The Lamp October 2014

lamp THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION

VOLUME 71 No.9 OCTOBER 2014

Mental health goes private SPOTCHECKS SHOW SHORTAGES PARKING PERMIT WIN Print Post Approved: PP100007890

PENSION CHANGES UNFAIR

CONTENTS

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

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

VOLUME 71 No.9 OCTOBER 2014

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

COVER STORY

12 | Mental health goes private Mental health services in New South Wales are another target of state government privatisation.

Jacinta Hoare RN PHOTOGRAPH: BELINDA SOOLE

REGULARS

5 6 8 35 37 41 43 47 49 50

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

STAFFING

18 | Spot checks find Shoalhaven shortages

NORTHERN BEACHES

15 | Fighting for public hospitals

6 | Win a stay on the Central Coast

Produced by Hester Communications T 9568 3148 Press Releases Send your press releases to: F 9662 1414 E gensec@nswnma.asn.au Editorial Committee • Brett Holmes, NSWNMA General Secretary • Judith Kiejda, NSWNMA Assistant General Secretary • Coral Levett, NSWNMA President • 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

Nurses and midwives have escalated the campaign against the privatisation of the new hospital planned for Sydney’s northern beaches.

RETIREMENT

22| Older workers suffer Hockey’s uncaring budget The Abbott government’s decision to raise the pension age will hurt people working in physically demanding jobs like nursing and midwifery the most.

COMPETITION

For all editorial enquiries letters and diary dates T 8595 1234 E lamp@nswnma.asn.au M 50 O’Dea Avenue, Waterloo NSW 2017

2014 CONFERENCE

29 | Life members give us heart and soul

Information and Records Management Centre To find old articles from The Lamp, or to borrow from the NSWNMA nursing and health collection, contact: Jeannette Bromfield, Coordinator T 8595 2175 E gensec@nswnma.asn.au The Lamp ISSN: 0047-3936 General disclaimer The Lamp is the official magazine of the NSWNMA. Views expressed in articles are contributors’ own and not necessarily those of the NSWNMA. Statements of fact are believed to be true, but no legal responsibility is accepted for them. All material appearing in The Lamp is covered by copyright and may not be reproduced without prior written permission. The NSWNMA takes no responsibility for the advertising appearing herein and it does not necessarily endorse any products advertised.

Privacy 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 2014 Free to all Association members. Professional members can subscribe to the magazine at a reduced rate of $55.

Individuals $80, Institutions $135, Overseas $145.

Among the four NSWNMA members awarded life membership at this year’s annual conference was Professor Debora Picone AM. THE LAMP OCTOBER 2014 | 3

EDITORIAL

BY BRETT HOLMES GENERAL SECRETARY

Let’s engage the community in the debate about public health The Baird government’s health privatisation agenda is broad and advanced and we must redouble our efforts to inform the public about what is going on.

“We have been reaching out to the public through paid advertising but we have to follow that up with personal conversations.”

Last month the Association escalated its efforts to bring to public attention the momentous decisions that the Baird government has made about our public health system without any community debate or an electoral mandate.

We have been running television ads in Sydney to draw attention to the government’s decision to privatise the new Northern Beaches Hospital.

We also lifted the profile of our campaign with a giant billboard in the heart of Premier Mike Baird’s own Manly electorate (see page 15).

We have staffed a campaign office to inform the local community about the government’s plans for their local hospital. NSWNMA members from Manly and Mona Vale hospitals have been leafleting their neighbourhoods.

There have been rallies outside Mike Baird’s electoral office where petitions and postcards were presented to him.

We have built a website – keepitpublic.org.au – which has resources for the campaign and information about a number of actions that nurses, midwives or the public can take.

This campaign resonates with the public. A recent Reachtel survey found that 75 per cent of northern beaches’ residents are opposed to the new hospital being privatised.

The Northern Beaches Hospital is not an isolated example.

In this month’s Lamp we also look at the privatising of mental health services in Dubbo.

We know that the whole of ADHC (Ageing Disability and Home Care) is to be turned over to the private sector. Palliative care and other community nursing are up for grabs.

No doubt the government had been hoping to bulldoze these major policy changes through without debate or opposition. This will not happen.

We are determined that the government will not sell off our public health system by stealth. The voting public must be able to express their opinion on such a fundamental change to the delivery of health services in New South Wales.

There is still a lot we can and must do to put pressure on this government to rethink its illjudged strategy to privatise public health services.

The state election is only six months away and is an opportunity for us to engage the public on

this issue. We have been reaching out to the public through paid advertising but we have to follow that up with personal conversations so we can build opposition to the government’s position.

Research tells us that the public instinctively understands that privatisation means they will be paying more for health and there will be less quality of care.

Every Association member can contribute to our campaign: simple talk to family, friends and everyone you meet in your daily life about the consequences of these privatisation policies.

Let’s build the debate about our public health system that the government would rather we didn’t have.

Patients should come before profits. A private health provider is obligated to provide a profit to its shareholders, or in the case of a nongovernment charitable organisation, a return to the parent organisation in the form of surpluses.

In each case money has to be diverted away from direct patient care.

Private hospitals and health services have their place in our health system for those people who choose to self fund or insure and have the capacity to fund the gap between insurance and services provided.

But private health services must not be allowed to undermine our universal access to high quality public health services.

WORKING TILL YOU DROP In this month’s Lamp we also look at the impact on nurses and midwives’ retirement incomes of the federal government’s changes to the pension age and superannuation (see pages 22 to 27).

These are cruel and uncaring changes that will impact greatly on professions that take a toll on ageing bodies, such as ours.

Already there is a structural problem with superannuation that greatly affects women: the retirement income of most women is diminished by taking time out from work to create a family.

The move to increase the pension age to 70 and the decision to postpone the increase in superannuation from nine to 12 per cent is yet another poor piece of public policy from Canberra that will have a negative impact on nurses and midwives.

THE LAMP OCTOBER 2014 | 5

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YOUR LETTERS

Send your local member a message Recent ICAC (Independent Commission Against Corruption) revelations have left me thinking. Both sides of government have provided significant fodder for the commission in recent months.

All the findings thus far can be accredited to avarice, selfishness and self-aggrandrisement.

Know your local member at both state and federal levels.

Know who you are voting for and give those individuals a clear message that the current outrage is simply unacceptable.

Adrian Walsh RN,Wollongbar

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HAVEYOURSAY Send your letters to: Editorial Enquiries email lamp@nswnma.asn.au fax 9662 1414 mail 50 O’Dea Avenue, Waterloo NSW 2017.

Please include a high resolution photo along with your name, address, phone and membership number.

Letters may be edited for clarity and space.

Anonymous letters will not be published.

SPECIAL OFFER FOR READERS All Lamp readers will receive a complimentary bottle of Toowoon Bay wine (a shiraz or semillon sauvignon blanc) when they mention The Lamp magazine when booking a stay at Kims. For more information and bookings, go to www.kims.com.au or contact (02) 4332 1566 To enter the competition, simply write your name, address, membership number on the back of an envelope and send to: Central Coast Competition 50 O’Dea Avenue, Waterloo, NSW, 2017 Conditions apply: prize is not valid over public holiday periods; prize valid for 12 months; bookings essential. Prize is subject to availability and not redeemable for cash. Competition entries from NSWNMA members only.

Competition opens 1 October 2014 and closes 31 October 2014. The prize is drawn on 1st of the month following the competition. If a redraw is required for an unclaimed prize it must be held up to 3 months from the original draw date. NSW permit no: LTPM/14/00042.

NOTICE TO MEMBERS

ANMF FEDERAL OFFICE FINANCIAL REPORT

The ANMF Federal Office Financial Report for the year ended 30 June 2014 is now available at www.anmf.org.au Members without internet access may obtain a hard copy of the report by applying in writing to: Federal Finance Officer Australian Nursing & Midwifery Federation Level 1, 365 Queen Street, Melbourne Victoria 3000

YOUR LETTERS

L ET TE R O F TH E M ONT H

Our aged need RNs I am deeply concerned by the Aged and Community Services Association of NSW and ACT describing the requirement to have an RN on duty at all times for high care residents as a “waste of limited resources�. (“Nursing home changes on hold�, The Lamp August 2014) Registered nurses are fundamental to the delivery of safe, quality health care. Registered nurses assess, plan, implement, direct, supervise nurses and unregulated care workers and review and evaluate the nursing care provided to our aged care residents.

The responsibility for the safe delegation of tasks rests ultimately with the registered nurse. He or she is guided by the experience, education and competence of nurses and unregulated care workers.

Aged care nursing involves specialised skills in clinical areas, including wound, catheter care, palliative and pain management.

Administration of medications has duty of care implications requiring skill, knowledge and judgement. RNs are responsible for detecting changes in our residents’ health and physical status that may indicate a need for medication review by the medical officer. RNs are able to administer medications from all appropriate drug schedules.

Another fast-emerging aged care specialisation is dementia management, which requires a high level of clinical competence and interpersonal communication skills.

In order to meet the requirements of certification and accreditation, aged care providers and their staff are required to demonstrate that care practices reflect the changing needs of residents under their care. It is part of the registered nurse’s role to plan and document the same regularly.

Every person has the right to quality care. This right does not diminish when he or she moves into a nursing home, regardless of physical or mental frailty. They are entitled to a quality service delivered by qualified professionals. This is clearly stated in the preamble of residents’ rights and responsibilities.

Jocelyn Hofman RN, Hazelbrook

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Cutbacks in Canowindra In May, the Western NSW Local Health District introduced new rosters for nursing staff based at Canowindra, Condobolin, Coonamble and Nyngan hospitals, citing the introduction of a new model of care for small hospitals and multi-purpose services.

Canowindra Soldiers Memorial Hospital lost 16 nursing hours per day from the morning shift, leaving just one RN and one EN to manage the 19-bed facility and two-bed emergency department.

In July, branch members rallied against staffing cuts, which have compromised patient care and nurse wellbeing, by holding a community awareness day in Canowindra’s main street to alert the public to what is happening at their local hospital.

The response from the community was fantastic. People were shocked and angry and wanted to know what they could do to help.

The cutbacks have been very upsetting for staff. Sick leave has increased and nurses are going home worn out and dissatisfied with the job they are doing.

While there is an escalation plan in place to respond to an inpouring of patients, it’s impractical and protracted. Nurses want to deliver the quality care the community deserves but are finding, with the dangerously low level of staff to patients, they are having difficulty doing this. Concerns are in the delay in being able to answer patient call bells and having to prioritise which patient needs attending first.

There are delays in attending observations, administering treatments and medications when patient numbers are high.When both nurses are in the emergency department, no one is left to care for inpatients.The phone is no longer being answered promptly as there is no one available to answer it.

The nurses run the hospital and hospital management can’t cut staff and expect the same care to be given.

Glenda Gavin RN, Canowindra

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To advertise please contact Patricia Purcell 02 8595 2139 // 0416 259 845 // ppurcell@nswnma.asn.au

THE LAMP OCTOBER 2014 | 7

NEWS IN BRIEF

Britain

Aspirin a day could keep cancer away An aspirin a day could dramatically cut the chance of getting and dying from common cancers, according to a comprehensive study which concluded that people between 50 and 65 should consider regularly taking low-dosage tablets.

Professor Jack Cuzick, head of the research team at the centre for cancer prevention at Queen Mary University of London, told The Guardian that taking aspirin “looks to be the most important thing we can do to reduce cancer after stopping smoking and reducing obesity”.

To obtain the benefits of aspirin people would have to take it for at least five years and probably 10.

While there are some possible negative effects, notably stomach bleeds, the study concludes that the benefits outweigh the risks.

Cuzick’s team, writing in the cancer journal Annals of Oncology, said that by taking low-dose aspirin every day for 10 years, bowel cancer cases could be cut by about 35 per cent and deaths by 40 per cent.

Aspirin could reduce rates of oesophageal and stomach cancers by 30 per cent and deaths from them by 35 to 50 per cent.

Aspirin also has a smaller preventive effect on other major cancers, according to the study. It could reduce the number of lung cancers by five per cent and deaths by 15 per cent. It could cut prostate cancers by 10 per cent and deaths by 15 per cent, and breast cancers by 10 per cent, with a reduction in deaths of five per cent.

The scientists recommended that people consult their GP before taking daily aspirin to prevent cancer.

“TAKING ASPIRIN LOOKS TO BE THE MOST IMPORTANT THING WE CAN DO TO REDUCE CANCER AFTER STOPPING SMOKING AND REDUCING OBESITY.”

Britain

Trade agreement threatens NHS British health unions are ringing alarm bells about the consequences of free trade agreements on health and other public services.

The NSWNMA has also been vocal about the negative impact the secret trade agreement, the Trans Pacific Partnership, will have on our health system and the Pharmaceutical Benefits Scheme.

British unions are grappling with a similar threat, the Transatlantic Trade and Investment Partnership (TTIP), which has identical goals and consequences.

The TTIP is being negotiated behind closed doors at the European Commission, between EU bureaucrats and delegates from the US, reported The Guardian.

The TTIP would allow US multinationals, or any firm with American investors, to sue future UK governments if they attempted to take privatised health services back into public ownership, hence jeopardising profits. This is an identical scenario faced by Australia under the Trans Pacific Partnership.

Britain’s largest trade union, Unite, has repeatedly warned about the potential impact on hospitals and GPs if the deal goes through.

“The Tories’ Health Act of 2012 opened our NHS up to profitmaking US private firms and a new trade deal threatens to make the sell-off permanent,” Unite’s general secretary Len McCluskey said.

The agreement could be a vote changer according to a survey commissioned by Unite.

A poll of more than 2600 voters across 13 marginal Conservative Party-held seats, found 68 per cent opposed the inclusion of the NHS as part of the deal. Opposition was highest among those planning on voting for Labour (78 per cent), but even among Conservative supporters only 23 per cent backed the inclusion of the NHS in the TTIP.

“The Tories’ Health Act of 2012 opened our NHS up to profit-making US private firms and a new trade deal threatens to make the sell-off permanent.”

8 | THE LAMP OCTOBER 2014

NEWS IN BRIEF

United States

Decriminalise sex work to control AIDS Sex work must be decriminalised in order to control the AIDS pandemic, according to scientists quoted in a series of research papers presented to the International AIDS conference held recently in Melbourne.

The series of studies will be published in the Lancet medical journal.

Reducing sexual violence by clients and abusers could reduce HIV infection rates by around a fifth in both high- and lowincome settings, and getting more sex workers on antiretroviral treatment for HIV would reduce the amount of active virus in their bodies and cut the rate of new infections by a third, researchers found.

But decriminalisation of sex work would be the preventative measure with the biggest impact, they say. Across all settings it would reduce HIV infections by 33 per cent to 46 per cent over the next decade.

The AIDS pandemic is becoming

increasingly concentrated in marginalised communities that are harder to reach. They are often people who live on the fringes of their own societies, including drug users and sex workers.

“Efforts to improve HIV prevention and treatment by and for people who sell sex can no longer be seen as peripheral to the achievement of universal access to HIV services and to eventual control of the pandemic,” Prof Chris Beyrer, director of the Johns Hopkins Centre for Public Health and Human Rights in the US, who coordinated the series, told The Guardian..

Together, the series of papers is a call to governments to decriminalise sex work, say Lancet editor Richard Horton and senior executive editor Pamela Das in a commentary.

“There is no alternative if we wish to reduce the environment of risk faced by women, men and transgender people worldwide.”

St. vincent’s hospital hiv inpatient unit

‘17 South’

“Decriminalisation of sex work would reduce HIV infections by

33% to 46% over the next decade.”

HOLD A PINK RIBBON FUNDRAISER

30th anniversary commemoration It’s 30 year since St. Vincent’s Hospital opened its doors and hearts to people with HIV/AIDS. We’ve come a long way from those dark and frightening days. If you are currently working or have ever worked in our inpatient or outpatient HIV services I’d like to invite you to a special commemoration event to be held on Friday 28th November 2014.

Please RSVP in the first instance to John McAllister on john.mcallister@svha.org.au

on Fundraiser Hold a Pink Ribb pport su d an er tob Oc s thi breast and by ted ec aff se tho ers. Together, nc ca al gic olo gynaec ence. fer dif a ke ma we can u .a pinkribbon.com 1300 65 65 85

I look forward to welcoming you on the day.

Associate Professor Anthony M. Schembri Chief Executive Officer | St Vincent’s Health Network Sydney

THE LAMP OCTOBER 2014 | 9

NEWS IN BRIEF

United States

Fewer overdoses with legalised marijuana New research published in the journal JAMA Internal Medicine shows that American states with medical marijuana laws have lower rates of anticipated opioid-related deaths than states that don’t have them.

United States

Teens need sleep School should start later so teens can sleep more, according to a report by the American Academy of Paediatrics.

The academy supports pushing back school start times for older kids, particularly teens, because it’s better for their mental and physical health, reported Time magazine. “The evidence is clearly mounting both in terms of understanding the repercussions that chronic sleep loss has on the health, safety and performance of adolescents, and there is also really solid compelling data supporting the fact that delaying school start times is a very important intervention that can mitigate some of the impact of sleep loss,� Dr Judith Owens, director of sleep medicine at Children’s National Medical Center, and lead author of the report, said.

The study shows that inadequate sleep among teens – anything less than 8.5 to nine hours a night on school days – can contribute to health issues such as obesity, diabetes, mood changes and behaviour problems.

According to the report the evidence supports giving teens more time in bed by pushing back the time they have to be at school to at least 8.30am. Even a half-hour delay can have dramatic effects on improving children’s health and academic performance.

The data shows that puberty may biologically wire teens to stay up late and wake up late, meaning that forcing them to bed earlier won’t do much good. The hormonal changes occurring during that period of development shifts their body clocks, which regulate the balance between sleeping and waking.

“FORCING THEM TO BED EARLIER WON’T DO MUCH GOOD.�

The researchers looked at death rates from opioids between 1999 and 2010 and found that the 13 states that allowed medical marijuana at the time had 25 per cent lower opioid mortality rates.

Their hypothesis was that patients with chronic pain perhaps switch from heavy drugs to marijuana, since cannabinoids in marijuana react similarly in the brain. About 60 per cent of all opioid deaths happen among people who have legitimate prescriptions. “Among people who use opioids illicitly, a relatively high proportion of them also use marijuana,� study author Dr Marcus Bachhuber of the Philadelphia VA Medical Center told Time magazine.

There is no clear causation Dr Bachhuber says, but the findings are still encouraging. “I think that any change that leads to fewer people dying of opioid overdoses would be a positive,� he said.

“American states with medical marijuana laws have lower rates of anticipated opioid-related deaths than states that don’t have them.�

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NEWS IN BRIEF

United States

Gender pay gap to widen

Moderate the salt

The gender pay gap – already at a record high of 18.2 per cent – is expected to blow out by a further two per cent under Abbott government proposed changes to workplace laws.

ACTU President Ged Kearney says women are at particular risk of being exploited under individual flexible arrangements (IFAs), which are a key part of the Abbott government’s Fair Work Amendment Bill.

It has been known for a long time that too much salt in the diet is bad for those with high blood pressure.

“If the government succeeds in passing the Fair Work Amendment Bill the already record high 18.2% pay gap will blow out even further.”

“These arrangements are individual contracts that let employers use women’s caring responsibilities against them by forcing them to trade off penalty rates for the ability to pick up their child on time from childcare, for example.

“Now the government wants to go even further by making employees sign a statement that will mean they can’t get compensation if they’ve been underpaid as a result of trading off entitlements under an unfair agreement.

“Currently it’s the employer’s responsibility to make sure the employee is better off overall on an individual contract, but the government is trying to change the law so workers must sign a statement that puts the responsibility on them – not their employer.”

Ged says the proposed changes to individual agreements are very similar to the highly unpopular Australian workplace agreements (AWAs) introduced under the Howard government’s WorkChoices.

“What we saw under AWAs was a two per cent widening of the gender pay gap. If the government succeeds in passing the Work Amendment Bill the already record high 18.2 per cent pay gap will blow out even further, just as it did under AWAs.”

“THE STUDY ALSO FOUND THAT A LOWSODIUM DIET WAS ASSOCIATED WITH HIGHER MORTALITY FROM CARDIOVASCULAR CAUSES.” A recent survey in the New England Journal of Medicine confirms this. It monitored more than 100,000 people in 18 countries and found that people who consumed more sodium generally had significantly higher blood pressures than those who did not.

People who consumed more than seven grams of sodium per day had a significantly higher chance of death than those who ate three to four grams per day. People consuming high levels of sodium had higher rates of heart attacks, heart failures and strokes.

A second study in the same New England Journal of Medicine found, however, that too little salt was also problematic.

When compared with those who consumed three to six grams per day, people who consumed less than three grams of sodium per day had an even higher risk of death or cardiovascular incidents than those who consumed more than seven grams per day.

This backs up a 2011 study published in the Journal of the American Medical Association, which followed more than 3600 people for a decade.

It too found that excessive salt intake was associated with high blood pressure but also found that a low-sodium diet was associated with higher mortality from cardiovascular causes.

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To find out more, visit sydney.edu.au/nursing/next-level THE LAMP OCTOBER 2014 | 11

COVER STORY

12 | THE LAMP OCTOBER 2014

Mental health goes private Mental health services in New South Wales are another target of state government privatisation.

THE NEW SOUTH WALES GOVERNMENT has taken a further step towards privatisation of public health services by contracting out mental health sub-acute services to a private company, Neami Limited.

The state government is paying Neami to run short stay, residential services in government-owned facilities at Broken Hill and Dubbo hospitals. Nurses at the facilities are employees of the NSW Ministry of Health but managed by Neami.

The newly built “step-up, step-down” facilities are designed for people living in the community and for in-patients transitioning back to their homes.

Fifteen such facilities are to be built in NSW with government funding for the next two years. It is unclear whether all 15 will be dedicated mental health facilities and whether all will be run by private operators.

NSWNMA General Secretary Brett Holmes says government funding to Neami has reduced the funds available to improve government-run mental health services.

“The Neami contracts should be viewed in the context of the state government’s all-round effort to privatise health services,” he said.

Neami is a Melbourne-based non-profit company funded by governments and philanthropic foundations to “improve mental health and wellbeing in local communities.”

Its 500 employees provide services to more than 3000 people in five states.

Neami’s Broken Hill and Dubbo centres opened in 2012-13. It is believed a new 20-bed, sub-acute mental health facility at Shoalhaven District Memorial Hospital, opened in Nowra in June this year, will be given to a private operator to manage in the near future. Built at a cost of $11.6 million, it is “closely linked” to the mental health inpatient service at Shellharbour Hospital, according to the state government.

The NSWNMA branch at Dubbo Base Hospital has raised concerns about safety and blurred lines of responsibility at the $7.2 million, 10-bed Neami facility, known as the Dubbo Mental Health Rehabilitation and Recovery Centre.

Dubbo Base Hospital mental health unit staff members were expected to attend to clients at the Neami facility after hours, at the request of Neami staff.

Access is via open grounds and the duress alarms carried by mental health unit staff do not function en route or at the facility.The grounds around the facility are unfenced. On one occasion, a female nurse had to visit the Neami centre in the early hours of the morning. She asked the mental health unit security officer to accompany her, for safety reasons, leaving the unit two staff down in their absence.

The NSWNMA took part in an occupational health and safety inspection

and advised mental health unit staff not to put themselves at risk by performing this service.

“The Association advised Neami management to look at another option such as escorting the client to the emergency department,” Brett Holmes said.

The Association inspection found that the Neami premises and duress alarm did not comply with NSW Health standards.

Duress alarms had no “man down” capability or pull cord trigger. They did not communicate with Dubbo Base Hospital staff or security. Clients had access to the unit front door and could let themselves in and out at any time using a key fob.

Some Neami staff had not received aggression management or patient restraint training.

The Association’s inspectors urged the development of a clear line of nursing management and a clear reporting framework for nurses working in the unit.

Brett said the Association acted to ensure that NSW Health and Neami were aware of, and met, their obligations and responsibilities to their employees under workplace health and safety legislation.

“As the nurses working at the Neami facility are employees of the Local Health District (LHD), and the LHD owns the premises, the LHD retains legal responsibility for their health and safety. Neami is jointly liable,” he said.

“THE NEAMI CONTRACTS SHOULD BE VIEWED IN THE CONTEXT OF THE STATE GOVERNMENT’S ALL-ROUND EFFORT TO PRIVATISE HEALTH SERVICES.” – Brett Holmes General Secretary NSWNMA

THE LAMP OCTOBER 2014 | 13

COVER STORY

Dilemmas of private management A privately operated mental health centre is presenting risks and difficulties for Dubbo nurses.

THE PRIVATELY RUN NEAMI SUBacute mental health service at Dubbo hospital replaces NSW Health’s former Darling Street centre, a block of flats that housed a step-up, step-down mental health service.

President of the NSWNMA Dubbo branch Jacinta Hoare, who works in the hospital’s mental health unit (MHU), described the Darling Street centre as “a great service, it worked really well.

“Darling Street workers would work with clients in their homes and take them shopping, to medical appointments and other activities,” she said. “If a client became unwell they would increase contact and if necessary accommodate them in the flats for closer observation.”

With the aim of successfully discharging patients back into the community, the in-patient unit also used the Darling Street centre to trial patients, who were close to being discharged from the acute service, on leave.

“The impact of the loss of that service was felt across the community and in-patient services as well as by the clients,” Jacinta said.

The Darling Street centre flats are now used as staff accommodation.

Realising the need to restore a step-up, step-down service the department built the Neami-run facility to provide 24-hour supported care with some on-site clinical support and treatment.

Neami claims to be “introducing a new model of recovery-oriented

14 | THE LAMP OCTOBER 2014

“OUR NURSES FELT VERY UNCOMFORTABLE ABOUT MEDICATING PATIENTS UNDER THESE CIRCUMSTANCES.” — Jacinta Hoare RN

care to NSW” known as the “Collaborative Recovery Model” developed by the University of Wollongong.

Neami says it has already achieved success in reducing the number of people “experiencing acute distress and requiring hospitalisation.”

Jacinta described the Neami centre as “a beautiful facility with the potential to work really well – but there are problems.”

The local health district (LHD) classifies the Neami facility as an inpatient service, yet it uses a community-based model of care. Jacinta says this causes confusion about which policies and rules nurses should be following.

“For example, the administration of medication has presented the service with some difficulty, given that nurses are not on site 24/7.

“Neami patients were presenting to the inpatient unit with a care worker, to be given PRN [as needed] medications, but we didn’t know their history and what medications they had been taking.

“Our nurses felt very uncomfortable about medicating patients under these circumstances. They were concerned about putting their registrations at risk by medicating somebody they didn’t know.

“It was then that the branch sought advice from our union officials. We understand the LHD now has interim measures in place to satisfy our concerns.”

The Neami unit opened with two full-time registered nurses but one left and was not replaced.

“The LHD is drawing on the MHU’s casual pool and part-timers, which makes it harder for the MHU to get staff to fill vacancies,” Jacinta said.

In another example of conflicting policies, a single care worker staffs the Neami centre overnight. That contradicts NSW Health policy that mental health care workers should not operate alone.

“Care workers are vulnerable to potentially unpredictable patient behaviour. In the past MHU staff went to the Neami facility to assist but had to abandon this because of the risks.”

PROTECTING PUBLIC HOSPITALS

From left to right: Tonya Wasley, Melissa King, Sonia Malar, Birsen (Bea) Kocak, Pablo Naucapoma, Cathlea Stampa, Lyn Hopper, Laila Dungca, Stephanie Cummings, Fiona Deegan, Shannon Welch.

Fighting for public hospitals Nurses and midwives have escalated the campaign against the privatisation of the new hospital planned for Sydney’s northern beaches. The NSWNMA commissioned a giant billboard to send a clear message to Manly MP and Premier Mike Baird to stop the privatisation of the new Northern Beaches Hospital.

The 30-metre wide billboard, located near the junction of Condamine Street and the Burnt Bridge Creek Deviation at Balgowlah, features 22 local nurses and midwives from both Manly and Mona Vale hospital branches.

THE LAMP OCTOBER 2014 | 15

PROTECTING PUBLIC HOSPITALS

September saw a flurry of activity with a rally outside the site of Sydney’s new Northern Beaches Hospital and nurses and midwives letterboxing local neighbourhoods. On September 3, members from the Manly and Mona Vale branches visited the office of local MP and Premier Mike Baird to deliver postcards written by concerned members of the public.

16 | THE LAMP OCTOBER 2014

Take action against the privatisation of the Northern Beaches Hospital The NSWNMA has set up a website at keepitpublic.org.au which has information and resources for our campaign against the privatisation of the new Northern Beaches Hospital.

ON THE WEBSITE YOU CAN: Register your support and leave a comment.

Send an email to your state MP against this privatisation.

Send an email to your local newspaper against the privatising of the new hospital.

Sign our petition.

Sign up to our community newsletter.

• • • • •

NSWNMA television ads

“I WAS DEVASTATED WHEN I HEARD PRIVATISATION WAS GOING TO OCCUR AT MY HOSPITAL.” LYN HOPPER, ICU NUM, NSW

The campaign also includes TV ads featuring Manly nurse Lyn Hopper.

THE LAMP OCTOBER 2014 | 17

SAFE STAFFING

Spot checks find Shoalhaven shortages More nurses have been hired at Shoalhaven District Memorial Hospital thanks to a decision by the NSWNMA branch to close beds because staffing levels were unsafe.

“If we had not resolved to close beds to maintain patient safety, it is unlikely we would have got the positive result we did.”

— Annette Alldrick 18 | THE LAMP OCTOBER 2014

THE SHOALHAVEN DISTRICT MEMORIAL Hospital’s 42-bed Medical Ward A was funded and staffed for 33 patients including four monitored cardiac patients. It regularly has 37.

The NSWNMA branch reviewed spot checks on staff numbers over a period of 14 weeks. The spot checks revealed that Medical Ward A fell short of the required 5.5 NHPPD (Nursing Hours Per Patient Day) by an average 70 hours per week.

The branch took its concerns to the hospital’s reasonable workloads committee but management offered no solution.

At a branch meeting the next day members voted unanimously to begin closing beds whenever staff levels fell below the mandated award ratio.

The branch said that, in line with normal practice, emergency cases presenting at the ward would get priority.

Shoalhaven Local Health District scrambled to fill vacant shifts and closed two beds because of a staff shortfall on night shift. The LHD later hired four agency nurses – two RNs and two ENs – for Medical Ward A. NSWNMA General Secretary Brett Holmes says management should have acted sooner in accordance with the Public Health System (state) Award clause 53(s)5, which says “action must immediately commence to rectify the (staffing) shortfall …”

Brett said LHD management needed to recruit additional permanent staff as part of a long-term plan to allow nurses to deliver the safe care that patients deserve, in line with the award.

“We will continue to support our branch members in their efforts to achieve the right balance of staff,” he said.

Branch secretary and delegate Annette Alldrick said the problem had been brewing for many months before nurses carried out the 14-week spot checks.

“When we took the results of the spot checks to the reasonable workloads committee there was still no positive response from management,” Annette said.

“If we had not brought this shortfall to management’s attention and resolved to close beds to maintain patient safety, it is unlikely we would have got the positive result we did.”

Annette said closing beds was a big step but nurses were desperate. She added: “They were prepared to do whatever was needed to resolve the problem because they couldn’t keep working under those conditions.”

Annette said that according to the Award the hospital should review staff numbers every year but had not done so for three years.A staffing review was under way last month (September).

Branch alternate delegate Katherine Higgins, the clinical nurse educator on Medical Ward A, said the staffing situation was made worse because “there are often more vacant shifts than can be filled by the limited casual pool. Management is frequently unable to replace like-for-like, resulting in RN vacancies being filled by enrolled nurses and enrolled nurse vacancies by assistants in nursing.

“The ward often ran on less than the minimum mandated staffing numbers.This created enormous pressures on all nurses and put patient safety at risk,” Katherine said.

“Spot checks allowed us to demonstrate clearly and objectively that the NHPPD staffing was below the minimum Award requirement for a prolonged period.

“When the workload is unmanageable nurses are forced to make choices about what they can and can’t achieve during the shift.This inevitably means that patient care is compromised and the risk of adverse patient outcomes is increased.

“Nurses’ documentation also becomes less than ideal, putting them at risk from a medico-legal perspective.

“Once the branch took the decision to close beds management acted very quickly and the situation improved.”

Katherine says management is planning to reconfigure Medical Ward A, which will alleviate many of the difficulties associated with a 42-bed ward.

She says nurses can help to resolve workloads issues by becoming familiar with the Award and the role of their reasonable workloads committee, adding:“It’s about patient safety which must never be compromised.”

“Once the branch took the decision to close beds, management acted very quickly and the situation improved.”

— Katherine Higgins CNE

How to resolve an issue — follow these steps Remember there is a free NSWNMA smart phone app to help you calculate required nursing hours (under the public health system award) and to record hours and patient counts for weekly spot checks .

Issues on your unit

Work issues

Individual or professional matters

For example, missed breaks, unreasonable overtime, no access to education, sick leave not replaced, or “like-for-like” not replaced, patient safety, short staffing, poor skill mix.

Work issue not related to workloads but affects more than one person.

For example, collective issues such as parking, security and safety.

For example, pay queries, leave issues, police interviews, coronial matters, fact finding, disciplinary matters or professional issues.

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1

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Report the matter to the Nurse Unit Manager at your ward meeting. On a Nursing Hours Per Patient day ward, ask for a spot check.

Contact your branch representatives.

Contact the NSWNMA immediately on 8595 1234, 1300 367 962 or gensec@nswnma.asn.au.

Include your name and membership number.

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4

If the matter is unresolved at ward level see your reasonable workloads committee (RWC) representative.

Collect data for two weeks then send it, with solutions, to the RWC with your name and ward.

If the issue is not resolved after two RWC meetings, members should follow formal grievance procedures.

THE LAMP OCTOBER 2014 | 19

Survey shows strong support for ratios A comprehensive survey of more than 5000 nurses and midwives has given a ringing endorsement to the effectiveness of our public health system nurse-to-patient ratios.

A STRONG MAJORITY OF PHS NURSES AND midwives recently surveyed by the NSWNMA believe that ratios have had a positive impact and have improved safe patient care.

Almost one in five respondents now works in a ward or unit where ratios apply.

Nearly 70 per cent of RNs or RMs who have experienced ratios directly or through other wards in their workplace, say they have had a positive impact on the workplace.

There were four key reasons identified by respondents as to why safe patient care had improved via ratios:

1

More time to spend with patients, to get to know them, monitor them and “nurse” them – rather than checking off a “to do” list of administering medications.

2 3 4

The level of patient care has improved in general.

Staff feel less stressed, there is better morale and they are better able to cope with workloads.

There are less medical errors and more time to admit patients.

EXTENDING AND IMPROVING RATIOS IMPORTANT A majority – 86 per cent – of nurses and midwives surveyed consider the outcome of extending ratios to be very important to them personally.This was an increase of 13 per cent from a similar survey conducted in 2012.

Ratios were particularly important to those who didn’t yet have them: of this group 94 per cent considered ratios to be very important to them personally.

An overwhelming 95 per cent of respondents believe the extension of ratios is important to the nursing and midwifery professions.

Similarly 97% consider the extension of ratios as important to safe patient care and patient outcomes.

97% OF NURSES AND MIDWIVES SURVEYED CONSIDER THE EXTENSION OF RATIOS AS IMPORTANT TO SAFE PATIENT CARE AND PATIENT OUTCOMES.

SCEPTICAL ABOUT GOVERNMENT COMMITMENT Survey respondents remain skeptical about the Baird government’s commitment to ratios, although there was slightly more optimism than two years ago. Only six per cent of members think that ratios are secure.

More than half – 57 per cent – of members believe the government will remove or reduce ratios.

Only 17 per cent think the government will keep ratios (nine per cent think they will keep them as they are, eight per cent think they will expand them) a figure that is up slightly from two years ago.

Thanks to all member s who participated in the “Have your say in May” survey.

THE LAMP OCTOBER 2014 | 21

RETIREMENT INCOME

Older workers suffer Hockey’s uncaring budget The Abbott government’s decision to raise the pension age will hurt people working in physically demanding jobs like nursing and midwifery the most.

NSWNMA GENERAL SECRETARY BRETT Holmes says the decision to raise the pension age to 70 is cruel and uncaring.

“Many people are not physically capable of working to 70,” he said. “Many nurses and midwives will have no choice but to retire before pension age for health reasons. Denied the pension, they will be forced to live off their superannuation and other savings, if they have any.

“This is particularly so for female nurses who make up 90 per cent of the nursing workforce. Most of them have not had access to superannuation for much of their working lives, because they were raising families.”

Brett points out that before the September 2013 election the Liberals said they had no intention of putting the pension age up to 70.

“The Abbott government has broken

“THIS IS CLOSE TO RECKLESS BY THE FEDERAL GOVERNMENT.” — Trish Power, SuperGuide.com.au

22 | THE LAMP OCTOBER 2014

author of SuperGuide.com.au, says raising the pension age to 70 “without offering supporting policies to transition older workers into a new world of working longer in meaningful employment, is close to reckless by the federal government.”

She said the government’s decision was partly based on a Productivity Commission recommendation and noted: “This same report also recommended that retired home owners should be forced to access the equity in their home to pay for health costs.”

The progressive think tank Per Capita says raising the pension age will hurt those in lower paying, more physical occupations: “The sort of jobs people are likely to stay in longer are managerial and professional jobs, whereas very few people in sales, community work or machinery operation work to a later age”.

another election promise.”

The government announced the move in the 2014 federal budget. It will become law if it passes through the Senate. It will mean that those born from 1966 onwards will have to wait until they are 70 to claim the age pension.

The previous Labor government had already announced a gradual increase in the eligible pension age to 67 for those born after a certain date (see table below).

A pension age of 70 is high by international standards.The United States, Germany, Iceland, Norway and Denmark currently have, or are moving towards, retirement ages of 67. The United Kingdom is increasing the pension age to 68.

The Abbott government’s pension changes have drawn widespread condemnation.

Superannuation expert Trish Power,

When can I get the pension?

The Abbott government wants to make Australians wait longer before they can start drawing the age pension. If its legislation passes through the Senate, the new ages for receiving the pension will be: Born

Age pension age

Before July 1952

65

Earliest start date

From 1 July 1952 to 31 Dec 1953

65.5

1 July 2017

From 1 Jan 1954 to 30 June 1955

66

1 July 2019

From 1 July 1955 to 31 Dec 1956

66.5

1 July 2021

From 1 Jan 1957 to 30 June 1958

67

1 July 2023

From 1 July 1958 to 31 Dec 1959

67.5

1 July 2025

From 1 Jan 1960 to 30 June 1961

68

1 July 2027

From 1 July 1961 to 31 Dec 1962

68.5

1 July 2029

From 1 Jan 1963 to 30 June 1964

69

1 July 2031

From 1 July 1964 to 30 Dec 1965

69.5

1 July 2033

From 1 Jan 1966 onwards

70

1 July 2035

While managers and professionals make up 29 per cent of the workforce, they constitute 46 per cent of those who retire after the age of 70. Labourers on the other hand make up 13 per cent of the workforce, but 21 per cent of those who retire before the age of 55.

Per Capita says the superannuation system massively favours those on higher incomes who are least dependent on the age pension. It notes “over 50 per cent of superannuation tax concessions are paid to Australia’s top 20 per cent of income earners.”

In another blow to the elderly the Abbott government’s budget will change the way the age pension and other pension payments are indexed.

From July 2017 the age pension will increase in-line with the consumer price index (CPI) only, rather than fastergrowing measures such as male average full-time weekly earnings.

Households dependent on the age pension “would fall further into relative poverty under this change” wrote The Guardian’s economics columnist Greg Jericho.

The Association of Superannuation Funds of Australia (ASFA) defines a “modest retirement lifestyle” as one “better than the age pension, but still only able to afford fairly basic activities.”

ASFA estimates the minimum amount required per week to achieve a modest standard of living in retirement is $448 for singles and $645 for couples. However this assumes that retirees own their home outright.

The current maximum age pension payment per week is $383 for singles and $577 for couples.

Greg Jericho says reducing the rate of indexation “will only exacerbate this gap between what the pension provides and what is classed as a ‘modest retirement lifestyle’.”

“MANY NURSES AND MIDWIVES WILL HAVE NO CHOICE BUT TO RETIRE BEFORE PENSION AGE FOR HEALTH REASONS.” — Brett Holmes

THE LAMP OCTOBER 2014 | 23

RETIREMENT INCOME

Pension changes unfair say nurses and midwives Jan Dilworth

The NSWNMA deplores the Abbott government’s decision to lift the eligibility age for the pension to 70.

THE NSWNMA’S RECENT ANNUAL conference said it was wrong to force an older retirement age on occupations such as nursing and midwifery that require hard physical work.

The conference supported a resolution from the Royal Prince Alfred Hospital (RPAH) branch calling on the Association to raise awareness of the issue.

Branch delegate Eleanor Romney said it was unfair to deny nurses and midwives the old age pension until they turned 70.

“Some nurses will be capable of working until 70 but some won’t,” she said. “If you want to keep working to 70, and you’re physically capable, that’s fantastic.

But it’s not going to be true for everyone.

24 | THE LAMP OCTOBER 2014

“THE OLDER YOU GET THE HARDER IT IS TO STAY IN THE WORKFORCE.” — Jan Dilworth

“There is no indication that this change will be accompanied by a concerted effort to find work for older nurses. Are they going to be expected to stay in clinical work until 70?”

Eleanor said that like many women, female nurses who took time out of the workforce to raise families had reduced opportunities to contribute to their superannuation.

She says nurses and midwives will also be hit by other government budget measures such as more expensive loans for university fees.

“It will take longer to pay off university loans, and if nurses take time out of the workforce for family commitments, the

Eleanor Romney

“ARE NURSES EXPECTED TO STAY IN WORK UNTIL 70?”

— Eleanor Romney university debt will keep accumulating.

All this will further restrict their capacity to contribute to their superannuation.”

RPAH BRANCH DELEGATE AND ASSISTANT branch secretary Jan Dilworth has worked as an RN and RM for more than 40 years.

She said she “made the decision some time ago to seek a role that was less demanding in terms of rotating rosters, night duty and work expectations.

“It was not a decision made lightly, as patient care is essentially what nursing and midwifery is all about. However if the retirement age goes up to 70, not everyone will get that choice.

“Older nurses and midwives who have

experience on their side are more likely to have to continue working rotating rosters, including nights, which can be physically and emotionally demanding.

This workload is not always sustainable as individuals age.

“The budget announcement is not likely to affect my entitlement to the age pension, but younger adults, including my children who were born in the eighties, will have to remain in the workforce until they are 70.”

More than 38 per cent of nurses are aged over 50 according to the Australian Nursing and Midwifery Federation. The average age of employed nurses in 2011 was 44.5, up from 43.7 in 2007.

Consequently many nurses and midwives are approaching retirement age and “pushing the boundaries in caring for their patients who now have more complex health issues, thus making the physical nature of the work, shift work and the expectations of the role much harder,” Jan said.

“The older you become the harder it is to stay in the paid workforce. By raising the pension age, the government is taking away people’s choice about when they can stop work.

“Most nurses and midwives won’t be able to afford to live off their savings or superannuation while waiting to become eligible to receive the pension.”

THE LAMP OCTOBER 2014 | 25

RETIREMENT INCOME

Mining magnates pocket your super A tawdry deal between Tony Abbott and Clive Palmer to delay the increase in compulsory superannuation from nine to 12 per cent by seven years will cost Australian workers $125 billion in collective retirement savings by 2025 according to the ACTU.

THE INCREASE IN THE AGE FOR THE AGE pension to 70 for workers born after 1965 will give Australia the world’s highest official retirement age.

Now Tony Abbott has delivered the other half of the double whammy to workers’ retirement by delaying the increase in compulsory superannuation from 9 to 12 per cent by seven years, in a behind-the-scenes deal with mining magnate Clive Palmer.

The increase in superannuation was to be funded by the mining tax, which has now been repealed. Tony Abbott, Joe Hockey and finance minister Mathias Cormann claim the changes mean workers will end up with more money in their wage packets.

“This is plainly wrong,” Gary Weaven, former ACTU assistant secretary and now chair of Industry Funds Management said.

“There is simply no mechanism by which a foregone 2.5 per cent increase in super will translate into a 2.5 per cent increase, or any increase, in your pay packet, unless your employer is feeling particularly considerate and benevolent.

“For a start, consider the position of the growing number of people who rely on the minimum wage. Will the government now direct FairWork (Commission) to determine a series of increases to compensate? Fat chance.

“Similarly, will other workers suddenly find that their awards are adjusted to provide increased minimum rates over the next few years? And will the mining companies whose profits will now be higher, both as a result of lower tax and 26 | THE LAMP OCTOBER 2014

lower superannuation contributions, decide to unilaterally pass on the benefits to their employees? Again, extremely unlikely.”

WOMEN THE BIGGEST LOSERS Industry super funds say ordinary Australians will suffer the most from the delay.

Their economic modelling shows that a 25-year-old earning an average wage over their working life is likely to retire with $100,000 less due to the changes.

A 45-year-old earning $90,000 will miss out on more than $60,000, while a 60-year-old earning $100,000 will be short-changed upwards of $10,000.

But women will be the biggest losers.

“Increasing the super guarantee is particularly important for low-to-middle income earners, especially women whose careers are interrupted while they are raising children,” ACTU secretary Dave Oliver said.

A report from the Australia Institute has found that women already end up with only 59 per cent of the superannuation balance of men at retirement age. The proportion of women with no superannuation (38.5 per cent) is also higher than that of men (31.6 per cent).

Dave says there will be serious negative economic ramifications from the decision to delay the superannuation increase.

“It would have delivered greater financial security for workers, addressed the problems of an ageing population and supported the economy with investment in national infrastructure and jobs – but Tony Abbott and Clive Palmer’s dirty deal

scraps all of that,” he said.

The minerals resource rent tax was supposed to fund the cost to government of increasing the super guarantee rate to 12 per cent by 2019/20, through annual increases of 0.25 per cent.

The super contribution has already risen to 9.5 per cent, but will now stay at that rate until 2017, when it will increase by 0.5 per cent annually until it reaches 12 per cent.

UNION PUSH FOR SUPER INCREASES The ACTU says unions will push workplace claims to claw back the superannuation increases.

“Australian workers cannot afford any delay in increasing the superannuation guarantee from 9 per cent to 12 per cent so we’ll fight to lock these increases in at the workplace level now,” Dave said.

“More than four million Australian workers are covered by enterprise bargaining agreements and unions will be fighting to get clauses into all new agreements that will see workers get the increases to their superannuation that they were counting on.

“Employers would have already budgeted and planned for this increase in the superannuation guarantee so there is no reason for them not to do the right thing by their workers and pass it on instead of pocketing it.

“Unfortunately, we don’t expect employers to line up to give workers what they deserve so Australian unions will fight for it.”

1

2

3

What they had to say 4

1. Gary Weaven, chair Industry Funds Management “The legislative outcome achieved by the government is basically a transfer of wealth from working people to the mining sector.”

2. Greens leader Christine Milne “If ever there is a conflict of interest, it is this one. How is it possible that you can have a coal billionaire voting to vote down a mining tax?”

3. David Whiteley, chief executive Industry Super “It will mean less investment in productivity-enhancing infrastructure, more pressure on future federal budgets due to increased reliance on the pension, and the creation of a two-tier super system, with inequitable access to tax concessions depending on income.”

4. Dave Oliver, secretary ACTU “Increasing the super guarantee is particularly important for lowto-middle income earners, especially women whose careers are interrupted while they are raising children.”

5. Tony Abbott, Prime Minister “By delaying the increase in the superannuation guarantee levy we are keeping more money in workers’ pockets.”

5

Key figures Abbott’s super changes will see a 25-year-old average income earner lose around $100,000 throughout their working life.

The changes will cost Australian workers $125 billion in collective retirement savings by 2025.

The delay in the increase of the super guarantee, with the scrapping of the low income super contribution scheme, will hit national savings by a staggering $150 billion by 2025 (source: Industry Super Australia).

The axing of the mining tax will cost the federal budget $6.5 billion.

Women retire with only 59% of the superannuation balance of men (source: Australia Institute).

THE LAMP OCTOBER 2014 | 27

COMMUNITY NURSES

Nurses win parking permits Community alliance wins support from Sydney councils to help nurses find parking.

How to get involved

COMMUNITY NURSES WILL FIND IT A LOT easier to make home visits in Sydney’s inner west following a decision by two councils to provide special parking permits for community nurses and home care workers.

Marrickville and Leichhardt councils approved the permits after a campaign by the NSWNMA in coalition with community groups.

Marrickville and Leichhardt councils join the City of Sydney Council, which already has a special care worker parking permit in place.

The campaign for the permits was led by the Sydney Alliance, a coalition of unions, community groups, religious organisations and schools, that uses the tools of community organising to make the city a better place to live.

The campaign involved the NSWNMA working with organisations such as the NSW Cancer Council, St Brigid’s Parish in Marrickville, the Justice and Peace Office of the Catholic Archdiocese of Sydney and United Voice to lobby the councils.

Registered nurse Barbara Ackroyd of Marrickville Community Health Centre says exemption from parking fees and time limits in crowded inner city streets is an important breakthrough.

“We are very grateful to the councils and the union, which has given us fantastic support,” Barbara said.

“The Balmain–Leichhardt area is terribly busy with narrow streets and onehour parking is common.You are lucky to get a spot let alone to be able to move your car to another spot nearby.And meters are often broken.”

Barbara got involved in the campaign and addressed Marrickville councillors before they voted on the permits.

28 | THE LAMP OCTOBER 2014

‘IT’S REALLY IMPORTANT THAT I DON’T HAVE TO WORRY ABOUT GETTING A PARKING TICKET.’ — Barbara Ackroyd RN

She explained that community nurses and home care workers were spending more and more time searching for vacant car spaces, reducing the time they could spend with clients.

“I work in palliative care so I can never tell how long I’m going to be with a patient and family. It’s really important that I don’t have to worry about getting a parking ticket,” Barbara said.

“It is also important from an occupational health and safety point of view that we don’t have to carry loads of equipment great distances.

“The councillors gave us a really good reception.

“They said they understood how difficult our job was. They were keen to help us do our job efficiently and safely without being put under pressure.”

Sydney Alliance spokesperson Rita Martin, a NSWNMA organiser, said previous attempts by the local health district and unions to achieve parking permits had failed.

“The recent campaign for care worker parking permits was a great example of what can be achieved when people work in coalition to identify and respond to local issues,” she said.

Sydney Alliance and the NSWNMA invite nurses to attend community meetings to discuss citywide concerns, such as affordable housing and public transport, as well as local issues, such as palliative care and lymphoedema services in northern Sydney.

Come to your local meeting to find out what is being done to create real improvements in your community.

To register for the meetings listed below visit the website www.sydneyalliance.org.au/actions.

Mention that you are a NSWNMA member when you register.

Western Sydney District Wednesday October 29, 6pm Venue TBC – Parramatta Northern District Thursday October 30, 6.30pm Mercy Catholic College Chatswood.

Nepean Valley District Sunday November 9, 1 pm Padre Pio Catholic Church Glenmore Park TRAINING The NSWNMA will host a two-day training session for nurses and midwives interested in learning about community organising. The training will be held on Thursday and Friday, 6-7 November, at the Association’s head office in Sydney at 50 O’Dea Avenue Waterloo.

For more information follow this link: www.sydneyalliance.org.au/2_day_ training

2014 ANNUAL CONFERENCE

Life members give us heart and soul

Conference celebrates Elvine’s century

Among the four NSWNMA members awarded life membership at this year’s annual conference was Professor Debora Picone AM. D EBORA P I CON E WORKED I N TH E public health system for 36 years and was the first nurse to be appointed DirectorGeneral of NSW Health, a position she served with distinction from 2007 to 2011.

She joined the NSW Nurses’ Association in 1975.

“I hadn’t planned to be overly involved except I used to go to the branch meetings faithfully and my tutor sister told me to take the notes, so that automatically made me branch secretary and then of course the rest was history,” Debora told the Association’s annual conference as she accepted her award.

“So I want you to know that I was no slouch when I was in the union and I did a lot of things – I know that some of it’s in dinosaur-land time, but a couple of them were pretty good,” she said.

“I think our founders would be very proud of us today. This Association was founded for a noble cause and that cause is as real today as it was back in 1932.

“Nurses hold a very special position

in the hearts of the community – I don’t need to tell you that – and for all of us, exercising leadership gives meaning to our lives, it allows us to contribute to the lives of others and in many small and sometimes large ways, we get to make the lives of other people better.

“What unites us is something that is greater than all of us; we are a part of a profession that every year makes the lives of millions of people better.

“We teach and research and these traditions and services are carried on. It is the Association that looks after us.

“I am so proud of the Association, I really am – I tell Brett and the team this regularly – you strive valiantly, you maintain your value system, you know no fear, you are brave and courageous souls, you are daring and you are generous.

“I am so proud of you. I will cherish my award forever, it is the most important award that’s ever been given to me because it’s been given to me by my profession.”

Annual conference broke from traditional proceedings this year to mark an incredible milestone in the life of nurse Elvine Elliot Horsfall. Born 17 days after the outbreak of WWI, Elvine began her early working life as a teacher before beginning her nursing career in Cowra in 1940. Over the years she held numerous nursing positions in Cowra, Orange and Sydney, including seven years as supervisor at the Edith Cavell Memorial Home for retired army nurses.

Elvine has been a member of Association for 68 years and received life membership in 1990.

Attendees at our 2014 annual conference joined Association officials in wishing Elvine a very happy 100th birthday.

Life members 2014 Four NSWNMA members were awarded life membership at this year’s annual conference: Lorraine Emerton (ex Goulburn Base Hospital branch) Robyn Bean (ex Milton-Ulladulla Hospital branch) Gai Pickering (ex St George Hospital branch) Debora Picone AM (First nurse to become director general of NSW Health) THE LAMP OCTOBER 2014 | 29

2014 ANNUAL CONFERENCE

Passing on the courage Women are the dominant users of social media and it is enabling them to be heard as never before. But there has been a backlash, warns social commentator and writer Jane Caro.

BEFORE HE ATTACKED FORMER PRIME Minister Julia Gillard and several other high profile women, radio shock jock Alan Jones should have read poet Robert Congreve who wrote way back in 1697 that “hell hath no fury like a woman scorned”.

Jones’ comment that women were “destroying the joint” created one of the greatest outpourings of female rage the world has seen, thanks to a Twitter hashtag that went viral.

Advertising executive and writer Jane Caro created the hashtag #destroythejoint one Friday night. She was reading angry tweets about Jones’ comment. Women were defending themselves.

“The problem was the tone of voice. If you’re defending yourself that means you have something to defend,” she told NSWNMA annual conference.

To change the tone from the defensive 30 | THE LAMP OCTOBER 2014

she tweeted: “I’ve got time on my hands tonight so I’m coming up with ways to #destroythejoint, being a woman and all.

Ideas welcome.”

What followed were feisty, ribald, funny and thoughtful suggestions on how to go about the task of joint destruction. But in the short term, women may have scored an own goal.

“I think there’s a tremendous fear of the fact that women all over the world have stepped out of their box and they can now have unmediated access to the public conversation for the first time in history,” Jane said.

“It’s why we’re seeing a tremendous resistance to women getting ahead, why we’re seeing a real rollback on reproductive rights in the United States, which is quite frightening.

“Why we’re also seeing some of the

things going on in places like Iraq and Afghanistan where women are starting to lose what few rights they have. Why in Australia we have just one woman in federal cabinet.”

In India, the Dalit women, the most untouchable of the untouchables, are rebelling against millennia of extreme oppression, marching in the streets against gang rapes.

“Those rapes are not new, they’ve been going on for a very long time.What’s new is that women are able to contact one another about the terrible things being reported by a whole lot of other women and then they feel encouraged to take to the streets,” Jane told the conference audience.

“The literal meaning of encourage means to pass on courage and that is what social media is doing for women; so you

“THE MESSAGE BEING SENT TO WOMEN, PARTICULARLY TO YOUNG GIRLS, WAS ‘DON’T YOU ASPIRE FOR HIGHER OFFICE GIRLIE BECAUSE WE’LL EVISCERATE YOU IF YOU DO’.”

—Jane Caro

don’t feel like the lone voice any more, or the lone group.You know that just as there are people who disagree with you, there are many, many people who agree with you and that helps.”

But, she says, it is important for women to keep speaking out.

“We mustn’t get so afraid of the backlash that we forget about the extraordinary sense of community support, mischievously and with fun and excitement and power, that women are finding with one another in social media, which, by the way, we dominate.”

Jane believes while some of the sexism directed at former Prime Minister Gillard

by Alan Jones and others was unconscious, some was deliberate.

“The message being sent to women, particularly to young girls, was ‘don’t you aspire for higher office girlie because we’ll eviscerate you if you do.’

“Politics is a hostile scene for everyone.

I can be as rude about prime ministers, including, perhaps particularly, our current one, as anyone else. But I’m not rude about him because he’s a man.

“I’m rude about him for a whole lot of other reasons. I think criticism of Julia Gillard was entirely justified as long it was about her policies and her actions as Prime Minister.

“But when she was pilloried and crucified for being a woman then we entered different territory.”

Jane believes society is still caught up in the old “either or” dichotomy for women.

“A woman can be either the angel of the house, the sanctified woman, the saviour of all, the wonderful mother Madonna type figure. Or she can be the whore, the bitch from hell; but there’s nowhere in between.

“The problem for women and particularly I’d say for women in your profession, a caring profession, is that we are still stuck in a world that believes that whereas it’s perfectly acceptable for men to do things for money, women are still expected to do them for love, and when I say love I mean for nothing.

“We incorporate this sense of having to do things for nothing to earn our right to exist. It’s an observation I’ve made of women that they often feel they don’t have a right to be; they have to earn their right to exist. So they’re always justifying their existence by performing service for others.

“It’s my observation that men, and I have laboured mightily to take a leaf from their book, think they they’re pretty special just damn being.”

THE LAMP OCTOBER 2014 | 31

2014 ANNUAL CONFERENCE

Sex and persecution Consensual same sex activity is against the law in 78 countries and is a capital offence in seven of those. Australia recognises sexual orientation and gender identity as valid grounds for asylum, but there’s a lack of cultural sensitivity in applying the law.

IMAGINE BEING ASKED TO PROVIDE LETTERS from people you have had sex with, in order to confirm to a government official that, yes, you really are gay, lesbian, bisexual, transsexual or intersexual* (LGBTI).

And imagine that you are asked to do this because you have fled from a country where you faced enormous discrimination, not only from police or legal authorities but also from a medical profession that has stigmatised your sexuality or gender identity as ill, perverse or sinful.

Yet according to rights advocate and Sydney Law School teacher Sen Raj “people are being coerced into sexual activity in order to be recognised as a LGBTI refugee.”

Sen was speaking at the 2014 NSWNMA Professional Day. “There are horrible stories about migration agents encouraging applicants to go out clubbing to meet with people, to get letters of,‘yes I slept with this person therefore they’re gay,’ in order to authenticate their sexual lives,” he said. “This is enormously troubling because a lot of people haven’t had any sexual experiences and that’s part of the reason that they have fled persecution because they see what that might entail.Yet they’re required to prove their sexuality through those means.”

Instead there should be an interdisciplinary approach involving law, policy, medicine, science and social work in assessing and dealing with LGBTI refugees, Sen says. There should also be cultural training to avoid stereotyping.

“Instead of talking so much about 32 | THE LAMP OCTOBER 2014

proving people’s sexual development in terms of what’s their identity, when did they discover they were gay, how many sexual partners have they had, how well versed are they in Oscar Wilde and Greco-Roman wrestling, we should be talking about things to do with their own narrative.

“Let them talk about when they knew they were different, when did that difference become something that was stigmatised or something they knew was bad, when did that stigma become something that caused them shame or humiliation or fear and how that led to particular harms and what sort of harms they faced because of that,” Sen said.

But he says Australia’s current asylum system demands compliance with narrow stereotypes and that is re-traumatising people.

“They are now being forced to engage in particular activities and experiences because they feel that’s the only way they’ll have their stories respected and recognised.

“There are a lot of people who we might label with terms like lesbian, bisexual, transgender, queer or intersex, who come from communities and cultural contexts where those terms have no resonance. It’s important when we talk about the intersections of refugee issues and LGBTI issues to first recognise that the labels themselves can be quite troubling “What they’re dealing with is trauma and it’s often enormously difficult to expose your story to people who are disbelieving of your narrative or your identity

or questioning your legitimacy as someone who is gay or lesbian, because you fail to conform to some stereotype or another.

“A lot of people feel a lot of internalised shame and stigma and aren’t willing to disclose that their basis of persecution is sexual orientation and gender identity.

“Not only do they carry that burden of silence and shame, they’ve created a psychological internalised stigma, a kind of careful thought and differences in approach that aren’t always reduced to a one-size-fits-all model.”

A lot of questions asked of LGBTI asylum seekers assume narratives about their need to have sexual contact, in order to know if they’re gay.

“I laugh when I read transcripts of these questions and answers and then I think ‘omigod this is real, I’m not reading satire, I’m actually reading an exchange with an administrative decision maker’.

“Do we ask people to identify if they’re heterosexual if they haven’t had any same sex contact? We don’t. It’s important when we’re challenging a lot of these assumptions to realise that people’s experiences of who they are don’t follow these neat progressions, don’t follow neat narratives.

“We need to rethink the cultures and programs and policies we have in place.

Part of the challenge is providing networks so that the groups we’re working with and supporting can lead their own development.” *Intersexuality is a discrepancy between external and internal genitals.

“PEOPLE ARE BEING COERCED INTO SEXUAL ACTIVITY IN ORDER TO BE RECOGNISED AS A LGBTI REFUGEE.” — Sen Raj

THE LAMP OCTOBER 2014 | 33

ASK JUDITH Employer wants my medical records

Change to Medicare item numbers?

I am an RN working in the public sector and have sustained a non-work related injury. I have been using sick leave and have been off work for more than two months. My employer has asked me to sign a consent to release medical information form, so they can receive further information about my medical condition. Can they do this?

The options available to your employer in addressing concerns about your condition are outlined in the Sick Leave Management policy PD2009_050 clause 2.8 Evidence of sickness or incapacity: “… While employers may require the medical certificate to indicate the nature of illness, staff have a right to confidentiality in relation to the reason for sick leave. Where an employer has concerns about the ability of a staff member to perform the duties of his/her position or to do so safely, the employer should: • Seek the staff member’s consent to discuss his/her prognosis with the provider of the medical certificate, or, if the staff member does not consent to this • Seek a second medical opinion.”

You cannot be forced to sign the consent form; however your employer may ask you to attend an independent medical examination at their expense.

I am an RN Practice Nurse working for a small regional general practice, performing home visits. Can I still assist a medical practitioner in conducting Medicare Benefit Scheme (MBS) Health Assessments and can my practice still claim “nurse time” via Medicare item numbers, or has the federal government recently changed this arrangement?

An RN Practice Nurse can still assist a medical practitioner by undertaking the information collection stage of a health assessment and by providing patients with information about recommended interventions at the direction of the medical practitioner. In the first half of 2014 the federal government, via the Department of Human Services, issued revised factsheets explaining which MBS item numbers can be claimed by GPs, and this includes the time spent by nurses in performing health assessments. Fact sheets explaining the current MBS Health Assessment Items can be found at: www.health.gov.au/internet/main/publishing.nsf/ Content/mbsprimarycare_mbsitem_general_factsh eet The NSWNMA and the Australian Practice Nurses Association (www.apna.asn.au) continue to monitor the federal government’s policy changes in this area and oppose any adverse changes that would cause economic loss to practice nurses or their practice.

Returning early from maternity leave

Getting ready to retire

I am employed as an EN at a public hospital and am currently on maternity leave. When I commenced maternity leave I advised my manager of my return date but since then my circumstances have changed and I wish to come back earlier. Can I do this?

Yes you can, as per clause 34 (vi) of the Public System Nurses and Midwives State Award which reads: “After commencing maternity leave, an employee may vary the period of her maternity leave, once without the consent of her employer and otherwise with the consent of her employer. A minimum of 14 days’ notice must be given, although an employer may accept less notice if convenient.

The conditions relating to variation of maternity leave are derived from Section 64 of the Industrial Relations Act 1996.”

This means that you can change your return date once, without permission, as long as you have given a minimum 14 days’ notice in writing.

I am an AiN working for a private aged care provider and am considering retiring in the next few years. Due to my limited financial situation I will be seeking to go on the aged pension. Should I be concerned about changes the federal government is introducing regarding the qualifying age for the aged pension?

The changes to the qualifying age for the aged pension will affect those planning to retire in the next few years and who are hoping to qualify for the aged pension.

Women born before 1 January 1949 currently reach the pension qualifying age at 64 and a half, and women born between 1 January 1949 and 30 June 1952 at age 65.

The qualifying age for men born before 1 July 1952 is currently 65.

From 1 July 2017, the qualifying age will increase from 65 years to 65 and a half years and will then rise by six monthly intervals every two years, reaching 67 by 1 July 2023.

The aged pension is also subject to income and asset means testing and Australian residency requirements.

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

The NSWNMA recommends that you obtain independent financial advice prior to retiring. For more details visit the Department of Human Services website at: www.humanservices.gov.au/customer/services/cent relink/age-pension

Taking adoption leave I am an RN in the public health system and need to travel overseas in the near future, at short notice, to take custody of an adopted child. How much notice do I have to provide to my workplace for taking adoption leave?

The Public Health System Nurses and Midwives State Award 2011 under clause 34 states as follows: “34(b)(iii) Applications – Due to the fact that an employee may be given little notice of the date of taking custody of a child, employees who believe that, in the reasonably near future, they will take custody of a child, should formally notify the employer as early as practicable of the intention to take adoption leave. This will allow arrangements associated with the adoption leave to be made.”

“34(b)(iv) Variation after Commencement of Leave – After commencing adoption leave, an employee may vary the period of leave, once without the consent of the employer and otherwise with the consent of the employer. A minimum of 14 days’ notice must be given, although an employer may accept less notice if convenient.”

We suggest that you notify your employer that you are anticipating taking adoption leave and also advise them of how much time you think you may be taking.

Patient asked me about will I am an RN working in the public health system. If a patient has approached me in relation to a will, should I decline to become involved in the issue?

Yes. The new NSW Health Information Bulletin IB2014_022 Will Making in Public Health Facilities states that: “Staff should not generally canvass the issue of wills except in extreme circumstances.

Under no circumstances should a staff member be involved in the preparation of a patient’s will or attempt to exert influence in regard to the terms of a patient’s will. If nominated as the executor of a will, a staff member should decline the appointment.”

For more information go to www.health.nsw.gov.au/policies/

THE LAMP OCTOBER 2014 | 35

SOCIAL MEDIA

WHAT’S

NURSE UNCUT

HOT

A BLOG FOR AUSTRALIAN NURSES AND MIDWIVES

THIS MONTH

www.nurseuncut.com.au

Do you have a story to tell? An opinion to share? nurse uncut is written by everyday nurses and midwives.

Send us your ideas at nurseuncut@nswnma.asn.au

Nurse Uncut is also on Facebook: www.facebook.com/NurseUncutAustralia and on Twitter @nurseuncut

“So how long have you been nursing?” – Finn’s new grad diary www.nurseuncut.com.au/so-how-long-have-you-been-nursing-finns-new-grad-diary-5

It’s a difficult question to answer for a new grad nurse – Finn asks her peers what they usually reply when patients ask.

ED nurses are different www.nurseuncut.com.au/emergency-department-nurses-are-different

A new study finds that emergency department nurses are more extroverted and open than average, which helps when working in such a demanding workplace.

Stevie’s diary: not “just” an EN www.nurseuncut.com.au/stevies-diary-not-just-an-enrolled-nurse

She’s finished her studies and is soon to start an EN new grad program. Stevie reflects on what she wants from nursing.

Karys: my love of nursing and midwifery (parts 1 and 2) www.nurseuncut.com.au/karys-my-love-of-nursing-especially-midwifery

Karys recently retired on the Central Coast after an eventful 56-year career, including delivering her daughter’s two babies.

Triage! A nursing cabaret www.nurseuncut.com.au/triage-a-nursing-cabaret

Zuleika Khan, RN and entertainer, has written a one-woman comedy that tells true stories of being at the hospital front door.

Anti-bullying seminars strike a chord www.nurseuncut.com.au/anti-bullying-seminars-strike-a-chord/

Aged care nurses were highly appreciative of recent workshops explaining new legislation on workplace bullying.

New on SupportNurses YouTube channel Nurse Helen McCue looks back On the 30th anniversary of Union Aid Abroad – Apheda. >> youtu.be/mTnGzS5UKtw Sending the Premier a message Nurses and community wrote their own signs for this early morning event on the Northern Beaches site. >> youtu.be/Dr9zXpnYeDA

NSWNMA on Instagram!

Yes, we’re on Instagram, so share your local photos with us @nswnma and #NSWNMAforce4change.

Follow us on Twitter NSWNurses & Midwives @nswnma Watch us on YouTube SupportNurses Connect with us on Facebook

New South Wales Nurses and Midwives’ Association >> www.facebook.com/nswnma Look for your local Ratios put patient safety first >> www.facebook.com/safepatientcare Branch page on Aged Care Nurses >> www.facebook.com/agedcarenurses our website.

THE LAMP OCTOBER 2014 | 37

SOCIAL MEDIA

WHAT

Keep me logged in

Forgot your Password?

NURSES & MIDWIVES

SAID & LIKED on facebook www.facebook.com/nswnma Welcoming our new grad diarist

Stevie began her new grad Enrolled Nurse diary for Nurse Uncut and was warmly welcomed.

Super freeze will hit hard The Abbott government’s superannuation freeze will hit nurses and midwives hard.

Extrovert emergency Do you work in Emergency? Apparently you are more likely to be a friendly extrovert than the average Australian!

Answering that awkward question “So how long have you been nursing?” Finn’s latest diary entry for Nurse Uncut tackles how the new grad should answer that awkward question.

Pyne’s stereotypes We asked if you’d seen Christopher Pyne on the 7.30 Report. Host Sara Ferguson asked Pyne if his uni fees plan would hurt women and poorer students more than wealthy students. His answer was astounding. To paraphrase: women study teaching and nursing, men study law and dentistry, law costs more than nursing, therefore women will pay less for nursing. Our readers were not amused.

PHOTO GALLERY

Nurses loved this meme and shared it in droves.

As a student EN, one year behind Stevie, I’m so excited to have this blog to read.

Congrats on your new grad position. I coordinate a large program up here in North Qld and am going to read your blog to my new EN grads that start in a few weeks!

Congratulations Nurse Stevie, welcome to the wonderful world of nursing. The world is now your oyster and can open up some amazing opportunities. I graduated as an EN back in 1997, then did my Parentcraft Certificate and here I am actually precepting new grads and students in the operating theatres. Good luck hunnie, you will do well.

As a grad EEN, we are not just an AiN with the capability to give meds (as I have been told before)! We go through a tough jam-packed 18 months of hard work to learn what we learn!

Does this mean we get back paid the part of the increase they didn’t give us because of the super increase? I think not!

The federal government has said that employers will pass on the lack of super increase as a wage rise. Does this mean that public sector nurses in NSW will receive a pay rise to compensate? After all they took the super increase from our last pay rise.

I never cease to be appalled by this government. Penalty rates next on the agenda ... they will attack us at every turn.

Does it say anything about being awesome?

I have amused myself with my own theories about personality types based on ward.

Haha, always said you was special!

Include your training years in your answer and tell them how long you’ve wanted to be a nurse.

I often tell my patients it’s great when I have a student buddied with me as they are so up-to-date with the research.

36 years, hospital trained ... and honestly? Ready to hang up my stethoscope ... over it!

You young’uns can have it. Lead the way, my time is done. Good luck.

41 years. Such a great privilege but also an incredible struggle. Getting close to handing over to the next generation.

In its 2013 Annual Report, Sydney University reported that as at 31 March 2013, women made up 55.8% of full-time undergraduate enrolments and 58.7% of full-time postgraduate students. Not sure how you could possibly say women wouldn’t be hurt more.

Chris Pyne studied law. It just goes to show that an expensive education doesn’t necessarily produce people with sensible ideas!

How disrespectful and sexist!

So on that basis, as a guy about to start studying nursing, do I pay less as a nurse (cheaper course) or more because I’m a guy?

Booooo!

Aged care members on the Northern Beaches came to our pop-up campaign shop for morning tea.

Disability nurse Noelene Williams found support from firies for our petition against privatisation.

Gilgandra branch members say “Medicare co-pay, no way!”

THE LAMP OCTOBER 2014 | 39

test your

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Across 1. A subnormal concentration of fibrinogen in the blood (16) 9. Recent or new (3) 10. A patient who is recovering from a disease, operation, or injury (12) 11. Ankles (5) 12. Inducing to vomit (8) 14. Total destruction or disintegration (4) 15. Relating to the branch of medicine concerned with pregnancy and childbirth (9) 17. Another side of oneself; a second self (5.3) 19. An earpick (9) 22. Disorder characterized by a short attention span, impulsivity, and in

some cases hyperactivity (1.1.1) 24. Any disease of muscle (8) 28. Denoting a disease brought into a region from elsewhere (7) 30. Dideoxycytidine (1.1.1) 31. Ocular albinism (1.1) 32. The compound joint between the femur, patella, and tibia (4.5) 34. The lower jaw of a vertebrate animal (8) 36. Silicon (2) 37. Artificial insemination (1.1) 38. A circular or slightly oval amputation in which a long incision is made in the axis of the limb (6.10)

Down 1. A cardiac murmur not associated with a heart lesion (10.6) 2. Biological weapons (7) 3. Pruritus (9) 4. A unit of mass equal to 1/16 of a pound avoirdupois or 28.349 grams (5) 5. The enamel covering the crown of a tooth (6.3) 6. Dutifully complying with the commands (8) 7. A hard crust or scab (6) 8. Endogenic toxicosis (16) 13. To seal or fasten with wax or cement (4)

16. To stretch out or put forth; to grasp or attain by extending or advancing (5) 18. Relodge (9) 20. An acid which forms a red color with ferric salts (8) 21. The biologic unit of heredity (4) 22. Auris dextra (1.1) 23. Diabetes mellitus (1.1) 25. Palladium (2) 26. Not passive (6) 27. A connecting structure, jugum (4) 29. A group of atoms (4) 33. Expel (4) 35. Left frontoanterior fetal position (1.1.1) 37. Gold (2) THE LAMP OCTOBER 2014 | 41

EDUCATION@NSWNMA

WHAT’S ON OCTOBER 2014

all our courses can be booked online! www.nswnma.asn.au/education ——— • ———

Practical Strategies to Manage Stress and Prevent Burnout – 1 day 29 October NSWNMA Waterloo Members $85 Non-members $170 ——— • ———

Foot Care for Nurses – 2 days 29-30 October Ballina Members $203 Non-members $350 ——— • ———

Tools in Managing Conflict and Disagreement – 1 day 13 November Gymea Members $85 Non-members $170 ——— • ———

Policy and Guideline Writing – 1 day 13 November NSWNMA Waterloo

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

Are you meeting your CPD requirements? – ½ day 20 November Grafton 2 December Broken Hill – note change of date Suitable for all nurses and midwives to learn about CPD requirements.

Members $40 Non-members $85 ——— • ———

Legal and Professional Issues for Nurses and Midwives – ½ day 21 November Grafton 3 December Broken Hill – note change of date Topics include Health Practitioner Regulation National Law, potential liability, the importance of documentation, the role of disciplinary tribunals and writing statements.

Members $40 Non-members $85 ——— • ———

For more information about specific courses phone Matt West on 1300 367 962.

Update Me? Would you like to be notified by email of upcoming NSWNMA Education seminars in your area? Send us an email with the subject line “Update Me” as well as your name, member number and preferred email address to:

education@nswnma.asn.au

NURSING RESEARCH ONLINE

The Australian Journal of Advanced Nursing aims to provide a vehicle for nurses to publish original research and scholarly papers about all areas of nursing. Papers develop, enhance, or critique nursing knowledge.

Sleep quality in the elderly either living at home or in a nursing home Gulseren Daglar RN PhD, Cumhuriyet University, Silvas, Turkey, Sukran Ertekin Pinar RN MSN, Cumhuriyet University, Selma Sabanciogullari RN PhD, Cumhuriyet University, Professor Sultan Kav RN PhD, Baskent University Ankara, Turkey.

The aim of this study was to analyse sleep quality and the factors affecting it in the elderly living at home or in nursing homes.

There are many factors affecting sleep quality in older adults, including respiratory problems during sleep, restless leg syndrome, nocturia, pain, osteoarthritis, heart failure, incontinence, prostate hypertrophy, menopause-related problems, pruritus, allergies, Alzheimer’s, depression, dementia, social isolation, loneliness, being bedridden, experiences of loss, drug use, and living in nursing homes. (Akkus and Kapucu 2008; Eser et al 2007; Goktas and Ozkan 2006).

Some of the consequences of poor sleep quality in the elderly include cognitive decline, increased risk of falls, daytime fatigue, reduced physical and mental health and health-related quality of life status (Bilgili et al 2012).

Better quality of life in elderly people can be achieved by increasing sleep quality as well as promoting good sleep. In order to improve their quality of life and health status, the assessment of sleep characteristics by health-care providers, especially by nurses, is essential and is an important caring activity.

Nurses play an important role in recognising the negative effects of sleep disturbances. In the assessment of the sleep characteristics of the elderly, taking a detailed history, sleep hygiene, sleep patterns, diseases and drugs should all be evaluated (Ulusoy Kaymak et al 2010; Beck-Little and Weinrich 1998).

Health care professionals should be aware that the sleep problems of the elderly are an integral part of life. Close observation to detect signs of sleep problems and insomnia, listening carefully to what they say about sleep problems and their complaints about sleep, evaluating their sleeping habits and influencing factors, and implementing interventions for the problem are important (Chen et al 2010; Lai and Good 2005; Ancoli-Israel 2004). www.ajan.com.au/Vol31/Issue4/1Kav.pdf

Introduction of a novel, mobile, nurse-led prostate cancer (PCa) education and testing service Helen Crowe RN, BAppSci (Adv Nurs), GradDip EpiBiostats, MNursSci (NP), Epworth Prostate Centre, Richmond, Victoria, Australia, Patricia Bugeja RN, MNurs, Epworth Prostate Centre, Dr Addle Wootten BBSc (Hons), DPsych (Clin), MAPS (CClin), Epworth Prostate Centre, Nicholas Howard RN, Urology Research Nurse, Epworth Prostate Centre, A/Professor Declan Murphy MB, Bch, BaO, FRCS Urol, Epworth Prostate Centre, Ben Challacombe BSc (Hons), MS, FRCS (Urol), Consultant Urologist, Epworth Prostate Centre, Professor Anthony Costello MBBS, FRACS, FRCSI (Hon), MD, Senior Urologist, Epworth Prostate Centre.

The aim of this paper was to describe the development and evaluation of a mobile, nurse-led PCa education and testing service. PCa remains a controversial health issue for men, with ongoing debate about the risks and benefits of testing and treatment (Chapman and Barratt 2010; Myers et al 2005; Weinrich et al 2003) and guidelines offering conflicting advice.

It is the most common cancer affecting Western males (Ferlay et al 2010), accounting for almost a third of male cancer diagnoses in Australia in 2007, with 3000 being the second leading cause of male cancer deaths (AIHW 2012).

Conflicting advice about undergoing testing for PCa means that general practitioners may be uncertain about what to recommend, and men may not receive information to allow them to make an informed decision.

This nurse-led service offers a novel means of providing men with information about the risks and benefits of PCa testing and treatment, both in a group setting and through individual consultation, thereby allowing men to make an informed choice about whether or not to undergo testing, and then providing an opportunity for testing. www.ajan.com.au/Vol31/Issue4/2Crowe.pdf

The effects of workplace bullying on physicians and nurses Associate Professor Dilek Ekici RN, PhD, Gazi University, Ankara, Turkey, Assistant Professor Alper Beder, MD, PhD, MSc, Baskent University, Ankara, Turkey.

In general, bullying consists of the behaviour targeted at a person to humiliate and stigmatise socially. It also aims at sabotaging the victim’s reputation by attacking their character and professional competence.

A person can experience bullying at work from managers, supervisors, co-workers or subordinates (Yıldırım and Yıldırım 2007). The major difference between “experienced” bullying and “intentional” bullying is the frequency and longevity of the negative behaviours.

The effects of deliberate and systematically repetitive psychological oppression become evident as a collection of injuries gradually develop in the individual (Dilek and Aytolan 2008).

These individuals experience a variety of physiological, psychological and social problems that are related to the intense stress and anxiety of bullying (Johnston et al 2010; Einarsen et al 2009).

In the literature, people exposed to long term and persistent bullying at work have been reported to have low self-esteem and selfconfidence (Cleary et al 2010; Einarsen et al 2009; Hoosen and Callaghan 2004) and to suffer from social isolation, stigmatisation and ill-adjustment (Johnson 2009; Hutchinson et al 2008;) as well as demonstrating anxiety, aggression, depression or depression-related symptoms.

Many bullying victims have been known to demonstrate symptoms of post-traumatic stress disorder (MacIntosh et al 2010; Yıldırım 2009) and some have reportedly attempted suicide (Yıldırım 2009; Yıldırım and Yıldırım 2007).

On the other hand, individuals experiencing bullying at work have poor job satisfaction, work performance, motivation and efficiency, while their social relations suffer at work and home (Johnston et al 2010; MacIntosh et al 2010; Yıldırım 2009; Hutchinson et al 2008).

It is clear from various statistical studies and analyses that this situation is alarming for the workers and damaging for the facility (Johnston et al 2010; MacIntosh et al 2010; Yıldırım and Yıldırım 2010; Yıldırım 2009; Hutchinson et al 2008).

The obvious detrimental effects bullying has on health professionals make it essential that early intervention takes place and that staff recognise what is happening and prevent further bullying (Schoonbeek and Henderson 2011). www.ajan.com.au/Vol31/Issue4/3Ekici.pdf THE LAMP OCTOBER 2014 | 43

LIONS NURSES’ SCHOLARSHIP Looking for funding to further your studies in 2015?

The trustees of the Lions Nurses’ Scholarship Foundation invite applications for scholarships for 2015.

Nurses eligible for these scholarships must be resident and employed within the State of NSW or ACT. You must currently be registered with the Nursing and Midwifery Board of Australia and working within the nursing profession in NSW or the ACT, and must have a minimum of three years’ experience in the nursing profession – the last twelve months of which must have been spent in NSW or the ACT. Applicants must also be able to produce evidence that your employer will grant leave for the required period of the scholarship.

Details of eligibility and the scholarships available (which include study projects either within Australia or overseas), and application forms are available from: www.nswnma.asn.au The Secretary Lions Nurses’ Scholarship Foundation 50 O’Dea Avenue, Waterloo NSW 2017 or contact Matt West on 1300 367 962 or mawest@nswnma.asn.au

Completed applications must be in the hands of the secretary no later than 31 October 2014.

44 | THE LAMP OCTOBER 2014

Quality legal advice for NSWNMA members c c c c c c c c c

Compensation and negligence claims Employment and Industrial Law Workplace Health and Safety Anti-Discrimination Criminal Law Free standard Wills for members Probate / Estates Public Notary Discounted rates for members including First Free Consultations for members on all matters.

Offices in Sydney and Newcastle with visiting offices in regional areas (by appointment).

Call the NSWNMA on 1300 367 962 and find out how you can access this great service.

THE LAMP OCTOBER 2014 | 45

BOOKS

BOOK ME Introduction to Aging: A Positive, Interdisciplinary Approach Judith A Sugar, Robert J. Riekse, Henry Holstege and Michael A. Faber Springer Publishing Company www.springerpub.com RRP $75.00 ISBN 9780826108807 Introduction to Aging: A Positive Interdisciplinary Approach dispels many of the myths about aging through careful reporting of facts, issues and trends. Included in this book is a discussion of the roles in the family, workplace, and the wider community. Each chapter addresses the issues at hand using extensive research in a simplified, applied manner. The application of important historic and current research to the issues older people face is the primary goal of this text.

Diagnosis Made Easier: Principles and Techniques for Mental Health Clinicians (2nd ed.)

James Morrison Guilford Press (available through Footprint Books) www.footprint.com.au RRP $52.95 ISBN 9780729542081 Diagnosis Made Easier takes the reader step-bystep through diagnostic decision making in mental health. It includes principles and decision trees for evaluating information from multiple sources and constructing valid, clinically useful working diagnoses. More than 100 vivid graphic designs – from the straightforward to the toughest cases – illustrate the practical application of these methods. Essential topics include developing a differential diagnosis, dealing with comorbidity and determining when physical illness may be the cause of mental health symptoms.

Older People: issues and innovations in care (4th ed.)

Rhonda Nay, Sally Garratt and Deidre Fetherstonhaugh Churchill Livingstone (available through Elsevier Health Australia) www.elsevierhealth.com.au RRP $104.95 ISBN 9780729541633 Now in its fourth edition this trusted textbook provides a unique collection of conversations and commentaries by leading international and local experts on a range of contemporary issues around the care of older people. This text reflects new thinking in care and includes the ideas and experiences of policy analysts, nurses, doctors, allied health professionals and the consumer experience, mainly from an Australian perspective but with international contributions based on contemporary research. It also points readers to evidence, where it exists.

SPECIAL INTEREST Sleep Soundly Every Night, Feel Fantastic Every Day: A Doctor’s Guide to Solving Your Sleep Problems Robert S. Rosenberg Demos Medical Publishing (available through Footprint Books) www.footprint.com.au RRP $25.95 ISBN 9781936303724 This is an excellent text that helps find answers to the age old question of why some people are unable to get a good night’s sleep. The book aims to help people identify and understand the symptoms and guide them to the most likely problem or disorder. It also offers practical treatment solutions to help get good sleep straight away and to determine whether consulting a sleep expert would be right for them.

NEW! The NSWNMA Library Catalogue is now online!

Visit www.nswnma.asn.au/library-services-online-library-catalogue/ for the link to open the catalogue, plus instructions on how to use it. Once you have searched by keyword or browsed the subject areas available you can send loan requests directly to the library via a quick online form.

Many online resources can be accessed directly through web links included in the catalogue listing.

Mental Health: A Person-Centred Approach Nicholas Procter, Helen P. Hamer, Denise McGarry, Rhonda L. Wilson and Terry Froggatt Cambridge University Press www.cambridge.org RRP $89.95 ISBN 9781107667723 This book aligns leading mental health research with the human connections that can and should be made in mental health care. It seeks to deepen readers’ understanding of themselves, the work they do, and how this intersects with the lives and crises of people with mental illness. This book adopts a storytelling approach, which encourages engagement with the lives and needs of consumers and carers in mental health. Each chapter features learning objectives, reflective and critical thinking questions, extension activities and further reading.

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 Information and Records Management Centre (IRMC). Contact Jeannette Bromfield gensec@nswnma.asn.au or Cathy Matias 8595 2121 cmatias@nswnma.asn.au. All reviews by NSWNMA IRMC Coordinator/Librarian Jeannette Bromfield. Some books are reviewed using information supplied and have not been independently reviewed.

THE LAMP OCTOBER 2014 | 47

MOVIES

movie of the month

PRIDE Pride is an exposé in solidarity, unionism, support and the achievements that can be brought about when disparate groups of people stand united, writes Meg Collins.

The year is 1984; the archconservative Margaret Thatcher rules Britain with an iron fist and doesn’t wear a velvet glove at all.

Welsh miners are on strike and times are inordinately difficult; both the miners and the British government remain steadfast in their respective positions.

Financially things have become desperate for the miners when they receive an offer of political and financial support from a most unlikely group, the LGSM – Lesbians and Gays Supporting Miners. Homophobia is rife, with the advent of HIV and general ignorance surrounding it. The miners find the idea of support from this group abhorrent and refuse to enter into a discussion with them.

But the LGSM are not deterred and persist in providing the miners with the assistance they so desperately need. Eventually they arrive in the miners’ small Welsh town to confront them.

This is a comedy/drama with an ensemble cast starring Bill Nighy and Imelda Staunton. The screenplay is well written and this is why the film floats.

It is based on a true story and I have been

informed that the screenplay is about 85 per cent truth, 15 per cent fiction.

I found myself lost in the enjoyment of this film. It is heart warming and inspirational and a good example of what can happen when different groups unite in solidarity.

If you’ve had a bad day at the hospital and could do with a really good laugh and some inspiration, I strongly advise you to see this film. Four stars from me!

IN CINEMAS OCTOBER 30 Meg Collins is an RN at the Royal Prince Alfred Hospital, Sydney.

METRO MEMBER GIVEAWAY Email The Lamp by the 12th of the month to be in the draw to win a double pass to Pride thanks to EntertainmentOne. email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

DVD SPECIAL OFFER

Set in a dangerous future world a decade after the collapse of the western economic system, The Rover depicts an Australia without law or order. The country’s natural resources have attracted a range of dangerous opportunists and life is cheap.

When Eric (Guy Pearce), a loner travelling the desolate towns and roads of the outback, has his car stolen, he embarks on a mission to ruthlessly track down the thieves. He soon forms an unlikely partnership with Rey (Robert Pattinson), the naïve younger brother of gang member Henry (Scoot McNairy), who has left Rey behind in the bloody aftermath of the gang’s most recent robbery. Both gripping and terrifying, The Rover’s power lies in its strong relation to reality.

RURAL MEMBER GIVEAWAY Email The Lamp by the 15th of this month to be in the draw to win a dvd of The Rover thanks to Roadshow Entertainment. email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

THE LAMP OCTOBER 2014 | 49

conferences, seminars, meetings

DIARY DATES

diary dates is a free service for members. Please send event details in the format used here: Event name; Date and location; Contact details; by the 5th of each month.

Send your event details to: lamp@nswnma.asn.au Fax: 02 9662 1414 Post: 50 O’Dea Avenue Waterloo NSW 2017. All listings are edited for the purposes of style and space.

RPA Midwifery Conference 2014: Complex Care in Midwifery 1 November Sydney www.slhd.nsw.gov.au/rpa/cmnr rpawb.research@email.cs.nsw.gov.au Australasian Society of Anaesthesia Paramedical Officers National Conference 1-2 November Albury www.asapo.org.au Developmental Disabilities, Challenging Behaviour and Mental Health Conference 7 November Sydney www.sydney.edu.au/healthsciences/cdrp/events/current-events.shtml Midwives on the Tweed 11th Annual Education Day – Galloping Forward 7 November Tweed Heads midwivesonthetweed@iprimus.com.au High Dependency Nursing Conference: Beyond the basics 7 November Westmead Ryan.Thomas@health.nsw.gov.au Connecting for Successful Aging Forum with Hugh McKay 12 November Kingsford 9382 3753 • ACPSforum@gmail.com 6th Australian Rural and Remote Mental Health Symposium 12-14 November Albury www.anzmh.asn.au/rrmh Spotlight on Liverpool Lives: A talk by Dr Jennifer Harrison 13 November Liverpool City Library Cystic Fibrosis Nurses Education Day 14 November Westmead Sharon.simonds@health.nsw.gov.au The Crown Princess Mary Cancer Centre Symposium 21 November Parramatta www.sydneywest.org.au/symposium Diversity and Inclusion in Action – Dementia Symposium 14 November Batemans Bay www.trybooking.com/Booking/BookingEvent Summary.aspx?eid=78365&bof=1 catherine.crowe@gsahs.health.nsw.gov.au

NSW Unions NSW – Work Health and Safety 9 October Sydney rdocwra@unionsnsw.org.au Unions NSW – Injured Workers and Compensation Conference 10 October Sydney rdocwra@unionsnsw.org.au Spirited Women: Residential Retreat for Women Living with Cancer 13-17 October Bundanoon www.questforlife.com.au/Spirited-Women PANDDA 2014 Conference – Professional Association of Nurses in Developmental Disability Areas 15-16 October Parramatta www.pandda.net Pain Interest Group Nursing Issues Professional Development Day 17 October Sydney www.dcconferences.com.au/pigni2014 Nursing and Midwifery Unit Managers Society of NSW Annual Conference 17 October Ettalong Beach www.numsociety.org.au Blacktown and Mount Druitt Hospital Nursing and Midwifery Research and Innovation Symposium 23 October Caroline O’Donnell 0422 006 786 Michelle Nehmer 0439 266 642 APNA Continuing Education for Nurses in General Practice 24-25 October Sydney www.apna.asn.au/nigp Bones on the Beach – Orthopaedic Conference 25 October Wollongong karin.tarne@sesiahs.health.nsw.gov.au Neuroscience Conference: Their brain in our hands 29 October St George Hospital Sheila.pomfret@sesiahs.health.nsw.gov.au 9113 3614 or 0422 418 255

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Diabetes and Diabesity Update Day 15 November Eveleigh www.dnsw.eventbrite.com.au or 1300 136 588 St George Hospital – Code Red Dinner 19 November Sandringham www.fight4stgeorge.com/#!upcomingevents/c1jx3 2nd National Play Up Convention – Creative Ideas in Ageing 24-25 November Luna Park Sydney Australasian Cardiovascular Nursing College 9th Annual Conference 13-14 March 2015 Coogee www.acnc.net.au

ACT Australia and New Zealand Society for Vascular Surgery Annual Scientific Conference 11-13 October Canberra www.vascularconference.com/2014 3rd Biennial Australian Capital Region Nursing and Midwifery Research Centre Conference 16-17 October Canberra Registration: www.rcnmp.com.au

INTERSTATE Australian Association for Infant Mental Health National Conference 2-4 October Brisbane www.infancy2014.com.au ACMHN 40th International Mental Health Nursing Conference 7-9 October Sofitel, Melbourne 02 6285 1078 www.acmhn2014.com or events@acmhn.org Greening the Healthcare Sector Think Tank The Health Sector as a Leader in Low Carbon Transformation 14 October Brisbane www.caha.org.au Aged Care Nurse Managers Conference 30-31 October Melbourne www.totalagedservices.com.au/index.php?q= acnm-conference.html Dementia + Community Care Conference 2014 30-31 October Melbourne www.totalagedservices.com.au/index.php?q= dcc-conference.html National Nursing Forum – Staying ahead of the game 2-4 November Adelaide www.acn.edu.au/forum_2014 PHAA 2nd National Sexual and Reproduction Health Conference 18-19 November Melbourne phaa.net.au/NSRH2014Conference.php Australasian College for Infection Prevention and Control Conference 23-26 November Adelaide www.acipcconference.com.au World Indigenous Health Conference 2014 15-17 December Cairns www.indigenousconferences.com Australian and New Zealand Addiction Conference 4-6 March 2015 Surfers Paradise www.addictionaustralia.org.au No 2 Bullying Conference 29-30 June 2015 Gold Coast www.no2bullying.org.au

INTERNATIONAL Nurses Christian Fellowship International PACEA Conference: Compassion: The Cornerstone of Care 10-14 October Nadi, Fiji pacea-region@gmail.com 4th International Conference on Violence in the Health Sector 22-24 October Miami, USA www.oudconsultancy.nl/MiamiSite2014/inde x.html International Conference on Infectious and Tropical Diseases 16 -18 January, 2015 Phnom Penh, Cambodia 10times.com/ictid Asia Pacific Hospice Conference: Transforming Palliative Care 30 April - 3 May 2015 Taipei, Taiwan www.2015aphc.org

REUNIONS Sydney Hospital Graduate Nurses Association Annual Lunch 1 October Parliament House, Sydney Jeanette Fox 02 4751 4829 bekysa@tpg.com.au Mater Graduate Nurses Association Annual Reunion 19 October North Sydney Joan Taniane 0401 344 363 joans2458@yahoo.com Rydalmere Hospital Staff Reunion: Celebrating 200 years 24 October Janice Sillett 02 9842 2404 Janice.Sillett@facs.nsw.gov.au Sandra Burgess 02 9334 0581 Sandra.Burgess@facs.nsw.gov.au Prince Henry Hospital PTS Jan 1964 meetup at annual PHH reunion 25 October Helen Millan (nee Flanagan) helenmillan@bigpond.com Prince Henry Hospital April 1964 Class Reunion Hospital reunion and dinner to follow 25 October 1pm Little Bay Margaret Vincent (nee Dewick) margie.v@optusnet.com.au or 0413 293 812 NEC Prince Henry/POW Hospitals Oct 1972-75 Group 25-26 October Margret Brignall (nee Samuel) 0418 646 959 Sonia Keeling (nee Graf) 0407 221 407 Marcia Jarvis (nee Fitch) 0438 415 647 Dianne Walkden (nee Edwards) 0400 621 470 Gill Gillon (nee Horton) 0401 048 205 Waikato Polytechnic Nursing Graduates of 1987-1989 Reunion 1-2 November Hamilton, New Zealand Molly Forbes 0403 904 650 mollywoppie@gmail.com West Metropolitan Group School of Nursing: Westmead Hospital 1979 intake 8 November Sydney Meg Board (nee Adcock) mboard@bigpond.net.au or 0416005650 St Vincent’s HIV ward 17South 30th Anniversary Commemoration 28 November John McAllister john.mcallister@svha.org.au

diary dates is a free service for members.

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