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lamp the

magazine of the NSW Nurses’ Association

volume 63 no.9 October 2006

Transforming

MENTAL

HEALTH


First State Super knows that nurses work hard That’s why we’d like to give you something to lighten the load Helpful tips for your super

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www.firststatesuper.com.au Competition starts Monday 2 October 2006 and closes Thursday 30 November 2006 at 5.00pm (AEST). The prize will be drawn on Monday 4 December 2006 at 10.00am (AEST) at Suite 3, Level 17, 83 Clarence Street Sydney NSW 2000. The winner will be contacted by phone. To enter you must be a current member of First State Super. For competition terms and conditions please see our website www.firststatesuper.com.au Authorised under NSW Permit No. TPL 06/10379, ACT Permit No. TP 06/03791 Important note: Please consider the First State Super Product Disclosure Statement (PDS) having regard to your own situation before deciding whether to become a member or continue membership. A copy is available by calling us on 1300 650 873 or visiting our website. The information contained in this document is current as at October 2006. Prepared by FSS Trustee Corporation (FTC) ACN 118 202 672, AFSL 293340, RSE L0002127, the trustee of First State Superannuation Scheme RSE R1005134. 2 THE LAMP OCTOBER 2006 COMP NURSE 10/06


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ABOUT THE LAMP

C O N T E N T S

Contacts NSW NURSES’ ASSOCIATION For all membership enquiries and assistance, including Lamp subscriptions and change of address, contact our Sydney office. SYDNEY OFFICE 43 Australia Street Camperdown NSW 2050 PO Box 40 Camperdown NSW 1450 (all correspondence) T 8595 1234 (metro) 1300 367 962 (non-metro) F 9550 3667 E gensec@nswnurses.asn.au W www.nswnurses.asn.au HUNTER OFFICE 120 Tudor Street Hamilton NSW 2303 ILLAWARRA OFFICE L1, 63 Market Street Wollongong NSW 2500

Cover story

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Transforming mental health 14 Cover Sue Kennedy, Nurse Practitioner, St George Hospital Psychiatric Emergency Care Centre

NSWNA COMMUNICATIONS MANAGER Noel Hester T 8595 2153 NSWNA COMMUNICATIONS OFFICER Olivia Nassaris T 8595 1263 For all Lamp editorial enquiries, letters and diary dates: Salim Barber T 8595 1234 E sbarber@nswnurses.asn.au M PO Box 40 Camperdown NSW 1450

News in brief

Workloads

THE LAMP PRODUCED BY Lodestar Communications T 9698 4511

10 10 10 11 11 11 11 13 13

33 Beds may close at Wagga Wagga

PRESS RELEASES Send your press releases to: T 9550 3667 E gensec@nswnurses.asn.au

152 more overseas nurses Access block ‘kills patients’ NSW Health issues aged care guidelines Medicare rebates made easy ALP’s hospitals for elderly Punitive tax hits 500,000 Pacific nurses focus on healthy living Greater Southern gets new CEO Scholarships to re-enter workforce

NSWNA education program 13 What’s on this month

Agenda 20 Dark side of guest labour 457 Visas are loose and open to abuse 21 Overseas nurses abandoned by broker 22 Shackled to a bank loan 26 Nurse practitioners advance against the odds 29 Country town loses its nurse practitioner

Industrial issues 24 107 workers face massive individual fines 25 IR shorts

37 Vicki has the world at her feet, thanks to Apheda

Lifestyle 38 Members’ tips 41 Movie reviews 45 Book me

Obituary 43 Coronary care was Brenda’s passion

Regular columns 5

Editorial by Brett Holmes 6 Your letters to The Lamp 35 Ask Judith 47 Our nursing crossword 49 Diary dates

Competition 39 Win a Star City dinner and tickets to Priscilla Queen of the Desert – The Musical

Special offer

Aged care 31 Aged care nurses meet in Blue Mountains

21

Special people

22

39 10 double passes to the hit comedy play The Hospital 41 10 double passes to see World Trade Centre

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THE LAMP EDITORIAL COMMITTEE Brett Holmes, NSWNA General Secretary Judith Kiejda, NSWNA Assistant General Secretary Coral Levett, NSWNA President John Lyons, Coonabarabran District Hospital Jonathan Farry, RPA Hospital Mark Kearin, Wyong Hospital Roz Norman, Tamworth Base Hospital Stephen Metcalfe, Lismore Base Hospital Therese Riley, St George Hospital ADVERTISING Patricia Purcell T 8595 2139 or 0416 259 845 F 9550 3667 E ppurcell@nswnurses.asn.au RECORDS AND INFORMATION CENTRE - LIBRARY To find old articles in The Lamp, or to borrow from the NSWNA library’s nursing and health collection, contact: Jeannette Bromfield, RIC Coordinator T 8595 2175 E gensec@nswnurses.asn.au General disclaimer The Lamp is the official magazine of the NSW Nurses’ Association. Views expressed in articles are contributors’ own and not necessarily those of the NSW Nurses’ Association. 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 NSW Nurses’ Association takes no responsibility for the advertising appearing herein and it does not necessarily endorse any products advertised. Privacy Privacy statement: The NSWNA collects personal information from members in order to perform our role of representing their industrial and professional interests. We place great emphasis on maintaining and enhancing the privacy and security of your personal information. Personal information is protected under law and can only be released to someone else where the law requires or where you give permission. If you have concerns about your personal information please contact the NSWNA office. If you are still not satisfied that your privacy is being maintained you can contact the Privacy Commission. Subscriptions Free to all Association members. Ex-members can subscribe to the magazine at a reduced rate of $44. Individuals $60,THE Institutions Overseas2006 $100.3 LAMP$90, OCTOBER


Members – Sign up a new member and go in the draw to win a fabulous trip to

NORFOLK ISLAND PRIZE INCLUDES; Return air fares with Nor folk Air from Sydney to Nor folk Island for two people 7 nights at Poinciana Cottages 7 days car hire Half Hour Hot Stone Massage per person Talpacific Holidays Convict Club Card offering gifts and discounts on shopping, touring & dining. WIN DAVID JONES VOUCHERS Once you have recruited 4 new members to the NSWNA, you will be awarded a $20 David Jones voucher, and for every member after that you’ll receive a further $5 voucher. It’s that easy! MEMBERSHIP APPLICATION FORMS HURRY – CALL THE ASSOCIATION NOW FOR YOUR RECRUITMENT KITS! PH: 8595 1234 (METROPOLITAN AREA) OR 1300 367 962 (NON-METROPOLITAN AREA) OR GO TO

www.nswnurses.asn.au

4 THE LAMP OCTOBER 2006

COMPETITION CLOSES 30 JUNE 2007


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E D I T O R I A L BY BRETT HOLMES GENERAL SECRETARY

A collective approach needed on the big issues g The nursing shortage creates a terrain where a host of health policy issues such as skill mix, health management, training, and industrial issues are all in play. From our union perspective, it is both a strength and a weakness.

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he nursing shortage can be seen as a strength when we are arguing for better wages and conditions – but it does make us vulnerable to attacks across multiple environments. Employers are clearly unable to recruit enough nurses locally and are looking to either bring in nurses from overseas or, more sinisterly, create alternative categories of workers parading as nurses. In this issue of The Lamp (pp 20-23), we look at some of the issues facing overseas nurses in Australia. We are not opposed to the use of overseas nurses to address the acute aspects of the shortage but we are opposed to their exploitation before or after their arrival. There are also important policy issues that need to be addressed such as the lax implementation of 457 Visas by the federal government and the need to give priority to more university places for nurses. This is a vital pillar in any viable strategy to fill the vacancies in our hospitals with appropriately educated nurses. Other tactics being used by employers to fill nursing positions are of even greater concern to us. These tactics are particularly visible in aged care with the advent of the Certificate IV aged care worker who is unlicensed and used by employers in traditional nursing roles including administering medications and supervising staff. Nurses need to think carefully about skill mix issues. We eagerly await research

their traditional role of administering medications is now outdated. This is particularly clear in aged care where employers are using the nurse shortage and economic factors to push hard on who should administer medications. Under intense pressure from aged care employers, the Nurses and Midwives Board is currently reviewing its policy on delegating the administration of medications to other categories of staff. Nurses will need to respond strategically to this threat if we are to maintain our pivotal role in health care provision that until now we have assumed is our right and obligation. We need to seriously assess whether the role of AiNs should be licensed as a complementary part of the nursing family with registered and enrolled nurses. The public deserves the same sort of protection with new categories of workers who have direct contact with patients as they get from the registration of nurses. There are many other big ticket items in play in the health sector and workplace relations that have great relevance to nurses besides the administration of medications. The federal Health Minister Tony Abbott has often floated the idea of the federal government taking over health from the states and recently proposed that the management of public hospitals should be privatised. There is also the massive threat posed by the federal government’s IR changes to the pay and conditions of nurses and their right to be represented by their union. We cannot pretend these things are not happening or will go away. We need to recognise them, debate the issues in a robust way and then stick together and defend our interests. n

‘Employers are using the nurse shortage and economic factors to push hard on who should administer medications.’ undertaken by University of Technology Sydney on skill mix and workload (The nursing workloads, skill mix and patient outcomes study). This rigorous study will give us a clearer appreciation of the relationship between skill mix and workloads. But we cannot sit on our hands while we wait for this research. As a profession we need to think clearly and realistically about how we manage the whole problem of skill mix. The commonly held belief that nurses are able to define themselves by

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LETTER of the month

L E T T E R S

Cherie Desreaux and Kate Griew (right)

Professional identity worth fighting for We recently attended the NSWNA annual conference as delegates representing our branch. A number of occasions arose where motions were dismissed as divisive, unfair or likely to create unnecessary conflict between registered nurses/midwives and enrolled nurses. We would like to request further debate in the hope that some of the issues get addressed without undermining the strength of our union or our relationships with our colleagues working under different parts of the award. In a time of nursing and midwifery shortages, many Area Health Services and facilities have used grades of nurses, other than that which is seen as ideal, to fill gaps in numbers. Most registered nurses and midwives recognise this scenario and have felt the frustration of working shifts with an unrealistic skill mix, unable to provide basic care that every nurse, midwife and health consumer should expect to be able to deliver and receive. ‘Gap-filling’ with inappropriately qualified or skilled nurses or other health professionals is a short-term solution that compromises patient care and puts both the registered staff and inappropriately placed nurse at risk. In addition, it undermines job satisfaction and staff retention. It does however allow management to justify, on paper, that they have the numbers. While these issues can be taken up at our reasonable workloads committee, we would argue we should only have to fight this fight in that arena as a response to a change in ward profile. Protecting the professional identity, promoting the education, skills and identity of registered nurses and midwives while valuing the role of the enrolled or other grade of nurse, should be an ongoing activity of both the union head office and all of the members. We do not want to wait until after the event has occurred. We don’t want patients receiving care that is lacking. It is offensive that inappropriately placed nurses have to struggle with 6 THE LAMP OCTOBER 2006

tasks they are not equipped for. We do not want to see registered staff consider leaving nursing or midwifery because of the frustration of enduring these situations, feeling there is no end in sight. A career pathway ensures appropriately qualified staff have their own rightful positions in our professions of nursing and midwifery. In our opinion it is a mistake to place the needs of the Registered Nurse and Registered Midwife on the backburner. Protecting our professional identities is an important fight, it is important to continue to differentiate between Registered Nurse, Registered Midwife, and other grades of nurses or we render our pathways obsolete. Cherie Desreaux and Kate Griew, Royal Prince Alfred Hospital

Sue Gray

Delayed Super I would like to highlight a situation with my superannuation that I am sure must be affecting other Association members. I pay a significant amount into my HESTA superannuation fund over and above the compulsory employer contributions. I have become aware in the past few months, since becoming more accustomed to monitoring all my financial transactions on the Internet, that my voluntary contributions are held by the pay office for up to 14 weeks (so far) before transferring them into my HESTA account. Advice from my accountant indicated that the Area Health Service, as my employer, is required to transfer all monies from the previous quarter into my superannuation account by the 28th of the next month. Thus, I am hoping to receive all monies owed from this quarter, and the previous quarter, by 28 October. At present, I am still owed $1,200 from May to June 2006. I would like to take this opportunity to thank the NSW Nurses’ Association for having the tenacity to follow this up. I would also like to strongly encourage members to regularly check the status of their superannuation deposits on the internet. Sue Gray, Tresillian Family Care Centres

Debra Stibbard

Long lost cousins The August edition of The Lamp ran a lifestyle piece about me and my coffee orchard (‘Coffee Queen’, page 38). This little story had a lovely result I would like to share. I received a letter at work from a registered nurse in Newcastle whose name is also Debra Stibbard. She wrote that she was flabbergasted to see her name attached to someone she had never seen or heard of. It’s not that common a name, and she was curious to find out if we were related. I phoned her and, yes, we are related. Second cousins, in fact. Our grandfathers (Raymond and Vivian) were brothers, our fathers first cousins. We all originated in the New England area of NSW where I grew up. Debra’s father left the area in his youth and settled in Kempsey. He died over 20 years ago so Deb has had nothing much to do with his side of her family. However, she has always been curious. She was even thinking of attempting a family tree, which I could reassure her has already been extensively done by a daughter of another brother to our grandfathers. I’m getting her a copy. We are looking forward to getting together now and exploring our family. Long-lost cousins with a couple of amazing coincidences – both born in the mid-’50s, both registered nurses, both named Debra (same spelling) connected by a little story in The Lamp! Thank you for publishing my story, I hope Lamp readers enjoyed it. Debra Stibbard, Ballina Hospital Debra Stibbard won the prize for this month’s letter of the month, a $50 David Jones voucher. C

NOTICE

The ANF Federal Office Financial Report for the year ended 30 June 2006 is now available at www.anf.org.au Members without internet access may obtain a hard copy of the report by applying in writing to: Finance Manager, Australian Nursing Federation Level 2, 21 Victoria Street Melbourne, Victoria 3000


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Gayle Hartley

Chief Nurse’s ‘disappointing’ response I am writing on behalf of the Gosford Hospital branch of the NSWNA. Six delegates from Gosford Hospital attended the Annual General Conference held 19-21 July. Our congratulations to the organisers, it was an excellent three days. We are all motivated to continue our work in regards to raising awareness about the IR laws. ACTU Secretary Greg Combet is such a powerful, passionate speaker, a statesman in waiting. At conference, a number of delegates put questions to the NSW Chief Nursing Officer, Debra Thoms, regarding the reality of the loss of nurses in key leadership positions due to the AHS restructuring. Gosford branch delegates were

amazed, and disappointed, that the Chief Nursing Officer was clearly not able to respond appropriately to these questions. This was particularly disappointing as she had been present the previous day when the Minister for Health, Mr Hatzistergos, gave a presentation after which many issues and concerns were raised by delegates. We would like to express our unhappiness that one of our delegates was gagged by the Chair, which prevented further constructive discussion. Surely this is a crucial time for the nursing profession and nurses expect the Chief Nursing Officer of NSW to be wellinformed and supporting nurses in regard to these important matters. Gayle Hartley, CNC NSWNA Branch Secretary, Gosford Hospital Editor’s note: A/Professor Debra Thoms replied to a number of questions regarding the restructure and made it clear she was not authorised to speak on industrial relations matters. Given that A/Professor Thoms had indicated her inability to respond to the questions, the NSWNA President Coral Levett moved the discussion on.

NOTICE

The Australian Nursing Federation NSW Branch audited Financial Report for the year ended 30 June 2006 is now available on the Members’ page at www.nswnurses.asn.au Members without internet access may obtain a hard copy of the report by applying in writing to: Brett Holmes, Branch Secretary, Australian Nursing Federation – NSW Branch 43 Australia Street, Camperdown NSW 2050

LETTER of the month The letter judged the best each month will be awarded a $50 Myer voucher, courtesy Medicraft, Australia’s largest manufacturer of hospital beds and furniture. For more information on Medicraft products, visit www.medicraft.com.au or call 9569 0255.

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L E T T E R S

Defending nurses’ rights at work Jeffery Wade Shelley

Anna Lee

Private nurses need IR facts

Disappointing content

I would like to thank The Lamp for supporting its members and fighting for our rights. Industrial relations laws are a major issue facing nursing today and into the future. A lot of nurses may not have yet seen the repercussions of these laws, as these nurses are protected by the State Government’s decision to make them Crown employees. But what will happen to them if we have a change in State Government? What about the many nurses like myself who are not working as Crown employees and are under the private aged care award? My award runs out in 2009. Will my employer start rolling out Australian Workplace Agreements, and what will these ‘agreements’ consist of? Will they be fair? Or will the employer ‘consult’ with their employees and roll them out in our organisation before 2009? I don’t know what my employer’s future plan is. But one thing I do know is that when this happens we are going to need the support of our union and the support of Crown employees. My employer has already cut our working conditions by cutting our staffing levels. And everyone has read in recent editions of The Lamp what has happened to our enrolled nurses’ employment and conditions, so I can only imagine what conditions our future employment will contain. I don’t believe that The Lamp is being pushed as a political wheelbarrow by the Labor Party, as one reader wrote. I believe the Labor Party is supporting us nurses. A lot of people working in the private sector rely on The Lamp for updates on industrial relations laws. There is only one way all nurses will be protected and that is if we are united. The Lamp is one way of keeping us united.

I have just received and scanned through my latest copy of The Lamp (September 2006). Once again I was disappointed at the content that continues to fill its pages and must agree with Gemma Horsburgh (The Lamp, September 2006). I, too, am sick of pages and pages of politically influenced issues that seem to have taken over a once interesting and thought-provoking magazine. I did find interesting the editor’s response justifying the continued bombardment we get about federal industrial relations matters and how these will affect us as nurses and ultimately our patients. I agree that nurses do have a right to know how IR laws will impact on them. However, to make a fully informed decision as you have stated is our democratic right, should we not be making these decisions with fully unbiased information? That is hardly what you are printing in The Lamp. Do we really need to read on pages 26 and 27 that interest rates are up again, that so is the price of petrol and that we as nurses are feeling the sting? There is enough of this sort of sensationalism in the everyday media – we do not need it in The Lamp. You advertise The Lamp as providing vital information, up-to-date news with interesting special features. Well the special features are certainly few and far between, the interest rate and petrol price story is certainly not new and I would not consider the story about a couple paying more for their mortgage (September edition, page 27) as vital information. It’s time to review and update The Lamp, give us some interesting reading material, give us unbiased information and get off this political wagon. Give us innovative and positive stories about what our colleagues are doing and stop telling us how nurses are undervalued. If this is what we are constantly reading from our association this is exactly how we are going to think. And how wrong is this?

Jeffery Wade Shelley, Shoalhaven Nursing Home 8 THE LAMP OCTOBER 2006

Anna Lee, Prince of Wales Hospital

Editor’s Note: The information we publish about federal IR laws is not biased. It is written from a union perspective with an emphasis on how the laws will impact on NSWNA members and their union. We believe it is important that nurses hear this perspective through their union magazine because formidable resources have been mobilised in favour of the laws – including $55 million of taxpayers’ money spent by the federal government on politically partial advertising supporting the laws. Powerful media outlets such as the Murdoch press are also biased in favour of these laws. We have included articles about how the laws impact on workers other than nurses because we believe they are cautionary stories that illustrate what these laws are doing to real people. They could just as easily be used against nurses. An important role for any union is to fight for the economic interests of its members. An analysis of the cost of living including interest rate rises is an important factor in any wage claim. In the increasingly decentralised bargaining environment – a direct and deliberate product of the Howard government’s new IR laws – an understanding of these economic factors by NSWNA members will be essential to maintaining and improving nurses’ wages and conditions. It is important to understand that we are not attacking the Howard government, the Liberal Party or their laws in The Lamp. We are defending nurses and their union from an attack by the Howard government launched through these new laws. This is not a fight of our choosing. It has happened because the Howard government, without any mandate on this issue at the last federal election, has chosen to declare war on unions and their members’ working conditions, including your union the NSWNA.

EVERY LETTER PUBLISHED

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Got something to say?

Send your letters to: Salim Barber email sbarber@nswnurses.asn.au fax 9550 3667 mail PO Box 40 Camperdown NSW 1450 Please include a photograph along with your name, address, phone and membership number. Letters may be edited for clarity and space.

Diane Lang

IR laws a community concern I am writing to respond to the letter in the September issue of The Lamp, headed ‘Wheelbarrow?’ The writer claimed The Lamp was being used as a ‘political wheelbarrow constantly being pushed for the Labor Party’. I’m sorry, but I just don’t see it that way. We don’t live in a hospital, we live in a community and as such we should want to be informed and help not only nurses and patients, but everyone. That’s why the NSWNA is trying to explain to us that the union movement and the entire country’s working conditions are under attack. It is either roll over and give in, or stand up and fight for our rights. But in order to fight we need to be knowledgeable and fully understand how the IR laws are going to affect every one of us as well as our parents, grandparents, children and grandchildren. If not, we will continue to decline into a deep dark hole that has no way out. The Lamp articles are not saying who to vote for, they are only telling us what the Liberal government’s IR policies are, and how they are already affecting people. It’s up to us, the Australian public, to decide what alternative

government we want in. But it is also up to us as to how that can happen and it certainly won’t happen by doing nothing. We need to work as a community, not as individual professions, so at the end of the day we will be able to remove these unjust laws. Diane Lang, AIN, Imlay House Pambula

Laura Grossi

IR threat to private nurses

The September issue of The Lamp included a letter from a member ‘registered in 2001’ complaining about the magazine publishing stories on how the new IR laws are affecting various workplaces. With all due respect to the member, the Nurses’ Association has fought hard for improved wages and conditions to be available to all nurses. It is imperative nurses align themselves with political leaders that continue to support nurses and all current award conditions, in their entirety. Which of our current award conditions would you choose to lose?

In response to the article by Gemma Horsburgh (Letters, September page 6), nurses working in the private sector (eg. nursing homes) are subject to IR changes that will affect every resident as well as the staff whose work is physically and mentally exhausting day in day out. Gemma Horsburgh writes from a small regional area of NSW. She needs to update her ideas about IR changes and do a lot more reading about how these changes are affecting nurses in the private sector. I am an AIN. I have worked in an aged care facility and it has taken 19 years for my hourly rate to increase from $6.40 p/hr to $16.46 p/hr at present. Under the IR changes, my hourly rate will drop to $12 p/hr. Why should we have to work so hard to receive such a small salary? I wish one day I could have the power to enforce IR changes that would effect all politicians.

Karen Fernance Assistant Secretary Bankstown Hospital Branch

Laura Grossi, Scalabrini Village nursing home

Karen Fernance

Support leaders who support nurses

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N E W S I INN BBRRI IEEFF

152 MORE New aged care OVERSEAS NURSES he State Government has recruited 152 nurses from the UK and Ireland to help ease the nursing shortage in NSW. The foreign nurses will begin working in NSW hospitals over the next six months. More than half hope to live in Australia permanently. The recruitment of overseas nurses was announced by NSW Health Minister John Hatzistergos as he launched a new campaign urging school students to consider a nursing career.

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The foreign nurses will begin working in NSW hospitals over the next six months. Called No Two Days Are Ever The Same, the campaign targets school career advisors with a multimedia package including stories from real nurses about their work. The minister said the influx of UK and Irish nurses ‘shows our hospitals are attractive places to work’.

ACCESS BLOCK

‘KILLS PATIENTS’ ccess block – a shortage of available inpatient beds – is responsible for potentially preventable deaths in emergency departments, a study has found. The study was made by the Australian National University and Canberra Hospital’s emergency department. Researchers discovered the mortality rate up to 10 days after presentation was 0.063% in times of low access block and 0.116% in times of high access block. The results were calculated from about 42,500 patients at times of low access block and about 36,000 patients when access block was high.

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guidelines released g NSW Health has issued a number of publications and guidelines to improve long-term care options for older people with severe behavioural and psychological systems associated with dementia and/or mental illness. The management and accommodation of older people with severely and persistently challenging behaviours: Summary Report

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evere behavioural and psychological symptoms associated with dementia and/or mental illness are a considerable source of distress to those who manifest them and those who experience them. Such symptoms present challenges for residential aged care services and hospital services in providing care. To address this issue, the Centre for Mental Health, NSW Health, commissioned this report to investigate accommodation and management options for older people with severely challenging behaviours, with a particular focus on developing long-term care models within the residential aged care sector. Summary Report: The management and accommodation of older people with severely and persistently challenging behaviours

Guidelines for working with people with challenging behaviours in residential aged care facilities – using appropriate interventions and minimising restraint The guidelines for working with people with challenging behaviours in residential aged care facilities have been developed to guide clinical staff in caring for residents with challenging behaviours while ensuring the residents live their lives with dignity within a secure place of residence.

The guidelines propose procedures for the assessment and development of care plans. The document will assist residential aged care facilities to review their practices, policies and protocols regarding the issues of restraint, medication use and management of challenging behaviour to ensure they reflect the evidence base and the views and experiences of the community as a whole. The guidelines will also assist in improving staff skills in caring for older people within these environments. Guidelines for working with people with challenging behaviours in residential aged care facilities – using appropriate interventions and minimising restraint

Specialist Mental Health Services for Older People NSW Service Plan This plan is intended to guide the development of specialist mental health services for older people in the Area Health Services across NSW over the next 10 years. Pressure on these specialist services will grow as the population ages and the number of older people with complex mental health problems increases. The plan outlines the relevant policy, planning and demographic context, key mental health issues for older people, the broader service system of which specialist services are a part, and strategic priorities in older people’s mental health. n NSW Service Plan for Specialist Mental Health Services for Older People (SMHSOP) 2005–2015 NSW: A new direction for Mental Health

You can download a copy of all of these publications at www.health.nsw.gov.au


Photo courtesy of ANF (Victorian Branch)

MEDICARE REBATES

Punitive tax MADE EASY hits 500,000

laiming Medicare rebates will be quicker and easier from next year. Patients will be able to claim rebates electronically at the doctor’s surgery and have the money credited to their bank account within 24 hours. That will mark a massive improvement on the current system where patients often have to queue at Medicare offices and wait weeks for refunds. Staff in doctors’ surgeries will swipe patients’ Medicare and EFTPOS cards. The Prime Minister said the new system would greatly benefit the 80,000 people who stand in Medicare queues each day. Taxpayers will also save, with processing costs expected to fall from $3.50 to just a few cents per rebate.

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p to half a million people may be forced to pay a tax of 1% of their income in 2006-07 as a penalty for not taking out private health insurance.

The number of people privately insured has fallen from 44.8% in 2001 to 43% today. Premiums have risen 41% since 2001. The tax penalty, which applies to singles earning more than $50,000 and couples earning more than $100,000 per annum, was introduced in 1997 to force higher income earners to buy private insurance.

Since then, incomes have risen but the thresholds for the penalty have not been indexed. Last year, the average wage passed $50,000 so the penalty can no longer be said to apply to higher incomes only. Roger McBride, marketing manager for an insurance broker, told The Sydney Morning Herald: ‘We estimate the government has taken more than $1 billion from taxpayers since the introduction of the surcharge. ‘And it will have an absolute windfall this year with many taxpayers liable for the first time.’ The Australian Consumers Association said the number of people privately insured has fallen from 44.8% in 2001 to 43% today. Premiums have risen 41% since 2001. n

ALP’S HOSPITALS

Pacifi c nurses focus FOR ELDERLY on healthy living he ALP’s new federal health policy will include specialist hospitals for elderly people. Opposition health spokesperson Julia Gillard said the policy would aim to provide improved care for thousands of frail old people who are stuck in public hospitals because they cannot access residential aged care. Labor says the move will also cut public hospital waiting lists and save $500 million per year in wasted resources. Ms Gillard said the Howard government deliberately under-funded aged care, a federal responsibility, knowing that elderly people unable to access nursing homes would end up in state-funded public hospitals. ‘We want public hospitals to be dealing with the things they are supposed to be dealing with – not the GP-style complaints and offering accommodation to people who should be in residential aged care,’ said Ms Gillard.

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ustralian delegates attended the 13th South Pacific Nurses’ Forum in Samoa from the 3-8 September to discuss the theme ‘Healthy nurses for a non-communicable disease free Pacific’. Fesolai Taulapapa Faamanatu Nielsen, Samoan Nurses’ Association President, said the aim was to highlight the need for nurses in the Pacific region to promote healthy eating and healthy living to be free from non-communicable disease (NCD). She said that those already affected by NCDs also needed to make necessary changes, such as a commitment to regular exercise, to improve their diet and to have good medical compliance. Nurses of the South Pacific will aim to develop and introduce exercise and weight loss programs and education programs to promote healthy eating in their area and report back to the next conference in 2008. In his address to the conference, the Prime Minister of Samoa, Tuilaepa

Samoan nurses’ leader Fesolai Taulapapa Faamanatu Nielsen

Lupesoliai Sailele Malielegaoi, said: ‘The forum will provide an opportunity for all participants to strengthen collegiality and form partnerships within the nursing profession regionally, while improving community awareness of NCD and prevention of NCD.’ n THE LAMP OCTOBER 2006 11


NSWNA announces it’s new

DIRECT DEBIT TRAVEL PRIZE! PRIZE 30 DE DRAWN CEM 2006 BER

HERE’S HOW YOU CAN GET ONE OR MORE CHANCES TO WIN Q cancel your payroll

WIN A TRIP FOR 2 ON A WORLD EXPEDITIONS 7 DAY EXPLORE KAKADU AND BEYOND ADVENTURE Kakadu is possibly the most exciting adventure destination in Australia. Camping, swimming, and canoeing over crystal clear waters. Travelling in a small group, with your own guide you will explore the remote beauty of the Top End. 12 THE LAMP OCTOBER 2006

deductions and start paying your fees through direct debit/auto credit and you will go in the lucky draw. Q convince your colleagues to convert from payroll deductions to direct debit/ auto credit and you, and each of your colleagues who switch to direct debit/auto credit, will go in the lucky draw. Q sign up a new member using the direct debit/auto credit method of paying their fees and you, and the new member, will go in the lucky draw. Membership Application Forms or Direct Debit or Direct Credit forms can be downloaded from our website www.nswnurses.asn.au. Alternatively call the NSWNA on 8595 1234 (metro area) or 1300 367 962 (non-metro area) for more information.


Photo courtesy of ANF (Victorian Branch)

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N E W S I INN BBRRI IEEFF

Greater Southern gets new CEO

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SW Health has appointed a new Chief Executive of the troubled Greater Southern Area Health Service.

Greater Southern took so long to pay its bills that some suppliers were refusing further supply Heather Gray, currently in charge of children’s, youth and women’s health services in South Australia, will take up the position in October. The NSW Director-General of Health, Robyn Kruk, said Ms Gray was highly successful in her previous role as CEO of the former Wentworth Area Health Service in Sydney. ‘Prior to this she spearheaded regional healthcare for communities in western NSW in her role as CEO of the

former Far West Area Health Service,’ Ms Kruk said. Ms Kruk described Ms Gray as an excellent administrator and an inspiring innovator. Greater Southern was one of two Area Health Services criticised early this year by the State Auditor-General, Bob Sendt, for exceeding their budgets and regularly failing to pay creditors on time. Mr Sendt said Greater Southern took so long to pay its bills that some suppliers were refusing further supply, creating many practical difficulties for health services in the Area. n

Scholarships to re-enter workforce

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he Royal College of Nursing has announced scholarships to encourage RNs and ENs back into the workforce. Scholarships are available to nurses whose registrations have lapsed and have not practiced for five years or more. The scholarships worth a maximum of $6,000 each have been announced under the National Nurse Re-entry Scheme. The scholarships are aimed at applicants currently undertaking or intending to undertake an accredited or approved Australian nursing program or course that will enable them to re-enter the nursing/midwifery workforce in an Australian State or Territory. The RCNA also administers the Continuing Professional Education (CPE) Scheme for Rural and Remote Nurses

available to RNs and ENs to undertake postgraduate CPE courses and to attend conferences within Australia as presenters or delegates. Scholarships are worth a maximum of $10,000 each for up to two years of study. Applicants must be Australian citizens or permanent residents who have a current practicing certificate and must be able to demonstrate that they are practicing in a rural or remote area of Australia. For more information, please visit www.rcna.org.au. To contact the RCNA, please email scholarships@rcna.org.au or call the freecall number: c National Nurse Re-entry Scheme 1800 11 22 40 c Continuing Professional Education Scheme 1800 11 72 62. n

education progra a n m nsw

WHAT’S ON THIS MONTH

s Leadership Skills in Nursing 11 October, Coffs Harbour, 1 day Suitable for all nurses in leadership roles. The seminar focuses on the challenge of leadership and provides strategies to develop potential and manage effective teams. Members $85 • Non members $226 Branch Officials $74 s Basic Foot Care for RNs & ENs 16-17 October, Coffs Harbour, 2 days A VETAB accredited course that aims to provide nurses with the competence to provide basic foot care. Members $203 • Non members $350 Branch Officials $175 s Legal & Professional Issues for Nurses 19 October, NSWNA, ½ day Suitable for all nurses. Topics covered include the Nurses and Midwives Act 1991, potential liability, documentation, role of disciplinary tribunals including the NMB, writing statements. Members $39.50 • Non members $85 Branch Officials $28 s Bullying in the Workplace 23 October, Westmead, 1 day Suitable for all nurses and provides strategies for reducing the incidence of bullying and the skills to cope with bullying behaviours. Members $85 • Non members $226 Branch Officials $74 s Basic Foot Care for AINs 27 October, Batemans Bay, 1 day Seminar provides the AIN with sufficient theory and practice to maintain basic foot hygiene for the healthy foot in compliance with NSW Health policy and under the supervision of RN or EN. Members $101 • Non members $175 Branch Officials $87.50 s Drug & Alcohol Nurse Forum 27 October, NSWNA, 1 day Seminar is suitable for all nurses. Members $30 • Non members $50 Branch Officials $28 LAMP OCTOBER 2006 13 To Register, go THE to www.nswnurses.asn.au or ring Carolyn Kulling on 1300 367 962


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Transforming mental health care g Psychiatric Emergency Care Centres are delivering results for patients – and reducing the burden on busy emergency departments.

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epean Hospital’s PECC has transformed mental health care and eased the burden on the emergency department, says the unit’s senior nurse Joanne Seymour. Joanne, a mental health nurse practitioner, credits the PECC with delivering much faster assessment of patients followed by a high level of co-ordinated intervention by a range of health professionals and carers. ‘We historically had many mental health patients in the ED with no trained mental health nurse after hours,’ she said. ‘That was not optimal treatment for the patients and contributed to a serious access block in ED.’

problems or are presenting predominately for psychiatric reasons,’ Joanne said. ‘We aim for immediate treatment as soon as the patient is assessed and admitted. Most do not need to be admitted to our in-patient unit. We are responsible for discharge planning and we quickly involve all required services – drug and alcohol, social workers etc. ‘In-patients are with us a maximum 48 hours but the average length of stay recently has been 11-12 hours. ‘If a person requires further treatment it is our job to find the most appropriate place for them. It’s important where possible to transfer people back to the area they live in so they can receive continuity of care. ‘If an adolescent or aged person is

‘We aim for immediate treatment as soon as the patient is assessed.’ PECC staff include two nurses on every shift, a NUM and a psychiatric Chief Medical Officer. ‘As soon as patients enter the PECC they get an immediate mental health triage – usually by a senior mental health nurse – whether they have co-morbid medical

14 THE LAMP OCTOBER 2006

involved we may continue in-patient care for a couple of days until we can get them into an age-specific bed.’ Nepean’s PECC team have been operating for almost two years inside the ED as they wait for separate premises to become available. PECC in-patients are usually accommodated in a six-bed nursing bay within the ED. ‘Not having a physically separate PECC unit is very challenging. We are trying to manage people in an environment that’s not optimal, so we have to be very careful in identifying risk – for example, an absconding risk or self harming risk – when the patient comes in.

‘We nurse people on observation levels and every client is within line of sight of a mental health nurse at all times. If they need to go to the bathroom or outside for a cigarette then two staff escort them throughout the department to make sure they are safe. They get an intense level of intervention while they are here.’ Joanne says the PECC has definitely reduced access block in the ED. ‘Our interaction with ED staff is fantastic – they are very appreciative that we’ve supported their role and we work very well with them. ‘We educate ED staff formally and informally: they work collaboratively with us and observe what we do, and we also conduct regular education for the ED nurses and Medical Officers on multiple mental health issues. ‘ED staff have learned a lot about mental health issues and caring for mental health patients and, conversely, we’ve learnt a lot about medical issues and nursing people with complex medical problems.’ Joanne believes a PECC provides a unique working environment especially for nurses who are relatively early in their careers. ‘It is a significantly different work environment because it combines elements of both a standard in-patient facility and a community/assessment facility. ‘A relatively junior nurse working in a PECC would have a different focus to their learning and end up with a wider range of skills,’ she said. n


Transforming

MENTAL

HEALTH

FACTS ABOUT PECCS

‘It is a significantly different work environment because it combines elements of both a standard in-patient facility and a community or assessment facility.’ Day in a life of a PECC nurse: (clockwise from top) Joanne Seymour in the ED, on the phone to a patient's family member, conducting a patient assessment, consulting with Dr James Mallows and doing handover with Wendy Kipling (acting NUM) and Kirk Huchinson (RN)

SW Health is setting up Psychiatric Emergency Care Centres (PECC) in the emergency departments of nine major hospitals. Four PECC units are now operating at Liverpool, Nepean, St George and St Vincent’s and five more will follow at Hornsby, Wyong, Blacktown, Campbelltown and Wollongong. PECCs are one response to the sorts of problems identified by the NSW Auditor General’s report of May 2005. The AG found that some patients were spending long periods in EDs while waiting for acute mental health beds. Patients also were leaving the ED before being properly assessed – sometimes with serious consequences. PECCs provide rapid access to specialist mental health care while helping to improve patient flow in EDs. PECCs combine the functions of mental health assessment and discharge planning with observation and short-term care of up to 48 hours in a 4-6-bed unit. Patients normally are referred to the PECC following initial medical triage and assessment in the ED. PECCs are staffed round-the-clock by senior mental health nurses and other professionals.

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C O V E R S T O R Y

Senior nurses build a new model of care g Five clinical nurse consultants and a nurse practitioner form the core of St George’s Psychiatric Emergency Care Centre.

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urse Practitioner Sue Kennedy says it wasn’t hard to recruit a team of experienced senior mental health nurses to staff St George Hospital’s PECC. ‘They saw it as a challenge and an opportunity to help build an innovative model of care from the ground up,’ said Sue, one of only eight mental health NPs registered in NSW. Sue and five colleagues – all mental health clinical nurse consultants – played a key role in creating the PECC at St George. 16 THE LAMP OCTOBER 2006

They wrote all policies, protocols and job descriptions based on NSW Health guidelines and the national mental health plan. ‘It was a lot of hard work but it was also very exciting to be able to set the parameters of our work right from the start,’ Sue said. In bringing the PECCs into operation, Sue and fellow PECC coordinators from other hospitals attended a series of NSW Health working parties. ‘I took the information back to the CNCs and together we worked out how the new model would operate.’

Having an ED and PECC staffed by senior mental health nurses has done a lot to raise the profile of mental health nursing in the hospital, Sue believes. ‘We now have six senior positions that more junior nurses can aspire to and work towards. It shows that senior nurses no longer have to move into management in order to follow a career path – as a CNC or NP you remain actively involved in patient care.’ Sue says that before the St George PECC was established, after hours patients would be managed by an ED nurse and/or doctor while waiting for


Transforming

MENTAL

HEALTH

‘It was very exciting to be able to set the parameters of our work right from the start.’ an on-call psychiatric registrar or community team to come in. ‘The ED nurses did an excellent job, but they are very busy with a range of patients and there are aspects of mental health care they don’t have the background for. ‘Under the PECC system, patients now have fast access to a highly experienced mental health nurse, with a CNC on every shift.’ St George PECC is attached to but physically separate from the ED. Sue and the CNCs do an initial assessment of the patient and can admit them to the six-bed PECC unit for up to 48 hours if necessary. ‘We can do a lot of crisis intervention in 48 hours. We ask ourselves, “What will this patient need to make them better?” And we frequently liaise with a range of other professional people – psychiatrists, social workers, psychologists, drug health services and GPs – to achieve that outcome. ‘We are also involved in counselling and educating patients and families, and can assist with resources if they are

homeless or having problems managing their money.’ Sue says some patients with more complex problems who need long-term care are not suited to PECCs. ‘In these circumstances we arrange admission to an in-patient facility, preferably in an area where the patient lives or we can also arrange ongoing community services to meet a patient’s ongoing needs.’ n

Top: Sue Kennedy with PECC team colleagues (clockwise): Rebecca Renee, nursing student; Mark Goodnew, CNC; Poonan Prakash, EN; and Conor Chytra-McGirr, RN. Below: a calm environment for assessing patients

THE LAMP OCTOBER 2006 17


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Forum debates workloads tool for mental health g Spotlight on key concerns of mental health nurses

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he design and trial of a tool to measure workloads of mental health nurses was one of several issues discussed at a recent forum on mental health organised by the NSWNA. Other subjects included mental health issues in aged care and violence and aggression in the workplace. The most contentious discussion concerned the document National safety priorities in mental health: a national plan for reducing harm endorsed by the federal and state health ministers’ advisory council. The document proposes that the use of seclusion and restraint should be eliminated or reduced ‘where possible’. Nurses at the forum were concerned about the safety implications of this proposal and agreed it requires more

consultation and discussion with frontline nurses. This document is available online at: www.health.gov.au/mentalhealth Brett Holmes, NSWNA General Secretary, and Debra Thoms, NSW Chief Nursing Officer, launched Stress Management for Nurses, a booklet containing useful exercises and techniques to help nurses manage stress at work. Brett said the Association and NSW Health worked together successfully on the booklet and were exploring the possibility of developing a workloads tool for nurses in the mental health sector. ‘Nowhere else in the world has a tool been developed to adequately address the workload of mental health nurses. The NSWNA would like to produce one that will reflect the work you are being asked to undertake,’ Brett said. ‘In the meantime, it is important to

LIONS NURSES’

SCHOLARSHIP

Looking for funding to further your studies in 2007? The trustees of the Lions Nurses’ Scholarship Foundation invite applications for scholarships for 2007. Nurses eligible for these scholarships must be resident and employed within the State of NSW or ACT. You must be registered or enrolled with either the NSW Nurses and Midwives Board or regulatory authority of the ACT, and must have a minimum of three years’ experience in the nursing profession 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

18 THE LAMP OCTOBER 2006

or overseas), and application forms are available from: The Honourary Secretary, Lions Nurses’ Scholarship Foundation 43 Australia Street, Camperdown NSW 1450 or contact Ms Glen Ginty on 1300 367 962 or gginty@nswnurses.asn.au

Completed applications must be in the hands of the secretary no later than 28 November 2006.

remember that mental health nurses are still covered by Clause 53 of the award dealing with reasonable workloads for all public sector nurses.’ He highlighted the critical role mental health nurses play in the debate and discussion regarding the health care system and the federal government’s damaging changes to the industrial relations system. ‘We are living proof that unions such as ours have an important role to play in industrial relations, improving the working lives of nurses, and improving our health system and society,’ Brett said. ‘Each and every one of you should know that your conditions are being put under stress and strain from the federal government. It is important that nurses think of the big picture in the coming months about what is best for you as an employee and our society.’ n


Transforming

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HEALTH Judith Nicholas, RN at Northcourt Aged Care Facility, was motivated to attend the mental health forum for personal and professional reasons.

g Helen Bailey (right), RN at Wyong RAFT (rehabilitation assertive follow-up team) said she would like to see a workloads tool designed for mental health nurses. ‘I understand that a workloads tool in mental health would be the first of its kind in the world. While we might not come up with an ideal model, there has to be something for people to use,’ Helen said. 8 RN Samantha Johnstone (left), also of Wyong RAFT, agreed that workloads are one of the most pressing issues being discussed by nurses in the workplace. ‘The Association has conducted training and we are setting up a workloads committee at a local level. We aim to address some of the issues such as payments of allowances, skill mix and to develop a way to measure a reasonable workload to reflect the caseload of community mental health nurses,’ Samantha said.

‘I’m interested in the growing need for mental health education and resources for nurses working in aged care. Aggression and violence towards other patients and staff are big issues in our sector. I’m also interested in the role of carers in mental health because of my own experiences with my daughter who has d Dianne schizophrenia and is Paul, CNS currently in at Chatswood Community acute care.’ Mental Health, said: ‘It’s great that the NSWNA has organised this forum. It allows us to discuss issues of concern and it’s also a good opportunity to hear the different experiences of colleagues working in other areas of mental health such as aged care, drug and alcohol services, inpatient and community mental health.’ d Donna Earsman, RN at RNSH, said more nurses need to be recruited to work in the mental health sector but in doing so management must recognise the need for experienced nurses to have more time to spend mentoring young and entry level nurses. Donna felt that the discussion and debate on the reduction or elimination of seclusion use was ‘interesting’ and ‘it is a serious issue that the NSWNA membership needs to discuss in more detail.’

5 Brett Holmes, NSWNA General Secretary, and Debra Thoms, Chief Nursing Officer, officially launched the Stress Management for nurses. They are pictured with the authors of the booklet. THE LAMP OCTOBER 2006 19


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AGENDA

Dark side of guest labour 457 Visas are loose and open to abuse g The use of temporary skilled migration, especially the use of the so-called 457 Visa, has become a hot public issue, with frequent media exposés of workplace exploitation. This darker side is also found in nursing but with a chronic labour shortage these visas also fill a need. The Lamp looks at the issues.

Labor’s immigration spokesperson Tony Burke

Immigration Minister Amanda Vanstone

WHAT IS A 457 VISA

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The 457 Visa scheme was originally designed to bring foreign executives into the country for short stints in management. It was then expanded for employers who could not find local workers with specific skills. The criteria have now been relaxed so that even truck drivers, factory workers and kitchen hands are now brought in using the visas. 20 THE LAMP OCTOBER 2006

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nions have voiced concerns that the federal government’s handling of its temporary worker visa program is creating a tier of second-class workers in Australia who have no rights and are vulnerable to being underpaid, mistreated and abused. In one case, unions exposed unsafe and exploitative working conditions for around 50 Chinese workers at Wetherill Park in western Sydney. The workers were building a $60 million tissuepaper mill. They used equipment that did not meet safety specifications, they did not have the appropriate licences to operate vehicles and were allowed to carry out dangerous tasks. One man was seen welding a pipe he was tied to while swaying high in the air dangling from a crane. Union concerns are backed by researchers at the University of Western Sydney’s Centre for Innovation and Industry Studies, who have published a highly critical report of the temporary skilled migration system. Among its concerns are: c the government is using the scheme to push down local wages c the principle of equal work for equal pay will be undermined c visas can last up to 4 years c there is no longer a need for labour market testing or to demonstrate the activity is key to the business c there is no longer a requirement for employers to demonstrate a training benefit to Australian workers c there is no need to have credentials vetted by Australian accrediting authorities c there is no requirement for companies who sponsor workers to have a legal presence in Australia.

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overseas temporary workers are in a difficult position in the event of industrial conflict between employers on whom they are completely dependent c restrictions on the movement of 457 Visa holders is dangerously close to ‘bonded labour’. The report details the dramatic rise in the use of the visas. 40,000 people are expected to be granted 457 Visas this year, up 43% on 28,000 visas last year and a 66% increase on 2003-04. There are now 75,000 people in Australia working on these visas. Although employers must pay award rates or set minimum wages of between $41,000 and $51,000 per year, depending on location and skill level, they are not obliged to pay Australian market rates and they no longer have to advertise locally before they recruit overseas. ‘The program should be overhauled to force employers to seek Australian labour before looking offshore, and to pay market rates,’ said Labor’s immigration spokesperson Tony Burke. Immigration Minister Amanda Vanstone has admitted that importing foreign workers helps keep wages down. She has publicly defended the foreign guest worker scheme saying it stopped unions from pushing excessive wage demands. ‘Some parties are opposed to the recruitment drive because it opens up the industry to other pools of employees, which undermines the unions’ ability to exploit high wages amid the skills shortage,’ she told the West Australian. But there are divisions within the federal government over the use of overseas labour. Liberal Alby Schultz (Hume) has questioned why meatworkers are being brought in on temporary visas when skilled Australians are out of work, while National Party whip Kay Hull wants the scheme extended to cover fruit picking.n


Opportunity costs g Abandoned by a labour broker, Fijian nurses get help from the NSWNA.

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hen Ruci Kava saw an ad in the Fiji Times looking for nurses to come to Australia she saw it as an opportunity to move to greener pastures. ‘I was a senior nurse manager at a big hospital in Fiji, but the money wasn’t that great and I was attracted to coming over to Australia. I came over here so I could pay my mortgage back home,’ she told The Lamp. The package, offered by the agency Cytech, contained better pay compared to Fiji, plus a living away from home allowance and the option to stay. Cytech promised that at the end of an initial 18-month contract there were three options: to continue with the same client or Cytech would find another facility or Ruci could go back home to Fiji. ‘I was employed as a ‘residential care officer’, a care giver, and I accepted,’ said Ruci. When Ruci arrived with other Fijian nurses on 457 Visas, Cytech collected money from each on arrival for ‘relocation fees’. ‘I came alone and had to pay $2,000 but there were others who had kids and they had to pay more,’ she said. ‘On top of that we had to pay Cytech for accommodation and furniture. They provided us with a flat with a dinner set, a bed, and bedding. We had to pay for this out of our wages – another $970. I had to pay over $150 per fortnight until they recovered the full amount.’ Ruci, along with other Fijian nurses, was employed as a ‘residential care officer’ at Wesley Gardens Nursing Home. ‘But we were all experienced RNs in Fiji and effectively we were doing the same thing here. We had the skills and we used them for the benefit of the clients,’ she said. Then Wesley terminated its contract with Cytech leaving the Fijian nurses in the lurch.

‘I did my full 18-month contract with Wesley. Some of the other nurses had only done four, six or eight months of their contracts and then their jobs were terminated,’ she said. ‘My expectation was that Cytech would get me another job. But they said they couldn’t do anything and I’d have to go back home. ‘The union is trying to help us out. We’re waiting to do the overseas qualified nurses assessment program at the College of Nursing. It will take seven weeks.’ Unless Ruci can change her visa status, the course will cost her another $6,000. ‘I don’t know how I’m going to make it. Two months without a job and then two months during the course without pay. ‘I’m depressed and frustrated. It’s turned out to be sour and I didn’t expect that. I’m having sleepless nights not knowing how to cope. It is inhuman to treat us like that. I now regret coming here.’ n

‘I don’t know how I’m going to make it.Two months without a job and then two months during the course without pay.’ Ruci Kava THE LAMP OCTOBER 2006 21


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Shackled to a bank loan g A labour supplier saddles Indian nurses with massive debt – but their workmates and the NSWNA are on their side. or Susan Jain and Sangeetha Pillai, Australia wasn’t the obvious destination when they decided to leave their homes in Kerala, India, to further their nursing careers. For Sangeetha, with an honours degree in nursing, an MA in Sociology, eight years experience as a clinical instructor at a college of nursing and an exemplary level of English, there were also opportunities in the USA and Europe to work as a nurse. Susan, with 12 years under her belt working as an RN, also had the qualifications and experience to work anywhere in the developed world. ‘We knew a lot about what it was like to work in the USA and Europe because there are a lot of Indian nurses working there, but we didn’t have much knowledge about Australia - except for cricket and kangaroos,’ said Sangeetha. But when an agency arrived at their workplaces promoting jobs in Australia the incentives were seductive. ‘They gave a good impression about what you’d be paid, about the lifestyle and the professional opportunities,’ said Susan. The Indian agency, Sir Edward Dunlop Hospital Pty Ltd, linked to an Australian

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agency NI, told them they would be earning 2 lakhs (200,000 rupees) worth $5,755 per month as RNs in Australia; astronomical amounts of money for India. There was a catch – before they could start work as RNs they had to do a sixmonth course at La Trobe University in Melbourne – for which they would need to take out a bank loan organised by the agency for 8 lakhs ($23,000). They were told this was to buy things they would need for their course like computers and mobile phones. ‘When we went to the bank the amount had changed from eight to 14 lakhs (over $40,000),’ said Susan. ‘In India, even for a middle class person, these are life savings.’ At the bank, feeling under pressure, they signed a large wad of papers including for the loan. The next afternoon they were told their visa had been approved. They flew out a few hours later. ‘We were rushed into making a decision. It was hard to make a judgement,’ said Sangeetha. They never received any papers from the agency or the bank about the loans. On arrival in Australia the dream opportunity they had been sold in India started to look more like indentured labour.

During the course, they were initially given $100 a week for living expenses from the loan that was now administered in Australia by NI. This amount was later raised to $120 after they protested strongly that they couldn’t live on it. ‘Getting the money was literally begging. We never saw a penny ourselves from the loan,’ said Susan. ‘Then we met other Indian nurses who were practising as RNs in Australia after doing a six-week course and who had only required a loan of 2 lakhs ($5,755). ‘Then we realised what was going on. I felt helpless.’ The loans still remain outstanding but the NSWNA is advising Susan, Sangeetha and 19 of their colleagues of their legal rights. They are also buoyed by the support they have received from their employers and colleagues, with Susan now working at St George Private and Sangeetha at Unanderra Nursing Home near Wollongong. ‘My NUM tried hard to solve the problem. The hospital helped with permanent residency. Everyone was very supportive from the beginning till now,’ Susan said. ‘The nurses union has also been very good to us. At least someone is standing alongside us.’n

More university places for nurses a nati

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report by the University of Western Sydney’s Centre for Innovation and Industry Studies argues that the reliance of some employers on 457 Visas reflects a major economic failure of the Howard government to maintain an effective training and skills formation system. ‘Skills shortages require a systematic approach to domestic training and career development supplemented by stocks of skilled migrants,’ the report said. The report lists the stagnation of training numbers, an ageing population and the changing nature of employment relationships as among the key causes of the skills shortage. 22 THE LAMP OCTOBER 2006

Unions and the Labor Party have been strongly critical of the federal government’s reliance on the 457 Visas to solve critical skills shortages. In turn, Prime Minister John Howard has accused the Labor-run states of being ‘up to their armpits in these visas’. He said the NSW Department of Health was the biggest user of the 457 Visa Scheme last year. The state government lays the blame for this need to go offshore squarely at the feet of the federal government. ‘We are forced to look overseas because the Commonwealth government won’t provide enough university places to

train new nurses,’ NSW Health Minister John Hatzistergos told The Sun Herald. The national statistics on nurse education do tell a story of poor domestic labour market planning in the nursing sector: c only 5,720 nursing students graduated in 2004 c 12,451 students commenced nursing degrees in 1996. By 2004 the number of commencements along with the number of funded university places had dropped to 8,803 c in 2005, 2,761 or 20% of eligible nursing applicants missed out on an undergraduate nursing place c almost half of the current nursing


Susan Jain (right) and Sangeetha Pillai

THE ETHICAL DILEMMAS OF NURSE MIGRATION he NSW Nurses’ Association policy on overseas recruitment of nurses and midwives is mindful of the dilemmas posed by the skilled nursing workforce shortage that Australia shares with many nations. ‘The implications of the global competition for nursing and midwifery skills necessitate some ethical consideration, given that aggressive recruitment of nurses and midwives from undeveloped countries has potentially catastrophic consequences for the health care systems in those regions,’ the policy says. ‘We recognise that nursing is an internationally mobile profession and welcome overseas nurses and midwives working in this country. However, it is important to emphasise

T onal priority workforce will contemplate retirement in the next 10-15 years. It is estimated that NSW needs another 1,426 nurses to properly staff its public hospitals. Two hundred British and Irish nurses are expected to arrive over the next few months, following a recruitment drive in Britain by the State Government. Last year, 300 nurses came from these same countries. In April this year, the federal government announced an extra 1,000 places for nursing nationally, starting from 2007. However, only 176 of these places have been allocated for NSW, 150 of them to be offered in Sydney. n

that the importation of nurses and midwives from overseas is neither an effective nor desirable first instrument to overcome poor domestic labour market planning.’ How catastrophic the impact can be is illustrated by statistics compiled by the World Health Organisation. According to WHO, the Americas with 10% of the global burden of disease, has 37% of the world’s health workers spending more than 50% of the world’s health budget. The African region has 24% of the burden but only 3% of health workers commanding less than 1% of world health expenditure. The exodus of skilled professionals in the midst of so much unmet health need places Africa at the epicentre of the global health workforce crisis (World Health Report 2006).

The full version of the NSWNA Policy on Overseas Recruitment of Nurses and Midwives is available on the NSWNA website – www.nswnurses.asn.au THE LAMP OCTOBER 2006 23


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NSWNA members formed part of the group of 107 union members attached to a chain to represent the 107 Australian construction workers charged under the Howard government’s harsh industrial relations laws.

107 workers face massive individual fines

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ne hundred and seven building workers face fines of up to $28,000 each after the Howard government decided to personally prosecute them for striking. The workers, who were building the $1.5 billion Perth to Mandurah railway, walked off the job in late-February, after the sacking of a union delegate who complained about repeated health and safety breaches. The delegate, Peter Ballard, launched an unfair dismissal case and won a confidential out-of-court settlement. The Australian Building Construction Commission (ABCC), set up by the federal government to police the building industry, could not prosecute the workers’ union, the CFMEU, because union officials had not approved strike action. So the ABCC moved to sue individual 24 THE LAMP OCTOBER 2006

workers under special laws applying only to the building industry. Now 107 rank-and-file workers, and their families, face massive fines and the possible loss of their houses, if convicted. The entire union movement is giving strong support to the building workers. ACTU Secretary Greg Combet said the union movement has launched a fighting fund to defend workers prosecuted under the new regime. ‘We’ll fight for them wherever we need to and for anyone else who faces the same treatment,’ he said. ACTU President Sharan Burrow said: ‘We are going to see these laws ripped up. They are not decent. This is not an Australia we want. ‘If the government turns its back on working Australians, then we will turn our back on a government which doesn’t deserve to rule our country.’ n

NURSES SUPPORT THREATENED FAMILIES Therese Riley and other NSWNA members attended a late-August rally in support of the 107 building workers facing crippling fines. Therese is an NSWNA Councillor and an RN, working in staff education at St George Hospital. She first heard about the plight of the Western Australian building workers at the NSWNA Conference in July, where a resolution of support was passed. ‘I think it’s really important that we have a knowledge of what’s happening in other industries,’ said Therese. ‘We shouldn’t believe we will escape these attacks, so we need to support each other.’ Therese said that fines of more than $28,000 were an attack on families. ‘It’s abhorrent.’ And she said that nurses should not be complacent. ‘Sometimes things happen by stealth. We’ve seen examples of this even in our own industry. It can happen in health as well.’ Therese attended the support rally ‘to display our support for workers in other industries’ and to ‘stand up for our democratic rights’.


IR SHORTS

DOCKED A WEEK’S PAY FOR REFUSING OVERTIME

I

n the latest WorkChoices atrocity, Melbourne electrical parts manufacturer, Heinemann Electric, docked their employees a full week’s pay because during that week the workers banned overtime. The overtime ban was imposed in an effort to secure employee entitlements under a new enterprise agreement. Freehills – the law firm that helped write the federal government’s new IR laws – advised the South African-owned company that refusing overtime amounts to industrial action and therefore the workers cannot be paid for the 38 hours work they did. Both John Howard and Workplace Relations Minister Kevin Andrews supported the actions of Heinemann Electric in refusing to pay the workers.

‘These workers were not on strike, John Howard – they were at work. It is outrageous that ordinary Australian workers should be docked pay for hours they have worked.’ ‘I make the point that this in no way arises from the operation of WorkChoices because there has been a prohibition on the payment of strike pay in Australian law for 10 years,’ John Howard told parliament. Unions were incredulous that workers could be accused of striking, despite working a 38-hour week. ‘These workers were not on strike, John Howard – they were at work. It is outrageous that ordinary Australian workers should be docked pay for hours they have worked,’ said ACTU Secretary Greg Combet. ‘This interpretation of the law by a company that helped draft it clearly indicates the intent of the Howard government in plunging ACTU Secretary Greg Combet

IT’S NOT IN THE PUBLIC INTEREST FOR THE PUBLIC TO KNOW ‘Either the documents contain he release of key documents used further evidence that the economic to develop the federal governargument for its legislation doesn’t ment’s IR laws has been blocked by stack up or it canvasses the unfinished the Prime Minister’s office because they would lead to ‘speculation about business the government has in store for Australian workplaces in future workplace reform’, according the future,’ said the to The Australian newspaper. Opposition’s The Australian had asked for industrial the documents under Freedom of relations Information laws but was stymied by spokesDepartment of Prime Minister and person Cabinet Secretary Peter Shergold, who said it was contrary to the public Stephen Smith. interest to release the documents. ‘Workplace reform legislation is now in the public domain and disclosure of the working documents may divert attention away from the actual legislation to a discussion of the options … later discounted,’ he wrote. Both John Howard and the government’s number three, Nick Minchin, have both signalled Department of Prime Minister and Cabinet that more workplace reform can Secretary Peter Shergold be expected.

T

employers and employees into outright warfare and shows that management in this country now has the upper hand,’ said Dean Mighell of the Electrical Trades Union, representing the workers.

LABOR BACKS STRONGER COLLECTIVE BARGAINING RIGHTS

L

abor leader Kim Beazley has released a policy aimed at strengthening collective bargaining rights in the workplace. Under the policy if an employer objected to a collective agreement the matter would go to the Industrial Relations Commission. If the Commission found a majority of workers were in favour, it could order collective bargaining negotiations to commence. John Howard condemned the policy and argued for the rights of the employer, saying Labor’s policy ‘would restrict the right of Australians to run their own businesses in the way they think fit.’

VEIL OF SECRECY ON AWAS TOO

A

cademics accused the federal government of blocking access to databases of AWAs and collective agreements once freely available on the internet. ‘There’s no way any more for anyone external to the government to critically analyse what is going on with AWAs,’ said Gillian Considine, from the University of Sydney Workplace Research Centre. This was backed by another wellknown academic, Professor David Peetz of

‘There’s no way any more for anyone external to the government to critically analyse what is going on with AWAs.’ Griffith University, who said the federal government’s Office of the Employment Advocate had barred access to collective agreements which had once been available online through WageNet. n THE LAMP OCTOBER 2006 25


s

AGENDA

Nurse practitioners advance against the odds g Pioneers tell of obstacles to innovation

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ore than a decade after their tentative introduction to the NSW health system, nurse practitioners are growing in number

and confidence. Pilot projects started in 1994 and NPs were officially accepted into the health system five years ago. There are now 70 authorised NPs and two midwife practitioners. A further 20 nurses are in transitional positions and working towards authorisation by the NSW Nurses and Midwives Board. About 70 nurses are studying NP postgraduate courses. NPs are controversial because they extend the nursing role into the diagnosis and treatment of diseases, ordering diagnostic tests, accepting referrals and referring patients to other health professionals. Early NPs who pioneered the role met strong opposition and found the going tough. Some still do, while others say their personal battle for acceptance is over. Ten pioneer NPs have told their stories to neonatal RN Jann Foster, who is researching the nurse practitioner movement in NSW for her PhD at the University of Western Sydney School of Nursing. ‘The pioneers met many obstructions, though these have tended to decrease over time,’ Jann says. ‘One of them told me: “The battle’s over for me – I’ve finally won”.’ Jann warns, however, that the pioneers’ experience indicates the creation of a NPfriendly health system will be a marathon, not a sprint. Major obstacles remain. In an interview with The Lamp, Jann drew on her research with pioneering NPs to discuss lessons from their experiences. Some of the barriers faced by early NPs are identified in the following excerpts from the interview.

Public scepticism ‘The public generally still see nurses in the roles they performed 20 years ago. Most people are unaware that nurses’ roles have changed in response to the changing 26 THE LAMP OCTOBER 2006

needs of the health care system brought about by such things as new technology, faster turnover of patients, and the greater incidence of chronic disease. The public still see us as being supervised by doctors and this is reinforced by images through TV programs such as All Saints.

Lack of provider status ‘NPs are legally able to prescribe medication but have no access to the pharmaceutical Benefits Scheme (PBS) that subsidises the cost of prescriptions. This is a major problem for the community. ‘Patients must pay more for a NP’s prescription than one written by a doctor. NP patients in remote areas may be forced to choose between paying extra for a prescription or travelling hundreds of kilometres to see a GP. ‘The PBS issue also affects NPs in emergency departments. When they prescribe a

‘Many NPs said they were acutely aware of the responsibility of being pioneers, and felt if they did anything wrong it would be seized on by the doctors. ‘NPs work within clinical guidelines which have been a major area of contention. Initially, the process of developing the guidelines was laborious, partly because it involved the AMA, which is opposed to the very concept of NPs who aren’t supervised by doctors. Some doctors attempt to limit NPs’ practice by opposing their clinical guidelines.

Relations with other nurses ‘The introduction of NPs alters working relationships within health care teams, including relations between NPs and other nurses. Some NPs identified a lack of trust from nursing colleagues who questioned their expertise. ‘For example, some nurses insisted

‘The battle’s over for me – I’ve finally won.’ drug the hospital – rather than the federal government – has to cover the cost. Some NPs who have run out of their meagre stocks of medications after just a few days, have been told by their hospital, ‘That’s it, we have no funding for more medications. ‘NPs are sometimes given starter packs to get a patient started on a course of antibiotics. The patient then has to see a doctor to get another script in order to finish the course. Some patients have used the starter packs then stopped the medication – with all the ramifications of not finishing a course of antibiotics. ‘In the US, where the NP movement is far more advanced, NPs undertook an aggressive lobbying campaign among legislators and finally won provider status in 1997.

Doctor resistance ‘The Australian Medical Association continually claims that NPs offer a secondclass service. The AMA puts out more press releases attacking the concept of NPs the more they see NPs gaining a foothold.

on verifying orders written by an NP with a doctor, thereby undermining the confidence and effectiveness of the NP. ‘NPs said they constantly had to explain their roles to other nurses. They needed to explain that a NP is an expansion of nursing practice rather than a move into a medical practitioner’s role. In other words, working from a nursing model not a medical model. ‘They had to combat the view that the only people who should be diagnosing or ordering diagnostics or prescribing medication, are doctors. ‘NP positions initially received special funding. However, some Area Health Services eliminated vacant part-time senior nursing positions in the process of creating NP positions. Or they replaced a CNC position with an NP position, which created tension between nurses.

Key role of managers ‘Health care managers play a critical role in developing sustainable NP roles. Yet in the early days, minimal thought was given to


the importance, needs and role of managers in successfully introducing NPs. Managers of NPs need support themselves. They rely on support networks to share insights, information, experiences, challenges and difficulties. Some pioneer NPs experienced amazing obstruction from some managers. One patient on their way to see a NP told the manager, ‘I’m here for a consultation with the NP’ and the manager replied, ‘Over my dead body!’ ‘NPs also met obstruction from managers in developing clinical guidelines. For example, being told the Area Health Service could only afford one guideline – for example, for the pill or the morning-after pill, but not both. ‘One of the early NPs was asked by her area management to define how much of her time was spent as a NP and how much as a RN. This showed a complete lack of understanding of the NP role. ‘If managers don’t fully understand what the role is it is very hard for them to know how to use the NP properly.

‘Today nurses who succeed in becoming NPs have more support available to them, and many of the issues raised have been, or continue to be addressed.’ Jann Foster

Lack of support and resources ‘Many of the NPs were not accustomed to developing clinical guidelines, they had to learn that for themselves. ‘One nurse authorised to work as a NP never managed to take up the position because she could not get her clinical guidelines up and running – there was just no support. Another NP in a small country town suffered so much obstruction she’s no longer working as a NP, and no one has replaced her. ‘Pioneer NPs reported that a lack of office space, facilities and resources had a detrimental affect on their practice. More than one NP had to share a room and conduct consultations with patients while other staff were present. ‘A lack of space was identified as leading to increased patient waiting times, wasted clinician time and a decrease in NP-patient interaction time. ‘NPs were forced to search for a phone to return calls, many did not even have their own desks and had insufficient storage for confidential documents.’

Evolving role Jann stresses that while these barriers were identified by pioneer NPs, the role will continue to evolve over time. ‘Today nurses who succeed in becoming NPs have more support available to them, and many of the issues raised have been, or continue to be addressed,’ Jann says. n THE LAMP OCTOBER 2006 27


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seek.com.au 28 THE LAMP OCTOBER 2006


s

AGENDA

Hitting a brick wall g A country town loses its nurse practitioner

W

endy Swann lasted just over a year as a nurse practitioner in a town of 2,500 people in rural NSW. Despite strong support from patients and other nurses, ignorance and obstruction from within a system that did not know how to support the role made her job impossible, she says. Yet Wendy remains enthusiastic about the NP role and is seeking to resume work as an NP in a new location. ‘Being a nurse practitioner is about making use of the untapped potential of our profession,’ she told The Lamp. ‘It is very satisfying to be able to care for individuals in a collaborative and accountable way, not just to be seen as operating under the supervision of others. ‘Being a NP is about expanding and maximizing the role of a nurse.’

‘Management was divided on the need to develop and support the new role.’ A trained nurse for 27 years, Wendy was a RN at a district hospital when she became one of the first authorised NPs in NSW. ‘I had been nursing at that hospital for several years, as an RN, educator, and midwife, and was well known to staff and the community. ‘Some members of the Rural Doctors Network were supportive and had been involved in the earlier pilot NP project. However, despite some enthusiasm in the early consultation process, local GPs were not supportive. ‘Nursing management across the board, had difficulty with the relative autonomy of the NP role within the traditional structure.’

Perpetual staff shortages meant Wendy was required to fill shortfalls in staffing. The NP role was funded from the existing nurses’ budget, which made the staff shortage worse. ‘Basically, the health service didn’t know what to do with me, and it became more and more difficult to evolve the role in the environment that existed,’ she explained. ‘The NP project in the area lost momentum as it lost support within upper management. All levels of management were clearly divided on the need to develop and support the new role. ‘In an environment of limited funding and lack of space, there were very few resources to support the role. Computer access was limited and I ended up buying my own computer. ‘I was given shared office space with others who resented the intrusion, and sharing an office restricted patient privacy. My hours of work were limited by budgetary constraints and so as not to attract penalty rates. ‘All my patients and rank and file nurses were really supportive, but eventually I decided I couldn’t continue hitting a brick wall and left the job.’ The hospital’s NP position is still vacant. Wendy went to work for the Flying Doctor Service and is now arranging to move into a NP program in another part of the State. She believes small towns have the greatest need for NPs yet their health structures are least likely to cope with such a non-traditional role. ‘I strongly feel that nursing management needs as much support and direction as the individual NP, so they can develop the role

together, well away from power plays and traditional hierarchies. ‘Nurses in rural and remote areas are the heart and soul of their communities and are often the difference between life and death regardless of the presence of medical care. Patients, rural doctors and health services stand to benefit greatly when the nurses’ role is allowed to develop. ‘Management and critics of NPs need to overcome their suspicion and distrust of the role and embrace it. ‘Nurse practitioners are raising the profile of nursing and will help to make it a more attractive career. Nursing is barely scratching the surface of what it could contribute to health care in this country – Australians haven’t yet seen the full contribution nurses can make.’ n

Wendy Swann THE LAMP OCTOBER 2006 29


30 THE LAMP OCTOBER 2006


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A G E D

C A R E

Aged care nurses meet in Blue Mountains

D

espite the cold, more than 40 members attended a NSWNA aged care meeting in the Blue Mountains to learn how the federal government’s industrial relations legislation might impact on aged care nurses. Speakers from the Association and the aged care sector covered issues such as threats posed to employees, decent employers and quality of care for residents – as well as the need to protect the role of nurses in aged care. Yvonne Thomas, AIN from The Ritz nursing home, said she attended in order to understand more about the industrial relations laws. Yvonne said she was ‘better off finding out the facts from the union’ because she believed the mainstream media’s coverage of the new laws was not always accurate. Cheryl Edwards, DON from Anita Villa nursing home, spoke with the support of her employer, from the perspective of an operator who does not want to reduce the rights and conditions of employees. Cheryl said the laws had ‘an unsettling affect on the staff’. The facility owner recognised that the industrial relations

Shirley Lee and Robyn Whatman from the NSWNA introduce the panel of speakers at the meeting: (from left) Jill Biddington (NSWNA), Cheryl Edwards (DON Anita Villa nursing home), Lucille McKenna (DON Palm Grove nursing home), Brian Mason (NSWNA) and Phil Doyle (‘Your Rights at Work’ community group).

legislation ‘put sanctions on us valuing our staff’ and that the nursing home would maintain the current conditions enjoyed by staff because they ‘value the people that work with us and for us’. ‘Although good operators won’t want to act negatively towards their employees, not everyone is safe and there are still nurses who are vulnerable,’ she said. Cheryl urged members to talk to their work colleagues, their local federal Member of Parliament and the union about protecting fair pay and conditions for staff working in aged care.

The Blue Mountains is a part of the seat of Macquarie, held by Liberal Kerry Bartlett, and is one of the most marginal seats in NSW. A swing of only .33% at the next federal election is needed to unseat her and deliver an alternative MP who will protect Australians’ rights at work. The Blue Mountains ‘Your Rights at Work’ committee encourages all nurses living in the area to get involved in the community campaign. For more details, contact Phil Doyle on 0416 155 235 or Pat O’Beirne on 4758 6493. n

Members attending the Blue Mountains aged care meeting. THE LAMP OCTOBER 2006 31


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s

WORKLOADS

Beds may close at Wagga Wagga g Bans threat brings swift action on vacancies

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agga Wagga Base Hospital nurses got no action on their repeated appeals for more staff – until they decided to impose workplace bans. ‘We felt we had no alternative,’ said branch president and ICU nurse Tania Gleeson. ‘We have a vacancy rate of around 45 full-time-equivalent nurses in a 259-bed hospital. We tried through meetings and letters to get a meaningful response but we felt as though we just got fobbed off. ‘In some areas replacement staff had been approved but not recruited, mainly because of serious problems in the recruitment process which weren’t being addressed.’ The bans decision, assisted by local media coverage of the excessive workload imposed on nurses by understaffing, helped management grasp the seriousness of the problem. Union-management negotiations via the hospital’s reasonable workloads committee (RWC) so far have resulted in agreement that beds may be closed, and/ or elective surgery cancelled, if staffing is inadequate. The RWC has also agreed to: c Increase nurse numbers and improve the skill mix in the ED c Prevent areas such as the eye and plaster rooms from being used to treat ‘spillover’ patients from the ED c Urgently recruit a nurse to focus solely on bed management

‘Staff were already working long overtime when winter set in and the Health Department announced their winter strategy for extra beds.’

Wagga Wagga Base Hospital branch president Tania Gleeson

c

Conduct a more visible recruitment campaign including outside the Greater Southern area c Make greater use of internet-based recruitment software. Tania said the hospital’s recruitment process meant six management personnel were required to sign off on the employment of one nurse.

‘It has taken so long in the past for a nurse to be employed at WWBH that experienced applicants have given up and gone to work for the local private hospital,’ she said. ‘It also takes too long to finalise new employees’ contracts. We have had nurses working for up to six weeks without being paid due to this delay. ‘The staff shortage has resulted in a serious access block in ED with ambulances blocked in turn because they can’t offload patients from their stretchers. ‘Because of the staff shortage, intensive care can’t handle more than about two ventilators – we used to have five. ‘Staff were already working long periods of overtime when winter set in and the Health Department announced their winter strategy for extra beds. That strategy was introduced with the proviso that the policy be approved by the RWCs. But at WWBH the RWC wasn’t consulted – management stated they were not aware this policy had to be discussed, and accepted, by the RWC, and hence more beds were opened without any consultation.’ Tania said nurses were fed up with the strain of covering for staff vacancies, and became discouraged by the lack of management response to RWC incident reports. ‘Things are looking better now and the union is helping the branch to get action via the RWC,’ she said. ‘The branch is getting regular briefings about the situation and will closely monitor staffing and workloads.’ n THE LAMP OCTOBER 2006 33


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s

Q & A

ASK

JUDITH Relieving in a higher grade I have been relieving in a higher grade position in a public hospital for the past 18 months and am continuing to do so, but I have been told that I am not entitled to have my leave accrued at the higher rate. Is this correct?

No, this is not correct. If you have relieved continuously for one year or more in the same higher-graded position and are continuing to act in that position you are eligible for payment for higher duties allowances for any annual leave, longservice leave, sick leave or short leave which is taken during the further period of relief. Please check circular 94/48 (PD2005_443) for further information.

Knocking back overtime I am a nurse employed at a public hospital. Recently, I finished a shift and the NUM asked me to do 2 hours overtime. I would have been happy to work back. However, I had to pick up my children from school and there was no one else available to pick them up. The NUM said that I had no choice but to stay back, but I really had to leave. Where do I stand in this situation?

Clause 25 of The Public Health System Nurses’ & Midwives’ (State) Award states that an

WHEN IT COMES TO YOUR RIGHTS AND ENTITLEMENTS AT WORK, NSWNA ASSISTANT GENERAL SECRETARY JUDITH KIEJDA HAS THE ANSWERS. employer may require an employee to work reasonable overtime. However, an employee may refuse to work overtime in circumstances where it would be unreasonable. What is ‘unreasonable’ is determined by a number of factors including: (i) any risk to employee health and safety (ii the employee’s personal circumstances including any family and carer responsibilities (iii) the needs of the workplace or enterprise (iv) the notice (if any) given by the employer of the overtime and by the employee of his or her intention to refuse it; and (v) any other relevant matter. Given your circumstances and the short notice of the overtime request, you would have good reason to decline to work back in this instance.

Superannuation while on workers’ compensation I work in a nursing home and have been on workers’ compensation for three months. Recently, I received a statement from my superannuation provider and have noticed that my employer has not been paying my superannuation while I have been off work. I have spoken to both my employer and superannuation

provider and was informed by both that the employer is not obliged to make the contribution. Is this correct?

Employer superannuation contributions are not payable by private sector employers if an employee is receiving workers’ compensation payments. These payments are excluded from ordinary time earnings under the Superannuation Guarantee Legislation.

Superannuation while on maternity leave I am employed in a public hospital and will be going on maternity leave in two months time. I will be on paid leave then going on unpaid leave. Is my employer required to make the superannuation guarantee payments for me while I am on maternity leave?

When you are on paid maternity leave your employer is obliged to make the compulsory employer contributions to First State Super or to another complying superannuation fund on your behalf, but they are not obliged to make the contributions on the unpaid section of your maternity leave. This is in accordance with Department of Health Policy Directive PD2005_350. It applies to staff employed in the public sector but not the private sector. n

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N PE EWC SI AI LN P BE R S O IPE LF E

RN Vicki McMahon (centre) receives first prize in the raffle from Candice Feuerring of Union Aid Abroad – APHEDA (left) and Dascia Bennett of Members Equity Bank.

Vicki has the world at her feet g Vicki McMahon wins trip of a lifetime in APHEDA raffle

V

icki McMahon arrived home one morning after finishing night shift as RN at Nepean Hospital, and received a phone call that made her day: she had won the Union Aid Abroad–APHEDA 2006 raffle first prize – a trip for two around the world. Vicki was delighted. She bought a ticket in the raffle to support APHEDA – winning first prize was an unexpected surprise. ‘It was a lovely gift, I wasn’t expecting anything but won something – it was serendipity,’ she said. ‘It’s good to see the work that APHEDA is doing – especially in countries like East Timor. The needs in places like

that are huge. I will definitely continue to support the organisation.’ Dascia Bennett from Members Equity Bank, which sponsored the raffle, said: ‘It is natural for us to support an organisation like Union Aid Abroad– APHEDA because our culture was born

Candice Feuerring, a representative from Union Aid Abroad–APHEDA, congratulated Vicki and was pleased with the success of the raffle. ‘The APHEDA raffle is one of our biggest fundraisers for the year. This year we raised over $76,000. It’s a great event

Vicki was delighted. She bought a ticket in the raffle to support APHEDA – winning first prize was an unexpected surprise. out of the union movement.’ Members Equity is a membership bank set up by industry super funds and unions. ‘It’s clear synergy for us to sponsor the APHEDA raffle. We don’t have massive sponsorship arrangements but this is one that we thought went with the culture of our bank.’

because it also helps to raise the profile of the organisation. People who are selling the tickets are talking about who we are and what we do,’ said Candice. Vicki is unsure about when she and her husband will be taking their holiday but ‘seeing Europe’ will be a dream come true. n THE LAMP OCTOBER 2006 37


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Potty about pottery g After a busy day managing a retirement village, nurse Fiona Barrett can’t wait to get elbow deep in clay – and her kids love to join in.

F

iona Barrett believes she was lucky to have an inspirational art teacher who sparked her interest in pottery at a time when she wasn’t really interested in other school work. ‘In hindsight, at school I was unfocused, immature and only interested in my social life,’ she admits. ‘I had a great time and my HSC results reflected just that, but I did manage to get 100% in art’ – and a love affair with clay to last a lifetime.

‘Kids love it because it is tactile, they can see instantly what they are achieving.’ Fiona finds the process of creating something with her hands ‘gratifying’ and often gets so engrossed in what she is creating that she loses sense of time – a pleasant change from being on the go all day as Acting DoN at Condobolin District Retirement Village and a busy mum of two. After many years working in an emergency department Fiona was ‘tired of the system’. She dreamt of potting full time and was lucky enough to make her dream a reality when she was on maternity leave. ‘When we had our first child, Lilla, I had a break from nursing and pottered for about 18 months. I really loved being at home with Lilla and a bag of clay,’ she said. After she had her second child, Oscar, Fiona booked herself into a pottery class one night a week at the local School of the Arts. ‘The classes pushed me along and I learnt different skills and techniques. It was also good to meet other inspiring people who were just as passionate about clay.’ Last year Fiona held an exhibition of her work with three other artists and 38 THE LAMP OCTOBER 2006

Fiona Barrett

describes the experience as ‘a great personal achievement’. Fiona uses a method called hand building, as opposed to the wheel method. She says it’s time consuming and slow, but also ‘rewarding and soothing’. To build the pot she uses what is called the ‘coil’ method. The clay must be kneaded first and rolled out in a coil, like a snake, of even thickness. The size of the pot will determine the thickness of the coil. After the pot is built it is air-dried. After a couple of days when it is ‘leather dry’ Fiona spends hours and hours ‘burnishing’ it, rubbing it with the back of a spoon to create a beautiful smooth silver surface.

She then rubs the pot with butter and does the first firing ‘bisque’ in a kiln at 1080 degrees. The second firing is done in a primitive home-made kiln made by her dad – half a 44 gallon drum, lined with bricks, holes in the bottom for drawing and a plough disc for the lid. After glazing and firing her wares Fiona opens the kiln – a feeling ’like Christmas’. Half the fun is not knowing whether the result will be successful or disastrous. Fiona recommends potting as a great family activity. It makes sense really. After all, what kid doesn’t like being elbow deep in mud? Working with clay is inexpensive, you can do it at home and you can get supplies even if you live in a remote area.


‘My children, probably like most children, love getting dirty. Kids love it because it is tactile, they can see instantly what they are achieving,’ Fiona says.

Feeling potty? If you can picture yourself re-enacting that scene in the movie ‘Ghost’ or if you want to have some fun and get your hands dirty then Fiona recommends you book in for a class or course at your local community college, join a potters’ group or channel your inner artist at home. ‘Potting is the most wonderful art because you can learn for a life time and what you create can last for many life times,’ she points out. n

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THE COMEDY PLAY THE HOSPITAL The Hospital is a Norwegian production starring Guri Glans, Gunhild Aubert Opdal and Ingrie Enger Damon as three rather lascivious nurses going spectacularly off the rails. Described as ‘a loopy, sexy, highly entertaining work’ this physical theatre work by Jo Strømgren Kompani is set in a shabby provincial clinic where there are no patients but one well stocked medicine cabinet! Venue: Dates: Times: Artists Talk: Tickets: Bookings:

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The NSWNA is giving away 10 double passes to the preview of The Hospital on Tuesday 24 October at 6.30pm. To win, email sbarber@nswnurses.asn.au with your name, NSWNA membership number, address, and phone number. First entries win!

THE LAMP OCTOBER 2006 39


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L I F E S T Y L E

World Trade Centre g One of Hollywood’s most ‘political’ directors tells a story of survival from the September 11 attack on the United States.

T

he fact that this is an Oliver Stone movie caught my attention. He is known for his hard-hitting films with political comment. My own views of the September 11 disaster are a mixture of politics and tragedy for the people who are left suffering. The two main characters are Port Authority police – played by Nicholas Cage and Michael Pena – called in to evacuate the building. Cage is Sgt John McLoughlin, a 20-year veteran who had been on duty in 1993 at a similar disaster – a bomb blast. He leads fellow officers to the North Tower. Almost immediately they are in danger as the building has already been hit and debris is starting to fall. They manage to grab some equipment and as the falling debris becomes heavier they are told by McLoughlin to take shelter in the lift shafts, as they are the strongest parts of the building. McLoughlin and Officer Jimeno (Pena) are trapped about 20 feet below ground with another officer, who dies some time later. There were only 20 people pulled out alive, McLoughlin and Jimeno were numbers 18 and 19.

The story from then on is dominated by their will to survive and the parallel story of their wives, children and families from the moment they found out where they are and what had happened. McLoughlin’s wife Donna, played by Maria Bello is not as convincing in the role of a distressed wife/mother as is Maggie Gyllenhaal playing Allison Jimeno. Gyllenhaal is really good, playing a character who was quite heavily pregnant and had to get through this with a toddler to care for. Cage and Pena are terrific – fine acting when only the top halves of their bodies were visible. Their characters were extremely lucky to have survived and owe their lives to not only their determination but also to another character who believed he had ‘a mission’ to perform on that day. When he heard the news, Marine Sgt. Thomas donned his uniform and went to the disaster site. He met up with another Marine and they combed the sites and were turning back just as they heard Jimeno tapping on a pipe. This is an unusual film for Stone to have made. Stone cast against type but managed to get the best out of his actors. The effects were outstanding and the camera work had you right in there – no escape was possible. n

Reviewer Lyn Kelly, RN at Camperdown Mental Health Service.

WANTED STAR REVIEWERS & TIPSTERS FOR OUR REVIEW PAGES

We're seeking members with a non-nursing skill or talent they'd like to share with other nurses. You could be a whiz in the kitchen. Or have some DIY plumbing and homehandy tips. Or a wild and wonderful interest or skill. Be it strange, extraordinary or useful, we'd love you to come on board as a NSWNA tipster. We are also seeking closet film buffs to share with other nurses their views on the movies they love and hate. It’s a chance to see previews of next month’s new releases. Please contact us with expressions of interest to be part of our tipster and movie review team. Be part of the action by calling Salim Barber now on 02 8595 1219 or email sbarber@nswnurses.asn.au

World Trade Center directed by Oliver Stone runs from 5 October. Find out more on the website www.wtcmovie.com

SPECIAL OFFER FOR NSWNA MEMBERS The Lamp has 10 double passes to give away to see World Trade Centre, thanks to United International Pictures. To enter, email Salim Barber at sbarber@nswnurses.asn.au with your name, membership number, address and contact number. First entries win! THE LAMP OCTOBER 2006 41


Go further than you ever imagined Take your career to the next level How’s your job? Chances are, it’s fine. You’re successful, respected, taking care of business and having fun. But if you’re like most people, you dream of something more. Broader horizons, bluer skies. You’ve come this far - it’s natural to want to rise to the next level. It’s easier than you think. In just one to two years, and in some cases from home, you can earn a graduate degree in a specialised health field, and enter an exciting new career in this thriving industry. Graduate programs: • Master of Health Science (Health Informatics) • Master of Health Information Management • Master of Health Science (Clinical Data Management) • Graduate Certificate of Health Science (Clinical Data Management) Career options: • Clinical trials and research • Clinical data management • Health informatics • Health IT • And many more. The sky’s the limit for health professionals with a graduate degree. Apply now for 2007! For more information call +61 2 9351 9494 email himinfo@fhs.usyd.edu.au or visit www.fhs.usyd.edu.au/pg2007.

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42 THE LAMP OCTOBER 2006


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O B I T U A R Y

Coronary care was Brendaâ&#x20AC;&#x2122;s passion Brenda Kay Clarke

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Brenda was confident and competent and found it difficult to put up with some of our â&#x20AC;&#x2DC;frequent flyersâ&#x20AC;&#x2122;. Brenda didnâ&#x20AC;&#x2122;t suffer fools or freeloaders who would bear the brunt of her triage assessment. Peering over her glasses she was often telling our doctors what to do and had the ability to correct their diagnosis. However under that skin she was a very generous and kind person. She had a wonderful sense of humour and was always at staff parties (sometimes with Kel) thoroughly enjoying herself but always tried to avoid the lurking cameras â&#x20AC;&#x201C; there are many photos of her with her head down or an arm across her face. Brenda was on her way to work a night shift when she had a cardiac arrest and was subsequently resuscitated and airlifted to Westmead Hospital. It is with our deepest regret that Brenda (surrounded by her family) never recovered and died on Sunday 23 July 2006. Her family, friends and colleagues at Bellingen Hospital mourn her passing and the nursing profession has lost a most valued member. n By Valmai Sims, NUM, Bellingen Hospital

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urses at Bellingen Hospital mourned the recent loss of Brenda Clarke who brought so much knowledge and experience to this rural hospital with her skills in coronary care. Brenda undertook her general nurse training at Sydney Hospital from 19761979. On completion she worked as a RN for a year at Royal Hobart Hospital. She completed her midwifery training in 1980-1981 at the Lyall McEwan Hospital in Elizabeth, South Australia, and later worked in its Coronary Care Unit â&#x20AC;&#x201C; an area that was to become her niche. In 1982 Brenda moved back to Sydney, working at Ryde and Marrickville

hospitals in intensive care, acute care and coronary care. She had a passion for caring for patients with acute life threatening illnesses and to further her career she enrolled in the intensive care course at Royal Prince Alfred Hospital. After completing the course in 1987 she started work at Westmead Hospital on the surgical ward where she relieved the NUM. After two years at Westmead Brenda applied for a NUMâ&#x20AC;&#x2122;s position in the medical-surgical ward at St Davidâ&#x20AC;&#x2122;s Private Hospital in Eastwood, where she worked for seven years. Brenda decided a sea change was needed and moved to Woy Woy where she worked at Brisbane Waters Private Hospital in the Coronary Care Unit from 1996-2003. During this time she found her soul mate Kel and they married and decided to move to Urunga and build a house on Newry Island. Brenda started working at Bellingen Hospital in 2003 as a casual and this soon led to a permanent part time position. She was always willing to share her wealth of experience and we were always grateful for her assistance and advice with interpretation of ECGs

THE LAMP OCTOBER 2006 43


NSW Nursing and Midwifery Scholarship Fund

MENTAL HEALTH SCHOLARSHIPS NSW Health is offering three streams of mental health scholarships for 2007: • Mental Health Enrolled Nurse to Registered Nurse Scholarships; • Mental Health Postgraduate Scholarships; and • Mental Health Innovation Scholarships.

MENTAL HEALTH ENROLLED NURSE TO REGISTERED NURSE SCHOLARSHIPS Available to enrolled nurses employed in the NSW public health system working or seeking employment in mental health and undertaking a Bachelor of Nursing degree in 2007. Must also have an intention to work as a registered nurse in mental health in the NSW public health system upon completion of nursing degree. Up to $5,000 available per applicant in 2007*. Applications close 30 November 2006 (for study in 2007).

MENTAL HEALTH POSTGRADUATE SCHOLARSHIPS

MENTAL HEALTH INNOVATION SCHOLARSHIPS

Available to registered nurses employed in the NSW public health system working or seeking employment in mental health and undertaking postgraduate study in 2007 in a mental health course accredited under the Higher Education Act (2001). Up to $5,000 available per applicant in 2007*. Applications open 1 December 2006 and close 28 February 2007 (for study in 2007).

Available for mental health specific projects that stimulate the development of flexible, contemporary models of practice in the areas of rural, metropolitan, community, inpatient and forensic nursing. Five scholarships up to $10,000 each available*. Applications open 1st October 2006 and close 31 December 2006 (for projects that commence before 31 January 2007). *further criteria applies

For further information and application forms visit the Nursing and Midwifery Office website at www.health.nsw.gov.au/ nursing/scholar.html or contact the Project Officer Scholarships via email on nscholar@doh.health.nsw.gov.au

Nurse-Midwife-Schollarship-v3.indd 1

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L I F E S T Y L E

Book me Urinary and Fecal Incontinence: Current Management Concepts (3rd edition) by Dorothy B. Doughty, Elsevier Australia, RRP $104 : ISBN 0-323-03135-8 This third edition of Urinary and Fecal Incontinence highlights principle-based nursing management and provides an in-depth review of the physiology of continence, the pathologic mechanisms producing incontinence, and the current treatment options for the various types of incontinence, with emphasis on behavioural therapy.

Breastfeeding A-Z: Terminology and Telephone Triage by Karin Cadwell and Cindy Turner-Maffei, Jones and Bartlett Publishers (available through Elsevier Australia), RRP $65 : ISBN 0-7637-3533-7 Breastfeeding A-Z is a first attempt to provide a quick reference and triage tool for nurses, physicians, nutritionists, breastfeeding peer counsellors,

N E W

R E F E R E N C E

lactation consultants, and counsellors with evidenced-based reference about common breastfeeding terms and issues that may present as telephone calls. Triage guides for common problems such as breast pain, engorgement, and concerns about milk supply are referenced as well as containing an encyclopaedia of terms relevant to breastfeeding in both plain language and medical terminology.

Pocket Guide to Perioperative and Critical Care Echocardiography (includes mini CD) by Colin Royse, Garry Donnan and Alistair Royse, McGraw Hill Australia Pty Ltd, RRP $44.95 : ISBN 0074716115 This handy book is aimed at introducing and simplifying the practice of echocardiography and ultrasound by focusing on the essential, basic information needed for successful use by surgeons, anaesthetists and physicians as well as students. A bonus mini-CD is included that provides an extensive collection of moving ultrasound images for detailed views, with graphics for further explanations and pointers to specific images.

B O O K S

A V A I L A B L E

Drug Information Handbook for Perioperative Nursing Including Drug and Herbal Interaction references, Geriatric and Pediatric Dosing, and Abbreviations and Measurements published by Lexi-Comp, Incorporated (available from Elsevier Australia), RRP $66.00: ISBN 1591951399 This book contains information not readily available in other nursing drug reference books. Each phase of the perioperative encounter is addressed, with emphasis on special situations central to the perioperative patient care environment. Reference items are not available for loan but may be viewed by visiting the NSWNA Library.

Eat, Play and Be Healthy: Harvard Medical School Guide to Healthy Eating for Kids by W. Allan Walker with Courtney Humphries and foreword by Walter C. Willett, McGraw Hill Australia Pty Ltd, RRP $24.95 : ISBN 0-07-144186-7 Eat, Play and Be Healthy aims to help parents adopt a nutritional strategy that is best for the long-term health of their children and bring them up-to-date on the latest knowledge about how the foods children eat affect their health. Picking up where Dr. Walter C. Willettâ&#x20AC;&#x2122;s international bestseller Eat, Drink, and Be Healthy left off, W. Allan Walker, M.D., shows how to apply the research-based Healthy Eating Pyramid to a childâ&#x20AC;&#x2122;s unique needs, drawing on his forty years of clinical research, as well as the latest scientific findings. n

Reviews by NSWNA librarian, Jeannette Bromfield.

WHERE TO GET

OCTOBER

NEW RELEASES These books are all available on order through the publisher or your local bookshop. Members of the NSWNA can borrow any of these books and more from our Records and Information Centre. For borrowing information, contact Jeannette Bromfield, 8595 2175, jbromfield@nswnurses.asn.au or Cathy Matias, 8595 2121, cmatias@nswnurses.asn.au THE LAMP OCTOBER 2006 45


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CRoSSWoRD Test your nursing knowledge in this monthâ&#x20AC;&#x2122;s crossword. 1 7

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16 17

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7. 9. 10. 11. 13. 14. 16. 18. 19. 20. 21. 24. 25.

1. 2. 3. 4. 5. 6. 8. 12. 15. 17. 22. 23. 26.

Penicillin helps destroy these organisms (8) Wrist pain, carpel â&#x20AC;Ś.. syndrome (6) Aperient (8) Grain similar to wheat (3) Treatment towards the end of life (10) The upper jaw (7) Evaluate (6) Common name for clavicle (10) Applied a cold pack (4) Type of religion (3) Someone suffering from memory loss (8) Croaky, husky voice (6) A common analgesic (7)

A mild, very common analgesic (11) Doctor, abbrev (2) Part of the knee (7) Hormones often used to treat inflammation (8) Morphine and nitrous oxide fall into this category of drugs (12) A substance applied to the skin (3) Drugs which allay anxiety and have a calming effect (14) Removes an organ (11) Voice boxes (8) Substance found in cigarettes (7) A swelling or protuberance (4) Digit of the leg (3) Intravenous, abbrev (1.1)

Solution page 49 THE LAMP OCTOBER 2006 47


CAREGIVERS a change is as good as a rest

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w w w. anmc .org . au (02) 6257 7960

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DIARY DATES Conferences, seminars, meetings SYDNEY, HUNTER & ILLAWARRA Macquarie Hospital NSCC Free Mental Health Week Movie Screenings 7 Oct, Northern Syd. Educ. Ctr. amphitheatre Contact: Winnie, (02) 9887 5989 Who Cares for the Elderly? Nurses Do! 13 Oct, 8am - 4:30pm, Liverpool Hospital Cost: $30. Contact: Kristie Evans, (02) 9828 4819, Kristine.Evans@swsahs.nsw.gov.au Foundations in Diabetes Management 16 – 20 October, RNSH Contact: Valerie Gilbert (02) 9926 7229 vgilbert@nsccahs.health.nsw.gov.au ACAT Nurse Special Interest Group 17 Oct & 5 Dec, 1 – 3pm, Bankstown Hosp Contact: Wendy Oliver (02) 9722 7300 Wendy.Oliver@swsahs.nsw.gov.au An Evening with Patch Adams 18 Oct, 6:30 – 7pm, the Sofitel Wentworth $150 (nurses’ special), $1,200/ table of 10. Info: Charolotte Lunn, Event Manager, (02) 9699 2000, charlotte@marksonparks.com Community Nurse Audiometrist Assoc. Inc – 24th Annual Conference Date: 18 – 20 October, Noahs on the Beach Contact: Karen Johnston (02) 4952 3328 Email: cathkel@optusnet.com.au NSW Health Awards Expo 2006 Date: 19 Oct, Australian Technology Park Contact: Michelle Wensley Email: MWENS@doh.health.nsw.gov.au Pain Management Conference Date: 20 October, Wollongong Hospital Contact: Sonia Markocic (02) 4253 4426 sonia.markocic@sesiahs.health.nsw.gov.au Balancing Safety and Risk in Maternity Care Seminar Date: 20 October, 8:30am – 4pm, Functions Gallery, UTS Tower Building Lvl 6. Cost: $75 (employed midwifery students), $60 (unemployed midwifery students) or $90 (full fee). Registrations close 12 Oct. Contact: Priya Nair (02) 9514 2977 The NSW Urological Nurses Society (NUNS) Annual Conference Date: 21 October, Four Points Sheraton Htl Cost: $80 members, $120 non-member (incl. $40 membership) Contact: Karina So (02) 9767 5000

Diary Dates Diary Dates is a free service for members. Please send the diary dates details, in the same format used here – event, date, venue, contact details, via email, fax, mail and the web before the 5th of the month prior, for example: 5th of August for September Lamp. Send information to:

3rd Blood and Bones Conference 24 Oct (8am – 5pm) and 25 Oct (8:30am – 3:30pm), the Children’s Hosp. Westmead. $100 pp/day for registrations before 3 Oct and $110 after. Contact: Leanne Shearer (02) 9845 1023, LeanneS2@chw.edu.au

and 5:30pm respectively, Concord Hosp. Info: (02) 9518 7722, info@CCtatConcord. com or www.cctatconcord.com for pricing.

CNSA – AGM/ Education Evening Date: 25 Oct, 5:30pm, Ecco Restaurant Free for members, $10 for non-members incl. meal & drinks. Contact Tracey Cosgrove by 23 Oct on (02) 9926 8200 or tcosgrove@nsccahs.health.nsw.gov.au

Youth Health 2006 Conference Date: 13 – 15 Nov, Sydney Showground Contact: Sharyn Low, (02) 4572 3079 Email: sharyn@mob.com.au

E-Health Conference Date: 30 Oct – 1 Nov, Swissotel, Sydney Admission packages from $1,799 + GST Contact: Sam Morrow (02) 9229 1067 NSW Palliative Care State Conf. Date: 2 – 3 November, Orange Contact: Joan Ryan (02) 9515 7755 Email: joan@email.cs.nsw.gov.au NSW Christian Fellowship – The Light Still Shines Conference Date: 2 Nov, 9am, Macquarie Educ Ctr Contact: Jane (02) 9449 4868 Tresillan EN Parentcraft Seminar 3 Nov, 8:30am – 4:30pm, Canterbury Hosp. Cost: $55. Contact Anne Kulscar (02) 9787 0869, annek@email.cs.nsw.gov.au Wound Care Assoc. of NSW Inc 3 – 4 Nov, West. Plain Zoo. Members: free Contact: Amy Keough (02) 6885 8666, Amy.Keogh@gwahs.health.nsw.gov.au Re-Energise: The Nutrition Conf. 4 Nov, Next Generation Hlth & Racquet Club Contact: Matt O’Neill (02) 0920 9511 Email: matt@smartshape.com.au National Asbestos Awareness Day 7 Nov, 10am – 2pm, Maritime Museum Contact: Hannah Middleton, (02) 9637 8759, info@adfa.org.au 16th Annual Spinal Injury Nurses Association Conference 9 Nov, College of Nursing, Burwood Contact: John Hebblewhite (02) 4736 3592, jhebblewhite@bigpond.com NSW and ACT Liaison Mental Health Nurses Conference 10 Nov. Conf: 9am – 5pm, Dinner: 6:30pm NSWNA Conference Room, Camperdown Contact: Dennis Casey (02) 6620 3000 Cardiovascular CT at Concord Date: 10 Nov, 8am – 5pm. Dinner at 7pm Salim Barber Email: sbarber@nswnurses.asn.au Fax: 9550 3667, mail: PO Box 40 Camperdown NSW 1450 Please double-check all information sent is correct. The Lamp cannot guarantee that the issue will always be mailed in time for the listed event. Due to high demands on the page, some dates too

Nurses Christian Fellowship. Prof. B/fast Date: 11 Nov, 9am, Koorong Book shop Contact: Jane (02) 9449 4868

Assoc. of Discharge Planning Nurses Date: 13 Nov, 2pm, Concord Hospital Contact: Kerrie Kneen, (02) 9487 9750 Email: Kerriek@sah.org.au 5th Annual Neuroscience and Trauma Professional Development Day Date: 17 Nov, 7:30am, Westmead Hosp. Contact: Katherine Schaffarczyk 9845 5555, page 09134, Katherine_ Schaffarczyk@wsahs.nsw.gov.au The Beat Goes On: RNSH Cardio. Conf. Date: 17 Nov, The Carlton Crest Hotel Cost: early bird $125 (ends 5 Oct), full $150. Contact: Carolyn Morgan, (02) 9926 8852, cmorgan@nsccahs.health.nsw.gov.au

Email: ammaconference@leishmanassociates.com.au 7th Australian Day Surgery Conf. “Today, Tomorrow and Beyond” 10 – 11 Nov, Grand Hyatt, Melbourne Contact: Caroline Handley, (03) 9249 1273, caroline.handley@surgeons.org

Reunions Crookwell District Hospital – Laying of the foundation stone celebration 6 Oct, Crookwell District Hosp. Museum Contact: Beryl Croker (02) 4832 130 Royal Prince Alfred – PTS Oct 1966 Date: 7 Oct, Sydney Harbour Cruise Contact: Marian Mitchell (02) 6556 9628 Email: Rowarna@hotmail.com Albury Base Hosp. Past Graduates and Employees Assoc. 50th Reunion Date: 14 Oct, Commercial Club, Albury Contact: Lyn Dynan, (02) 6021 2888 Email: saef2212@hotmail.com Marrickville District Hosp. Reunion Date: 21 October, 2pm, Masonic Club Contact: Evelyn Kelly (02) 9817 7421 Email: Gladesville@yahoo.com.au

The HIV Nursing Practice Workshop Date: 20 – 23 November, Surry Hills Contact: Education Unit, (02) 9332 9720, albeducation@sesiahs.health.nsw.gov.au

RAHC – 40yr Reunion PTS 1966 Date: 21 Oct, Epping Club, 12pm – 5pm Contact: Maureen Bennett (Clayden), (02) 4421 4935, terrystipper@shoal.net.au

39th Australian Assoc. of Gerontology Date: 22 – 24 Nov, Wesley Conference Ctr Contact: Jane Howorth, (02) 6650 9800, aag@eastcoastconferences.com.au

Auburn District Hosp. – PTS Oct 1976 Date: 28 – 29 October, Hunter Valley Contact: Sbyers, (02) 9626 9861

Renal Society of Australasia NSW 28 Nov, 6 – 8pm, NSW College of Nursing Info: Susana San Miguel, (02) 9828 5544

INTERSTATE Australian & NZ Orthopaedic Nurses’ Assoc. 2nd Annual International Conf. 12 – 13 Oct, Rydges Lakeside Canberra Contact: Gemma Gregson Email: anzona@eventcorp.com.au

Batemans Bay Hospital Reunion Date: 19 Nov, Corrigans Beach Park Area Contact: Bernadette Brandes (Whitty) (02) 4471 3191 Royal Hospital for Women, Paddington – Midwives Group 1993-94 Date: 8 Dec, 7pm, Royal Hotel Paddington Contact: Linda Bates (nee Mahoney) (02) 6542 5355, slbinvest@optusnet.com.au

Crossword solution

2nd Annual Conference of the Australian Practitioner Association Date: 13 Oct (9am – 3pm) and 14 Oct (9:30am - 5pm), Legends Htl, Gold Coast Contact: Fiona Wilkie (02) 9954 4400 Email: Fiona@dcconfrences.com.au 2006 Defence Health & AMMA Conf. 19 – 22 Oct, Brisbane Conv. & Exhibition Contact: Jane Beattie, (03) 6234 7844, close to publication or too far in the future may be cut. The dates that are to be printed are for three months in total. For example, in the March Lamp = March, April, May dates will be printed. Only Diary Dates with an advised date and contact person will be published. Diary Dates are also on the web – www.nswnurses.asn.au

Special Interest Groups Special Interest Groups is now part of Diary Dates. If you are a special interest group, you now must send information about your event as above.

Send us your snaps If you’re having a reunion, send us some photos and any information from the night, and we’ll publish them. THE LAMP OCTOBER 2006 49


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You spend your life looking after others, now let us look after you. really enjoying the low rate at Members “ I’m Equity Bank, especially with the member discount, fewer charges, and the great service I get from everybody I talk to there! Being a full time worker and mum doesn’t leave me much time to get to a bank before 5pm, so having Members Equity come to see me at work was fantastic. My mobile lender made the application process so quick and easy, I barely had to do anything! Being able to do my banking on the phone, at Australia Post and on the internet has also made my life a lot easier so now I have more time for the things that are important to me.

Janelle: Members Equity Bank customer. Janelle and Mitchell

Members Equity Bank offers you A lower interest rate with a special discount for NSWNA members (you could save up to $20,856!*) No application or valuation fees No ongoing monthly or annual fees

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$20,856

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Westpac (Premium Option)

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Simply book an appointment to see one of our mobile lenders (we’ll come to you!), complete a home loan application form and we’ll send you a Peter Alexander voucher worth $50^.

Call us today to make your appointment on 1300 308 357. ^Applications must be completed by 31 December 2006 to be eligible for Peter Alexander voucher. One voucher per application. *The savings compares the comparison rate (7.24% p.a.) for a Members Equity Super Members Standard Variable Rate Home Loan (SMHL) with the major banks comparison rates (listed above). All comparison rates are for Standard Variable Rate Home Loans of $150,000 for a term of 25 years, repaid monthly. It is assumed interest rates and fees remain unchanged for the full loan term, all repayments are made on time and no additional payments are made. The features of these home loans may vary. In some circumstances lenders (including those shown in this table) may offer loans with lower rates. WARNING: These comparison rates are true only for the examples given and may not include all fees and charges. Different terms, fees or other loan amounts might result in different comparison rates. A comparison rate schedule is available from Members Equity Bank. SMHL is only available to eligible union and super fund members including NSWNA members. Fees and charges apply. Terms and conditions available on request. Applications are subject to credit approval. All interest rates are current as at 06/09/06 and are subject to change. 41845/0906

52 THE LAMP OCTOBER 2006

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