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THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION

VOLUME 70 No.6 JULY 2013

Print Post Approved: PP241437/00033


Our look has changed but our commitment to our members hasn’t First State Super is committed to the ongoing support of nurses and midwives. What make us different is that we exist to grow our member’s wealth, not our own. We work with our members to help them build and secure their financial future. If you would like to be a member of the super fund that puts its members first, call 1300 650 873 today.

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CONTENTS

lamp THE

CONTACTS NSW Nurses and Midwives’ Association For all membership enquiries and assistance, including Lamp subscriptions and change of address, contact our Sydney office.

VOLUME 70 No.6 JULY 2013

Sydney Office 50 O’Dea Avenue, Waterloo NSW 2017 (all correspondence) T 8595 1234 (metro) 1300 367 962 (non-metro) F 9662 1414 E gensec@nswnma.asn.au W www.nswnma.asn.au Hunter Office 8-14 Telford Street, Newcastle East NSW 2300

COVER STORY

12 | Nationals get health message Members of the NSWNMA from across the state travelled to Bathurst to champion the cause of country health services.

NSWNMA Communications Manager Janaki Chellam-Rajendra T 8595 1258 FOR ALL EDITORIAL ENQUIRIES, LETTERS AND DIARY DATES: T 8595 1234 E lamp@nswnma.asn.au M 50 O’Dea Avenue, Waterloo NSW 2017 Produced by Hester Communications T 9568 3148

From left to right: Kim Eason, Leonie Keen and Deborah Noakes.

Press Releases Send your press releases to: F 9662 1414 E gensec@nswnma.asn.au

PHOTOGRAPH: TIM DALBY

REGULARS

5 6 8 27 35 39 41 43 49 50

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

COVER STORY

COVER STORY

16 | Candlelight protest greets Nationals

More than 400 NSW National Party delegates made their entrance along a pathway lined by nurses holding candles.

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 ppurcell@nswnma.asn.au Records and Information Centre – Library To find old articles from The Lamp, or to borrow from the NSWNMA nursing and health collection, contact: Jeannette Bromfield, RIC Coordinator T 8595 2175 E gensec@nswnma.asn.au

MPs VISITS

The Lamp ISSN: 0047-3936

18 | Facts play second fiddle to misinformation

22 | MPs feel the heat A small army of nurses in more than 40 electorates across the state had something to say about the O’Farrell Government trying to hide behind its own bad laws.

COMPETITION

9 | Win a $1000 holiday voucher

COST OF HEALTH

30 | American health: Exorbitant, inefficient and out of reach. Medicine is big business in the United States and ordinary Americans pay an exorbitant price for questionable outcomes.

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 J U LY 2 0 1 3 | 3


Being a member of the NSWNMA suddenly got easier! Introducing the do-it-yourself membership online portal Now you can change your personal details, pay your fees and even join online using membership online.

It’s easy. Simply register with your membership number, name and email address and create your own password. From then on, use your member number and password to log in directly to the Members login area on the website.

You can now change your details at any time – address, workplace, credit card number, mobile number, etc. You can pay fees online, print a tax statement or request a reprint of your membership card – it’s simple. There are dedicated areas for branch officials.

Membership online via www.nswnma.asn.au


EDITORIAL BY BRETT HOLMES GENERAL SECRETARY

Nationals are letting down their constituents National Party MPs should be fighting tooth and nail to get a better health deal for their country areas. Instead they are rolling over to their government’s own spin, that people in rural New South Wales don’t need safer patient care delivered by better nursing hours or ratios.

“The Association strongly believes country people are entitled to health care as good as that delivered to patients in metropolitan areas…”

Nurses and midwives were prominent and vocal outside the 2013 NSW National Party conference held in Bathurst on Friday and Saturday 14-15 June. Extending and improving mandated minimum nurse-to-patient ratios to rural hospitals is a key component of our 2013 Public Health System campaign. The Association strongly believes country people are entitled to health care as good as that delivered to patients in metropolitan areas, particularly when it comes to nursing care that can be delivered in situations where medical and other health support is in short supply. We are doing our bit to see that happens and have allocated considerable resources to fighting for better patient care in the bush. One would think that the National Party would be a natural ally for us in this campaign. Sadly, the response we got from National MPs at their conference was far from impressive. Present in Bathurst were nursing and midwifery representatives from 16 of the 19 National Partyheld state electorates, each keen to brief their local MP on the issues and developments in the campaign. These nurses and midwives are totally committed to ensuring regional and rural hospitals are treated equally with the big Sydney, Newcastle and Wollongong hospitals. Formal invitations to a briefing were issued to the 16 MPs, but only three responded. Andrew Fraser (Coffs Harbour) stopped to talk to his constituent, but later went on radio to say that the whole campaign was about union bosses wanting a conflict with the state government. We can’t tar all National members with the same brush. There were many grassroots party members at the conference who were effusive in their praise for what members are trying to achieve and who pledged their support. But they were the victims of wilful deception by their party leadership when the issue was discussed at the conference.

Party leaders such as Andrew Stoner and Melinda Pavey (the Parliamentary Secretary for Regional Health) continue to peddle inaccurate information about our campaign and the state of nurse numbers in New South Wales. The National Party and the government continue to claim credit for recruiting 4000 nurses since the election. This is disingenuous. When pressed this 4000 becomes 2700 Full Time Equivalents. Of these, 1580 of the 2700 nurses were won by the NSWNMA’s 2010 campaign, which was signed off by the previous Labor government. In an information sheet presented at the conference Melinda Pavey used the failure of the previous Labor government to agree to nurse-to-patient ratios in community nursing, emergency departments OR a further increase in clinical Nurse Educators as an excuse for the current state government not to agree to improved patient safety. Furthermore the National Party and the government criticise Labor for not signing up for ratios and claim that “ratios” do not apply in the NSW Health System. This is bizarre and patently false. The previous government did sign up to ratios, albeit after a tough campaign waged by this union. A formula for allocating extra nurses expressed in both nursing-hours-per-patient-day and ratios exists within the award. We have never disputed the existence of “nursing-hours-per-patient-day” but NHPPD can clearly be translated into ratios in the award. Putting semantics to the side, what is clear is that the O’Farrell Government has waged a war to roll back the NSW public sector, with the exception of nurses, teachers and police from its first day in office, and the National Party is prepared to back them to the hilt even at the expense of its core constituents. No one should forget that the improvements to patient safety, offered by our current ratios claim, can only be delivered via a political decision by this government.

T H E L A M P J U LY 2 0 1 3 | 5


YOUR LETTERS

LETTER OF THE MONTH

We need ratios – now!

“I am beginning to realise how severely important nurse-to-patient ratios are to us.”

I am a third year RN/RM and until recently had worked in Sydney hospitals my entire career. The past few months I have been working in my hometown rural area. Only now am I beginning to realise how severely important nurse-to-patient ratios are to us. In large Sydney hospitals, staffing is difficult enough. However, there are often many avenues of assistance you can call on – medical staff on after-hours shifts, senior nursing staff or an after-hours clinical manager who isn’t afraid to get his/her hands dirty. Even in Sydney, though, this often isn’t enough back up. In rural areas, the patients accumulated within the 30-bed ward and emergency department (collectively called a “hospital”) are not necessarily palliative care patients or post-operative surgical patients or cardiac monitoring/arrest or an obstetric clinic. But all too often all these groups of patients are represented within the hospital. Here, within a 30-bed hospital, for acceptable patient care, we would need at least 7.5 nurses (and extra staff for a busy ED). These nurses would need to be capable in all areas of nursing care, to have some understanding of neurological issues, chest pain and cardiovascular issues, bladder and bowel problems, orthopaedic issues, mental health issues, paediatric care and, of course, the needs of the elderly and associated geriatric issues. Most of the time this hospital has five nurses. Most of the time there is not a Medical Officer on site. A lot of the time nurses in my hospital are overwhelmed with a majority of ageing patients that have heavy care requirements and admissions of “acopia”. Occasionally, a child is admitted or a cardiac patient is admitted to the monitored bed. And then one of the four nurses not working in the ED will be required to stop attending to the elderly patient with severe dementia, and let her risk falling, because there is now a patient on the ward who is at a greater risk of deterioration. And everybody else is busy. I’m not sure what it will take for the people in power to embrace and integrate safe nurse-to-patient ratios in all areas of nursing (a pay rise would be nice while they’re at it). But there is one thing for sure – patients will die when they don’t need to and nurses will quit if conditions don’t change, now. I am only third year registered and I am already looking into other career options. There is no time left. We need ratios now. Laura Morton RN/RM, South Coast

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 6 | T H E L A M P J U LY 2 0 1 3

Serious devotion to midwifery I recently had the privilege of going on a midwifery study tour of South Africa led by Professor Cathy Warwick CBE (Royal College of Midwives, UK). Together with 25 midwives from the UK, Australia, and New Zealand, I embarked on a life-changing tour. Our journey took us to public and private hospitals, rural clinics and the University of Western Cape. We attended regular professional visits and talks. I was honoured to meet hundreds of amazing South African midwives and midwifery students. To give readers some idea of the situation, Baragwanath Public Hospital in Johannesburg has a maternity ward very similar to the old “Florence Nightingale” wards. They have 60,000 births per year and admit 90 patients to maternity each 24-hour period. Unless you have the money to pay for private neonatal care, the survival rate of premature babies and twins is low. In rural areas it can take up to two hours to get an ambulance in an emergency. Mortality rates for mothers and babies remain high. Despite medical challenges, lack of resources and funding, as well as staff shortages, South Africa has some of the most amazing midwives I have met. They provide care to grateful communities while faced with unimaginable workloads; they have a serious devotion to midwifery and they always work with a positive attitude and a smile on their face. This tour has greatly affected me. I am now a more proud, confident and devoted midwife. Donna-Lee Houghton,Woolgoolga Read Donna-Lee’s full story at www.nurseuncut.com.au

SAYSOMETHING

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


YOUR LETTERS

Don’t write off AiNs and EENs In regards to Araceli Javier CNS’s letter regarding skill mix, (June Lamp – Skill mix crucial to safety) I believe the author was wrong in regard to junior RNs and EENs not having the correct skills and knowledge. Some junior RNs have worked for many years as AiNs or EENs and have upgraded to RN. I know experienced EENs who have better knowledge and clinical skills than a lot of senior RNs for example in vac dressings, venipuncture and cannulation. Many EENs have worked for many years on acute wards and are accredited in many fields that are not acknowledged in monetary terms. Skill mix on paper may look bad but you should look at the available staff you have and their knowledge and experience. Do not tar all with the same brush Araceli. The experienced EENs are a valuable part of any nursing team along with many junior RNs. Also a third year RN with no previous nursing experience can become a CNS. Peter Goldsmith RN,Wollongbar Work to the roster Regarding the story about Wollongong Hospital, “Theatre nurses win more staff ” (June 2013 Lamp); it is the very nature of nurses that management takes advantage of. They know that nurses want to see all operations/procedures done. They know nurses will stay back to complete lists. As far as the people in higher management (the Suits, Fat-Cats, BeanCounters, etc.) can see, all operations are being done. So what’s the problem? The problem is that the true extent of under-staffing is masked. The fat cats don’t see or hear otherwise. So, nurses need to work as they are rostered; be it a six or eight or 10 hour shift. At the end of the shift, you go home. Yes, you may be leaving a list unfinished, but that is the job of Nursing Management to ensure that staff members are found to finish the list – or the list stops when there are no staff members available. Staff should be asked if they can work back past their rostered finishing time and are within their rights to say “no”. We are required to do “reasonable overtime” only. Louise (name withheld), Central Coast

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NEWS IN BRIEF

IN GREECE, CUTS IN HIVPREVENTION BUDGETS HAVE COINCIDED WITH A

World

Australia

Recessions hurt, austerity kills

Nurses told: leave Newman alone

Two of the world’s leading health economists claim that that more than 10,000 additional suicides and up to one million extra cases of depression have been recorded across Europe and the United States, since governments began introducing austerity programs in the aftermath of the global financial crisis. In their new book, The Body Economic, David Stuckler from Oxford University and Sanjay Basu from Stanford University, show that austerity is having a “devastating effect” on public health in Europe and North America. Since the recession began in the United States, more than five million Americans have lost access to healthcare, as a result of losing their health insurance along with their jobs But the most extreme case, Stuckler told the Guardian newspaper, was Greece, where cuts in

200% INCREASE IN THE VIRUS. HIV-prevention budgets have coincided with a 200% increase in the virus. Suicide rates have risen more than 60%. “Austerity to meet targets … is leading to a public-health disaster,” he says. “Greece has cut its health system by more than 40%. As the Greek health minister said: ‘These aren’t cuts with a scalpel, they’re cuts with a butcher’s knife’.” Britain, Stuckler said, was “one of the clearest expressions of how austerity kills”. Suicide rates were falling before the recession. But since the last British election and the coalition government’s introduction of austerity measures, suicides are on the rise.

X

T R

E M E L Y L O N G W A I T I N G L I S T S I N N S W

8 | T H E L A M P J U LY 2 0 1 3

Queensland nurses at one of the state’s biggest hospitals have been warned to stop criticising the state government and blaming it for budget cuts in front of patients, according to the Sydney Morning Herald. Royal Brisbane and Women’s Hospital management were told there had been complaints about staff criticising Queensland Premier Campbell Newman, as well as the state government in general, in front of other staff and patients. An internal email instructed Executive Directors and Directors of Service to remind their staff of the “inappropriateness” of discussing political opinions. “There have also been instances where complainants, discussing concerns with staff, have been advised that there is nothing that they (the staff) are able to do with regard to staffing, access to care and other issues, ‘so go to the Health Minister and complain to him’,” the email said. Staff were told to stop telling patients “to go to the minister” with their complaints.

Australia

Still waiting to abolish the “waiting list for the waiting list” When in opposition, NSW Health Minister Jillian Skinner said that after years of “Labor rorting, it’s time to measure the real waiting lists”. “We will abolish Labor’s ‘waiting list for the waiting list’,” she said in March 2011. But according to the Sydney Morning Herald we are still waiting for that to happen. Patients are being forced to wait more than two years to see a specialist doctor – “the hidden waiting list” before waiting up to another two years for surgery. “It’s the waiting list to get onto the waiting list for surgery,” AMA (NSW) president Brian Owler told the Herald. “If you don’t have private health insurance, the waiting time is sometimes years - not just for surgery, but for things like testing for childhood allergies, and the pain clinic.” A letter from Liverpool Hospital eye clinic, to a Sydney patient, obtained by the Herald, said due to the high demand for services “and the current resources available, the waiting period at the present time for a routine appointment is approximately two-and-a-half years”. The Optometrists Association Australia says some people are housebound for four years while waiting for eye surgery. NSW/ACT chief executive Andrew McKinnon said the wait for an appointment with an ophthalmologist was compounded by the further wait of one to two years for elective surgery.


COMPETITION

NEWS IN BRIEF

Britain

Big tobacco and right-wing think tanks The British public health charity ASH (Action on Smoking and Health), has voiced its concern at the funding of several right-wing think tanks that have been influential players in formulating the public policy of the Conservative government of David Cameron. The Adam Smith Institute (ASI) and the Institute of Economic Affairs (IEA) have been key critics of plans to force retailers to sell cigarettes in plain cartons – a policy pioneered by the Gillard Government and which Britain’s conservative government had promised to follow, last year. The Cameron Government later backtracked on the plan. According to the Observer newspaper, both think tanks have been recipients of tens of thousands of pounds in funding from leading tobacco companies. British American Tobacco has confirmed that in 2011 it gave the IEA £10,000, plus £1,000 in event sponsorship. Last year it donated a further £20,000 to the institute. The ASI confirmed that 3% of its funding came from tobacco firms. “For the government to allow its policies to be influenced by tobacco-funded think tanks would be a breach of its legal obligations under the World Health Organisation tobacco treaty,” Deborah Arnott, chief executive of ASH, said.

Deborah Arnott

“FOR THE GOVERNMENT TO ALLOW ITS POLICIES TO BE INFLUENCED BY TOBACCOFUNDED THINK TANKS WOULD BE A BREACH OF ITS LEGAL OBLIGATIONS.” —Deborah Arnott

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NEWS IN BRIEF

Australia

Australia

Scholarships available

Crack down on visa rorts

The federal government has a range of scholarships and other financial support particularly for Aboriginal and Torres Strait Islanders, but also for others who want to pursue a career in health but can’t afford to study or train.

The ACTU has voiced its concern that the current foreign worker visa program is allowing the exploitation of imported workers by unscrupulous loan sharks and employers. This follows an investigation by Fairfax media that revealed more than 200 cases of extensive rorting of s187 and s457 visas. The federal government responded to the report with a crackdown on visa abuses. Immigration Minister Brendan O’Connor introduced a bill that would require employers trying to hire foreign workers under the s457 visa scheme to first explain their attempts to recruit suitably qualified Australians. The bill would give new powers to Fair Work inspectors and require sponsors to perform “labour market testing”. This would require companies wishing to hire workers on s457 visas to show they had tried to recruit suitable Australian citizens or residents to the position, or provide recent research about labour market trends. Opposition leader Tony Abbott defended the current system of foreign worker visas. He said no system was “absolutely perfect” and there was almost nothing that was “absolutely foolproof ”. ACTU secretary Dave Oliver welcomed the crackdown but hit out at the attitude of business. “What about all the talk recently from employers about the importance of productivity and ensuring business remains fruitful so the economy can tick along? Their choice, to invest in overseas workers in a bonded-labour style of employment, confirms that we cannot trust companies to make the best choice for Australian workers or the broader Australian economy. “We need protection in law that guarantees that rights and conditions are not gambled away behind a smokescreen of spin, conservative influence and abuse of foreign workers,” he said.

There are generally two categories: equity scholarships are awarded to people who have faced some form of disadvantage that has limited their opportunities; merit scholarships are awarded to students who do well at school. Sometimes a combination of both merit and equity criteria are applied. Some scholarships are only available to Aboriginal and Torres Strait Islander people, while others are available to anyone who meets the criteria. Most scholarships are awarded for full-time study. Those that allow study part-time usually pay a percentage of the full scholarship amount that is proportional to your study load. For more information visit http://healthheroes.health.gov.au/ financial-support#scholar

POSITION V VACANT ACANT A

PROFESSIONAL OFFICER – PERMANENT FULL-TIME (Research Focused) $104,082 package + 19 day month + 5 weeks leave W Would ould you like to use your research and nursing/ midwifery experience promoting p the professional interests of nurse nurses urses and midwives? m Association The he Associati Associa sociati socia atioon seeks a creative and d self-motivated with self-motiva self-mot self tivated ti ed d nurse rse or o midwife m relevant evant postgraduate postggraduate ate qualifications qualificaationss and qualification experience e xperience in research and and analysis. analy analysis

To T o be considered considered for this rrole ole you will need: 2

Recognised qualifications in the field of nursing or midwifery and postgraduate qualifications in a related area.

2

Demonstrated experience in research practice and publication.

2

At least five years experience in nursing or midwifery and an understanding of trade union issues.

2

An ability to network with key stakeholders at a senior level.

2

To review,, development policy analysis, review T o be proficient in po nt and implementation..

2

Demonstrated project management skills.

2

The capacity to promote the interests of our members ers through activities activit vities such as issue identification and critique, lobbying, influencing agendas, age gendas, alliance-building, consultation and liaison.

You ou must hold registration with Nursing and Midwifery Board Y d of Australia, occasionally. have a current drivers licence and be able to travel occasionally asion sionally. For information on how to apply go to nswnma.asn.au .au and a search h for fo jobs@nswnma.asn.au ‘jobs’ in the search box or email jobs@nswnma.as jobs@nswnma a.asn.au assn au Applications close Friday ay 19 July 2013. 3. Opportunity NSWNMA is an Equal O NSW rtunity unity Employer ployer and we invite yyou too be part p of pa o an n association as that fosters fosters a diverse div w workplace. wo


NEWS IN BRIEF

Australia

Corrupt behavior exempt from new IR laws Queensland unions have announced that they will launch a High Court challenge against extreme anti-union laws that include provisions that restrict the rights of unions to publicly debate unpopular government policies. The Queensland Liberal National Party government led by Campbell Newman has introduced the Industrial Relations (Transparency and Accountability of Industrial Organisations) And Other Acts Amendment Bill 2013, which the government claims will cover both trade unions and employer groups. But Queensland unions say the legislation is blatantly political and will retrospectively require unions to make financial information available to the public, while employer organisations will be exempt. The new laws come hard on the heels of a corruption scandal involving the LNP candidate for Redcliffe, Scott Driscoll. The Queensland Industrial Commission has just released a damning report on Driscoll’s management of the employer organisation, the Queensland Retailers and Shopkeepers’ Association. “The only known case of an allegation of corruption happens to be a former LNP member who donated to the LNP and will not be subject to retrospective legislation,” Queensland Council of Unions’ general secretary, Ron Monaghan, said. “This is an example of how prejudiced and fanatical the Newman Government is in its hatred of unions.”

EDUCATION@NSWNMA

WHAT’S ON JULY 2013

Practical, Positive Actions in Managing Stress and Burnout – 1 day 10 July NSWNMA, Waterloo 13 August Penrith

Members $85 Non-members $170 ——— • ———

Appropriate Workplace Behaviour – 1 day 12 July Goulburn • 2 August Gymea Topics include why bullying occurs; anti-discrimination law and NSW Health policies; appropriate behaviour in the workplace; identifying unlawful harassment and bullying; what to do if subjected to unlawful harassment and bullying; how to use workplace grievance procedures; identifying, preventing and resolving bullying.

Members $85 Non-members $170 ——— • ———

Are you meeting your CPD requirements? – ½ day 25 July Dubbo • 22 August Albury Seminar suitable for all nurses and midwives.

Members $40 Non-members $85 ——— • ———

Legal and Professional Issues for Nurses and Midwives – ½ day 26 July Dubbo • 23 August Albury 29 August Port Macquarie

SAVE THE DATE

Topics include the Health Practitioner Regulation National Law, potential liability, the importance of documentation, the role of disciplinary tribunals and writing statements.

Members $40 Non-members $85 ——— • ———

Basic Foot Care for RNs and ENs – 2 days 29 & 30 August Penrith

Members $203 Non-members $350 ——— • ———

Computer Essentials for Nurses and Midwives – 1 day

9 0TH Y E A R A N N I V E R S A R Y

25 September Prince of Wales Hospital, Randwick Seminar suitable for all nurses and midwives.

Members $85 Non-members $170 ——— • ———

NSWNMA Member Negotiation and Advocacy Program 2013 Negotiation and Advocacy Part 1 18 September NSWNMA, Waterloo 20 November NSWNMA, Waterloo For delegates/activists/members. Negotiation and Advocacy Part 2 The IRC, FWA, AHPRA and You 18 September NSWNMA, Waterloo 20 November NSWNMA, Waterloo ——— • ——— For more information regarding the Member Negotiation and Advocacy Program contact Lyn Stevens 8595 1234 (metro) or 1300 367 962 (regional).

——— • ——— To register or for more information go to www.nswnma.asn.au/education or phone Carolyn Kulling on 1300 367 962 T H E L A M P J U LY 2 0 1 3 | 1 1


COVER STORY

Nationals get health Members of the NSWNMA from across the state travelled to Bathurst

“We will now intensify our campaign in the electorates 1 2 | T H E L A M P J U LY 2 0 1 3


message to champion the cause of country health services.

held by the National Party.”

NURSES SET UP CAMP FOR THREE DAYS OUTSIDE the NEW South Wales National Party’s annual conference in Bathurst last month, as part of our campaign for equal nurse-to-patient ratios across the state. Sixteen nurses, representing all but three of the 19 NSW electorates held by Nationals MPs, took up positions outside the conference, bringing the ratios issue to the attention of more than 400 conference delegates. The National Party holds most of the rural seats in the state parliament and is a coalition partner with Barry O’Farrell’s Liberals in the state government. Delegates arriving for a welcome reception the night before the conference opened were met by a line of nurses holding candles, in a vigil outside the National Racing Museum, Mount Panorama. A NSWNMA advertisement in the local paper the next day called on Nationals MPs to put the safety of their country constituents first. To keep the message of equal treatment for rural nursing in the forefront of delegates’ minds, a mobile NSWNMA billboard followed them all over town, including parking outside Rydges at Mount Panorama where the Nationals hosted a business breakfast. NSWNMA General Secretary Brett Holmes said the 16 nurses took time off work to make the trip to Bathurst because “they are passionate about the safety of country patients. “Assistant General Secretary Judith Kiejda and I wish to pass on our heartfelt thanks for the effort everyone put in over the three days. All our members looked, sounded and behaved like true professionals and made a compelling case for country patients,” he said. “Many rankand-file conference delegates did express support for safer nursing levels throughout the state, but were overruled by the politicians, who have caved in to the Liberal Party premier, treasurer and health minister on the issue. “You would think MPs of the National Party, whose slogan is ‘For Regional NSW’, would be fighting tooth and nail to get country hospitals treated equally with city hospitals. “However only a few MPs gave the NSWNMA representative from their electorate a hearing and even they did not achieve anything effective at the conference on behalf of rural and regional nurses, midwives and patients. “We will now intensify our campaign in the electorates held by the National Party.”

T H E L A M P J U LY 2 0 1 3 | 1 3


COVER STORY

Why we went to Bathurst

“It’s not about us as individuals but nursing Deborah Noakes, Child and Family Health Nurse, Forster.

“I’m here to advocate to National Party politicians for ratios that already apply to city areas, to be extended to country areas and specialty areas like EDs, pediatric wards, intensive care units and to community health. As a community nurse I’m particularly passionate about seeing some equity in nurse staffing in the community as well as in hospitals. The whole event has given me a better understanding of the ratios issues, which will give me confidence to be able to talk to my local MP. I gained a lot in campaigning with other nurses and the NSWMNA organisers alongside me. I hope this will give me ideas and confidence to do the same at home.”

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Kim Eason, Endorsed Enrolled Nurse, Gilgandra Multi Purpose Service.

“My electorate of Barwon has many isolated rural hospitals and it’s very important they get ratios. Without mandated safe numbers it gets very dangerous at times for patients and staff. We have a 19-bed lockdown ward for high nursing care patients, with two highly demented people who wander. At times the ward has to be covered by one nurse while the rest have to go to accident and emergency. I’ve come here [to Bathurst] on my days off. I feel very passionate about trying to make the National Party and my local MP aware of the importance of fighting for the cause of having ratios throughout rural areas. I think politicians are getting the message that we do care about what we do, that it’s not about us as individuals but nursing as a whole. I think they see that we are actually very professional in how we are carrying out this campaign.”


Our rural and regional representatives Here are the names of the rank and file union members who took time off work to go to Bathurst to lobby for their fellow nurses and midwives outside the National Party conference:

ballina barwon bathur st burrinj uck clare nce coffs harbour dubbo lismore monaro murrumbidge e myall lake s northe rn table lands orange orange tamworth uppe r hunte r

as a whole.” Leonie Keen, Registered Nurse, Queanbeyan Hospital.

“This is an important issue for the future of nursing and we just want politicians to listen to us. Rural hospitals like Queanbeyan have fewer nurses on shift than city hospitals, things can fall apart really easily and patient care is put at risk. If our nurses are exhausted and given no time for tea or lunch breaks they will eventually get sick of the conditions and go to nearby Canberra hospital where they get more support. Ratios will help Queanbeyan to keep our experienced staff. We hope our message about safe patient care is sinking in with National Party delegates. The fact that we’re campaigning here in the freezing cold weather shows we’re not going to back down.”

rita lewis kim eason lynette sloane cathy sm ith tyrone dungey sue white lynne mackande r g il wilson leonie ke e n kim hoare de borah noake s maryann krug liz rivas lyn murphy matthew cartan adrian king

Stoner doesn’t get it Country hospitals do not need the same staffing ratios as big city hospitals, according to the National Party leader in New South Wales, and Deputy Premier, Andrew Stoner. Mr Stoner told ABC radio on June 14: “Now this argument that country hospitals ought to have the same as the peak city hospitals is like comparing apples and oranges. There are conditions that are not treated – you have different complex ranges of treatments that are not done in many country hospitals that are done in places like Royal North Shore. So you simply can’t compare it…” NSWNMA General Secretary Brett Holmes says Mr Stoner has missed the point. “The fact is a patient having a hip or knee replacement in a regional hospital like Goulburn, Bathurst or Grafton, is only allocated five hours nursing per day, while the same patient at Sydney’s Royal North Shore Hospital or Newcastle’s John Hunter has a mandated minimum of six nursing hours allocated per day. That is not fair.”

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COVER STORY

Candlelight protest When more than 400 NSW National Party delegates arrived at the National Racing Museum, Mount Panorama, to register for their annual conference last month, they made their entrance along a pathway lined by nurses holding candles. The nurses handed out welcome cards reminding conference delegates of the need to extend to country health facilities the minimum nurse-to-patient ratios recently won for city nurses. NSWNMA members from rural districts across New South Wales travelled to Bathurst to put their case. They included Tyrone Dungey, NSWNMA branch secretary at Grafton Base Hospital, who said the candlelight vigil got a mixed reaction from delegates. “A lot of them are surprised we are here. There is quite a lot of interest, a few rebuffs but mostly positive.” Nurses, who walked the streets of Bathurst talking to the public and gathering signatures on a petition, reported a high level of awareness about the campaign. Some National Party delegates told nurses our campaign was the talk of the conference. The Nationals’ member for Bathurst, Paul Toole told the Western Advocate the nurses and midwives’ presence during the conference couldn’t be missed. “They had a mobile billboard which stalked us everywhere we went,” he said.

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greets Nationals

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COVER STORY STORY COVER

Facts play second fiddle to misinformation “Seek truth from facts” goes an old Chinese saying. That’s a bit hard to do when the O’Farrell Government and the Ministry of Health, whether deliberately or not, peddles a line of misinformation about our campaign. Incredibly they are saying that ratios do not apply in the NSW Health system. The Lamp looks at what they are saying about our ratios campaign and tries to set the record straight. What the government is saying about our ratios campaign

GOVT: The nurse staffing formula is the same for all regional and metro hospitals.

“Ratios” do not apply in the NSW Health system. Instead there is an agreed formula based on “nursinghours-per-patient day”.

FACTS: THIS IS UNTRUE. Country hospitals and some specialties do not have the same nurse-topatient ratios as hospitals in the city.

THE FACTS THIS IS UNTRUE. We have never disputed the existence of NHPPD (we want to improve on it). The Award uses both nursing hours and ratios. Zoe-Anne Guinea (Tweed), Kim Hoare (Murrumbidgee) and Rita Lewis (Ballina) at the National Party conference

Sue White from Coffs Harbour.

Maryann Krug with Adam Marshall.

GOVT: The government has recruited 4000 nurses by headcount (more than 2000 FTE) against its commitment of 2475 more nurses

In front of the Barry O’Farrell office.

FACTS: THIS DOESN’T STACK UP. Our last ratios campaign delivered 1580 more full-time equivalent positions to the system. If we look at the continuing shortages in the areas where we didn’t win ratios last time – community nursing, EDs and neo-natal ICUs – as well as the obvious need for more staff in country areas, then the government’s assertions of having delivered significantly more nurses on top of the 1580 looks dubious. What is tangible and verifiable is that there are 1580 extra FTE nurses in the system because it is guaranteed by the award, following a hard fought win in our last campaign. Ratios must be extended and improved in country areas and specialty areas for better patient safety.

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Andrew Stoner Oxley Electorate

Please stand up for country patients

GOVT: Andrew Stoner, a National Party member for Oxley was quoted as saying this about our ratios campaign on radio: “Now this argument that country hospitals ought to have the same as the peak city hospitals is like comparing apples and oranges. There are conditions that are not treated – you have different complex ranges of treatments that are not done in many country hospitals that are done in places like Royal North Shore. So you simply can't compare it but if you look at the sheer statistics 1300 extra nurses across regional New South Wales, the Nurses’ Association should stop misleading their members and they should applaud the Nationals for what they've done since they came to power in New South Wales.” FACTS: Independent research shows that a majority of nurses in NSW believe that ratios in the Public Health system are necessary for safe patient care. Our ratios claim is carefully researched and tailored based on international findings, and not a misrepresentation by the Association’s leadership. We argue that patients in the country should have the same nursing care as patients in the city for similar procedures like tonsillectomies, hysterectomies and hip and knee replacements just to name a few. Our research tells us that nurses and midwives, as well as the public, agree.

Can’t talk or won’t talk? Barry O’Farrell has just responded to letters mailed to him from NSWNMA branches earlier in the year about our campaign. While nurses and midwives have been engaged in animated discussions with MPs throughout the state about our campaign to improve ratios, the Premier is reluctant to “make any comment on the outcome of those discussions before they are completed.” We note the letter is dated 19 June, twenty days after his Government rejected our claim for the second time; twenty days after his Ministry of Health announced it would push ahead with a new Public Health System Award with only a 2.25% pay increase. NSWNMA General Secretary Brett Holmes says improving patient care in NSW will ultimately require political initiative from the Premier. “It is disappointing that Barry O’Farrell has squandered the opportunity to show leadership on this issue,” he said.

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COVER STORY

Clearing the air The government’s misinformation has left many confused about our campaign including their own MPs and some nurses and midwives. The Lamp answers some of the typical questions being asked about our campaign to improve patient safety. WHEN IS MY NEXT PAY RISE? Nurses and midwives are due a pay rise this July. The government has partially agreed to your 2.5% claim for 2013, but with two strings attached. The government wants to “discount” the 2.5% pay increase by shifting 0.25% of it into your superannuation instead of paying you the whole amount in cash. The government is using the pay increase to try to shut down your ratios campaign. They are hoping nurses will go quiet. As The Lamp went to print the Industrial Relations Commission (IRC) has decided in the union’s favour — that your pay increase should be the full 2.5%. However, the Treasurer has told the media the governement is considering changing its own law to impose the lesser 2.25% cash payment.

CAN THE INDUSTRIAL RELATIONS COMMISSION DECIDE ON OUR CLAIM ONCE AND FOR ALL? In 2011 the NSW government changed NSW industrial law and took away the Industrial Relations Commission independent power to arbitrate disputes. The Commission no longer has any “teeth” because the law says it cannot grant pay increases of more than 2.5% per year, unless nurses and midwives trade off existing conditions. The government has changed the law so that an improvement to the nurseto-patient ratios system is considered an “improved condition” for nurses – therefore to get improved patient care you are being asked to trade off conditions such as leave or penalties.

HOW CAN WE MAKE THE GOVERNMENT IMPROVE AND EXPAND CURRENT NURSE-TO-PATIENT RATIOS IN THE AWARD? Under this government’s new laws, there are only two ways to gain improved award based ratios: • By nurses trading off hard won conditions, such as breaks and leave; or • By applying political pressure on the NSW government. The government made the new law in 2011 – and they can change it. On May 31, 1000 nurses and midwives visited the offices of their local Member of Parliament, around the state, to lobby for ratios. The impact of these actions were felt by all from the Premier of NSW Barry O’Farrell to the Minister of Health Jillian Skinner. It was widely reported in the local media and several MPs reacted by going on the attack, while others felt that they had been misinformed about the real facts around ratios by the Ministry of Health. You’ll have your opportunity again to participate in an action. Please attend your branch meeting or speak to your organiser to find out more.

I ALREADY WORK IN A WARD WITH RATIOS – HOW WILL THIS CAMPAIGN HELP OUR PROFESSION? Two years ago nurses and midwives across the whole state, including nurses from all specialties, took strike action and refused to re-open beds – and the first step towards ratios for all specialities was won. 1580 FTE nursing positions were introduced into the health system because of this. It’s time to take the next step to improve the system for our profession. Winning ratios in emergency departments, paediatrics and specialties like community nursing will mean huge improvements in the care delivered to patients in these areas. Winning better ratios in regional hospitals will save lives through safer stabilisation and retrievals to city hospitals. This government has already shown that they are motivated by the bottom line and not patient safety. To safeguard your future interests, and the profession’s, we encourage you to get involved in this campaign now in any way you can.

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WHY IS THE GOVERNMENT RESISTING THE EXTENSION AND IMPROVEMENT OF A RATIOS/NURSING HOURS SYSTEM? The government wants the “flexibility” to change the current staffing system without consulting nurses. The award gives us some control over our working conditions. The government does not want this. The government is putting out information to the media and politicians that is misleading and misrepresents our ratios claim: It says that “ratios” don’t exist in the current system and that we are being unreasonable and are asking for a new staffing system. This is untrue. We are happy with the current nursing hours per patient day formula (which can be translated into ratios in the award) we merely want to extend and improve ratios in country hospitals and specialties that don’t currently have them. They also say the current staffing system is the same for metro and regional hospitals. This is untrue. Nursing hours per patient varies according to the postal code you live in. They say we are being unreasonable and seeking a “one size fits all” solution. The fact is, our ratios claim is carefully researched and tailored based on international findings. In independent research nurses told us that improving and extending ratios in the public health system was their top priority.


PHOTO CHRIS SEABROOK

STAFFING

RUNNING OUT OF PATIENCE: NSW Nurses and Midwives’ Association Bathurst branch members Lyn Sloane and Tatiana Muller (front) and their nursing colleagues are fighting planned cuts at Bathurst Base Hospital.

Bed closures hit Western hospitals Communities rally in support of nurses and midwives as positions go at Bathurst and Orange. BATHURST HOSPITAL HAS BEEN HIT BY THE closure of five surgical beds following the loss of nine full-time equivalent jobs, including five nursing positions. Affected nurses were transferred to fill vacancies elsewhere in the hospital. “No individual nurse lost their job but five nursing positions have gone,” said Tatiana Muller, president of the hospital’s NSWNMA branch. “Management got rid of the cafeteria earlier this year and this looks like another cost-cutting measure.” Management reclassified the five affected beds as surge beds, to be opened and closed when needed and staffed by casuals. Tatiana said any delays in finding casual staff could result in bed block in the emergency department. “Bathurst does not have an EMU (Emergency Medical Unit) where patients can stay while waiting for an inpatient bed,” she said. Bathurst residents attended two community rallies, at Victoria Park and outside the office of National Party MP Paul Toole. “Just as an example of what these bed closures mean, on the day of the rally we had a patient come in with a complicated break

to his leg and needing surgery,” Tatiana said. “Surgeons were available at Bathurst hospital but there was no commissioned bed for him. So this poor kid and his family had to go all the way to Orange.” Speakers at the Victoria Park rally included the Association’s Assistant General Secretary Judith Kiejda, three specialist doctors, and three Bathurst city councillors. Judith Kiejda said it was time National Party MPs stood up for people in regional and rural New South Wales, who are the very people they claim to represent. “Bathurst Hospital already has longer surgery waiting times than the national average – 54 days for Bathurst against the national average of 31 days in 2011-12 – and the hospital should be working to shorten that time, not closing surgery beds and reducing theatre sessions,” Judith said. Chairman of the Bathurst Medical Staff Council, Dr Ray Parkin, told the rally the bed closures would result in longer waiting times in accident and emergency and delays to surgery, and could compromise patient safety. At Orange Hospital, 60 kilometres from Bathurst, nurses led a community protest outside the office of National Party member

for Orange, Andrew Gee, to draw attention to bed closures, inadequate nurse-to-patient ratios and other health care issues. Orange Hospital’s closure of 12 subacute beds for sub-acute and palliative care patients was the main focus of the protest by about 80 nurses and other local residents, including Fire Brigade staff and members of the Central West Union Alliance. Secretary of the hospital’s NSWNMA branch, Luke Marks, said Western NSW Local Health District had transferred the beds to smaller hospitals (at Molong, Blayney and Canowindra) without adequate consultation with nurses and the community. A resolution passed by a meeting of 85 branch members described the lack of consultation as “disrespectful to staff, but most of all to the patients whose lives have been disrupted at this awful personal time.” Luke said affected staff members were redeployed to fill vacancies in other parts of the hospital. “Initially staff members were simply allocated to new wards based on recommendations from management. But after we protested they were given a choice of where they wanted to go within the vacancies of the hospital,” Luke said. T H E L A M P J U LY 2 0 1 3 | 2 1


MPs VISITS

MPs feel The O’Farrell Government may be trying to hide behind its but a small army of nurses in more than 40 electorates


the heat own bad laws to avoid improving and extending ratios, across the state had something to say about that.


MPs VISITS

ON MAY 31 MORE THAN ONE THOUSAND nurses descended on the electorate offices of state MPs, determined to hold their local politicians to account and to push the case for better ratios. Twenty members, representing both Ballina and Byron District Hospitals, marched down the main street of Ballina to National MP Don Page’s office.They met with Mr Page who said he would take their concerns back to cabinet. More than 60 people – nurses and members of the general public – turned out in Bathurst to tell local MP Paul Toole to support our campaign. Nurses even persuaded the MP to wear our campaign badge. More than 2000 people have signed a petition to protest staffing cuts at Bathurst Hospital. Mr Toole says he supports removing the inequities that exist between city and regional hospitals. There was plenty of local media at rallies held in the Clarence electorate, where 35 nurses and members of the public came together to pass on a strong message to local MP Chris Gulaptis. Nurses set up a stall outside the Casino post office to collect signatures and, in a telling act of solidarity, local pubs banned the selling of beer until our petition was signed. Campbelltown had a great turnout of 25 members plus numerous supporters from the public.They collected more than 200 signatures and marched on MP Bryan Doyle’s office. Mr Doyle was present but refused to come out and speak to them. Coffs Harbour members were told by the staff of their local MP, Andrew Fraser, that he was out of the electorate, although he was seen getting a coffee an hour later! In Dubbo, 28 nurses and midwives were supported by a number of off duty police officers and other members of the public. Pru Goward, the MP for Goulburn, met a delegation drawn from the 50 nurses and midwives who gathered outside her office. She professed to understand that ratios are a part of the award, along with Nursing Hours Per Patient Day, and says she will discuss the inequities between rural and city hospitals with Health Minister Jillian Skinner. Nurses from Leeton and Narrandera joined their colleagues in Murrumbidgee to talk to MP Adrian Piccoli about our campaign. More than 50 people were in attendance and the gathering received good coverage on WIN TV. More than 80 people turned up in Orange to bring MP Andrew Gee up to speed. Mr Gee respectfully met the nurses and midwives present and agreed to take their message back to premier Barry O’Farrell. The event was reported by local TV and both local newspapers. NSWNMA General Secretary Brett Holmes said the day of action was an outstanding success. “It is vital we keep the pressure on MPs and get them to transfer that pressure to the government’s senior leaders,” he said. “We need to maintain the momentum and let MPs know we will not be brushed off with platitudes. “They are our representatives and we expect them to advocate on behalf of patients, nurses and midwives for better patient care when they are dealing with those important decision makers.” 2 4 | T H E L A M P J U LY 2 0 1 3


STAFFING

Nepean members win more staff A decision to cap patient numbers and stop work seems to have put an end to chronic understaffing in the maternity unit. A DECISION BY NURSES AND MIDWIVES to limit the number of new maternity patients at Nepean Hospital has forced management to approve additional staff for its under-strength maternity service. A total of 21 full-time equivalent (FTE) positions have been added to the service’s staff profile and nurses will work jointly with management to look at models of care and recruitment efforts. The assistant secretary of the NSWNMA branch at Nepean Hospital, Debbie Renshaw, said nurses were generally happy with the new staffing profile, which has more staff for all maternity wards except antenatal. “We would not have achieved this result without being prepared to cap patient numbers and take other action,” Debbie said. She said negotiations were continuing over management’s “ridiculous” claim that the antenatal ward was overstaffed. The branch put staff shortages on the agenda last year, but nurses’ concerns were not taken seriously until March this year when a blaze of negative publicity hit the hospital. A Sydney newspaper reported that a pregnant woman was sent away from the hospital without any medical assessment and later gave birth in the hospital car park. Two days later another woman was sent home and gave birth on her kitchen floor. In March, management admitted there had been a Birthrate Plus miscalculation and the maternity service was short 21 full-time staff. However they refused to provide a new staffing profile or detail appropriate recruitment plans. Judith Kiejda, the Association’s Assistant General Secretary, said: “Not only are Nepean staff exhausted, they are deeply concerned that health care is being compromised. They have reached their limit and cannot continue in this way.”

On May 23, a unanimous branch resolution warned: “Due to the critical staffing shortages across the entire service we are deeply concerned for the women and babies who are reliant on our care. To ensure their safety we have no choice but to limit the number of new maternity patients who enroll, until we are appropriately staffed.” The branch agreed that from June 3 all new, low-risk, antenatal patients from outside the geographical area would be referred to a public hospital within their own catchment. All current maternity patients would continue to be treated at Nepean Hospital and no high-risk or emergency obstetric patients would be denied care. “We are forced to this position with the greatest regret for our community. We urge management to progress and recruit midwives against the vacancies as an absolute priority,” the resolution said. On June 3 the branch agreed not to cap services, pending further negotiations, while reserving the right to take action if talks broke down. However management still refused to provide a ward-based breakdown of the new staffing profile, so on June 12 the branch voted to hold a secret ballot of nurses to approve a four-hour stop work meeting on June 25. On June 17 management provided the ward-based breakdown of staffing profiles and agreed to backfill vacancies. On June 19 members voted to call off industrial action. Debbie Renshaw said the branch asked for the post-natal ward to be given priority in staff recruitment, as they were short 11 FTE midwives. “They have been working short for a long time; they are very stressed and midwives are crying almost on a daily basis. They are frustrated because they can’t give patients the care they deserve.”

“We would not have achieved this result without being prepared to cap patient numbers and take other action.” —Debbie Renshaw

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ASK JUDITH In 2012, the state Liberal government led by Premier Barry O’Farrell introduced sweeping changes to the Workers’ Compensation Scheme. From 1 January 2013, all injured workers in New South Wales, who made workers compensation claims prior to 1 October 2012, and who have been in receipt of weekly benefits for a period of more than 130 weeks, will be gradually transitioned on to the new scheme. One of the steps the new legislation requires the insurer to undertake, as part of this transitioning, is a Work Capacity Assessment and decision.Your case manager does this assessment, using the documents in the insurer’s possession. The insurer must undertake this assessment prior to reducing or ceasing your weekly benefits. Under the new scheme, weekly benefit entitlements for all injured workers in New South Wales will cease after 130 weeks of benefits having been received unless: The worker is assessed as having no current work capacity; or The worker has a capacity to work and has returned to work for no less than 15 hours a week and is earning at least $155.00 per week. If you have no work capacity or are working more than 15 hours per week your weekly payments will continue at 80% of your Average Weekly Earnings. In summary, if the insurer decides you have some work capacity, but you are not working 15 hours or more per week, your weekly payments will cease. In reality, only those injured workers who can successfully demonstrate total incapacity to work will have ongoing entitlements. The aim of the legislation appears to be to dramatically reduce the number of workers entitled to any ongoing weekly payments after they have received them for two-and-a-half years. WORKERS WHO ARE PARTIALLY INCAPACITATED FOR WORK AFTER 130 WEEKS If you are working and earning more than the “deemed transitional amount” (currently $920.20 gross) you will no longer be entitled to ongoing weekly compensation. It should be noted that after the first 52 weeks of incapacity, Average Weekly Earnings (AWE) under the new scheme do not include overtime payments, shift allowances or penalties. WORKERS WHO ARE TOTALLY INCAPACITATED FOR WORK AFTER 130 WEEKS If you are a worker who is found to have no current work capacity and you are considered likely to continue to remain incapacitated for work indefinitely, you will be entitled to 80% of your average weekly earnings, up to the maximum of $1,838.70 per week.You will be entitled to this amount up until 260 weeks or five years. After five years only the most seriously injured workers (>20% WPI) will be entitled to ongoing weekly payments of workers compensation. The Workers Compensation Commission has no jurisdiction to deal with disputes arising from the work capacity decisions of insurers. As a first step, the worker can apply for a review of the decision of the insurer and it will be allocated to a different Case Manager for internal review. At this step the worker needs to provide some medical evidence relating to their work capacity and has 30 days to do so. The next step is a review of the insurer’s decision by Workcover and lastly, by the Workplace Independent Review Office. If you are an injured worker and you receive a Work Capacity Assessment or decision notice, we invite you to contact our office on (02) 8595 1295 as soon as possible for advice and assistance, noting that the worker only has 30 days to request a review of the insurer’s decision.

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

Injured prior to new law Do the new workers compensation changes apply to me if I sustained an injury prior to the government’s changes in 2012? Yes all injured workers will be affected by sweeping changes introduced to the workers compensation scheme, whether the injury was sustained prior to or after the introduction of the changes to the legislation. All injured workers in New South Wales, who made claims prior to 1 October 2012, and who have been in receipt of weekly benefits for a period of more than 130 weeks, will gradually be transitioned on to the new scheme. A number of our members have already been notified by the insurer that their work capacity is being reviewed.

My work capacity is under review Am I required to attend a medical or vocational assessment when notified by the insurer that my work capacity is being reviewed? No. The insurer is only required to notify you that the review will be happening. The insurer then makes an assessment based on whatever reports they have at the time.You will then be notified of their decision and any adjustment to your benefits. If you do not agree with the decision and believe additional information should be considered, you have strictly 30 days to request a review. Due to the restricted timeframe, the complex nature of what additional material may be required, and the fact that you may not be aware of your rights, it is important that as soon as you are notified of a pending review you contact your workers compensation solicitor or the Association to ensure your rights are protected. Association members can be referred to our workers compensation solicitors, NEW Law, for assistance with all aspects of their claim. NEW Law anticipates that several thousand injured workers in New South Wales will receive notification from their insurer, some time in the near future, advising them that their claim is the subject of a transitional work capacity decision and/or this has resulted in a notice of reduction or cessation of wages. T H E L A M P J U LY 2 0 1 3 | 2 7


SUPERANNUATION

Fairness out the window “It is highly unfair for Mr Abbott to target this group for budget savings.”

The Coalition’s superannuation plans will hit low-paid and middle-income earners the hardest.

—brett holmes NURSES’ HOPES OF BUILDING enough superannuation for a comfortable retirement suffered a blow with Tony Abbott’s announcement of the Coalition’s superannuation policy. Mr Abbott said a Liberal-National government would “defer” measures to raise the Superannuation Guarantee (SG) from 9% to 12% and abolish the Low Income Superannuation Contribution (LISC). Labor’s Superannuation Guarantee increase and LISC represented significant wins for industry super fund members, including nurses, when passed by parliament last year. Under the current law the SG rate will increase gradually with initial increments of 0.25 percentage points on 1 July 2013 and on 1 July 2014. Further increments of 0.5 percentage points will apply annually up to 201920, when the SG rate will be set at 12%. With 12% guaranteed contributions, a 30-year-old, earning average

full-time wages (about $1450 per week), would have an extra $108,000 in retirement savings. However, not if the Coalition is elected at the September 2013 election. While the increase to 9.25% for the 2013/2014 year will remain in place, it will not increase any further until 2016 at the earliest. NSWNMA General Secretary Brett Holmes said Mr Abbott’s decision to abolish the LISC would hurt more than 3.6 million Australians earning less than $37,000 per year. “It is highly unfair for Mr Abbott to target this group for budget savings,” Brett said. “The LISC provides a tax rebate of up to $500 for those wage earners, meaning they effectively pay no tax on their concessional super contributions. “The LISC was brought in to correct an injustice for low income earners, who used to pay as much, if not more, tax on their super contributions than on their wage income.”

Editor’s note: Brett Holmes is a Trustee Director of HESTA Superannuation and is not speaking on behalf of HESTA. 2 8 | T H E L A M P J U LY 2 0 1 3


Experts blast Liberal plan Superannuation experts have blasted Tony Abbott’s assault on the retirement incomes of low and middle-income earners.

“An enormous cost to individuals’ retirement incomes and the economy.” — david whiteley

CHIEF EXECUTIVE OFFICER OF THE FINANCIAL Services Council, John Brogden – a former Liberal leader in New South Wales – called Mr Abbott’s policy to “defer” 12% super “a bitter disappointment and a blow to the retirement savings of Australians.” “This short-term decision will reduce retirement savings by $46 billion over the next 10 years,” Mr Brogden said. “It will also push the increased cost of an aging population onto future generations. “There is a very strong public policy and economic rationale for raising the Superannuation Guarantee to 12%.” He called on the Coalition to re-commit to increasing the Superannuation Guarantee to 12% after the proposed two-year deferral. Trish Power, publisher of the consumer advice website SuperGuide, and author of several books on superannuation, called the Liberals’ decision to scrap the low-income superannuation contribution scheme (LISC) “unwise and unfair”. She said the LISC was designed to end a situation where low-income earners were penalised by having to pay a higher superannuation tax than their income tax. “The LISC is a long overdue and fair super policy that is a no-brainer from the perspective of retirement income policy,” she said. David Whiteley, chief executive of the Industry Super Network, urged the Coalition to reconsider its plans, which represented “an enormous cost to individuals’ retirement incomes and the economy” he said. Mr Whiteley said the increase in the super guarantee had been widely debated and received broad consensus in the community as critical to ensuring adequate retirement savings for an ageing population. “It is estimated that within 20 years, people will need to support themselves for an average of 30 years in retirement.” He said if the superannuation guarantee did not increase, taxpayers would have to foot the bill.

“YET ANOTHER ATTACK ON LOW INCOME EARNERS WHO ARE ALREADY STRUGGLING.”

BLOW TO RETIREMENT SAVINGS Bathurst AiN Desiree Pearson is studying for her nursing degree full time and can only work part time, at a nursing home. She earns well below $37,000 a year and therefore benefits from the Low Income Superannuation Contribution (LISC). Desiree said she was “shocked and quite disgusted” to hear of the Liberal plan to abolish the LISC. “That’s not going to be fair – it’s going to put a lot of low income people at a disadvantage. That extra cash makes a big difference at the end of your working life when you retire,” she said. “In today’s climate most people can’t afford to live just on the pension, they need decent superannuation too.” She described Mr Abbott’s proposal to delay the Superannuation Guarantee increase as “yet another attack on low income earners who are already struggling. “If the Liberals get their way a lot of people will have to work longer before they can retire.”

T H E L A M P J U LY 2 0 1 3 | 2 9


COST COVER OF STORY HEALTH

American health: exorbitant, inefficient and out of the reach of many Medicine is big business in the United States and ordinary Americans pay an exorbitant price for questionable outcomes. As a trend towards the privatisation of public hospitals emerges in Australia, The Lamp investigates the US health system to see what we can learn.

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KEY TO GRAPHS 2012 total hospital and physician average cost in us dollars. source: the international federation of health plans

CONSERVATIVE STATE GOVERNMENTS ARE driving a growing trend to privatise many of the operations of new public hospitals in Australia. The federal opposition has indicated that it also favours greater involvement of the private sector in the running of public hospitals. Unions fear this signals a move towards a US health model, where private provision predominates and good health care is out the reach of many Americans. According to one of a series of exhaustive studies done by the McKinsey & Co consulting firm, the United States spends more on health care than the next 10 biggest spenders combined: Japan, Germany, France, China, the UK, Italy, Canada, Brazil, Spain and Australia. The United States spends $2.7 trillion, or nearly 18%, of its Gross Domestic Product on health care. This is nearly twice as much as other developed countries, including Australia, which spends around 9%. To look at it another way: the clean up for Hurricane Sandy, which devastated a number of American cities, cost $60 billion. The US spends that each week on healthcare. The US Congressional Budget Office says that if medical costs continue to grow unchecked “total spending on health care would eventually account for all of the country’s economic output”.

HEALTH IN THE UNITED STATES IS VERY BIG BUSINESS. The US Bureau of Labor Statistics projects that 10 of the 20 occupations that will grow the fastest in the US by 2020 are related to health care. New York may be the world’s financial services capital, but of its 18 largest private employers, eight are hospitals and four are banks. These health care companies are highly profitable, have deep pockets and political clout. According to the Center for Responsive Politics, the pharmaceutical and healthcare product industries, combined with organisations representing doctors, hospitals, nursing homes, health services and Health Maintenance Organisations, have spent $5.36 billion since 1998, lobbying Washington. That towers over the $1.53 billion spent by the defense and aerospace industries and the $1.3 billion spent by oil and gas interests over the same period. What has been dubbed the “healthcare-industrial complex” spends more than three times what the military-industrial complex spends in Washington. EXPENSIVE CARE LAGS BEHIND While the United States is easily the world leader in medical spending, numerous studies conclude that Americans get care that lags behind that of comparable developed countries.

Of 17, high-income countries, studied by the National Institute of Health in 2013, the United States had the highest or near-highest prevalence of infant mortality, heart and lung disease, sexually transmitted infections, adolescent pregnancies, injuries, homicides, and disability. Together, these issues placed the US at the bottom of the list for life expectancy. The Commonwealth Fund, a respected private US foundation specialising in health care, ranked the United States last in the quality of health care among similar countries. The US Census Bureau reported that 49.9 million American residents, 16.3% of the population, were not insured for health care in 2010. A 2004 Institute of Medicine report said: “The United States is among the few industrialised nations in the world that does not guarantee access to health care for its population.” A 2004 OECD report said: “With the exception of Mexico, Turkey, and the United States, all OECD countries had achieved universal or near-universal (at least 98.4% insured) coverage of their populations by 1990.” A 2010 report by Physicians for A National Health Program, observed that lack of health insurance caused roughly 48,000 unnecessary deaths every year in the

25% OF ALL SENIOR CITIZENS DECLARE BANKRUPTCY DUE TO MEDICAL EXPENSES. T H E L A M P J U LY 2 0 1 3 | 3 1


COST OF HEALTH

2012 total hospital and physician average cost in us dollars. source: the international federation of health plans

THE US SPENDS $60,000,000,000 EACH WEEK ON HEALTHCARE. United States. In 2007, 62.1% of people filing for bankruptcies claimed high medical expenses as the cause of their insolvency. A 2013 study cited in the Journal of Internal Medicine found that about 25% of all senior citizens declare bankruptcy due to medical expenses, and 43% are forced to mortgage or sell their primary residence. In 2000, the World Health Organisation (WHO) ranked the US health care system 37th in overall performance and 72nd by overall level of health among 191 member nations included in the study. IT’S THE PRICES, STUPID Every year, the International Federation of Health Plans – a global insurance trade association that includes more than 100 insurers in 25 countries — releases survey data showing the prices that insurers pay for different drugs, devices, and medical services in different countries. When the costs are broken down into different categories the stand out in every graph is the amount paid by Americans compared to people living in comparable developed countries. An MRI can cost $2871* in the United States compared to $363 in France. In the Netherlands it costs $731 to stay in

hospital per day, in the United States $12,537*. The reasons for this are complex and shocking. An influential 2003 study of international healthcare costs by Gerard Anderson et al titled It’s the prices, stupid demonstrated that Americans don’t use more health care services than other like countries. In fact, the opposite: Americans spend less time in hospital and see the doctor less often than in other similar countries. “The United States spends more on health care than any of the other OECD countries spend, without providing more services than the other countries do. This suggests that the difference in spending is mostly attributable to higher prices of goods and services,” they concluded. And why are these prices higher? “Other countries negotiate very aggressively with the providers and set rates that are much lower than we do,” Anderson says. “They do this in one of two ways. In countries such as Canada and Britain prices are set by the government. In others, such as Germany and Japan, they’re set by providers and insurers sitting in a room and coming to an agreement, with the government stepping in to set prices if they fail.” In the United States, pricing that covers

the great majority of people is virtually a privatised free-for-all. Providers largely charge what they can get away with, often offering different prices to different insurers, and an even higher price to the uninsured. In most other developed countries prices are set centrally and everyone pays close to the same amount. FAILURE OF THE FREE MARKET According to Dr David Blumenthal, president of the Commonwealth Fund and a former adviser to President Obama, the profit-centric US health market is full of distortions. “In the US we like to consider health care a free market. But it is a very weird market, riddled with market failures.” In February this year Time magazine featured a 28-page cover story – Bitter Pill: why medical bills are killing us – which scratched below the normal political debate about American health and provided a devastating critique of the rampant profiteering that plagues the American system. Most American debate about health care centres on “who should pay?” but Time journalist Steven Brill asked a different sort of question – “why does it cost so much?”. In other words he followed

*95th Percentile Cost. Source:The International Federation Of Health Plans 3 2 | T H E L A M P J U LY 2 0 1 3


2012 total hospital and physician average cost in us dollars. source: the international federation of health plans

49,900,000 US RESIDENTS, 16.3% OF THE POPULATION, WERE UNINSURED IN 2010. the money and started by analysing lineitem by line-item a number of medical bills. What he found again and again, in hospitals across the country, were breathtaking mark ups on every line item. One example Brill looked at was that of Sean Recchi who was diagnosed with non-Hodgkin’s lymphoma.When his wife Stephanie tried to book him into the MD Anderson Cancer Centre in Houston – officially a non-profit unit of the University of Texas – she was told the cost of Sean’s first visit, to be examined so a treatment plan could be devised, would be $US48,900 to be paid in advance. When Sean and his wife arrived for his first treatment he was held in reception for 90minutes, because the hospital could not confirm that their cheque had cleared. He was only allowed to see his doctor after he advanced the hospital $US7500 from his credit card. The total cost for Sean to get his treatment plan and initial doses of chemotherapy was $US83,900. When Brill analysed Sean’s bill there were 344 separate line items with what he described as “aggressive mark ups” ranging from $US283 for a chest x-ray (for which hospitals are paid $US20.44 for patients eligible for Medicare) to $36 each time a nurse drew blood. All up, the charges for blood and other lab tests cost

Recchi more than $US15,000. Had he been eligible for Medicare he would have paid several hundred dollars. Recchi was charged $US13,702 for one injection of 660mg of the cancer drug Rituxan. Brill calculated that the hospital would have paid $US3000-$3500 for the dose – a mark up of 400%. NOT-FOR-PROFITS MAKING PLENTY OF PROFIT Although MD Anderson is officially a non-profit hospital its operating profit for 2010 was $US531 million – a profit margin of 26% on revenue of $US2.05 billion. The president of the hospital Ronald DePinho’s annual compensation was $US1,845,000. The role of not-for-profit health providers in the United States is interesting for Australian observers as this is a model favoured by conservative governments in this country. Time magazine reported that when McKinsey, aided by a Bank of America survey, pulled together all hospital financial reports, it found that “the 2900 non-profit hospitals across the country, which are exempt from income taxes, actually end up averaging higher operating profit margins than the 1000 for-profit hospitals, after the for-profits’ income tax obligations are

deducted. In health care, being non-profit produces more profit.” CAUTIONARY TALE FOR AUSTRALIA NSWNMA General Secretary Brett Holmes says the United States health system – largely privatised and fragmented offers a cautionary tale for Australia. “Governments always look to privatisation as an easy fix when they have budgetary problems but the American experience just cries out ‘don’t go down this path’. “The cost of American health care puts enormous financial stress on the country and on individual patients. “It is highly reliant on the private sector and it teaches us a valuable lesson – health does not operate like a rational market. It is inefficient and prone to profiteering. “When people are sick they are not in a position to seek the best market choice. And paradoxically, in the United States those who are least able to afford it pay the highest rates. “For all its faults, our universal health care system is a model of efficiency in comparison and we should not allow our governments, who are either lazy or ideologically driven, to move towards a system that is patently not working for the majority of the population.” T H E L A M P J U LY 2 0 1 3 | 3 3


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I am a nurse who is not a nurse www.nurseuncut.com.au/i-am-a-nurse-who-is-not-a-nurse/

Gloria Vlcek graduated from Sydney University with a BSc and Masters in Nursing – but cannot find a new grad position.

Too much work, not enough time www.nurseuncut.com.au/too-much-work-not-enough-time-community-nurses-speak/

Two community nurses recount the pressures they face every day at work.

Writing Kitty’s War www.nurseuncut.com.au/2013/05/page/2/

Historian Janet Butler grew up in the same district as Australian WW1 nurse Kitty McNaughton – and wrote a book about her.

Child and family health nurses speak out www.nurseuncut.com.au/too-much-work-not-enough-time-community-nurses-part-2/

There are not enough hours in the day for these community nurses to see the babies and families they should be seeing.

Ciara wins first prize www.nurseuncut.com.au/ciaras-film-wins-first-prize/

Student Ciara Rafferty’s film Arthur…? won first prize at the 2013 NSWNMA Nurses & Midwives’ Short Film Festival.

The Australian Midwives and Nurses Workplace Survey 2013 www.nurseuncut.com.au/the-australian-nurses-midwives-workplace-survey-2013/

Take this survey conducted by Monash University and the Australian Nursing Federation, on employment and workplace issues facing our profession.

Video interviews with disability nurses www.nurseuncut.com.au/video-interviews-with-disability-nurses/

Short interviews with nurses who are concerned, and stressed, by their working conditions.

The Soulcatcher www.nurseuncut.com.au/the-soulcatcher/

Carolyn Guichard’s powerful horror film was runner-up at the Nurses and Midwives’ Short Film Festival.

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Kiama MP

Maybe a few “hard-working nurses” should visit the not so hard-working Kiama MP...

After our MP events on May 31, the MP for Kiama told his local newspaper: “The protesters we saw are not the hard-working nurses you see in our public hospitals, they are simply union activists.” This drew quite a response!

Bondi Vet Dr Chris Brown lent his support to the ratios campaign.

I am flabbergasted at Gareth Ward’s comment. He is unfortunately my local member. To say that the union delegates, who give hours of their own time to improve the conditions of their colleagues and for safer patient care, are not the hardworking nurses of this state is disgusting. We are nurses and our first priority is our patients ... does that make us union thugs? If so, I wear the badge proudly! That is such an offensive thing to say. Our demands are pretty basic and much needed to ensure safe patient/consumer care. I challenge him to walk into his nearest emergency dept and tell the staff they are just a bunch of union activists. Clearly this man has no idea what he is talking about. How ignorant! Doesn’t he know that nurses all over voted for better nurse-to-patient ratios?

Ratios Ad Our TV ad calling for 1–to–3 in EDs drew praise.

Finally the truth is out, without passionate and exceptional nurses working in the system, the system will fall down. Thank you for the truth in this latest ad. It’s just crazy. Acuity is getting higher, more comorbidities! Know that you have the support of your colleagues around the country, particularly from we Victorians who, after our own terribly long fight, are behind you as you work to keep and improve ratios and conditions – you are not in this alone.

Government says no to ratios Members were furious when the state government flatly rejected our claim for improved ratios.

I’m rethinking my nursing career. It’s just too damn hard to get work in the first place and when you get it, it’s dangerous and exhausting. Let’s put Barry in a ward that doesn’t have ratios and see how he likes it not to be attended to in a timely fashion. It’s time we as members start turning up the heat on MPs. This is one nurse who prays daily for retirement. I have simply had enough.

Does colour matter? Hunter midwives and kids’ nurses saw red about losing their purple uniforms. We asked what you thought of the new uniforms.

City vs Country Medical directors of four Sydney EDs were on 7 News talking about the problems facing public hospitals.

The coloured uniforms are a way for the kids to know their nurses and it puts a smile on their faces. It’s appalling that the money is not being spent on frontline staffing. All that money spent changing uniforms and new grads can’t get jobs!

Come out to the country! Hope you aren’t desperately unwell out here, because it might take days to get you somewhere where someone can actually fix your problem. I am a Clinical NUM in ED in a rural town; more than 90% of the time we are overfull. I am amazed and proud of the staff I work with for their ability to provide the high level of care to patients under the current conditions. How can the current government not care about the people of NSW?

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NURSING RESEARCH ONLINE

The Australian Journal of Advanced Nursing (ajan.com.au) is an excellent, free, online resource for nurses and midwives. The influence of personal characteristics on perioperative nurses’ perceived competence: implications for workforce planning Brigid Gillespie, Griffith University, Lois Hamlin, UTS, Denis Polit, Griffith University, Wendy Chaboyer, Griffith University. In Australia, as in many other developed countries, the number of surgeries completed is rising. For instance, in Australia, 1.9 million surgical separations were recorded in 2009-2010, a yearly increase between 2005-2006 of 1.5% for public patients and 4.6% for private patients (AIHW 2011a). Consequently, it is imperative that an appropriately trained workforce of operating room nurses is available. This paper reports the results of a national study of Australian perioperative nurses, examined the relationships between demographic characteristics and domains of perioperative competence. Currently there is limited understanding of the extent to which demographic characteristics contribute to perioperative nurses’ perceived competence. www.ajan.com.au/Vol30/Issue3/2Gillespie.pdf

The challenges for families managing an adolescent with an intellectual disability and type 1 diabetes Sharon Hillege, University of Western Sydney, Susan Fallagher, ACU, Jennifer Evans, ACU. People take on the role of parenthood with the understanding and acceptance that they will be responsible for the care and development of their

offspring until they are able to function independently. It is important to understand what effect it has on families when total independence is unlikely because the child is diagnosed with a chronic disorder. This paper describes the challenges of caring for two adolescents who have intellectual disability and type 1 diabetes mellitus (T1D). www.ajan.com.au/Vol30/Issue3/3Hillage.pdf

To investigate the concerns and benefits of job sharing a communitybased Clinical Nurse Consultant role Gay Woodhouse, Southern NSW LHD, Tracey Finn, Kaleidoscope, NSW, Karen Johnson-De Witt, Kaleidoscope, NSW. The role of the Clinical Nurse Consultant was established in New South Wales, Australia in 1986. Since its inception the role has taken on differing role practices and expectations differ for each CNC role. It is, however, agreed that the CNC role has several focus points. These include leadership, clinical practice, consultation, education and research (O’Baugh et al 2007, pp 12-21). The Youth Health team Clinical Nurse Consultant role was developed in 1998 and was developed initially to meet an identified need to provide health care and support to homeless and at-risk-of-homelessness young people in the community. The Youth Health team aims to improve the health outcomes of young people with complex health and social needs in the community. This is an account of a qualitative descriptive study of the concerns and benefits of job sharing the Clinical Nurse Consultant (CNC) Youth Health team role.

The development and evaluation of a preceptorship program using a practice development approach Karen Ford, University of Tasmania, Helen Courtney-Pratt, University of Newcastle, Mary Fitzgerald, Charles Sturt University. Nursing workforce pressures have resulted in increased numbers of enrolments in undergraduate programs and increased numbers of beginning level registered nurses entering practice. The preceptorship model is widely used in nursing and midwifery for supporting beginning level practitioners. It is now the case that nurses and midwives, irrespective of their years of experience or educational qualifications, can be required to supervise and support undergraduates, trainee enrolled nurses, refresher course nurses and new staff for a significant part of each working week. This paper reports on a Practice Development initiative undertaken to develop and evaluate a Preceptorship Workshop for nurses and midwives. Responding to concerns of key stakeholders in the preceptor program at this research site, a new workshop was developed that drew on a Practice Development framework. www.ajan.com.au/Vol30/Issue3/1Ford.pdf

www.ajan.com.au/Vol30/Issue3/4Woodhouse.pdf

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19. A synthetic progestin used mainly to treat breast cancer (9) 21. Beneath (5) 23. Both tonic and clonic, referring to muscular spasms (12) 27. Substance produced by a gland (9) 29. A stroke or attack (5) 30. Enteric coated (1.1) 31. Transient acantholytic dermatosis (1.1.1) 34. A child between birth and age one (6) 35. Antagonistic to fungi (11)

Down 1. Colour blindness (14) 2. Lower esophageal sphincter (1.1.1) 3. The navel (9) 4. An instrument for measuring the flow of viscous liquids, such as blood (9) 5. Transient acantholytic dermatosis (1.1.1) 6. Drug overdose (1.1) 7. Pertaining to disease of the nervous system (11) 8. A bonelike substance covering the root of a tooth (8) 9. A habit peculiar to an individual (12)

14. Producing bile (9) 15. Axial point (5.5) 20. Treatment, payment, health care operations (1.1.1) 22. Relating to the calf bone (7) 24. Cul-de-sac (6) 25. A building where ambulatory patients receive health care (6) 26. Relating to the iris (6) 28. Rhenium (2) 32. Adenosine triphosphate (1.1.1) 33. One of nurse classification (1.1)

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BOOK ME Bush Nurses – Inspiring true stories of nursing bravery and ingenuity in rural and remote Australia Edited by Annabelle Brayley Penguin Books j www.penguin.com.au RRP $29.99 j ISBN 9781921901393 Bush nurses working in rural and remote Australia drive the ambulances, operate the clinics and deliver the babies. They are on call around the clock and there are no days off. They often make do with whatever is at hand while working in some of the most isolated places on the planet. Be they devastating family tragedies, close scrapes with bushfires or encounters with true larrikins of the outback, some of these stories will make your hair stand on end, others will make you laugh and cry. All tell of the courage and resourcefulness of nurses who have been the backbone of medical practice in remote Australia for more than a century.

Chronic Fatigue Syndrome/ME – Support for Family and Friends Elizabeth Turp Jessica Kingsley Publishers j www.jkp.com RRP $18.95 j ISBN-9781849051415 People with Chronic Fatigue Syndrome (CFS)/ME experience extreme tiredness and a range of other symptoms including pain, headaches, impaired concentration and memory, anxiety, sleep problems and palpitations. The condition can affect all areas of a sufferer’s life and, in turn, the lives of those close to them. This book provides families and friends of people with CFS/ME with an accessible introduction to the condition, and explains what can be done to support those who have it. The book addresses the emotional, social, and practical aspects of having a loved one with CFS/ME, explains how to understand the changes in their relationship with the sufferer, how to manage stress, and where to go for further help and support. It also includes detailed case studies and practical advice from a wide range of people with mild, moderate, and severe CFS/ME, and their loved ones. The book could also be a useful resource for health professionals who wish to deepen their understanding of CFS/ME, including home helps, care staff, counsellors, therapists, doctors, and nurses.

Psychological Aspects of Functioning, Disabilty And Health (Insider Perspective and Counselling Strategies) David B Peterson Springer Publishing Company j www.springer.com/ RRP $69.00 j ISBN 9780826123442 This textbook focuses on psychopathology as classified in the Diagnostic and Statistical Manual of Mental Disorders (DSMIV-TR), and discusses how it can be integrated into the International Classification of Functioning, Disability and Health (ICF) to assist mental health professionals while diagnosing and treating people with mental disorders. A good reference for students, the book serves as a natural bridge between the DSM-IV-TR and the ICF. Students will learn how to use ICF’s biopsychosocial approach for conceptualising mental health functioning (body functions and structures), disability (activity limitations and participation restrictions), and contextual factors (environmental and personal factors).

SPECIAL INTEREST Just A Union … of Nurses – The Rise to Political Power of the California Nurses Association By John Siver RN, PhD Legacy Book Publishing www.legacybookspublishing.com RRP $21.95 j ISBN 9781937952341 In 1995, the California Nurses Association disaffiliated from the American Nurses Association, which had historically billed itself as THE voice of nursing. In just four years they managed to accomplish what no other nursing group or organisation had previously managed – a mandated nurse-patient ratio law. It was an epic battle, and pitted a group of determined, bedside practicing nurses, against some of the strongest lobbying groups in healthcare, including groups within nursing itself. The political tactics used, and the legal battles this organisation had to confront were daunting, and resources were scarce in the beginning. All of these struggles are documented in Just a Union and examined as a model of political empowerment.

Psychosocial Aspects of Disability – Insider Perspective and Counselling Strategies Irmo Marini, Noreen M. Glover-Graf and Michael Jay Millington Springer Publishing Company www.springer.com RRP $85.00 j ISBN 9780826106025 This is an excellent book, but the best parts are the stories of the disabled, which give readers insights into their struggles and triumphs. Using a minority model perspective to address disability, the book focuses on historical perspectives, cultural variants regarding disability, myths and misconceptions, the attitudes of special interest and occupational groups, the psychology of disability with a focus on positive psychology, and adjustments to disability by the individual and family. A wealth of counseling guidelines and useful strategies are geared specifically to individual disabilities. Author Irmo Marini is a prominent professor and researcher who became disabled as a young adult.

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 gensec@nswnma.asn.au or Cathy Matias 8595 2121 cmatias@nswnma.asn.au. 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 J U LY 2 0 1 3 | 4 3


CPD courses within NSW >

13 September | Understanding Dementia | RN/EN | One day | 7 CPD hours | Burwood

>

17 – 18 September | Nursing patients with an intellectual disability | RN/EN | Two days | 14 CPD hours | Burwood

>

19 – 20 September | Wound Management | RN/EN | Two days | 14 CPD hours | Wagga Wagga

>

24 – 25 October | Palliative care | RN/EN | Two days | 14 CPD hours | Bega

>

5 – 6 November | Pain Management | RN/EN | Two days | 14 CPD hours | Burwood

www.acn.edu.au 1800 COLLEGE (26 55 343) ssc@nursing.edu.au Australian College of Nursing

Are you a registered nurse? Have you considered a career in midwifery? If you answered yes to both these questions, read on...

Proud P roud to to be the the lawyers lawyers for for NSWNMA NSWNM MA members members * *

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

W With ith every pur purchase rchase c of a Scrub TTop, op op, o you yo ou rreceive e eceive this campaign TT-Shirt --Shirt for

FREE!

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

SCRUB TOP

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

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

Size (cm)

XS

S

M

L

XL

2XL

3XL

4XL

5XL

Half Chest Circumference

53

56

59

62

66

69

73

77

81

Half Hem Circumference

54

74

78

82

General Guide for Female 8/10 SCRUB PANTS PANTS A

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.

57

60

63

67

70

10/12

12/14

14/16

16/18

18/20

20/22 22/24 24/26

33

37

40.5

43.5

46.5

50.5

54.5

58.5

Half Waist (Relaxed)

29

Half Waist (Stretched)

47

51

55

58.5

61.5

64.5

68.5

72.5

76.5

Half Hip

55

59

63

66

69

72

76

80

84

Out Seam Length

103

105

107

109

111

112

113

114

115

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 www.totalimagegrouponline.com/nswnurses 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 sales@totalimagegroup.com.au 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 uniforms@totalimagegroup.com.au


Grow your career

by joining ACN! We W e believe believe that that e each ach a and nd e every ver y n nurse urse iin n Australia have opportunity Australia should should h ave tthe he o pportunit y tto o grow and ffurther grow ttheir heir career career and urther our our profession. profession. > Education Education tthat hat p pays ays

For For membership information and online application visit: www.acn.edu.au www.acn.edu.au or freecall 1800 061 660

> True True representation representation > M Membership embership benefits benefits to to help help you you grow grow

Australian College of Nursing

The Edith Cavell Trust

Scholarships for the academic year 2014 Applications for the Edith Cavell Trust Scholarships are now being accepted for 2014. Members or Associate Members of the NSW Nurses and Midwives’ Association or the Australian Nursing Federation (NSW Branch) are invited to apply. Applicants should meet one of the following criteria: 1. Student nurses undertaking full-time courses leading to initial registration as a nurse or midwife. 2. Registered or enrolled nurses who wish to attend:

4 6 | T H E L A M P J U LY 2 0 1 3

an accredited clinical nursing education course of six months or less, either full-time or part-time; an accredited nursing conference or seminar relevant to applicant’s clinical practice. 3. Properly constituted nursing organisations, faculties or schools of nursing or registered or enrolled nurses wishing to: attend full-time, relevant postbasic studies at an approved institution for a period or periods of more than six months;

undertake an academically approved research program in the theory and practice of nursing work; conduct or fund a relevant professional or clinical nursing educational program. Applicants must be currently

registered with the Nurses and Midwives Board of Australia. Applicants must use the official Edith Cavell Trust application form. Details of the Edith Cavell Trust Rules are available on request and will also be supplied with the application form.

For further information or forms, contact: The Secretary – The Edith Cavell Trust 50 O’Dea Ave, Waterloo, NSW 2017 T Mrs Glen Ginty on 1300 367 962 E gginty@nswnma.asn.au W www.nswnma.asn.au – click on ‘Education’

Applications close 5pm on 31 July 2013


Keep warm this winter in NSWNMA mer rc chan merchandise chandise

Navy y Bonded B Polar Fleece ece Vests

$25 $2

available e in S, M, L, L and an XXXL XL, XXL

Red Heron Jackets – also available in Navy

$40

available in S, M, L, XL (Red) and M, L, XL (Navy)

Bonded Polar Fleece Zip Front Jackets

$30

NSWNMA mer merchandise chandise is not only stylish and comfortable, it is affordable afffor f dable and sold at cost to members.

available in S, M, L, XL, XXL and XXXL

To order der form T o order, order, fax the or to Glen Ginty, (02) 9662 1414 or post to: NSWNMA, venue, Avenue, 50 O’Dea A ven v Waterloo Waterloo NSW 2017

Navy Layered Vests

$40

der forms Merchandise order Merchandise or also available on

www www.nswnma.asn.au .nswnma.asn.au

ORDER FORM

available in S, M, L, XL, XXL and XXXL

Navy Bonded ded Polar Fleece Ve ests $25.. Quantity: Size: S M L XL XXL XXXL Red Heron Jackets $40. Quantity: Size: S M L XL

Address Postcod Postcode Phone (h)

Navy Heron Jackets $40.. Quantity: Size: M L XL Navy Layered Vests e $40. Quantity: M L XL XXL Size: S

Name

(w)

Method of payment

XXXL

Bonded Polar Fleece Zip Front Jacket $30.. Quantity: M L XL XXL XXXL Size: S Total o cost of order $ Please include postage and handling of $5 per orderr.

(mob) Cheque Bankcard

Mastercard Money Order

Visa

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/

T H EeL A M P J U LY 2 0 1 3 | 4 7 Signatur


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MOVIES

movie of the month WHAT’S IN A NAME (Le Prénom) Directors Matthieu Delaporte and Alexandre de la Patellier offer up a lively take on love, friendship and baby naming that should titillate Francophile audiences, writes Stephanie Gray. The film is set entirely in one apartment where five friends argue, spill secrets and generally push each other’s buttons. Pierre (Charles Berling) and his wife Élisabeth (Valerie Benguigui) are having a dinner party – their guests, Elisabeth’s brother Vincent (Patrick Bruel), his pregnant girlfriend, Anna (Judith El Zein) and longtime friend Claude (Guillaume de Fonquedec). This diverse selection of dinner guests set the scene for a lively evening. Uproar ensues when Vincent, about to become a father for the first time, announces the name proposed for his baby son. This bunch of 40-something friends find their dinner party transformed into a dinner disaster. An amusing and well-acted French farce. The twists and quid pro quos ultimately force the various characters to face truths about themselves and one another. Nothing is ever as bad as it seems. Based on a play of the same name, this film promises to entertain and certainly not bore any filmgoer. It is light and fluffy and a great, rainy afternoon delight. IN CINEMAS JULY 25 Stephanie Gray is an RN with the Australian Red Cross Blood Services < The French version of the movie poster

ciné files MEMBERGIVEAWAY

DVDGIVEAWAY

The Lamp has 15 in-season double passes to give away to What’s In A Name thanks to Madman Entertainment. The first 15 members to email their name, membership number, address and telephone number to lamp@nswnma.asn.au will win.

Guillaume de Fonquedec and Valerie Benguigui won Best Supporting Actor and Best Supporting Actress at the 2013 César Awards presented by the French Academy of Cinema Arts and Techniques. 

RN O’Bray Smith described this film as “good, not so clean fun” when she reviewed it for our February issue. “This British rom com is not as spectacular as Love Actually but would hold its own against Four Weddings and a Funeral ,” O’Bray wrote. “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.” Australian Rose Byrne stars as Nat, an independent successful woman who dreams of falling in love. Along comes Josh (Rafe Spall), a failing novelist who loves dancing badly, drinking beer and acting like a juvenile. The movie also stars Minnie Driver who gives a strong performance and adds a bit of cheek. To celebrate the film’s DVD release The Lamp has six DVDs of I Give It a Year to giveaway thanks to Hopscotch Films. For your chance to win one of the six DVDS write your name, address and membership number on the back on an envelope andSteve post to: Coogan as Paul Raymond I Give It A Year DVD Competition 50 O’Dea Ave Waterloo NSW 2017 ONLY ONE ENTRY PER MEMBER THE LAMP JUNE 2013 | 49


DIARY DATES

conferences, seminars, meetings NSW

ACT

NSW Urological Nurses Society (NUNS) Education Day – Urology Trauma 5 July Burwood RSL Club • 9990 4148 urological_nurses@hotmail.com www.anzuns.org Grace Centre for Newborn Care Seminar: The vulnerable neonate and the surgical NICU 2 August Parramatta CCNC.SCHN@health.nsw.gov.au 23rd Annual Spinal Injury Conference 19-20 August Burwood jhebblewhite@bigpond.com www.sina.org.au 13th Rural Critical Care Conference 23-24 August Albury www.ruralcriticalcare.asn.au Enrolled Nurses Professional Association of NSW  Annual Conference 19-20 September Sydney Members $310, Non-members $340 1300 554 249 rjroseby@gmail.com PANDDA 24th Conference Partnerships & Possibilities – Nursing Practice in Disability. Models for Health & Social Equity. 16-17 October Parramatta Damian Heron 98422 306 damian.heron@pandda.net www.pandda.net Australian Nursing and Midwifery Conference 17-18 October Newcastle www.nursingmidwiferyconference.com.au Amy McIntosh 0423 497 038 2013 Transplant Nurses’ Association Conference 24-25 October Sydney www.gemsevents.com.au/tna2013/ Karitane 2013 Gala Ball (90th anniversary) 26 October Sydney Town Hall Vanilla Bean Events 9712 3861 amy@vanillabeanevents.com.au

12th Australian Palliative Care Conference  3-6 September Canberra www.dcconferences.com.au/apcc2013/ Congress of Aboriginal and Torres Strait Island Nurses 15th National Conference and AGM 6-8 October Canberra www.catsin.org.au

INTERSTATE Health Informatics Conference 15-18 July Adelaide hic2013@hisa.org.au www.hisa.org.au Cancer Nurses Society of Australia 16th Winter Congress 25-27 July Brisbane www.csnawintercongress.com.au 2013 ILCA Conference: Born to Breastfeed: A Global Public Health Imperative 25-28 July Melbourne registrar@ilca.org www.ilca.org 14th International Mental Health Conference 2013 5-7 August Surfers Paradise anzmh.asn.au/conference Mental Health Services 23rd Annual Conference ‘Forging the Future’ 20-23 August Melbourne (02) 9810 8700 Fax (02) 9810 8733 info@themhs.org www.themhs.org SMART STROKES 2013 - 9th Australasian Nursing & Allied Health Stroke Conference 22-23 August Brisbane Stephanie Rogers smartstrokes@theassociationspecialists. com.au www.smartstrokes.com.au Public Health Association Australia 42nd Annual Conference A fair go for health: tackling physical, social and psychological inequality 16 –18 September Melbourne www.phaa.net.au/42nd_Annual_ Conference.php

Crossword solution

Australian College of Nurse Practitioners 2013 Conference 24 - 27 September Hobart www.dcconferences.com.au/acnp2013/ CRANAplus 2013 Annual Conference From the cradle to the grave 25-28 September Darwin  crana.org.au/about/conference/ conference@crana.org.au 2013 Australasian College for Infection Prevention and Control Conference 30 September – 2 October Gold Coast www.acipcconference.com.au Australian College of Midwives 18th Biennial Conference 30 September - 3 October Hobart www.acm2013.com Australian Day Surgery Nurses Association 2013 National Conference 12-13 October Melbourne www.adsna.info Michelle Berarducci (02) 9799 1632 nswadmin@adsna.info 5th Australian Rural & Remote Mental Health Symposium  14-16 October Geelong (07) 5502 2068 hanzmh.asn.au/rrmh/ Dementia and Community Care Conference 30-31 October Melbourne Wayne Woff 03 9571 5606 office@totalagedservices.com.au www.totalagedservices.com.au Indigenous Allied Health Conference 26–27 November Adelaide iaha.com.au/events/2013-conference

OVERSEAS 24th International Nursing Research Congress 22-26 July Prague www.nursingsociety.org/STTIEvents/Res earchCongress/ 2nd World Congress of Clinical Safety 12-13 September Heidelberg www.iarmm.org Australasian Nurse Educators Conference 2013 9-11 October Wellington www.nursed.ac.nz/ 8th European Congress on Violence in Clinical Psychiatry 23-26 October Ghent www.oudconsultancy.nl/GhentSite/ International Conference on Infectious & Tropical Diseases (ICTID) 16 -18 January, 2015 Phnom Penh http://ictid.webs.com/

REUNIONS

M O N O C H R O M A T I S M

A L N U T E M O S E B L I O B A L A I I E L O C A I U E G E S T E P O N I C O I A E C R E T E C E U A N T I M Y

R H E O M E T E R C L I N I C

I T I O N D E A U E D T O R O I N O T O P A E D A N A T H O L I P L O N I C R I I C O N T A D I N O T I C

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F P A O

C E M E N T U M

N D H I

I D I O S Y N C R A S Y

N F R I B T U S L A F A N T R P

Wollongong Hospital May 1972-75 Date TBA Maureen Robertson (Sherley) 0438 830 790 RPA July ‘63 50-year-reunion 6th July venue TBA Evelyn Patrick (nee White Rogers) evelyn-patrick@hotmail.com Mater Graduate Nurses Association annual reunion 20 October Liturgy 11.30am Lunch 12.30pm Mary McKillop Place, North Sydney Joan Stort 0401 344 363 joans2458@yahoo.com St George Hospital Graduate Nurses Association AGM & annual reunion 26 October Luncheon: Torwood Lounge, Ramsgate Judith Cornell jcornell@netspace.net.au

NOTICE Former Australian Inland Mission (AIM) nurses who worked under John Flynn and Rev Fred McKay till 1977 sought for research project. Contact Daryl Lightfoot at archives@pcnsw.org.au, wmhs@gmail.com or (02) 9690 9374.

ausmed.com.au/listen


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The Lamp July 2013