Mark Butler, the Minister for Mental Health and Ageing is on the ABC program “Q & A” tonight at 9.35pm, along with Independent Rob Oakeshott and others.

It would be great to have some questions about aged care asked via email or video question – which you can do ahead of time via this link.

If you use Twitter you can also make comment during the program.

You could ask how staffing numbers affect quality of care, about the wages gap, the loss of nurses especially registered nurses, and how reform needs to make a difference to the people receiving care, not just be about financial reform.

We’re sure our aged care nurses have plenty of other questions!

Image credits: ABC

The following question was raised in our forum last week, have you ever been forced or told to complete education or study in your own time (unpaid)?

“Last year our hospital gave us a list of online courses we had to complete in our own time. It was over 50 hours’ worth, six days. In addition they have added extra online courses such as Bloodsafe. We were recently informed that we are to expect even more online learning to do in our own time. It isn’t voluntary.
I don’t know of any other job where staff are required to do unpaid work at home and have to present the certificates at work to be marked off.  I’d probably do a lot of it in my own time if they were just suggestions of courses that might be of interest. The expectation that we do it, and have to, is what is really annoying me.”

A reply from a fellow reader said:

“My manager refuses to grant us any study leave unless it is a preceptorship hospital run course or a NSW College of Nursing paediatric nursing course.
We have mandatory E-Learning modules that we must complete annually on our intranet. We are a virtually paperless ICU with computers at each bedside.  However, given it is an ICU and one seldom has time to open work emails to get notices whilst caring for critically ill patients much less complete mandatory education.
It is difficult to even attend in-services given the size of our unit and the number of staff available to relieve us for this purpose. APHRA is demanding 20hrs of CPD but try fitting that in.”

What happens at your workplace? One of our other forum participants suggesting checking your employment agreement. You should ask your local union rep about the rules and regulations and check what tasks, if any, you are required to do unpaid.

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Image credit: Wikipedia

This question was asked in our forum last year. Read it and let us know what you think. In this case, the husband refused for his wife to be treated by a male doctor as it was against his religion, the wife ended up passing away.

“On presentation to the public health system or private system, all patients have rights, or do they? What do they sign when a formal admission is completed and they go to wards?

On night shift there were five male staff. Night MO and on-call were both males. A female was admitted from ED and normal obs required to be taken, however the husband refused any male to touch his wife as it was against their faith. It was explained there were no female staff on duty and the doctor was also male.Don’t forget to subscribe to our Nurse Uncut newsletter

He objected despite his wife needing bloods to be watched which were up and running from ED. No other beds available at all. She was also in ISO as being Hepatitis C.

What to do? No other staff was allows to rotate just for this patient as our ward had gastro and strict infection control in place. Patient was 27 years old and spoke perfect English. He refused us to give medications as well…

So where does this place Duty of Care for nurses under the Health Act and what would you do?

Night Reg asked them to sign away all claims to cover the Hospital and staff. They refused to do this.

Other hospitals were called to see if a transfer could take place? PLEASE. A total joke!! Security was called and the husband was removed as he was not a patient and Police were called to assist.

His wife died in our shift. We were all shocked and asked for the next day off. As a professional nurse we stand confronted each day with new events and we can but remember we are all human, breath the same air, see the same sun each day and all need rest, water and food.

The husband never returned to see the body and we took comfort in the fact he must have been totally devastated and in shock to see her so ill. They had been married just one year and returned to Australia from the UAE after seeing family there.

Guys what would you have done? Called in an emergency Agency RN at 12.30 PM; called in your NUM or CNC to come in?”

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As Nurses, in any field of practise, we interact with doctors, or Visiting Medical Officers, as some like to be called.

How have working relationships changed over the last 20, 30, or even 50 years?

We hear of terms like ‘handmaiden’ of the doctor, but is this true today?

Let’s hear from as many readers as possible, about how their working relations with doctors have changed over the years.

Do you still think you are only a servant of the doctor? Do you feel you are the one who directs the VMO in your working environment?

Are the popular TV shows an accurate reflection of Nurse and Doctor working relations?

Tell us what YOU think on this issue.

Join our latest contest: Are you our chattiest nurse? Get the chance to win a relaxing weekend at Port Stephens!

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One of our new forum members, nursing1, a mature age student nurse, raised the following question.

“I passed 1st year of my nursing degree in 2009. I have deferred this year and hope to return to university next year and complete my degree.  During my very prac last year I had the facilitator from hell and almost put in a formal complaint about her attitude toward me.  Her actions made me really think about my decision to enrol at university and have a career change mid life. I am hoping that fellow Nurse Uncut members may be able to perhaps give me some postive affirmations as to why I should continue and re-enrol next year…?”

We are sorry to hear this, nursing1, and hope that the bad experience with your facilitator has not put you off. A paper published by La Trobe University in Victoria discussed the importance of mid-life career transitions to nursing and mature age students.

‘Australia’s health care system is facing acute workforce shortages as the health workforce ages, more people opt to work part-time and the recruitment pool for those commencing employment diminishes.

For nursing, attracting an appropriately qualified workforce, in sufficient numbers to meet the demands of a changing health care system, is a complex task with no easy solution.

An initiative was developed that focused on looking at strategies to make it easier for people to enter, progress and re-enter the nursing profession.

Key reports have indicated that mature age students may be an important group in future workforce planning as numbers of the school leaver group diminishes and individuals more frequently change career directions.

Education providers see mature aged student nurses as a highly motivated group with strong communication skills and attributes such as time management, work ethic and life experiences were identified. The range of skills and experience that mature age students bring to the education and clinical setting is viewed as extremely valuable for the profession.

Overwhelmingly students reported satisfaction with their career choice despite the significant hurdles that they face in pursuing studies in nursing.’

Do we have any nurses that made a mid-career transition who can offer support or advice to nursing1? Are you a student nurse at the moment – what are your thoughts?

Image credit: RobW

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This post was proudly brought to you by the NSW Nurses’ Association.

It was Father’s Day last weekend. How did the Father’s in your life spend the day? Do you need a special day to honour your Father?

Richard Thomas from the Sydney Morning Herald said even though his 80-year-old dad is 22,500 kilometres away, he regularly sends him tokens of gratitude and affection “for a lifetime of fatherly care and love.” He does this without “relying on a designated day instructing me to do so“.

“I know as a father what I value most is to see my children happy and healthy with a little bit of obedience thrown in. And as any father will know that a child’s gleeful laugh is worth all the overpriced and overpackaged tat that was sold to commemorate this day. Yesterday morning I was greeted with the warmest of hugs, a couple of handmade cards and a cup of tea in bed from my kids and that just about made me the happiest dad in the world,” he says.

Some of our Forum members have been chatting about how they or their Fathers spent the day.

Foxylass said unfortunately her poor dad is spent Father’s Day in hospital. Bernhardt spend the day at a wedding and received hugs from his daughters and a handshake from his son, which he says is worth far more than presents.

How did you honour the special men in your life? What does Father’s Day mean to you?

Image credit: mikebaird.

Source: Sydney Morning Herald.

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This post was proudly brought to you by the NSW Nurses’ Association.

One of our new forum members Krishna had some interesting thoughts on the changing nursing workforce. So much that we thought it deserved a blog post. We’d be really interested to hear your views so share them below!

She has been nursing for 30 years and says she has noticed a shift in “life values” between the 70′s-80′s trained nurse and the upcoming young grads of today.

“But this isn’t a bad thing,” she says.
“In the 80′s we looked up to Alan Bond and Christopher Skase for ‘how to make a quid’. Well…really…where did that get us? We worked and worked, to pay for the pools, the McMansions, the overseas travel, the gadgets. We commuted for up to two hours a day to work….are we insane?

Then the ‘new breed‘ came. The grads who go part-time after a year or two. The “life-stylers. I take my hat off to them. Sure they want to travel, but they don’t yearn for the stuff we did.

Where does that leave the nursing profession? With not many 3rd-6th year nurses working full-time?
Have a look around your ward. How many are “babies” newly graduated, how many are in the middle group and how many of us “crusties’ are on your staffing profile? Where are the 3rd-6th years??

If we look in to the future of the nursing workforce we have to understand what drives the newly graduated today. It is certainly not the hierarchical response of the past (do as I say.) They have the power to leave. And this will impact on our profession significantly within the next 10 years.

The change is happening. So, for example, when NSW health wants to trial “pattern rostering” like in Hunter New England, why would a young person stay?

What is happening in the private sector? Or, more significantly, in aged care? The vitriol is alive and well with the ‘party’ spin-doctors but let’s see what really unfolds. A “Hung parliament” might actually be a good thing to shake up the two major parties. We’ll “watch this space.”

Bernhard agrees that there are more RNs of less than five years post-grad experience in areas that used to have regular ‘long-term’ nursing staff.

What do you think? What is your staffing profile made up of? What drives the new graduate today?

Image credit: University of Miami.

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This post was proudly brought to you by the NSW Nurses’ Association.

Are you employed on a casual contract? do you know all the rules, regulations and entitlements?

One of our recent forum questions was on casual staff and whether they are eligible for overtime if working more than 40 hours in a week…can you help?

Q: Is a casual pool employee eligible for overtime if over 40 hours are worked in any one week period?

Amanda63 thought casual staff could not be paid overtime due to the fact that they ARE casual.

“In the public award, as far as I’m aware, casual staff do not attract overtime due to the fact that they are casual. This has been a point of debate for some time with the casual staff, particularly if you are doing more than 8 hours straight on the same day.”

Amanda63 also says: 

“Many may not be aware but in the public hospital system the award states that on Sundays an employee doing overtime will be paid double time from the commencement of the shift (not time and a half for the first two hours), and double time and a half for public holidays.

“Sunday and public holiday overtime attract different codes to overtime at any other time when entered in to the computer.”

What do you think? Do you have any advice for casual staff?

Can you help with this question? Do you have any feedback?

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Image source: Christiana Care

This post was proudly brought to you by the NSW Nurses’ Association.

From time to time we go back and check out past questions asked by our forum members. In April Starrie asked if anyone had feedback from working overseas. She wanted to work overseas but wasn’t set on any particular destination.

“Hi–I want to work overseas and was wondering if anyone had any feedback about their own travels? At this stage I’m not sold on any one destination, although not sure if I’m keen to work in the UAE. Any tips, recommended agencies, do, don’ts MUCH appreciated! Thanks.”

A few of you put your two cents worth in.

Some of the best advice was:
- To register with overseas nursing agencies to make the job-hunt process simpler.
- To contacting nursing agencies overseas and start the paperwork before you even leave home, so when your turn up the process is a lot easier.
- To ask agencies for advice of visa requirements.

Nursing abroad.net says working overseas can be a very rewarding and valuable experience, offering challenges and a new outlook on health care. Many nurses find that the experience enhances their development and increases their confidence both in a personal and a professional capacity.
Opportunities for nurses to work overseas are varied, ranging from working with development organisations in remote, rural conditions, to working in developed countries in highly technical environments.

There will be many positive reasons for wanting to nurse overseas, including the challenges of working and living in another country with a different culture.
Nurses from the UK who are looking to work in other developed countries may be attracted by higher salaries and a better standard of living or a warmer climate.

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

What other advice do you have on working overseas? What countries have you worked in? Can you share some of your experiences?

Maybe even write us a guest blog about your experiences nursing in foreign lands. Contact us at admin@nurseuncut.com.au with your stories!

Image credit: Kossy @ Finedays.

Sources: Nursing Abroad and Overseas Nurse

This post was brought to you by the NSW Nurses’ Association.

The launch of the standardised observation chart with a colour-coded warning system, dubbed ‘Between the Flags’, was implemented at all NSW hospitals this year.

The program was dubbed “Between the Flags” because it was based on the way Surf Life Savers keep watch over us and ensure we remain within safe boundaries.
Research into health systems around the world shows that some warning signs can be recognised earlier.

Between the Flags supports doctors and nurses in knowing these signs, making clinical decisions on when to seek help and what sort of help is needed.
The chart dictates exactly what action staff must take when a person’s vital signs (obs) fall within the ‘yellow’ zone, which indicates early deterioration and the need for a clinical review, and the more critical ‘red’ zone, which calls for a rapid response.

The standardised system improves the way medical staff recognise and respond to patients who are clinically deteriorating.

A question regarding mandatory obs was raised by Bookworm, one of our Nurse Uncut members in our Forums:

“Since between the flags came in it is mandatory to do obs on patients at least three times a day. This is not required for aged care patients in a designated aged care unit.
I work on a Medical ward and we average half of our patients waiting for placement. A few have been with us for two years. Apparently we might get around the requirement for tds obs if the docs change the frequency and document it on the obs chart.

We have enough trouble trying to get altered calling criteria. We’ve tried to get them to document altered obs frequencies on the obs charts but then you have to get them to do it every week with the new chart.”

Has anyone else come up with a solution to this?”

What are your thoughts?

Does anyone else have trouble getting altered calling criteria?

Has anyone had trouble adjusting to “Between the Flags”?

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Image credit: Horizon 2035

Sources: NSW HEALTH; NSW NURSES’ ASSOCIATION.

This post was brought to you by the NSW Nurses’ Association.