The Lamp September 2010

lamp the

magazine of the NSW Nurses’ Association

Print Post Approved: PP241437/00033

volume 67 no.8 September 2010

BETTER ‘AWAY TO GO’

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2 THE LAMP SEPTEMBER 2010

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ABOUT THE LAMP

C O N T E N T S

Contacts NSW NURSES’ ASSOCIATION For all membership enquiries and assistance, including Lamp subscriptions and change of address, contact our Sydney office.

SYDNEY OFFICE 43 Australia Street Camperdown NSW 2050 PO Box 40 Camperdown NSW 1450 (all correspondence) T 8595 1234 (metro) 1300 367 962 (non-metro) F 9550 3667 E gensec@nswnurses.asn.au W www.nswnurses.asn.au HUNTER OFFICE 120 Tudor Street Hamilton NSW 2303 ILLAWARRA OFFICE L1, 63 Market Street Wollongong NSW 2500

Cover story

lamp the

magazine of the NSW Nurses’ Association

volume 67 no.8 September 2010

Print Post Approved: PP241437/00033

BETTER ‘AWAY TO GO’

Nurse staffing ratios

NSWNA COMMUNICATIONS MANAGER Noel Hester T 8595 2153 NSWNA COMMUNICATIONS ASSISTANT Laura McDonald T 8595 1258 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

‘A better way to go’ 1414 Cover Bree Graham, RN in ED, RPA Photography by Sharon Hickey

News in brief 8 8 9 9 9 10 10 10 11 11 11 13 13

National registration: Period of grace for renewals NSWNA wins battle in war against Macquarie Hospital Services Victorian hospitals to embrace iPads Nurses to be trained to help mentally ill stop smoking Australian anti-smoking practices get the thumbs up Buy a health diary and support breast cancer research Quarter of nurses in UK would strike Nurses in South Africa go on strike Malaysia set to launch new service scheme to recruit more nurses Nurses criticise homebirth risk report Rising obesity levels may mean more work for nurses Sri Lankan nurses’ union calls off pay protest Student nurses in Thailand seek help as their program collapses

NSWNA education program 13 What’s on

Agenda 22 Big plans for Local Health Networks

Occupational Health and Safety

THE LAMP PRODUCED BY Sirius Communications T 9560 1223 W www.siriuscommunications.com.au

32 Violent resident puts nurses at risk 35 OHS News

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

NSWNA matters

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

36 NSWNA Branch News

Obituaries 42 Michelle Craine: Courageous leader and champion of Veterans 43 Joan Elizabeth Hunt: A long life devoted to nursing 44 Kathryn Anne Sheppard: A midwife who loved to share her skills and passion

Regular columns 5 6 29 30 31 40 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

Aged care 24 The good for-profits … vs the not-so-good

37 Win a break to Samurai Beach Resort Port Stephens

Because we care

Special offers

26 ANF/QACAG report to Productivity Commission: Aged care needs overhaul, says ANF

13

16

40 Win 20 double passes to Furry Vengeance and The Sorcerer’s Apprentice and 25 double passes to The Disappearance of Alice Creed

31

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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.

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.

4 THE LAMP SEPTEMBER 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

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E D I T O R I A L

BY BRETT HOLMES GENERAL SECRETARY

Ratios claim finalised g As The Lamp goes to press, members are voting on the staffing ratios component of the public health system claim.

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or the past month Judith Kiejda, Lisa Kremmer and I have criss-crossed the state with NSWNA organisers to explain the details of our ratios claim and what we are trying to achieve.

In all the meetings we have attended there has been very positive feedback about the structure of the claim. NSWNA branches are just about to vote on this component of the 2010 public health system pay and conditions claim as The Lamp goes to print.

The vote brings to a close a long, intensive process of consultation and validation about our proposed solution to the crippling staffing issues that have bedevilled the public health system for far too long.

The interim ratios claim was fine tuned after members provided feedback at 55 meetings throughout the State, and the State Government will be served the final ratios claim in the second week of September 2010 – if approved.

We still have no response to the wages component of our claim served in mid-May.

Where to from here?

We now enter a phase of our campaign where we start to exert pressure on NSW Health and the State Government to deliver a solution to the pressing problem of your ability to provide safe levels of patient care due to staffing and skill mix issues.

Throughout September we will be bringing all MPs up to speed on the details of our claim and with members’ involvement advocate for it as a solution to make our public health system better.

We start to exert pressure on NSW Health and the State Government to deliver a solution to the pressing problem of your ability to provide safe levels of patient care due to staffing and skill mix issues.

It will be important that all nurses in the public health system join together in action if we are to win a satisfactory outcome for this part of our claim.

Without doubt the State Treasurer Eric Roozendaal will cry poor and argue that the claim is totally unaffordable.

We understand that the funding of ratios and future supply of appropriatelyskilled nurses are significant issues but it

is our responsibility to advocate and act for safe patient care. Both these issues can be addressed with some government commitment.

Our members need a staffing mechanism that is transparent, funded and enforceable if they are to provide a safe level of care.

Guaranteeing a mandated minimum nurse-to-patient ratio in our public health system is, in our opinion, the best thing that our State Government could do in the interests of the people of NSW. Hiding behind a AAA credit rating doesn’t help a patient in a hospital or a client in the community who isn’t receiving the care they need to be a productive member of our community.

It will be a significant test of the NSWNA and its members to convince the community and our State politicians that a significant investment in the public health system is of the highest priority for the people of NSW. If we are to win ratios in this campaign, we need a strong commitment and active participation from public health system members and strong community support for what we are trying to achieve.

Annual conference decides no name change For those members who haven’t been given feedback by their delegates from annual conference I can advise that the NSWNA will not be changing its name.

There was extensive debate at conference about this issue and delegates decided not to change the wording in our name from ‘Association’ to ‘Union’, nor to incorporate midwives into our title.n THE LAMP SEPTEMBER 2010 5

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L E T T E R S

LETTER of the month Stephen Langford

Well done on a fantastic Annual Conference I would like to congratulate all involved with the Annual Conference. I cannot even think of the highlights as there were so many.

Perhaps, or certainly, one of them was the talk given by Kuini Lutua, President of the Fijian Nurses’ Association, on Professional Day. Many of us know what it is like to work in a repressive workplace with arbitrary rules, no real give and take in the running of the nursing home or hospital. What if the whole country was like that? Then it would be like Fiji. Fiji has given us so many fantastic nurses, so full of good humour; I think we should also give something back. For instance, as Kuini suggested, we could make it easier for Fijian RNs here to get registration.

Thanks to the executive for inviting this wonderful nurse leader. Can we have at least one speaker from our region every year? That would be great.

And there was so much more. It was a tonic to hear O’Bray from Royal Prince Alfred Hospital Branch say that she has not joined the Union to get more money, but to help people.

And pressing for the lifting of the blockade of Gaza was one way of doing that. I loved that. Fighting for decent wages and conditions for nurses will always be the Association’s core business, but there should always be room for solidarity with others who are genuinely oppressed.

The space given to the Sydney Alliance and the Better Services for a Better State Campaign was more than worthwhile. What they had in common was the struggle for the common good, for services.

There was so much. How did Coral Levett, Association President, get us through 56 things to vote on without losing it? Even with wit and humour? And the food was great, of course. Again, a big bravo to all those who put it together.

Stephen Langford, War Memorial Hospital, Waverley.

6 THE LAMP SEPTEMBER 2010

Rhonda Brossmann

It’s worth fighting for your entitlements I am writing to thank our local NSWNA delegates and organisers, especially Suzanne McNeil and Wendy Goodman, from the John Hunter Hospital following their assistance in representing members from Coronary Care Unit to ensure unpaid shift penalty payments were paid.

Staff in our Coronary Care Unit discovered they weren’t being paid the correct shift penalty allowances when taking annual leave. This practice had been going on for so long that staff and managers thought their pays were correct.

As the managers had been subject to this system before stepping into their current roles they were also unaware they were paying their staff incorrectly. As the confusion around the correct penalty payments escalated, I personally sought help and clarification from the pay office, which established an omission of shift penalty when on annual leave, and our local Branch of the NSWNA, which informed me of the entitlement of six years’ back pay and the correct procedure for claiming back pay.

As I informed my colleagues and management of our entitlements, I was met with mixed reactions: Was it worth it? It could be only a couple of dollars?

How will this affect the budget? My answer to this was, ‘Yes it is worth it!’

My penalty rates are my entitlements, no matter what amount, and I personally did not want to see this mistake happen again to me, my colleagues or anyone in my profession.

The Union assisted in our appeal to senior management and the pay office

for a review of the Coronary Care Unit shift penalties entitlements, and when finally conducted, this audit identified numerous occasions where staff were not paid correctly.

Some amounts were small but some were considerable. Payment has finally been made and line management educated on the correct method of calculating holiday shift penalties.

The whole process from our first appeal through auditing, and back pay payment took approximately nine months. This incident highlights a number of things. First, know your entitlements; second, if you don’t think your pay is correct, speak to your NUM and/or the pay office; and third, if you don’t get the right answers speak to your Union delegate.

Rhonda Brossmann, John Hunter Hospital.

Rhonda Brossmann won the prize for this month’s letter of the month, a $50 Coles Myer voucher.

The letter judged the best each month will be awarded a $50 Coles Myer voucher, courtesy of Medicraft Hill-Rom. For details on the range of hospital beds, trolleys, mattress & care solutions, please visit www.medicrafthill-rom.com or call (02) 9569 0255 *Proudly Australian Made*

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. Visit www.subscribe.smh.com.au/lamp for more details.

Thanks for competitions

Ben Wright

Don’t waste union fees on ads supporting politicians What a shock it was to see the NSWNA advertising on prime-time television. I sat there anticipating that it would be an ad to put pressure on the State Labor Government as the NSWNA negotiates the new award for public hospital nurses.

However, I was bitterly disappointed when the ad became an endorsement for Julia Gillard. I certainly did not find the assertions made by the nurse/actress true for nurses in Western Sydney.

I don’t believe our Union fees should be used to support certain political parties in media campaigns. Nurses should not be used as a political tool wielded by the union movement in order to gain votes for politicians. It reflects poorly on the NSWNA and poorly on the nursing profession. Let the politicians do the campaigning and please put our union fees to better use.

Ben Wright, Anaesthetic Nurse, Auburn Hospital.

Editor’s response: Our election campaign and the public health system pay and conditions campaign have a consistent message: we need more nurses if we are to deliver safe patient care.

The Federal Election – when politicians and the public are focused on policy including health policy – is an opportunity to disseminate our message and garner support for our campaign goals, including mandated nurse-to-patient ratios.

The statements in our TV ads were factual. The Coalition Government, after 13 years in office and despite governing during a time when Australia had a booming economy, left Australia with a critical shortage of nurses. Tony Abbott was the Health Minister for the last five years of Coalition Government.

Over the past three years the Federal Labor Government, despite governing during the Global Financial Crisis, has invested significant funds in the health system including for more nurses in all sectors.

Obviously, this is yet to be felt down on the ground. It takes time for the benefits of nurse education and workforce planning to flow through to actual numbers in the health system. But the NSWNA believes that for the first time in a very long time the trends are going in the right direction.

Mandy Short

Get active, delegates I have just attended my second Annual Conference. In my first year as a delegate I have stuttered, stammered and died of nervousness at times as I’ve learned to speak at the microphone. I’ve found the more experienced delegates to have been fantastically supportive. There were several brand new delegates at this year’s conference who got up and spoke for the first time, which was wonderful, and it does becomes easier the more you do it.

The NSWNA executives are great at guiding you through unfamiliar procedure. (Thanks Coral and team!) I’ve had resolutions won, lost, and this time amended to within an inch of their lives (yet another new experience for me) but I encourage all delegates to get up and ‘have a go’. For the smaller Branches I don’t think there would be a single delegate in the room who wouldn’t help you, and the resources of the life members are invaluable. Utilise the life members because they really do like to be involved and they can teach a new delegate so much.

Being a delegate carries a great responsibility. You are the ‘voice’ for your members back home. NSW Health and many private facilities give delegates trade union days to let you represent them. This is an honour and a privilege. The Association also pays most of your expenses so you can afford to represent your members.

In return delegates have a moral obligation to represent their Branches. It is not a free ride to Sydney. If you don’t have a resolution to bring to conference or Committee of Delegates then I encourage you all to participate in the debates. New faces at the microphone and fresh ideas are very, very welcome and supported. Be active; be Union.

Mandy Short RN and Delegate, Coffs Harbour Hospital Branch.

Michele Hall A lovely surprise came in the mail from The Lamp – nine DVDs I had won in the June edition’s competition.

Thank you so much.

I love The Lamp; there’s always something interesting and informative in it.

Michele Hall, RN, Armidale Hospital

To all the fantastic staff at the NSW Nurses’ Association, thank you so much for the wonderful time I had at the Parrot Stump Farm at the Hunter Valley, which I was lucky enough to win.

I had a great time – thanks so much.

Kate Russell, RN In the April issue of The Lamp I was fortunate to win the competition, which was two nights at the Mercure Hotel with free parking and breakfast and tickets to see West Side Story at the Lyric Theatre.

My husband and I had two wonderful nights in the city and absolutely loved the musical.

Thank you again.

Catherine Papallo, 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.

THE LAMP SEPTEMBER 2010 7

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NATIONAL

REGISTRATION: PERIOD OF GRACE

FOR RENEWALS he move to national registration has caused some panic and confusion among members in regards to renewing their registration.

In terms of renewals the new system is different. In the NSW system of registration for nurses and midwives there were 12 renewal dates – the last day of each of the 12 months of the year (ie. 31 January, 28 February, 31 March, 30 April, 31 May, 30 June, 31 July, 31 August, 30 September, 31 October, 30 November and 31 December).

If a nurse or midwife had not renewed by the specified date (ie. one of those listed above), and this means they had not paid their renewal fee, their registration would lapse the next day (ie. the first day of the following month) and they would no longer appear on the register.

They would remain unregistered until they paid their fee, which would need to be accompanied by the $10 late fee.

However, this is not the case in the new national system. The national law, which took effect on 1 July 2010, provides for a period of grace of one month and one day after the practitioner’s period of registration ends for an application for renewal to be made.

The practitioner remains registered during this grace period and is able to work. It seems that some managers, both nursing and HR, may not be fully acquainted with the new legislation and system.

Members should check the national register to see if they are on it. If they are, they are still registered.

The register can be accessed at www.ahpra.gov.au/Registration/ Registers-of-Practitioners.aspx

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8 THE LAMP SEPTEMBER 2010

NSWNA wins battle in war against Macquarie Hospital Services Members employed in Macquarie Hospital Services’ private hospitals have scored a victory in their fight to force their employer to bargain in good faith for Dr Tom Wenkart an Enterprise Agreement.

Fair Work Australia has ordered Macquarie to provide a comprehensive draft agreement including an offer NSWNA Assistant on salary increases General Secretary by 7 September Judith Kiejda and to meet with the Association on a fortnightly basis to negotiate an Enterprise Agreement.

While most private hospitals have had agreements for a couple of years and are now negotiating second and third agreements, Macquarie still has no agreement in place.

While most private hospitals have had agreements for a couple of years and are now negotiating second and third agreements, Macquarie still has no agreement in place.

In October last year, Macquarie wrote to staff saying they were prepared to bargain but it was February 2010 before Dr Wenkart, the Chief Executive of Macquarie, agreed to meet with the Association.

At the initial meeting he advised that he wanted large scale changes including a

new classification structure and significant changes to the way people were paid.

Instead of an hourly rate plus allowances and penalties for different hours, he wanted to roll it up and have a single rate.

‘The NSWNA said it was prepared to look at Dr Wenkart’s proposals in good faith, as long as he provided the details so the Association could understand the impact on our members. Without the details members could not assess whether the changes being sought were acceptable’ said NSWNA Assistant General Secretary, Judith Kiejda.

‘With help from the Union, staff at Macquarie are a step closer to getting the Enterprise Agreement they deserve.’

However, over the many months between February and August Dr Wenkart failed to respond to requests to negotiate a salary increase and to provide the details that would allow the Association to negotiate the matters he said he wanted in the agreement.

Staff were becoming increasingly frustrated at the delays, so the NSWNA notified Fair Work Australia that Macquarie was not negotiating in good faith. Vice-President Watson of Fair Work Australia heard the matter on 19 August.

The hearing delivered a good outcome for members, with the tribunal ordering Macquarie to provide a comprehensive draft agreement for negotiation by 7 September. It also requires the Association to provide a draft agreement and for the parties to meet every two weeks to negotiate an agreement.

‘There is still some way to go, but this is a victory for members who are hopeful that serious negotiations can now occur,’ said Judith Kiejda. ‘With help from the Union, staff at Macquarie are a step closer to getting the Enterprise Agreement they deserve.’

Vice-President Watson also provided leave for either party to bring the matter back to Fair Work Australia should they need further assistance.

VICTORIAN HOSPITALS TO EMBRACE

IPADS

urses and graduate doctors in Victoria will have access to the latest technology under a new Brumby Labor Government program to introduce iPads in hospitals.

Health Minister Daniel Andrews has announced $500,000 for a pilot program that will deliver 500 iPads for graduate doctors in medicine, Nurse Practitioners and advanced practice nurses to use while treating patients in hospital.

Mr Andrews said from January next year, the Brumby Labor Government would pilot the use of mobile, wireless technology in hospitals.

‘The iPads will allow doctors and nurses to access any webenabled application run by their hospital as they move around the hospital, as well as allowing them to tap into health information resources. The iPads will connect via the wi-fi networks that allow secure, safe wireless connectivity within the hospital while not affecting other important and sensitive electronic patient care equipment.’

Mr Andrews said the Government would assess the benefits of the pilot before further expanding the program.

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Nurses to be trained to help mentally ill stop smoking

Australian antismoking practices get the thumbs up

The Cancer Council NSW and RaggAhmed, a health and communications consultancy, with funding from NSW Health, are running a project to help reduce smoking among people with mental illness.

The Australian Government received hearty congratulations from Dr Shin Young-soo, World Health Organisation Regional Director for the Western Pacific, for its stance on anti-smoking.

Described by Dr Shin as a ‘major victory for public health’, the comprehensive package to target smoking by the Australian Government includes a ban on brand names on cigarette packets.

The Australian Government also announced a 25% increase in the excise tax on tobacco products that will increase the price of a pack by $2.05 and will push the price to around $20.85 a pack within three years.

In most countries of the Western Pacific region, a pack of cigarettes costs less than $5.60. The cost of a pack of a popular brand in China is about $2.

In countries such as the Lao People’s Democratic Republic, the Philippines and Vietnam, a pack of a popular brand sells for less than $1.

‘Australia has again taken the lead in showing how political resolve can help put an end to countless deaths from tobacco use,’ Dr Shin said.

‘With higher prices, smokers will be discouraged from smoking. Young people will not be encouraged to start.

The message is clear: the Australian Government is moving toward making any form of promotion of tobacco unacceptable.’

‘Tackling Tobacco: smoke-free mental health’ will offer training to nurses.’

‘Tackling Tobacco: smoke-free mental health’ will offer training to nurses and others in how to offer support to people with mental illness who wish to quit smoking. The project will provide practical tools and strategies on how to manage clinical situations, such as the monitoring of people taking clozapine and management of withdrawal symptoms.

The training will be offered throughout NSW next year. There will be a survey conducted to gauge the views of mental health staff towards smoking, prior to and following the education sessions.

A website will offer a suite of resources, updates and links to relevant sites, so that nurses have access to the latest information and carry out world’s best practice.

More information will be provided in The Lamp as it becomes available.

THE LAMP SEPTEMBER 2010 9

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BUY A HEALTH

DIARY AND

SUPPORT

BREAST CANCER RESEARCH

Quarter of nurses in UK would strike Nurses have become so concerned about their job security and working conditions that more than a quarter say they would go on strike, according to a poll by Nursing Times.

In its largest ever survey, the nursing journal found that out of more than 5,000 respondents, 26% would consider striking if they were unhappy with their working conditions, and only 15% would not consider any industrial action. The majority – 67% – said they would work to rule, such as leaving work the minute their shift ended or breaks started.

38% of respondents feel insecure about their job and live in fear of being retrenched, and 50% said they did not feel optimistic about the future of nursing in the NHS.

he news is all good when you buy the 2011 Australian Women’s Health Diary. You’ll get the latest health and wellbeing information, the perfect daily organiser, and a bonus pen.

Plus, with all proceeds from the diary going to the Breast Cancer Institute of Australia to support vital breast cancer research, you’ll be helping to save lives.

The 2011 Australian Women’s Health Diary is now on sale for just $14.95 at newsagents, Commonwealth Bank branches and selected Woolworths and Safeway supermarkets. It can also be purchased online at www.bcia.org. au or by telephoning 1800 423 444.

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10 THE LAMP SEPTEMBER 2010

The survey found that 38% of respondents feel insecure about their job and live in fear of being retrenched, and 50% said they did not feel optimistic about the future of nursing in the NHS. Ealing and Harrow provider services nurse consultant Linda Nazarko said the scale of change planned for the NHS had left nurses ‘very fearful’.

‘I don’t think nursing has a history of taking industrial action. But people are incredibly worried about their jobs,’ she told Nursing Times.

Nurses were divided over whether industrial action should compromise patient care. Around half of respondents said such action should never affect patient care, while more than a quarter said it would only work if patient care and services were affected.

The difficulty of organising effective action without compromising patient care was laid bare by the survey.

Mental health and intensive care nurses were most likely to consider going on strike, while practice nurses, health-care assistants and nursing directors were the least likely to say they would take any form

of action, including protesting outside working hours.

Issues most likely to initiate strike action among respondents were spending cuts if they compromised patient care, pay cuts and a worsening of pension terms.

The survey also revealed that, although the majority would consider industrial action, 44% were prepared to sacrifice a pay rise to protect their job.

Nurses in South Africa go on strike South African nurses took part in a large public sector strike in August despite a court ordering essential staff to return to work.

According to the Financial Times, hospitals, as well as schools and courts, have been severely affected by the action.

Workers took strike action after the Government failed to resolve a dispute over wage increases.

Nurses and other health workers blockaded hospitals, which remained functioning only after volunteers and military medics stepped in.

Some protests turned violent and the military were brought in to keep the peace.

Workers took strike action after the Government failed to resolve a dispute over wage increases.

The labour court ruled that essential staff, including doctors, nurses and teachers, could not take part in the strike.

But Patrick Craven, from the Congress of South African Trade Unions, told the Financial Times the order would not make ‘any fundamental difference to our overall strategy’. Nurses and all other participants in the strike would stay away from work until further notice, he added.

Despite months of negotiation, the Government and the unions failed to reach an agreement over pay rises. The unions want an increase of 8.6% and a monthly R1,000 ($153) housing allowance, but the Government said it could go no higher than 7% with a R700 allowance.

MALAYSIA SET TO LAUNCH

NEW SERVICE

SCHEME

TO RECRUIT MORE NURSES he Health Ministry of Malaysia has promised an increase in the number of nurses by 2015. Due to a current shortage Malaysian Deputy in Malaysia, the Health Minister Ministry has rolled Datuk Rosnah Rashid Shirlin. out a new service scheme to address the problem.

‘The ratio of nurses to the population as of last year is 1:340.

The ratio will be 1:200 by 2015 with the increase in the number of nursing graduates from institutions of higher learning,’ said Deputy Health Minister Datuk Rosnah Rashid Shirlin.

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‘The ratio of nurses to the population as of last year is 1:340.

The ratio will be 1:200 by 2015.’

This means the current number of 6,148 graduates from 98 public and private institutions will be increased to 9,000 per year from this year.

The scheme will include nursing career promotional campaigns in secondary schools; attractive education schemes up to diploma and degree levels; more promotional opportunities for nurses currently practising; incentive payments; and contract work after retirement.

Nurses criticise home birth risk report The Royal College of Midwives (RCN) in the UK has hit back at reports claiming homebirth leads to high rates of perinatal mortality.

Medical journal The Lancet published Cathy Warwick the results of a study led by Dr Joseph Wax of the Maine Medical Centre in New Hampshire, which found that for healthy women, giving birth at home instead of in hospital doubled the chances of the baby dying.

the Netherlands has been under attack for a year,’ she said.

She also accused The Lancet’s editorial of being ‘misogynistic’.

‘The publication of evidence with flaws is being used globally to deter women from choosing midwiferyled options, such as homebirth, and to pathologise and demonise normal childbirth. What shocked us about The Lancet editorial about homebirth was its language and tone and how it pumped the hype about the dangers of homebirth, and made sweeping and misogynistic statements, such as “Women do not have the right to put their baby at risk”.

‘No mother would ever put her baby at risk and there is no evidence base to suggest that having a homebirth deliberately puts a baby at risk,’ said Ms Warwick.

‘We are extremely concerned that there Rising obesity levels appears to be a worldwide may mean more anti-homebirth, antiwork for nurses midwife and anti-normal Nurses may be forced to take on greater responsibilities to take the pressure off birth movement.’

Commenting on the cumulative global impact of this report and other international studies and reports criticising homebirth and midwife-led care in America, Australia, the Netherlands and elsewhere, Cathy Warwick, General Secretary of the RCN, said: ‘We are extremely concerned that there appears to be a worldwide anti-homebirth, anti-midwife and antinormal birth movement. We feel under attack and that there is a concerted and calculated global attack and backlash against homebirth and midwife-led care.’

Homebirth is being unfairly pilloried by some sectors of the global medical maternity establishment, Ms Warwick added.

‘There is a danger that risk during childbirth is presented in a way that is leading women to believe hospital birth equals a safe birth – it does not; there is no hard and fast guarantee that a woman will have a safer birth in a hospital than at home.’

Ms Warwick expressed disappointment that homebirth is being wrongly linked to high perinatal mortality rates.

‘What particularly concerns me is the relativity of risk during pregnancy is not being fully discussed in these reports. Meanwhile, research on positive outcomes for women about homebirth in

overworked GPs if obesity levels continue to rise, a study has found.

Overweight people are more likely to visit their GP than smokers or the unfit.

Dutch researchers found that overweight people are more likely to visit their GP than smokers or the unfit.

The team from Maastricht University looked at GP data from almost 4,500 adults.

Study leader Dr Marjan van den Akker said the research team could not say definitively why overweight people required more visits to their GPs than other patient groups, but speculated that minor complaints such as sleep problems and musculoskeletal pains could account for higher visit rates.

GPs would come under increasing pressure as obesity becomes more common and other ways of managing demand may need to be considered, Dr van den Akker added.

‘The role of the Nurse Practitioner is already common in diabetic patients, chronic lung disease and the elderly, so it’s very feasible that they could take on this role.’

The research was published in the journal Family Practice.

THE LAMP SEPTEMBER 2010 11

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N E W S I INN BBRRI IEEFF

s Policy & Guideline Writing 10 September, Camperdown, 1 day Seminar is suitable for all nurses.

Members $85 • Non-members $170 s Review & Implementation of Guidelines & Policies 12 November, Camperdown, 1 day Seminar is suitable for all nurses.

Members $85 • Non-members $170.00

Sri Lankan nurses held a week-long protest for wage rises.

Sri Lankan nurses’ union calls off pay protest The largest public sector nurses’ union in Sri Lanka, the Public Sector United Nurse Union (PSUNU) has called off a weeklong protest for wage rises.

The week-long black band protest had outlined 11 demands, the most important of which were the pay discrepancies of nurses; working conditions and access to training programs.

The All Ceylon’s Nurses Union (ACNU), which is affiliated to the PSUNU, said nurses had ‘gained no new victory for the last 10 years’ and had ‘lost what they had gained previously’.

However, both unions have called off industrial action in support of the current government’s call for sacrifices during the war against the Tamil separatist group the Liberation Tigers of Tamil Eelam (LTTE).

PSUNU leader Ananda Thera said: ‘We told our members to be patient until the war finished, as we should first defend the country. Now there is a widespread resentment among our members. We had discussions with the Health Minister and the authorities and wrote to the President but we have had no response. Now we have to do something.’

Even though the Colombo Consumer Price Index increased by 47% from 140.8 in 2006 to 206.8 in 2009, the Government has yet to pay cost of living increases since 2006. In that year, nurses received a pay rise of 1,759 rupees ($15.50) per month, while other health workers got an average increase of 1,000 rupees. Since then there have been no salary increases.

Student nurses in Thailand seek help as their program collapses At a time when global nurse shortages are seeing more and more countries stepping up their recruitment and training of nurses, one nursing program in Thailand is failing to produce qualified nurses that meet international standards.

Nakhon Ratchasima College’s Faculty of Nursing study program has failed to meet the standards of the Thailand Nursing Council and has some students failing to progress in their studies while others have been declined nurse licences to begin practice.

Thailand’s Parliament Committee for Labour has invited representatives of the Office of Higher Education Commission (OHEC), the Student Loan Fund (SLF), the affected students and alumni to discuss the situation.

In some cases second to fourth year students must repeat their course all over again, and although the OHEC has arranged new study places for the affected students, finances are definitely an issue.

Student nurse Amporn Thuithaisong has requested that the authority allow them to transfer study credits or to get additional training so they won’t need to retake courses and spend more on tuition fees. However, this may prove difficult as the SLF only allows loans for a four-year period, meaning many students will not find funding for their repeated study program. There are 230 students and 63 alumni affected by this.

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 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 that 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 Aged Care Nurses Forum 3 September, Camperdown, 1 day This seminar Members $30 • Non-members $50 s Mental Health Nurses Forum 22 September, Camperdown, 1 day Members $30 • Non-members $50

TO REGISTER or for more information go to www.nswnurses.asn.au or13ring THE LAMP SEPTEMBER 2010 Carolyn Kulling on 1300 367 962

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C O V E R S T O R Y

Feedback from Roadshow

Ratios is the better way g This month the NSWNA visited members at 55 workplaces across NSW to consult and validate the nurse ratios claim. ‘Ratios is the better way to go’ was the resounding feedback from NSWNA members.

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SWNA General Secretary Brett Holmes, Assistant General Secretary Judith Kiejda and NSWNA officers hit the road this month to visit members at public hospitals right across NSW and answer questions and gather feedback on the nurse ratios claim.

The claim for nurse-to-patient ratios and skill mix is part of the 2010 Claim for a new Award for public health system members. The ratios claim describes models developed by the NSWNA for nurse-to-patient ratios and tools for the following specialties: medical, surgical, emergency, palliative care, rehabilitation, inpatient mental health, community health, community mental health and operating theatres.

Brett Holmes said, ‘We met with members from the different nursing specialties at a representative range of public hospitals from large metropolitan hospitals in Sydney to rural and regional hospitals as far afield as Albury and Armidale to Tweed Heads and Wagga Wagga.’

There was a strong turn out to the NSWNA meetings, with resounding feedback that members agree nurse ratios is the best solution to the staffing pressure in NSW public hospitals.

Judith Kiejda told members that nurses should not have to cope with staffing issues that are out of their control and impacting on the delivery of safe patient care. ‘The nurse-to-patient ratios 14 THE LAMP SEPTEMBER 2010

NSWNA General Secretary Brett Holmes

to go

NSWNA Assistant General Secretary Judith Kiejda

Don’t risk it, report it g We need to report risks and near misses

NSWNA General Secretary Brett Holmes and Assistant General Secretary Judith Kiejda visited members at RPA Hospital to explain the nurse ratios claim.

models in the claim would ensure a mandated base number of RNs and the right skill mix on a shift.

‘For too long members have struggled to cope with ever-increasing staffing pressures. We just keep going because we care about our patients.

But we need to fight for ratios because currently staffing issues are putting our patients at risk.’

Judith stressed to members the importance of being an active part of the campaign to win nurse ratios. ‘You need to start preparing to take some action,’ she said.n

urses need to report near-miss incidents as a result of short staffing using the NSW Health Incident Information Management System (IIMS), according to NSWNA Assistant General Secretary Judith Kiejda.

‘I hear numerous stories every week when I visit workplaces about things going wrong and near misses and the reason comes down to lack of staff and appropriate skill mix.

‘Nurses are a caring profession and we put up with staffing pressure because we don’t want to let our patients down. We work under strain, work without enough staff, we don’t make a fuss, we don’t complain, we don’t report near misses and risks because we are so busy caring for our patients.

‘But because we don’t complain and don’t report incidents

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there’s an inadequate record of the real picture. And because the picture looks ok, nothing is done.

‘Inadvertently, we might be neglecting our professional responsibility as advocates for our patients by not reporting all risks and near misses because of staffing issues.

As patient advocates we have a responsibility not to accept insufficient staff and the consequences.

‘Nurses don’t have to accept personal responsibility for circumstances beyond your control.

‘I encourage all nurses to follow NSW Health’s own guidelines and report all incidents and risk of incidents – and that includes when inadequate staffing means patients are at risk,’ said Judith.

NSWNA members are asked to also email the NSWNA details of risks and near misses that occur as a result of staffing issues: campaign2010@nswnurses.asn.au THE LAMP SEPTEMBER 2010 15

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Members back nurse ratios

‘A lot less would be missed’ ‘If we had the right numbers of staff with the right skill mix, it would take a lot of pressure off the RNs. Often we only have two RNs on the floor for 28 patients and we have to supervise and be accountable for EENs’ and AiNs’ work, which is a huge extra responsibility. If we had more RNs or experienced nurses with the correct skills and knowledge, a lot less would be missed in terms of error detection, accurate documentation and early recognition of deteriorating patients.

‘This is a common problem when your allocation for the shift is predominantly junior and agency staff, with an inappropriate staff ratio.

‘If we have RNs call in sick we often get them replaced with agency first-year RNs, some of whom have only done one or two shifts outside university or with an agency AiN, so they are not replacing the skill mix, which is very frustrating and potentially dangerous on an acute ward. It’s a huge problem as it puts more pressure on existing staff and often a lot more gets missed.

‘It’s very difficult for me to fulfill my full role as a CNS, especially when I come on duty and I’m given 10-14 patients and an EEN, which seems to be the norm. It’s the same case for my educator, who is actually supposed to be indirect with patient care but is surged as a nurse on the floor when we are short staffed, so we miss out on in-services.

‘Occasionally we get a lucky shift and have three or four RNs and the difference in the dynamics of the whole shift is remarkable in terms of holistic patient care, documentation, staff morale and making sure you’ve done everything you can for your patient.

The job satisfaction is so much better. Everyone comments on it when we have a lucky shift like that.

I only wish there was more of them.’

Tanya Bronn, CNS in surgical ward, Hornsby Hospital

16 THE LAMP SEPTEMBER 2010

‘The right numbers of staff with the right skill mix is essential’ ‘Proper nurse-to-patient ratios would mean patients get the level of care they require. For people on our ward it’s the more basic things that get missed. Nurses prioritise so they will do anything that needs to be done if the patient is deteriorating, but things like making sure patients’ teeth are brushed, making sure they get a proper shower, not a five-second bird bath, making sure their hair is brushed are missed.

‘If we had the right numbers of staff and skill mix, we’d get more time to spend on actually talking to patients, interacting with them, building up a better relationship. We’d also be able to spend more time to assess them, whether it be for their cognition or physical limitations.

‘We’ve had multiple near misses. It’s quite scary. On our ward the majority of patients are confused and don’t know what they are doing from one day to the next. Some of them are in danger if they fall; it’s a huge safety issue. They need a high level of care so having the right numbers of staff with the right skill mix is essential.

‘If nurses had more time to spend with patients and give them more support, they’d be able to deliver the standard of care they’d like to. They’d feel like they had met the patients’ needs so it would be more satisfying. It would also mean less burnout for nurses.’

Alicia Agius, Acting NUM, neuro-surgical ward, Royal North Shore Hospital

‘Time for basic nursing’

Peter Buckney with colleagues Kym Whitta and Robyn Carroll (right).

‘On our ward, which is rehab, we have a lot of aged care and geriatric rehab patients. Because of understaffing on the afternoon shift, the nurses are too busy doing routine stuff so that basic things like changing wet beds get missed. We do it when we come on night shift and that puts us an hour and a half behind on our own work.

‘If you’re understaffed, pills and observation comes first and basic nursing gets missed. There shouldn’t be a differentiation between these types of nursing in aged care but let’s face it, you don’t go to the Coroner’s court for a wet bed. The right staff mix would mean patients’ basic nursing needs would be met.’

Peter Buckney, night shift RN, rehab ward, Blue Mountains Hospital THE LAMP SEPTEMBER 2010 17

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Members back nurse ratios ‘Time to do my CNS role’ ‘Having the right numbers of staff with the right skill mix would make a huge difference for us. The skill mix is the biggest problem for my ward. There are a few of us who have been there a long time like myself but they’re getting fewer as we get older and the physical load is getting heavier and heavier. The patients are getting sicker and sicker.

‘Normally they would go to HDU but now they come to us. We have non-invasive ventilation on our ward so anybody who doesn’t need to be intubated comes to our ward and it’s really hard because you might have two senior staff on a shift and four junior staff such as ENs. We are now using AiNs on our ward and we have really complex sick people. When you have ENs and AiNs the RN then has to take on a greater responsibility for things like medication and IV medications, which is something we use a lot of.

‘All ENs and AiNs can do is observation. We have some EENs who can do medications but in small amounts and they have to come to you for assistance all the time.

We have never had a situation on our ward where the team leader could be free to be there to assist everyone else – you have to take your own patients and also help everyone else.

‘I’m never able to do my role as CNS properly. If you’ve got an EN in the group you can’t give the EN the sick patients because if you do, you are making twice as much work for yourself. You get asked 1000 questions a day.

I know that’s why you’re there as a CNS and I have no problem with that but if we had more staff it would make it so much better – you could concentrate on educating your staff, educating your patients better and looking after them better.

‘I trained in the hospital system many years ago and the little things you used to do for patients you can’t do anymore. It used to be team nursing: you’d be given a job, you’d do it and it was much easier – you weren’t rushing around like a mad dog all the time. Now you are allocated a number of patients and some of them are so sick that everyone else who is not so sick gets neglected.

You’d love to be able to spend time with the poor man who’s just been told he’s got cancer but you can’t because you’ve someone who’s on non-invasive ventilation who needs constant monitoring.

‘Ratios that include more experienced staff would make a huge difference to both patient care and nurses’ job satisfaction.’

Julie Chapman, CNS, respiratory unit, RPA

18 THE LAMP SEPTEMBER 2010

Your help needed to win ratios e all need to get active to win our ratios campaign. During September we want to reach out to the community and to our State politicians for their support in our campaign to achieve mandated nurse-to-patient ratios. There are two activities in particular you can help with: c Distribute leaflets in your block so your neighbours will understand how they will benefit from the safer hospitals our campaign will deliver.

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Lobby your local State MP and convince him or her how their constituents will be better off as a result of our campaign.

If you want to get involved in these activities, contact your NSWNA branch or email your contact details to campaign2010@nswnurses.asn.au or phone Rita Martin on 8595 1234.

‘Time to give patients the care they deserve’

‘Our care would be better’ ’Patient to Nurse ratios will greatly improve patient outcomes. It would enable nurses not to miss vital clinical indicators for patients because the workload will ensure less mistakes and greater results. As a result of greater attention and care a patient is less likely to deteriorate.

There was a recent situation where we were short staffed and a patient deteriorated, but it worked out well due to the strong teamwork of all clinicians within the ED. With ideal numbers of nurses and appropriate skill mix nurses would not be stressed and have to work under pressure, creating a much better environment for patients.’

‘With ratios, nurses wouldn’t be stressed and run off their feet. We’d have the appropriate amount of time to be able to give the care that patients deserve.

Near misses can happen because you’re rushed, and extra hands on the ward would give people more time and care.’

Brenda Clarke, EEN, Holbrook Hospital

Bree Graham, RN in ED at RPA THE LAMP SEPTEMBER 2010 19

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C O V E R S T O R Y

What’s in the nurse staffing ratio claim g Summary of the 2010 Claim for Nurse Staffing Ratios and Skill Mix for Safe Patient Care.

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he NSWNA submitted an interim claim for nurse staffing ratios and skill mix to NSW Health in June, and has been visiting members in workplaces across NSW to consult and validate the claim.

The nurse staffing ratios claim is part of the 2010 Claim for a new Award for public health system nurses and midwives.

The claim contains models developed by the NSWNA for nurse-to-patient ratios and tools for the following specialties: medical, surgical, emergency, palliative care, rehabilitation, inpatient mental

NSWNA General Secretary Brett Holmes

ENSURING ADEQUATE SKILL MIX The claim includes provisions for skill mix to ensure the delivery of safe patient care: c For each ward or unit a certain percentage of RNs must be rostered on each shift to ensure adequate skill mix. c There are limitations on the maximum number of AiNs that can be performing work on any shift. c The decision to roster an AiN is subject to the Nursing Unit Manager’s professional judgement.

health, community health, community mental health and operating theatres.

The claim for each nursing specialty is tailored to the particular nursing requirements of patients and relevant environmental factors.

The nurse-to-patient ratios claim replaces the current Award mechanism to regulate workloads – ‘the General Workload Calculation Tool’ (GWCT), which now only covers 30% of medical/ surgical wards and does not provide a comprehensive model to ensure the right numbers of nurses and skills are available on all shifts and wards.

NSWNA General Secretary Brett Holmes said: ‘When we developed the General Workload Tool in 2004 we were clear that if it didn’t work we would pursue nurse-to-patient ratios.

With the Award coming to an end, we

MANDATED STAFF RATIOS c For each specialty and peer group, the claim provides: 6 the ratio of nurses to patients for morning shift; 6 the ratio of nurses to patients for afternoon shift; 6 the ratio of nurses to patients for night shift. c All absences from the roster of clinical nursing staff will be replaced or backfilled by an employee of the same Award classification. c In situations where a ward has staffing above that suggested in the claim, those numbers cannot be reduced.

20 THE LAMP SEPTEMBER 2010

sought to seize the opportunity to find a way to ensure our members have enough resources with the right skill mix to provide safe patient care.’

Ensuring adequate staffing and skill mix for safe patient care The nurse staffing ratios claim would ensure a mandated base number of nurses on a shift but it also has sufficient flexibility to factor in skill mix and acuity.

The claim provides the ratio of nurses to patients for each morning, afternoon and evening shift, with variations according to your ward or unit’s specialty area and peer group (these are set by NSW Health).

With nurse-to-patient ratios, all absences from the roster of clinical nursing staff will be replaced or backfilled by an employee of the same Award classification to ensure the quality and safety of patient care, and the necessary budget provision for this to occur should be made.

There may be situations where a ward has staffing above that suggested by our claim. In these cases, the claim states that those numbers cannot be reduced.

The staffing ratio does not include support positions or classifications such as: Nursing Unit Manager, Clinical Nurse Educator, Clinical Nurse Consultant, Nurse Practitioner, administrative support staff and wardspersons. These would be employed in addition to the nurses ratio.

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c The staffing ratio does not include support positions or classifications such as: Nursing Unit Manager, Clinical Nurse Educator, Clinical Nurse Consultant, Nurse Practitioner, dedicated administrative support staff and wardspersons. These would be employed in addition to the nurse staffing ratio. c A proportion of CNEs must be employed for a certain number of nurses. c CNEs should be rostered on seven days of the week over each roster period.

In addition to the RN ratio, the claim provides that a proportion of CNEs must be employed for a certain number of nurses. CNEs should be rostered on seven days of the week over each roster period.

The nurse-to-patient ratios claim would ensure a mandated base number of nurses on a shift but it also has sufficient flexibility to factor in skill mix and acuity.

The claim also provides a consultation process regarding the introduction of AiNs to the roster for any ward or unit. It includes provision to ensure Nursing Unit Managers have the delegated authority to make the final decision about whether patient care can be maintained with an AiN role as part of the unit’s skill mix. This means if the NUM believes AiNs can enhance the nursing care for that unit then they can employ one but there cannot be more than one AiN per shift. No AiNs are to be rostered in emergency, palliative care or inpatient mental health units or wards.n The Safety in Numbers document on the NSWNA website explains which peer group your hospital belongs to, and provides the complete details of the nurse staffing ratio claim for your specialty area and peer group.

Our huge variety graduate certificates, graduate diplomas, masters and research degrees give you plenty of scope to advance in a range of clinical, education and management areas.

APPLICATIONS OPEN SOON FOR 2011 Find out more online or at one of our Information Evenings Phone: 1800 ASK UTS Online enquiry: servicedesk.uts.edu.au

nmh.uts.edu.au/pginfo THE LAMP SEPTEMBER 2010 21 UTS CRICOS PROVIDER CODE 00099F UTS449NMH

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A G E N D A

Big plans for Local Health Networks g NSW Health reveals plans for Local Health Networks.

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SW Health has released a discussion paper on the Federal Government’s health reforms, which will transform the State health system into a National Health and Hospitals Network.

The discussion paper includes proposed boundaries for the new Local Hospital Network. The full discussion paper with an outline of the proposed new boundaries can be accessed online at www.health.nsw.gov.au Earlier this year the Federal Labor Government announced wide-ranging reform of the national health and hospitals system. Central to this reform was the creation of Local Health Networks to replace the current Area Health Services and a greater emphasis on primary care.

The reform has been agreed to by seven states and territories and the Commonwealth. West Australia was the only state that did not sign up to the agreement.

Seventeen Local Health Networks in NSW will replace the existing eight Area Health Services. The LHNs will comprise a single hospital or group of

MEDICARE LOCALS Medicare Locals is the name given to the primary health-care organisations that will be set up by the Federal Government.

According to Federal Health Minister Nicola Roxon, ‘They will be responsible for improving and coordinating GP and primary care services in local communities. Their first task will be to improve access to after-hours GP services.’

The first centres are due to commence operation in mid 2011.

22 THE LAMP SEPTEMBER 2010

THE NUTS AND BOLTS OF THE LOCAL HEALTH NETWORKS c Each LHN will have a Chief Executive and a governing council. c The LHN will negotiate a service agreement with the NSW Government. It would manage its own budget and develop a strategic plan to deliver improved health outcomes to its local community.

c It is expected that metropolitan LHNs would cover a population of at least 500,000 with regional and rural LHNs less than 500,000. c Responsibility for industrial relations functions including pay and conditions resides with the state government.

Seventeen Local Health Networks in NSW will replace the existing eight Area Health Services.The LHNs will comprise a single hospital or group of hospitals and other health services that are geographically linked. hospitals and other health services that are geographically linked.

They will work closely with the primary health care organisations (to be called Medicare Locals), which are to be established by the Commonwealth.

There will also be two specialist networks: the Sydney Children’s Hospitals Network (Randwick and Westmead) and the Forensic Mental Health Network.

The Federal Government will take full responsibility for funding and policy for all general practice and primary care.

It will also become the dominant funder of the public hospital system, increasing its share from 40% to 60%.

The discussion paper proposes that each Local Health Network should include a principal referral hospital, a clinical school and high-level EDs. It is proposed that each LHN would be self-sufficient

in high-level complex services such as cancer services, maternity services, cardiac services, stroke services, paediatric services, and mental health services.

NSW Health has conducted numerous consultations across the State. It says a key feedback point was the importance of preserving clinical networks and clinical councils and the need for local clinicians to have a role on local governing bodies.

The NSW Government says it wants to implement the national reforms without delay to provide certainty and to reap the benefits of the changes.

Under the agreement NSW will receive around $1.2 billion for recurrent and capital funding over a four-year period. The funding will be linked to performance targets based on improved access for patients.n

NURSES NEED TO BE REPRESENTED IN THE NEW LHNS There are positive elements in the move to Local Health Networks but restructure fatigue is a danger, says NSWNA General Secretary Brett Holmes.

‘I know many of you will be concerned that once again wholesale restructuring of our health services is on the cards. I think most experienced NSW nurses and midwives would have some level of restructure fatigue and I think it is important this is acknowledged as we contemplate another major rearrangement of services into Local Health Networks,’ said Brett.

In broad terms, and along with most health stakeholders, the NSWNA welcomes the move to restructure in order to enhance local decision making and to strengthen clinician involvement.

‘It is clear the existing arrangements have created problems due to the excessive size of some of the AHSs and the remoteness of decision making processes from the reality at the coalface.

‘The challenge for the NSWNA is to ensure that the nursing and midwifery perspectives and insights are effectively represented in the new structures. There is also the very important issue of how the nurses and midwives currently in area level nursing and midwifery positions will be absorbed into the new structures.

‘I encourage nurses and midwives at every level to engage in the consultation processes that are underway to maximise nursing and midwifery inputs to the process,’ said Brett Holmes.

NURSING EDUCATION AND WORKFORCE SUPPORT NEED TO BE MAINTAINED

By Coral Levett, Nurse Manager, Education SESIAHS ‘The new structure effectively goes back to what we had five years ago. I have no problem with that; it worked before. Nurses on the floor won’t notice much difference.

‘The problem with the discussion paper is there is no detail about the nursing structures that operate across the area health services like nurse education and workforce support services.

‘We did get some efficiencies with getting bigger.

Previously, the Illawarra had poor nurse education services while South East Sydney had good ones, and with the amalgamation the Illawarra gained. We wouldn’t want a gap to open up again when the AHS is split.

‘I would like to see that we learn from experience so we get the best of both worlds. That is, we have Local Health Networks of an appropriate size but we also have network DONs and good nursing education and workforce support services across the network.

‘I also want to see equity in clinical representation on the governing council.’

THE LAMP SEPTEMBER 2010 23

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A G E D C A R E

The good for-profits … vs the not-so-good g The NSWNA wishes to congratulate for-profit employers that have valued nurses and signed Enterprise Agreements that protect wages and conditions. Disappointingly, there are still a number of employers that have not yet signed up to an agreement. But there’s still time!

8 NOT GOOD ENOUGH! Employers that HAVE NOT offered an agreement

EMPLOYER

ESTABLISHMENT NAME

Accredited Aged Care Aus. P/L

The Grange – Albury

L & D Management Services P/L

Bisaxa P/L

Sir Joseph Banks Nursing Home

Living Choice

Buckland Convalescent Hospital

Buckland Aged Care Service

Chandos Nursing Home P/L

Chandos Nursing Home

M.N.H P/L

Mayfield Aged Care

Clermont Nursing Home P/L

Clermont Nursing Home

Maksymow, Mr O & Mrs V

Fairmont Aged Care Facility

Cuzeno RVM P/L

Beauty Point Retirement Resort

Manchester Unity Australia Ltd

Dalcross Management P/L

Collaroy Aged Care Facility

Denever P/L

Botany Gardens Nursing Home

Domacwa Holdings P/L

Murrayvale Aged Care

Marlowe Homes P/L

St George Aged Care Centre

Farad Nominees P/L

Queanbeyan Nursing Home

McLean Care Ltd

Grace Munro Centre

Gladstone House Nursing Home P/L Gladstone House Nursing Home

Montana Nursing Home P/L

Montana Nursing Home

Grafton Aged Care Home P/L

Grafton Aged Care Facility

Moran Health Care (Australia) P/L Moran at Little Bay

Hardzac Holdings P/L

Ainsley/Auderbury Nursing Home

New Horizons Enterprises Ltd

New Horizons Aged Care

Homewood Care P/L

Homewood Nursing Home

Petrac P/L

Ocean View Banora Point

Hunter Valley Care P/L

Amaroo Lodge Nursing Home

Profke Holdings P/L

Glenhaven Retirement Village

Northcourt Aged Care Facility

H N McLean Retirement Village

Figtree Point Aged Care Facility

Provectus Care P/L

Glen Residential Care Centre (The)

Hamilton Nursing Home

Quirindi Retirement Homes

Elmswood Hostel

Wynwood House Nursing Home

Rasko Holdings P/L

Goondee Nursing Home

Quirindi And District Nursing Home

Waterview Aged Care Facility Ibis Care Bexley

Roseneath Nursing Home P/L

Roseneath Nursing Home

Ibis Care Big Sister Hostel

Sirrah P/L

Cabrini Nursing Home

Ibis Care Blakehurst

TBG Senior Living Services P/L

Anthem Continuous Care Retirement Community Huon Park Retirement Village

Bay Aged Care Facility - Blakehurst

Trustee for Huon Park Operator’s Trust

Camden House

Tulich Family Communities

Jesmond Aged Care P/L

Jesmond Aged Care Facility

Kenna Investments P/L

Bankstown Aged Care Facility

Hillside At Figtree

Eddystone Nursing Home Endeavour Nursing Home (Kogarah) Kilbride Nursing Home Merrylands Nursing Home Wollongong Nursing Home Windermere Nursing Home

Blue Hills Manor Durham Green

Camden Nursing Home

24 THE LAMP SEPTEMBER 2010

Coffs Harbour Nursing Centre South West Rocks Nursing Centre

Bethal Aged Care

Korlim P/L

Courtlands Retirement Village Manchester Unity Aged Members Centre

Sir Thomas Mitchell Nursing Home

IBIS (No 2) P/L

Alloura Waters Broadwater Court

Buckland Nursing Home

I & E Klein Investments P/L

Altona Nursing Home

Vision Lifestyle Projects Pty Ltd

Hunters Hill Lodge

T

he majority of for-profit aged care employers have now offered either the ACAA template agreement, which protects the pay and conditions of nurses working in for-profit nursing homes in NSW or their own version of an Enterprise Agreement.

The ACAA agreement, negotiated by the NSWNA with the Aged care Association of Australia (ACAA), provides a model template Enterprise Agreement for aged care employers in the for-profit sector. The agreement delivers pay increases above the inflation rate, protects all conditions under the previous NAPSA and adds some new rights.n

4 EMPLOYERS ON BOARD

Check out the lists below and opposite and if your employer is listed as not signing the ACAA agreement, contact the Association so we can help you take action in your workplace to get an Enterprise Agreement that gives you fair wages and conditions.

Think twice about working for an employer that’s dragging their feet on your pay increase!

SummitCare

Frenchmans Lodge Phillip House

Employers that HAVE recently adopted the ACAA template

Canley Gardens

EMPLOYER

ESTABLISHMENT NAME

Elizabeth Gardens

Albanese Aged Care Group

Genista Nursing Home – Greystanes

Nyora Gardens

Meredith House Aged Care Facility

St Mary’s Gardens Jamison Gardens

Whitehall Nursing Home Apex Software P/L

Lark Ellen Nursing Home

Terrigal Grosvenor Lodge P/L

Clendon Care P/L Columbia Nursing Homes P/L

Cook Care Group

Veronica Nursing Home

Canberra Nursing Home St Joachims Nursing Home

Thompson Health Care P/L

East West Health Care P/L

Ernest Enterprises P/L Halenvy P/L

Milford House Nursing Home

Columbia Aged Care Services – Acacia Centre Marrickville

Turramurra House Nursing Home

Strathdale Nursing Home

Abbey Nursing Home (The)

Peninsular Nursing Home – Mona Vale

Bowral House Nursing Home

Elizabeth Lodge Aged Care Facility

Avalon House Nursing Home

Rotherham Nursing Home

Terrey Hills Nursing Home

Tarragal House Nursing Home

Mona Vale House Nursing Home

Windsong at Manly

Sir William Hudson Memorial Ctr Sir William Hudson Memorial Nursing Home

Winston House Nursing Home

Linburn Nursing Home P/L

Miranda Aged Care Facility

MacLean Valley Nursing Home P/L Mareeba Nursing Home

Ballina Nursing Home

Palms Aged Living Mng. Serv. P/L Palms Nursing Home (The) Benessere Health Care P/L

Summer Hill Aged Care Service – Nursing Home

Ark Health Care P/L

Parkview Nursing Home Hillcrest Nursing Home

Rockdale Nursing Home

Russell Lea Nursing Home

Weeroona Nursing Centre

Lansdowne Nursing Home Parramatta Nursing Home

Vaucluse Nursing Home

Aspic Holdings P/L

Ferndale Gardens Aged Care

Glenwood Nursing Home

Baldwin Care P/L

Ashley House Nursing Home

Sirius Cove Nursing Home

Berala on the Park HR P/L

Berala on the Park

Alloa Nursing Home

Clover Lea Holdings P/L

Clover Lea Nursing Home

Caroline Chisholm Nursing Home

Convalescent Construction P/L

Plateau View Nursing Home

Beaumont Terrace

Erma Nom. P/L & Milgerd Nom.

Shangri-La Nursing Home

Alma Place Aged Care Facility

Fairfield Nursing Home (Hold.) P/L Fairfield Nursing Home

Barclay Gardens

Menaville Nursing Home

Hutchinson Healthcare Group

Linburn Nursing Home

Kingswood Court Aged Care

Laurieton Lakeside Aged Care Residence Hall & Prior

Wahroonga Nursing Home

Willowood Nursing Home

Sir James at Dalmeny Aged Care

Doherty & Associates P/L

Maxine Louise Aged Care Facility Mathew John Nursing Home

Gymea Bay Nursing Home

Seabeach Gardens Lodge Nursing Home

Huntingdon Nursing Home P/L

Huntingdon Residential Aged Care Facility

Pacific Heights Nursing Home P/L Pacific Heights Nursing Home

Magnolia Care P/L

Magnolia Manor Aged Care Kanwal

Pathways Aged Care P/L

Cronulla Nursing Home

Oreison P/L

Fairlea Nursing Home

Killara Gardens Aged Care

S’Antonio da Padova Nursing Home

Salmar Holdings P/L

Beecroft Nursing Home

S’Antonio de Padova Protettore di Poggioreale Syd N/H

Samir P/L

Curie Nursing Home

Stamen Contractors P/L

Garden View Nursing Home

Rosehill Nursing Home

Trinity Aged Care P/L

Crown Gardens Residential A/C (Low Care)

St Ezekiel Moreno Ltd

St Ezekiel Moreno Nursing Home

SummitCare

Elizabeth House

Crown Gardens Residential A/C (High Care) The Willows Private N Home P/L Willows Private Nursing Home (The) THE LAMP SEPTEMBER 2010 25

s

B E C A U S E W E

C A R E

ANF/QACAG report to Productivity Commission

Aged care needs overhaul ‘Inadequate staffing levels, inappropriate skill mix,’ reports ANF

T

he ANF has highlighted the concerns of its members about the current delivery of aged care services in residential settings.

‘Inadequate staffing levels, inappropriate skill mix, excessive workloads, declining standards of

care, and excessive documentation, are frequently reported,’ it said.

‘These concerns, combined with the differences in wages between the aged care and acute sectors, have all contributed to difficulties recruiting and retaining qualified nursing staff to work in aged care.

‘Long-term reform in the aged care sector will not succeed without the provision of a robust, highly educated and skilled nursing workforce, transparency and accountability of funding, additional funding for wages and attractive career paths in aged care.’

ANF Recommendations c The Australian Government fund the ANF to develop minimum standards that provide for staffing levels and skill mix in aged care settings. c There is recognition of the professional skills of Assistants in Nursing, (however titled) through a national licensing system regulated by the Nursing and Midwifery Board of Australia (NMBA). c There is a mandated/legislated Federal requirement for 24-hour Registered Nurse cover for all high-care residents in aged care facilities, inclusive of those lowcare facilities with ageing in place. c The Australian Government fund the development of a workload management tool for use in residential aged care to be linked to the existing Aged Care Funding Instrument (ACFI). c The ACFI funding model be reviewed by the Australian Government to enable the incorporation of Nurse Practitioners in aged care. c The current regional and rural undergraduate and post-graduate scholarships, funded by the Australian Government for nurses working in aged care, be extended to include urban areas.

26 THE LAMP SEPTEMBER 2010

c A mechanism be developed by the Australian Government to monitor the use of funds by Residential Aged Care Facilities (RACF) to develop and implement Graduate Nurse Programs in aged care. c In line with the recommendation above, there is an acquittal system implemented to ensure the money made available for the graduate nurse programs is directed to wages and educational support for graduates. c The Australian Government determines a benchmark of the cost of care in aged and community care. c The Australian Government close the wages gap between nurses and Assistants in Nursing, (however titled), working in aged care and their public hospital counterparts. c That dedicated funding is made available by the Australian Government to close the wages gap, and that provision of the funding is conditional on the achievement and maintenance of wage parity. c The Australian Government legislates for the introduction of annual reporting on the way aged care providers spend their funding, particularly on care activities and staff.

c The funding arrangements for accommodation and care components of aged care services be accounted for separately, using the ACFI model. c The aged care standards agency is required to use professional guidelines as benchmarks during accreditation. c A national education program be developed by the Aged Care Standards and Accreditation Agency (ACSAA) to ensure consistent application of national benchmarks of its Accreditation Standards and Quality Care Principles to enable alignment of all processes, with the end result being the assurance of high-quality care to our frail elderly citizens. c That compulsory benchmarks are federally legislated by the Australian Government in relation to occupational health and safety in residential and community aged care. c That an independent Aged Care Complaints Commission be established with an Aged Care Complaints Commissioner appointed who will report directly to the Federal Minister for Ageing.

g In their initial submissions to the Government’s Productivity Commission Inquiry 2010 ‘Caring for Older Australians’, the ANF and QACAG have recommended an overhaul of the aged care sector, including more funding for nurses.

Quality Aged Care Action Group Inc Lobby for Positive Change

Dignity and Respect in Ageing

Keep Nurses in Aged Care

Photo: Steve Bull

Older People Carers, Relatives Friends, Nurses

A Community Voice in Aged Care in NSW

NSW Nurses’ Association – a proud sponsor of QACAG Inc

QACAG submission to Productivity Commission In its submission to the Productivity Commission, Quality Aged Care Action Group (QACAG) features several comments from its members, many of whom are current or former aged care nurses.

QACAG also makes recommendations around good models of care, staff ratios and skill mix, staff recruitment and retention, licensing of AiNs, and the establishment of an Aged Care Complaints Commission and Aged Care Commissioner.n A banner developed by Steve Bull for the Quality Aged Care Action Group.

QACAQ RECOMMENDATIONS c Development of programs and systems to assist residents and families to better understand the sector, to more easily find the best facility for their needs and to make the transition easier from home to nursing home. c Good models of care to be properly examined and benchmarked. c Identify how to connect ‘success’ with good care and ensure financial viability is intrinsically connected with good care ie. values or care driven, consumer satisfaction driven, not solely profit driven. c Consider a combination of regulation and incentive in regards to care models. c Ensure accreditation processes are improved to measure what actually occurs, not what is documented to occur. c A formula for mandatory staffing numbers and skill mix, and a

system tying a set proportion of funding to staffing. c Protection of the current requirements in NSW for an RN to be on duty at all times in a nursing home. c A minimum requirement that an RN be on duty in any residential facility where there are high-care residents, as a minimum part of a staffing formula. c Workforce strategies to combine the aim of attracting newly graduating staff and younger staff into aged care, while valuing older, experienced staff to balance a mix of age and experience. c The proposal submitted by the ANF on licensing of AiNs and care staff to be adopted. c Ongoing input and representation from older people, consumer groups and carers be built in to all phases of the aged care reform process.

WHAT QACAG MEMBERS SAID

‘

As the number of nurses employed in aged care decreases, so does the appeal for nurses making this their career choice.

The erosion of nursing positions de-professionalises and devalues the work, and ultimately this devalues the care of older people.

(DoN, QACAG President)

‘

’

A main issue for me is the funding tool, it needs to be simplified to reduce paperwork, to increase the quality of care and guarantee adequate staffing levels.

(RN, QACAG Metro)

‘

A colleague told me that the facility has 113 beds and with ageing in place, and 93 of these residents have now been assessed with high care needs. Recently the staffing mix has been changed to remove the RN position off the night duty roster, and to have a CSE (care service employee) as Team Leader (ie. not a nurse) and just have an RN on call.

(RN,QACAG Metro)

‘

’

I have seen so much change over 30 years, and the biggest change by far is less staff per shift, and more residents with more complexity to look after.

(RN, QACAG Metro)

’

THE LAMP SEPTEMBER 2010 27

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nnn%fiXe^\%ejn%^fm%Xl fi nnn%fiXe^\Ylj`e\jj%Zfd%Xl G% ') -*0* /),' 28 THE LAMP SEPTEMBER 2010

s

Q & A

ASK

JUDITH

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

Unable to take meal breaks I work on a busy ward in a public hospital and due to the workload we are regularly unable to take our meal breaks. Usually, staff who are unable to take their break have been finishing the shift half an hour early. Our NUM says we can no longer do this, but is not offering any alternative to make up for the untaken meal breaks. What is the correct procedure?

Staff who work an eight-hour shift are entitled to two ten-minute (or one twentyminute) paid tea breaks, and one half-hour unpaid meal break. These breaks are to ensure staff receive appropriate rest and refreshments to enable them to continue on through their shift. Sometimes, due to unforeseen circumstances, staff are unable to take their meal break and when this occurs they should contact whoever is in charge (After Hours Supervisor etc), and ask if a replacement can be sent to enable staff to take their break; or if this is not possible, he or she would be able to authorise overtime payments for those staff affected.

If staff are regularly unable to take their breaks, then this is a workload issue and should be directed to the NUM in the first instance, and if unresolved should be pursued through the Reasonable Workloads Committee.

Asked to work during annual leave Recently, while on annual leave, my NUM rang to ask if I could come into work as it was very busy and short staffed. I agreed to do this, and thought I would be paid overtime for the shift, but I wasn’t. Should I have been?

No. If you come in to work during your annual leave you are paid as ordinary time and have the annual leave day credited to your annual leave hours.

Three years casual, can I go permanent?

I am an RN who has worked casually in a public hospital for three years. I average about 72 hours per fortnight

as a casual, but would ideally like to be made permanent. I have approached my NUM regarding this but he advised me there were no vacancies at present.

A colleague believes it is not necessary for me to wait until a vacant position comes up due to the length of time I have been working on a casual basis.

Can you confirm this?

Your colleague is correct in this instance.

Clause 29. Part-time, Casual and Temporary Employees, Part II B of the Public Health System Nurses’ (State) Award allows for casual employees who have been: “… engaged by a particular employer on a regular and systematic basis for a sequence of periods of employment under this Award during a calendar period of six months shall thereafter have the right to elect to have his or her ongoing contract of employment converted to permanent full-time employment or part-time employment …”

You should notify your NUM of the above provisions so that arrangements can be made to make your position permanent.

Registration paperwork not received by NRB I am an RN whose registration is due at the end of this month. I have not received paperwork from the new National Registration Board advising me of the process to renew. I have tried to renew online at the AHPRA website but do not have a password and have been unable to contact the National Registration Board to clarify. I am concerned I will be unable to renew on time and therefore unable to work as an RN.

Under the previous registration system in NSW, registered and enrolled nurses who did not pay registration fees on time, prior to the registration date, were considered to be unregistered the very next day and were unable to work as Registered or Enrolled Nurses.

However, in the new registration scheme all registrants have a one-month grace period ie. you have one month after your registration date to renew your registration before you will be considered to be unregistered. The Nursing and Midwifery Board advises as follows:

‘As long as you renew your registration within one month of it falling due, you will be registered under what is called a grace period. You can still work in this period; you will still be registered; and your employer can review your registration status online.’

For details see the following website: www.nursingmidwiferyboard.gov.au/en/ News/What-do-I-do-if-my-registration-isabout-to-expire.aspx You also need to check that the contact details the Nursing and Midwifery Board Australia (NMBA) has for you are correct and the NMBA is able to mail renewal paperwork to you. The address the NMBA has for you will be the address that the NSW Nurses’ and Midwivies Board (NMB) had for you at your last registration date.

Your address can be checked on the AHPRA website, Register of Practitioners at: www.ahpra.gov.au/Registration/ Register-of-Practitioners.aspx If your address is correct and you do not receive the paperwork you need to contact the NMBA helpline on 1300 419 495.

If your registration lapses you will be notified by the NMBA and you will need to apply for new registration. Some nurses will be able to have those applications fast tracked and the information about that will come with the letter advising that your registration has lapsed.

Compulsory professional development for all midwives and nurses I am a Registered Nurse and midwife.

Am I required to complete 20 hours compulsory professional development (CPD) for nursing plus another 20 hours CPD for midwifery?

Yes. The Nursing and Midwifery Board of Australia advises on its website that you will be required to complete 20 hours of nursing CPD and 20 hours of midwifery CPD per year. However, if CPD activities are relevant to both nursing and midwifery professions, those activities may be counted as evidence for both nursing and midwifery CPD hours. For full details see the following website:www.nursingmidwiferyboard.gov. au/en/FAQ-and-Fact-Sheets.aspxn THE LAMP SEPTEMBER 2010 29

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

What’s hot on Nurse Uncut HOT TOPICS Keeping colds and flu at bay

WHAT YOU SAID ABOUT ... BULLYING

‘

I haven’t noticed any decline in bullying. It is as prevalent in nursing as it was when I started.The only difference I can see is that it is more subversive – starting rumours, antagonising, or passive aggressive behaviour. Belittling of EENs by RNs is the most common I have noticed in recent times. It really is a culture that needs to be broken and the sooner the better.

Be it hand hygiene, healthy eating, garlic sandwiches or working with respiratory patients to build up immunity, nurses share their tips of how to keep nasty colds and flu viruses away. How do you prevent yourself coming down with the sniffles? Share your tips at Nurse Uncut.

Can nurses get OHS officers fined?

If nursing staff do anything illegal and they get hurt, the Occupational Health and Safety Officer in their facility gets fined. This is a common belief among nurses, but is it true? Find out at Nurse Uncut.

30 THE LAMP SEPTEMBER 2010

‘

There is something so wrong with our current system that actually facilitates and protects bullies in being able to dodge the consequences of this anti-social behaviour.This has to stop and be recognised as a significant and ongoing nursing issue. Perhaps all nurses must be made to attend some sort of mandatory sessions in what bullying in nursing is, and what to do and how to stop it.

‘

’

‘

In my 23 years nursing it is only since moving to the country that I have experienced bullying at all and find myself now questioning whether to continue in the nursing profession at all. It has been especially difficult as I went to my Nursing Unit Manager who was entirely unsympathetic and implied that I was at fault and that I needed to deal with it.

How does one manage bullying behaviour when your own boss denies it exists and is not inclined to discuss/deal with any issues raised?

’

’

Sadly bullying is still alive and kicking (literally) within nursing. One of the difficulties is that most people are afraid to speak up.There are a lot of well-worded bullying and harassment policies with accompanying rhetoric spouted by health-care leaders; unfortunately the rhetoric disguises the reality that there remains little accountability for the bully and even less support and recourse for the victim.

’

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NURSING RESEARCH ONLINE

Florence Nightingale’s legacy lives on g 13 August 2010 was the 100th anniversary of the death of Florence Nightingale. This month Nursing Research Online takes a look at the life and legacy of the founder of modern nursing.

Florence Nightingale ABC Radio National, Rear Vision, 11 August 2010

She was really a member of the elite.

The family’s money had come from lead mining originally, and her father in fact was originally called William Shore, and he changed his name to Nightingale to honour the fortune that he inherited from Peter Nightingale and they had two main residences: one was in Derbyshire, Lea Hurst; and the other was in Hampshire, Embley Park, which they acquired in 1825.

And the significance of Embley Park?

If you Google it or visit it, it’s a very, very impressive mansion and they had over 100 acres of land attached to it. It is a stunning estate and was almost contiguous with Broadlands, which was the residence of Lord Palmerston, so you can see here that there’s a social as well as a geographical contiguity between the Nightingales’ social and domestic life, and those members of the political elite of the day. And the house played host to many of the literati and many of the intelligentsia of the day. www.abc.net.au/rn/rearvision/ stories/2010/2918308.htm

The Collected Works of Florence Nightingale

www.uoguelph.ca/~cwfn/ Introduction/index.html

Lady With The Lamp ABC Radio National, The Spirit of Things, 15 August 2010

Florence Nightingale is remembered as the pioneer of professional nursing, but it was a minor part of her life compared to her passion for a new religion. Striving to unite with the ‘God within’, whose laws were consistent with scientific knowledge, Florence was a radical theologian who urged religious reform. On the centenary of her death, biographer Val Webb reveals the real Florence Nightingale behind the myth: At 70, Florence Nightingale wrote to a close friend, ‘When very many years ago I planned a future, my one idea was not organising a hospital but organising a religion.’ History did not listen to her.

Everyone knows the Florence Nightingale who took nurses to the Crimean War and returned to found modern nursing. Few know the Florence who wrote a ‘new religion’ for England’s poor; or the Florence who penned a fifty page tirade about how Victorian families ‘murdered’ their daughters by keeping them in the drawing room; or the Florence who was writing a book on medieval mystics; or the Florence who retired to her home as an invalid at thirty-eight and, from there, orchestrated incredible poor reform around the globe for 50 years after Crimea.

Florence Nightingale Museum The Museum is independent and has over 2,000 artefacts owned by and associated with Florence Nightingale, the Crimean War, nursing and Florence Nightingale’s legacy. It is located on the site of the original Nightingale Training School for Nurses, at St Thomas’ Hospital on London’s vibrant South Bank.

From Florence’s slate she used as a child, her pet owl Athena, to the Turkish lantern used in the Crimean War, the collection spans the life of Florence Nightingale, the Crimean War and Florence’s nursing legacy up to the present day.

If you have an enquiry about Florence Nightingale or the museum’s collection, email the Collections Manager, kirsteen@florence-nightingale.co.uk or write to the museum address.n Courtesy of Florence Nightingale Museum

All the available surviving writing of Florence Nightingale will be published in The Collected Works of Florence Nightingale – most for the first time. Sixteen printed volumes are scheduled in the series, of which 13 have now been printed. The Collected Works of Florence Nightingale makes available Nightingale’s major published books, articles and pamphlets (many long out of print) and a vast amount of unpublished correspondence and notes. Extensive databases, notably a chronology and names index, and the original, unedited, transcriptions, will also be published in

electronic form. This will permit convenient access to scholars interested not only in Nightingale but other major figures of her time. Known as the heroine of the Crimean War and the major founder of the modern profession of nursing, Florence Nightingale (1820-1910) appears here also as a scholar, theorist and social reformer of enormous scope and importance.

‘Florence Nightingale: The Making of a Radical Theologian’, Dr Val Webb, www.valwebb.com.au www.abc.net.au/rn/spiritofthings/ stories/2010/2978727.htm THE LAMP SEPTEMBER 2010 31

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OCCUPATIONAL HEALTH AND SAFETY

Violent resident puts nurses at risk g A situation involving a violent resident with complex needs at a rural nursing home has highlighted the risks facing staff and other residents at aged care facilities.

M

embers of staff at a private aged care facility in rural NSW were placed under mental stress and at risk of physical harm when a resident with complex and acutely challenging behaviours – including violent outbursts – was admitted to the facility.

The resident was one of the small percentage of people under 50 who are in nursing homes because there is nowhere else to put them. She had a history of violence – including assaults on nursing staff at a previous aged care facility – and the receiving facility was not suited to high, complex care of this kind.

‘The true extent of her challenging behaviour was not made clear, but the facility was at fault because it had an admissions policy that was inappropriate for the care needs of that resident,’ said NSWNA Assistant General Secretary Judith

Kiejda. ‘She was aggressive towards staff and residents most of the time, and had

a number of major violent episodes.

She created a sharp weapon and on one

WHAT TO DO IF YOU’RE EXPERIENCING VIOLENCE AND AGGRESSION AT WORK It is the responsibility of staff to report risks to management, and both the NSWNA Branch and the OHS Committee should be involved.

Workplace violence is grossly underreported by nurses, but you have an obligation to report. ‘Not only is it in your best interests but it’s also in the best interests of other residents as they can be injured as easily as nurses,’ said NSWNA Assistant General Secretary Judith Kiejda.

If reporting your concerns to management doesn’t lead to satisfactory outcomes, contact the NSWNA. ‘We have the expertise, and we can intervene on behalf of our members to assist them to resolve OHS issues and to achieve safer and healthier workplaces.

Protecting the confidentiality of our complainants is always of the highest priority in our dealings with the industry’, said Judith.

The College of Nursing creating nursing’s future

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32 THE LAMP SEPTEMBER 2010

occasion it took several police officers to restrain her.’

With no duress alarms available or a duress response plan in place, no safe havens, and no staff with the level of training required to care for a resident with such acute needs, the impact on nursing staff at the facility was severe.

Judith. ‘The staff are specifically trained for acute care and that’s not what happens in aged care. Aged care facilities usually have just one RN for the whole place and the rest will be AiNs or ENs.’ The NSWNA made recommendations to management as well as lodging a formal complaint with WorkCover. As a result, duress alarms are now in place at

‘She created a sharp weapon and on one occasion it took several police officers to restrain her.’

The local NSWNA Branch at the facility initially approached management with their concerns, then the Union’s OHS team became involved and did an assessment of the entire situation.

After yet another major violent episode, the resident was eventually transferred to a public sector facility with a high-care mental health unit more suited to her needs.

‘These kind of facilities are very safe for residents because they can’t get weapons, and cutlery counts and other such measures are carried out,’ said

OHS PROBLEMS IN AGED CARE This case highlighted significant areas of concern, not only at this particular facility, but in most OHS cases that NSWNA officers investigate in aged care workplaces: c The design of many aged care facilities is inadequate for the needs of high-risk residents.

For example, there may be many areas where nurses can be trapped, with no escape route or safe haven. c Duress equipment is often unavailable or unsuitable. c There is no written duress response plan formulated to inform regular and temporary staff of what should be done in this type of emergency.

Breastfeeding: Searching for Excellence CONFERENCE PROGRAM

9.00am 11.00am 1.00pm 2.00pm 3.15pm

c In country areas, support services for duress response such as police are often not available because of the time it takes to get there, and some police stations close at 10pm or midnight. c Lack of self-defence training for nursing staff. c Lack of staffing and inappropriate skill mix increase the risk of injury arising from violence/aggression risks. c Inadequate or inappropriate admissions policies can result in admission of residents whose complex needs cannot be safely met by the receiving facility, often placing staff and residents at risk of violence.

Breastfeeding experts Molly Pessl and Sue Cox unlock the latest thinking and research.

MELBOURNE November 15–16, 2010 DAY 1

the facility. ‘We are still waiting for them to do a duress response plan,’ said Judith.

‘Management has said it will employ security personnel to provide after-hours support on a needs-be basis when the police aren’t as readily available. The facility has also changed its admissions policy so it does not take in residents it is unable to properly care for.’n

Searching for excellence - Molly Pessl The science behind skin-to-skin - Sue Cox The confusion of numbers - Molly Pessl Effective education of all hospital staff in maternity units - Sue Cox Breastfeeding issues and the late pre-term baby - Molly Pessl

SYDNEY November 18–19, 2010 DAY 2

9.00am 11.00am 2.00pm 3.30pm

Milk production update (including expressing and storing breastmilk and colostrum) - Sue Cox Challenging feeds - Molly Pessl/Sue Cox Low weight gainers - Molly Pessl Talking a language new parents can understand - writing, talking and teaching for new parents - Sue Cox

Each day’s program includes morning tea, lunch and afternoon tea.The close of each day will be at 4.30pm.

Accreditation IBCLC CERPs: 12 L CERPs awarded (6 CERPs per day) CERPs Approval Number: C21061 This program has been submitted to the Australian College of Midwives for professional development approval.

For more information and online registrations, visit www.breastfeedingconferences.com.au or contact Barb Glare, phone 0488 757 334 or e-mail zacdan@datafast.net.au

THE LAMP SEPTEMBER 2010 33

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.

Super Members

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If you’re a member of a union The Super Members Term Deposit interest rates are up to 0.25% p.a. more than the interest rates for a Standard Term Deposit. See mebank.com.au for eligible super funds and unions. Fees and charges may apply. Terms and Conditions available on request. This is general information only and you should consider if this product is appropriate for you. Members Equity Bank Pty Ltd ABN 56 070 887 679.

34 THE LAMP SEPTEMBER 2010

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OCCUPATIONAL HEALTH AND SAFETY

OHS News g Developments are taking place in relation to uniforms and surgical smoke.

UNIFORMS

I

n October last year a comprehensive review by the Association of the current NSW public sector nurses’ uniform revealed what anecdotal evidence had long suggested: few nurses are satisfied with their uniform, and many are very dissatisfied.

Common complaints were in regards to the ordering and supply, quality and appearance and health and safety issues.

A vibrant and ongoing comment thread on Nurse Uncut continues to reveal that NSW nurses have had extremely negative and frustrating experiences with their uniforms.

Although the current contract runs until September 2011, negotiations for the next contract are already underway.

The Health Department recently held a workshop, which several delegates from the NSWNA attended, and the Union is meeting with the Department each

month to discuss uniform matters. The Department has also promised to invite representatives of the Association onto an advisory committee for the technical side of the contract.

The Health Department has proposed a scrubs-style uniform, with three different styles of tunic top and five styles of trousers similar to the scrubs uniform worn by ED nurses.

NSWNA Assistant General Secretary

Judith Kiejda said the biggest battle was likely to be around how many uniforms nurses get and the fabric.

‘We are asking for cotton or a high proportion of cotton. The Health Department has given us an undertaking that all companies involved, including fabric manufacturers, manufacturers of garments and suppliers and so on, will all have to be quality-accredited companies.

The Department has also said it is hiring a consultant to look at fabrics, so we are hoping something useful comes of that,’ said Judith.

‘We’re not going to please everyone because some nurses want a scrubs-style uniform and others don’t, but at least it’s going to be a lot more practical and comfortable than the current one.’

The NSWNA hopes that since negotiations are already underway, there will be time to roll out the new garments by the end of next year.

Regular updates will appear in The Lamp and on the NSWNA website.

Department will issue a short policy about the installation of smoke scavenging devices including timeframes for their implementation and informing area health services that they must put in place interim risk control measures.

‘It is good that the Health Department seems to be supportive in this matter,’ said

NSWNA Assistant General Secretary Judith Kiejda. ‘Surgical smoke is dangerous to nurses’ health and the only thing they can do at the moment to protect themselves is to wear respiratory protection. The Union will continue to press the Department to ensure that requirements are put in place to ensure nurses’ health and safety at work.’n

Although the current contract runs until September 2011, negotiations for the next contract are already underway.

SURGICAL SMOKE Last year a group of nurses put forward a resolution at the NSWNA Annual Conference, calling for action to prevent nurses being exposed to surgical smoke in operating theatres.

Surgical smoke rising from tissue being burnt, as in laser surgery or diathermy, carries potential health risks. The smoke can carry toxic compounds and infectious agents. Modern equipment has scavenging devices attached to prevent the smoke from being inhaled by staff, but older equipment does not have these devices.

The NSWNA began investigations into the situation and has been gathering information to present to the Health Department. The Department is now conducting research and a survey of area health services in regards to surgical smoke and where scavenging devices have been fitted.

Once this information is collated, the

THE LAMP SEPTEMBER 2010 35

s

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

NSWNA Branch News

the campaign for in e tiv ac t ge rs be g NSWNA mem mpaigns. d other community ca an s, tio ra ng fi af st safe

NSWNA General Secretary Brett Holmes explained the details of the ratios claim to members at Bankstown Hospital Branch.

Members at Shoalhaven District Memorial Hospital Branch and Milton-Ulladulla Hospital Branch attended a meeting about the staffing ratios claim.

Members at Fairfield Hospital Branch showed support for staffing ratios.

3Nursing students at the University of Tasmania Rozelle campus recently enjoyed a barbeque sponsored by the NSWNA, where members of the Ryde Lions Club lent their time to assist with the barbeque. Lions has always been a great supporter of nurses and the NSWNA, constantly working to raise funds for its Nursesâ&#x20AC;&#x2122; Scholarship (see ad on page 34).

36 THE LAMP SEPTEMBER 2010

C O M P E T I T I O N

ak to Samurai B each Resort Win a bre

Port Stephens Relax and unwind at the award-winning Samurai Beach Resort, Port Stephens.

The Lamp is offering one lucky member the chance to win a relaxing break at Samurai Beach Resort, Port Stephens’ newly crowned winner at the 2010 North Coast Tourism Awards.

Located only two and a half hours north of Sydney and set in eight hectares of stunning bushland and nestled on the edge of the magnificent One Mile Beach and Samurai Beach sand dunes, this is the perfect escape to nature.

Members at Shellharbour Hospital discuss the for staffing ratios claim: (left to right) Diana Wilson (Branch Secretary and Delegate), Frank Testa (ED NUM) and Karin Tilden (Assistant Secretary and Delegate).

The prize includes two nights’ midweek accommodation in a two-bedroom villa for four people, a sand boarding tour with Port Stephens 4WD Tours, dolphin watch cruise with Moonshadow Cruises, entry into Oakvale Farm and Fauna World, $50 worth of Brewery Bucks from Murray’s Brewery Port Stephens, and two tandem parasails from Port Stephens Parasailing*.

The total prize package is valued at $1,280.

SPECIAL OFFER TO ALL NSWNA MEMBERS In addition to this great prize, Samurai Beach Resort is also offering NSWNA members a special offer: simply ring 1800 822 200 for a complimentary ‘Super Saver Booklet’ which has savings at Samurai Beach Resort as well as various local tours, restaurants and attractions valued at over $500 (limit one booklet per caller/address).

Visit www.samuraibeachresort.com.au for more information or to book fantastic hot deals along with a range of other accommodation packages. Alternatively freecall 1800 822 200 for bookings and availability.

To enter this month’s competition, simply write your name, address, membership number on the back of an envelope and send to: Samurai Beach Resort Getaway Competition PO Box 40, Camperdown NSW 1450 Competition closes 30 September 2010.

Only one entry per member will be accepted. *Conditions: subject to availability before 31 March 2011, not valid weekends and NSW school holidays. Offers valid for four people.

NSWNA activists and Branch Officials attended the NSWNA’s ‘Fairness at Work in Aged Care’ two-day training program held at the Association’s Camperdown office.

THE LAMP SEPTEMBER 2010 37

38 THE LAMP SEPTEMBER 2010

THE LAMP SEPTEMBER 2010 39

s

A T

T H E

M O V I E S

The Disappearance of Alice Creed g The relationship between a woman and her two kidnappers is explored in this dark drama.

Review by Robin Moon, RN MM, RNSH

GIVEAWAYS FOR NSWNA MEMBERS

FURRY VENGEANCE For mother nature, revenge is a dish best served… furry!

V

ery black is what you would call this kidnapping drama.

From the opening scene to the very end there is more than a twist in this convoluted tale.

Filmed on the Isle of Man, there are only three actors in the entire movie but you barely notice this because each is fully developed in a commanding and often slightly disturbing manner.

The family-moneyed Alice is kidnapped by two men in a brooding and slightly off-kilter opening scene and from there things never go according to what we know of stereotypical kidnapping plots.

There’s a quite bizarre relationship triangle that emerges; each one is plausible yet disturbing. At one point the relationships develop to a point where your sympathy moves from the hog-tied Alice with a bag on her head and urinal between her legs to Danny, the less experienced of the perpetrators.

40 THE LAMP SEPTEMBER 2010

Alice’s aching indignity is palpable and yet it’s Danny we’re more interested in. However, Alice enters into a battle of wills, which strains the already fractious relationship between Danny and Vic, the steely ex-criminal, and the ending turns from a foolproof plan to a desperate struggle for survival.

Given that I usually like a ‘nice’ drama with well-developed themes, no suspense and a guaranteed happy ending, I was quite surprised at how this movie developed. I didn’t get a gnawing pit of anxiety in my stomach that a knife or gushing blood would appear somewhere; it was more that I wanted to see how the plot actually developed. Just as I thought I knew where it would head, the direction would change.

Pleasantly enjoyable if you like dark themes and need something out of the ordinary to ponder upon one rainy afternoon.n The Disappearance of Alice Creed opens on 9 September.

After transplanting his family to the Oregon woods for his new job overseeing the construction of a supposedly ’ecofriendly’ housing development, Dan Sanders (Brendan Fraser) thinks his biggest problem will be helping his city-loving wife Tammy (Brooke Shields) and naturephobic teenage son (Matt Prokop) adjust to their new surroundings, while pleasing his demanding boss (Ken Jeong). But Dan’s troubles have only begun once the local animals discover his leadership role in the destruction of their habitat. He soon lands atop their most wanted list, and realises how much trouble a few feisty forest creatures can cause!

With his wife and son poised to abandon him, and his construction project in jeopardy, Dan escalates the feud to all-out intra-species war that can only have one winner.

Furry Vengeance opens on 23 September.

The Lamp has 20 double passes each to Furry Vengeance and The Sorcerer’s Apprentice and 25 double passes to The Disappearance of Alice Creed. To enter, email lamp@ nswnurses.asn.au with your film preference, name, membership number, address and contact number. First entries win!

The Sorcerer’s Apprentice g This fast-paced action movie offers escapism for both adults and children. © Disney

L

ike many kids, I loved The Sorcerer’s Apprentice story, which was then magically brought to life in Walt Disney’s Fantasia.

Given these positive memories I looked forward to this movie.

The tale goes back to 740 AD when the wise Merlin had taken three apprentices, Balthazar (Nicholas Cage), Veronica (Monica Bellucci), and Horvath (Alfred Molina), who joined him in his fight against Morgana Le Fay. When Horvath betrayed him, Merlin was killed. Eventually Balthazar was able to trap Morgana and Horvath within a nesting doll called the Grimhold. Hundreds of years later, Horvath escapes.

We then move to present-day New York where the immortal Balthazar recruits young Dave to keep Horvath from releasing Morgana and conquering the world.

Dave Stutler is a 10-year-old kid, who 10 years later as a young physics student (Jay Baruchel), is fated to become the Prime Merlinian, the only one who can defeat Morgana. He is thrown into the middle of a centuries-long good-versus-evil battle between powerful sorcerers who wield an infinite display of supernatural powers, eventually leading to a spectacular climax in the heart of New York.

Both Nicolas Cage and Alfred Molina give excellent performances. Cage is a convincing, slightly manic action hero with loads of charm as Dave’s teacher/mentor.

Molina is in great form in his ‘Hiss the Villain’ performance, though you do wonder why the Brits seem to have conquered nearly all of Hollywood’s nasty baddie roles!

The chemistry between Cage and Baruchel is great, with the latter playing the reluctant hero, a Harry Potter-type character, who is distracted by Beckie (Teresa Palmer), his pretty love interest.

It is a fast-paced Disney ‘in-between teen’ action ride, totally different to the Fantasia story. However, we do get a small re-enactment with a short scene where our geeky hero Dave, as the apprentice, sets the brooms to work to complete his chores. It is an amusing scene but a poor imitation of the Mickey Mouse original.

My expectations were for a quirkier, character-driven tale of a completely different genre. Instead, the formulaic action flick left me disappointed. Nevertheless, if you want exciting escapism and something to keep your kids entertained, you might consider it.n The Sorcerer’s Apprentice opens on 9 September.

Review by Murray James, RN, St John of God Private Hospital

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

Gifts so good, you won’t want to give them away.

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

We are seeking closet film buffs to share with other nurses their views on the movies they love and hate. It’s a chance to see previews of next month’s new releases. Please contact us with expressions of interest to be part of our movie review team. Call Editorial Enquiries now on 02 8595 1258 or email lamp@nswnurses.asn.au THE LAMP SEPTEMBER 2010 41

s

O B I T U A R I E S

Courageous leader and champion of Veterans MICHELLE CRAINE 1945–2010

P

roof that life is bittersweet has been in full evidence recently, as Michelle Craine, long-time Director of Nursing at Sydney’s Lady Davidson Private Hospital, was honoured by the RSL for her lifetime of work with Veterans and War Widows, just days before her own life came to a premature close after a brief period of ill health.

The National Executive of the RSL awarded Michelle its highest civilian honour, the Certificate of Merit and Gold Badge Award, for her tireless efforts on behalf of the Veteran community over her years at both Concord Hospital and for the past 22 years at Lady Davidson.

She was the person everyone rallied around in times of trouble; in turbulent times, those around her knew they could always turn to her.

Her nursing career began in 1963, when she was just 17. Michelle moved from her home in Newcastle to Sydney in order to commence her nursing training at Royal Prince Alfred Hospital, a challenge she handled with a wisdom and maturity beyond her years – qualities that would come to define her to many colleagues. During those formative, early years at RPA, she made several friendships that were to last a lifetime.

Michelle began working full-time at Concord in 1978, which she loved and where she remained for the next 10 years until 1988, when she embarked on her career at Lady Davidson.

It was with her significant tenure at Lady Davidson that Michelle truly found 42 THE LAMP SEPTEMBER 2010

her calling. After starting out as Bed Manager, she soon moved into the Deputy Director of Nursing role before becoming Director of Nursing in 1991. She then further completed her Master’s Degree in Health Management, from which she graduated in 1992 with a Distinction.

Michelle had a deep love and respect for those who gave their life for our country and she ensured the hospital celebrated and remembered the important days of Anzac Day, Remembrance Day, and the commemoration of the Battle of Villers-Bretonneux and the Battle of Long Tan. Never was that more evident than during the 1994 bushfires when, with the lives of over 200 Veterans at risk, Michelle worked around the clock to ensure the safe evacuation of patients.

As friends and colleagues described Michelle, the very high regard and esteem in which she was held shone through, as time and time again they would recall her grace, wisdom and good humour.

She was the person everyone rallied around in times of trouble; in turbulent times, those around her knew they could always turn to her when they needed guidance, genuine care and a courageous leader.

Healthscope CEO Bruce Dixon paid tribute to Michelle, thanking her for her outstanding contribution and excellent work and loyalty at Lady Davidson and for the thousands of patients she helped, and for her contribution to the wider community in general.

Lady Davidson General Manager Cheryl Jaeschke said the hospital would be left with memories of Michelle’s personal strength, experience and

wisdom, her dignity, her dynamic management style and clinical skills, but above all, her delightfully warm and caring personality and the friendships, which grew over many years.

Michelle had a quiet personality and wasn’t much fussed on being the centre of attention, but also knew how to let her hair down with her loved ones. She was funny, even more so during her last weeks, never being short of a quip or a one-liner during these most difficult of times.

Her bravery, grace and dignity throughout this time was truly honourable.

Michelle touched many people’s lives and will be missed more than she could imagine.n

By Virginia Edwards, Lady Davidson Private Hospital.

A long life devoted to nursing JOAN ELIZABETH HUNT 20 September 1921–19 March 2010

J

oan Hunt was born in the small NSW country town of Willow Tree and her early education was in Gunnedah.

Her father moved around the State with his bank employment and Joan completed her senior schooling at the Methodist Ladies College in Burwood. Her father was by now in Lismore and Joan worked as secretary/typist before commencing her nurse training at Royal Prince Alfred Hospital in July 1940.

She worked at Cowra and Rachael Foster Hospital where she did her Diploma of Nursing Education. She was appointed to the staff at Hornsby Ku-

ring-gai Hospital as Head of the School of Nursing in 1970. Joan was responsible for providing education programs for both the general student nurses and inservice program for the more than 500 registered staff. She retired in 1987 and was a life member of the NSWNA. Joan achieved a very high standard of nursing care and in State examination results. She was highly respected as mentor to her staff and a firm friend to her colleagues.

Joan regularly attended opera, symphony concerts and enjoyed golf, entertaining and gardening.

We thank her for her contribution to nursing for all those years and loyal friendship to many.n

By Margaret Greening, Former DON, Hornsby Ku-ring-gai Hospital Life member NSWNA

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THE LAMP SEPTEMBER 2010 43

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O B I T U A R I E S

A midwife who loved to share her skills and passion KATHRYN ANNE SHEPPARD 15 February 1962–15 June 2010

K

athy tragically lost her life in a light plane crash near Sydney on Monday 15 June 2010. Head nurse/ midwife for Wingaway, an aeromedical patient transport firm, Kathy was en route to Brisbane undertaking a routine transfer.

Kathy also worked as a midwife at Port Macquarie Base Hospital.

Kathy was a daughter, sister, partner, mother, midwife, nurse, awesome soccer player and our friend.

Kathy’s many loves included her four girls: Rachel, Nichola-Kate, Stephanie and Erin, their father Glenn Sheppard, her partner Ron O’Brien, her extended family and, of course, us.

She loved soccer, flying and midwifery, caring for women and their families, helping to bring new life into the world, as well as the many other patients she cared for.

Kathy was one of the Sheppard ‘girls’ who were the stars of our soccer team Midwives and Mayhem. Despite the majority of the team having little or no soccer skills we managed to bamboozle the opposition and win the six-a-side Women’s B grade final in 2001!

Kathy’s love of flying saw her work as a flight nurse for Wingaway for approximately 10 years. This included the back transfer of babies and mothers to Port Macquarie Base Hospital from a tertiary hospital following either premature birth or illness requiring neonatal intensive care – this was Kathy’s favourite ‘transfer job’.

Kathy worked as a midwife at the Hastings District Hospital and then at Port Macquarie Base Hospital since its opening in 1994.

Kathy, Glenn Sheppard and their dear friend Rae Condon attended many local women and their families for homebirths.

Kathy was an amazing midwife, with excellent intuition and safe skills. Kathy saw birth as a miracle, a privilege to be part of, and her care of so many families will last a lifetime, regardless of where or how long 44 THE LAMP SEPTEMBER 2010

ago that baby was born. There are families across the districts that are grieving the loss of ‘their’ midwife, who was so very special to them; she helped bring their precious baby safely into the world, something they will treasure forever.

One of Kathy’s greatest attributes was her willingness to share her knowledge and love of midwifery to those around her. She was one of the most inspirational midwives at Port Macquarie Base Hospital, always having time for midwifery students, medical students or anyone interested in learning her skills.

Her belief in a woman’s ability to birth her baby left women feeling confident in their own ability, yet reassured that Kathy was always alert for early signs that may indicate medical assistance was required. Her passion to provide holistic care to women and their families was unsurpassed.

Kathy’s skills as a midwife commanded the utmost respect from all who worked with her: midwives, obstetricians and paediatricians alike.

She loved her friends and was always bright and bubbly, a joy to work with.

Kathy, had a wicked sense of humour and was the instigator of many practical jokes, including glad wrap over the loo and confetti above the doorway! She certainly made working night duty bearable.

Kathy was the person you wanted to work with – when there was time to have fun, but also when there were emergencies. Her calm, level head was always reassuring in a crisis.

Kathy was a kind, caring, compassionate person who would do whatever she could, whenever she could. She was respected and admired for her genuine nature and outstanding skills as a midwife. She was a wonderful human

being who loved life, and those people whose lives she touched loved her in return.Her vivacious smile, contagious laugh, sunny disposition and willingness to help made her loved by all – family, colleagues, friends, administration, doctors, ancillary staff and, of course, the families and patients she cared for.

Friends and families from across Australia are joined in their grief and sorrow with the sudden and tragic loss of Kathy’s life.

To Kathy: we thank you for your unconditional love, your wonderful sense of humour, your warmth, your inspiration, and your friendship. It has been a privilege to work with you and we have been truly blessed to be part of your life. We will miss you desperately. You will always live on in our hearts.n As a legacy to Kathy a scholarship fund has been established by the staff of Port Macquarie Base Hospital. The aim of the fund will be to promote Midwifery Education within our unit. Please contact Louise Harper at Louise.Harper@ncahs.health.nsw. gov.au for information.

By Louise Harper, on behalf of Kathy’s friends and colleagues from Port Macquarie Base Hospital and surrounds.

s

B O O K S

Book me Mental Health First Aid Manual (2nd ed.)

By Betty Kitchener, Anthony Jorm and Claire Kelly, University of Melbourne, ORYGEN Youth Health Resource Centre, RRP *$30.00 : ISBN 9780980554137 This edition of the Mental Health First Aid Manual provides information about the major types of mental disorders, the best types of help available, local resources, and how to apply the steps of mental health first aid to various situations. The manual is also used to support the awardwinning 12-hour MHFA course.

Nursing Know-How: Evaluating Signs and Symptoms

By Springhouse Publishing Company (available through Lippincott Williams & Wilkins), RRP *$50.00 : ISBN 9780781792059 This volume of the new Nursing Know-How series offers howto guidance on the latest techniques for evaluating over 250 important signs and symptoms. Each sign or symptom is presented on a page or a twopage spread in bulleted format. Numerous illustrations and flow charts complement the text as well as case clips, which share rapid response team approaches to real-life scenarios. There is also the addition of a

quick action feature in the text that explains how to determine and what to do if your patient needs emergency care.

Drowning in Drainage?

The Liverpool Hospital Survival Guide to Drains and Tubes (1st ed.)

By Quan D. Ngo, Vincent W. T. Lam and Stephen A. Deane, atminformation, RRP *$29.95 : ISBN 9781740790468 This small, practical manual is an attempt to provide some of the answers by assembling information about common surgical drains and by offering advice and guidelines about the care and trouble-shooting of these common devices. It is likely to be of interest to ward nurses and junior hospital doctors, medical and nursing students, operating theatre nurses and surgical trainees.

Davis’s Q & A Review for the NCLEX-RN Examination

By Kathleen A. Ohman, F. A. Davis (available through Elsevier Australia), RRP *$65.00 : ISBN 9780803621879 Davis’s Q & A Review for the NCLEX-RN Examination features 5,038 questions in all, with 1,340 of those being alternative item format questions. The text contains a bonus CD-Rom with 3,000

WHERE TO GET THIS MONTH’S NEW RELEASES These books are all available on order through the publisher or your local bookshop. Members of the NSWNA can borrow any of these books and more from our Records and Information Centre.

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

Disclaimer: Some of the items featured in

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

PUBLISHERS’ WEBSITES c c c c

F. A. Davis: www.fadavis.com Elsevier Australia: www.elsevier.com.au Quay Books: www.quaybooks.co.uk Lippincott Williams & Wilkins: www.lww.com c Atminformation: atmsales@med.usyd. edu.au (email) c ORYGEN Youth Health Resource Centre: http://oyh.org.au

questions that can be selected according to specific content area, client need categories and subcategories, integrated processes, or phase of the nursing process, or by a 275question comprehensive exam.

Manual of I.V. Therapeutics: Evidence Based Infusion Therapy (5th ed.)

By Lynn D. Phillips, F. A. Davis (available through Elsevier Australia), RRP *$54:00: ISBN 9780803621848 Manual of I.V. Therapeutics: Evidence Based Infusion Therapy is a perfect resource for any setting where infusion therapy skills are required. This title features a bonus CDROM packaged with every book that include a 300-question test bank with rationales as well as case studies from the book with critical thinking questions and answers.

It includes competency skill checklists for evaluating procedures and presents detailed step-by-step procedures for subcutaneous infusion of pain medication, peripherally inserted catheters (PICCs), epidural pain medication administration, and patientcontrolled analgesic therapy. It examines delivery of IV therapy in the home setting.

Pioneering Theories in Nursing

By Austyn Snowden, Allan Donnell and Tim Duffy, with a foreword by Sir George Castledine, Quay Books, RRP *$35.00 : ISBN 9781856424004 Pioneering Theories in Nursing presents leading nursing theorists and their contribution to nursing theory and practice, including nurses from abroad who have influenced UK practice, and takes the reader through the history of nursing and the men and women who have developed nursing as a profession.

Each theorist has details of their biography, a summary of their writings, an explanation of their theories, demonstration of the use of their theory in practice and the influence they have had on the field.n *Price in Australian dollars at time of printing THE LAMP SEPTEMBER 2010 45

Look stylish this Spring

Unisex Navy Rugby Shirt with Denim Collar 65% polyester, 35% cotton Long sleeves

$25

Available in sizes S,M,L,XL,XXL

Unisex Navy Rugby Shirt with White Collar 65% polyester, 35% cotton Long sleeves

The latest NSWNA merchandise is not only stylish and comfortable, it is affordable and sold at cost to members.

$25

Available in sizes S,M,XL,XXL

Unisex Polo Navy Blue T-Shirt

Ladies Navy Rugby Shirt with White Collar

Short sleeves

95% cotton and 5% elastane Long sleeves

$25

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

$25

Available in sizes 12, 14, 16, 18

Large Wrist Watch

$30 was $40 each

AL SPECI E PRIC

Fob Watch (Silver)

$40

Nurses Joey Navy

$25

Nurses Joey Pink

$30

â&#x20AC;&#x2DC;Nurses are the Heart of Healthâ&#x20AC;&#x2122; Mug

$6

The items shown inside these pouches are not included.

To order, call 8595 1234 (metro) or 1300 367 962 (non metro) and ask for your merchandise order form. Or go to our website www.nswnurses.asn.au 46 THE LAMP SEPTEMBER 2010

Please include postage and handling of $5 per order.

s

CRoSSWoRD

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

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ACROSS

1. The most common type of steroid in the body (11) 6. Subjective symptoms at the onset of a migraine headache (4) 8. Downy hair on the body of the fetus and newborn baby (6) 9. Inflammation of the suspensory ligament of the eye lens (9) 10. Motherhood (9) 11. Relating to the bile (6) 12. The wing of the nose (8) 15. Resembling pus (5) 18. Our nursing magazine (4) 19. Body cavity (5) 20. Matter that remains after something

has been removed (7) 22. A plant body without true stems or roots or leaves or vascular system (7) 24. Self, same (4) 25. The thick short innermost digit of the forelimb (5) 26. An indentation at the edge of any structure (5) 27. One thousand grams (4) 28. Negative, opposite (3) 29. The presence of chyle in blood (9)

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DOWN

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Abdominal cavity (6) Feeding on both plants and animal (10) The principal organ of digestion (7) A protein that acts as a catalyst to

induce chemical changes in other substance (6) 5. One of the four major types of cancer (8) 6. Congenital absence of the spleen (7) 7. Test of purity, trial (5) 12. Excessive ammonia in the urine (10) 13. Indurations; hardening (9) 14. Removal of a benign or malignant lesion from the breast (10) 15. The tissue between tendon and its sheath (9) 16. Having a double uterus (9) 17. A type of fecal diversion (9) 21. A lip, or liplike organ (6) 23. One of the proteins into which actomyosin can be split (5) Solution page 49 THE LAMP SEPTEMBER 2010 47

DIARY DATES Conferences, seminars, meetings SYDNEY, HUNTER & ILLAWARRA Day Surgery Nurses Association of NSW Conf. – ‘Education into Practice’ 11 September, Sydney Masonic Centre Contact: Tricia Goh, 9553 9905, pgoh@aesthetic daysurgery.com.au, www.adsna.info The Children’s Hospital at Westmead, Paediatric Perioperative Seminar 11 September, 8am-5pm, The Sebel Hotel, Parramatta.

Contact: Claudia Watson, 9845 2112 or claudiw2@chw.edu.au Stockton Centre (previously Stockton Hospital) Centenary Celebrations 13-19 Sept (official opening on 15 Sept), Stockton Centre, Fullerton St, Stockton.

Contact: John Naylor, 4928 0891 or john. naylor@dadhc.nsw.gov.au The Mental Health Services 20th Annual Conference 14-17 Sept, Sydney Convention Centre Cost: $750, full fee, 3 days.

Contact: 9810 8700, www.themhs.org

Ausmed Conference • ‘Acute Coronary Syndromes’: 17-18 September, UTS. Cost: $451.

• ‘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 Wound Care Association of NSW Inc Education Evening ‘Assessment & Management of Burn Injury’ 22 September, 6-9pm, Emily’s at Macquarie Hospital, North Ryde.

Contact: Melissa O’Brien, 8382 3640 McKesson NSWNA Branch Meeting 25 September, 1pm Contact: mcknswnabranch@gmail.com 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

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

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

Cardiac Cath Lab Nurses’ National Conference 16-17 October, Bimet Lodge, The Junction, Newcastle. Contact: Nessie Duff at duffn@ramsayhealth.com.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

Wound Care Association of NSW Conference & 1 Day Workshop 5-6 Nov, Merimbula RSL. Contact: 0428 922 679 or www.wcansw.com.au

INTERSTATE AND OVERSEAS

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 RURAL 17th Enrolled Nurse State Conference ‘TWENTY 10 and BEYOND’ 16-17 Sept, Cessnock Supporters Club, Cessnock. Cost: members $220, nonmembers $260. Contact: Roz Norman, 1300 554 249 or nroseby@bigpond.net.au

18th International Congress on Palliative Care 5-8 Oct, Palais des Congres, Montreal, Canada. Contact: April O’ Donoughue, info@pal2010.com, www.pal2010.com 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 2nd International Conference on Violence in the Health Sector ‘From awareness to sustainable action’.

27-29 October, The Netherlands,

Master of Medicine and Master of Science in Medicine (Psychotherapy) course 20010 – 2011 University of Sydney

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

Intensive supervision of the candidates' own psychotherapeutic work forms the major component of the course work. Lectures, seminars and supervision take place on Thursday mornings. A treatise is required at the end of the course for completion of the degree.

The course is open to Psychiatrists, Psychiatrists in Training, Medical Practitioners, Psychologists, Social Workers, Mental Health Nurses and allied practitioners with a basic degree in the health sciences, who have clinical experience working in the Mental Health field and who are professionally registered with professional indemnity allowing them to practice in NSW. The number of places in the course is limited. x

Course Fee: $5,160.00 per semester (approx.)

Applications Close Definitely on 10th December 2010 Interviews will be in late January 2011 Inquiries and application forms can be obtained from:

Dr A. Korner / Dr L McLean, Tel 9840 3335 Fax: 9840 3572 Email: michelle.phillips@swahs.health.nsw.gov.au Website: http://sites.google.com/site/conversationalmodel/ 48 THE LAMP SEPTEMBER 2010

Amsterdam, De Meervaart.

Contact: www.oudconsultancy.nl/ Violence-Healthsector/program.html

16 Sept, Stockton Centre, Fullerton St. Contact: John Naylor, 4928 0891 or john. naylor@dadhc.nsw.gov.au

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

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

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’ 19 November, Manchester, UK. Contact: www.mkupdate.co.uk/ coursedetails.php?ID=253

Reunions Stockton Centre (previously Stockton Hospital) Staff and Client Reunion

Diary Dates 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.

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 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.

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 October, 10am-1pm, Metro Residences Rydalmere Recreation Hall than on to Rosehill Bowling Club.

Contact: J Sillet, 9334 0541 or Irene Clout, 9334 0557 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, psu34047@bigpond.net.au/ Maria Hulme (née Honner), hulme@internode.on.net

NSWNA Events Education Dates: • Mental Health Nurses Forum: 22 September, NSWNA Camperdown.

• Enrolled Nurses Forum: 8 October, NSWNA Camperdown.

• Legal & Professional Issues for Nurses & Midwives: 15 Oct, Wagga RSL Club.

• Basic Foot Care for RNs & ENs: 19-20 October, West’s Diggers, Tamworth.

• Computer Essentials for Nurses & Midwives: 25 Oct, Concord Hosp., Concord • Appropriate Workplace Behaviour: 29 Oct, Ex Services Club, Coffs Harbour.

Contact: Carolyn Kulling, 8295 1234/ 1300 367 962, www.nswnurses.asn. au/topics/2761.html

NSWNA Branch Officials’ & Activists’ Training Program 2010 ’Negotiation and Advocacy Part 1’ Wed 22 Sept & Wed 17 Nov. ’Negotiation and Advocacy Part 2’ Wed 22 Sept & Wed 17 Nov. ‘Fairness At Work in Public Hospitals’ Thurs 23 Sept & Fri 24 Sept.

Venue: NSWNA Camperdown.

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

Notices Mental Health Consultation Liaison Nurses’ Association of NSW & ACT 10th Annual Conf. – Call for Abstracts Abstracts are invited for papers which illustrate and focus on the past, present and future of MHCL nurses. Presenters are encouraged to speak to innovative and current practices about how they have evolved in their clinical settings.

Abstracts close 1 October 2010 Contact: Wayne Keevers, keeverw@wahs. nsw.gov.au/ Kerrie Cooper, kcooper@ stvincents.com.au, www.mhclna.org.au

Crossword solution

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9:44:41 AM THE LAMP21/1/10 SEPTEMBER 2010 49

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TAX RETURNS

Specialised Service for Nurses and Hospital Staff Maximum Tax Refund Within 14 Days sub. to ATO • Fees from Refund & Fully Tax Deductible • Professional, efficient, Personal Service, 7 Days • Negative Gearing, Shares/ Property, Capital Gains Tax • Overdue & Late Returns • Tax Planning

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