishing j j RRP $70 j ISBN 9780826117786 Comprehensive Systematic Review for Advanced Nursing Practice addresses the basic concepts of systematic reviews and their relationship to clinical practice and policy. The books also describes how to find and select the best available evidence, and explores specific types of systematic reviews including experimental, observational, and economic evidence, as well as current and future use of the process. This book should be a must read for all health professionals who are seeking to do the best they can in health care.

Navigating the Maze of Research: Enhancing Nursing and Midwifery Practice (3rd ed.) Sally Borbasi and Debra Jackson

jMosby Elsevier Company j j RRP $67.50 j ISBN 9780729540902 Navigating the Maze of Research is the ideal tool for nursing students in Australia and New Zealand who are learning to access, evaluate and apply research findings in everyday clinical practice at an introductory level. This updated edition contains more case studies linking clinical practice to research, and increased detail on sampling techniques, reliability and validity.

Willingly into the Fray. One Hundred Years of Australian Nursing. Edited by Catherine McCullagh

j Big Sky Publishing j j RRP $34.99 j ISBN 9780980658262 Willingly Into the Fray provides a rare view through the lives of Australian Army nurses from the early  days of 1899 to modern times. Sixty-five nurses tell their stories in voices often fraught with emotion and mired in distress at what they have seen, endured and railed against. Many of these stories are told for the first time, particularly those of the recent campaigns, peacekeeping operations, disaster relief and humanitarian missions. Since the first intrepid Boer War nurses set out, Australian Army nurses have forged a proud and enviable reputation. They are justifiably renowned for their determination to provide quality medical care despite extreme privation, perilous circumstances and, at times, a lack of the most rudimentary medical equipment.

Applied Therapeutics. The Clinical Use of Drugs (9th ed.) Edited by Mary Anne Koda-Kimble, Lloyd Lee Young, Brian K. Alldredge, Robin L. Corelli, B. Joseph Guglielmo, Wayne A. Kradjan and Bradley R. Williams

jWolters Kluwer j j Lippincott Williams & Wilkins j j RRP $190.95 j ISBN 9780781765558 This completely updated ninth edition of Applied Therapeutics incorporates the latest drug treatments, therapeutic practices and guidelines and uses a case-based approach to help students master the fundamentals of drug therapeutics. More than 850 tables provide quick access to comparative drug information, pharmacokinetic properties, treatment options, dosing guidelines, risk factors and disease and diagnosis information. A companion Website offers fully searchable text animations of pathophysiologic concepts and additional case studies.

Miller’s Nursing for Wellness in Older Adults (1st ANZ ed.) Edited by Sharyn Hunter

jWolters Kluwer j j Lippincott Williams & Wilkins j j RRP $99.00 j ISBN 9781920994297 Nursing for Wellness in Older Adults uses a wellbeing approach to the theory and practice of caring for older adults, while dealing with both the physiological and psychosocial aspects of ageing. The text includes progressive case studies in a variety of care settings to help student’s link theory to practice. Cultural, social and legislative considerations for Australia and New Zealand are included throughout.

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. T H E L A M P F E B R U A R Y 2 01 3 | 4 3


Karen Draddy 21 December 1951 — 2 January 2013

[e\ Karen completed her general nursing training at Gosford Hospital in 1973, followed by her midwifery training at Auburn District Hospital in 1974. In 1983 Karen became the Midwifery Unit Manager at Mona Vale Hospital and remained in that role until her retirement in 2012. Karen made a significant contribution to the nursing and midwifery profession in New South Wales as the Branch President,Vice President and life member of the NSW Nurses and Midwives’ Association, a member of the Australian Nursing Federation and the Australian College of Midwives, a representative of the Northern Beaches Lactation Interest group and as a panel member for tribunals and professional practice for the Nurses and Midwives’ Board of NSW. However, one of Karen greatest loves was the Nursing and Midwifery Unit Managers’ Society of NSW, where she was an Executive Member, Past President, News Editor and Secretary. Karen was bestowed the honour of life membership of this society and was delighted with this accolade. Karen was a remarkable ambassador for nurses and midwives and took great delight and personal interest in mentoring junior midwives and Nurse/Midwifery Unit Managers, who were grateful for her guidance and support.

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Karen was actively involved in the community including participation in Soroptimist International (an international organisation for business and professional women who work to improve the lives of women and girls in both the local community and throughout the world). Upon retirement Karen became a member of the Mona Vale Hospital Auxiliary in a volunteer capacity and was appointed Deputy President, which allowed her to continue her association with the hospital she dearly loved. Her work in the community and at Mona Vale Hospital was recognised in 2005 when Karen was awarded the prestigious honour of Pittwater Woman of the Year. All those who knew Karen gained a clear insight that here was a passionate advocate for equity and fairness. She was loyal and generous and caring for those in need and would always be honest and speak her mind. Karen will be sadly missed by her nursing and midwifery colleagues, her family and her large circle of friends. Jacqui Edgley, Director of Nursing and Midwifery, Mona Vale Hospital

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movies of the month

I GIVE IT A YEAR special offer

A total chick flick, perfect for watching with your single mates, writes O’Bray Smith. This British rom com is not as spectacular as Love Actually but would hold its own against Four Weddings and a Funeral. Nat (Australian actor Rose Byrne) is a high-flying, driven, and gorgeous, independent woman who dreams of falling in love. Conveniently, along comes Josh (Rafe Spall), a failing novelist who is very different, and single. Josh loves dancing badly, drinking beer and acting like a 12-year-old, not the kind of man who would normally travel in Nat’s social circle. They fall in love and seven months later get married. Disaster was always going to strike these two love birds: it’s like watching a train wreck of love. Enter stage left Aussie Simon Baker (looking adorable though a

little old) and Anna Faris, who play two single, attractive people, set to temp Nat and Josh, and prove that perhaps there is only one person for us in life, even if we sometimes get it wrong. The movie also stars Minnie Driver who gives a strong performance and adds a bit of cheek to an otherwise sedate cast. I Give It a Year doesn’t make you think, doesn’t challenge your morals and certainly doesn’t educate you on world politics. At times it had me roaring with laughter (and horror), at times I giggled uncontrollably and to be honest, at times I cringed at how forced some of the comedy was. There were small glimpses of Bridesmaids style shock value, but overall it was your typical British comedy. It was good, not so clean fun, and I would watch it again. O’Bray Smith is an RN at the Royal Prince Alfred Hospital


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

4 6 | T H E L A M P F E B R U A R Y 2 01 3

DVD GIVEAWAY Woody Allen’s follow-up film to Midnight in Paris, To Rome With Love is full of romance and comedy and stars another fine ensemble cast: Penelope Cruz, Alex Baldwin, Judy Davis and more. The DVD is out on 20 February and The Lamp has five DVDs to giveaway thanks to Hopscotch Entertainment. For you chance to win write your name, address and membership number on the back of an envelope and send to: Rome with Love DVD Competition 50 O’Dea Ave Waterloo NSW 2017 ONLY ONE ENTRY PER MEMBER WILL BE ACCEPTED.


SWEENEY A seriously muscular and stylish bit of cops and robbers action, writes Stephanie Gray. The Sweeney delivers adrenalinpumping thrills ’n spills, as a tough team of London police takes violent measures to get crime off the streets. This film adaptation, by director Nick Love, of the hit British television series from the 1970s is aimed very much at solid mainstream release. With a good deal of panache, it also has the humour and cinematic moves to appeal to many lovers of a film of this genre. The casting of rugged British actor Ray Winstone as Detective Jack Regan, head of the London police’s Flying Squad team (the title derives from Sweeney Todd, Cockney rhyming slang for Flying Squad) works well. The role was played by John Thaw in the television series. British rap star Ben Drew (aka Plan B) takes on the key role of Regan’s sidekick, Detective George Carter (played by Dennis Waterman in the 1970s). The squad is overseen by Frank Haskins played by Damian Lewis, who set up the team, recruited Regan and spends much of his time fighting off official criticism of the violent tactics they use. Regan’s team are investigating rumours of a bank robbery and also looking into the murder of a woman during a jewellery store robbery, when they discover they are being investigated by internal affairs, led by Ivan Lewis. This further complicates things for Regan, given that he is having a passionate affair with Lewis’s wife, who happens to be part of the Sweeney team. The film works best because of the wonderful overhead shots of a burnished and modern London, and when the team are speeding around looking for the bad guys. There are some wonderfully staged shoot-outs across Trafalgar Square. If you enjoyed the 1970s TV series you will have fun with this big screen version. Great viewing for fans of British cop shows, right down to the well-known and abused phrase – “you’re nicked”. Stephanie Gray is an RN with the Australian Red Cross Blood Services.

ciné files several members of the real flying squad were convicted and jailed for corruption.

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

T H E L A M P F E B R U A R Y 2 01 3 | 4 7

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2013 Postgraduate Scholarships NSW Health is offering the following nursing & midwifery postgraduate scholarships in 2013. Category 1: Clinical Studies Category 2: Education Category 3: Management

These scholarships are available to full time or part time registered nurses or registered midwives employed and currently working in the NSW public health system (Further criteria applies). Applications open 3rd December 2012 and close 1st March 2013.

For further information an application forms visit

4 8 | T H E L A M P F E B R U A R Y 2 01 3

DON’T PUT YOUR NSWNMA MEMBERSHIP AT RISK! The State Government could at any time stop payroll deductions. As a matter of urgency please convert to the Direct Debit or Credit method of paying your fees.

BE PREPARED. CHANGE TODA TODAY. ODAAY. Download, complete and return your Direct Debit form to the Association.

www Alternatively call us on Metro 8595 1234 or Rural 1300 367 962 Authorised by B.Holmes, General Secretary Secretary,, NSW Nurses and Midwives’ Association


conferences, seminars, meetings SYDNEY, HUNTER & ILLAWARRA National Disability Services NSW 2013 State Conference 11-12 February Hilton Sydney Miriam Sosin 9256 3133 Nepean Midwives Conference: Taking Midwifery to the Future 1 March Sebel Resort & Spa, Windsor Social Media and Critical Care March 11-13 Sydney Conference and Entertainment Centre Council for Children’s Nurses NSW Biennial Conference: Winds of Change — Thinking into Action March 14-15 Waterview Conference Centre, Bicentennial Park, Sydney Think arthritis and osteoporosis 16 March Clinical update day Kolling Institute, RNSHt 9 May-11 July. 6.30-9.30pm One evening a week for 10 weeks Sydney Clinical Pharmacology Seminar 10-11 May Sydney High Acuity Nursing Course 4-5 June Newcastle The ALERT course : Acute Lifethreatening Emergencies, Recognition & Treatment

12-13 July Sydney Basic Life Support & Advanced Cardiac Life Support 1-2 November Sydney Paediatric Advanced Life Support 3 November Sydney Difficult Airway Management 21 November Sydney Anaesthesia & Post Anaesthesia Care Nursing Seminar 22-23 November Sydney The ALERT course: Acute Lifethreatening Emergencies, Recognition & Treatment 29-30 November Newcastle

ACT, INTERSTATE & OVERSEAS 1st Indo-European Symposium on Coercion 1-3 February Mysore, India Working together 7th Annual conference of the Australasian Cardiovascular Nursing College 23-24 February Auckland, New Zealand 0416 049 825 Continence Management in the ACT 22 March Marilyn Woodcock (02) 87415699

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5 0 | T H E L A M P F E B R U A R Y 2 01 3

A B D N E X A T N A D E C O M A G I D O S E S U U T O B I P E D A A P U T U M I I E C H E A L A N A L A T U S, Tackling Asthma in Australia/National Asthma Conference 2013 19-20 March Rydges Lakeside, Canberra 2013 World Congress for Psychiatric Nurses 2-4 May Winnipeg, Canada International Council of Nurses (ICN) 25th Quadrennial Congress 18-23 May Melbourne Australian No 2 Bullying Conference 22-24 May Outrigger, Surfers Paradise 14th International Mental Health Conference 2013 5-6 August Outrigger, Surfers Paradise 2nd World Congress of Clinical Safety 12-13 September Heidelberg, Germany 8th European Congress on Violence in Clinical Psychiatry 23-26 October Ghent, Belgium

REUNIONS Royal Melbourne Hospital January 1973 PTS Claire Jenkin (Furlong) 0420 810 544 St Vincent’s Hospital Sydney January 1973 PTS reunion 16 March Julie Campbell (Coombs) 0405 737 361 RAHC March 1973 PTS reunion 17 March Celebrate 40 years since we commenced training. Bronwyn Exley Jenny Elliott Sherran Alexander (Peck) Allandale Hospital Cessnock 50th year reunion 23 March. Tickets $45 Call Cessnock Supporter Club (02) 49 932655 May 1976 Blacktown District Hospital Reunion 25 May. 6pm. Lily’s Restaurant, Seven Hills Karen Walker Diane Shinnick via Facebook

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The Lamp February 2013  
The Lamp February 2013  

In this issue: it's time to vote on the recommended Public Health System claim, our new TV ads, pay rises at Forster Private and more.