The Lamp October 2010

lamp the

magazine of the NSW Nurses’ Association

volume 67 no.9 October 2010

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TO WIN RATIOS

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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

Take action to win ratios 14 NSWNA launches campaign to win ratios Take action to win ratios Set up a Workplace Campaign Committee ‘Untenable’ staffing at Shoalhaven Five extra beds at Bathurst Base – but it’s not enough 20 NCAHS puts budget over patient care

12 14 16 18 19

volume 67 no.9 October 2010

TAKE ACTION TO WIN RATIOS

Cover Print Post Approved: PP241437/00033

Marichell Beltran, RN, Mount Druitt Hospital, with her dog, Fluffy.

News in brief

Industrial issues

8 8 8 9

31 St Vincent’s closes, new hospital opens

NSWNA education program 11 What’s on

Aged care 22 Domain nurses celebrate inaugural agreement 24 Broad debate at Aged Care Forum 27 Crisis looming in aged care

Occupational Health and Safety

Fighting fit nurses 38 Sleep tight when doing nights

NSWNA matters 41 NSWNA Branch News

Regular columns 5 6 33 34 35 42 45 47 48

Editorial

by Brett Holmes Your letters to The Lamp Ask Judith Nurses online Nursing research online At the movies Books Our nursing crossword Diary dates

Competition 37 Win a pair of special sandals

Special offers

28 OHS inspection forces Gulgong Hospital closure 37 Duress alarm win at Prince of Wales

43 Win 30 double passes to Gainsbourg and 5 movie packs to RED

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NSWNA COMMUNICATIONS MANAGER Noel Hester T 8595 2153 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 Sirius Communications T 9560 1223 W www.siriuscommunications.com.au PRESS RELEASES Send your press releases to: T 9550 3667 E gensec@nswnurses.asn.au

Photography by Sharon Hickey.

First State Super focuses on women ANF membership grows Register for Sydney Alliance training Regional hospitals struggle with ED treatment times 9 World War I nurses celebrated in new play 9 Laws prevent transparency over medical errors 11 Nursing students fail to spot deteriorating patients 11 Obese patients difficult to manage in ED 11 Dementia costs set to soar

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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THE LAMP EDITORIAL COMMITTEE Brett Holmes, NSWNA General Secretary Judith Kiejda, NSWNA Assistant General Secretary Coral Levett, NSWNA President John Lyons, Baradine MPS Roz Norman, Tamworth Base Hospital Elsie May Henson, Barraba Multi Purpose Service Peg Hibbert, Hornsby & Ku-Ring-Gai Hospital Michelle Cashman, Long Jetty Continuing Care Richard Noort, Justice Health ADVERTISING Patricia Purcell T 8595 2139 or 0416 259 845 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 THE LAMP ISSN: 0047-3936 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.

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. Professional members can subscribe to the magazine at a reduced rate of $50.

Individuals $73, Institutions $120, Overseas $130.

Got a story to tell?

Nurses and midwives, you can now apply to attend the Association’s sponsored 2 day NIDA short film making workshop.

Wednesday 27 and Thursday 28 October, from 10am to 5am.

The two day course will introduce the essential elements needed to take a film from concept to screening. Working with industry professionals the workshop will cover story structure, script development, visual narrative,

preproduction, lighting, sound, and editing.

This course will be delivered in a practical and constructive environment, with the participants using practical exercises to develop skills.

“I have recently made two short films which have given me such excitement, empowerment and satisfaction — both personally and professionally. It has also given me a medium to express and communicate information and research to a very switched on audience.

I attended the NIDA film course supported by the NSW Nurses Association. This course gave me many skills but more importantly gave me the confidence to make ‘Simply the Best’.

I was awarded 2nd prize in 2009 and I was thrilled.

This year I made ‘Bon Appetit’ which made it to the finals but I have so many more stories to tell.” — Sue Taggart

Check out the Association’s website www.nswnurses.asn.au to apply for sponsorship to attend the 2 day NIDA short film making course, or view the 2010 Nurses’ Short Film Festival films, and see the rules and conditions for the 2011 Nurses’ Short film Festival.

The NSW Nurses’ Association Short Film Festival is proudly sponsored by: 4 THE LAMP OCTOBER 2010

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E D I T O R I A L

BY BRETT HOLMES GENERAL SECRETARY

We’re all campaigning for nurse-to-patient ratios g The NSWNA and members are busy campaigning to inform the community and encourage the NSW MPs to support our claim for nurse-to-patient ratios.

F

or several weeks now NSWNA members have visited NSW MPs to encourage them to support our campaign for mandated nurse-to-patient ratios.

We are telling MPs that the implementation of nurseto-patient ratios in Victoria 10 years ago has made things considerably better in their health system. It has led to a much safer environment for patients, improved the morale of the nursing workforce, attracted many experienced nurses back to nursing and reduced public complaints about the system.

The people of NSW are entitled to similar outcomes. If Victoria can do it, we can do it.

We understand the funding of ratios and the future supply of appropriately skilled nurses are significant issues. But they are not insurmountable – especially with a commitment by the State Government and, with national health reform underway, the Federal Government, which will soon directly fund 60% of the cost of hospital procedures.

We have made it clear that guaranteeing a mandated minimum nurseto-patient ratio in our public health system is, in our opinion, the best thing our State Government could do in the interests of the people of NSW. It will also ensure the national reform process does actually improve people’s experience of the hospital and community health system.

Our campaign will only succeed if we enlist the support of the community, show our willingness to act in the workplace and apply pressure on the Government.

Many of our members have been letter boxing their neighbourhoods with

At the core of our message – always – is advocacy for the interests of nurses and the health system. leaflets about our claim (see p.15). I would encourage you to help us get our message out in this way. A 20-minute walk around your block could convince many people to support us.

We also intend to educate the public about the benefits of ratios through TV advertising.

Advertising to support nurses and health Over the last few years the NSWNA has undertaken several TV advertising campaigns.

I acknowledge that some members are uncomfortable with some of our TV advertising during elections. It is an intervention into political and policy debates that isn’t taken lightly.

We have done so because we cannot just rely on the goodwill of politicians if we are to fix the problems in our health system. Experience shows us that both major parties will sit on their hands and do nothing unless we act and take the public with us.

At the core of our message – always – is advocacy for the interests of nurses and the health system, not for any particular party. Ultimately, we call it as we see it at the time. And sometimes that means acknowledging that one party’s policies are more in the interests of nurses and the health system than others.

We still retain our political independence. Unlike many other unions we are not affiliated to the Labor Party and will remain so.

Our campaigns and interventions have produced results. WorkChoices was turned back and even a diehard supporter like Tony Abbott has been forced to a position where it is ‘dead, buried and cremated’.

After a decade and more of neglect, billions of extra dollars have been pumped into the public health system and there has been a significant increase in funding of aged care nurses.

We cannot assume that because everyone loves a nurse that politicians will do the right thing by us. We have to do what we can to make sure our voice is heard and that politicians understand our capacity to influence public opinion on health and workplace issues.n THE LAMP OCTOBER 2010 5

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L E T T E R S

Danielle Doughty

Give paediatric nurses some coverage I would like to draw to the attention of the NSWNA and its members the recent changes in paediatric healthcare services in NSW. On 20 May, the Minister for Health announced the creation of a single health-care entity responsible for paediatric services in NSW: The Sydney Children’s Hospitals Network (Randwick and Westmead).

Under this new administration, Sydney Children’s Hospital and The Children’s Hospital at Westmead would merge their services. This announcement was overshadowed by other political events that day, and barely rated a mention in the media.

As a paediatric nurse, I am bitterly disappointed that the representative body for NSW nurses also failed to highlight this historic healthcare reform. The merging of hospitals has many potential implications for nursing staff, such as increased workloads, redundancies and possible requirements for staff to work at both sites (Westmead and Randwick).

Flicking through the last few editions of The Lamp, I failed to find one article that discusses paediatricspecific issues. Although we represent a small proportion of the workforce, the concerns of paediatric nurses are just as great as those providing care for adults.

Staffing ratios and increased workload resulting from often inappropriate transfers are two such concerns.

Patients requiring treatment for

dehydration, asthma management, simple lacerations and closed reductions of forearm fractures are often turned away from major tertiary facilities (that are more than capable of managing their care), and redirected to the major paediatric hospitals. Not only does this cause chaos in ED, Operating Suite (where I am employed), and the wards, but it also burdens a system already struggling to care for the ‘sickest of the sick’ children.

Although reform in aged care is desperately required, I feel the recent changes in paediatric health-care services warrants attention from the NSWNA. Greater awareness of the issues facing nurses employed in paediatric facilities is required in order to inform policy planning and public opinion.

Danielle Doughty, RN

National registration still confusing Thank you for your reply in the September issue of The Lamp regarding national registration. Now maybe I am getting a bit crankier in my old age but this reply has raised further issues for me and those I work with.

First of all, what is a modest pecuniary, which the Board members receive? The privacy issue seems to have gone out the window given that anyone can view any health professional’s past misdemeanours without any right of reply. I don’t see why we should be deprived of seeing what is paid to those in a responsible position. I noted that there was a very large hike in the registration fee when it went from $50.00 in 2006 to $104 in 2010. This is a tax deductible so I only have to pay $75 out of my pocket. This is not a lot for some but a great deal for others.

AUSTRALIAN NURSING FEDERATION NSW BRANCH

FINANCIAL REPORT The Australian Nursing Federation NSW Branch Financial Report for the year ended 30 June 2010 will be available on the members’ page at www.nswnurses.asn.au from Monday, 18 October 2010.

Members without internet access

6 THE LAMP OCTOBER 2010

may obtain a hard copy of the report by applying in writing to: Brett Holmes, Branch Secretary Australian Nursing Federation NSW Branch 43 Australia Street, Camperdown, NSW 2050

Now let’s get back to the AHPRA. It is getting from every health professional in Australia $106 and the NSW Health Board jumped from $50 to $95. This is certainly a lot more than the consumer index for that period, so where is all the money going?

Did the large hike in NSW go to redundancy payments? Is this large amount going to a lot of public servants?

In other words, where are the financial statements? Oh, I did write and ask when I found out where to go about a fortnight ago, but to date have not even a whisper in reply.

The information I did glean from the site is that these are ministerial appointments, so have we handed over the reins to the Government and it is not a case of who is best at the job but who is best at politicking?

It was written in the NSWNA’s reply that there is a jurisdictional component to the Act. If that is the case, why are past misdemeanours entered when in law once a person has served their punishment then their record cannot be used against them in the future? By leaving this record available rather than expunging it, the person is being denied their freedom to continue practising and being judged by others who were not present at the hearing or the incident.

I am also interested in who we can complain to about the registration bodies as there doesn’t seem to be an impartial body that can investigate or who AHPRA is answerable to that I can see. I didn’t mind when I was paying my $50 but I certainly do now.

So the biggest question is who is watching the watchers?

Peter Bolton, RN

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.

Balanced rostering is completely unbalanced I don’t know where you get your information about this garbage of balanced rostering. I work in the delivery suite at John Hunter Hospital (JHH) and have recently got a copy of my roster.

Our preferences are not being met and there are no permanent preferences. I asked for weekends and late shifts during the week and not to work any more than two nights in a row.

My roster is more mornings than late mornings, one weekend a month and one month I have two nights in a row (I am six shifts a fortnight) and in the second week I have two nights on, two off, a late, and two nights. Great – 48 hours in one week.

I really don’t think I got my preference at all – do you? No one I talk to has got anything they wanted. Maybe we should all resign from the Union and then someone might pay attention to the poor staff who are getting this dished out.

There is no point at all talking to the NUMs at JHH about our preferences; our preferences will be considered, not that we can have them.

This is all wrong by saying in The Lamp it will allow flexibility for nurses.

Our flexibility to request shifts and days off has in fact been taken away.

I know how this system works as my husband and son have it in the mines – they can’t swap or request so just go off sick if they need to go somewhere.

I will be either resigning or cutting my hours to two shifts a week; I do not want to work this restricted roster that we will be stuck with forever. Who wants to work four nights in row when

Every letter published receives a 6 month weekend subscription to the Herald, valued at over $114!

Subscribe to the Herald today to save 41% off the newsstand price and enjoy the convenience of the paper delivered to your home each morning.

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you are part time? Nearly all the parttime staff have been given all their nights for the fortnight in one block. This is not fair at all.

The staff have not agreed to this balanced rostering and never will: we do not have a choice.

Print some staff opinions of it if you’re game.

Jenny Bonnette, Midwife, John Hunter Hospital Editor’s response: In early September 2010, Hunter New England Area Health Service (HNEAHS) filed an urgent dispute in relation to the John Hunter Hospital Branch’s proposed industrial action in relation to the introduction of Balanced Rosters. The dispute was listed in the Industrial Relations Commission on Thursday, 2 September 2010 before Deputy President Harrison.

While sympathetic to our members’ concerns, Deputy President Harrison stated the NSWNA should have brought the matter back to the Industrial Commission rather than move to industrial action.

He strongly recommended that the JHH Branch withdraw the proposed industrial action and return to the IRC on Monday, 6 September 2010.

At the IRC on 6 September 2010, the NSWNA reported the ballot for industrial action had been withdrawn. The NSWNA indicated we had a huge volume of feedback from our members identifying serious problems with their draft Balanced Rosters, which strongly indicated that in many cases the Balanced Roster Guidelines had not been followed.

Some trends that emerged from the feedback from members showed that in many cases the roster sequences on the unit roster template were not being changed to incorporate employee preferences as required by the Guidelines, and also the principle of mutual benefit was either not applied, or applied inconsistently.

We submitted that if the process was to

continue in a constructive way to resolve the problems, and to take the pressure off both the HNEAHS and our members, the proposed ‘go live’ date of 4 October 2010 for the implementation of Balanced Rosters should be deferred.

The HNEAHS submitted that they are following the Guidelines and argued they needed to continue with the agreed process to identify the areas of non-compliance; otherwise they would be replicating the same mistakes. DP Harrison stated the parties had taken an evidence-based approach to the new roster system since the dispute was first listed in December 2008 and it was his view that the parties should proceed on that basis.

Accordingly, the parties agreed to enter into conciliation to examine the problems with the Balanced Rosters on a unit-by-unit basis with the assistance of DP Harrison.

A number of Branch delegates and members from John Hunter Hospital and Royal Newcastle Centre, including members from Obstetrics and Gynaecology, participated in the conciliation conference and were given the opportunity to have their say.

The dispute was listed for a report back on Monday, 13 September at 10am. The NSWNA has been directed to report back on whether our members in the following units are satisfied with their Balanced Rosters: RNC 1,2,3; JHH - Division of Surgery - G1, G2, G3, F1, F3; Obstetrics and Gynaecology - Birth Centre, Ante-natal, Post-natal, Delivery Suite, Gynaecology.

The Association met with members from Obstetrics and Gynaecology on Wednesday, 8 September 2010 at 12.30pm. We continued to meet with our members and gathered detailed evidence of their concerns in relation to the Balanced Rosters for report back to the Industrial Relations Commission on Monday, 13 September 2010.

For further information on the background of the Balanced Roster research study and Guidelines, and an update on the IRC hearing on 13 September, please go the NSWNA website.

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 8.30am to 5pm.

NSWNA Information Officers are available until 7pm.

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 OCTOBER 2010 7

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N E W S I INN BBRRI IEEFF

FIRST STATE

ANF membership grows

Register for Sydney Alliance training

ON WOMEN

The ANF has seen a massive increase in its membership across the Australian health system, with almost 25,000 new members joining the Union in the past 12 months.

ANF Federal Secretary Lee Thomas said membership had risen 13% between June 2009 and August 2010, standing now at more than 192,000 members, and is likely to reach 200,000 members

by Christmas.

As well as working in the public health system, a significant number of new members are employed within the for-profit aged care sector.

‘Our new members include nurses, midwives and AiNs, which is a real vote of confidence in the ANF,’ said Lee. ‘We believe the unprecedented growth in the private aged care sector reflects the fact that the aged care industry is crying out for urgent reform.’

Online registrations are now open for the six-day residential Advanced Training course that Sydney Alliance is running in late October and early November.

SUPER FOCUSES irst State Super has launched a website providing information specifically for women and superannuation.

The site aims to help women who have to juggle work, family and community responsibilities get up to speed on their super options, and how they might be able to improve their retirement benefit.

Content of the site has been driven by First State Super member research, and draws on many other sources such as work done by the Australian Financial Literacy Foundation.

Visit www.womenandsuper. com.au for more information.

F

The Sydney Alliance’s aim is to build a society where a culture of leadership and relationships helps regenerate our democracy and effects change.

The Sydney Alliance is a coalition of individuals and groups whose aim is to build a society where a culture of leadership and relationships helps regenerate our democracy and effects change.

Visit www.sydneyalliance.org.au for more information and to book.

LIONS NURSES’SCHOLARSHIP

Looking for funding to further your studies

in 2011?

The trustees of the Lions Nurses’ Scholarship Foundation invite applications for scholarships for 2011.

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 2010.

8 THE LAMP OCTOBER 2010

REGIONAL

World War I nurses celebrated in new play

STRUGGLE WITH ED TREATMENT

Nurses who served in World War I are taking centre stage in a new play staged in the historic defence tunnels at Headland Park in Mosman.

Based on original narratives and diaries of Australian army nurses, Through These Lines tells the journey of one nurse, Sister Florence Whiting, and her departure from Australian shores to service in the Dardanelles on the island of Lemnos in Egypt and the casualty clearing stations of the Western Front.

The play explores the contributions made by the women of the Australian Army Nursing Service during World War I, as well as their connections, losses and personal victories.

Producer and Director Cheryl Ward said she was inspired by Headland Park to create the play as it was the site of the third largest wartime hospital in Australia during World War I. ‘Within Headland Park are battlements and tunnels from 1871, built to protect our harbour from attack. About 50 metres into the side of one hill is a room that was used to store ammunition.

This is to be our performance space.

And having found the venue, I needed something to perform in it,’ said Cheryl.

‘And the nurses kept coming back to me. These amazing women experienced more than we non-nurse types will ever

HOSPITALS

TIMES L arge regional hospitals in NSW are struggling to treat ED patients who require urgent attention within the timeframes benchmarked by the Government, according to the latest report by the Bureau of Health Information.

The Hospital Quarterly Report, which examines statistics gathered for NSW public hospitals between April and June 2010, found that of 122,200 patients who arrived in the ED by ambulance, only 68% were accepted into the care of the ED within 30 minutes of the ambulance arriving. The NSW target is 90%.

There are national targets that specify how long patients in an ED should wait from the time they are first assessed to the time they receive treatment, depending on their triage category.

From April to June 2010, NSW patients were seen in the recommended timeframe for all categories except triage category 3 (most in need of urgent attention), where 74% were seen in the recommended time frame.

Government benchmarks state that 75% of such patients should start their treatment within 30 minutes of being assessed by the triage nurse.

But at Manning Base Hospital only 50% were able to do so. At Calvary Mater in Newcastle the figure was 53%, while at Lismore, Tamworth and Port Macquarie Base hospitals it was 56%, 60% and 61% respectively.

The regional hospitals’ category 3 performance was the worst in the State, where the average was 72%.

understand. I feel emotional at the thought of what they went through both during and after the war. Having never been called on to face my fears, I feel humbled to have been able to read their words and hopefully come close to telling their stories.’

Through These Lines runs until 24 October.

Thursday to Saturday 8pm, Sunday matinee 4pm. For more information and to book tickets, visit www.throughtheselines. com.au or phone 1300 31 41 51.

Laws prevent transparency over medical errors Health professionals’ fears about the legal consequences of discussing medical errors with patients are stifling their willingness to disclose such mistakes, a University of Melbourne study has found.

The survey, led by Professor David Studdert from the University of Melbourne’s Schools of Law and Population Health, queried nurses and doctors from around Australia with experience in conducting ‘open disclosure’ – candid conversations with patients following adverse medical events.

Ninety per cent identified legal fears as a major or moderate barrier to open disclosure.

‘When the Australian health ministers introduced a national Open Disclosure Standard in 2003 Australia established itself as a world leader in this area. But our study indicates two key things – there are some holes in the regulatory structure supporting these activities, and clinicians charged with leading this work are concerned about that,’ said Professor Studdert.

‘Health professionals appear worried that if they share information with a patient about problems in care it might be turned back on them in a negligence or disciplinary case. This is unfortunate, especially given emerging evidence that openness about adverse events may actually work the other way and reduce the likelihood that injured patients will take legal action.’

The study, published in the Medical Journal of Australia in September, also found inadequate training for health professionals about how to conduct open disclosure with patients was a major barrier to open disclosure.

Professor Studdert said new laws were needed to prevent information shared in open disclosure from being used in legal proceedings.

THE LAMP OCTOBER 2010 9

Nurses see it all.

Now they can tell it all.

WRITE IT. SHOOT IT. SEND IT.

The 2011 Nurses’ Short Film Festival.

Showing at the Randwick Ritz Cinema, Monday 9 May 2011.

Entries close 25 February 2011 Enter now for your chance to win

$5000

for full details of the 2011 film festival and to check out the 2010 finalists’films: www.nswnurses.asn.au The NSW Nurses’ Association Short Film Festival is proudly sponsored by: 10 THE LAMP OCTOBER 2010

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Nursing students fail to spot deteriorating patients Final-year nursing students are failing to assess, identify and respond to patients either deteriorating or at risk of deterioration, a study has found.

A group of researchers from Monash University, in collaboration with British academics, put 51 finalyear, final-semester student nurses in a simulation laboratory. Students completed a knowledge questionnaire and two video-recorded simulated scenarios (mannequin-based) to assess skill performance.

The scenarios simulated deteriorating patients with hypovolaemic and septic shock. Situation awareness was measured by randomly stopping each scenario and asking a series of questions relating to the situation.

The mean knowledge score was 74% and the mean skill performance score across both scenarios was 60%.

Skill performance improved significantly by the second scenario but declined significantly in both scenarios as the patient’s condition deteriorated.

The study – published in the October issue of the Journal of Clinical Nursing – suggests that student nurses, at the point of qualification, may be inadequately prepared to identify and manage deteriorating patients in the clinical setting.

Obese patients difficult to manage in ED Patient obesity significantly increases the difficulty of their management in the ED, a study of 750 patients has found.

A cross-sectional survey of patients and medical, nursing, and radiography staff of Victoria’s Austin Hospital ED undertaken between October 2008 and March 2009 found doctors reported that physical examination, palpation of the chest or abdomen, finding anatomical landmarks, and general procedures were most affected by the level of obesity.

Nurses reported that patient positioning and mobilisation, assistance with clothes, and intravenous cannulation were most affected.

Radiographers reported that patient positioning and obtaining a good image were most affected.

The study is published in the August issue of Emergency Medicine Australasia.

Dementia costs set to soar Worldwide, the costs of dementia are set to soar, according to the latest World Alzheimer Report 2010.

The report, which was released

by Alzheimer’s Disease International (ADI) on 21 September to coincide with World Azheimer’s Day, estimates an 85% increase in costs to 2030, based only on predicted increases in the numbers of people with dementia.

The total estimated worldwide costs of dementia are US$604 billion in 2010.

These costs account for around 1% of the world’s gross domestic product, varying from 0.24% in low-income countries, to 0.35% in low-middleincome countries, 0.50% in highmiddle-income countries, and 1.24% in high-income countries.

Costs of informal care (unpaid care provided by families and others) and the direct costs of social care (provided by community care professionals and in residential home settings) contribute 42% of total costs worldwide.

If dementia care were a country, it would be the world’s 18th largest economy, ranking between Turkey and Indonesia, the report found. And if it were a company, it would be the world’s largest by annual revenue, exceeding Wal-Mart (US$414 billion) and Exxon Mobil (US$311 billion).

ADI said there is an urgent need to develop cost-effective packages of medical and social care that meet the needs of people with dementia and their caregivers across the course of the illness, and evidence-based prevention strategies.

‘Governments and health and social care systems need to be adequately prepared for the future, and must seek ways now to improve the lives of people with dementia and their caregivers,’ it said.

s Legal & Professional Issues for Nurses and Midwives 15 October, Wagga, ½ day 5 November, Port Macquarie, ½ day 26 November, Newcastle, ½ day Topics covered include the Nurses and Midwives Act 1991, potential liability, importance of documentation, role of disciplinary tribunals including the NMB, writing statements.

Members $39 • Non-members $85 s Basic Foot Care for RNs & ENs 19 & 20 October, Tamworth, 2 days This course aims to provide nurses with the competence to provide basic foot care.

Members $203 • Non-members $350 s Computer Essentials for Nurses and Midwives 25 October, Concord, 1 day Seminar is suitable for all nurses and midwives.

Members $85 • Non-members $170 s Enrolled Nurses Forum 27 October, Camperdown, 1 day Seminar is suitable for all enrolled nurses.

Members $30 • Non-members $50 s Appropriate Workplace Behaviour 29 October, Coffs Harbour, 1 day Topics covered include understanding why bullying occurs; anti-discrimination law & NSW Health policies; how to behave appropriately in the workplace; identify behaviour which constitutes unlawful harassment and bullying; what to do if subjected to unlawful harassment and bullying; how to use workplace grievance procedures; identify, prevent and resolve bullying.

Members $85 • Non-members $170 s Drug and Alcohol Nurses Forum 19 November, Camperdown, 1 day Seminar is suitable for all nurses.

Members $30 • Non-members $50 s Review & Implementation of Guidelines & Policies 12 November, Camperdown, 1 day Seminar is suitable for all nurses.

Members $85 • Non-members $170

TO REGISTER or for more information go to www.nswnurses.asn.au or11ring THE LAMP OCTOBER 2010 Carolyn Kulling on 1300 367 962

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NSWNA launches campaign to win ratios g Nurse-to-patient ratios campaign launched after strong endorsement from members.

Left to right: Luke Marks and Clare Waite joined Brett Holmes in answering questions from the media.

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SWNA General Secretary Brett Holmes publicly launched the NSWNA claim for nurse-to-patient ratios on 20 September after a resounding ‘yes’ vote from public health system members.

One hundred and seventy-five Branches at public hospitals and services voted on

the claim for nurse-to-patient ratios in early September, with a ‘yes’ vote from 174 Branches.

Nurse-to-patient ratios is part of the 2010 Claim for a new Award for public health system nurses and midwives.

Brett Holmes told media at the launch: ‘Public hospital and community health-care nurses across NSW want

STILL NO RESPONSE TO CLAIM The NSWNA still has not received a response from NSW Health to the 2010 public health system pay claim.

The NSWNA submitted the pay and interim ratios claim in May and the final NSWNA ratios claim, which was approved by members, in September.

The claim included a 5% pay and pay-related allowances increase per year over the four-year agreement and improvements in conditions such 12 THE LAMP OCTOBER 2010

as 1% extra super, reinstatement of higher grade duty payments for every shift, increased paid maternity leave and paternity leave.

NSWNA General Secretary Brett Holmes said NSW Health has had three months to respond to the claim.

‘We’re now pressing the department for a timely response. It’s time for a fair offer with decent pay and the conditions that nurses deserve.’

a major overhaul of the State’s public hospital and health-care system through the introduction of mandated minimum nurse-to-patient ratios.’

The claim includes nurse-to-patient ratios for the nursing specialties of medical, surgical, emergency, palliative care, rehabilitation, inpatient mental health, community health, community

Clare Waite (left), Luke Marks (second from left), and Stephanie Dart (right) shared recent cases they have experienced that highlight the effect on nurses of under-staffing.

mental health, critical care and the 2008 ACORN tool for operating theatres.

‘Nurse-to-patient ratios would be the biggest reform of the NSW public health system in decades. Nurse-topatient ratios would mean certainty with nurse numbers and skill mix.

There would be a mandated number of nurses for a certain number of patients.’

Luke Marks explained the importance of ratios to reporters.

‘The NSW health system has been plagued by nurse shortages and poor skill mix for a long time. Research conducted by the NSWNA reveals a climate of unrelenting pressure on the nurses and their deep concerns for patient safety.’

At the media conference, NSWNA members Stephanie Dart, CNE from Mount Druitt Hospital; Clare Waite, CNS at RPA Hospital; and Luke Marks, RN at Orange Base Hospital explained recent cases they have experienced that highlight the pressure on nurses.

‘Despite the best efforts of nurses, the NSWNA, other health workers, the Health Department and the State Government, the pressure on nurses to provide timely, safe care has continued to grow,’ said Brett.

Over the coming weeks NSWNA members are gearing up for a very determined community campaign to win ratios. The campaign will include advertising, public events and meetings with State and Federal politicians.n

COMMITTEE OF DELEGATES PASSES MOTION FOR COMMUNITY CAMPAIGN The NSWNA Committee of Delegates (COD) meeting passed a resolution on 21 September to conduct a determined community campaign to ensure the Government delivers a fair offer of wages and staffing ratios.

The COD expressed concern at the failure of the NSW Government to provide an offer to nurses and midwives to secure fair pay and conditions since our Award expired on 30 June 2010, and demanded that the Government provide an acceptable pay and conditions offer by no later than Wednesday 6 October 2010, or face an escalating campaign.

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Take action to win ratios

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SWNA branches are now gearing up for a very determined community campaign to win nurseto-patient ratios.

NSWNA Assistant General Secretary Judith Kiejda said, ‘Branches are getting organised and active to win ratios. This is going to be our toughest fight but the most important – we’re fighting for safe patient care. We need to let the Government know we’re determined to win ratios, and inform the community about the current staffing crisis with nurse-to-patient ratios as the solution.

WHAT YOU AND YOUR BRANCH CAN DO TO HELP WIN RATIOS Establish and be part of a Workplace Campaign Committee (WCC) at your workplace to organise campaign activities to win ratios. Contact your NSWNA Organiser for assistance in establishing a WCC and organising activities.

Write to and visit your local MP. The NSWNA has developed a Safety in Numbers kit to explain the campaign to MPs. Phone the Association on 1300 367 962 for a kit.

‘Nurse-to-patient ratios can only be achieved if all members get involved.’

‘We need nurse-to-patient ratios to fix the staffing crisis in our public hospitals and services. The outstanding success of ratios in Victoria in ensuring safe care and addressing the nurse shortage proves it is the best solution.

‘Nurse-to-patient ratios can only be achieved if all members get involved.

If everyone does their little bit, we can win this,’ said Judith ‘I strongly urge all members to take a moment to support the campaign. It’s not hard, it doesn’t have to take a lot of time ... and it can be heaps of fun. Most importantly, your effort will make a big difference.’n

Hand out campaign brochures to your community. The NSWNA has developed ‘Our community deserves safe patient care’ brochures to explain the campaign to the community. Phone the Association on 1300 367 962 for brochures.

Make sure your contact details are up to date. The NSWNA needs your mobile number, email address and Award classification so we can get campaign materials to you fast.

Encourage all your friends and workmates to be NSWNA members – there is strength in numbers. They can join online or by phone today.

Make sure you come to Branch meetings at your hospital or service.

NSWNA Assistant General Secretary Judith Kiejda 14 THE LAMP OCTOBER 2010

Visit the NSWNA website for more information:

www.nswnurses.asn.au

DELIVER LEAFLETS IN YOUR STREET On your way to the bus stop, the railway station, the local shop, as you walk the dog – it only takes five minutes to deliver leaflets to letterboxes in your street or block.

The Lamp joined Marichell Beltran, RN at Mount Druitt Hospital, as she distributed leaflets while walking her dog, Fluffy.

‘We need to let the community know about the staffing problems in our hospitals, and that ratios are the solution,’ says Marichell.

‘Distributing leaflets to houses in my block is an easy way to do that. It takes five minutes but it makes a big difference. If the community understands that nurse-to-patient ratios is the solution to staffing problems in our hospitals they will support our campaign to win ratios.

With the community on side, there will be more pressure on the Government to listen.

‘We all need to do our bit to fight for ratios.

Letting the community know about the staffing problems in our hospitals by distributing leaflets is something everyone can do,’ Marichell says.

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Set up a Workplace Campaign Committee g NSWNA Branches across the State are setting up Workplace Campaign Committees to promote the safe staffing campaign to the wider community.

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or our campaign for mandated nurse-to-patient ratios to succeed, we need the support of the wider public. One way to co-ordinate your efforts in reaching your local community is to set up a Workplace Campaign Committee (WCC).

Members at Bankstown Hospital set up their WCC a few weeks ago and already have an event planned to coincide with Walk to Work Day on 1 October.

Walk the Block will see WCC and other members walk around the street at lunch-

Sam secures MP support for NSWNA campaign am Webb, RN at St George Hospital, visited local MP Dr Andrew McDonald to ask for his support for the NSWNA claim for nurse-to-patient ratios.

A weekend shift with particularly bad staffing pressures spurred Sam’s decision to visit his MP. ‘I decided I had to do something.

I planned to visit anyway but terrible staffing problems made me decide I had to do something now.

The NSWNA organiser made an appointment and I decided to come along,’ he told The Lamp.

‘On the afternoon shift on Sunday, a CNS was replaced by an AiN due to sick leave. This left an EN and AiN covering 12 patients. The in-charge RN was also expected to take 12 patients

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16 THE LAMP OCTOBER 2010

as well as assist the nurses. I was finishing my shift but I didn’t leave because I was worried that the skill mix was inadequate.

‘It’s not acceptable that experienced nurses are replaced by an AiN. Inadequate skill mix is unacceptable and impacts on patient care.

‘I explained what happened to Andrew McDonald and how with ratios this wouldn’t have happened.

‘He was very helpful. As an expaediatrician he has worked in the hospital system and understood that ratios would provide better outcomes.

Nurses would be able to do their jobs and this makes it easier for doctors to do their jobs. He said he would support our campaign,’ said Sam.

time, handing out NSWNA leaflets on the safe patient care campaign to the public.

State MP Alan Ashton is already on board and will be joining members on the walk.

At a Branch meeting, five members from different departments in the hospital volunteered to be on the committee, and each one was designated a specific task. For example, one person is a dedicated media spokesperson, another is creating a flyer to advertise the Walk the Block event.

At the first meeting committee members engaged in what’s known as community mapping: identifying influential

‘It’s not acceptable that experienced nurses are replaced by an AiN. Inadequate skill mix is unacceptable and impacts on patient care.’

Sam Webb, RN, St George Hospital

people in the local community who would support the campaign. These range from local journalists, church leaders, aged care groups, councillors and MPs. Marika Seremetkoska, CNE, is the WCC co-ordinator and is creating a database of members keen to be involved in helping the committee.

‘There are 500 members at Bankstown.

Each of the five WCC members has agreed to approach 100 members in our different departments, give them 10 leaflets each and ask them to letterbox them in their street.

This means 5,000 leaflets will be delivered,’ Marika told The Lamp.

It’s this teamwork that is essential to a successful WCC, Marika stressed. ‘You only need to commit about half an hour

Members of Bankstown Hospital’s Workplace Campaign Committee divided up tasks between them to co-ordinate activities to raise community awareness.

a week. It’s quite easy to set up – you’ll be surprised how easy – and it’s not very time-consuming either, as long as there is a lot of teamwork involved and everyone pitches in,’ she said.

The WCC at Bankstown meets every

two to three weeks to report back and plan future strategies.

‘It’s a fantastic way of getting publicity for the campaign and to let the local community know what it’s about,’ said Marika.n

Sam Webb, RN at St George Hospital, visited his MP Dr Andrew McDonald to tell him about his recent experiences with chronic under-staffing. At the end of the meeting, he had secured the support of Dr McDonald for nurse-to-patient ratios.

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‘Untenable’ staffing at Shoalhaven g Members at Shoalhaven District Memorial Hospital are demanding action to address inadequate staffing in the operating theatres.

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urses at Shoalhaven Hospital have struggled with inadequate staffing in the operating theatres since late 2009, and increased activity in the theatres has led to more pressure on nurses to provide safe patient care. The increased surgical activity in the theatres means the unit is not staffed to ACORN 2002 Standards.

NSWNA members sought to address staffing issues with management and after management failed to respond, the NSWNA and members called an urgent dispute meeting with hospital management to address serious staffing concerns in the operating theatres. At the meeting management and the Union agreed that a staffing review is to be undertaken by an independent reviewer, with input from the theatre nurses to the review.

NSWNA Assistant General Secretary Judith Kiejda said current staffing levels in the operating theatres only takes into account the intraoperative nursing roles without considering duties that are additional to direct patient care. ‘Management have failed to acknowledge or understand the scope of the perioperative nurse’s role. This has been exacerbated by increases in surgical activity without a commensurate increase in staffing.’

A review by nurses of the past several months’ rosters demonstrates that the

Nurses at Shoalhaven are considering a community campaign to force management to address staffing problems at the hospital.

FTE staffing provided has lagged further behind the ACORN Standard. Initial estimates of staffing shortfalls show that theatres are being staffed with at least 4 and at times as many as 7 FTE less than the ACORN Standard.

‘Management have failed to acknowledge or understand the scope of the perioperative nurse’s role.This has been exacerbated by increases in surgical activity without a commensurate increase in staffing.’

NSWNA Assistant General Secretary Judith Kiejda 18 THE LAMP OCTOBER 2010

Nurses say management has been attempting to fill staffing gaps by increasing the number of rostered 10hour shifts. The CNE and NUM have also been slotted in to fill vacancies on the daily work schedule to cover sick leave. The ACORN Standard makes an allowance for sick leave but by fully allocating the available part-time and casual staff there is no provision within the current staffing level to backfill sick leave shifts without using the CNE and NUM. Nurses at Shoalhaven District Memorial Hospital are considering a community campaign to keep the pressure on management and inform the community, media and their local MP of the staffing problems at the hospital.n

Five extra beds at Bathurst Base – but it’s not enough g The re-opening of five beds at Bathurst Base Hospital is a good win – but there is still a long way to go to address the staffing crisis.

staffing shortages. Staffing in the ED is sometimes still unsafe. Our staffing ratios at times are quite dangerous. We’re only staffed for eight beds and we constantly run at 17 treatment areas including people sitting in chairs waiting to be treated, with no increase in our staff numbers.’

An emergency escalation plan at the hospital states that once the ED fills up with eight patients, extra resources should be allocated to alleviate the bed block.

‘We’ve had some good wins with the introduction of a CIN in ED seven days a week, and a staff increase on night duty of one FTE, which we’ve all seen the benefit from as it allows us to have five or six patients overnight as well as the usual presentations,’ said Lyn.

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campaign by the NSWNA has resulted in the reopening of five beds at Bathurst Base Hospital and some extra nursing staff in ED. ‘This is a big win that Branch members have fought hard for,’ said NSWNA Assistant General Secretary Judith Kiejda.

‘ED has received extra funding for a Clinical Initiatives Nurse (CIN), an extra senior nursing position seven days a week and another permanent staff member on night shift. The ED nurses are happy because they have been very short-staffed and struggling to deal with increased presentations.’

But while the moves are a positive step in the right direction, they are not enough to remedy the staff shortages that have plagued the hospital since it closed 15 beds several years ago.

Increasing staffing pressure Over the past 12 months, the ED has seen a huge increase in the number of presentations, with the closure of St Vincent’s private hospital exacerbating an already dire situation.

‘There has been an incredible strain on staff and an overloading of services,’ said Judith Kiejda. ‘There are often large queues of people lining up in ED and ambulances backed up.’

The Association met with local MPs and pushed for Federal funding to open more beds at the hospital. The five beds and extra ED nursing staff were funded

by COAG. But the NSWNA is concerned that

‘Staffing in the ED is sometimes still unsafe. Our staffing ratios at times are quite dangerous.’

Lyn Sloane, NUM, ED, Bathurst Base Hospital

five beds is not enough, and there are not enough nurses to staff them.

‘Five beds is a fraction of what is needed,’ said Judith. ‘We need all 15 beds re-opened – they are desperately needed.

The closure of St Vincent’s Hospital has exacerbated the problem. Bathurst Base is still beyond capacity even with the extra five beds. There is a massive pressure on staff. Without the right numbers of staff we can’t deliver safe patient care.’

Lyn Sloane, NUM in ED and Branch President, said staff are working long hours and having to do a lot of overtime – including unrecognised overtime.

‘They are very stressed in the workplace,’ she told The Lamp. ‘Even now, with the five new beds open, we are still experiencing bed block. There are still

Good wins but not enough ‘We’ve also had our CNE position increased. It was a full-time position that was reduced, then increased again, so we now have a CNE four days a week instead of five days a fortnight. So that’s a bit of an improvement, but the CNE is doing a fair bit of clinical work – they are not there doing what they are supposed to be doing; they are filling in vacant shifts and that’s true across the hospital.

‘These are small steps and good wins, but we have a long way to go.

‘Mandated nurse-to-patient ratios would improve patient care and reduce the stress levels of nurses,’ said Lyn. ‘We’d be able to give better quality care and have an in-charge-of-shift to coordinate patient flow in the department, without having a clinical workload.

Currently, especially on afternoon and night shifts, the in-charge has a clinical workload and is trying to manage the department. Generally, that person is the most senior and experienced so they usually have the sicker patients.

‘Ratios would improve responses to emergencies. Even the medical emergency teams are only staffed on the bare minimum. There doesn’t seem to be the staff available to respond adequately,’ said Lyn.n THE LAMP OCTOBER 2010 19

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NCAHS puts budget over patient care g Staff employed by North Coast Area Health Service are furious at the organisation’s announcement that it plans to cut another 62 jobs.

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embers at chronically under-staffed facilities throughout the North Coast Area Health Service (NCAHS) are up in arms over its latest announcement that it plans to cut another 62 FTE positions – many of which are likely to be nursing roles.

NCAHS has already cut 350 FTE positions, putting a massive strain on remaining staff.

‘This announcement comes at a time when NCAHS is suffering a staffing crisis,’ said NSWNA Assistant General Secretary Judith Kiejda. ‘Nurses at Kempsey Hospital ED had to engage in a long and sustained campaign earlier this year to win one more nurse per shift. There is a history of NCAHS prioritising budget over patient care.

‘There are diabolical staffing problems across NCAHS, with little to

‘Ratios would be magic.’

Gil Wilson, CNS, Lismore Base Hospital ICU and Branch Secretary

20 THE LAMP OCTOBER 2010

no recruitment occurring. One frontline community nurse position was vacant since last November, before it was finally advertised this month. NCAHS has a history of staffing cuts leading to crisis.’

The area health service invited the NSWNA to a presentation in September showing how it had benchmarked costs at its facilities, compared with facilities in other area health services.

‘NCAHS said the results show it is not doing as well budget-wise, but they benchmarked against very different facilities – it’s like comparing apples with oranges,’ said Judith.

Fed up with staff cuts Gil Wilson, a CNS in ICU at Lismore Base Hospital and Branch Secretary, said staff were angry and frustrated by the prospect of more job cuts, which will lead to even more increased workloads on the remaining staff.

‘We are sick of being hammered and now they are talking about taking even more from us. On one of the rare times I went to the wards recently, the staff said, “We need to strike now,” and this was the first time they were in unison about this.

They said, “Tell us to walk out.” I could have walked the hospital out that afternoon.

They are incredibly frustrated that NCAHS thinks it can take more staff hours away from patient care. Every ward had at least one person working overtime,’ said Gil. This latest announcement by NCAHS is the fourth round of job cuts. According to Gil, there has been an ‘unofficial recruitment freeze’ for some time. This has led to a backlog of ambulances in ED, and existing staff being exhausted and stressed because they have to do extensive overtime.

‘There were five ambulances loaded up in ED the other day. On one shift there were nine people doing overtime at Lismore Base alone to fill up the holes. A lot of nurses are doing double shifts to minimise the impact on patient

care. This means tired nurses with a hell of a workload.

‘With the current workloads tool it’s a constant battle – we are faced with NCAHS wanting to take 10 or more hours out of most wards.

‘There is a lot of pressure on staff and everyone is fed up. We are horrendously busy and it seems that recruitment takes forever. It’s been like that since the budgetary cutbacks. The area health service is trying to create unrealistic budgets.

‘The job cuts are disgusting. NCAHS needs to take a really close look at where the cuts are going to come from because it’s trying to get blood out of a stone – you can’t take any more from us,’ said Gil.

Ratios is the solution Ratios, mandating the right numbers of staff with the right skill mix, would solve the staffing problems across NCAHS facilities, said Gil. ‘Ratios would be magic. I wouldn’t be spending so much of my time arguing about workloads. They couldn’t screw around with us if we had ratios. Ratios would prevent area health services putting budget over patient care.’

And it’s not just Emergency Departments that are suffering from serious staff shortages.

A community nursing job remained vacant for more than 255 days since last November. It was finally advertised last month.

‘We only have 5.1 FTEs in the general nursing part of community health and a second person resigned recently. This was the straw that broke the camel’s back – to have two FTEs vacant was making it impossible to provide a service,’ said Rhonda Allen, CNS in parent education.

‘Even before the second resignation, one of our nurses went off with a back problem and she felt it was caused by the stress of trying to fit everything in.

We cover long distances here; you’re out there in the car getting stressed and

worried and rushing – it’s an OHS issue.

When referrals come in you just find a way to do them somehow even if you don’t have time,’ said Rhonda.

‘We have a nurse educator position that was vacant for years and it took a long time to get someone. She stayed for a year and left, so the NUMs have to do a lot of that work – the competencies – and that’s another thing on their shoulders. NCAHS has finally agreed to advertise this position.’

But, according to Rhonda, sometimes positions go through the whole recruitment process but do not get signed off at the end. ‘There is still scepticism

from all of us as to whether these positions will actually happen. The staff get very despondent.’

Chronic under-staffing means the nurses are unable to provide quality patient care. ‘I work in the child and family area and our numbers have gone down and down. We are committed to see new mums when they come home in the first fortnight and we are not seeing them at the moment in the early days, so we’re not doing as well as we could,’ said Rhonda.

NCAHS said it will reveal details of which jobs and at which hospitals it plans to cut, and will begin consultation in October.n

‘You’re out there in the car getting stressed and worried and rushing – it’s an OHS issue.’

Rhonda Allen, CNS in parent education

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Domain nurses celebrate inaugural agreement g Three years of campaigning have paid off for members at the for-profit provider Domain, with their employer offering their first ever Enterprise Agreement.

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t was a long fight but a determined campaign by aged care nurses and the NSWNA has seen Domain Principal Group (DPG) finally come to the bargaining table and negotiate a three-year Enterprise Agreement with the NSWNA. The three-year Agreement will protect all the conditions aged care nurses had under the Notional Agreement Preserving a State Award (NAPSA) (many of which would have been lost under transitional arrangements to the Modern Award from 1 July this year), adds some new rights, and includes real pay increases above the inflation rate.

‘The Union support was very important as no one else has the time, effort and know-how to fight for what we need.’

Lyn Robertson, AiN, Endeavour Nursing Home

Staff at the for-profit employer will receive a 3.5% increase to wages from the date they vote for the agreement and 3.7% increases in July 2011 and July 2012, with the possibility of a higher increase in 2011 if the Federal Government improves aged care funding.

Four weeks’ maternity leave and one week’s paternity leave are among the other benefits, which also include improvements to the nursing classification structure by recognising Certificate III qualifications and a new EEN classification; casuals being able to ask for their jobs to be made permanent; a process to manage workload problems; and an improved higher duties allowance.

The agreement is based on the Aged Care Association Australia (ACAA) 22 THE LAMP OCTOBER 2010

template and was modified in the negotiations. It was negotiated by the NSWNA, the Queensland Nurses Union and the Health Services Union, and covers around 3000 staff at 28 facilities in NSW and two in Queensland, with the largest group of those employees being nurses.

Members’ involvement delivers win NSWNA General Secretary Brett Holmes said members’ involvement with the campaign has delivered a fantastic win.

‘Hundreds of members petitioned DPG for an Agreement and showed that a majority of staff wanted an Enterprise Agreement. DPG took way too long to bargain with the Association and give staff the extra pay they deserved, but it got there in the end after a sustained campaign by aged care nurses at all the employer’s facilities.

‘The active involvement of members at local Branches in building the campaign has delivered this pay offer as well as additional benefits and is a perfect example of why it’s important not to give up and to fight for your rights at work,’ said Brett.

New NSWNA Branches, strong membership Throughout the long campaign, two new branches (Coffs and Murwillumbah) were formed and 110 new members joined the Union, which now boasts 86% membership in some facilities across DPG. Members were active and provided input through bargaining committees, teleconferences and face-to-face meetings at the negotiations table.

Yolanda Gleeson, an RN at Tweed Heads nursing home, has been involved in the campaign since the beginning.

‘We continually petitioned management and had discussions in the workplace,’ she explained. ‘We canvassed what everyone wanted on a Branch level and held meetings in the region.’

‘The only way to go these days is to campaign and push and push and fight for our rights.’

Marta Frasca, AiN, Killarney Vale Nursing Home

Representatives of the NSWNA visited the Branch regularly and Yolanda stressed the importance of having the Union fight on your behalf.

‘If we didn’t have the Union, we’d probably be in a far worse position.

They came out and encouraged Branches to hold meetings and discuss what was going on. Even to get Domain to the bargaining table to discuss having an Agreement was hard enough and the Union really pushed for that. If we didn’t have the NSWNA, we wouldn’t have what we have today,’ said Yolanda.

Marta Frasca, an AiN at Killarney Vale nursing home, was also part of the campaign since the very beginning.

KEY BENEFITS OF THE AGREEMENT c 3.5% increase to wages from the date staff vote for the new agreement. c 3.7% increase to wages in July 2012.

c Annual review of part-time hours to make sure your contracted hours match your real hours of work.

c Agreement to run from July 2010 to June 2013.

c Casuals may ask for their jobs to be permanent.

c The possibility of a higher increase in 2011 if the Federal Government improves aged care funding.

c A process to manage workload problems.

c Allowances increased by 3% per year.

c Reinstatement of the in-charge of shift allowance, on-call allowance and continuing education allowance and other items lost in the transition to the new Nurses Award in January 2010.

c 3.7% increase to wages in July 2011.

According to Marta, key to the campaign’s success was a strong Union presence at the workplace and a proactive approach by members.

‘We had lots of meetings and collected signatures for a petition. I went around with the petition and made everyone sign! You have to be very proactive. I’d say to my colleagues, “Just go in the staff room and sign, please.” The NSWNA were there for us every step of the way: they came every time we called them to ask what is going on and what is the best thing to do. They really helped us and we do need them,’ said Marta.

Marta has no hesitation in encouraging nurses at other facilities without an Enterprise Agreement to campaign proactively for one. ‘It’s definitely worth it. The only way to go these days is to campaign and push and push and fight for our rights. We have to negotiate our wages nowadays and keep doing it and it’s the only way we’ll have wages that are fair,’ she said.

Lyn Robertson, an AiN at Endeavour Nursing Home, joined the campaign in February this year when she realised just how much she and her

c Four weeks’ maternity leave and one week’s paternity leave.

c Expense-related allowances increased by inflation rate. c Improvements to nursing classification structure by recognising Certificate III qualifications and a new EEN Classification.

colleagues stood to lose if they moved to the Modern Award.

‘Under the NAPSA we had good allowances, shift loading, 11 public holidays, the right to a rostered day off for full-timers and many other conditions that we would have lost under the Modern Award, and our pay would have decreased too. My workmates had pretty much had enough of waiting around. You want to get proper wages and conditions for the hard work you do,’ said Lyn, who enjoyed taking part in the negotiations.

‘Sitting at the bargaining table, I felt like I was positively involved in the

c Improved higher duties allowance.

c Recognition of the role of workplace union representatives.

negotiations. Although Domain took far too long to negotiate with us, once they did eventually come to the table, they were quite amicable. The Union support was very important as no one else has the time, effort and know-how to fight for what we need as nurses. Without the Union, we can’t do anything,’ said Lyn. At the time The Lamp went to press, members were due to vote on the Agreement. If the draft agreement passes the vote, it is then submitted to Fair Work Australia for legal approval. It has been agreed that the first increase will be back paid from 1 September.n

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THE LAMP OCTOBER 2010 23

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Broad debate at Aged Care Forum g The training of carers in medication duties, the challenges of attracting new graduate nurses into aged care, and the unique issues of gay and lesbian residents were among the subjects addressed at our recent NSWNA Aged Care Nurses Forum.

Shortage of RNs highlights importance of training carers

Carla Unicomb 24 THE LAMP OCTOBER 2010

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ged care facilities need policies and procedures for medication duties, and with the shortage of RNs, a delegation process, Carla Unicomb told the forum.

Carla is an RN, Oncology Nurse and Director of Training Beyond 2000, which trains assistants and carers in Certificate III and IV. Carla said a lot of RNs feel the training of AiNs is important.

‘There are those who feel it is their domain to do the medications. However, due to the shortage of Registered Nurses, they don’t have that luxury,’ she said.

‘By getting carers to give medications, they’re able to use them for the lunch time medication round, which leaves the RNs free to do other things, which they have found to be very beneficial.’

Carla said it is important for facilities to have policies and procedures in place to do their own training and re-assessing of carers.

‘Obviously if they feel they’re not competent to do it, they shouldn’t allow them to do it.

‘It’s not good enough for us to do the training and a year later the facilities say, “Oh you’ve done that module.” It’s also important to have Medication Committees in facilities and make sure that RNs are represented on the committees so that their concerns are heard.’

Carla pointed out that short-staffing is a major issue when it comes to followup training.

‘Most employers are pretty good because of accreditation issues. However, they are also short-staffed and there’s no Registered Nurse so they want to make sure carers are trained properly.’

Increased demand Ageing gays and lesbians in aged care and the still face discrimination challenges of recruitment Discrimination is the main issue facing

Begin with the end in mind

ageing gays and lesbians, said Russell Westacott, Director of Client Services at ACON, Australia’s largest Lesbian/Gay/ Bisexual/Trans (LGBT) health and wellbeing organisation.

Anne Meller Betty Krstevska

Betty Krstevska, RN, Nurse Manager at St George Hospital acute aged care ward, said the biggest obstacle to recruiting graduate nurses into aged care is the actual name itself. ‘The concept of aged care and whatever the graduate nurses’ understanding is of aged care is that it’s not really an exciting place to work.

Everyone associates aged care with working in a nursing home as opposed to what it’s really about,’ she said.

Betty said on her acute aged ward there is a focus on the team model to ensure staff support in a busy challenging environment.

‘We see confused patients who are bed-bound, patients with dementia or have behavioural issues. The patients that are here as opposed to nursing homes are here with acute medical problems so we do a lot of interventions that are surgical or medical,’ she said.

‘From our point of view, that keeps the new nurses interested. The support and education we’ve been able to provide is important as well.

‘When I first came here we were so short-staffed, which could be a reason why people would want to leave. But now we’re fully recruited and the concept of team work especially has worked fantastically.

‘Aged care is just a name; it doesn’t matter whether it’s an aged care ward, a surgical ward or a critical care area. Because of the ageing population there’s always going to be elderly patients wherever you go to nurse. It makes you learn and appreciate having the experience so much, and it’s beneficial to any nurse,’ said Betty.

Russell Westacott

‘It can come from the actual service providers themselves or it can come from other people within the aged care facilities – other patients or clients. We also hear stories about people going back into the closet as they get older; not being open about their sexuality and needing to conform and have a more comfortable situation within the aged care facility.’

Russell said ACON has been trying to advocate for sensitivity training for aged care service providers particularly in areas where there are large gay and lesbian populations. It recently received funding from the Commonwealth Government to do this.

‘ACON has a work group that meets every second month and we try to advance the issue of LGBT and ageing on both the research and policy agenda and try to get funding as well.

‘ACON has started services that are providing support to people with HIV. We’d like to be able to get some funding to re-orient that program and help people in their homes who are ageing in the gay and lesbian community, but at the moment it’s been difficult to secure funding. The ageing work groups help do some cleaning and take the person to the supermarkets, or to the doctor’s office. We’d like to be able to provide that for the older gay and lesbian community who may not be comfortable with the existing services,’ said Russell.

Anne Meller, Clinical Nurse Consultant, Chronic and Complex Care, Advance Care Planning at South Eastern Sydney and Illawarra AHS spoke to the seminar about the process of preparing for possible scenarios near the end of life.

‘It’s quite likely that we’ll spend a longer time towards the end of our lives lacking mental capacity or not being able to make our own decisions. Therefore, it’s really important to think through those things beforehand and to have conversations with family or those close to you,’ she said.

‘Where possible, appoint someone who can make health decisions and personal care decisions that would accord with your wishes.’

Anne said one way of doing that is to write an advance care directive.

‘Often what happens is people haven’t had the discussion, and families don’t want to raise what may be perceived as an upsetting subject.

‘We’re all obliged to promote and maintain the health and well-being of the patients. As nurses we need to be vigilant; we are making decisions, we’ve got [to have] the best level of information and evidence.

‘We have to be on guard to act in the best interest of people and look out for people who are vulnerable and who might be at risk of abuse; whether that’s psychological, financial, or physical, it’s ensuring that people get access to treatment and services and they’re not denied that because they lack the required mental capacity to understand the situation fully,’ said Anne.n THE LAMP OCTOBER 2010 25

ARE YOUR WORKMATES OR FRIENDS MEMBERS OF THE NSWNA? Why not ask them and if they aren’t, sign them up. Like you, they need the security of belonging to a strong and dynamic union.

Not only will you be building your union by signing up a new member, you and a friend could win this fabulous holiday on Lord Howe Island. The more members you sign up, the more chances you have to win!

The prize* includes a seven-nights’ stay with meals at Pinetrees Lodge, return flights for two on Qantaslink from Sydney, airport transfers on Lord Howe Island, and some activities.

26 THE LAMP OCTOBER 2010 *

Conditions apply.

Experience the natural beauty and tranquility of world-heritage-listed Lord Howe Island. Enjoy great food, good accommodation and outstanding hospitality at the historic Pinetrees Lodge.

Pinetrees Lodge is situated on one of the prime aspects of Lord Howe Island as it has unsurpassed access to the lagoon.

Cycling, reading, birdwatching, scuba diving, surfing, swimming and bush climbing – it’s up to you! And if you believe your cardiac health is up to it you can always attempt the challenging climb up Mt Gower. We have been told that this climb is worth every strenuous step as the views from the top are incredible.

So, if you are up for this sort of holiday where you will enjoy uncomplicated days, crystal clear waters and uncrowded and unspoilt beaches, make sure you ask the nurses and midwives you work with if they are members of the NSWNA!

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 DRA

WN 3 0 JU N E 2011

s

A G E D C A R E

Crisis looming in aged care g Unless the aged care system undergoes major reform it will be crippled by burgeoning costs and eventually become unsustainable, reports National Seniors Australia.

A

new report commissioned

by National Seniors shows the Australian aged care system to be on the brink of crisis and struggling to cope with the increasing demands of a rapidly ageing population.

The report, The Future of Aged Care in Australia, was prepared by Access Economics. It outlines the main issues and problems facing the current aged care system: staffing and bed shortages; an aged care system under stress and underresourced; and a worrying decline in the quality of care in nursing homes and in the delivery of services.

Residential aged care staff are projected to increase by around 14.1% by 2020 in contrast to a 56.8% increase in demand.

The report says unless the aged care system undergoes major reform, it will be crippled by burgeoning costs and eventually become unsustainable.

Access Economics quotes some alarming facts on aged care in Australia.

‘The aged care system is experiencing rapid demand growth due to demographic ageing, increases in income and expectations, and increasing prevalence of chronic disease. These factors have led to Treasury estimates that Australian Government spending on aged care will more than double relative to national income over the period of the Third Intergenerational Report [2010 to 2050],’ it says.

‘Residential aged care staff are projected

to increase by around 14.1% by 2020 in contrast to a 56.8% increase in demand.

There is a need for improved wages and conditions to attract skilled staff, better training and advancement opportunities, and a more positive workplace culture.’

National Seniors Chief Executive, Michael O’Neill, says all this spells bad news for consumers.

‘Older Australians are already feeling the effects of a system in decline. In the past five years the ratio of more qualified to less qualified staff has dropped, and the ratio of residents to staff has increased.

‘Not only do nurses get paid $300 a week less in aged care but when the system is run as a business, cost cutting comes in the way of staffing reductions.

‘This situation is unacceptable in a country as advanced and as wealthy as Australia,’ he says.

ANF Secretary Lee Thomas says both the Federal Government and providers play the blame game in aged care.

‘The Federal Government says it pours billions of dollars into aged care each year, providers say it’s not enough.

ANF Secretary Lee Thomas

‘It’s common sense that when you’ve got a $300-a-week wages gap between aged care nurses and nurses working in other sectors people are going to have to make decisions about their family budgets. Many of them don’t want to do that but they have to,’ said Lee.n

KEY POINTS OF THE NATIONAL SENIORS AGED CARE REPORT c Government spending on aged care will more than double relative to national income between 2010 and 2050. c In the past five years quality of care in nursing homes has deteriorated with the ratio of more qualified to less qualified staff dropping and the ratio of residents to staff increasing. c Patients record greater satisfaction and better health outcomes on a number of clinical indicators when

there are higher proportions of Registered Nurses. c In the next 10 years nursing home staff numbers are projected to increase by only around 14% yet demand is set to jump by almost 60%. c There is an urgent need for improved wages and conditions to attract skilled staff, better training and advancement opportunities, and a more positive workplace culture.

THE LAMP OCTOBER 2010 27

s

OCCUPATIONAL HEALTH AND SAFETY

OHS inspection forces Gulgong Hospital closure g GWAHS closes dilapidated Gulgong Hospital due to serious OHS risks – and opens acute services clinic.

A

number of OHS problems at Gulgong Hospital led to it being closed last month. These included a poor duress alarm system, security breaches, and asbestos issues.

But a determined campaign by the local rural community, including NSWNA members at the hospital, resulted in the area health service agreeing to open an acute services centre that would allow the nursing staff to keep their jobs.

Members had been complaining to the OHS department for some time about safety and security problems at the 101-yearold hospital but to no avail. Despite some patching up measures, no money had been spent on capital works for up to 50 years.

28 THE LAMP OCTOBER 2010

‘Members have to work in a safe environment so we have been lobbying the Federal Government and the Health Minister Nicola Roxon to provide Commonwealth funding for a new multipurpose centre to be built on the Gulgong site,’ said NSWNA Assistant General Secretary Judith Kiejda.

NSWNA Delegate at the Gulgong Branch Rebecca Nairne, EEN, said many of the 17 nurses had worked at the hospital for more than 20 years and had pleaded with the Greater Western Area Health Service (GWAHS) to make some improvements to ensure the safety of staff.

‘We all knew the state of the building was quite bad. We’d been asking OHS to get things done for ages but nothing ever got done. We needed new duress alarms and to change the windows from glass to plexiglass, which is shatter-proof,’ said Rebecca.

‘There were issues with our morgue, too. We used to have to walk up to the morgue, which was about 400m up the back of the hospital but you had to go over a footpath, then over a road and it

was all gravel and dirty, and getting the trolley in was a bit of an issue. You’d go to OHS but nothing would get done.’

Working in isolation was another problem for staff. ‘We have a limited number of staff, like any small hospital – usually two in the mornings, afternoons and evenings – but you could be in ED and the other person in the ward with a patient and you wouldn’t be able to hear them if they were in trouble or vice versa,’ said Rebecca.

At the request of members, the NSWNA called in WorkCover inspectors, who visited the hospital in March where they found multiple violations of OHS requirements that put staff at risk.

GWAHS was ordered to carry out a series of improvements, including new duress alarms, replacing all windows with shatter-proof glass, installing security mesh screens, making doors lockable and alarmed and reconfiguring hospital rooms for security reasons.

But GWAHS decided the costs involved in implementing these measures were not practical and closed the hospital on 29 August.

F SPECIAL O R S AI A LS

WIN A

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MB ap

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– Perfect

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The Lamp is offering four lucky readers the chance to win a pair of MBT Sapatu sandal-shoes – valued at $369 a pair.

Gulgong members took part in a determined campaign to save the hospital. Rebecca Nairne, EEN, is pictured second from left.

Thousands of Australian nurses are turning to MBT footwear to prevent back pain and joint injuries, and reduce the discomfort associated with spending extended periods of time on their feet.

Staff – many of whom have had their babies and seen family members die at the hospital – were devastated at the loss to the community, and worried about their jobs.

‘We’d been asking OHS to get things done for ages but nothing ever got done.’

Rebecca Nairne, EEN

GWAHS initially planned to only run a HealthOne clinic offering primary and community services, leaving the majority of staff with the only option of working at Mudgee Hospital.

Although Mudgee is only 23km away from Gulgong, there is no public transport between the two and a taxi costs $70 one way.

However, a community rally, the creation of a Save Gulgong Hospital Facebook page and discussions between GWAHS and the NSWNA resulted in the area health service agreeing to offer acute services at the HealthOne centre.

‘We now have 12 hours Monday to Friday of acute emergency services and eight hours on Saturdays and Sundays.

This is a huge win. It means most of the staff have been accommodated and the community can be treated locally.

It was a big improvement to go from nothing to getting the acute services,’ said Rebecca. ‘And we’ve been told if the multipurpose centre gets up and running we will all have first choice for jobs.’n

Research has shown that wearing MBTs decreases stress on knee and hip joints by 19%; and increases muscle activity by 28% in the buttocks, 37% in the hamstrings and 38% in the lower limbs, compared to conventional footwear*. This makes MBTs ideal for nurses who are constantly on the go.

Available in both black and white, MBT Sapatu sandal-shoes are designed to keep feet cool, dry and comfortable. Like all MBT footwear, the Sapatu has a raised, curved and cushioned sole that spreads pressure over the whole sole of the foot and promotes comfort. The curved sole promotes a slight imbalance, which causes feet, leg and back muscles to constantly make small adjustments to maintain balance. This continuous ‘microexercise’, even when you are standing still, improves blood circulation which constantly regenerates muscles and nerves, greatly reducing foot, leg and back discomfort.

To enter this month’s competition, simply write your name, address, membership number and your shoe size (Australian) on the back of an envelope and send it to: MBT Sapatu competition PO Box 40, Camperdown, NSW 1450.

Competition closes 31 October 2010.

Please note: only one entry per member will be accepted. *According to studies at the University of Calgary, CAN; Sheffield Hallam University, UK; Rennbahnklinik Basle, CH etc. in comparison to conventional shoes.

THE LAMP OCTOBER 2010 29

o t t r e v n Co ct Debit Dire e n

i e h t t W a y y a e t n s d s y l, S riou

& Havnce to a cha

e u t x o u l H a a L i r g Shan

Start paying your NSWNA fees by Direct Debit for the chance to win a two-night stay in one of Sydney’s top five-star hotels, the Shangri-La Hotel, Sydney.

The Direct Debit prize includes two nights’ accommodation in a Horizon Deluxe Grand Harbour View Room with Horizon club privileges, breakfast on the Horizon Club Floor or option of a full hot breakfast on Level 1 of the hotel.

Afternoon tea, evening drinks and Canapes on the Horizon Club Floor are also included, as well as two rescue release treatments in CHI, The Spa to treat and relieve muscle tension in the troubled areas of your body.

Situated in the historic Rocks district within easy walking distance of the city’s main shopping and commercial districts, with breathtaking views of Sydney Harbour, the deluxe five-star Shangri-La Hotel, Sydney, offers the city’s largest guest rooms, all with water views. The Shangri-La Hotel, Sydney, offers a wide selection of dining options and Australia’s first CHI, The Spa.

Here’s how you can win

2Cancel your payroll deductions and start paying your fees

through direct debit and you will go into the lucky draw and/or

2Convince your colleagues to convert from payroll deductions

to direct debit, and you and each of your colleagues who switch to direct debit will go into the lucky draw and/or

2Sign up a new member using the direct debit method of paying

their fees, and you and the new member will go into the lucky draw.

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

Membership Application forms or Direct Debit forms can be downloaded from our website www.nswnurses.asn.au 30 THE LAMP OCTOBER 2010

Alternatively call the NSWNA on 8595 1234 (metro area) or 1300 367 962 (non-metro area) for more information.

s

I N D U S T R I A L I S S U E S

St Vincent’s closes, new hospital opens g Members at St Vincent’s Hospital in Bathurst have won redundancies and new jobs at a day surgery that has opened on the site.

W

hen Catholic Healthcare announced the closure of St Vincent’s private hospital in Bathurst in March this year, staff were devastated. The 62 nurses faced an uncertain future with the possibility of unemployment.

But thanks to a determined campaign by the NSWNA Branch, in conjunction with the local community, all nursing staff have received redundancy pay-outs and the option of new jobs at a day surgery that has opened on the site.

In August a company called Day Procedures Australia leased the premises from Catholic Healthcare to open the new Bathurst Private Hospital. At the time The Lamp went to press, staff were being interviewed and due to start work at the end of September.

NSWNA Assistant General Secretary Judith Kiejda hailed the successful outcome. ‘This is a big win in that staff have ongoing employment and all nurses have secured redundancies,’ she said.

Helen Price, an RN who has worked at St Vincent’s for 10 years, said members were happy with the positive outcome.

‘We are pleased Catholic Healthcare agreed to pay us redundancy packages.

They gave us a 3.5% pay increase in July so they will pay the redundancies with the increase. This includes casuals who have been working for five years or more,’ Helen told The Lamp.

‘The redundancy pay-out has been calculated for permanent part-timers for an average of their hours up to the last pay packet in August. They are averaging the hours rather than going by contract

hours because many of us do extra hours outside of our contract. That is fair and everyone is happy with this outcome.’

Some stability ensured Although most of the staff have been offered fewer hours than they originally had at St Vincent’s, they nevertheless face a more stable future.

‘I have been offered permanent part-time hours. They are not the hours I want but the new owners can’t sign off on hours until they know how busy they are going to be,’ said Helen.

‘We’ll be offered fewer hours but with extra shifts. It’s a foot in the door and we’ll go from there. It’s a much better outcome than we originally anticipated a few months ago when the closure of St Vincent’s was announced.’

After Catholic Healthcare was forced to announce the hospital’s closure in March when the media got wind of the news, the Association organised a rally, which was attended by around 250 nurses as well as members of the local community.

The NSWNA called on the State Government to release new funding from the Treasury to open the 15 beds at Bathurst Base Hospital that were closed several years ago, which would allow the hospital to employ more staff, including those from St Vincent’s. Bathurst Base has since opened five beds with the aid of Federal funding (see story page 19).

Union Officials met with State MP Gerard Martin and were instrumental in setting up a working party comprising key stakeholders to consider options for the community and nurses.

‘The Association took part in a lot of negotiations to make sure we didn’t miss out on our redundancy packages, to make sure Catholic Healthcare were fair and to make sure long-term casuals didn’t miss out,’ said Helen Price. ‘The Union was very, very helpful. It’s been worth all the hard work to get a very good result. It goes to show that when things get tough, it’s worth sticking it out.’

The NSWNA has just begun negotiations with the owners of Bathurst

‘The Association took part in a lot of negotiations to make sure we didn’t miss out on our redundancy packages, to make sure Catholic Healthcare were fair and to make sure long-term casuals didn’t miss out.’

Helen Price, RN, St Vincent’s Hospital

Private Hospital about awards and a possible Enterprise Agreement.

It is understood Daycare Procedures Australia will continue to lease the current premises for the next 18 months while investing their capital expenditure into building a new facility.n THE LAMP OCTOBER 2010 31

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Q & A

ASK

JUDITH

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

Constantly short staffed I work in an aged care facility where we are constantly short staffed.

Management have now advised that any nurse on sick leave will not be replaced unless it is the one RN on duty.

We are taking short cuts, feel we are not providing the best care to our residents and it is only a matter of time before a resident is harmed in some way. What can we do about getting more staff?

Your employer has an OHS obligation under the Occupational Health and Safety Act 2000, part 2 division 1 section 8.1 to both the employees at the facility and the residents and a duty to provide good appropriate and adequate care to all residents. The Act states ‘an employer must ensure the health, safety and welfare at work of all employees of the employer’.

If you have a Branch, ask for a Branch meeting to discuss this issue with all the Branch members. If you don’t have one you might consider forming one and calling the NSWNA to assist you.

You need to be collecting statistics about the number of staff on duty, the number off duty, the sick leave not replaced, breaks not taken, overtime paid and unpaid, duties not attended, any incidents due to lack of staffing.

Your Branch then needs to take these statistics to management to ask for more staff. You should also write a letter to your OHS committee asking for a risk assessment, attaching a copy of your statistics.

Rostered on but not paid sick leave I am an RN in a private hospital with a permanent part-time contract of employment. I often work above my contracted hours when my ward is short-staffed and these extra hours are written into my roster each fortnight. I recently had to call in sick before one of these ‘above contract’ shifts but my manager isn’t paying me sick leave. Is this correct?’

No. If those shifts have been rostered you should be paid sick leave if you are not fit for duty. All the major private hospital employers include a provision in their union collective agreement which notes that rosters cannot be changed ‘merely by reason of the fact that they are on sick leave’. Consequently, you should be paid sick leave for rostered ‘above contract’ shifts.

Retirement age but entitled to Workers’ Comp I work as an RN in a private hospital and was recently injured while on duty.

As I am past retirement age I was told it was no use putting in a WorkCover claim and to use my accrued leave. Is this correct?

No, this is not correct. You are entitled like any other worker to make a Workers’ Compensation claim where work is a major contributing factor to an injury.

Under the Workers Compensation Act 1987, section 52 (2) (b) states, if a person

‘receives an injury on or after reaching the retiring age – a weekly payment of compensation shall not be made in respect of any resulting period of incapacity for work occurring more than 12 months after the first occasion of the incapacity for work resulting from the injury’.

That is, if your claim is upheld you are entitled to compensation payment up to a maximum of 12 months. You should therefore immediately lodge a claim with your employer’s insurers.

Need an updated police check I work in aged care and have been told I need an updated police check. I have arranged and paid for this myself but it hasn’t arrived yet and my employer says I can’t work until the new certificate is received. Is this correct?

It is a condition of employment that all existing staff members have a police certificate that is less than three years old.

That is, an updated certificate needs to be provided every three years.

However, the Accountability Principles that apply to aged care providers stipulates at 1.23 (b) that an approved provider must ensure that ‘if there is no such police certificate, an application for a police certificate has been made’.

Therefore, you can continue to work provided you supply your employer with a statutory declaration that you have made an application to obtain a police certificate.n

SYDNEY HEALTH LAW Sydney Law School offers Australia’s leading specialist program in health and medical law. Available to health professionals and non-lawyers, our programs can help improve your career opportunities in nursing and health care management.

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Choose from: - Graduate Diploma in Health Law - Master of Health Law - Graduate Diploma in Public Health Law

For more information visit: sydney.edu.au/law/health THE LAMP OCTOBER 2010 33

s

N U R S E S O N L I N E

What’s hot on Nurse Uncut g Between the Flags, agency nurses, what nurses are talking about in the Nurse Uncut forums – and don’t forget to check out Nurse Uncut for details on our latest contest!

HOT TOPICS Your thoughts on ‘Between the Flags’ www.nurseuncut.com.au/ between-the-flags-your-thoughts/ The launch of the standardised observation chart with a colour-coded warning system, dubbed ‘Between the Flags’ was implemented at all NSW hospitals this year.

The program was dubbed ‘Between the Flags’ because it was based on the way Surf Life Savers keep watch over us and ensure we remain within safe boundaries.

Research into health systems around the world shows that some warning signs can be recognised earlier. Tell us what you think on Nurse Uncut.

Is agency nursing for you?

Nursing overseas

www.nurseuncut.com.au/ is-agency-nursing-for-you/

www.nurseuncut.com.au/ leaving-on-a-jet-plane/

Agency nursing, whether working for an agency full time, or part time as a way to supplement your core job, means nurses can be flexible with choosing what shifts they want to work, and where.

Agency nursing allows nurses to have control over their schedules and assignments, which, in turn, can allow them to focus more on patient care than on facility politics.

But what are the advantages and disadvantages of being an agency nurse?

Share your views on Nurse Uncut.

There are many positive reasons for wanting to nurse overseas, including the challenges of working and living in another country with a different culture.

It is important to understand how the health sector in a country is organised. There may be very different working practices for nurses, even in developed countries. Learning the language of the country will be important as it will be difficult to practise safely and completely without a good command of the host language.

What advice do you have for nurses wanting to work overseas? Share your views on Nurse Uncut.

And don’t forget to check out Nurse Uncut for our latest October competition!

You can find all the details at: www.nurseuncut.com.au

WHAT ARE NURSES TALKING ABOUT? Problems with an agency shift

Thoughts on the ‘Essentials of Care’ program

www.nurseuncut.com.au/component/option,com_ccboard/ Itemid,24/forum,13/topic,449/view,postlist/#ccbp3130

www.nurseuncut.com.au/component/option,com_ ccboard/Itemid,24/forum,13/topic,539/ view,postlist/#ccbp3114

‘

Last night I did an agency shift at a private hospital in my area.The staff rostered on was myself as an agency RN and another agency RN.The person in charge was one of the regular hospital staff from that ward. Around midnight I was checking out morphine with her and she asked me to go give it. I was a little surprised; she said she cannot as she is an EN. I was a little upset because I believe had anything gone wrong, it would have been on the head of us two agency RNs.We were not even informed, and because the EN carried the DD keys all night, I only assumed she was an RN at the start of the shift.

34 THE LAMP OCTOBER 2010

’

‘

The intention is noble and great. It is a wonderful opportunity to really change the workplace.

Unfortunately, the change is so great that the staff feel like they are on a “runaway train”. Nobody I work with is against change. Change is occurring every day.

But the speed is leaving us exhausted and cranky.

Tell us your views on the Nurse Uncut forums!

’

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NURSING RESEARCH ONLINE

Assessing the cost effectiveness of prevention g A major report on preventing illness in Australia has applied an economic cost-benefit analysis to identify which prevention measures are worthwhile and which aren’t providing value for money.

The Assessing Cost Effectiveness project is a unique study involving 130 health experts who assessed 123 illness prevention measures.

‘This is probably a world first in terms of the number of interventions that we looked at: 150 interventions across a whole range of risk factors and disease groups. So in many ways this is path-breaking research that was funded by our National Health and Medical Research Council.’

Rob Carter, Professor of Health Economics, Deakin University

The Assessing CostEffectiveness in Prevention report was launched on 8 September 2010 The Assessing Cost-Effectiveness in Prevention (ACE Prevention) is a large, five-year study that was funded by the National Health and Medical Research Council (NHMRC) and jointly led by Professor Theo Vos of the Centre for Burden of Disease and Cost-Effectiveness at the University of Queensland and Professor Rob Carter of the Deakin Health Economics Unit at Deakin University.

The overall aim of this project was to provide a comprehensive analysis of the comparative cost-effectiveness of preventive intervention options addressing the non-communicable disease burden in Australia, with a specific focus on Indigenous Australians.

ACE Prevention is the most comprehensive evaluation of health prevention measures ever conducted worldwide, involving input from 130 top health experts.

The research team assessed 123 illness prevention measures to identify those that will prevent the most illness and premature deaths and those that are best value for money. For comparison purposes, 27 treatment interventions were included. www.sph.uq.edu.au/bodce-aceprevention

Report calls for value for money on preventative health PM with Mark Colvin, ABC News, 8 September 2010

A major report has come up with a list of measures it says could prevent a million premature deaths. The aim was to work out what spending was worthwhile and what wasn’t. Among the measures deemed worthwhile were a junk food tax, lap-band surgery for the obese, and screening Indigenous Australians for diabetes and chronic kidney disease by the age of 25. The measures the report says should be dropped include some screening programs for prostate cancer, and illicit drug education in high schools.

Health experts have welcomed the report but aren’t sure whether many of the programs will win the support of the minority Federal Government. www.abc.net.au/pm/content/2010/ s3006411.htm

ACE Prevention pamphlets Each pamphlet gives a brief overview of one of the topics in ACE Prevention.

Below are some examples of topic areas.

Cost-Effectiveness of Skin, Cervical and Prostate Cancer Prevention and Breast Cancer Treatment.

Main messages from this topic are that

the current cervical cancer screening program would become more efficient if the starting age is raised to 25; or the screening interval is extended to three years; or a more accurate screening test is used. Also that HPV vaccination of 12year-old girls in Australia is cost-effective if accompanied by a screening program with a starting age of 25 and/or a threeyear, instead of two-year interval.

Cost-Effectiveness of Preventive Interventions for Adult Depression

Key messages from this topic are that screening in general practice for early signs of depression followed by brief interventions is cost-effective and could avert up to 20% of the burden of depression.

Cost-Effectiveness of Alcohol Interventions

Intervention to prevent alcohol-related disease and injury is highly cost-effective: a package of seven preventive interventions could achieve a 31% reduction in the harmful and hazardous health effects of alcohol. Although the current practice of random breath testing in Australia is cost-effective, if the $71 million that is currently spent on random breath testing could be invested in more cost-effective interventions, over 10 times the amount of health gain could be achieved.n www.sph.uq.edu.au/aceprevention-pamphlets THE LAMP OCTOBER 2010 35

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OCCUPATIONAL HEALTH AND SAFETY

Duress alarm win at Prince of Wales g Staff in the acute mental health unit and ED at Prince of Wales Hospital are delighted with their new duress alarm system, which offers a higher level of safety than existing models.

A

new duress alarm system has given staff at the Kiloh unit and ED at Prince of Wales Hospital peace of mind when it comes to their safety.

The system – which has additional safety features to the basic models previously installed at the hospital – came about after a sustained campaign by the NSWNA’s OHS officers and Branch members.

Kiloh, the acute mental health unit, had problematic duress alarms for several years. After a major incident in which a malfunctioning alarm meant the response to come to the aid of a staff member was delayed, the situation came to a head.

South East Sydney Illawarra Area Health Service (SESIAHS) investigated the incident, and its own risk assessment recommended a new duress alarm system as the existing one did not comply with Health Department guidelines and did not work properly.

The area health service sought quotes but there was a considerable delay, so the Branch became active in pursuing the issue.

ED nurses had also been trying to secure a new duress alarm system for several years.

‘The ED nurses only had the alarms you hang around your neck, which are a risk in themselves, and they weren’t even connected to the security team, so they were pretty much useless,’ said NSWNA Assistant General Secretary Judith Kiejda.

‘It puts a lot of stress on staff who are trying to find someone who is having a major problem, because the alarms would send people to the wrong area. And, of course, it adds to the stress of the person having the problem not knowing if someone will come to their aid.’

during a consultation process – had been ordered for both departments.

Barbara Daly, NUM in ED, said staff are very happy with the new alarms.

‘It’s a more sophisticated device than we had previously, so the capability and cover are a huge improvement for us. It’s fully integrated and has more capabilities than the basic models, such as a ‘man down’ feature. There’s also voice activation on it, which enhances individual safety. It’s a much-needed safety device for staff.’

In the past, staff were cautious of how they managed patients who could present as a risk to them, according to Barbara.

‘We had to look at where we put people and took into account the visibility of these types of patients. When you’re looking after someone who may be behaviourally challenged, you can’t leave them in isolation; you have to have a visual cue on them.

‘The new alarm system has been a much appreciated gain and staff are really happy about it. It’s a reassurance to us that

‘It’s a much-needed safety device for staff.’

Barbara Daly, NUM, ED, Prince of Wales Hospital.

Collaboration between the Branch, the OHS officers at the NSWNA and SESIAHS management resulted in the new duress alarm system being prioritised.

At the time The Lamp went to press, the new system – approved by nurses

these devices offer much more in terms of protection than what we had previously.’

The NSWNA understands that SESIAHS is looking at implementing a priority plan of installing the new duress alarm system across the entire area health service.n THE LAMP OCTOBER 2010 37

s

F I G H T I N G

F I T N U R S E S

Sleep tight when doing nights g Night shift can play havoc with your sleep patterns.

For nurses juggling shift work and busy lives, here’s what you can do to make sure you maximise your quantity and quality of sleep.

R

esearch shows the average night shift worker loses around one to two hours of sleep every day. Humans are not naturally nocturnal, and constantly switching from day to night duty can result in poor-quality sleep that can lead to health problems.

‘The most important thing to realise is most people don’t really adapt so they don’t become nocturnal,’ says Dr Delwyn Bartlett, co-ordinator of medical psychology at the Woolcock Institute of Medical Research.

‘The average person is sleepy at night and more alert during the day. Anecdotal evidence of case histories suggests it takes 70 days and 70 nights for the average human to become nocturnal so the average person won’t do it, even if they are on full-time night shift because they have a day off, so they are constantly pushing against their sleep-wake clock.’

To sleep at night you need a falling body temperature, but anyone who has

‘When going home in the morning you should wear sunglasses because light in the morning is not helpful for you.’

Dr Delwyn Bartlett

done night shift knows that towards the morning you get cold and sleepy and find it hard to concentrate.

‘By the time night shift workers go home in the morning they are starting to wake up,’ says Dr Barlett. ‘Even though they are exhausted, their brain is telling them to wake up for the rest of the day.’

We all go through various stages of sleep, with each cycle having its own benefits.

‘During deep sleep or slow wave sleep, you’ll get the secretion of growth hormone, which provides the

DOs AND DON’Ts DO:

DON’T:

c Make your bedroom as dark and cool as you can

c Answer the phone

c Wear an eye mask c Wear ear plugs c Use a fan or set your air conditioner to turn on at lunch time c Go for a walk in the late afternoon c Wear sunglasses when you leave work c Turn your phones off c Eat healthy food and drink plenty of water at work (See the March 2010 issue of The Lamp for tips on healthy eating).

38 THE LAMP OCTOBER 2010

c Check your email when you get home c Drink tea or coffee or eat junk foods on night duty c Organise too much activity during the day.

opportunity for the body to repair damaged cells as the brain shuts down, especially the front part of the brain,’ says Dr Barlett. ‘What people seem to miss out on is dream sleep and stage two sleep, which is light sleep. We are still learning about the significance of stage two sleep.’

Night shift workers miss out on the lengthy sleep that comes after doing day shifts. This is due to the body temperature becoming warmer as the day goes on and also because external noises are likely to disturb sleep.

So what can nurses who are rostered on night duty do to maximise the quantity and quality of their sleep?

‘It’s good to get an afternoon bright light so go for a walk in the late afternoon after you have woken up if you can because it delays sleep onset,’ says Dr Bartlett. ‘You want light at work too – bright for the first half of the shift and in the latter half the perfect circumstance is reduced light.

‘When going home in the morning you should wear sunglasses because light in the morning is not helpful for you. If you can, don’t do the washing or take the kids to school. The optimal situation is for you to go home and go to sleep straight away while your body temperature is cool.

‘Use sleep masks and if the room gets a lot of light, blue-tack some black rubbish bags to the window to make it as dark and as cool as you possibly can. Use white noise such as a fan, unplug your landline telephone and turn your mobile off,’ says Dr Bartlett.n

Fighting fit nurses’ tips for successful sleep Straight to bed, no distractions Theresa O’Leary is a midwife who does rotating shifts, including nights, at Royal Prince Alfred Hospital in Sydney. She’s single and goes to sleep as soon as she gets home.

wear ear plugs and I’ve got a very good eye mask that’s very dark and comfortable. These help a lot, especially the ear plugs.

‘I put my mobile phone on silent.

That’s a shift work strategy for me.

I don’t have a landline phone in the house and in the past when I have had one it’s been unplugged.

‘I’m able to come home and go straight to bed. I’m always exhausted in the morning so I go to bed and get my best sleep in the morning – I’ll get about four hours. If you have a break at night when you’re at work, snooze for an hour in the chair so the hours of sleep add up.

‘I

‘Don’t do anything that will stop you sleeping when you get home – like checking your emails and try not to organise to do too much when you’re on night duty. I find I sleep in the morning, wake during the afternoon, then probably get a couple more hours sleep in the evening, so try not to pack too much in so you can get the sleep when you need it – no mega shopping sprees!

‘Be organised about the food you eat. Bring healthy meals in to work.

At 4am you always feel dreadful and a cup of coffee or cakes and biscuits won’t help you sleep.’

Exercise helps me sleep Donna Hopkins is an RN who works in the psychiatric unit at Nepean Hospital. She has worked permanent night shift for the past four years as it allows her to juggle her work/life balance with three young children. use exercise to help me sleep. I do a lot of running around with the kids but I also go to the gym four or five times a week to do kick boxing.

‘I finish my night shift 7.30am. I go home and get the kids ready for school and drop them off at 9am. Then I go to a 9.30am kick boxing class, which finishes at 10.30am, so I go home and go to bed. I’m pretty exhausted by then. I get about four or five hours of sleep, except if someone gets the blower out and does their lawn, but generally I’m out like a light and wake up when my alarm goes off to collect the kids from school.

‘I don’t wear an eye mask as my room is pretty dark. In the summer it’s more muggy and more difficult to get off to sleep, so I usually set the timer on the air conditioner so it comes on around lunch time when the weather really starts to warm up.

‘I take the landline phone off the

‘I

hook. I do have the mobile beside me and switched on in case of an emergency with the kids but I tell people not to call me on the mobile unless it is an emergency.

‘I don’t drink any coffee. I have a health drink in the morning to get me through the kickboxing class. I recommend drinking plenty of water when on night shift. Because of the air conditioning you get dehydrated. Tea and coffee are no good as they act as a diuretic so you go to the toilet all the time and this doesn’t help you sleep.

THE LAMP OCTOBER 2010 39

40 THE LAMP OCTOBER 2010

s

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

NSWNA Branch News g NSWNA members get active in campaigns and protests, and celebrate achievements.

ormation Base listened to an inf Nurses from Tamworth rt of the pa as , spital’s auditorium session held in the ho ll mix ski d an ng ign for safe staffi Association’s campa ratios roadshow.

Surgical nurses at Armidale read up on the Safety in Numbers for Safe Patient Care document during the recent roadshow when NSWNA organisers visited hospitals across the State.

Students studying for their diploma in Enrolled Nursing at Dubbo TAFE were excited to join the NSWNA as associate members. (Associate membership is now free for students for the length of their course – for more information ring the NSWNA.) Aged care nurses at Beecroft Nursing Ho me created a placard encouraging their col leagues to fight for be tter pay and condition ‘Do Nothing = Get No s: thing’.

THE LAMP OCTOBER 2010 41

s

A T

T H E

M O V I E S

Gainsbourg g The life and loves of rebellious French artist, singer and songwriter Serge Gainsbourg come under the spotlight.

Our reviewers and tipsters receive a delightful ABC Classics CD for uplifting enjoyment!

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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 Anni Cameron, Clinical Co-ordinator, Nursing Section, St George College of TAFE

T

his film centres on the life of the French artist, singer and songwriter of the ’60s, Serge Gainsbourg. Born Lucien Ginsburg of Russian Jewish parents, as a young man his friends persuaded him to change his name to the more appealing Serge Gainsbourg.

In the opening sequences, the young child Serge is rejected by a little girl on a summer beach as ‘too ugly’ with his hooked nose and prominent ears.

The film then switches to his wartime childhood in German-occupied Paris.

There he reacts against his father’s harsh determination to turn him into a classical musician. His later tendency for épater les bourgeois (shocking the middle classes) and other rebellious ways is shown at a young age by being the first person to turn up and demand his yellow star before other Jewish citizens start forming a queue.

The grim atmosphere of the time makes an indelible impression on the young Serge. Anti-Semitic posters that line the streets conjure up images that continue 42 THE LAMP OCTOBER 2010

to habitually follow him throughout the rest of his life. Initially a rather grotesque, cartoon-like Humpty Dumpty caricature follows him around during his youth but morphs into a more mockingly elongated, suave beak-nosed caricature as Serge matures. With praying-mantis limbs this caricature becomes his imperious alter ego. Does it pose the possibility of Gainsbourg, with his surges of creativity and grandiose (later dissolute) behaviour, being in a long line of creative individuals throughout history who have flown under the diagnostic radar? Bipolar disorder?

Gainsbourg is shown as a compulsive illustrator and budding artist yearning to become a great painter. His precocious interest in painting, music and sex merge when he attends a life class where he’s supposed to keep his back to the nude model. Later he engages the model and takes her to a bar for a drink where he meets an elderly music hall chanteuse, enthusiastically singing along with her to her biggest hit: a naughty number called ‘Coco’. The scene is set for things to come.

The film is rather vague in its treatment of the war and in its aftermath. Eric Elmosnino (who bears an uncanny resemblance to the real Gitane chain-smoking iconoclast) takes over as the charismatic, heavy-drinking Gainsbourg, painter, performer, lover and composer viewed through a kaleidoscope of ever-changing genres.

The film focuses on his affairs and alliances with Brigitte Bardot and Jane Birkin, with scant attention paid to his earlier marriages. However, the film also assumes the audience will know who all the main French pop culture characters from the ’60s and ’70s are. Laetitia Casta, amusing as Bardot, flounces around Serge’s apartment wrapped in a sheet, charming his awed parents. Birkin is portrayed fetchingly and playfully by Lucy Gordon. In one scene, Serge’s music producer warns them both that their still well-known erotic duet ‘Je t’aime … moi non plus’ (performed in the original version) could land them in jail – such were the social mores of the French establishment at that time.

One of the most pleasing aspects throughout the film is the music whereas, despite the great cinematography, the highly graphical and visual cartoon fantasies tend at times to be a distraction.

Towards the end, as the smoke-enveloped Gainsbourg becomes increasingly dissipated, the film itself feels heavier and more ragged and lacking in that certain je ne sais quoi that enables the viewer to leave feeling nicely satisfied.n Gainsbourg opens on 4 November.

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RED g The ‘oldies’ are the stars of this enjoyable bigaction, humorous flick.

Review by Wayne Lynch, RN, Kirketon Road Centre and CNC, Concord Drug Health Services.

Colourful Necessities Watches | Scissors | Torches | Diaries | Reference Cards

R

ED (Retired Extremely Dangerous) stars Bruce Willis, Helen Mirren, Morgan Freeman and John Malkovich as a group of retired CIA operatives and an ex-KGB agent, who come out (of retirement) fighting, when they find themselves targeted by some of their own people.

Some Generation ‘Wise’ people leaving the cinema afterwards said: ‘Old people trying to be groovy.’ (‘Hmm,’ I thought. ‘Young people trying to be cynical?’)

Willis leads this big-action, no brainer movie with lots of (Hollywood) blood shed, car chases, explosions and so on.

There’s a fair bit of violent fisticuffs: shoot me, drop a CEO’s table on me from a great height, throw me through a plate glass window and I’d probably need a few months recovering in hospital (though with the current public hospital bed situation I’d probably only be kept overnight) but not our combatants – they shrug such things off.

There’s good support from Richard Dreyfuss, Ernest Borgnine and Julian McMahon (in a small but humorous – for Aussies – political role) and Mary-Louise Parker (whose role seems underwritten and whose romance with Willis seems manufactured).

Underwritten, or not, the ‘old people’ eat up the script, spit it out and look like they’re having fun doing it. I’m nailing my colour to the mast, and it’s RED.n RED opens on 28 October.

GIVEAWAYS

FOR NSWNA MEMBERS

The Lamp has 30 double passes to the preview of Gainsbourg and 5 movie packs to RED (each consist of a double passes and a limited edition RED t-shirts). To enter, email lamp@ nswnurses.asn.au with your film preference, name, membership number, address and contact number. First entries win!

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THE LAMP OCTOBER 2010 43

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B O O K S

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On Radji Beach: The Story of Australian Nurses After the Fall of Singapore

Book me Mosby’s Pathophysiology Memory NoteCards: Visual, Mnemonic, and Memory Aids for Nurses (2nd ed.)

By JoAnn Zerwekh, Jo Carol Claborn, Tom Gaglione, Miller and Ashley Garneau, Elsevier Health Sciences, RRP *$30.50 : ISBN 9780323067478 Mosby’s Pathophysiology Memory NoteCards is a set of colourful cards designed to help you learn and remember pathophysiology. With 96 fullcolour cartoons covering pathophysiologic concepts, they use humour and mnemonics to make review easier and more fun.

These cards are useful in preparing for the NCLEX[registered] or classroom exams, as a clinical reference, for writing care plans, or for patient teaching information.

ECGs Made Easy – Book and Pocket Reference Package (4th ed.)

By Barbara Aehlert, Mosby (available through Elsevier Australia), RRP *$87:00: ISBN 9780323069243 ECG’s Made Easy offers clear explanations and plenty of practice exercises that make it easier than ever to understand and interpret basic dysrhythmias. Each ECG rhythm includes a sample rhythm strip and a discussion of possible patient symptoms and general treatment guidelines.

Student-friendly features include ECG

Pearl boxes with insights based on realworld experience, and Drug Pearl boxes highlighting medications used to treat dysrhythmias. This package includes a handy pocket reference for on-the-go access to the most essential information, plus a plastic heart rate calculator ruler for fast interpretation of rhythms.

Mosby’s Guide to Nursing Diagnosis (3rd ed.)

By Gail B. Ludwig and Betty J. Ackley, Mosby (available through Elsevier Australia), RRP *$49.00 : ISBN 9780323071727 This pocket-sized reference is ideal for use in clinicals, in class, and at the bedside. A condensed version of the Nursing Diagnosis Handbook, 9th Edition, Mosby’s Guide to Nursing Diagnosis uses a quick-access format to help students make nursing diagnoses and write care plans with confidence and ease. It includes the most recent NANDA-I approved nursing diagnoses, suggested nursing diagnoses for over 1,300 patient symptoms, and a guide to creating care plans including desired outcomes, interventions, and patient teaching.

Perioperative Safety

By Donna S. Watson, Mosby Elsevier (available through Elsevier Australia), RRP *$49.00 : ISBN 9780323069854 Perioperative Safety helps you reduce risk in a setting where even small errors can lead to life-threatening complications. Expert author Donna Watson addresses essential safety principles and concepts, covering

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.

Me are based on information received and have not been independently reviewed.

For borrowing information, contact Jeannette Bromfield, 8595 2175, jbromfield@ nswnurses.asn.au or Cathy Matias, 8595 2121, cmatias@nswnurses.asn.au

PUBLISHERS’ WEBSITES

Disclaimer: Some of the items featured in Book

Reviews by NSWNA librarian, Jeannette Bromfield.

c c c c

Elsevier Australia: www.elsevier.com.au Elsevier Health: www.elsevierhealth.com Lippincott Williams & Wilkins: www.lww.com Macmillan Australia: www.macmillan.com.au

By Ian W. Shaw, Macmillan Australia, RRP *$34.99 : ISBN 9781405040242 On Radji Beach tells the story of the 65 nurses from the Vyner Brooke, a coastal freighter that was used to help evacuate Singapore after it fell to the Japanese on 15 February 1942. The unfortunate events that followed saw the freighter bombed, with 21 out of the 22 nurses who were among the survivors killed by the Japanese rather than accepting their vote to surrender.

The remaining nurse who survived, Vivian Bullwinkle, brought the truth about this atrocity to light, and went on to experience the internment camps, starvation and disease that took away many of her friends. patient safety with topics such as the latest safety strategies and initiatives, perioperative safe medication use, preventing infections, anaesthesia safety, normothermia management, and electrosurgery. Case studies show the application of safety concepts in real-world situations.

Rapid Assessment: A Flowchart Guide to Evaluating Signs & Symptoms

By Lippincott, Williams and Wilkins RRP *$29.95 : ISBN 158255272X Rapid Assessment: A Flowchart Guide to Evaluating Signs & Symptoms is a unique, practical handbook of flowcharts. Succinct clinical information is a time-saving aid to the quick and accurate assessment of 200 common signs and symptoms. Arranged alphabetically on easy-to-scan, two-page spreads, bulleted information about possible diagnoses, treatment, and patient counselling leads the nurse through the assessment process.n *Price in Australian dollars at time of printing THE LAMP OCTOBER 2010 45

Post-graduate Diploma in Mental Health Nursing in Canberra (Full Scholarship)

First Semester February Intake – 2011 ACT Health through Mental Health ACT (MHACT) has developed a program for Registered Nurses (RNs) to gain post-graduate mental health nursing qualifications.

Registered Nurses who undertake the program are: • Paid while they study; • Guaranteed a scholarship to cover course fees; • Well supported • Eligible for a qualification allowance on completion and; • Able to fast track their nursing careers.

The Post Graduate Diploma in Mental Health Nursing is an excellent means by which RNs can build their knowledge and skills base in caring for people experiencing a range of mental health conditions. The program is clinically based and provides RNs with part-time paid employment with MHACT for 12 to 18 months in Canberra, while they study through the University of Canberra.

Eligibility/other requirements: Registered or eligible for registration with the Nursing and Midwifery Board of Australia and Drivers licence. Applicants need to be an Australian Citizen or have permanent residency to apply.

Living in Canberra offers a culturally diverse lifestyle and stimulating environment with all the benefits of a city while retaining its rural personality. It is an ideal place to educate and bring up a family.

For information on the selection criteria please go to the ACT Health Website at www.health.act.gov.au

During the program, RNs rotate through a range of diverse clinical services, including crisis assessment, acute inpatient, rehabilitation, community adult, child and adolescent and older persons as well as placement options with specialist teams.

Contact Officer: Natalie Robinson (02) 6205 3661 or natalie.robinson@act.gov.au

Closing Date: 5 November 2010

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46 THE LAMP OCTOBER 2010

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CRoSSWoRD

Test your knowledge in this month’s nursing crossword.

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1. Inflammation of the lungs (9) 6. Injury resulting from tensile force to muscle (6) 9. The part of the trunk that lies between thorax and pelvis (7) 10. The cellular membrane lining the central canal of spinal cord and brain ventricles (8) 11. Necessary, indispensable (9) 12. A passage or channel (6) 14. Umbilical hernia (14) 16. Spleen (4) 17. Removal of foreign materials from a wound or burn (11) 19. The most abundant steroid in animal tissues (11)

21. Hirsute (5) 22. A rare and usually harmful gene, not necessarily generated recently (6) 24. A U-shaped bone at the base of the tongue that supports the tongue muscles (5) 26. To withdraw fluid from a cavity (3) 28. Excretion of lactose in the urine (10) 29. Yellow-fever mosquitoes (5)

s

DOWN

1. Dummy medication or treatment (7) 2. The internal bony framework of the body (12) 3. The tendency of an object in motion to continue in motion (8) 4. Incapable of independent existence (9)

5.

6.

7.

8.

Devoid of cells (9) Destructive to spermatozoa (11) Glowing (7) International Confederation of Midwives (3) 13. Hygienic (8) 15. Intoxicated, especially by alcohol (10) 16. Relating to tears (8) 17. Inflammation of a ligament (8) 18. Respired air (6) 20. Oiliness (6) 23. Brissaud disease, habit spasm (3) 25. A nucleic acid that contains the genetic instructions used in the development and functioning of all living organisms (3) 27. A fluid product of inflammation (3) Solution page 49 THE LAMP OCTOBER 2010 47

NSWNA Branch Officials’ & Activists’ Training Program 2010

DIARY DATES Conferences, seminars, meetings SYDNEY, HUNTER & ILLAWARRA Solace Association – 12th National Solace Grief Conference 8-9 Oct, Vibe Hotel, Goulburn St, Sydney.

Contact: Ken, 9529 4805/ Margaret, 4655 1575 or solace@gmail.com Postgraduate Information Evening Sydney Nursing School 13 October, 6-8pm, University of Sydney.

Contact: http://sydney.edu.au/nursing Australasian Rehabilitation Nurses Association 20th Annual Conference 14-15 Oct, Novotel North Beach Hotel, Wollongong. Contact: Penny Kearney, 9808 9385 or Penny.Kearney@royalrehab. com.au, www.arna.com.au/edu.html Cardiac Cath Lab Nurses’ National Conference 16-17 October, Bimet Lodge, The Junction, Newcastle. Contact: Nessie Duff at duffn@ramsayhealth.com.au Ausmed Conference • ‘Understanding CPDs’: 18-19 October, Quality Hotel Cambridge, Surry Hills.

• ‘Working in teams & effectively dealing with conflict’: 28-29 0ct, Quality Hotel Cambridge, Surry Hills.

• ‘Psych Nursing Assesment Skills’: 11-12 Nov, Quality Hotel Cambridge, Surry Hills.

• ‘Safety at Work – Dealing with Highly Unpredictable Situations & Behaviours’ for Nurses & Allied Health Workers: 9-10 December, UTS. Cost: $451.

Contact: (03) 9375 7311 or www.ausmed.com.au

4th Bi Annual Eastern Dementia Network Aged and Dementia Care Symposium 22 October, Batemans Bay RSL Soldiers Club, 8.30am-4pm. Cost: early bird $30 before 24 Sept/ $40 after Contact: Cathie Crowe, 0448 364 282 ‘A Way with Pain’ Professional Development One Day Conference Focus on acute pain management, counts as 4.5 continuing prof. dev hrs.

29 October, Lilyfield Contact: Sue Lee, 9113 2381, Susan. lee@sesiahs.health.nsw.gov.au Kidney Health Australia National Fundraiser Big red BBQ ‘Racing to Save Lives’ 30 Oct, Sydney Turf Club, open to the public.

Contact: www.bigredbbq.com.au Nurses Christian Fellowship Conf.

1 Nov, Notre Dame University, Darlinghurst.

Contact: Jane, 9449 4868 Wound Care Association of NSW Conference & 1 Day Workshop 5-6 Nov, Merimbula RSL. Contact: 0428 922 679 or www.wcansw.com.au All About Kids, Organ and Tissue Donation in Paediatrics 29 Nov, The Children’s Hospital Westmead Contact: Karen Joy, 9382 4872 or Karen. joy@sesiahs.health.nsw.gov.au

Confused Older Person’ 3 Dec, 8am-4.30pm, Liverpool Hospital Auditorium. Contact: Rachna Garg, 9887 5728 or rgarg@nsccahs.health.nsw.gov.au

’Negotiation and Advocacy Part 1’ Wednesday 17 November. ’Negotiation and Advocacy Part 2’ Wednesday 17 November.

Venue: NSWNA Camperdown.

RURAL Community Nurse Audiometrists Association Inc, 28th Annual Conf.

– ‘Hearing Through the Years’ 20-22 October, West Diggers Tamworth.

Contact: Kathy Challinor, 0428 667 502, www.cnaa.org.au Midwives on the Tweed Annual Education Day 25 Oct, 8am-4.30pm, Tweed Heads Bowling Club. Contact: Donna, 0414 311 066 or midwivesonthetweed@iprimus.com.au INTERSTATE AND OVERSEAS National Forum on Safety and Quality in Health Care – ‘Society, Regulators and Health Providers: a clash of expectations?’

25-27 October, National Convention Centre, Canberra. Contact: www. sapmea.asn.au/forumsqhc2010 Change Champions’ Masterclass Radical Health Care Reform under a Minority Govt, facilitated by Pippa Bagnall 10 November, 2-6pm, Adelaide SA Contact: (02) 9692 0533, info@ changechampions.com.au

Sydney West Wound Interest Group Meeting 30 Nov, 5-6pm, Our Lady of Consolation, Rooty Hill. Contact: Jill_Sparks@wsahs. nsw.gov.au, 8887 4484, 0414 192 691

2nd Annual Art of Good Health & Wellbeing International Arts & Health Conf.

16-19 November, Sidney Myer Asia Centre, University Melbourne, VIC. Contact: info@artsandhealth.org or www. artsandhealth.org

NSW Agency for Clinical Innovation Aged Health Network ‘Caring for the

43rd Australian Association of Gerontology National Conference

Contact and registration: Diana Modderno at NSWNA on (02) 8595 1234 (metro), 1300 376 962 (rural), or visit diary dates at www.nswnurses.asn.au 17-19 Nov, Hotel Grand Chancellor, Hobart.

Contact: Jayne Hindle, Susan Contempree, Amy McIntosh, (02) 6650 9800, aag@eastcoastconferences.com. au, www.eastcoastconferences.com.

3rd Annual HITH Australasia Scientific Conference ‘The Highway to Health’ 18-19 November, The Hilton on the Park, Melbourne, VIC. Contact: Janis Coconis, Janis.Coconis@ sesiahs.health.nsw.gov.au or www.archi. net.au/events/upcoming/hith2010 M&K Update – Clinical training Courses in UK for Nurses & Allied Health Professionals ‘The Future Role of Support Workers & Assistant Practitioners’, ‘Ear Care workshops for Nurses’, ‘Immunisation Update – Immunisation Training’ Manchester, UK. Contact: www.mkupdate.co.uk

Reunions Sydney Hosp. Graduate Nurses’ Assoc.

Luncheon at State Parliament House and visit to Lucy Osburn / Nightingale Museum 6 October, luncheon starts at 12 midday.

Contact: Jeanette Fox, 4751 4829

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48 THE LAMP OCTOBER 2010

Diary Dates

CJ Cummins (Psychiatric) Unit of Royal North Shore Hospital 9 October, 2pm, The Kirribilli Club, 11 Harbourview Crescent, Lavender Bay Contact: Evelyn Kelly, 9817 7421 or 0411 331 023, gladesville@yahoo.com.au Wollongong Hospital 1973 General Nurse Graduates 9 October, Wollongong.

Contact: Adriana Van Bockel (née Pesch), 4228 3641 or arieada@hotmail.com Marrickville District Hosp. Reunion 16 October, 2pm, Masonic Club,169 Castlereagh St. Contact: Evelyn Kelly, 9817 7421/0411 331 023, gladesville@yahoo.com.au Mater Graduate Nurses’ Assoc – Annual Reunion Mass & Lunch 17 Oct, 11.45am mass at Our Lady Star of the Sea Catholic Church Kirribilli, & 12.45pm lunch at Vibe Hotel, Milsons Point Contact: Cathie Molyneux, matergrads@ matersydney.com Rydalmere Hospital 100+ years Anniversary & Staff Reunion 22 Oct, 10am-1pm, Metro Residences Rydalmere Recreation Hall then on to

Rosehill Bowling Club. Contact: J Sillet, 9334 0541 or Irene Clout, 9334 0557 St George Hospital October 1990 Midwifery 20 Year Reunion 23 Oct, 12.30pm, St George Leagues Club Contact: Megan Norrish, 0429 043 046, megannorrish@hotmail.com/ Kathy Donovan, 0407 262 754, kathyejamieson@hotmail.com St Joseph’s Hosp. Auburn, Feb’78 PTS 27 November, TDD, Sydney.

Contact: Shirley, 0438 631 225, shirms1@ yahoo.com.au/ Vince, vcarroll@tpg.com.au 30 Year Reunion – General Nursing RPAH March 1980 PCB Seeking interest for a reunion in Nov. Contact: Denise Borwick (McComb), 0414 692 105, dborwick@bigpond.net. au or Facebook: Royal Prince Alfred Hospital March 1980 PCB Group.

Armidale & New England Hospital, 30 Year Reunion – Light Green Group Seeking interest. Contact: Brian Rapley, 6366 3242 or open1@iprimus.com.au St Vincent’s Hospital, Darlinghurst, March 1978 PTS, 30 Year Reunion March 2011. Contact: Patsy Sullivan,

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 and the web before the 5th of the month prior, for example: 5th of May for June 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. psu34047@bigpond.net.au/ Maria Hulme (née Honner), hulme@internode.on.net

NSWNA Events Education Dates: • Basic Foot Care for RNs & ENs: 19 & 20 Oct, West’s Diggers, Tamworth.

• Computer Essentials for Nurses & Midwives: 25 Oct, Concord Hospital.

• Appropriate Workplace Behaviour: 29 Oct, Ex Services Club, Coffs Harbour.

• Legal and Professional Issues for Nurses & Midwives: 5 Nov, Panthers Club Port Macquarie & 26 Nov, Panthers Club Newcastle.

• Review & Implementation of Guidelines & Policies: 12 Nov, Sydney TBD.

Due to high demands on the 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.

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.

Diary Dates are also on the web – www.nswnurses.asn.au/events

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.

• Drug & Alcohol Nurses Forum: 19 November, Sydney TBD. Contact: Carolyn Kulling, 8295 1234/ 1300 367 962, www.nswnurses.asn. au/topics/2761.html

Crossword solution

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This course teaches staff not only how to respond effectively to the warning signs that someone is about to lose control, but also addresses how staff can deal with their own stress and anxiety when confronted with these difficult situations.

For further details on CPI’s Nonviolent Crisis InterventionSM training course, call us toll-free at 1800 55 3247, visit crisisprevention.com, or email us at info@crisisprevention.com.

Join us at an upcoming training course: 12–15 October 2010 Brisbane, QLD

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THE LAMP OCTOBER 2010 49

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50 THE LAMP OCTOBER 2010

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52 THE LAMP OCTOBER 2010

FSS NURSES LAM 0810

If you work in either a public or private hospital (or perhaps both) you can use First State Super for all your super requirements. This could include your employer’s superannuation guarantee (SG) contributions if they provide choice of fund. You may need to complete a Standard Choice form – visit Brochures and forms on our website for a copy.