The Lamp November 2008

lamp the

magazine of the NSW Nurses’ Association

volume 65 no.10 November 2008

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ABOUT THE LAMP

C O N T E N T S

Cover story

lamp the

magazine of the NSW Nurses’ Association

volume 65 no.10 November 2008

Maternity leave breakthrough: proposal for 18 weeks paid leave 14 Cover

MATERNITY LEAVE

BREAKTHROUGH

From left: Eleanor Romney, CNS, RPA Hospital, with baby John; Jennifer Beddoe, RN, St George Private Hospital, with Ebony and Zachary; Fiona Goodman, NUM, Mosman Private Hospital.

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News in brief

Professional issues

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28 Robot nurses

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Modernisation threatens nursing awards NSWNA official joins US Nurses on Golden Gate Bridge march Red vests for medicating nurses Whistleblowers wanted Report calls for reform of NT intervention National OHS Harmonisation Della Bosca down on booze ads Workers docked for aged-care deaths Bathurst Base Hospital remediation go ahead RNS builder connected to Bathurst fiasco RPA gets first intraoperative MRI scanner Busy Busby ladies again deliver for Liverpool Federal judge slams building watchdog Call for union collective agreement for student workers New student nursing places Training for western tobacco traders One million health workers wanted Guns for Iraqi doctors New study questions phone triage effectiveness New cytotoxic drug guidelines Coffee myths busted Study to test near-death experiences

NSWNA education program 13 What’s on

Agenda 22 A bigger role for nurses 23 Let’s make Sydney a more liveable city

NSWNA COMMUNICATIONS MANAGER Noel Hester T 8595 2153 NSWNA COMMUNICATIONS ASSISTANT Russell Burns T 8595 1219 For all Lamp editorial enquiries, letters and diary dates: Editorial Enquiries T 8595 1234 E lamp@nswnurses.asn.au M PO Box 40 Camperdown NSW 1450 THE LAMP PRODUCED BY Lodestar Communications T 9698 4511

From the field 30 The highs and lows of IVF nursing

Occupational health and safety 32 Dealing with patient obesity 35 Helping injured nurses return to work

NSWNA matters 37 Doug goes to WA on Direct Debit

Lifestyle 38 Movie reviews 42 Book me

Obituaries 41 Madge Nielson: the world needs more like you

PRESS RELEASES Send your press releases to: T 9550 3667 E gensec@nswnurses.asn.au THE LAMP EDITORIAL COMMITTEE Brett Holmes, NSWNA General Secretary Judith Kiejda, NSWNA Assistant General Secretary Coral Levett, NSWNA President John Lyons, Baradine MPS Mark Kearin, Blacktown/ Mt Druitt Hospital Roz Norman, Tamworth Base Hospital Stephen Metcalfe, Lismore Base Hospital Peg Hibbert, Hornsby & Ku-Ring-Gai Hospital Michelle Cashman, Long Jetty Continuing Care 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

Regular columns

THE LAMP ISSN: 0047-3936

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General disclaimer The Lamp is the official magazine of the NSWNA. Views expressed in articles are contributors’ own and not necessarily those of the NSWNA. 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 NSWNA takes no responsibility for the advertising appearing herein and it does not necessarily endorse any products advertised.

6 27 45 47 49

Editorial

by Brett Holmes Your letters to The Lamp Ask Judith Nursing online Our nursing crossword Diary dates

Competition 31 Win an escape to Port Stephens

Industrial issues

Special offers

25 GWAHS nurses at breaking point

38 Win 20 double passes to see RocknRolla, and 25 double passes to The Wackness and Hunger

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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

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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.

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Membership Application forms or Direct Debit 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.

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E D I T O R I A L

BY BRETT HOLMES GENERAL SECRETARY

Paid maternity leave break through g Partnerships with like-minded groups pay off, with paid maternity leave firmly on the political agenda.

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ustralian unions have been fighting hard for many years for more family-friendly workplaces. Now there has been a significant breakthrough with a recommendation from the Productivity Commission for a national scheme for paid parental leave.

The commission proposes 18 weeks’ paid leave – 18 weeks for mothers and two weeks for fathers.

The leave would be paid at the adult minimum wage with employers contributing the guaranteed 9% superannuation payment.

This is a great win for the union movement and for the community and women’s groups who have worked together so resolutely to get the issue high on politicians’ agenda. For public hospital nurses, the 18 weeks at the Federal minimum wage rate would be in addition to the existing 14 weeks they now receive at full pay. For many nurses in private hospitals and aged care, it will be a new entitlement.

The ACTU must be congratulated for getting paid maternity leave on the political agenda and keeping it there. When we achieve victories like this, and others like the Your Rights At Work campaign, it is a reminder of the value of our affiliation to the peak union bodies.

When you are trying to achieve good outcomes for working women and men on these big picture issues you need to do so in partnership with like-minded groups.

Unions, churches and community groups join together After several months of discussion, including at Committee of Delegates, the NSWNA Council has decided to become a participating organisation in the Sydney Alliance.

The Sydney Alliance is an initiative of Unions NSW and other groups in civil society, drawing together an impressive coalition of faith-based groups, unions and community organisations (see story page 25).

When you are trying to achieve good outcomes for working women and men on these big picture issues you need to do so in partnership with like-minded groups.

It is a new, non-party-political citizens’ coalition that aims to improve the quality of urban life in Sydney.

The benefits of working within such a diverse and representative group are not to be underestimated. Such a broad coalition would normally be expected to be divided

by its differences. When its members act together in common cause they have a lot of power.

Our initial interactions with the groups have convinced us that health and aged care are issues other participant organisations rank as a priority for their members.

The Nurse Power Fund was set up to give the NSWNA the opportunity to work across a range of areas around organising, campaigning and paid media, but it always had the flexibility to try new and different ways of improving the general life of members.

The Association’s influence with employers or government cannot resolve every issue that affects members and their families.

Nurses will benefit from wider improvements in society. We believe joining the Alliance is an opportunity to be a part of a larger collective voice that can have an influence in shaping the quality of life in Sydney.

The NSWNA Council and Committee of Delegates discussed the issue of this initiative being restricted to Sydney, when we have so many of our members throughout New South Wales. But we were persuaded that the Alliance would initially have more impact if it concentrated its efforts close to the seat of state government power. If the initiative is successful in Sydney we would like to see it extended to the whole state and have the benefits the Alliance achieves become universal for all members.

We are a large union at the upper end of the affiliation scale and our contribution will be $40,000 a year for three years.

Our campaigning focus continues in private hospitals with negotiations well under way with the large employers. The participation of members in their campaigns is critical if we are to get a good result and I urge all private hospital nurses to get involved.n THE LAMP NOVEMBER 2008 5

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LETTER of the month

L E T T E R S

Galatea Price

All nurses should join the Union I wish to congratulate Brett Holmes and the organisation he leads.

Having been a member of the union for many years, I have seen considerable improvement in the administration of the NSWNA over the years and specifically since Brett became the General Secretary.

The first time I met Brett was a long time ago when he was my organiser.

Once again, I urge all personnel who are working in the industry – whether as an AiN, undergraduate, EN, or RN; whether working in the public or private system, aged care, nursing home, or hostel – to join the NSWNA. Attend union branch meetings at the place of your employment, get to know your organiser and get aquatinted with your union branch officials. Serve a term or two yourselves as union branch officials. If you do not have a branch in the place where you work, get together and establish one. The association will be more than happy to provide support and guidance for you.

The NSWNA is the only organisation you can genuinely depend upon to give you the right advice and support – whether moral or legal.

The strength of the association is its membership. A strong union will actively work for your interests at all levels, whether negotiating salary and wages with the government of the day, or looking after you interests at the local level.

Every nurse should encourage fellow nurses who are not members to join.

Working together we will ensure our Association remains strong so that it can protect the rights of nurses. Support your association and become a member if you are not already. You never know when you will need the Association’s help and advice. The world is full of surprises, it has never been more important than now to belong to the union.

Nurses, know your rights and stand up for your rights. If you believe you have been wronged, or you have been unfairly treated, get advice from your Association. Managers are not always fair 6 THE LAMP NOVEMBER 2008

and impartial. Often they are eager to take decisions, make judgments without even having all the facts.

I would also like to thank Linda Alexander, and especially Chris Blair, for their prompt support and advice. I couldn’t have had a better team looking after my rights. They were there when I needed them. It would have been much harder for me to obtain justice without their support. Brett, you have selected and appointed the best people to work for your members. Congratulations!

Galatea Price, CNS Ryde Hospital

Chris Flannery

Aged care checks daunting I am contacting you to express my amazement at the outdated manner of a recent ‘spot’ inspection at the aged care facility where I am employed as a Registered Nurse and Educator.

In no other industry would professional staff be asked to instantly produce records and documents without notice, often records from years earlier that are not easily accessible. With the stress this places on the Director and her staff, it’s no wonder nurses are leaving the industry and going elsewhere.

Over 35 years of caring, the majority of nurses I have met only want what is best for the care of their residents and the excessive paperwork required by the system reduces the care we can give to patients.

It’s certainly time that the Association lobbied for a change to the ‘agency’ style checks, to represent all levels of nurses including those in administration.

Aged care nurses are not the enemy and if the system continues as is, I’m sure they will continue to retreat.

Chris Flannery RN/Nurse Educator Chatswood Community Nursing Home

Got something to say?

Send your letters to: Editorial Enquiries email lamp@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.

Peta Broekman

City or bush, we’re all nurses I work in a rural hospital where most of the training and education courses are not locally available. While attending courses in metropolitan venues there is a sense of ‘us and them’. We each feel that our particular plight is worse than ‘theirs’.

Not having a doctor on-site (or even on-call), poor equipment, travelling and waiting for beds in referral hospitals is frustrating enough, but so are aggressive patients, long waiting times, bed block and dealing with ‘junior’ doctors. Due to staffing shortages and secondment, nurse exchange is not possible so we are not able to exchange roles to see how the ‘other half live’.

Due to the current pressures we are all under, nurses are not only losing empathy for their patients they are also losing empathy for each other. Once characterised by our caring nature, we now focus on how to CARE (Cover Arse and Retain Employment). No matter where we live – city or bush – we all have families to support, we are all doing the best we can with what we have and we are all nurses. By caring for each other we will all find it easier to care.

Peta Broekman, Scott Memorial Hospital Peta Broekman won the prize for this month’s letter of the month, a $50 David Jones voucher.

LETTER of the month The letter judged the best each month will be awarded a $50 DJ’s 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.

Natalie Holmes - Wellington Time

Josie Byrne

Thanks, NSWNA, for lobbying on mat leave I was recently fortunate enough to represent the NSW Nurses’ Association in a contingent visiting Parliament House in Canberra.

The group was made up of union officials and rank-and-file union members, like me, lobbying federal MPs for the introduction of a maternity leave scheme for all Australians.

Currently Australia (like the USA) seriously lags behind the rest of the world with no universal maternity leave. The UK has a 39-week paid maternity leave scheme and Canada has 50 weeks. Even Iran and the Peoples Republic of Congo have 14 weeks.

The trip was (very well) organised

by Unions NSW who have proposed a maternity leave model (supported by many groups including the Australian Breastfeeding Association and the NSW Midwives’ Association) of six months paid maternity (or primary carer) leave and four weeks’ paid paternity leave. Six months leave is considered appropriate because it would enable women to breast feed their babies according to World Health Organisation guidelines. Our meetings with many high profile MPs (including Treasurer, Wayne Swan) at Parliament House were very encouraging.

I was very enthused by their willingness to engage and empathise with the need for an improved system for parents in the workforce.

Those first months of a newborn’s life are very difficult for the parents.

It’s a huge adjustment to make – the sleep deprivation, the change in family dynamics, the change of priorities etc. It is also a stressful time for relationships and it would be so helpful to remove the financial stress for a little while, too.

The Productivity Commission recently found that indeed there is a need to introduce a paid maternity scheme but at this stage an 18-week model is what has been suggested.

Unions NSW is planning future lobbying projects and it is essential that

Wellington Graduate Nurses Association members (from left): Di Neville, Kay Munro, Judy Forrest, Cecily Wilson, Shauna Jones, Elizabeth Parkes and Betty King. the union movement continues with this important campaign.

Thank you to the NSW Nurses’ Association for the opportunity to be a part of it and for enabling a proud mum and nurse to take this matter to our law makers in Canberra.

Josie Byrne, RN, Ryde Hospital

Farewell Wellington women’s clinic The Wellington Graduate Nurses Association was formed in July 1971 to bring together Graduate Nurses for fellowship and ongoing education.

In early 1978, the Wellington Country Women’s Association asked if the Association would run a clinic around female health issues, as there were no female doctors in the town.

Planning began for guest speakers, clinics, lots of literature and a childminding facility. Our original idea was for a one-day clinic but in the end a week was organised due to the high demand.

At the end of the week everyone had still not been seen, and a decision was made to continue on a fortnightly basis until everyone had been seen.

Thus began the first Women’s Health Clinic in NSW. It was independent and run by volunteers with no charge to the client. A clinic began on the coast around six months later run by Community Health, which is the type of clinic that still runs from these centres today.

From 1978 until 2008, we have funded the clinic through fund raising events, such as luncheons for 500 women, Melbourne Cup days, fashion parades and raffles.

We have sourced our female doctors from the surrounding area – often doctors looking to re-enter the workforce after maternity leave. For the past 10 years we have had the same doctor who travelled to do the clinic because of her own dedication and the commitment she saw in the Wellington group.

Over the years, we have held men’s health days targeting prostate cancer, mental health, pesticide poisoning and bowel cancer.

In 2001, we won the National Health and Medical Research Council award for ‘Health Volunteers’ in NSW and then went on to win the award for all of Australia.

In November this year we will hold our last clinic as there are now a number of female doctors in town. It is with some regret, but also much pride. We always said if we only saved one life a year the clinic was worthwhile and this, and more, has been achieved.

Kay Munro, RN, Maranatha House, Wellington

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THE LAMP NOVEMBER 2008 7

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N E W S I INN BBRRI IEEFF

MODERNISATION

THREATENS NURSING AWARDS ore than 6,000 nurses have signed petitions, as part of a united national campaign run by the ANF demanding the Australian Industrial Relations Commission (AIRC) retain occupational awards for nursing.

ANF Federal Secretary Ged Kearney said nurses are concerned that the AIRC will replace nursing awards with generic industry awards as part of the Federal Government’s award modernisation process.

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If nurses are forced into generic industry awards ... health care standards will be further reduced, particularly in aged care.

‘Nurses want to work under an occupational award because nurses contribute to all areas of health care, including working in businesses, aged care, the community and hospitals. Also, importantly, many nurses can be employed in multiple areas. For example, aged care and community care or public and private sectors and they identify strongly with their nursing profession wherever they work,’ she said.

If nurses are forced into generic industry awards with non-specific career structures and minimum conditions of employment, health care standards, patient and resident care standards will be further reduced, particularly in aged care.

‘The best way to protect nurses’ wages and conditions is by continuing under a nursing award. This is supported by the ACTU, which supports the status quo where possible, and therefore supports maintaining an occupational award for nurses.’

8 THE LAMP NOVEMBER 2008

US nurses march across the Golden Gate Bridge

NSWNA official joins US Nurses on Golden Gate Bridge march When NSWNA officer Susan Pearce attended the California Nurses’ Association Conference in San Francisco last month, she never expected she’d be carrying a placard across the Golden Gate Bridge in support of basic health care access.

‘As an Aussie nurse, it’s difficult to fathom that emergency presentations in the US must first be assessed for credit risk, which then determines the treatment they receive,’ she told The Lamp.

‘It is really as bad as they say. Some people do lose their houses when they get sick. It must be a nightmare for nurses working in that environment.’

Susan joined more than 1000 US nurses supporting universal access to health care as they marched across Golden Gate Bridge under the banner, ‘Bridge to health care – RNs know the way’.

‘It was a great day. The line of nurses stretched from one end of the bridge to the other and motorists were tooting their horns in support,’ Susan said.

The nurses, from 20 US states, were representing the California Nurses’ Association and its sister organisation, the National Nurses Organizing Committee.

The nurses were rallying in support of a bill, currently before the US Congress, proposing to expand the US medical benefits scheme, guaranteeing

health care through a single payer system – something we can easily take for granted in Australia, said Susan.

‘Australian voters have always risen to the threats to our health care system so it just makes me wonder how they ever let it get that bad over there. During August, another 592,000 Americans lost their jobs – that is effectively another half a million people without health insurance.

Susan will report on the conference in next month’s Lamp.

Red vests for medicating nurses Nurses on medication rounds in Welsh hospitals are being issued with special red vests in a bid to prevent mistakes and delays while delivering drugs to patients.

The red vests serve as a clear warning to patients, doctors and other staff that the nurses are on medication duty and cannot be disturbed while they administer medicines.

The pioneering project follows a Welsh survey that revealed nurses could be interrupted up to 17 times during a medication round.

Cardiff nurse Natalie Schell, who came up with the idea, told the Welsh media that the system had helped to improve the safety of medicine administration.

‘By reducing interruptions we are also helping the nurses to focus on individual patient needs and give them the help and advice they need to take their medications safely and effectively,’ she said.

WHISTLEBLOWERS

WANTED esearchers at the School of Nursing & Midwifery at the University of Western Sydney are studying the experiences of nurses in relation to whistleblowing in the health service. Researchers want to interview nurses and midwives who have been whistleblowers, or who have worked in a facility where a whistleblowing incident occurred.

Professor Debra Jackson from the School of Nursing & Midwifery at UWS said that while there have been several well-publicised cases of whistleblowing by nurses, relatively little is known about the experiences of whistleblowers or other witnesses.

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Often the individuals involved are very traumatised by these events ‘We have a lot to learn from these types of situations. Yet, often the individuals involved are very traumatised by these events and, as a profession, we don’t necessarily go through a full reflective process afterwards,’ Professor Jackson said.

‘Though the NSWNA has an excellent policy on this issue, with some very clear guidelines designed to assist nurses considering such action, better understanding the experiences of those directly involved could help inform the development of additional strategies.’

If you work in the health care system and have been a whistleblower, or been involved in witnessing the ramifications or aftermath of a whistle-blowing event, UWS researchers would like to interview you about your experiences. Your anonymity and privacy are assured.

If you are interested in participating or in finding out more information, please call Professor Debra Jackson on (02) 4620 3532, or Dr Kath Peters on (02) 9685 9567.

Report calls for reform of NT intervention A report by the Northern Territory Emergency Response Review Board into the government intervention into Indigenous communities has called for a multitude of reforms – including the reintroduction of the Racial Discrimination Act and cessation of compulsory income management.

The report claims the intervention has ‘fractured’ the relationship between governments and Indigenous people while failing to improve school attendance or arrest anyone for child sexual abuse offences – the primary rationalisation for the intervention.

The report said the intervention should continue, acknowledging the improvements in housing and community health and more police stations.

‘In many communities there is a deep belief that the measures introduced by the Federal Government under the NTER (Northern Territory Emergency Response) were a collective imposition based on race,’ the report said.

Meanwhile, the High Court has heard that key aspects of the Northern Territory intervention, including the Federal Government’s five-year takeover of Aboriginal townships, were unconstitutional.

Traditional land owner Reggie Wurridjal and his sister Joy Garlbin have mounted a challenge to the intervention, claiming the forced five-year lease of their land amounted to an acquisition of their property rights and that the Commonwealth failed to do so on ‘just terms’ as required by the Constitution.

National OHS Harmonisation The national OHS review panel handed down its first report for consideration by the Federal Government in October.

The panel was formed following the decision of the Council of Australian Governments’ earlier this year to push ahead with the idea of a nationally consistent OHS system.

The second and final report is due in January, from which the Government intends to develop model legislation.

NSW currently has the highest OHS standards in Australia, which is reflected in a clear downward trend in workplace accidents and fatalities.

The NSWNA has no objection to a uniformed approach but is passionately committed to maintaining the current standards. The Association has provided submissions to the panel and is closely monitoring developments.

Della Bosca down on booze ads NSW Health Minister John Della Bosca plans to argue for a ban on alcohol advertising at a national ministerial council meeting in November.

The Federal NSW Health Health Minister Minister John Nicola Roxon said Della Bosca there needed to be a comprehensive response to tackle binge drinking and has not ruled out toughening advertising laws in response to Mr Della Bosca’s call.

40,000 drinkers [are] admitted to NSW hospitals each year with alcoholrelated injuries and illnesses.

Mr Della Bosca made the announcement after discovering 40,000 drinkers were admitted to NSW hospitals each year with alcohol-related injuries and illnesses.

‘I’m not pretending this is a new debate,’ he told the Sydney Morning Herald.

‘It’s an argument that goes back to governors King and Macquarie, but it’s a debate we need to have again. Selfregulation isn’t working.

‘For big multinationals, harm minimisation is all about the impact on the value of their brand.

‘A tough regulatory regime is the only thing they will understand.’

THE LAMP NOVEMBER 2008 9

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N E W S I INN BBRRI IEEFF

WORKERS

Bathurst Base Hospital remediation go ahead

AGED-CARE

Health Minister John Della Bosca last month confirmed the State Government was committed to the remediation of the Bathurst Base Hospital.

The Health Minister said contractors had started work on the hospital’s intensive care unit and that ‘improvements and adjustments’ would also be made to the paediatric unit, maternity, operating theatres and the emergency department.

The work will be undertaken progressively and completion is expected in the first quarter of 2009.

At this stage there has been no mention of remediation to the car park, which currently restricts ambulance, mortuary and patient transport bus access.

DOCKED FOR

DEATHS n Adelaide nursing home was caught red handed docking workers’ wages after patient deaths in an apparent attempt by management to cover the costs of bed vacancies.

Since March 2006, about 60 staff members have had $25,500 collectively deducted from their pay.

LHMU Assistant Secretary Chris Field told the Lamp he could not believe the practice went on for three years.

‘I was shocked with the detail of this particular case. It’s horrific that some aged care workers can’t even get paid their correct wages and that they have wages deducted for circumstances completely outside of their control,’ he said.

Workplace Ombudsman staff raided the privately-run home after a tip-off, and found the centre was unlawfully making deductions from the wages of nurses and care attendants.

Details of the case were revealed last month following the Workplace Ombudsman’s national audit of 179 aged-care facilities in South Australia, NSW, Tasmania, Victoria and the ACT. As a result, the nursing home, which the Workplace Ombudsman refused to name, agreed voluntarily to reimburse the staff.

A spokesman for the Federal Workplace Ombudsman, Craig Bildstein, said breaches had been occurring since 2005.

‘Time sheets that were already signed by staff for hours they’d worked were being altered by the payroll officer to cover these costs,’ he said.

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10 THE LAMP NOVEMBER 2008

RNS builder connected to Bathurst fiasco After six years, the NSW Government has finally decided on a builder to undertake the $736 million redevelopment of Royal North Shore Hospital.

NSW Health Minister John Della Bosca announced last month that the InfraShore Consortium was the preferred tenderer over Pinnacle Healthcare and the deal should be finalised later this month.

InfraShore, chosen from a shortlist announced almost two years ago, is made up of the financier ABN Amro, the construction company Thiess Pty Ltd and other service providers.

Thiess is owned by Leighton Holdings, whose other subsidiary, John Holland Group, is responsible for restoration of the Bathurst Hospital.

The delays have pushed back the completion date of the biggest health infrastructure project in NSW by three years – from 2010 to mid-2013 – though the community health building is due for completion in 2011.

In March, the Garling Inquiry heard the hospital was in such decay that the floor of its medical records room had collapsed.

A spokesman for Mr Della Bosca

said the project was delayed because the original plan did not include the demolition of the ‘brown’ building – the main part of the hospital – and the scale of the project had grown after community consultation.

A lack of consultation with medical staff in the final stages of planning was blamed for the design fiascos earlier this year at both the Bathurst and Orange Base Hospitals.

RPA gets first intraoperative MRI scanner Australia’s first intraoperative MRI scanner, one of only 26 in the world, is up and running at RPA. The scanner, purchased with a $6 million bequest, enables neurosurgeons to perform MRI scans during surgery to remove glioma and pituitary gland brain tumours without leaving the operating theatre or closing the incision.

Previously a single scan was done the day before the operation, which was far less accurate. Several scans can now be carried out during surgery, increasing the chances of successful tumour removal and reducing the chances of brain damage.

The scanner is part of a new stateof-the-art, purpose built operating theatre at RPA.

Busy Busby ladies again deliver for Liverpool The Busby Auxiliary presented Liverpool Hospital with yet another huge cheque in August from the sale of baby clothes and giftware at their stall.

In the last year the Auxiliary raised $83,214 which has been used to purchase 29 new pieces of equipment including tourniquet systems for the operating theatre and electrocardiograph diagnostic machines.

The Busby Auxiliary was formed 1984 and has about 11 volunteer members.

They received the Companion to the Liverpool Order – the highest award possible – in the 2006 Liverpool City Council awards for services to the community.

FEDERAL JUDGE SLAMS BUILDING

WATCHDOG he anti-worker bias of the Australian Building and Construction Commission (ABCC) has again been exposed – this time by the acting chief justice of the Federal Court.

In scathing comments issued from the bench last month, Justice Jeffrey Spender said the ABCC turned a ‘blind eye’ to dishonest employer behaviour and had failed to act in an even-handed way in its pursuit of the Plumbers Union and its Queensland secretary, Bradley O’Carroll.

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Justice Jeffrey Spender said the ABCC turned a ‘blind eye’ to dishonest employer behaviour.

Justice Spender said the case should never have been brought by the ABCC and, rather than prosecuting the union, it should have been investigating the employer, a company called Underground, and its ‘foul-mouthed industrial cowboy’ boss.

The humiliating result for the ABCC follows last month’s report by former judge Murray Wilcox QC finding that the building industry watchdog had discriminated against construction workers and infringed on their rights.

In his comments, Justice Spender said that rather than waste resources on an unfounded coercion case against the union, the ABCC should have been investigating ‘sham’ independent contracting operations and tax and superannuation evasion by Underground.

ACTU Secretary Jeff Lawrence said the case confirmed that the ABCC was biased against workers and unions and should be scrapped.

‘Workers have been subjected to secret interrogations and threats of jail from the ABCC simply for maintaining their right to silence.’

Call for union collective agreement for student workers With two out of three senior school students working part-time, a Sydney academic has called for schools, employers and unions to sign a collective agreement to help students balance their lives.

Margaret Vickers, from the University of Western Sydney’s Centre for Educational Research, told an Australian National Schools Network forum last month that thousands of Australian school students are struggling to cope with the competing demands of fulltime study and part-time work.

She said long hours, late shifts and minimum wages were features of the retail and fast-food sectors where most students worked. She urged employers to show respect and be flexible.

‘Employers need to understand that these young people are trying to be students as well,’ she told the forum.

‘Don’t give them late shifts.’

Professor Vickers also said that many schools were ‘out of sync with the busy, multifaceted lives of young people’.

The national forum’s push to get employers, unions and schools to endorse an agreement to protect the rights of students at school and work was backed

by ACTU President Sharan Burrow, who also spoke at the forum.

New student nursing places Almost 1,100 new Commonwealth-supported, higher education places in the ‘national priority area’ of nursing were announced by the Prime Minister, the Minister for Education and the Minister for Health last month.

The new student places are part of the Federal Government’s 2007 election promises and will commence from 2009.

NSW received 310 places, Victoria 280, Queensland 110, Western Australia 155, South Australia 135, ACT 54 and the Northern Territory 50.

In NSW, the placements have been allocated mostly to regional universities with the exception of the University of Western Sydney, which was allocated 65 places. Southern Cross University, Lismore, picked up 70 places; Charles Sturt University, Orange/Dubbo, 45 places; University of Newcastle, 50 places; and the University of Wollongong, 80 places.

The Government hopes the new placements will give more students the opportunity to qualify as registered nurses and will increase the number of nurses available to work in public hospitals.

Higher education providers have indicated that around 50% of the new places will be offered to enrolled nurses to upgrade their qualifications.

Training for western tobacco traders The Greater Western Area Health Service is urging the region’s tobacco retailers to properly train staff who sell tobacco products.

GWAHS population health area manager Dr Tony Brown said that with tobacco killing one in two smokers, tobacco trading carries a great deal of responsibility. Retailers and their staff are required under the NSW Public Health Act not to sell tobacco products to people under the age of 18 years.

‘Reducing young people’s access to tobacco products is an important public health strategy which aims to reduce the number of young people who take up tobacco smoking and die as a result of their addiction,’ he said.

Dr Brown said GWAHS was throwing its support behind tobacco retailers by offering to assist with staff training.

THE LAMP NOVEMBER 2008 11

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N E W S I INN BBRRI IEEFF

1 MILLION

HEALTH

WORKERS

WANTED he United Nations has launched a global plan to recruit one million doctors, nurses and midwives in poor countries to tackle maternal mortality.

The September launch coincided with an emergency session of the UN in New York seeking to make up lost ground in the effort to reach its millennium development goals.

Despite fears that the deepening global financial crisis will deflect Western nations from the fight against poverty, rich countries are being asked to stick by their aid pledges as the international taskforce aimed at mobilising money to address maternal mortality is being organised.

The taskforce will be cochaired by UK prime minister Gordon Brown and the World Bank president Robert Zoellick. Mr Brown told the UK’s Guardian newspaper it was unacceptable that one woman died every minute in childbirth.

‘Almost all these deaths are preventable. We urgently need to mobilise the resources to recruit the nurses, midwives and doctors to stop this tragedy,’ he said.

UN Photo

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12 THE LAMP NOVEMBER 2008

Guns for Iraqi doctors Iraq announced last month that it will allow doctors to carry firearms in an attempt to keep medical workers from leaving the war-torn country.

This follows an International Committee of the Red Cross report in March that estimated 2,450 doctors and nurses had been killed or kidnapped since the 2003 US-led invasion began.

‘Of the 34,000 registered doctors in 1990, at least 20,000 have left the country,’ the Red Cross report said.

The report goes on to state that the Iraqi health-care system is now in worse shape than ever.

‘Five years after the war began, many Iraqis do not have access to the most basic health care. There is a lack of qualified staff and many hospitals and health-care facilities have not been properly maintained.’

According to CNN, the Iraqi Government has also ruled that doctors can’t be detained by police without Ministry of Health approval, and security at doctors’ offices and hospitals will be bolstered.

The government is currently developing advertising campaigns, setting standard rates for checkups at private clinics, working to establish residential compounds and coming up with attractive salaries to entice refugee doctors and nurses to return home.

of health clinics, Medi7 in Victoria, Dr Nathan Pinskier, told The Canberra Times that it was difficult to make good medical decisions over the telephone.

He said it was important that healthadvice lines were prepared to reveal how they reached decisions and that they underwent routine and vigorous testing, which should be made public.

A review of the triage outcomes found the appropriate advice was not provided in 42% of cases.

Dr Pinskier said another problem associated with healthdirect Australia was that there was no mechanism for providing an incident report to the patient’s general practitioner.

Julian Henderson, chief executive officer of the National Health Call Centre Network, which funds the delivery of healthdirect Australia, said the network was different to the Dutch model.

He said the service had a computerbased protocol, which assisted staff in providing appropriate advice.

New cytotoxic New study questions drug guidelines New guidelines for the management of phone triage cytotoxic drugs and their occupational risks have been released by WorkCover effectiveness after an extensive and lengthy review.

A new Dutch study of after-hours phone triage centres published in last month’s British Medical Journal has seriously questioned their medical effectiveness.

Researchers in Holland called 17 after-hours services over 12 months and presented cases relating to fevers, vomiting and blood noses in both children and adults.

A review of the outcomes found the appropriate advice was not provided in 42% of cases.

The study has thrown more doubts on the new $200 million Federal and State Government national call centre, healthdirect Australia.

A former general practice adviser to the Royal College of General Practitioners and a director of a chain

Cytotoxic drugs are drugs that have a deleterious effects upon cells and many have been found to be mutagenic, teratogenic and carcinogenic.

Royal North Shore Hospital Oncology CNC, Vivienne Freeman, was instrumental in pulling together the best elements of Queensland and Victorian guidelines and adapting them for use in NSW health care facilities.

The Department of Health has issued a policy directive adopting these guidelines as the primary reference material for NSW health care facilities.

A copy of Cytotoxic Drugs and Related Waste: Risk Management Guide 2008 can be downloaded from: www.health.nsw.gov.au/ policies/pd/2008/pdf/PD2008_059.pdf

Coffee myths busted Caffeine addicts can raise their cups and take heart from the latest studies into the health effects of drinking coffee – well, at least until the next round of contradictory research, that is. The New York Times recently compiled these findings so crank up the espresso machine, pour yourself a long, short, flat, black latte and read on guilt-free.

Hypertension: Unlike cola drinkers, a study of 155,000 nurses who drank coffee for a decade reveals they were no more likely to develop hypertension than non-coffee drinkers.

Hydration: Studies conducted last year found that people who consumed drinks with up to 550 milligrams of caffeine produced no more urine than when drinking fluids free of caffeine. Above 575 milligrams, the drug was a diuretic.

Heart disease: An analysis of 10 studies of more than 400,000 people found no increase in heart disease among daily coffee drinkers. In fact, a 15-year study of 27,000 Iowa women found one to three cups a day reduced the risk of cardiovascular disease by 24%.

Cancer: In an international review of 66 studies last year, scientists found moderate coffee drinking had little if any effect on the risk of developing pancreatic or kidney cancer. In fact, another review suggested that coffee halves the risk of developing liver cancer. Another study of 59,000 women in Sweden found no connection between coffee, tea or caffeine consumption and breast cancer.

Bone loss: Human physiological studies have found only a slight reduction in calcium absorption and no effect on calcium excretion.

Weight loss: Contrary to popular belief, a study of more than 58,000 health professionals followed for 12 years, found both men and women who increased their caffeine consumption gained more weight than those who didn’t.

Recent disease-related findings suggest coffee drinkers also have a 30% lower risk of Parkinson’s disease and a 28% lower risk of Type 2 diabetes.

Study to test neardeath experiences The largest ever study into near-death experiences is to begin in hospitals across the UK and US. The UK’s Nursing Times reports that the three-year investigation, coordinated by Southampton University, will study 1,500 survivors to see if any experienced ‘out of body’ experiences while they had no cardiac or brain activity.

Study author Dr Sam Parnia, an expert in the field of consciousness during clinical death, said death is not a specific moment.

‘It is a process that begins when the heart stops beating, the lungs stop working and the brain ceases functioning,’ he said ‘During a cardiac arrest, all three criteria of death are present. There then follows a period of time [from a few seconds to an hour or more] in which medical efforts may succeed in reversing the dying process.’

A part of the study will involve images being placed on shelves that can only be seen from above.

Recent scientific studies have demonstrated 10 to 20% of people who go through cardiac arrest and clinical death report lucid, well-structured thought processes, reasoning, memories and sometimes detailed recall of events during their encounter with death.

Researchers have shown the brain areas active in near-death experiences are the same as those active in dreams – and that people who report such experiences are able to slip into dream states more easily than others.

s Aged Care Seminar Series – Module 5; Building and Managing an Effective Team 12 November, Camperdown, 1 day This series will be conducted

by Dot Yam who is a Consultant / Facilitator / Counsellor in communication and human relations management. Dot is well known in the health care industry as a dynamic and committed professional whose enthusiasm is infectious. Her seminars are always well received and highly evaluated by participants. Topics include • Essential ingredients in developing and building a cohesive team • Communicating and working with different personalities • Managing stress when things get tough Members $80 • Non Members $120

TO REGISTER or for more information go to www.nswnurses.asn.au or ring Carolyn Kulling on 1300 367 962

THE TROUBLE WITH TUESDAYS You may be finding it hard to talk to our information officers on Tuesdays.

This is because Tuesday is the one day of the week when all our staff are in the office for staff and team meetings. These meetings are essential for information distribution and planning activities.

If at all possible, please don’t ring on this day as there can be considerable delays. But if you need urgent assistance, you will get it.

Our information department receives approximately 900 calls per week, and the phones are ringing hot from 8am to 5.30pm.

We are working hard to meet your needs and thank you for your patience.

Call 8595 1234 (metro) or 1300 367 962 (non-metro).

THE LAMP NOVEMBER 2008 13

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C O V E R S T O R Y

Paid maternity leave a step closer g Productivity Commission proposes 18 weeks at minimum wage.

pressures, will flow through to all family members including partners,’ she said.

‘The absence of a national system of paid leave has created financial pressure and forced many members back to work too soon after giving birth,’ said Judith.

A recent ANF survey revealed that 68% of respondents had returned to work early for financial reasons. The survey also showed that when they returned to work, nurses and midwives were less able to continue breastfeeding and had difficulty establishing healthy family relationships.

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n an important breakthrough for working women and their families, the Productivity Commission has proposed a national scheme for paid parental leave that could give nurses up to 32 weeks paid maternity leave.

The Commission’s plan for 18 weeks’ paid leave follows years of union lobbying for a universal scheme. One year after the election of the Rudd Government, a national scheme is finally on the agenda.

The Productivity Commission proposes that the Federal Government pay the adult minimum wage (currently $543.78 a week or an annual total of $9,788) on top of current maternity leave schemes, with employers contributing a 9% superannuation payment based on the minimum wage.

Fathers would also be eligible for two weeks’ paid paternity leave.

The Commission is seeking responses to its proposal and will hold public hearings before it makes a final report to the Government next February.

NSWNA Assistant General Secretary Judith Kiejda welcomed the proposal as an important breakthrough, given that Australia is the only country in the 30-member Organisation for Economic Co-operation and Development, besides the US, that does not have a national paid maternity leave scheme.

‘This proposal is a step towards recognising the right of all Australians to paid parental leave,’ Judith said.

NSW public health system nurses and midwives currently receive 14 weeks’ paid maternity leave at full nursing pay rates. Under the Productivity Commission proposal, if current arrangements are maintained public health system nurses and midwives would still receive the 14 weeks at full nursing pay rates – plus an additional 18 weeks at the adult minimum wage rate, bringing to 32 the total number of weeks’ paid maternity leave.

14 THE LAMP NOVEMBER 2008

‘We cannot afford to lose these nurses because of inadequate parental leave.’

NSWNA Assistant General Secretary, Judith Kiejda

Private hospital and aged care nurses and midwives who currently receive paid maternity leave would also have the period of leave topped up so they receive an extra 18 weeks’ paid leave on top of their current arangements.

Many private hospital and most aged care employers still provide no paid parental leave for nurses.

Judith said the Productivity Commission proposal would lend weight to the NSWNA’s push for paid parental leave in the private health sector.

NSWNA members and families to benefit Judith said the provision for paid maternity leave was particularly significant for the NSWNA as the majority of its members are women.

‘It’s a breakthrough that will directly benefit nurses and midwives who need time off work to have and care for their babies.

Women need time to recover from a birth, bond with baby and establish breastfeeding.

‘The benefits of having a mother who can take time off work to care for her baby, without having to worry about financial

Paid maternity leave will boost retention of nurses Judith said international evidence showed women were more likely to return to work after a decent period of paid maternity leave, with some Australian employers reporting a return rate of up to 90%.

‘The NSWNA has long understood the value of paid parental leave schemes in stimulating lifetime employment rates of nurses and increasing retention rates for the health system, with reduced costs for training and recruitment.’

Big gains but further to go The Assistant General Secretary said the NSWNA believed a national scheme should provide payment for 26 weeks, to enable babies to be exclusively cared for by their parents for six months.

‘We think 26 weeks is needed, in the interests of mother and child health and assisting women to re-enter the workforce,’ she said.

‘Large numbers of experienced female nurses and midwives in their late 20s and 30s are also at the stage of their lives when they are having, or thinking about having, families. We cannot afford to lose these nurses because of inadequate parental leave.’

The Union will push employers in all healthcare sectors to top up any national scheme to the full nursing pay rates, she added.

‘We will be also pushing to have super paid according to the employee’s full wage rather than at the Federal minimum wage,’ said Judith.n

Fiora Sacco

LONG SERVICE AND HOLIDAY LEAVE COVERS SHORTFALL leanor Romney, a CNS at RPA Hospital, is three months into her maternity leave with her first child, John.

Eleanor chose to take 12 months off to care for her baby – believing this to be best for mother and child. To achieve this Eleanor is taking 28 weeks at half pay and a further 24 weeks long service and annual leave, also at half pay.

‘I feel very fortunate I’ve got this time off – and I thank the work of the unions over the years for that – but the reality is that to take this time off I had to use all my long service and holiday leave,’ she told The Lamp.

‘Our budget is tight and we’re probably only coping because we don’t

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have a massive Sydney mortgage – that would have had a big impact on how much time I could take off. We depend on my partner’s income and we’re definitely not putting any savings away.

‘Nursing is a female-dominated profession and if we want to retain experienced nurses we need to provide longer maternity leave.

‘The World Health Organisation recommends that mothers breastfeed exclusively for six months. Even with an extremely flexible workplace, breastfeeding is very tricky to manage if you’re back at work.

‘I believe the Productivity Commission’s recommendation of an extra 18 weeks at the minimum

wage, on top of 14 weeks at full pay for public health sector nurses, would be a terrific improvement. ’I think this whole issue says something about the society we live in – about how much we value our families and our children. We should be doing all that we can to make parental leave accessible to everyone – not just women and not just people who are working. There needs to be provisions for fathers to do this too.

‘We’re always looking at how to keep people in the workforce, especially women my age. If we want to continue to tap into this age group we have to provide better maternity leave,’ said Eleanor.

THE LAMP NOVEMBER 2008 15

C O V E R S T O R Y

Fiora Sacco

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SCHEME WOULD RETAIN EXPERIENCED NURSES

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iona Goodman is a NUM at Mosman Private Hospital and is expecting her first child two days after Christmas.

Fiona decided to delay having children until she had consolidated her career, but that now means it may be more difficult for her, as a NUM, to share a roster when she returns to work.

Fiona is planning to take a full year off, even though she thinks will only get four weeks paid maternity leave from her employer, Healthscope, and a further two weeks when she returns to work.

16 THE LAMP NOVEMBER 2008

‘A child spending the first year with their mother would be ideal but I think that is going to be quite difficult due to finances,’ she said.

‘We will try to survive on my husband’s wage but that will put him under a lot of pressure so I may have to return to work sooner than I’d hoped.

‘It would be a lot easier with an extra 18 weeks at the minimum wage, though I think 26 weeks at full pay would be much better for new mums.

‘I believe society appreciates the

value of child rearing and companies don’t want mothers to leave the workforce entirely. Paid maternity leave, flexible working hours and affordable child care would go a long way towards retaining experienced senior nursing staff in the health system.

‘I think it is important we achieve flexibility in the workplace, especially for NUMs, and that parity between the public and private sector includes equal maternity leave.’n

Fiora Sacco

TWO MONTHS NOT ENOUGH

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ennifer Beddoe, RN, returned to work at St George Private Hospital in April after having her second child, Zachary, last November. At her Ramsay-owned hospital she was entitled to eight weeks’ paid leave. After using all her available holiday leave, Jennifer had to do the last three months without pay.

‘Eight weeks paid leave is just not long enough. I had to go back because we simply ran out of money,’ she said.

‘As nurses, we can’t work right up to the due date so we have to begin our maternity leave before the birth ... and if you have a caesarean like me you have

only just recovered from that by the time your paid maternity leave runs out.

‘It also affects how long you can keep breastfeeding your baby. I know we can breastfeed or express milk at work but for a lot of us that’s simply not practical.

This affects how long some women can breastfeed and I think that’s wrong – I was forced to put my baby on the bottle before I was ready. That was the only choice I had.

‘Working with young children, you have to rely on family or friends or your partner – but he’s also a nurse and has to work 12-hour shifts. Try coordinating two shift-worker rosters … it just doesn’t

happen so I have to rely on my mum.

There’s no other back up. Childcare is ridiculous when you’re working shifts and my work has no childcare facilities.

Without my mum I either couldn’t have babies or I’d have to quit work.

‘I hope the Government implements the Productivity Commission’s recommendation of an extra 18 weeks at the minimum wage. That would relieve a lot of financial pressure and allow us to spend a lot more time with our babies.

‘I’m glad we’re looking at the whole maternity thing because it’s just not fair.

I mean even if we got paid like the public sector it’d be better,’ said Jennifer.n THE LAMP NOVEMBER 2008 17

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18 WEEKS WILL HELP

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irst-time mum, Lara Knight, EEN at Lismore Base Hospital, wanted to spend the first year at home with her new baby Grace.

Resigned to the realities of modern maternity leave, the young North Coast nurse set about making ends meet on half her salary for 28 weeks and, like most new mums today, cobbling together whatever holiday pay and long service leave she could.

Six months into motherhood, Lara remains positive but things are getting tough for her and her husband Phillip – an organic macadamia and fruit farmer.

‘We live day-to-day on my income but by the time you’ve paid the loans and the bills it is a real struggle and we’re really only just coping.

‘The only reason I’ve been able to stay off work so far is because we have a house that came with the farm.

‘I think the proposed extra

MOTHERHOOD RESPECTED, AT LAST!

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PA midwife Cherie Desreaux is celebrating the arrival of her twins, Norah and Alexander – born in late October. Cherie told The Lamp the 18 weeks’ paid maternity leave for all working mothers, as proposed by the Productivity Commission, would be ‘a great move, a big step forward for working women’.

‘Finally, we have recognition that all women deserve paid maternity leave.

Motherhood needs to be respected,’ she said.

As a public health system midwife, Cherie is entitled to 14 weeks’ paid maternity leave, or 28 weeks at half pay.

‘I’m going to take 28 weeks at half pay,’ she said.

18 THE LAMP NOVEMBER 2008

Under the Productivity Commission proposal, Cherie would be entitled to 14 weeks’ paid leave at her full wage, plus an additional 18 weeks at the Federal minimum wage.

Cherie said the extra 18 weeks paid maternity leave proposed by the Productivity Commission would have ‘made a big difference’.

‘The Productivity Commission has put the right of women to paid maternity leave on the national agenda.

It shows that motherhood is important and other things will flow out of this. It will extend to other areas like child care, with acceptance that all working parents deserve affordable, quality child care,’ said Cherie.n

18 weeks at the minimum wage rate [recommended by the Federal Productivity Commission] will help but the NSWNA’s recommendation of 26 weeks at full pay would really ease the stress.

I mean the minimum wage [$543.78] is a bit ordinary, really. At present there are dozens of third world countries with more maternity leave than us.

‘It’s awful feeling like we have to choose between work and having children but my family will always come first – even if I have to give up work.

‘I’m still dreading the thought of putting Gracie into day-care when I go back to work,’ she told The Lamp.

‘I have a friend who had to put her baby into care at six weeks and I just can’t imagine how she copes. Another who returned to work had to quit because it was just too hard.

‘I want more kids but I think Phillip is worried about how we will afford it,’ said Lara.n

CAN’T AFFORD LEAVE BUT YOONIE COMES FIRST

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in-Hee Noh, RN at Manly Vale Nursing Home, is planning to take six months off work to care for her seven-week-old baby Yoonie.

Jin-Hee’s employer, Hardi, offered nurses a strong Union Collective Agreement with a payrise up to 29% – along with improved conditions. However, the agreement did not include provisions for paid maternity leave, so Jin-Hee is taking unpaid leave to care for Yoonie.

With a mortgage and other day-today financial pressures, Jin-Hee can’t really afford to have this time off work,

but she believes it’s very important a baby is cared for at home by its mother.

‘A mother needs time off to bond with her baby and establish breast feeding,’ she said.

‘I’m really trying to spend six months at home with her but we can’t really afford it. We’re really struggling financially. It’s causing me a lot of stress and worry.’

Jin-Hee said the extra 18 weeks’ paid maternity leave proposed by the Productivity Commission would have certainly relieved the financial pressure and worry.n THE LAMP NOVEMBER 2008 19

DRAWN 30 JUNE 2009

m e w m e n b a p u n g i S the chance to win a beautiful Broeomre holiday for

With more members we have a louder voice and a stronger union.

The more members at your workplace, the stronger your voice and bargaining position with your employer.

With more members we will achieve better pay and conditions for you!

Not only will you be making your union stronger by signing up a new member, you and a friend could be jetting off from Sydney to Cable Beach, Broome.

That’s seven nights of tropical bliss – just for signing up a new member!

20 THE LAMP NOVEMBER 2008

www.australiasnorthwest.com

The prize includes return flights from Sydney to Broome, seven nights in a two-bedroom apartment at Broome’s newest Resort, The Pearle of Cable Beach, a Gourmet Sunset Sail or Champagne Breakfast Sail for two from INTOMBI Broome’s Pearling Lugger Experience, car hire from Broome Broome Car Rentals plus a Willie Creek Pearl Farm Tour and a Pearl Luggers Tour.

HURRY! Call the Association now for a recruitment kit and recruitment incentive scheme details.

Ph: 8595 1234 (metropolitan area) or 1300 367 962 (non metropolitan area) or go to www.nswnurses.asn.au

www.thepearle.com.au

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C O V E R S T O R Y

$20,000 maternity leave win g Temporary nurse entitled to full benefit

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senior nurse manager on a temporary contract has won more than $20,000 in maternity leave payments extending beyond the end of her contract.

The North Coast Area Health Service (NCAHS) had no right to restrict maternity leave to the period of the contract, a NSW Industrial Relations Commissioner ruled.

The NSW Nurses’ Association took up the case of Lismore Base Hospital senior nurse manager Lyndal Van Eede after she was denied her entitlement to 14 weeks’ paid maternity leave under the Public Health System Nurses’ and Midwives’ (State) Award.

Lyndal went on maternity leave on 21 January 2008 but, since her contract finished on February 10, the NCAHS decided to pay only three weeks of her entitlement.

Commissioner David Ritchie said that when Lyndal started maternity leave she was an ‘eligible employee’, having been employed for more than the 40 weeks stipulated by the award. She was therefore entitled to the full benefits of the maternity leave clause and should be paid the 11 weeks outstanding.

NSWNA Assistant General Secretary Judith Kiejda said Lyndal’s win set a valuable precedent for public health system nurses throughout NSW. ‘The Commissioner found the paid maternity leave clause in the award does not depend on continuation of employment,’ Judith said.

Lyndal received a lump sum payment of $20,000 plus interest.

She was heavily pregnant when Commission hearings started and baby Joel was two months old when the case was settled.

‘I attended three Commission hearings in six months and at times I did wonder whether it was worth it.

However, I believed that in principle I was right,’ Lyndal said.

The NCAHS had no right to restrict maternity leave to the period of the contract, a NSW Industrial Relations Commissioner ruled.

The Union gave me confidence as they believed I had a reasonable case.

‘The outcome made it all worthwhile.’

Lyndal said she received conflicting advice from NCAHS human resources staff about whether she would be entitled to the full 14 weeks’ maternity leave.

Lyndal said she was very happy with the decision and pleased that other nurses would not have to fight the same battle in the future.

‘This is the first time I have sought advice from the Union on any issue during my career. However, I read the award and felt on principle that I had a case,’ she said.n

‘The union’s industrial officer Chris Blair and barrister Claire Howell believed it was worth pursuing and were very enthusiastic and supportive – they gave me the motivation to keep fighting.

‘I said to my partner, even if we aren’t successful, I’m happy that we challenged the system.

Lismore Base Hospital senior nurse manager Lyndal Van Eede THE LAMP NOVEMBER 2008 21

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A bigger role for nurses g Federal Health Minister Nicola Roxon says her health reforms include a bigger role for nurses and a change in priority towards prevention and primary care.

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ast month, in the Ben Chifley lecture – a significant forum for ALP policy presented annually in Bathurst – Federal Health Minister Nicola Roxon outlined her vision for reforming our health system. A key priority, she says, will be to shift more responsibility from doctors to nurses.

Roxon told doctors to cooperate with reform or face a pay cut.

‘There needs to be an incentive for doctors to eschew less complex work and focus on the work that does require their high-level skills and expertise. Or, if doctors don’t want to let go of it, to accept being paid less for devoting their highly-skilled and heavily-trained selves to less complex tasks,’ she said.

The Minister said there was a financial disincentive for GPs to provide the type of longer, intensive visit that prevention demands – ‘like teaching somebody how to lose weight, keep fit, and avoid diabetes’.

‘There is a long-standing, historical anomaly here. Our health system, including funding for health services, is organised almost entirely around doctors, despite the fact that many services are now safely and ably provided by other health professionals – nurses, psychologists, physiotherapists, dieticians and others,’ she said.

Nicola Roxon said it was possible for nurses and other health professionals to take on some of those responsibilities and

suggested Labor would make it attractive for them to do so.

‘In doing so, we will not only be redressing the historical bias towards medical intervention and acute care, we will be redressing the historical bias against the traditionally female nursing workforce,’ she said.

‘We will not only be redressing the historical bias towards medical intervention and acute care, we will be redressing the historical bias against the traditionally female nursing workforce.’

Health is crucial to tackling inequality In her speech, the Minister claimed that all the great health initiatives in the postwar period – especially the pharmaceutical benefits scheme and universal health care – were hard-fought social gains won under a Labor government.

‘Over time [there] is a clear cycle:

Labor introduces a signature health reform; it is opposed by the conservatives, and by the medical profession; as it gathers public support, the fight is won; and the Liberals are forced to accept that the reform has won community support and a firm place in Australian society,’ she said.

Despite this progress, she argued, health remains a major indicator of inequity.

‘If you want to judge how affluent a suburb is, you could check its tax returns – or you could look at its medical records.

Rates of diabetes, of heart disease, early deaths, infant mortality, how many teeth a person has left – all are clear markers of socio-economic status.’

This, she said, had two lessons for health policy. c First, that health policy can’t exist in a vacuum. As is most clearly demonstrated by our approach to Indigenous health, we know we must simultaneously work on improving housing, education, and employment. c Second, that investing just in hospitals can play only a very limited role in addressing disadvantage. It can do a great deal of good, but the chance at early intervention, and a better life, has been lost.

‘There is now much to be done. If we are to tackle inequality in this country, then reshaping health is crucial. If we want our kids to live longer, not shorter lives than us, we can’t afford to rest,’ she said.n

To read Nicola Roxon’s complete Ben Chifley Memorial speech visit: www.health.gov.au/internet/ministers/publishing. nsf/Content/sp-yr08-nr-nrsp200908.htm?OpenDocument&yr=2008&mth=9 22 THE LAMP NOVEMBER 2008

Let’s make Sydney a more liveable city g The Sydney Alliance, a new coalition of community groups, aims to shape the quality of urban life in Sydney.

‘There has been a deterioration in basic community values over recent years which cannot be regained or turned around by individuals alone. If the Alliance brings about change in any meaningful way it will be worthwhile.’

C

Lucille McKenna, DON & NSWNA Councillor, St Mary’s Villa

onventional wisdom would have us believe that a diverse range of faiths – Jews, Catholics, Protestants and Muslims – would struggle to find much in common. If trade unions and community groups were added to that melting pot, chaos should reign and a dialogue of the deaf should follow.

‘If unions join together with other organisations who work for the common good, it can only be beneficial.’

for a living wage (London), expanded public transport (Baltimore), or new apprenticeship programs to give local kids opportunities for high skilled jobs (Seattle). There are similar coalitions in Canada, Germany and the United States.

In all these overseas groups, unions play a key part as they do in the Sydney Alliance.

Although recently formed, the Sydney Alliance already boasts the Uniting Church NSW Synod, the Arab Council of Australia, the Jewish Board of Deputies, the Parramatta Diocese of the Catholic Church, Asian Women at Work and a number of unions as members.

The unions include NSW Teachers Federation, Unions NSW, CFMEU, LHMU and the USU. The Alliance is a non-part/ political organisation.

Kerry Rodgers, Clinical NUM, Nepean Hospital

Common ground with nurses

Not so, says Jill Biddington, Executive Officer of the Sydney Alliance, a coalition of community groups, faith organisations and unions that has come together to shape the quality of urban life in Sydney.

‘When people from seemingly different backgrounds talk to each other they find they have much more in common than they have differences,’ she said.

‘Reliable public transport, access to a decent health system, educational and job opportunities for their kids, a liveable wage – everyone living in a big city like Sydney shares these needs.’

The Sydney Alliance is modelled on similar organisations overseas that have successfully campaigned

The NSWNA Council recently voted to become a participating organisation in the Alliance. General Secretary

Brett Holmes says the Sydney Alliance will be a good vehicle for nurses to build relationships with organisations that we have not worked with closely in the past.

‘We can be more effective in achieving social change that will benefit nurses and their families if we build relationships with other organisations that share our aspirations to a fair society,’ he said.

‘What impresses me about these organisations is that they see how important a decent health system and quality aged care are for their members.

‘It won’t be hard for us to find common ground around issues like this that will be mutually beneficial.’

Brett says the Association is mindful that the initial focus of the Alliance’s activities will be in Sydney, when a large number of our members live in other parts of NSW. ‘If the initiative is successful in Sydney we would like to see it extended to the whole state and the benefits the Alliance achieves be universal for all members,’ he said. n

THE LAMP NOVEMBER 2008 23

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I N D U S T R I A L

I S S U E S

GWAHS nurses at breaking point g Introducing surge beds is the latest, desperate cost-cutting move by GWAHS.

N

urses at cash-strapped Bathurst Base Hospital are in dispute with the Greater Western Area Health Service (GWAHS) over a cost-cutting proposal to introduce surge beds.

The planned October introduction of surge beds triggered an immediate staff uproar at the hospital resulting in a NSWNA branch resolution rebuking the move.

NSWNA Assistant General Secretary Judith Kiejda said the introduction of surge beds was a desperate and cynical move by management to cut costs in the face of crippling financial problems.

‘We don’t object to the surge bed model of care but its viability is dependent on a range of outside services that Bathurst currently lacks,’ she said.

‘We know surge beds do not work when hospitals are short-staffed like at Bathurst.’

Association member and Bathurst Base Hospital Branch Secretary Christene Druce said the system was at the point of collapse and nurses could no longer maintain the unreasonable workloads being imposed upon them.

Christene is also the Orange Health Service’s Disaster Planning Project Officer but nothing could have prepared her for this crisis.

‘Honestly, this is the final straw in a very long saga for us,’ she told The Lamp.

‘At the time of commencing dispute, our members were carrying the brunt of 59 unfilled nursing positions we had identified at the hospital including many frontline clinical places. This is seriously jeopardising standards of practice and maintenance of care.

‘The pressure on staff to keep things going is huge. For a long time now we’ve been trying to function with inadequate budgetary allocations, poor budget management and poor recruitment strategies. Accompanying this has been

‘Nurses are overworked, close to burnout and morale is low.We’re seeing very high levels of overtime, casual and agency staff utilisation and part-time staff are regularly working well beyond their contracted hours.’

NSWNA Bathurst Base Hospital Branch Secretary Christene Druce

high levels of corporate bullying over a protracted length of time.

‘Nurses are overworked, close to burnout and morale is low. We’re seeing very high levels of overtime, casual and agency staff utilisation, and part-time staff are regularly working well beyond their contracted hours.’

The ongoing financial crisis at the GWAHS reached flash point last month as hospitals throughout the area began running out of critical medical supplies. Earlier in September, the GWAHS hit the headlines over unpaid food and transport bills.

In the latest controversy, nurses have had to borrow bandages and medical equipment from a veterinary clinic, and a doctor used his own money to buy urgent diagnostic supplies.

Nurse managers at sites across the

area report similar chaos and confusion.

Many have been refused credit by suppliers and some have also had to purchase critical supplies from their own pockets.

Meanwhile, doctors at Dubbo Base Hospital have passed a motion of noconfidence in the hospital’s management.

Judith described the situation at the GWAHS as nothing short of a train wreck.

‘For months now, nurses across the whole GWAHS have been heroically holding the health service together amid severe supply shortages, dire staffing levels and illconceived management strategies,’ she said.

‘Our members have been working tirelessly to keep services running but the crisis is now endangering patient and staff safety. We have never seen a situation like this before and the CEO of GWAHS must be held accountable.’n THE LAMP NOVEMBER 2008 25

Recent independent research has shown that 9 out of 10 pharmacists recommend Bio-Oil® for the appearance of scars.*

Bio-Oil helps improve the appearance of scars and stretch marks. It should be applied twice daily and massaged until fully absorbed. Bio-Oil is available at pharmacies and selected retail outlets in 60ml, 125ml and 200ml sizes from $14.95. bio-oil.com

Results of clinical trials: Photobiology Laboratory MEDUNSA 2006 1. Appearance of Scars: 65% improvement in appearance observed at 4 weeks (panellists: 24 Caucasians age 18-60, comprising 22 females & 2 males) 2. Appearance of Stretch Marks: 50% improvement in appearance observed at 8 weeks (panellists: 20 Caucasian women age 18-55) 3. Appearance of Uneven Skin Tone: 93% improvement in appearance observed at 6 weeks (panellists: 30 women age 18-55, comprising 15 Caucasian & 15 Negroid). All trials were observed by an independent expert clinician. They were single-blind & randomised with intra-subject comparison under controlled conditions. *The Nielsen Company, Independent Pharmacists’ Study, February 2007. †The Nielsen Company ScanTrack Pharmacy© for Bio-Oil 60ml.

Cosmetic & therapeutic skincare (excl washes, anti-fungal and cold sore preps) for the calendar years 2006 and 2007.

26 THE LAMP NOVEMBER 2008

No.1

s

Q & A

ASK

JUDITH

WHEN IT COMES TO YOUR RIGHTS AND ENTITLEMENTS AT WORK, NSWNA ASSISTANT GENERAL SECRETARY JUDITH KIEJDA HAS THE ANSWERS.

Holidays over Christmas I am preparing the roster for the Christmas/ New Year period and need to know which days are public holidays as staff are requesting leave. I have also been informed there is an extra holiday over this period.

The standard Public Holidays are: c Christmas Day – Thursday, 25 December c Boxing Day – Friday, 26 December c New Year’s Day – Thursday, 1 January.

If you are employed under the Public Health System Nurses’ and Midwives’ (State) Award 2008 there is an extra public holiday in lieu of the August Bank Holiday. This additional public holiday has been allocated as Friday, 2 January 2009.

If you are employed under the private hospital, nursing homes or another award instrument you will need to check with your employer which day has been allocated as the additional public holiday.

You also need to be aware that the day may already have been allocated on 4 August 2008 (which was the official August Bank Holiday) or if you live in an area where there is a local show day that may have been allocated as the extra day’s leave.

Transferring annual leave Is it possible to transfer annual leave between public hospitals, and if so, under what circumstances?

Yes, you can transfer your annual leave entitlements between public hospitals, providing you meet certain criteria. The criteria is set out in Department of Health Policy Directive PD2006_096 Staff Mobility as follows:

‘… an employee who ceases employment in one public sector service and immediately commences employment in another public sector service may elect to be paid the monetary value of accrued annual leave on termination, or have their entitlement transferred on commencement with the new employing organisation …”

So, the employee has the choice of being paid out their leave on termination or transferring, providing they meet the terms of ‘immediately commencing employment’, which is clarified in the document as: ‘… the employee entered duty on the next working day or within two months of the last day of service with the former public sector employer …”

If an employee has in excess of 40 days leave owing, the new employer can request the employee take payment for the excess (thereby only accepting the 40 days).

Sick leave for contractors I am an RN working in the public sector on a 0.4 FTE contract and I am rostered for additional shifts. These additional shifts bring me up to full-time hours. If my roster is posted and I am subsequently sick for a period greater than my contracted hours, am I entitled to sick leave to cover all the hours I am rostered to work?

Yes, if you have been rostered to work and you are subsequently sick, you are entitled to sick leave as long as you have the appropriate hours accrued to cover your sick leave.

Sick leave for part-time employees is calculated on a pro-rata basis of 76 hours per year for full-time employees.

This is explained in cls 37 (v) of the Public Health System Nurses & Midwives (State) Award, which states: ‘ … a part-time employee shall be entitled to sick leave in the same proportion of the 76 hours as the average weekly hours worked over the preceding 12 months or from the time of the commencement of employment, whichever is the lesser, bears to 38 ordinary hours. Such entitlements shall be subject to all the above conditions applying to full-time employees.

Provided that only part-time service on and from the beginning of the first pay period to commence on or after 1 January 1970, shall count for the purpose of this subclause.’

Am I entitled to tea breaks?

I work in a nursing home on permanent part-time 7 hour 45 minute shifts (7hrs 15 mins if you take out the meal break).

The DON has said that we are not entitled to any tea breaks. Is this right?

No, this is incorrect. The Nursing Homes, &c., Nurses’ (State) Award provides at 2(x): ‘Two separate 10-minute intervals (in addition to meal breaks) shall be allowed for each employee on duty during each ordinary shift of 7.6 hours or more; where less than 7.6 ordinary hours are worked, employees shall be allowed one 10-minute interval in each four-hour period.”

As you are working a shift of 7.25 hours you are entitled to one 10-minute tea break. This break counts as working time and should be paid as such.

If you have any questions about any aspect of your award, please contact the NSWNA on (02) 8595 1234.n

Little hearts need you to care!

As a professional in the nursing field you would see many little hearts in need of extra care and attention. If you have been thinking about fostering then we would encourage you to call us to find out how you can give a child this extra care and attention. Centacare provides training, support and financial assistance to carers. For more information please call Centacare on 8709 9333 or visit www.fosterkids.com.au THE LAMP NOVEMBER 2008 27 Centracare.indd 1

17/9/08 9:22:53 AM

s

PROFESSIONAL ISSUES

Robot nurses

g Technology is changing the way nurses work, with mixed results. No one doubts the value of a defibrillator or any life-saving device, but technology is also adding complication and further workload to nurses’ jobs.

T

echnology was supposed to make our lives easier.

The 1960s cartoon The Jetsons revolved around a family who have become lazy because technology has made their lives so easy – George Jetson’s only job is to push a red button for three hours a day, and the family has a robot maid to do all the housework. In 2008, that seems laughable. Technology hasn’t liberated us from work at all: even when we finish a shift it seems the computer is always on, and the mobile phone is always ringing.

Technology has encroached on nursing with mixed results. No one is going to argue against the value of a defibrillator or any life-saving device, but some of the technology nurses now have to use is changing the way we work.

Katrina Skylas is an ICU nurse at RPA and has seen a massive increase in the amount of technology in her work since she began nursing in 1994.

‘ICU is especially technology-based.

The technology has changed quite significantly, it’s become extremely sophisticated. It certainly increases your workload,’ she said.

Whether you’re working in ICU with complicated machines or simply have to access your email every day, technology can create more work. Continuous renal dialysis machines require a lot more knowledge and precise understanding of technology than ever before, and it means you have to monitor a machine as well as a patient. In many cases, technology doesn’t mean less work for nurses, it means more.

‘With the increase in technology there’s a lot more intervention at the bedside and it’s a lot more work for the nurse at the bedside. There are more things you’ve got to be accountable for and take into consideration,’ said Katrina. ‘Working with technology is part of working in ICU, but nursing care is fundamental.’

In some US hospitals, patients have been given barcodes in an attempt to reduce errors. At Boston’s Brigham and Women’s Hospital each patient was given a wristband barcode with their patient information on it, which nurses had to scan with a handheld device before they could give the patient any medication. The system was supposed to prevent nurses from giving incorrect

Perhaps the biggest problem with technology is that it can be an illusion – machines will never replace nurses or human judgement. medications or doses by mistake. But in the first trial of the system, nurses found many of the patient’s barcodes had the wrong information. The barcodes and cumbersome scanners simply created more work, stress and bureaucracy. Nor did the system prevent errors like a doctor prescribing the wrong drug or a drug a patient was allergic to. ‘The system can never replace a nurse,’ one nurse told The Boston Globe newspaper. ‘The nurse must

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still use her brain and know why she is giving a particular drug to this patient.’

A team from the University of Pennsylvania studied the barcode system, after it was introduced in five US hospitals, and found that 99% of errors were made by the barcode system, not nurses. Nurses frequently had to override the system, and the machines made some hospital rooms crowded and difficult to work in.

‘The surprising result is that the design and implementation of the technology, which is often relied upon as a cure-all for medication administration errors, is flawed, and can increase the probabilities of certain errors,’ wrote the researchers. ‘Equally surprising is the urgencies of care and the ingenuity of nurses to cope with these shortcomings.’

Any new technology also means you have to learn how to use it, which can be especially challenging for new grads. ‘It’s a lot for new grads to take on board – they’re quite big concepts to absorb. There’s a lot of technology that’s quite advanced. You need a lot of clinical knowledge to use some of it. Someone who’s new to the job can’t use the more complicated equipment – they need to have been around for one or two years,’ said Katrina. ‘So it’s also part of the job to provide education and training around new equipment.’

A study called ‘What Do Nurses Have

to Say About Information Technology in Their Workplace?’ asked 1,000 registered nurses in Queensland what impact they feel technology has on their job. The researchers concluded that the nurses ‘range from feeling indifference at one end of the spectrum to often feeling exhausted

the technology.’ While a technician might only know how to use a machine and which buttons to push, a nurse will know how and why that machine is working, and exactly what it is doing for the patient.

Perhaps the biggest problem with technology is that it can be an illusion

‘Anyone can be a technician,’ says Katrina, ‘But to be safe you need to be a clinician using the equipment with the understanding of why you’re doing something and how it’s impacting on the patient. A nurse is not a technician, they’re a clinician using the technology.’ and stressed out after dealing with it in the workplace. The concluding result from this research also demonstrates that there are many humanistic features in caring that were not considered by the IT industry when health information systems were developed or implemented.’

It’s possible to train a technician to use a particular machine, but that will never replace the real live knowledge and experience of a nurse. ‘Anyone can be a technician,’ said Katrina, ‘but to be safe you need to be a clinician using the equipment with the understanding of why you’re doing something and how it’s impacting on the patient. A nurse is not a technician, they’re a clinician using

– machines will never replace nurses or human judgement. ‘A lot of technology is taking over nursing, but it doesn’t replace the nurse. With increasing technology, people forget about touching the patient.

With dialysis you could focus on the machine and forget there’s a patient attached to it,’ said Katrina. No machine will ever replace the fact that, at the end of the day, in nursing we deal with people, and they need other people to provide their care.

‘There’s a patient attached to every piece of technology,’ said Katrina. ‘It doesn’t matter how much technology you have, you still need to care for the patient.

There’s a pulse under all that technology.’n THE LAMP NOVEMBER 2008 29

s

F R O M

T H E

F I E L D

The highs and lows of IVF nursing g IVF nursing is emotionally challenging but incredibly rewarding work, says Jeanene Stevenson, Nurse Educator at Sydney IVF.

W

hen NSWNA member Jeanene Stevenson was appointed Nurse Educator at Sydney IVF two months ago, she became the first IVF Clinical Nurse Educator in NSW, and only the second in Australia.

Having worked at the state-of-theart clinic for a decade, Jeanene is one of the most experienced IVF nurses in the country and has a clear understanding of the attributes and qualities needed to pursue this specialised form of nursing.

‘It can be difficult work but incredibly rewarding. Firstly you need mountains of emotional stamina. You have to be an excellent listener and a very empathetic person,’ said Jeanene.

‘Our patients often arrive here emotionally exhausted and very vulnerable. They bring stories of infertility, miscarriage, grief and loss and nurses need to be very sensitive to that.’

As Jeanene explains, emotions like anxiety, jealously, anger, guilt, fear, sadness and loss of self-esteem commonly accompany infertility, but sometimes patients slide into more serious states of panic and despair. Nurses need to be constantly alert to the signs that often come with a ‘palpable sense of urgency’, especially among older patients who feel the ‘clock is ticking’.

‘Some feel like they can’t even afford to wait another month,’ she said, explaining that IVF consultation involves a fine balance between the real possibilities and false expectations.

A typical day at Sydney IVF begins before 7am, with up to 50 patients arriving for their daily blood tests. There are drugs to issue, injections to give and, ‘lots of TLC 30 THE LAMP NOVEMBER 2008

and tissues to dispense’. The mornings are filled with assessment interviews, phone calls to-and-from patients and last minute ‘drop-ins’ to accommodate.

By afternoon, the blood tests and ultrasound results trigger another round of phone calls, this time to doctors determining treatments and organising procedures like egg collections and inseminations.

An upside to IVF nursing is the regular hours – for some, it is as close to ‘a normal job’ that they’ve had – though there can be some lively ‘negotiation’ as to who takes home the after-hours’ phone.

‘It’s an incredibly exciting place to work.When I started here 20 years ago the pregnancy success rate was only about 10%.

Our figure today is about 50% for women under 36 years of age.’

‘That can involve standing on a crowded bus trying to respond to a patient wanting to discuss her period, which can be quite awkward,’ said Jeanene.

Jeanene oversees the training and development of the clinic’s 15 ‘nurse coordinators’, who manage patients’ ‘journey’ (a key word at Sydney IVF) through the program.

‘IVF nurses need to counsel and guide patients and their partners through the difficult periods, calmly reassuring them while constantly reassessing outcomes and options,’ she said.

‘Our nurse coordinators meet regularly with the doctors, pathologists, sonographers, scientists and day-surgery staff, coordinating treatment and keeping patients as informed and relaxed as possible.’

Sydney IVF’s Patient Services Manager Sally Muir has seen the full evolution of the nurse coordinator’s role since she started as an IVF nurse 20 years ago.

‘The key to IVF nursing is relationship and trust. As we are handling their precious eggs and sperm, patients have to be able trust us and confidentiality is crucial. There is still a surprisingly strong social stigma attached to infertility that can be very difficult for patients to deal with and we have to respect that,’ said Sally.

‘But it’s an incredibly exciting place to work. When I started here 20 years ago the pregnancy success rate was only about 10%. Our figure today is about 50% for women under 36 years of age.

C O M P E T I T I O N Clinical Nurse Educator, Jeanene Stevenson (right), confers with Sydney IVF Nurse Coordinators.

Welcome to Port Stephens, Blue Water Paradise

the

Known as the Blue Water Paradise for its pristine and scenic environment, Port Stephens the gateway to the north coast of NSW. The area’s natural beauty makes it a perfect holiday destination ... pristine waterways, golden sandy beaches, majestic sand dunes, resident dolphins and unspoilt national parks.

About 160 Bottlenose Dolphins call this harbour ‘home’ and Moonshadow Cruises guarantee a range of cruising adventures to meet these resident dolphins. www.moonshadow.com.au Fancy a spot of adventure? Port Stephens Parasailing takes high flyers either solo or tandem soaring up to 150m above the water. www.portstephensparasailing.com.au Port Stephens 4WD takes visitors on a tour to the awe inspiring coastal sand dunes and the ‘Tin City’, a fishing village that emerges from the dunes like a mirage! And you’ll get to enjoy sandboarding down the dazzling white 30-50 metre high dunes. www.portstephens4wd.com.au

‘I used to go home and worry all night – which is not a bad thing in itself because you have to care to be a good nurse – but I learnt to cope. I’d go to the gym or go out and have a glass of wine.

But really, it’s the team element that’s essential. We all help each other to debrief and download when tragedy strikes.

‘I love being a part of this team. We all have a similar philosophy and a strong belief in what we are doing and it’s a privilege to be a part of our patient’s journeys.

‘We call it a ‘journey’ because that’s what it is. No one knows where it will end. Some end in healthy babies, some don’t – and when it doesn’t, we have to help them close the book on that and move on. It can be very difficult but sometimes we have to be very honest.

‘Some stay in touch, some come back for three or four babies, and some just want to forget about it and we never see them again. Everyone copes differently.’

Leaving the clinic, this Lamp journalist almost misses a corner covered with baby photos and thank-you cards. For a display that so touchingly signifies the ultimate success of IVF, it is surprisingly understated. It is then that I realise, while this is not intensive, emergency or palliative care, these nurses still practise daily on the sharp edge of life and death. Jeanene explains that while these photos are their most precious and treasured artefacts, they too must be careful to not attach themselves too tightly to the outcomes. If, as the proverb goes, life really is about the ‘journey’ rather than the destination, then nowhere at this moment is that more beautifully expressed than here at Sydney IVF.n

For a more relaxing pace, Sahara Trails offers horse riding for everyone, with a selection of three scenic trails through the forest and out to the lagoon for a beach and dune extravaganza. www.saharatrails.com Whether it’s a short break or a longer stay, the Marina Resort offers vibrant deluxe accommodation in the heart of Port Stephens, overlooking Nelson Bay Marina, next to dolphins, beach & cafes. www.marinaresort.com.au1 For all your information and booking needs, including hot deals and last minute rates, look and book at www.portstephens.org.au

WIN AN ESCAPE TO PORT STEPHENS The Lamp is offering members the chance to win a perfect short break to Port Sephens.* This month’s competition prize includes: c One night bed & breakfast for up to four people, midweek in the Family Room, at the Marina Resort; c A Port Stephens 4WD Beach and Dune Tour for two adults; c 2 x one-hour Aussie bush trail walk by Sahara Trails; c A Moonshadow Dolphin Watch Cruise for 2 adults and 2 children; c 2 x Tandem Parasails by Port Stephens Parasailing.

To enter write your name, address and membership number on the back of an envelope and mail to: Port Stephens Competition PO Box 40, Camperdown NSW 1450

Competition closes 30 November 2008. * Prize is subject to availability, not valid public holidays or long weekends.

1 Present this page for a 10% discount on direct bookings.

THE LAMP NOVEMBER 2008 31

s

OCCUPATIONAL HEALTH AND SAFETY

Dealing with patient obesity g Very obese, or bariatric, patients are weighing heavily on the NSW health system – and posing risks to nurses. Nurses say we need speciallydesigned systems, equipment, even room sizes, to deal with this growing problem.

E

arlier this year a 240kilogram Queensland woman was waiting for urgent transport to hospital. Too big for an ambulance, she also exceeded the weight capacity of a standard medivac aircraft, which can only take patients up to 150 kilos. She had to be transported to hospital in a Royal Australian Airforce Transport plane.

Closer to home, a NSW patient was too heavy to be weighed on conventional scales and had to be weighed on the scales of a loading dock via a forklift.

Australia’s increasing waistline is expanding so fast that health facilities are left struggling to keep up. There are 1.13 million obese people in NSW, and the numbers are growing by 15,000 people every year.

Bariatric patients are weighing heavily on the NSW health system. The number of obese admissions have skyrocketed in the

32 THE LAMP NOVEMBER 2008

past eight years. At Manning Base Hospital there were 37 obese patients admitted in 2001, compared to this year where the hospital has already admitted 265 obese patients. That’s a seven-fold increase in seven years.

One of the most difficult aspects of managing bariatric patients is mobility and manual handling. Many hospitals simply weren’t designed with obese patients in mind. The size of rooms, especially bathrooms, are often simply too small to fit bariatric patients.

The NSWNA, working with Australasian Health Facility Guidelines, is lobbying to have every new and renovated facility include bariatric-sized bathrooms and equipment.

Obese patients can present a higher risk to staff because they are harder to move and need special equipment.

Maggie Roden, an RN at Lismore Base Hospital, deals with obese patients

every day. A few years ago she sustained a shoulder injury while trying to move a semi-conscious woman who weighed about 140 kilos.

‘We were turning her over and her leg fell off the bed. I went to grab the leg, but with the weight and the angle it was at, I strained my shoulder, and that took time to heal,’ she said.

A NSW patient had to be weighed on the scales of a loading dock via a forklift.

Manning Base Hospital has set up a system to help nurses manage obese patients.

‘The most important thing is to have systems in place,’ says Eddie Wood, the manual handling coordinator at the hospital.

‘The system must be easy to follow.

We have a simple flagging system that’s compatible with nurses.’

The hospital has had no manual handling injuries for staff working with obese patients in the past eight years.

‘Once you’ve got systems to deal with obese patients and it’s supported by management, you can manage the

problem. If you don’t know what you’re getting, you can’t manage it.’

The problem is that not all hospitals have specific systems to help deal with obese patients. It’s important, for example, that nurses know the weight capacities of beds, slings, and wheelchairs to avoid accidents.

‘Sometimes a patient will present to a small 30-bed hospital, and that patient could weigh over 200 kilos, but the staff may not know the weight capacity of the beds,’ said Eddie. ‘So the bed maybe can’t take the weight of the patient, and that puts both the staff and the patient at risk.’

In some areas, patients who are over a certain weight range are automatically transferred to larger hospitals that have the equipment and capacity to manage them.

NSW Health recommends that staff develop a manual-handling plan for each bariatric patient, taking into account their age, physical condition, low exercise tolerance, medical condition and their psychological wellbeing, including fear and anxiety.

Bariatric patients usually have more health problems and more complicated disease interactions, and so delivering care is rarely straightforward.

‘Obese patients tend to have more co-morbidity,’ said Maggie Roden.

‘They might present at the hospital with cellulitis because of poor circulation to the skin, but then in the course of their treatment other problems are discovered.’

Obesity is linked with a range of health conditions including hypertension, heart disease, increased cancer risk, sleep apnoea, renal disease, and mental health problems including depression.

‘Malnutrition is also associated with obesity, and that’s a concern. But the education isn’t getting out there that obese

people can be malnourished. Their diet is often very high energy, low nutrition – processed food, sugary drinks, and there are actually not a lot of nutrients in there.’

The complications of obesity often translate into extra work for nurses. ‘Cannulating can be a real problem,’ said Maggie.

‘It can be very time consuming, and sometimes you have to get doctors involved.

Inserting central lines can be difficult, sometimes you can’t get venous access.’

These problems mean bariatric patients often need a higher level of care.

At Manning Base Hospital, one patient weighing 188 kilos required 96 staff attendances every day. By the end of her six-month stay in hospital, she’d received 10,912 staff attendances.

‘We were turning the patient over and her leg fell off the bed. I went to grab the leg, but with the weight and the angle it was at, I strained my shoulder.’

Maggie Roden, RN at Lismore Base Hospital

While most people understand that obesity is a serious health concern, the cause is often overlooked.

‘Obesity is an eating problem that has a massive impact on the health system and the patient’s quality of life,’ said Maggie. ‘So we can help them by referring them to a dietician. If we had an anorexic patient we would automatically refer them to a dietician – it should be the same for anyone with obesity.’

NSWNA NURSES’

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She adds that it’s important to treat the situation with appropriate sensitivity.

‘When you’re talking to the patient you need to be aware of how you approach the issue so they don’t take offence. It’s quite a sensitive area for some people, but at the same time it’s a real health concern.’

With all the extra issues that bariatric patients can bring, it’s easy to overlook the fact they are people who can sometimes use a little encouragement and support.

‘We had a long-term patient who was morbidly obese with multiple problems, and when they were discharged I really wondered how this person was going to survive on their own. But then the patient came back a few months later, and they’d really improved – they’d started walking, their mentality was so much better,’ said Maggie.

NSW Health has recently launched a $36 million campaign to help educate people about obesity, which includes launching a NSW Health Advice telephone service.

Nurses, too, can have a key role in helping to educate bariatric patients to improve their lives, said Maggie.

‘You can help bariatric patients by encouraging them to do as much as they can while they’re admitted. For some reason, there’s an education gap that’s just not reaching some people, and nurses can really help bridge that gap.’n

Name of the facility:

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Address: Contact number: (PH)

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NSWNA JOEY POUCH @ $25 EACH. Please include $5 postage & handling Amount: Cheque

Total cost of order: Money Order

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To order, fax the order form to Glen Ginty (02) 9550 3667 or post to: NSW Nurses’ Association, PO Box 40 Camperdown NSW 1450 Merchandise order forms available on our website www.nswnurses.asn.au

ORDER FORM

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Eddie Wood

27/10/08 11:35:24 THE LAMP NOVEMBER 2008AM 33

NSWNA WORKPLACE NOTICE BOARDS Helping you keep up-to-date with NSWNA news

‘The NSWNA notice board helps keep members up-to-date with information.’

Joel Organ, NUM and NSWNA Branch Secretary at Concord

Concord Hospital Branch is one of the many NSWNA branches that have requested and installed our new NSWNA notice boards.

‘The NSWNA notice board helps keep members up-to-date with information,’ said Joel Organ, NUM and NSWNA Branch 34 THE LAMP NOVEMBER 2008 Secretary at Concord.

These attractive boards have been designed to be placed in central areas of workplaces so nurses can access up-to-date Association materials.

The boards come in two sizes – large (pictured) or small – so you can choose what best suits your workplace.

If you are interested in obtaining a notice board for your workplace, please contact Lynne Ridge at the Association by email lridge@nswnurses.asn.au, or call her on 8585 1234 (metro) or 1300 367 962 (rural).

s

OCCUPATIONAL HEALTH AND SAFETY

Helping injured nurses return to work g Occupational Rehabilitation project aims to improve the occupational rehabilitation process for injured nurses.

T

he NSWNA is undertaking a project called The Outcome of Occupational Rehabilitation of NSW Nurses that aims to improve the occupational rehabilitation process for injured nurses in NSW. A collaborative project between the NSWNA and the University of Newcastle – funded by a WorkCover Partnerships Grant awarded in 2007, this research study sets out to explore the experiences and perceptions of injured nurses and workplace rehabilitation coordinators of the rehabilitation process, and identify the barriers to the successful occupational rehabilitation of injured nurses employed in health care settings in metropolitan and rural NSW. The research is being conducted by the Faculty of Health at the University of Newcastle.

An important source of information will be a questionnaire sent to a sample of injured nurses in November. Nurses will be asked to complete and return the questionnaire.

Focus groups have also been held with a number of rehabilitation coordinators from a range of employers.

NSWNA General Secretary Brett Holmes said the project derives from the Association’s concern about the occupational rehabilitation process and how it is being managed for injured nurses in NSW.

‘Nursing is a profession with a high rate of injury and currently the rehabilitation processes for nurses are limited,’ he said.

‘If you have been injured recently you may be invited to participate in this research project. I encourage members to share their experiences and perceptions of the rehabilitation process so we can improve the process for injured nurses.’

All nurses who have sustained an injury and have required rehabilitation between July 2006 and June 2007 are eligible to participate. Potential participants will be identified by WorkCover NSW and receive a study package inviting participation.

Participation in this research is entirely voluntary, anonymous and confidential.

No information will be collected that will identify the participants. The questionnaire should take about 30 minutes to complete.

‘The NSWNA will provide members with information about the research findings in future editions of The Lamp, or you will be able to obtain a copy of the research findings from the research team at the University of Newcastle,’ said Brett.

If you would like further information about this study, please email Maya Guest at maya.guest@newcastle.edu.au or phone 02 49217735.n

Like to hear how you can advance your nursing career?

SC1088

For clinically relevant education across a range of nursing specialisations, talk to Southern Cross University. Increased demand for highly trained nurses means we can offer Commonwealth supported places. Nurses with postgraduate qualifications or appropriate experience can apply for advanced standing. Courses are offered by distance education to help you balance family, work and study commitments.

For further information or to apply to study in 2009, visit scu.edu.au/healthscience THE LAMP NOVEMBER 2008 35

36 THE LAMP NOVEMBER 2008

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N S W N A M A T T E R S

Doug goes to WA on Direct Debit g NSWNA Direct Debit competition winner Doug Green savours the spoils of the Margaret River

R

eturning from their eightday Margaret River holiday prize, NSWNA Direct Debit competition winner Doug Green and his wife Caroline said they felt 10 years younger.

‘Honestly, I’ve travelled all over Australia but the Margaret River is something else. It totally surprised us – the people, the food, the wine – it was all excellent.

Doug switched his NSWNA membership payments to Direct Debit, taking full advantage of the security and convenience

Doug and Caroline Green take their favourite magazine on holiday

of the service, and automatically put him in the competition draw.

The trip was Doug and Caroline’s first holiday away from their kids in 13 years so they were determined to make the most of it.

‘We want to express our thanks to Minot Wines, the Burswood Holiday Inn, the Quest Serviced Apartments, the Riverglen Chalets, AVIS Car Hire, QANTAS, Wine For Dudes, The Margaret River Cave Network and, of course, the NSW Nurses’ Association for this unforgettable experience,’ said Doug.

So, take a leaf out of Doug’s book by switching your NSWNA membership fees to Direct Debit today and be in the running for December’s prize draw of two luxurious nights at the stunning Park Hyatt on Sydney Harbour.

Direct Debit is the safest way to pay your union fees, free of any third parties or hidden fees.

The forms are simple and, unlike payroll deductions, you don’t have to tackle more paperwork with each new job, as deductions only concern your bank details or credit card.n

About to become a registered nurse?

If so, congratulations on the successful completion of your nursing studies!

Now that you are joining the workforce as an RN it’s time to join the NSW Nurses’ Association (NSWNA).

It’s easy!

Membership forms can be downloaded from the NSWNA

Return your c ompleted NSW NA membership a pplication form for your FREE STETHO SCOPE AND N URSES’ DIARY Proudly spons ored by FIRST STATE SUPER .

www.nswnurses.asn.au

For further information call the NSW Nurses’ Association on (02) 8595 1234 or 1300 367 962 LAMP NOVEMBER 2008 37 Email: gensec@nswnurses.asn.au Address: PO Box 40, Camperdown NSW THE 1450

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L I F E S T Y L E

OUR REVIEWERS & TIPSTERS RECEIVE A DELIGHTFUL

ABC CLASSICS CD

FOR UPLIFTING ENJOYMENT! Gifts so good, you won’t want to give them away.

There is an ABC Shop near you. For locations visit abcshop.com.au or call 1300 360 111. Ask about our rewards program.

Review by Di Mannion, RN, St George Hospital

Hunger g Hunger tells the story of IRA prisoner Bobby Sands who led a hunger strike over conditions at the Maze Prison. The Lamp sent Di Mannion and O’Bray Smith along to see this confronting film.

‘Confronting and violent’, Di Mannion

H

unger takes up the story of some of the IRA members imprisoned in the Maze Prison during the 1980s.

The IRA prisoners felt they were not your ordinary, common-garden variety criminals but were political prisoners and deserved to be treated as such with the rights of prisoners of war. However, the British Government at the time, led by ‘the Iron Maiden’, Margaret Thatcher, saw things very differently and decreed they be treated as terrorists.

To achieve their aim, the prisoners adopted a ‘no uniform’ and ‘no wash’ protest.

This action bought out the worst response from the guards. Their response was extremely violent and nothing short of barbaric. The British Government chose to ignore them! The prisoners, led by Bobby Sands, decided more drastic action was needed and so began the hunger strikes.

Commencing with Bobby Sands and then another prisoner every two weeks, the hunger strike saw the death of ten men.

What follows was tormenting and horrifying. Scenes where prisoners were held down and scrubbed or body searched were sickening. In fact, several people left the theatre dry retching!

This is definitely not a film for the feint-hearted. The violence was confronting and extremely graphic.

38 THE LAMP NOVEMBER 2008

The technical side of the film was very well done with some scenes reducing the viewer to tears. Bobby Sands has a scene with the local priest and this was one of the most powerful scenes I have ever seen in a film. During the film the voice of Margaret Thatcher reminds the viewer of the tough stance taken by the British Government regarding the IRA terrorists – a view that is not too different from today.

I am old enough to remember this part of history. The news each night was often about the terrorist activities of the IRA and of innocent lives lost. The treatment dished out to the prisoners is also hard to understand or justify.

As nurses, we work to save or preserve lives. Sadly, this whole film goes against that grain. I felt no sympathy for the prisoners and even less for the guards who decided to dish out their own punishment.

I have no concept of what it takes for people to die/commit suicide or become a martyr for a cause. This film only serves to make it all seem futile.

‘Evocative and shows many points of view’, O'Bray Smith In order to appreciate this film the viewer must have an understanding of the events that took place leading up to the hunger strike. If, like me, you do not, then the first hour of the movie will be a puzzle.

Luckily, the first real conversation of the

Review by O’Bray Smith, RN,RPA

movie (perhaps the only conversation in the movie), coming at 54 minutes, not only sets the background but it challenges all your previous views on death, suicide, convictions, causes and the Thatcher years, compelling the viewer to challenge their beliefs.

This film evokes more than just pity and provides many points of view. The prison guards show their breaking points at the graphic dehumanisation and brutality they must dish out. No side was completely innocent, no side completely at fault.

The brilliance of the director captures the soul of Belfast overwhelmingly. The acting is brilliant and cannot be faulted.

Michael Fassbender, in the lead role, was incredible and a delight to watch, in more ways than one.

On a lighter note, you should appreciate the pressure area care provided and the hand washing techniques of the warden. A viewing must for all student nurses!n Hunger opens on 6 November.

GIVEAWAYS FOR NSWNA MEMBERS The Lamp has 20 double passes to RocknRolla and 25 double passes to The Wackness and Hunger. To enter, email lamp@nswnurses.asn.au with your name, membership number, address and contact number. First entries win!

Sex, drugs and dysfunctional relationships g After a slow start Wackness gathers pace as it explores life’s challenges and the value of friendship.

L

uke (Josh Peck) is a high school student on the verge of graduation.

He is an ambitious young man who peddles dope so he can continue his education at a tertiary level; Luke’s parents

are struggling financially.

He is currently in therapy and seeing Dr Squires (Ben Kingsley).

Luke is completely dissatisfied with his social status at school and in his inability to attract women.

Dr Squires is also incredibly dysfunctional, receiving dope from Luke as payment for his services.

Squires counsels Luke on relationships and self esteem. He advises him to take ‘little steps’ in his recovery and explore his sexuality. What Dr Squires doesn’t know initially is that Luke intends ‘exploring his sexuality’ with the good doctor’s stepdaughter.

Review by Meg Collins, RN, Royal Prince Alfred Hospital

The story begins slowly and seems to drag a little in the beginning. It gains pace later on and will hold your interest.

The most outstanding features about this film are the performances of the two leading actors. Predictably Kingsley is very skilled, proving his versatility. I was also impressed with Josh Peck who played the socially-unskilled teenager, looking at life through a drug haze.

This film reminded me of a few Friday and Saturday nights in the Emergency Department, when things had gone a bit too far for some. It is not for everyone, however, there are some very funny scenes that will leave you giggling. If you have an interest in illicit drugs and complex relationships, this film is for you.n The Wackness opens on 13 November.

Lock, stock and real estate g A fast-moving, raucous romp about sex, thugs and rock ‘n roll.

Strong violence and coarse language

ONLY AT THE MOVIES!

COMING SOON

F

rom Guy Ritchie, the writer and director of acclaimed films Lock, Stock and Two Smoking Barrels and Snatch, comes RocknRolla, a romp about sex, thugs and rock ’n roll. It’s noisy, fast moving, black humour involves a delightful range of inept and nefarious characters.

This action comedy takes an exciting ride into crime and low life in contemporary London, where real estate has supplanted drugs as the biggest market, and criminals are its most enthusiastic entrepreneurs. But for small-time crook, One Two (Gerard Butler), and shady Russian billionaire, Uri Obomavich (Karel Roden), there is only one man to see – the infamous Lenny Cole (Tom Wilkinson). A mobster from the old school, Lenny knows the right palms to grease and has his hand on the throat of any corrupt bureaucrat, broker or gangster who matters in this game. A phone call from Lenny and the property development red tape evaporates. But Lenny’s minder, Archy (Mark Strong), warns him that the hustlers from

Review by Elizabeth Joyce, RN, Shoalhaven District Hospital

the East, hungry criminals from the streets and everyone in between, not to mention the gorgeous accountant, Stella (Thandie Newton), are all vying to change the rules of commerce and crime he works by.

London’s underworld characters conspire, collude and collide with one another in an effort to get their hands on the land deal millions. As high rollers and petty criminals jockey for dominance, the true prize of one multi-million dollar deal falls into the least expected hands.

RocknRolla is the perfect diversional therapy after a harrowing shift at the hospital.

This film is sure to attract a cult following and I’m waiting to see its sequel.n RocknRolla opens on 6 November.

THE LAMP NOVEMBER 2008 39

LIONS NURSES’SCHOLARSHIP

Looking for funding to further your studies

in 2009?

The trustees of the Lions Nurses’ Scholarship Foundation invite applications for scholarships for 2009.

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 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 www.nswnurses.asn.au Completed applications must be in the hands of the secretary no later than 28 November 2008.

40 THE LAMP NOVEMBER 2008

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O B I T U A R I E S

The world needs more like you MADGE NEILSON 13 OCTOBER 1936–8 SEPTEMBER 2008

O

n Monday 8 September 2008, after three days in a coma, Madge Neilson died peacefully at the Sydney Adventist Hospital.

Madge was born in Cessnock, NSW, the daughter of a coal miner. She grew up in Cessnock and Swansea, attending school there and later going to Home Science Girls High in Newcastle. It was in the Hunter, against the background of the Great Depression that Madge’s fierce passion for social justice was born.

Married at 19, Madge had four children within seven years. In the 1970s, by then a sole parent, Madge commenced her nursing training at the Royal Newcastle Hospital.

She worked shiftwork, studied, sat exams and then went home to care for her family.

This was at a time when many nursing schools forbade nurses getting married and ‘family friendly employment policies’ were unheard of.

In 1986, Madge started work for the NSW Nurses’ Association. It was an ideal job for Madge, allowing her to combine her nursing with her passion for social justice. Her first job as an organiser was to open the Hunter office, and against all odds she made it work. She worked tirelessly for members throughout NSW until her retirement in March 2002.

There are too many wonderful Madge Neilson stories to recount. However, a few come to mind that illustrate Madge’s

determination and fearless representation of members.

The first relates to a rural base hospital where an ENT surgeon allegedly sexually abused anaesthetised female patients. OT staff had sounded the alarm bells, but to no avail. They came to Madge who took the matter on. The case, which ultimately went to court, ended years later but Madge supported staff right through the process.

Famously, the doctor’s barrister, crossexamining one of the OT staff, demanded to know what ’that lady from the union’ had told him to say. The answer was perfect: ’She told me to tell the truth’.

In December 1994, a newly registered nurse, Sandra Hoare, was murdered while on night duty in an isolated ward of Walgett Hospital. Madge spent months working with nurses at the hospital as they fought to understand how such a tragedy could occur. She sat with them and Sandra’s mother through the court proceedings that followed.

Another piece of life fell into place for Madge at the Association with the arrival of John Taylor (former Senior Industrial Officer), another coal miner’s kid from Cessnock. Madge and John quickly hit it off and they formed a loving partnership that John has described as the happiest years of his life.

They retired from the Association within a month of each other. They already had a home near Campbelltown, but they built a new one at Tallwoods (near Tuncurry).

Madge had the kitchen and garden of her dreams and John had his golf and a computer to keep abreast of the latest industrial issues.

In 2007, Madge was diagnosed with gallbladder cancer and told she had three months to live. Typically, she was not going to rollover without a fight, so she endured major surgery, chemotherapy, and radiotherapy. At the end of November last year things looked positive. However, the cancer returned.

To many of us who knew Madge she seemed indestructible. She was a tower of strength who was going to outlive us all – it is still hard to grasp that she has physically gone.

Madge, countless members will remember your work and will be forever grateful for your assistance. Your friends and family and many acquaintances, including some worthy adversaries, will never forget you.

Our hearts go out to John, your children, grandchildren and brother, and all their families at this time of loss.

The world needs more Madge Neilsons.n (Our thanks to Madge’s family for supplying background and some text for this article.)

THE LAMP NOVEMBER 2008 41

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L I F E S T Y L E

SPECIAL INTEREST TITLE

Blokes Babies and Breastfeeding (DVD)

Book me Therapeutic Interaction in Nursing (2nd edition)

By Christine L. Williams, Jones and Bartlett Publishers (available through Elsevier Australia), RRP $50 : ISBN 9780763751296 Therapeutic Interaction in Nursing provides an advanced theoretical explanation of therapeutic communication for the nurse and nursing student when encountering problematic situations.

Unique knowledge and skills are necessary for both the student and professional as they encounter challenges in their daily interactions with a variety of individuals, including the patient with a psychiatric illness, the cognitively-impaired patient, children, the critically ill, or the patient on a ventilator.

This multifaceted text not only provides the skill development required to communicate therapeutically in these difficult situations, it offers communication strategies and self-awareness exercises that will assist in the inner growth necessary to develop effective outer behaviour.

Clinical Skills in Child Health Practice

By Janet Kelsey and Gillian McEwing, Churchill Livingstone (available through Elsevier Australia), RRP $75 : ISBN 9780443103407 Clinical Skills in Child Health Practice is a textbook of clinical skills that offers an excellent resource for all professionals providing

care for children and young people. It presents a detailed step-by-step approach to clinical skills that may be used in both hospital and community settings.

Each skill is presented with the evidence base required to ensure up-to-date safe practice. Chapters provide rationale for each step of the skill and are enhanced by diagrams and photographs to give the practitioner clear guidance and the confidence to perform unfamiliar skills.

Lange Instant Access: AcidBase, Fluids, and Electrolytes

By Robert F. Reilly, JR. and Mark A. Perazella, McGrawHill Professional Publishers, RRP $31.95 : ISBN 9780071486347 This manual is an ideal tool for health care providers to rapidly attain a complete understanding of the basics of electrolytes and fluid disorders and acid-base and divalent disturbances, allowing an educated approach for diagnosis and management of these disorders.

Classroom Skills for Nurse Educators

By Carolyn Chambers Clark, Jones and Bartlett Publishers (available through Elsevier Australia), RRP $92.50 : ISBN 9780763749750 Classroom Skills for Nurse Educators provides legitimate and evidencebased classroom experiences that will engage learners with an active and independent learning method. This book has been written

WHERE TO GET THIS MONTH’S 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 Reviews by NSWNA librarian, Jeannette Bromfield.

PUBLISHER’S WEBSITES • • • •

McGraw-Hill: www.mcgraw-hill.com.au Elsevier Australia: www.elsevier.com.au Jones & Bartlett Publishers: www.jbpub.com/nursing Blokes Babies Breastfeeding: www.blokesbabiesbreastfeeding.com

42 THE LAMP NOVEMBER 2008

Produced by Graeme Gulloch, Blokes Babies Breastfeeding, RRP $34.95 (DVD) Written and produced by blokes for blokes, Blokes Babies Breastfeeding is a light-hearted parenting DVD that discusses the benefits of breastfeeding.

It is designed to give new dads or soonto-be dads some practical, hands on tips for understanding and helping with parenting, breastfeeding and bonding with their baby. to assist both the new and seasoned nurse educator to design and use effective learning systems where content and evaluation are based on behavioural objectives.

At the same time nurse educators need to consider innovative teaching methods as a way of dealing with the dehumanising effect of increasing learner-to-educator ratios, decreasing clinical facilities, and the need for critical thinking skills.

The Pediatric Diagnostic Examination

By Donald E. Greydanus, Arthur N. Feinberg, Dilip R. Patel and Douglas N. Homnick, McGraw-Hill Medical Publishers, RRP $70 : ISBN 9780071287272 The Pediatric Diagnostic Examination handbook offers a logical, systematic approach to differential diagnosis in children, and is ideal for developing the skills and confidence necessary for diagnosing pediatric patients. Incorporating must-know anatomy, pathophysiology, and diagnostic tools, Pediatric Diagnostic Examination will sharpen your ability to effectively manage every step of the diagnostic examination process. Provided by publisher.n

THE LAMP NOVEMBER 2008 43

The College of Nursing creating nursing’s future continuing professional development NOVEMBER 2008 Effective writing for work 6 November 2008 End of life issues 7 November 2008 Community and outreach care 10 November 2008

On-campus subjects are conducted at the College’s Burwood (NSW) campus unless otherwise stated.

Infection control in aged care facilities 10 & 11 November 2008

For more information, or to obtain your copy of the 2009 Handbook, please call 02 9745 7500 or email: sas@nursing.edu.au

Workplace learning and assessment 17 & 18 November 2008

Alcohol and other drugs 13 & 14 November 2008

Orthopaedic nursing practice 20 & 21 November 2008 Assertiveness skills workshop (Orange NSW) 21 November 2008 Organ transplantation 21 November 2008 Infection control: Introduction 24 November 2008

Respiratory nursing 26–28 November 2008 Breast cancer care workshop 27 & 28 November 2008 Day surgery and day procedure nursing 27 & 28 November 2008 Special care nurseries (Albury) 27 & 28 November 2008 DECEMBER 2008 Mental health for acute care nurses (Newcastle) 1–5 December 2008 Dual diagnosis 8 & 9 December 2008 Rehabilitation nursing 10 & 11 December 2008 Immunology fundamentals 15 December 2008 Acute stroke management (Wagga Wagga) 17 & 18 December 2008

www.nursing.edu.au

The College of Nursing

Recommend a clinically proven treatment for bruises.

100

Hirudoid advantage

75 50 25

96 hours

50 hours

Placebo

Hirudoid

P < 0.01

Time in hours

Hirudoid dissolves bruises up to 50% faster than placebo.7

0

Hirudoid contains mucopolysaccharide (MPS) to accelerate healing. MPS improves blood flow, promotes tissue regeneration by increasing collagen and elastin fibres in connective tissue and stimulates synthesis of hyaluronic acid which increases water-binding capacity.1,2 Studies have shown that the MPS in Hirudoid penetrates the skin in effective concentrations.3

Limitation of arnica

Hirudoid relieves symptoms of superficial thrombophlebitis 46% faster than placebo.8

A Cochrane review and others have found that arnica has no clear effect on bruising and swelling.4,5,6

Hirudoid is clinically proven.

150 125

Hirudoid advantage

100 75 50 25

126 hours

0 Placebo

58 hours

P < 0.05

Time in hours

MPS for healing

Hirudoid

1.Baici A, et al. Inhibition of human elastase from polymorphonuclear leucocytes by a glycosaminoglycan polysulfate. Biochem Pharmacol 1980; 29: 1723-1727. 2.Mitsuyama S, et al. Effects of glycosaminoglycan polysulfate on extracellular matrix metabolism in human cells. Res Commun Chem Pathol Pharmacol 1994. 3. Elling H. Drug Research 1987; 37(2): 212-213. 4.Ernst, et al. Efficacy of homeopathic arnica: a systematic review of placebo-controlled clinical trials, Cochrane Database of Abstracts of Reviews of Effects, 2008 Issue 1. 5.Homeopathic arnica for the treatment of soft tissue injury, Complementary and Alternative Medicine. www.cam.org.nz. 6.Is arnica a waste of money? www.nelh.nhs.uk. 7.Larrson, et al. Percutaneous Treatment with a Mucopolysaccharide of Experimentally Induced Subcutaneous Haematomas in Man, Thrombosis and Haemostasis 1985; 53 (3): 343-345. 8.Mehta P, et al. Treatment of superficial thrombophlebitis: a randomized double-blind trial of heparinoid cream. BMJ 1975; 3: 614-616. amba5325/tl 44 THE LAMP NOVEMBER 2008

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N U R S I N G

O N L I N E

Global warming puts the heat on health lobal warming will have significant effects on patterns of disease and illness. This month Nursing Online features several recent reports.

c water-borne infectious diseases, and other

Climate Change Health Check 2020

Garnaut Climate Change Review: The impacts of climate change on three health outcomes: temperature-related mortality and hospitalisations, salmonellosis and other bacterial gastroenteritis, and population at risk from dengue

c

health risks from poor water quality; diminished food availability: yields, costs/affordability, nutritional consequences; increases in urban air pollution (eg ozone), and the interaction of this environmental health hazard with meteorological conditions; changes in aeroallergens (spores, pollens), potentially exacerbating asthma and other allergic respiratory diseases; mental health consequences of social, economic and demographic dislocations (e.g. in parts of rural Australia, and via disruptions to traditional ways of living in remote Indigenous communities).

Dr Graeme Horton, Professor Tony McMichael, Doctors for the Environment, Australia, April 2008 In 2020, it is likely that Australian doctors and other health professionals will be seeing patients with a diverse range of climate change-related illnesses. The more vulnerable members of our community will be most affected by climate-related illnesses.

These include the elderly who cope less well with changes in temperature, and young children whose developing lungs are susceptible to ambient air pollution.

Climate change is of great relevance to the health care that will be provided by health professionals in coming years.

Australians need to know how our changing climate will affect the health of our community and there is an important role for health professionals to raise awareness in this area.

Planning for climate change should be part of every future deliberation in health services and this should include preparation for potentially large numbers of environmental refugees in our region as the century progresses. Effective health strategies will require collaboration between health professionals and other sectors of the community.

G

Hilary Bambrick, Keith Dear, Rosalie Woodruff, Ivan Hanigan, Anthony McMichael, June 2008 Climate change will affect the health of Australians over this century in many ways.

Some impacts will become evident before others. Some will occur via quite direct pathways (eg heatwaves and death); others will occur via indirect pathways entailing disturbances of natural ecological systems (eg mosquito population range and activity) or disruption to livelihoods and communities (eg mental health consequences of prolonged droughts and regional drying trends).

Most health impacts will occur at different levels among regions and population sub-groups, reflecting the influence of environment, socioeconomic circumstances, infrastructural and institutional resources, and local preventive (adaptive) strategies on the patterns of disease. The likely health impacts are many and varied. The main health risks in Australia from climate change include: c health impacts of weather disasters (floods, storms, cyclones, bushfires, etc.); c health impacts of temperature extremes, including heatwaves; c mosquito-borne infectious diseases (eg dengue fever, Ross River virus disease); c food-borne infectious diseases (including those due to Salmonella, Campylobacter and many other microbes);

c

c

c

c www.garnautreview.org.au/

CA25734E0016A131/WebObj/ 03-AThreehealthoutcomes/$File/ 03-A%20Three%20health% 20outcomes.pdf

Australian Health Policy Institute Policy Briefing Paper #2, August 2006.

WARNING: A rising temperature can be a sign of illness Stephen Leeder The health effects of global warming are largely indirect and follow from its effect on forests and farmland. As regions become either warmer and wetter or warmer and drier, the distribution of diseases due to mosquitoes, especially but not exclusively malaria, will change.

Knowledge is not at a stage where global predictions can be made confidently.

Increases in city temperatures already carrying substantial air pollution burdens, could mean trouble for people with respiratory disorders. More droughts may be handled in Australia, but what of the effects of these events upon less economically advanced nations where some of the worldâ&#x20AC;&#x2122;s 800 million malnourished people live? c www.ahpi.health.usyd.

edu.au/research/publish/ globalwarmingsrl0806.pdf

c www.dea.org.au/UserFiles/File/pdf_

documents/Climate_Change_Health_ Check_2020.pdf

Climate Change and Primary Health Care Grant Blashki, Tony McMichael, David Karoly Climate change and rising average global temperatures threaten to disrupt the physical, biological and ecological life support systems on which human health depends. This article overviews the evidence for human induced climate change, the predicted health impacts, and the role of primary health care professionals in managing these impacts. Primary health care has an important role in preparing for and responding to these climate change-related threats to human health.n c www.racgp.org.au/Content/

NavigationMenu/Publications/ AustralianFamilyPhys/2007issues/ afp200712/200712Blashki.pdf THE LAMP NOVEMBER 2008 45

Mind to Care

Sydney 2009 35th International Conference of the Australian College of Mental Health Nurses

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46 THE LAMP NOVEMBER 2008

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

1

2

3

5

6

4

7

8

9 10

11

12

13

14 15

16

17 18

19

20 21 22

24

23

25

s

ACROSS

1.

Painless contractions during pregnancy (7,5) Our colleagues who treat disease with radioactive isotopes (15) Free fluid in the peritoneal cavity (7) Disease caused by degeneration of nerves in the spinal cord, abbrev (1.1.)

Bone of the leg (5) Inflammation of the nose (8) Evening, abbrev (1.1.)

Crest of the hip bone, ... crest (5)

5.

8.

9.

10.

11.

12.

14.

15. Hollow tube inserted into the body (7) 18. Relating to the tongue (7) 20. Muscles of the upper arms (7) 21. A very long time (4) 22. Red blood cells (12) 24. Haemoglobin, abbrev (1.1.)

25. Recording the movement of the heart (12) s

DOWN

1.

2.

Obese (9) Substance dependence (9)

3.

Inflammation of a nerve of the upper leg (8) 4. Exams (5) 6. Healthcare facilities (9) 7. A colleague who evaluates hearing (11) 13. Ward where new mothers are found (9) 16. We breathe it (3) 17. Where a cannula often goes (7) 19. Inability to walk (6) 20. Wisdom and incisors (5) 23. Aged (3) Solution page 49 THE LAMP NOVEMBER 2008 47

Great legal advice for Nurses

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» Do you want to use the power of computers, the Internet and tele-health to deliver more effective, more efficient and more patient-oriented health care? If you are interested, then these courses may be for you:

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H5E Graduate Certificate in E-Health (Health Informatics) This is a part-time course comprising three compulsory units and one elective. All units are one semester in length.

Maurice Blackburn has offices in:

Courses are external, self-paced learning packages using electronic and/or print-based materials. They can be completed with a minimum of disruption to home and work life as there is no compulsory residential component.

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Call the Association information line on 1300 367 962.

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For more information, contact: University of Tasmania Department of Rural Health Phone: (03) 6324 4000 E-mail: Sue.Whetton@utas.edu.au

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48 THE LAMP NOVEMBER 2008

Diary Dates

DIARY DATES Conferences, seminars, meetings SYDNEY, HUNTER & ILLAWARRA Nurse Practitioner Forum – Lismore ’Riding the Wave of Change’ Wine & Cheese: 6 November, 6– 8pm.

Workshop: 7 Nov, 9am–4pm. Cost: free for NCAHS/ $50 for non-employees.

Contact: Anne Moehead, 6620 2612 leanne.wright@ncahs.health.nsw.gov.au Mental Health Consultation Liaison Nurses Assoc. of NSW & ACT 8th Annual Conference ’Beyond the Bell Curve: the adverse and diverse of CL mental health nursing’ 14 Nov, Harbourview, North Sydney Contact: mhclna.org.au Wound Care Association of NSW Annual 2-day Symposium 14–15 November, Opal Cove Resort, Coffs Harbour. Contact: Anne Batchelor, Anne.Batchelor@ncahs.health.nsw.gov.au 35th Clinical Oncological Society of Australia Annual Scientific Meeting ‘Driving Improved Cancer Outcomes’ 18–20 Nov, Sydney Convention Centre Contact: www.cosa.org.au ASET Forum 21 Nov, 9am – 4pm, St Vincents Hospital, Darlinghurst. RSVP by 31 Oct to kduncan@stvincents.com.au Australian Confederation of Paediatric and Child Health Nurses 2008 Paediatric Education Day 21 Nov, Comfort Inn Airport, Queanbeyan Contact: Emma.dimichiel@sesiahs.health. nsw.gov.au, www.acpchn.nsw.org.au NSW BFHI Workshop (Baby Friendly Health Initiative) 22 Nov, 29 Douglas St, Stockton. Cost: $120 Contact: Elizabeth Steinlein, elizabeth. steinlein@sesiahs.health.nsw.gov.au RNSH Cardiology Department Annual Conf. – ‘The Beat Goes On‘ for

multidisciplinary health professionals 28 November, Citygate Hotel ,Sydney Contact: Carol Morgan, 9926 8852, cmorgan@nsccahs.health.nsw.gov.au Heartbeat 2009 29–30 May 09, Novotel Brighton Beach Contact: Jessica Scicluna, 9211 6299, jessica@avantievents.com.au Website: www.heartbeat.org.au Sydney CAREX 2009 Aged Care Expo 15-16 July 2009, Rosehill Racecourse.

Contact: Wayne Woff, (03) 9571-5606 Web: www.totalagedservices.com.au

INTERSTATE AND OVERSEAS Aged Care Association Australia (ACAA) 27th Annual Congress 16-18 Nov, Hotel Grand Chancellor, Hobart, Tasmania. Contact: acaa@con-sol. com, www.agedcareassociation.com.au nd

2 Australasian Mental Health Outcomes Conference 24–26 Nov, Crown Promenade Htl (Melbourne). Cost: $800. Contact: 9265 0890, amhoc2008@meetingplanners.com.au

Social events Book Launch Nurse Managers: A Guide to Practice 2nd Edition By author: Andrew Crowther 11 Dec, Charles Sturt Uni. – Orange.

Contact: Kellie Miles, (03) 9375 7311, kellie@ausmed.com.au

Reunions Prince Henry & Prince of Wales Hospital – Class of August 1973 15 November. Contact: Deirdre Stewart (née Hill), 0432 418 942, dstewart@ sleepsmart.com.au/ Jan Martin (née monahan), janmartin1@optusnet.com.au Wagga Wagga Base Hosp. 1979 PTS Including Deniliquin and Temora girls.

23 Jan, Riverside Club & 24 Jan 09, Union Club Hotel. Contact: Sharyn Noonan (Wellham), 6931 3451/ Alison Giese (Meek), 6926 6261

Diary Dates is a free service for members.

Please send diary date 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: Editorial Enquiries Email: lamp@nswnurses.asn.au Fax: 9550 3667 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 St Vincent’s Hospital Sydney – March 1969 PTS – 40 Year Reunion 20 – 22 March 2009 Contact: Helen (Wilson) Kersten, 4232 1767/ 0417 651 881 or Jenny (Quilty) McNamara, 9344 5957/0412 508 332 Prince Henry Hospital Training Class of October ’66 – Seeking interest in Oct reunion (graduated March & June 1970). Contact: Janis Montgomery née Coconis, 0423 179 974 Sydney Hospital Group 78/2 Seeking interest in 30-years reunion Contact: Carolyn Moir, 9346 1418 or email cmoir@bcs.org.au Sydney Hospital Group 79/1 Seeking interest in 30-years reunion on 7 February 09. Venue: TBA Contact: Merryn Hopkins, 0437 979 868.

St Vincent’s Hopital Sydney: Nurses 40Years Reunion – PTS June 1969 Group June 2009, Sydney.

Contact: Carol Reidy (Taylor), 9489 3960, reidycarolyn@yahoo.com.au/ Chris Doig (O’Connell), 6920 7431, doigy@activ8.net

page, some dates too close to publication or too far in the future may be cut.

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 try to publish them.

Contact: NCF office, 9888 5842 • Prof. b/fast, 15 Nov, 9am, Pages Cafe, West Ryde. Contact: Jane, 9449 4868 ACAT Nurses Special Interest Group 21 October and 2 Dec, 1pm – 3pm, 2B Conference Rm Bankstown Hospital Contact: Wendy.oliver@sswahs.nsw.gov.au

NSWNA activist forums New England Activist Forum West Tamworth Leagues Club Phillip Street, West Tamworth, 17 Dec Hunter Activist Forum Wests Mayfield, Industrial Drive, Mayfield 11 December SESIAHS – Southern Illawarra Network Forum Lvl 1, 63 Market St, Wollongong 2 Dec SESIAHS – North and Central Network Forum 135 Alison Rd, Randwick, 9 December Contact: Diana Cajas, 8595 1234 or dcajas@nswnurses.asn.au

Crossword solution

Royal Prince Alfred Hosp. Reunions July 1962-1966 group Seeking interest.

Contact: Rosemary Cuneo, 9953 5257, rjohno@bigpond.net.au

Other notices Nurses’ Christian Fellowship • Annual Conf. ‘The Light Still Shines in a Suffering World‘, 14 Nov, 9am, St James Anglican Church, Turramurra.

THE LAMP NOVEMBER 2008 49

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Master of Science in Medicine (Psychotherapy) Course 2009 – 2011 / University of Sydney The University of Sydney, through the Department of Psychological Medicine, Westmead/Cumberland Campus, is offering a 3-year part-time course of training in psychodynamic psychotherapy, leading to a Master of Science in Medicine (Psychotherapy) degree. For the first time this program is being made available to non-medical graduates in the health sciences. This course provides a unique opportunity to students to gain in-depth training in psychodynamic psychotherapy and an academic qualification that is recognised by major professional psychotherapy organisations in Australia.

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Course Fee: $4,620 per semester Applications Close Definitely on 12th December 2008 Interviews will be early January 2009 Inquiries and application forms can be obtained from: Dr F Gerull / Professor R Meares + 61 2 9840 3335 Fax: +61 2 9840 3572 E: Friederike_Gerull@wsahs.nsw.gov.au http://conversationalmodel.googlepages.com/ 50 THE LAMP NOVEMBER 2008

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52 THE LAMP NOVEMBER 2008