N u r s e C l i c kJULY 2016

The nursing grad experience: A reflective case study

A nurse or an angel in scrubs? A health consumer's story

Responding to and preventing elder abuse in Australia

Nurses advocating for human rights and freedom

Advertorial @ACN

Aged care homes endorse new palliAGEDnurse app

Representation @ACN

ACN voices – meet our representatives

NMBA update

NMBA pleased to announce national health support service

In this edition

In focus @ACN

Vital Signs: Advocating for human rights and freedom

Corporate partner @ACN

Your investment in a piece of Australia

Corporate partner @ACN

Holding nurses to account: What to do when things go wrong

In Memory @ACN

In memory: Jeannie Ross Fraser FACN, 1923-2016

In focus @ACN

Nursing in the community: The bigger picture of patient care

Policy @ACN

Protecting the rights of older Australians from abuse

In focus @ACN

A nurse or an angel in scrubs? A health consumer's story

In focus @ACN

Climate & Health: Future disasters under new climate scenarios

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14

24

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2322 25

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In focus @ACN

The nursing graduate experience: A refelctive case study

2017 19

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Publishing details

Publisher

Australian College of Nursing

Editors

Karina Piddington

Wendy Hooke

Design

Nina Vesala

Emma Butz

Enquiries

t 02 6283 3400

publications@acn.edu.au

© Australian College of Nursing 2016

The opinions expressed within are the

authors’ and not necessarily those of ACN

or the editor. No part of this publication can

be reproduced without permission from

ACN. Information is correct at time of print.

All files marked ‘file photo’ or credited

to iStock are representative only and do

not depict the actual subjects and events

described in the articles.

Cover image: iStock/Emma Butz

ACN publishes The Hive, NurseClick

and the ACN Weekly eNewsletter.

Welcome

WelcomeAdjunct Professor Kylie Ward FACN, CEO of ACN

Welcome to the July edition of NurseClick.

We have some insightful articles this month that

highlight the immense difference support and

compassion can make to nurses and patients alike.

In her reflective case study, Rachel Wardrop

MACN shares her journey from struggling graduate

with no support network to valued and confident

nurse and educator, while a grateful health care

consumer tells of her experience with the ‘best

and the worst’ of the health care system in her

thank you letter of sorts, ‘A nurse or an angel in

scrubs?’

With compassion being synonymous with the

nursing profession, it’s no surprise that we are well-

positioned to advocate for human rights. Inspired by

a recent panel held by the Australian Human Rights

Commission, ACN Nurse Educator Trish Lowe

MACN discusses the importance of meaningful

conversation in this space and how nurses can

contribute in her regular column, Vital Signs.

Described as ‘compassionate, courageous and

committed’, Jeannie Ross Fraser FACN, who

sadly died on May 30 this year, encapsulates the

ethos of the nursing profession. With the help

of Jeannie’s dear friend Eve Chappell, we pay

tribute to the generous nurse and philanthropist,

who will be greatly missed by the Glen Innes and

nursing communities whom she gave so much to.

Once again, it is a pleasure to profile one of our

member representatives. Tracy Kidd MACN

is an exceptional nurse leader with a wealth of

experience in emergency nursing and we are proud

to have her representing ACN on the Australian

Resuscitation Council.

Following the recent release of the Australian Law

Reform Commission Elder Abuse Issues Paper, the

ACN Policy Team have put together an article on

this global social issue. If you have any experience

or expertise related to elder abuse, I encourage

you to share your knowledge to help inform ACN’s

response to the Elder Abuse Issues Paper.

Following up her inaugural piece in the June edition

of NurseClick, ACN’s Climate and Health Key

Contact Dr Liz Hanna FACN shares her expertise

once again in her Climate and Health column, as

she explores the climate's effect on global health as

it influences the intensity and frequency of disasters

around the world.

Finally, we feature a story from our Community and

Primary Health Care Nursing Week: Nurses where

you need them eBook. Vanessa Crossley's story

is a captivating look into the role of an in-home care

nurse — just one of the many forms a community

and primary health care nurse can take. If you are

a community nurse or know a community nurse, I

encourage you to share your story with us and get

involved in this year's Community and Primary

Health Care Nursing Week.

TO RESEARCH REVIEW

MAKING EDUCATION EASY FOR NURSESwww.researchreview.com.au

Subscribe

free

subscribe now

Visit www.collegianjournal.com

Read the latest in nursing research and practice in ACN’s digital journal, Collegian.

Access to the peer-reviewed publication is free for all ACN Members via the My ACN member portal, members.acn.edu.au

4Snapshot

In the news

Nat ional

Decrease in neural tube defects since folic acid added to bread

The introduction of the mandatory fortification of

bread with folic acid (in Australia) and iodine (in

Australia and New Zealand) in 2009 has resulted in

improved health outcomes, particularly for teenagers

and Aboriginal and Torres Strait Islander women,

according to a new report from the Australian

Institute of Health and Welfare (AIHW).

Read more

Health Tracker report card

The Australian Health Policy Collaboration has

released Australia’s Health Tracker, a report card that

provides a comprehensive assessment of the health

of Australians in relation to chronic disease and

their risk factors. The report card will track progress

towards the targets for a healthier Australia by 2025.

Read more

More Victorians to be able to die at home under government plan

More Victorians would be able to die at home under

an ambitious government plan to overhaul the state's

strained and fragmented palliative care system within

two years. About 800 people and 40 organisations

were consulted for the plan, many of whom stressed

that people want access to palliative care in their

homes and local areas.

Read more

Epileptic NSW children to trial cannabis

NSW children suffering severe, debilitating and

treatment-resistant epilepsy will soon be able to

access medicinal cannabis as part of an Australian-

first clinical trial. The experimental, cannabis-based

Epidiolex drug will be delivered through the Sydney

Children's Hospital to an initial group of 40 NSW

families in need, with the hope of expanding the trial

to hundreds within the next 12 months.

Read more

Irregular heartbeat a cause of stroke

Hundreds of thousands of Australians may be living

with an undetected killer that is putting them at

serious risk of stroke, experts warn. Around 460,000

Aussies have atrial fibrillation, an irregular heartbeat

which can be fatal if left untreated.

Read more

Study shows an increase in post-birth hysterectomies

The number of women who have had potentially

life-saving peripartum hysterectomies in Australia

has increased. New research on this rare, emergency

surgery has found the increase is strongly associated

with increased rates of caesarean sections in

Australia.

Read more

Cancer risk linked to skin cells exposed to high temperatures

Scientists have found that skin cells exposed to UV

light and a temperature of 39 degrees Celsius show

significant DNA damage, which increases a person's

risk of illness. They say the findings could be of

particular importance to people who work outdoors,

in warm climates.

Read more

High health care costs for obese preschoolers

Obesity even at a very young age is costing the

health system money, with obese pre-schoolers two

to three times more likely to be admitted to hospital,

a study has found. The study by the University of

Sydney's School of Public Health examined the total

health care costs of 350 pre-school aged children

over a three-year period and found those who were

obese had 60 per cent higher costs than healthy

weight children.

Read moreCRICOS registered provider: 00004G

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with postgraduate study

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5Snapshot

World

Womb scratch may double the chance of having a baby

A cheap and simple technique that involves

scratching the lining of the womb could double

fertility rates in women, research suggests. A

global study found that women who underwent the

procedure during natural or assisted conception had

birth rates 2.2 times higher than those who did not.

Read more

New genetic test can spot aggressive prostate cancer

For decades, doctors have been able to easily

identify women who have a higher risk of developing

breast cancer because of their genes. Now

researchers have recognized a similar set of genes

that can distinguish aggressive prostate cancer.

Read more

Mother's DNA is key to healthy ageing, study finds

A tiny repository of DNA inherited only from one's

mother may be key for healthy ageing, according

to researchers who swapped out mouse genes to

prove the point. The research team created two

sets of lab mice identical but for their mitochondrial

DNA (mtDNA) – and found that one group was much

healthier and more sprightly in old age.

Read more

Scientists are homing in on the secrets of limb regeneration

In recent research, scientists from Mount Desert

Island Biological Laboratory and the University of

Maine found that three evolutionary distant species

have important similarities in their microRNA – small

RNA molecules that regulate elements of gene

expression – which may be vital to their regenerative

abilities.

Read more

Unmasking Alzheimer's risk in young adults

The risk for developing devastating Alzheimer's

disease may be detectable in healthy adults younger

than expected, and new studies reveal how. A study

published in the journal Neurology suggests that the

risk factors for sporadic Alzheimer's can be detected

early in adulthood and might make a person more

susceptible to cognitive decline.

Read more

Hospitals on alert for global emergence of deadly, drug-resistant yeast infection

Health authorities in the United States and the United

Kingdom are alerting hospitals to be on the lookout

for an emerging multidrug-resistant yeast in patients

that is causing potentially lethal, invasive infections in

healthcare settings.

Read more

Artificial pancreas for diabetes patients could be available within a year

People living with type 1 diabetes could soon be

free of regular insulin injections, after researchers

said an artificial pancreas could become available

within a year. Those diagnosed with the autoimmune

condition need regular insulin injections, sometimes

up to six times a day, to compensate for a pancreas

that produces little or no insulin.

Read more

New 3D printing technique helps create jaw prosthesis for cancer survivor

The life of a cancer survivor has been changed

forever, thanks to a novel 3D printing technique

developed by scientists at Indiana University. The

revolutionary technique uses 3D modeling and

printing to create incredibly lifelike prosthetics faster

than conventional methods.

Read more

Call for nominat ions for Pol icy Innovat ion and Impact Award

The International Council of Nurses (ICN) is

calling for nominations for the first Kim Mo

Im Policy Innovation and Impact Award. The

recipient of this award will receive a grant for

advancing an innovative policy project focused

on a key global issue.

The award will be presented during the ICN

Congress Opening Ceremony on Saturday 27

May 2017 in Barcelona, Spain.

A nominee may be an individual nurse or a group

of nurses who have worked together on the

same project. Nominations must be received

at ICN headquarters by Friday 30 September

2016. Click here for more information about this

award.

6

New course openings for ACN's Breast Care Nurse Practicum

A few places have become available in our

September Breast Care Nurse Practicum, which

will run from Monday 19 – Friday 23 September.

This five-day program is designed for registered

nurses who are currently caring for patients

diagnosed with breast cancer.

Attendance is free and open to all nurses currently

working as breast care nurses, particularly in rural

and remote Australia.

Spaces are strictly limited and will fill fast – so

make sure you secure your place by filling out an

enrolment form today! If you are interested in

participating in this program in 2017, email us on

customerservices@acn.edu.au.

New CNnect improves user exper ienceIn 2010, the Australian College of Nursing (ACN)

launched its online education portal CNnect. This was

a significant leap forward into the digitally delivered

education world. Since then thousands of students

have completed graduate certificate and speciality

nursing courses, as well as registered training

organisation accredited nursing courses such as the

Advanced Diploma in Nursing, Certificate IV Training

and Assessment and CPD courses using CNnect.

Technology changes rapidly and ACN’s commitment

to improving educational products, services and

systems remains remains strong. We are determined

to ensure a high level of excellence for our students.

Against this background, ACN proudly launched an

improved and contemporary version of CNnect on 1

July 2016. Not only has the look changed, there has

been significant changes to CNnect functions which

will enhance the student experience and aid learning.

Key features include:

• Menu driven functionality that provides a one-stop-shop for navigation

• Improved access to learning content and material

• Contemporary design that works significantly better on mobile devices

• Improved student support resources

ACN prides itself as a learning organisation that is

responsive to student and member needs. After

seeking student feedback and ideas on CNnect

functionality, we spent some time making sure the

new CNnect addressed student needs.

We hope this new version of CNnect provides

a fertile environment for online learning and

engagement for thousands more nurses who

choose to study with ACN in the future.

Snapshot @ACN

Have Your Say

Are you a nurse working in advance care planning?

Researchers from The University of Sydney and

The Royal Melbourne Hospital are conducting a

survey to better understand health professionals’

knowledge, attitudes and practice behaviours

regarding advance care planning.

Respiratory, practice or palliative care nurses are

invited to complete a 15-minute survey that will

take you to only those questions relevant to your

discipline.

Click here for more information and to complete

the survey.

Calling renal nurses to inform study on complementary therapy during haemodialysis

A study exploring the views of renal nurses

towards the design of a yoga program for

haemodialysis related fatigue is seeking

participants for a short survey.

This study forms one of the initial research phases

being conducted as part of a larger sequential

multiphase mixed methods research project,

forming the basis of a doctorate of philosophy

at Western Sydney University. Consultation

with renal nurses will ensure the development

of clinically relevant yoga components for these

domains, explicitly addressing the protocol and

research design limitations identified in previous

yoga studies.

Click here for more information and to complete

the survey.

7In focus @ACNPolicy @ACN

Responding to and preventing elder abuse in AustraliaBy Stefan Wythes, Anita Pak and Carolyn Stapleton FACN

There has been significant media coverage about the issue of elder abuse as it is a growing problem in Australia and worldwide and with an ageing population is likely to worsen (Davey 2016, Wynne 2016). Elder abuse is defined as any type of abuse which can be one or more of either physical, emotional, sexual and financial, or involve neglect of people aged 65 years or over, either in a residential aged care facility (RACF), in private care, or living independently. It can be a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person (World Health Organization 2008).

The global population of people aged over 60 years and older will more than double, from 542 million in 1995 to about 1.2 billion in 2025 (World Health Organization 2016). Already around four to six per cent of elderly people have experienced some form of maltreatment at home, and it is estimated that 1 in 10 older people experience abuse each month (World Health Organization 2015). According to the World Health Organization (WHO) (World Health Organization 2015) this is likely to be a gross underestimation, as only 1 in 24 cases of elder abuse is reported, in part because older people are unwilling to report cases of abuse to family, friends, service providers or authorities.

In 2015, the Australian College of Nursing (ACN) made a submission to the New South Wales Legislative Council General Standing Committee No. 2 Inquiry into Elder Abuse (Parliament of New South Wales 2015). Some of the main arguments made by ACN in its submission include:

• The [need for the] development of a comprehensive statewide regulatory framework for preventing, detecting and responding to elder abuse.

• The creation of a single authority dedicated to the prevention, investigation of and intervention in elder abuse. This authority should be well promoted to enable people concerned about or affected by elder abuse to contact relevant services in a streamlined manner.

• The expansion of mandated reporting of suspected and actual elder abuse by aged care workers, health professionals and community workers beyond the residential aged care sector. Mandatory reporting would improve the detection of and response to elder abuse.

• The undertaking of mandated training of aged care workers, health professionals and community workers about the prevention and detection of and response to elder abuse. This training should take into account Australia’s culturally and linguistically diverse elderly population.

• The NSW government supporting the development of a coordinated national approach to addressing elder abuse to streamline current protections and address service gaps.

• The NSW Government to advocate with the Federal Government through appropriate bodies for the development of an international Convention on the Rights of Older People. Similarly to the United Nations Convention on the Rights of Children, this convention would frame for governments, their institutions and NGOs to ensure the key conditions are met ensure

peoples’ healthy ageing.

8

To view ACN’s submission in full, please visit the

Parliament of New South Wales website.

ACN’s recommendations in its submission to the

New South Wales Legislative Council General

Standing Committee No. 2 Inquiry into Elder Abuse

drew numerous parallels with the New South Wales

Legislative Council General Standing Committee No.

2 report, submitted on 24 June 2016 to the NSW

Government with 11 recommendations (General

Purpose Standing Committee No. 2 2016). Some of

the recommendations include:

“That the NSW Government embrace a

comprehensive, coordinated and ambitious approach

to elder abuse with the following elements:

• A rights based framework that empowers older

people and upholds their autonomy, dignity and

right to self-determination.

• A major focus on prevention and community

engagement.

• Legislative reform to better safeguard enduring

powers of attorney and to establish a Public

Advocate with powers of investigation.

• An ambitious training plan to enable service

providers to identify and respond appropriately

to abuse.

• An enhanced role for the NSW Elder Abuse

Helpline and Resource Unit.”

The overarching key recommendation to the NSW

Government by the Committee is to invest additional

resources in the prevention of elder abuse. This ought

to involve the development and funding of a new

prevention framework that provides for:

• Substantially enhanced primary prevention,

community education, awareness and

engagement, carer support and later life

planning initiatives.

• Specific resources for strategies targeting

culturally and linguistically diverse and Indigenous

communities and engagement with Multicultural

NSW and Aboriginal Affairs NSW.

The NSW Government’s response to the Committee’s

report is due for release in January 2017.

Around Australia numerous measures have been

adopted to address elder abuse. The Office of

the Public Advocate in Western Australia provides

“training, education and information sessions for

community members and service providers on

preventing, recognising and responding to elder

abuse” (Government of Western Australia 2015).

The office is a member of the WA Alliance for the

Prevention of Elder Abuse (APEA) which includes

government, non-government and voluntary

organisations working towards the prevention of

elder abuse. Furthermore, the Western Australian

Department of Local and Government Communities,

provides information for elder abuse victims and

support services which can be readily accessed

remotely (Department of Local Government and

Communities Western Australia, 2015)

In Western Australia, the agency Advocare, has been

operating an elder abuse hotline since September

2014, with the organisation’s Chief Executive, Greg

Mahney, revealing that the number of calls made

to the hotline was more than the organisation had

anticipated (O’Leary 2016). Mahney says the helpline’s

staff “can offer general advice but sometimes we

might need to refer them to a lawyer or the police”

(O’Leary 2016).

In April this year, in Victoria, the President of the

Australian Human Rights Commission, Gillian Triggs,

was speaking at the launch of a health justice

partnership placing lawyers within health practices,

such as GPs and physiotherapists’ offices, with the

intention of preventing elder abuse. Elder abuse

victims are more likely to seek assistance and report

abuse to their health practitioner than their lawyer,

so this initiative makes it easier for elder abuse

victims to speak out in a safe environment, often

while their abusers are waiting in the waiting rooms

(O’Leary 2016).

Preventing elder abuse requires a concerted effort

from multiple sectors. Health care workers play a key

role in detecting and treating victims of elder abuse and

in some countries the health sector has taken a leading

role in raising public concern about elder abuse, while

in others the social welfare sector has had greater

involvement (World Health Organization 2015).

In Australia, the health sector has been proactive

in raising concerns about elder abuse but it is

evident that Australia’s laws must be reviewed

to handle incidences of elder abuse. From 1 July

2007 Compulsory Reporting obligations came into

effect under the Aged Care Act 1997 (The Act).

The amendments to The Act relate to alleged

physical and sexual assault inflicted on seniors living

in Australian Government subsidised Aged Care

Homes (Aged Care Advocacy Service Inc., 2016).

There still remains a number of people who live in the

community who experience elderly abuse but do not

have the same reporting ability. Furthermore, there

is no central database in any state or territory for

recording incidents of abuse in the community sector

(O’Keeffee 2014).

In other incidences of alleged abuse (psychological,

social and financial), the law assumes that adults are

able to report incidences of abuse they experience.

The law does not differentiate an older person from any

other adult (Aged Care Advocacy Service Inc., 2016).

As elder abuse is multifaceted, current legislation

does not offer protection to older people. Reporting

of elderly abuse outside of the residential aged care

environment, falls upon each state and territories’

individual criminal jurisdiction (O’Keeffee 2014). 

The Victorian Government has been responsive

to the issue of elder abuse. In 2006, the Victorian

Government commenced work on the Elder Abuse

Prevention Initiative which highlighted the prevalence

of elder abuse in the community and guided older

people to where to seek information and advice

and know their rights. The initiative included the

introduction of “professional education and capacity

building, the implementation of policies, protocols

and referral pathways, and cross-sector cooperation”

(Victoria State Government 2016). In addition, the

government established the Elder Abuse Prevention

Advisory Group to provide advice to the Elder

Abuse Prevention Initiative with representatives from

government agencies and key sectors. Since 2008,

the Victorian Government has funded Seniors Rights

Victoria to provide information, support and advice to

older people experiencing elder abuse and includes a

free helpline which older people may contact (Victoria

State Government 2016).

Policy @ACN

“Already around four to six per cent of elderly people have experienced some form of

maltreatment at home, and it is estimated that 1 in 10 older people experience abuse each month.”

9Policy @ACN

The Attorney-General, Senator the Hon George Brandis QC announced a new Inquiry for the Australian Law Reform Commission (ALRC) on 'Protecting the Rights of Older Australians from Abuse' on 24 February 2016. The ALRC has now released an Issues Paper and is calling for public submissions.

The ALRC will inquire into and report on:

• existing Commonwealth laws and

frameworks which seek to safeguard

and protect older persons from misuse

or abuse by formal and informal carers,

supporters, representatives and others

including the regulation of living and

care arrangement and health; and

• the interaction and relationship of these

laws with state and territory laws.

ACN is making a submission to this inquiry and members are encouraged to share their experiences and expertise in relation to elder abuse to inform ACN’s response to the inquiry. To ensure your say, please respond to the ACN survey by 17 July 2016.

The Victorian Government also released the With

Respect to Age guidelines in 2009. These practice

guidelines are aimed at community agencies and

health services, and focus upon a multi-sector and

multidisciplinary approach to elder abuse (Victoria

State Government 2016).

The complexities of elder abuse are further

illustrated when considering those from culturally

and linguistically diverse (CALD) backgrounds. A

number of risk factors may prevent a person from a

CALD background from seeking help. This includes

dependency and isolation, cultural factors, a lack of

English language skills, smaller family networks and an

inability to seek support (Seniors Rights Victoria 2016).

Elder abuse is also prevalent in Aboriginal and Torres

Strait Islander (ATSI) communities. For example,

the term ‘elder’ may refer to a respected member

of the community irrespective of age. Therefore,

some organisations may use the term ‘family

violence against aunties and uncles’ to distinguish

this difference. A number of factors may influence

the incidence of abuse in older people in Aboriginal

communities. These include historical influences such

as the disposition of the land and the destruction of

the traditional Aboriginal life coupled with poverty,

high unemployment, high numbers of incarceration

and substance abuse (Seniors Rights Victoria 2016).

Elder abuse is a global social issue which affects

the health and human rights of millions of older

persons around the world, and an issue which

deserves the attention of the international community.

ACN believes that a coordinated response is

required to address elder abuse in the national and

international community.

Key messages

• Abuse may be physical, emotional, sexual or

financial and may include neglect. It can occur in

an aged care facility, or in the community.

• Risk factors for elder abuse can be related to the

individual, the perpetrator, relationships and the

wider environment.

• Elder abuse needs to be considered by any health

practitioner seeing elderly patients, as they have

a pivotal role in the recognition, assessment,

understanding and management of elder abuse

and neglect.

• If confronted with elder abuse, establish the

patient’s capacity to make decisions. Help

may need to be sought from the person legally

responsible for giving consent for their healthcare.

If this person is the abuser, then seek help from

the appropriate advocacy source in your state

or territory.

References:

Aged Care Advocacy Service Inc. 2016, Mandatory Reporting, viewed 7 July 2016 <http://www.sa.agedrights.asn.au/residential_care/preventing_elder_abuse/elder_abuse_and_the_law/mandatory_reporting>.

Davey, M. 2016, Gillian Triggs: older people subject to ‘abuse, violence and manipulation’, The Guardian Australia edition, viewed 7 July 2016, <https://www.theguardian.com/australia-news/2016/apr/22/gillian-triggs-older-people-subject-to-abuse-violence-and-manipulation>.

Department of Local Government and Communities Western Australia 2015, Seniors: Major funded services, viewed 11 July 2016 <https://www.dlgc.wa.gov.au/GrantsFunding/Pages/Seniors.aspx>.

General Purpose Standing Committee No. 2, Summary of recommendations, Elder abuse in New South Wales inquiry, viewed 7 July 2016, <https://www.parliament.nsw.gov.au/committees/DBAssets/InquiryReport/ReportAcrobat/6063/summary%20of%20recommendations.pdf>.

Government of Western Australia 2015, Preventing Elder Abuse, viewed 11 July 2016 <http://www.publicadvocate.wa.gov.au/E/elder_abuse.aspx>

Johannesen, M. & LoGiudice, D. 2013, ‘Elder abuse: a systematic review of risk factors in community-dwelling elders’, Age Ageing, vol. 42, no. 3, pp. 292–8.

O’Keeffee, D. 2014, Expert calls for legal reform on elder abuse, Australia Ageing Agenda, viewed 7 July 2016 <http://www.australianageingagenda.com.au/2014/11/28/expert-calls-legal-reform-elder-abuse/>.

O’Leary, C. 2016, Hotline reveals elder abuse, The West Australian, viewed 7 July 2016, <https://au.news.yahoo.com/thewest/wa/a/30585434/hotline-reveals-elder-abuse/>.

Parliament of New South Wales 2015, Australian College of Nursing Submission to the Inquiry into Elder Abuse, Submission Number 76, Parliament of New South Wales, viewed 7 July 2016, <https://www.parliament.nsw.gov.au/committees/DBAssets/InquirySubmission/Summary/53924/0076%20Australian%20College%20of%20Nursing%20.pdf>.

Post, L., Page, C., Conner, T., Prokhorov, A., Fang, Y. & Biroscak, B.J., 2010, ‘Elder abuse in long-term care: types, patterns, and risk factors’, Research on Aging, vol. 32, no. 3, pp. 323–48.

Seniors Rights Victoria 2016, Working with people from culturally diverse backgrounds, viewed 11 July 2016 <http://www.seniorsrights.org.au/toolkit/toolkit/working-with-different-cultures-languages-and-communities/>.

Victoria State Government 2016, Elder Abuse Prevention, viewed 11 July 2016 <https://www2.health.vic.gov.au/ageing-and-aged-care/wellbeing-and-participation/preventing-elder-abuse>.

World Health Organization, 2008, A Global Response to Elder Abuse and Neglect: Building Primary Health Care Capacity to Deal with the Problem Worldwide: Main Report, World Health Organization, Geneva, viewed 7 July 2016, http://www.who.int/ageing/publications/ELDER_DocAugust08.pdf.

World Health Organization 2015, Elder abuse Fact sheet No. 357, World Health Organization, viewed 7 July 2016, <http://www.who.int/mediacentre/factsheets/fs357/en/>.

World Health Organization 2016, World Elder Abuse Awareness Day, World Health Organization, viewed 7 July 2016, <http://www.who.int/life-course/news/elder-abuse-awareness-day/en/>.

Wynne, E. 2016, When elder abuse happens in plain sight families still feel powerless to stop it, Australian Broadcasting Corporation News, viewed 7 July 2016, <http://www.abc.net.au/news/2016-06-15/family-feels-powerless-to-stop-financial-abuse-of-grandmother/7513556>.

10In focus @ACN

Advocating for human rights and freedomBy Trish Lowe MACN

On a cold and wet, June night, 1500 people made their way to Sydney’s majestic Town Hall, motivated by an opportunity to hear Julia Baird host a panel discussion, featuring Australian of the Year Alumni: David Morrison AO, Nic Marchesi, Elizabeth Broderick AO and Julian McMahon.

The event was organised by the Australian Human Rights Commission, in partnership with the National Australia Day Council. Throughout the evening, Professor Gillian Triggs commended the Australians of the Year for their impressive leadership and inspiring work.

As the discussion continued, speakers addressed a range of human rights issues. Homelessness, gender inequality, indigenous health, capital punishment and the treatment of refugees and asylum seekers, were considered. The importance of meaningful conversation, valuing diversity and engaging with respect and dignity, were all proposed as potential solutions.

It was heart-warming to recognise how well-positioned nurses and midwives are to inform public opinion in this space. Since equity and fairness are two of the core ethical principles guiding us, these concerns are not new, nor the solutions foreign. Nurses and midwives are an articulate and powerful group, capable of contributing to this debate, with genuine authority.

The Australian College of Nursing’s policy team have recently engaged in discourse pertaining to children in detention, aged care health reform and the fiscally conservative 2016-17 health care budget. These contributions are welcomed and timely. For, as so eloquently suggested by American civil rights activist, John E. Lewis, “If not us, then who? If not now, then when?”

Trish Lowe MACN

Vital SignsACN has launched new member benefits

Visit www.acn.edu.au for more information or contact ACN Membership on 1800 061 660 or membership@acn.edu.au

DISCOUNTS ON ALL ACN COURSESMembers and Fellows can now receive a 10% discount on full fees for all ACN Courses.

MY ACNA new online portal where members can access all of their details, benefits and services. Members can update their profile and preferences, and specify the publications they wish to receive.

1, 2, 3 CPD COURSES FOR FREEMembers can now access three free CPD courses each registration year (1 June to 31 May).

“Nurses and midwives are an articulate

and powerful group, capable of contributing

to this debate, with genuine authority”

11

A nurse or an angel in scrubs?

By a health care consumer

In the early 1980s, upon my return from a dream six-week holiday in Asia, the “tummy bug” that I had picked up in the Philippines still had not abated. Yes, I unthinkingly drank several large glasses of iced water after a day trip to the Devils's Cave behind the Pagsanjan Falls and shooting its rapids in a dugout canoe. Much to my alarm, it got rapidly worse when

I started to pass large amounts of blood and I was eventually diagnosed with Crohn's Disease.

It’s now known that certain types of stomach bugs can trigger a Crohn’s episode. But at that time, not much was known about Crohn’s. According to the website of Crohn’s & Colitis Australia (formerly the Australian Crohn’s and Colitis Association), “Crohn’s disease now an emerging global disease, with Australia having one of the highest prevalence in the world. More than 75,000 Australians live with

it or ulcerative colitis, and numbers expected to increase to more than 100,000 by 2022”.

Needless to say, at 19 years old, my education was about to begin the hard way. For those not familiar with Crohn’s, it is a hideous, chronic inflammatory condition of the gastrointestinal (GI) tract, causing fever, nausea, stomach pain and cramping, inflammation, diarrhoea, malnutrition and bleeding that can result in anaemia. It affects the deepest layers of the intestinal walls. Parts of the bowel lining

are covered with open sores, becoming ulcerated and scarred. There is also a risk of complications that include fistulas, abscesses, fulminant colitis, toxic megacolon, bowel obstructions and perforation, and colorectal cancer.

As if those symptoms and complications aren’t enough, Crohn’s can impact on many other parts of the body, including the joints, eyes, mouth and skin, causing them to become inflamed. During the past 30 years of living with the disease, I have had painful sacroiliitis (inflammation and arthritis of the joints where the lower spine and the pelvis connect), in addition to regular eye problems, including increased pressure in the eyes, uveitis and episcleritis.

There is no cure for Crohn's; the cause is unknown. It is thought that genetics are involved – in my case Crohn’s is evident in my maternal grandfather's family. The treatment relies on suppressing the immune system so it stops attacking the GI tract and suppressing the inflammation that silently sent the immune system into hyper-drive in the first place. The treatment for a flare up is usually high doses of steroids, oral or intravenous, in my case both (hello weight gain and serious and bizarre infections as a result of the steroid’s actions). For me, maintaining a remission has been achieved with azathioprine (an immunosuppressive drug used for organ transplants and autoimmune diseases) plus a fortnightly self-injected dose of a new and powerful TNF inhibitor medication (adalimumab, known as Humira). Both of them have fairly scary side effects such as a high risk of melanoma, lymphoma and other delightful conditions. If they stop being effective then there’s the prospect of colorectal surgery, stoma and a colostomy bag. I’m reminded of that old saying of the treatment being worse than

the cause.

In focus @ACN

12

At 19, I had to confront the fact that the rest of my life

would revolve around doctors, medication and blood

tests, and I had to become knowledgeable about

what medication and food I could not have – certain

antibiotics could trigger a flare up. Ibuprofen, hot

cross buns, spices and fruit cake were also on the

“no” list. A tiny piece of my wedding cake triggered a

flare up that resulted in a fortnight in hospital and two

blood transfusions, and stubborn symptoms that took

a year to abate.

Not only did I think my life was over before it had

really begun, but that initial diagnosis started me on

a journey of the best and worst of the health care

system and it has brought some of the most special

and wonderful people into my life: the doctors and

nurses who have cared for me and gotten me well.

The best have undoubtedly been my

gastroenterologist and my GP, who have done a

brilliant job of managing my condition, limiting the

number and severity of flare ups that I experience

and getting me well as fast as possible afterwards.

However, despite their excellent management and

care, I have ended up in hospital several times in a

fairly serious condition, as a result of a debilitating

flare up that has come out of nowhere and hit me

extremely hard and fast. I can recall losing 25kg in

less than five weeks at the onset of severe flare up.

Another “best” has undoubtedly been the nursing

care I have been fortunate to receive, some of whom

I can only describe as angels on earth. They are the

inspiration for me putting pen to paper now.

As a result of the actions of the steroids, I have also

been hospitalised after becoming so ill from infections

that I have succumbed to long after I recovered from

the flare up that necessitated the steroids in the

first place.

In the late 1990s, I was recovering from a bout

of Crohn’s that, while not as bad as ones I have

subsequently experienced, put me into Concord

Repatriation General Hospital for five days (my

wonderful specialist is a VMO there). I went home on

oral steroids and insulin to control the very high blood

sugar spikes caused by the steroids, but that is a

story for another time. 

Several months later, and off the steroids, but with

an immune system still suppressed, I contracted an

obscure bacterial infection that delighted in feasting

on the cartilage in my ear.

I was away in Melbourne at a team building

conference when my ear blew up to what seemed to

be 10 times its usual size, was extremely hot, red and

so incredibly painful that I cannot describe it. I went

to a medical centre near the hotel we were staying

and came away with a prescription for Keflex. By the

next morning I knew I was in serious trouble despite

the antibiotics. I was nauseous, vomiting, had chills

and was as white as a sheet. My ear was so sore and

inflamed that every nerve ending in it was screaming

at me. I got myself onto the earliest flight back to

Sydney and then into a taxi to my GP, who took one

look at me and immediately phoned an ear, nose and

throat (ENT) specialist.

Looking back, I'm sure it was not very wise to get

on a plane with my ear in the state that it was in, but

I didn't want to be stuck in Melbourne and possibly

die in a hospital so far away from home and family.

The ENT saw me as soon as I arrived at his rooms

and sent me across the road to Hornsby Ku-ring-gai

Hospital’s ER for an emergency admission.

I have never forgotten the lovely nurse who took care

of me when I arrived in a ward in the Lumby building.

She stayed with me through the night, constantly

checking on me and administering a cocktail of

powerful antibiotics including gentamicin, plus an

assortment of IV fluids.

There were times when I was drifting away and she

persisted in talking to me and pulling me back to

consciousness as the antibiotics slowly got into my

system and started to fight the infection.

In addition to the doctor’s aggressive therapeutic

approach, I have no doubt that it was her care,

diligence and dedication that saved my life. The ENT

specialist later told me that he didn’t think I’d live

through that first night, such was the severity of the

infection and his fears about sepsis and septic shock. 

That wonderful nurse stayed with me, even though

her shift had ended, making sure that, when I was

moved into another ward in the main part of the

hospital the next morning, the nurses there were fully

briefed on the heavy-duty antibiotic regime. She finally

left when she was satisfied that she had provided an

adequate handover and that I was settled in the

new ward.

After a couple of days, and still on IV antibiotics, I

was taken to surgery to get my ear drained (it ended

up being done twice). When I returned from surgery,

I was told that there had been a visitor for me – the

nurse who had taken care of me that first night,

popped in on her break to see how I was doing. I had

often thought about her and I desperately wanted

say thank you. But, much to my dismay, no one

knew her name or which ward she was from and I

never got to thank her for what she did for me. The

care she gave me was not only to the best of her

professional ability, it was also way beyond her duty.

It still touches me that she came back to visit and

check on my progress.

To that amazing and caring nurse, I really hope you

read this. Thank you so much for what you did for me.

“Thank you” is hardly adequate but I am certain that

the reason I am still here today is entirely due to you

and I will never forget how you fought for me and kept

me here to see another day. 

To all the nurses who go beyond their job description,

like the dedicated dark-haired angel who cared for

me – thank you. You are truly inspiring and wonderful

people for whom nursing is more than an occupation

– it is a passion that can literally tip the scales in

your patient’s favour. You are angels in scrubs, you

personify “care” and you are the very best of our

health care system.

“To all the nurses who go beyond their job description, like the dedicated dark-haired

angel who cared for me – thank you”

Editor’s note:

This is a reflective piece, written by a person with Crohn’s disease. She is not a health care professional, the views, definitions and explanations are based on her experiences and her understanding of her illness.

If you are a nurse working in a gastroenterology ward or with patients with inflammatory bowel disease, you may benefit from studying ACN’s Graduate Certificate in Stomal Therapy Nursing, or a Wound Management unit of study. The next intake is in January 2017.

In focus @ACN

13Corporate partner @ACN

Your investment in a piece of Australia

Did you know, as a HESTA member, you’re

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this list of assets. HESTA recently partnered in a

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The benefits of collaboration

With one of our longstanding infrastructure

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we joined with fellow industry super funds —

AustralianSuper, Cbus and HOSTPLUS —

on the bid.

QSuper and Tawreed Investments Ltd (a subsidiary

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partnered on the NSW Ports Consortium’s

successful bid.

“Few investors have the capacity or access to

these long-term investments in high-quality, core

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Marie Corboy.

“By collaborating with others, we can invest in a more

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Corboy says.

The industry super advantage

Our latest port investments are 80% owned by

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member, call 1800 813 327 to make an appointment

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Issued by H.E.S.T. Australia Ltd ABN 66 006 818 695 AFSL 235249, the Trustee of Health Employees Superannuation Trust Australia (HESTA) ABN 64 971 749 321. This information is of a general nature. It does not take into account your objectives, financial situation or specific needs so you should look at your own financial position and requirements before making a decision. You may wish to consult an adviser when doing this. Before making a decision about HESTA products you should read the relevant Product Disclosure Statement (call 1800 813 327 or visit hesta.com.au for a copy), and consider all relevant risks (hesta.com.au/understandingrisk).

More people in health and community services choose HESTA for their super

Find out more

14In focus @ACN

Future disasters expected due to erratic Australian climateBy Dr Liz Hanna FACN, Key Contact ACN Climate and Health Community of Interest

Extreme climatic events

result in disasters when

the scale is massive

and the effects on

human health and

societies are both

profound and extensive.

Developing countries

are at heightened risk of

catastrophic disasters

due their high exposure

levels, high population

numbers, limited preparedness, and response and

recovery capacity.

Yet Australia is also highly vulnerable due the

erratic nature of Australia’s climate. Australia’s

rainfall is more variable than any other nation

(Love 2012) as the El Niño-La Niña cycle delivers

periodic floods and droughts with potentially

devastating effects on agricultural sectors and

threatens water security. This factor is a major

contributor to Australia’s relative low population

carrying capacity. Additionally, Australia’s heat and

propensity to heat waves presents major health

(Hanna and Tait 2015) and productivity threats

(Hanna, Kjellstrom et al. 2011).

The scorching summer of 2009 testified that

Australia’s response capacity can be sorely tested.

Amid the extreme heatwaves and catastrophic

fires across the southern states, deluge flooding

ravaged Queensland. Australia’s response systems

struggled to cope with the contemporaneous

surge demand for emergency responses and

recovery management.

The pattern of climate suggests that such unusual

circumstances can not only reappear, but amplify.

Real potential therefore exists that future climate

disasters will stretch Australia’s response capacity

to a state whereby we cannot promptly recover all

the people involved and safely secure them from

danger, re-establish telecommunications, and

provide the required transport, health, social and

emotional support.

A massive East Coast Low (ECL) in June 2016

brought a different type of national climatic

challenge. Many regions received the highest

rainfall for June on record, and unprecedented

daily totals for any month (BOM 2016). This event

left a trail of destruction spanning Queensland to

Tasmania, from floods and coastal erosion.

There were several deaths in New South Wales

and Canberra and two people went missing

in Tasmania. Insured losses exceeded $235

million from 32,000 claims across Queensland,

New South Wales, Victoria and Tasmania

(Insurance Council of Australia 2016), and the

uninsured cost will add to the damage and

personal trauma, loss and grief.

The relationship between disasters and human

health follows several pathways. Direct influence

is easily recognised, as the nightly news streams

scenes and heartbreaking stories into living rooms

across the country. Less apparent though are the

indirect pathways. These can linger for many years

beyond the event, long after the news cameras

have departed, and public empathy and donations

have dwindled.

Health impacts include loss of life, injuries, disease

as well as costly repair bills, loss of homes and

capacity to generate income. When occurring

on a major scale, this delivers a major shock to

communities. Resilient communities can bounce

back, but even in such a positive scenario, many

people find themselves unable to rebuild and

recover (Reser, Bradley et al. 2012).

Disasters can shift people and families from a

normal life to one of dependency. Mental health

issues can soar and bring multi-generational

hardship (Hanna, McCubbin et al. 2010).

Climate & Health

Dr Liz Hanna FACN

Flooded buildings can sustain further damage from mould, which can have severe health ramifications, including spikes in asthma and other respiratory tract symptoms, such as pneumonia.

15

It is common for the destruction of infrastructure in

disasters to hit the hardest in areas of pre-existing

low accessibility, making them even harder to

access. Transporting relief supplies and rescue

services to these areas is impossible or at best

extremely difficult. Hotels, restaurants and grocery

stores are forced to close.

Relief workers, repair crews and loss adjusters

must find accommodation outside the disaster

areas and travel up to several hours a day to their

places of assignment. Delays in relief supplies, loss

adjustment and repairs are the result.

After flooding, the surviving buildings can

sustain further damage from mould, which can

have terrible effects on their condition. Health

ramifications include spikes in asthma and

other upper respiratory tract symptoms, such

as coughing and wheezing as well as lower

respiratory tract infections such as pneumonia,

Respiratory Syncytial Virus (RSV), and RSV

pneumonia (Luber, Knowlton et al. 2014).

Delays in repairs and rebuilding can arise due to

insurance complications, and escalation in repair

bills (up to 40%) due the surge demand for scarce

labour and building materials (Munich Re 2016), and

leave people in damp houses for extended periods.

In moderate catastrophes, the transportation

network is usually restored in just a few days. After

more serious events, however, it can be months

before roads, railways, airports or ports are back in

full operation. Access to essential utilities such as

power, water and food, and vital services, such as

schools, and health care can remain fractured for

extended periods.

Damage to the local environment and vital health

supporting ecological services can further impact

health through interruptions to water supply, water

purification and sanitation, and cause infectious

diseases to spike. Food security is harmed through

protracted droughts, floods, and resultant health

effects are exacerbated by both pre-existing and

newly acquired poverty.

When climate disasters affect wealthy countries,

services are allocated and national response aims

to ensure that housing and emergency needs are

promptly provided. A suite of emergency response

agencies, including ambulance, police and fire

authorities, volunteers and State Emergency

Services, and the military are often called upon

to assist. Yet, when disasters befall developing

countries, populations can be dependent upon

foreign agencies and charities to provide those

emergency needs.

Not all disasters are sudden and short-lived. Some

are lower key, yet protracted. A slow-disaster can

unfold, such as the global food crises in 2008.

Widespread hunger is a trigger for social unrest,

as history has repeatedly testified (De Châtel 2014,

FAO 2016). Unrest can overturn governments

and spill over to other countries, and hence the

insecurity can adopt a political or international

flavour (Levy and Sidel 2014).

Climate change is increasingly generating fast and

slow disasters across many parts of the globe.

This prompted the Intergovernmental Panel on

Climate Change (IPCC) to release a special report

on disasters and climate change in 2012 (IPCC

2012). For the first time ever, the 5th Assessment

Report of the IPCC devoted an entire chapter to

human security (IPCC WGII, Adger WN et al. 2014).

The 2014 US Department of Defense Adaptation

Roadmap recognises the increased role for Defence

and National Security Guard to respond to natural

climate related disasters and urges the military to

incorporate climate change into “broader strategic

thinking about high-risk regions” (U.S. Department

of Defense 2014). In 2015, the Australian Defence

Force published The Longest Conflict: Australia’s

Climate Security Challenge (Sturrock and Ferguson

2015), which argued on page 9, “Australia is

underprepared and underpreparing for what is now

a known security threat”.

Margaret Chan, Director-General of the World

Health Organization, in her address to Sixty-ninth

World Health Assembly in June 2016 described

climate change as a slow-motion disaster

(Chan 2016). Australia needs to boost its climate

change preparedness, as we can expect more

weather disasters. For example, as a result of

anthropogenic influences on the climate system,

the additional heat and convective energy is

predicted to increase the frequency and severity

of cyclones and superstorms around the globe

(Bouwer 2011, IPCC 2013).

In focus @ACN

“Expanding the presence of nursing in response and recovery teams must be a central plank

to Australia’s climate preparedness.”

� � Suspendisse auctor quam convallis leo. Aliquam est purus.

11th Conference of the Australian College of Nurse

Practitioners (Incorporating NursePrac ED)

The Centre of Care

Alice Springs Convention Centre

30 August – 2 September 2016

INTERNATIONAL KEYNOTE SPEAKER Dr Tammy O’Rourke Assistant Professor,

University of Alberta, Canada

E: acnp2016@dcconferences.com.au

W: www.dcconferences.com.au/acnp2016

16

The relatively infrequent nature of these severe

events presents challenges for studies analysing

trends, however, increasing intensity trends have

been observed. Whereas the increase in cyclone

frequency has not yet been recorded in Australia

(Allen, Karoly et al. 2014), researchers advise

caution in assuming that Australia will be spared.

An increase in the length and the frequency of

severe thunderstorm environments, particularly over

the eastern parts of the continent, is projected. The

overall frequency of potential severe thunderstorm

days per year likely to rise over the major population

centres of the east coast by 14% for Brisbane, 22%

for Melbourne, and 30% for Sydney (Allen, Karoly

et al. 2014). Such increases will bear significant

potential health and societal implications.

Also, small-scale cyclones are projected to extend

further southward than historical patterns and East

Coast Lows (ECLs) are likely to show a marked

strengthening in warm season of between +17% to

+29% (Pepler, Di Luca et al. 2016). The widespread

system that flooded much of Australia’s eastern

seaboard and extended into Canberra in June 2016

was a cool season ECL. The full human toll and

damage bill will not be available for many months.

Multi-sectoral action is required to achieve

the health protection from climate change

(Figueres 2016). Australia is facing increases in

frequency and intensity of disasters, so a boost

in preparedness is essential to reduce harmful

effects. Nurses have a leadership role in delivering

community education, helping people to prepare

and protect themselves, to avoid risks.

Community education can also boost community

resilience by facilitating peer to peer support

when response teams are delayed or unavailable.

Expanding the presence of nursing in response

and recovery teams must be a central plank to

Australia’s climate preparedness. Direct service

provision in the acute sector, as well as assisting

people and communities in their long recovery

phase are also key nursing activities.

References:

Allen, J. T., Karoly, D. J. and K. J. Walsh 2014, "Future Australian Severe Thunderstorm Environments. Part II: The Influence of a Strongly Warming Climate on Convective Environments", Journal of Climate, vol. 27, no. 10, pp. 3848-3868.

BOM 2016, Extensive early June rainfall affecting the Australian east coast, Special Climate Statement 57, Melbourne, Australian Government Bureau of Meteorology, p. 24.

Bouwer, L. M. 2011, "Have Disaster Losses Increased Due to Anthropogenic Climate Change?", Bulletin of the American Meteorological Society, vol. 92, no. 1, pp. 39-46.

Chan, M. 2016, Address to the Sixty-ninth World Health Assembly, Geneva, Switzerland

De Châtel, F. 2014, "The Role of Drought and Climate Change in the Syrian Uprising: Untangling the Triggers of the Revolution", Middle Eastern Studies, vol. 50, no. 4, pp. 521-535.

FAO 2016, Peace, Conflict and Food Security: What do We Know about the Linkages? Technical Note. Rome, Food and Agriculture Organization of the United Nations 102.

Figueres, C. 2016, Address to the Sixty-ninth World Health Assembly, Geneva, Switzerland.

Hanna, E.G., Kjellstrom, T., Bennett, C. and Dear, K. 2011, "Climate change and rising heat: population health implications for working people in Australia", Asia-Pacific Journal of Public Health, vol. 23, no. 2, pp. 14S-26S.

Hanna, E.G., McCubbin, J., Horton, G. and Strazdins, L. 2010, "Australia, Lucky Country or Climate Change Canary: what future for her rural children?", International Public Health Journal, vol. 2, no. 4, pp. 501-512.

Hanna, E.G. and Tait, P.W. 2015, "Limitations to thermoregulation and acclimatisation challenges human adaptation to global warming". International Journal of Environmental Research and Public Health, vol. 12, no. 7, pp. 8034-8074.

Insurance Council of Australia (2016). Insurance losses from east coast low soar as the storm clouds start to gather again. Media Release. Sydney.

IPCC 2012, Managing the Risks of Extreme Events and Disasters to Advance Climate Change Adaptation (SREX) - Summary for Policymakers, IPCC WG II - Technical Support Unit, Cambridge, UK and New York, USA, IPCC.

IPCC 2013, Working Group I Contribution to the IPCC 5th Assessment Report "Climate Change 2013: The Physical Science Basis", Intergovernmental Panel on Climate Change, Geneva, Switzerland.

IPCC WGII, Adger, W.N., Pulhin, J.M., Barnett, J., Dabelko, G.D., Hovelsrud, G.K., Levy, M., Spring, U.O., Vogel, C.H. and e. al. 2014, IPCC WG1 II AR5, Chapter 12, Human Security, Climate Change 2014: Impacts, Adaptation, and Vulnerability, Volume I: Global and Sectoral Aspects, Cambridge, UK, Cambridge University Press: pp. 755-791.

Levy, B.S. and Sidel, V.W. 2014, "Collective Violence Caused by Climate Change and How It Threatens Health and Human Rights”, Health and Human Rights Journal, vol. 1, no. 16, pp. 32-40.

Love, G. 2012, Impacts of Climate Variability on Regional Australia, Melbourne, Bureau oif Meteorology, pp 9.

Luber, G., Knowlton, K., Balbus, J., Frumkin, H., Hayden, M., Hess, J., McGeehin, M., Sheats, N., Backer, L., Beard, C.B., Ebi, K.L., Maibach, E., Ostfeld, R.S., Wiedinmyer, C., Zielinski-Gutiérrez, E. and Ziska, L. 2014, Ch 9: Human Health, Climate Change Impacts in the United States: The Third National Climate Assessment, Melillo, J.M., Richmond, T.C. and Yohe, G.W., Washington DC, U.S. Global Change Research Program: 220-256.

Munich Re 2016, Large loss amplification – Effects of tropical storms in Australia, Munich Re, Munich.

Pepler, A.S., Di Luca, A., Alexander, L.V., Evans, J.P. and Sherwood, S.C. 2016, "Projected changes in east Australian midlatitude cyclones during the 21st century", Geophysical Research Letters, vol. 43, no. 1, pp. 334-340.

Reser, J.P., Bradley, G.L., Glendon, A.I., Ellul, M.C. and Callaghan, R. 2012, Public Risk Perceptions, Understandings and Responses to Climate Change and Natural Disasters in Australia, 2010 and 2011, Gold Coast, Australia, National Climate Change Adaptation Research Facility, pp.246.

Sturrock, R. and Ferguson, P. 2015, The Longest Conflict: Australia’s Climate Security Challenge, Sydney, Centre for Policy Development, pp 52.

U.S. Department of Defense 2014, 2014 Climate Change Adaptation Roadmap, Washington, Office of the Deputy Under Secretary of Defense for Installations and Environment, pp 20.

In focus @ACN

The frequency and length of severe thunderstorms is projected to increase, particularly over the eastern parts of the continent.

Sign up now for regular updates about immunisation programs and vaccines in Western Australia.

Emailvaccineupdates@health.wa.gov.au

17In focus @ACN

The nursing graduate exper ience: A ref lec t ive case s tudy

By Rachel Wardrop MACN

The graduate registered nurse (RN) undergoes an

assortment of challenges in their first year of practice

(Bull et al. 2015). In response, countries have adapted

various programs to provide support and direction

for the graduate nurse within this fragile time of

development. The role lacks general consensus

regarding structure internationally and therefore

retains within it flaws which impact on graduate nurse

development. This article describes one nurse’s

experience of her graduate year and highlights the

difficulties associated with the transition.

My first year as a graduate RN brought with it

an assortment of feelings; excitement, fear and

determination. I was educated for this role; I had the

skills, what could possibly stop me? I was employed

as a casual pool RN for my graduate transition year.

I felt like I was sent from pillar to post wherever there

was a deficit in staff. Nervous, I adapted to the clinical

environment by asking questions and attempting to

build relationships with staff.

There were facilitators employed to work with and

support the graduate nurses who would occasionally

check on us. Unfortunately, the support was provided

only once a month. After the first few months of

employment the graduates were informed that

funding had dried up and the facilitator positions had

been made redundant.

After losing the only support we had, my opinion of

this new profession started to drastically change.

As we moved further into the graduate year, the

expectations from other senior staff regarding our skill

level began to change. Even during one of my very

first shifts, I recall being placed in a situation which

I had not been trained how to deal with. Apparently,

permanent ward staff liked to utilise casual pool

members to do what they call their ‘dirty work’.

One shift, I was placed in a four-bed bay as a ‘special’

– a nurse who is required to monitor patients

as they have a tendency to walk about. Three of

these patients were high-care stroke patients with

advanced dementia and Alzheimer’s who were known

to be aggressive. The other was an alcoholic who was

known to be both verbally and physically aggressive

to nursing staff. I voiced my concerns at the beginning

of the shift, stating that I was not comfortable

with caring for these patients. My concerns were

overlooked with the response, “You’ll be fine”.

As I entered the four-bed bay, a feeling of dread

passed over me. Two of the patients were still being

fed and medicated via nasogastric tubes which just

added to my workload. As I circled the room checking

the charts, some of the patients started to rouse.

I pulled out my shift planner and detailed the day’s

events whilst waiting eagerly for the night duty nurse

to handover these patients.

After receiving handover and introducing myself

to the patients, I started my morning medication

rounds. Upon crushing medications for my first

patient, my alcoholic patient woke up in a fluster.

He wanted to go outside and have a cigarette. I

informed my patient that this was not permitted,

trying to re-orientate him to where he was and why

he was in hospital.

Whilst his frustration grew, I informed another nurse

that I needed help with this patient, she shrugged

and walked away. I felt powerless as this patient

grew even more impatient with me, now turning to

verbal threats of physical harm if I was to refuse his

request again.

I started to panic. The textbooks said nothing

about this. I mustered all of my courage to verbally

de-escalate the patient with one hand and signal for

help with the other. The nurse in charge sighed at

me and called security. I could hear the other nurses

gossiping about me as I sobbed in the tea room.

This experience was sobering for me.

On initial employment, I viewed the nursing world as

a child views the local candy store; heart aflutter and

eyes wide open. It was this event and many like it

that shocked me to my core; the profession was not

what I had expected. The concept of nurses eating

their young was not just a rumour, it was real. Yet, did

my expectations of my graduate year taint my ability

to cope? Were they too high? I started to question

my career choices. If this was the norm, did it set the

scene for the rest of my employable life?

"One shift in the emergency department awakened something in me."

18

I moved through the months of graduate

employment and noticed my personality started to

harden. I could feel myself drifting into the realm of

“this is as good as it gets, so don’t bother trying”.

I even looked at other avenues of employment as I

could feel the very essence of myself draining every

time I went to work.

In spite of the treatment I endured, mid-way through

my graduate year, something wonderful began to

happen. I was engaged in my Masters course at

the time with the end hope that I would develop my

skills and knowledge and become an advanced

clinician. It was an interesting and challenging

course which provided me with an understanding of

complex patient conditions and other areas such as

leadership and management.

The more I immersed myself in education, the

stronger my passion for self-development grew.

So I thought, “How can I turn this into something

different? How can I use this to my advantage?”

One shift in the emergency department awakened

something in me. One shift. That’s all it took and

I was hooked. The adrenaline and the urgency

of the emergency department coupled with a

supportive team was enticing. After one shift and a

recommendation from a senior clinical nurse, I was in.

It was in this environment that I learnt advanced

patient assessment, cannulation, interpretation

of bloods and dysrhythmias, management of the

psychotic patient and advanced resuscitation.

And out of all of it, staff supported each other

no matter how junior you were; there were no

expectations. If you made it through the shift

without being attacked or spattered with some

exciting form of bodily fluid then it was deemed

to be a good shift. I finally felt needed and

appreciated, not used and abused.

Yet still, the longing for education and to make an

impact lingered. As one of my core values, it has

always been within my composition to be significant.

To do something to be remembered for, something to

be valued for or even more so, a legacy. A proposition

to teach at a world-renown university was a chance

to step up and prove myself.

I now stand as an educator and an academic,

knowing that my experience will help others.

Knowing that what I do now is significant. Knowing

that age, does not determine your quality or degree

of contribution. Regardless of the role we are given, it

is about making it your own. Sometimes the process

of reflection reveals a lesson which can only be learnt

over time. And sometimes, it requires a little leap of

faith to find one’s own place in this world.

References

Bull, R., Shearer, T., Phillips, M. & Fallon, A. 2015, ‘Supporting Graduate Nurse Transition: Collaboration Between Practice and University’, The Journal of Continuing Education in Nursing, vol. 46, no. 9, pp. 409-415.

In focus @ACN

“If you made it through the shift without being attacked or spattered with some exciting form of bodily fluid then it was deemed to be a good shift. I finally felt

needed and appreciated, not used and abused.”

THE NATIONAL NURSING FORUMMelbourne Park Function Centre

THE POWER OF NOW

26–28 October

2016

CLICK HERE TO REGISTER TODAY Editor’s note:

If you are a nurse looking to gain more skills in providing care for patients during emergency situations, ACN offers online courses for registered and enrolled nurses. Click the links below to find out more:

• Principles of Emergency Care For RNs• Principles of Emergency Care for ENs

19Corporate partner @ACN

Holding nurses to account: What to do when things go wrong Nursing is often referred to as a science and an art.

A science in the sense that the nursing profession

is based on research and an art because nursing is

a profession grounded on caring for others and this

entails building therapeutic relationships with patients.

When things go wrong, however, nurses are held to

account as professionals.

Notifications and complaints

The Australian Health Practitioner Regulation Agency

(AHPRA) receives notifications and complaints about

nurses and midwives on behalf of the Nursing and

Midwifery Board of Australia (NMBA).

A notification can either be a voluntary notification or

mandatory notification. Anyone can make a voluntary

notification under the National Law about a registered

nurse or registered midwife (‘Practitioner’) or nursing/

midwifery student (‘Student’). This includes other

nurses, midwives, students, health practitioners and

members of the public. The grounds for making a

voluntary notification against Practitioners include that

(among others):

(a) The Practitioner’s professional conduct is or may

be of a lesser standard than might be expected;

(b) The Practitioner’s knowledge, skill or judgment

may be below the standard reasonably expected of

the practitioner;

(c) The Practitioner is not a fit and proper person;

(d) The Practitioner has an impairment; and

(e) The Practitioner has contravened the National Law.

Mandatory notifications are required to be made by

a registered health practitioner (e.g. nurse, doctor,

physiotherapist, pharmacist) where, in the course

of practising their health profession they form a

reasonable belief that another registered health

practitioner (e.g. nurse, doctor, physiotherapist,

pharmacist) has behaved in a way that constitutes

notifiable conduct or that a student has an

impairment that in the course of undertaking clinical

training causes the student to behave in way that

constitutes notifiable conduct.

For the purposes of mandatory notifications, notifiable

conduct means:

(a) Practising while intoxicated by alcohol or drugs;

(b) Engaging in sexual misconduct in connection with

the Practitioner’s practice;

(c) Placing the public at risk of harm because of an

impairment;

(d) Placing the public at risk of harm through practising

the profession in a way which is a significant departure

from accepted professional standards.

It is important to note that mandatory notification

provisions apply to nurses individually and the

NMBA may take action against a nurse who fails to

notify it of notifiable conduct. The Health Services

Commission in each State and Territory may also

refer matters to the NMBA.

What should nurses do when faced with a notification?

A notification to AHPRA and the subsequent

investigation process is stressful. This process

involves preparing statements and may also involve

having to appear personally before a panel or

Tribunal. All notifications made to AHPRA should

be taken seriously. Even if you consider that the

allegations are baseless, they may in fact still result in

you being cautioned by the NMBA.

If you are the subject of a notification, at first instance

you should seek assistance from your professional

indemnity insurer. Given the potentially serious

outcomes of an AHPRA investigation, it is important

that you give serious consideration to taking out your

own policy for professional indemnity insurance.

You should consider doing so, even if you are an

employee as your employer’s insurance does not

usually provide legal assistance to employees

in connection with disciplinary (and coronial)

investigations. There may also be the need for

separate representation from your colleagues at the

place of employment, and having your own legal

representation can provide much needed reassurance.

This article was written by Jayr Teng, legal practitioner, and kellie Dell’oro, principal of Meridian Lawyers. Meridian lawyers works closely with guild insurance, which offers insurance to nurses and nurse practitioners. This information is current as of May 2016. This update does not constitute legal advice. It does not give rise to any solicitor/client relationship between Meridian Lawyers and the reader. Professional legal advice should be sought before acting or relying upon the content of this update.

Cover doesn’t always mean protection.

Find out more

WATCH: See how Jenny, Peter and Teagan benefited through a Guild Insurance policy in their own name

20

Nursing in the community: The bigger picture of patient careBy Vanessa Crossley

The role of the community nurse differs greatly from the role of the ward nurse, the emergency nurse, the theatre nurse or the midwife.

Away from the bleeping monitors, the sterility and the bustle of the wards, you often discover the real person that lies beneath the patient.

It goes without saying that we ask the hard questions to our patients when they lie in a hospital bed. We enquire about pain levels, bowels that have opened (or not), allergies, medications, previous medical history and what the home environment is like that they will soon return to.

However, until you stand in that home environment with them, you do not get a true picture of their life outside the walls of the hospital.

Like an onion, they have layers that you often discover when they are able to relax in the comfort of their home.

The concept of total patient care and problem solving changes from the model we know when the safety net of the hospital is left behind.

As nurses, in all areas of practice, we are trained to look beyond “the man with the ulcer”, “the lady with the breast drain” or “the child with the burn” and discover other issues they may have.

In the home setting, that journey of discovery takes on a whole new meaning and even though the medical side of our practice may be our number one priority, the little things we discover help to make up the big picture of community nursing.

The elderly man who lost his wife many years ago, who has no family in this country and who cannot remember the last time he had a home-cooked cake, is not just the old man with the leg ulcer; he is the man who smiles and hugs you when you bring him a plate of cupcakes.

The 92-year-old man with the swollen legs is the man who is overjoyed when you help him tune in his television so he can watch the cricket.

The 80-year-old lady with the skin tear is the lady who thanks you for finding the number and calling someone to come and wash her dog as she no longer can.

The lady who has just lost her husband, who cries with you and thanks you over and over for helping her to re-frame her wedding photo.

The 45-year-old man who fought (and lost) against the roadway when he fell from his bike is the same man who is grateful when you run to take his sheets from the line as the rain starts to fall.

The sweet old man who fell in his driveway and broke his hand will grasp your hand and thank you when you help him with the “wretched fitted sheet” on his bed.

The 90-year-old lady who lives alone in a double-storey house with a steep driveway will be pleased to see you drag her bin up that driveway for her and bring her mail up the stairs. She is the same lady whose husband was your school principal many years ago.

After six long months it is hard to know if the patient’s wife is happier about his ulcer finally healing or the fact that you have successfully removed a coffee pod stuck in their machine with a pair of forceps. She hasn’t been this happy since you helped her take a photo with her mobile phone on your last visit.

The 68-year-old man who loves your visits because you make him laugh and his wife who loves your visits because you bought a tin of WD40 along and finally removed the grandkids crayon masterpieces from the kitchen cupboard door.

The paraplegic man who has just lost his old dog and who sits and looks through the “dogologue” book you have bought him to think about the shape his new best friend will take.

The four-year-old boy with a burn who hates you at first sight but is smiling through his tears at the end of the visit when you successfully name all his Thomas the Tank engine trains. “She even knows the white one Mum.”

The wheelchair-bound man who is ecstatic when you find, in your travels, a flag from his favourite football team to replace the one stolen from his chair. He takes your hand and says, “Mate, you have made a really rotten day so much better.”

The lady with the breast drain is the lady who smiles when you bend to pat her cat. She is glad you like him as he is her world.

There are many challenges in community nursing. The driving, the distance, the weather, the decision making, the animals, the driveways and the nursing itself.

You need to think on your feet and be clinically skilled in many varied areas. You don’t need qualifications or knowledge in baking, cleaning, animal care, football

teams or appliance repair, but it sure helps.

Events @ACN

Vanessa’s story features in the 2015

Community and Primary Health Care

Nursing Week: Nurses where you need them

eBook. This year, we’re asking nurses to

share a story that describes a time ‘when’

your nursing care has impacted on the

health and wellbeing of individuals and/or

communities. Click here to find out more

and submit your story for the 2016 eBook!

See next page for more information.

Vanessa Crossley

“The concept of total patient care and problem solving changes from the model we know when

the safety net of the hospital is left behind.”

Community & Primary Health Care Nursing Week

Nurses where you need them19–25 SEPTEMBER

21Events @ACN

Community & Primary Health Care Nursing Week

Nurses where you need them19–25 SEPTEMBER 2016

How to get involved:

There are a range of activities that ACN is encouraging nurses and the broader community to become involved in over the week. As part of the celebrations, ACN is seeking your interest in contributing to the Community and Primary Health Care: Nurses where you need them 2016 eBook, a collection of stories from Community and Primary Health Care Nurses.

This year, the eBook stories focus on the 'when' which may refer to a phase in life such as prenatal, early childhood, adolescence, ageing or dying. Alternatively, the 'when' may relate to a point in time when nurses care for individuals – such as when there are drug and alcohol issues, settling as a refugee, transitioning home after hospitalisation, during incarceration and a myriad of other times.

If you have an interest in sharing a story that describes a time ‘when’ your nursing care has impacted on the health and wellbeing of individuals and/or communities, then we encourage you to please submit your story.

Here are some other ways to get involved:

• Wear an orange scarf or t-shirt during the week of 19–25 September 2016 to show your support of Community and Primary Health Care Nurses.

• Hold an event during the week to get your town or city on the virtual map of supporters across the country and to share readings from the eBook to promote and discuss the important roles in Community and Primary Health Care Nursing. Events you can host may include a social gathering, morning or afternoon teas, public lecture or informal networking function.

REGISTER AN EVENT

• Nursing organisations can join ACN as a supporter of the week to raise awareness and the profile of Community and Primary Health Care Nurses. Supporters will be acknowledged on the ACN website and in the eBook.

• Spread the word to your networks! #nurseswhereyouneedthem

SUBMIT YOUR STORY

REGISTER AS A SUPPORTER

The Australian College of Nursing (ACN) Community and Primary Health Care Nursing Week: Nurses where you need them national campaign will take place from 19–25 September 2016 and its intentions are to:

• Raise awareness of the current and potential contribution of community and primary health care nursing and its impact on the health and wellbeing of individuals and communities;

• Inform the general public in order to increase their health literacy about community based health care options;

• Inform nurses of community and primary health care nursing roles and career opportunities;

• Inform state and territory governments as funders of many community and primary health care services and drivers of state health reform of the capacity of community and primary health care nurses;

• Inform the federal government as a funder of community and primary health care services and general practice based services and as a driver of national health reform of the capacity of community and primary health care nurses; and

• Inform other health professions active in community and primary health care to raise their awareness of community and primary health care nursing services.

Read the 2015 eBook

With thanks to the support of our official sponsors

22Representation @ACN

ACN voices – meet our representativesAustralian College of Nursing (ACN)

representatives ensure the views of the

nursing profession are at the forefront of

health care decision making. We harness

the expert knowledge, experience and

insights of our members and through ACN

representation activities we facilitate the

vital conversations about health and aged

care and the leading role that nurses play in

designing health care models and giving care.

Each month, we feature our valued member

representatives who are making a difference

through their active participation in ACN

representation activities.

Tracy K idd MACNWhich working group are you representing

ACN on?

I sit on the Australian Resuscitation Council (ARC)

National Branch. ACN is one of four nursing

organisations represented on the council.

What led to your interest in this area?

I have a 20-plus-year background in critical care/

emergency nursing and I am also an advanced

life support educator for the region I work in.

What is the most recent work out of the

working group and what were the major items

discussed?

The aims of the ARC are to foster and co-ordinate

the practice and teaching of resuscitation,

promote uniformity and standardisation

of resuscitation and to act as a voluntary

co-ordinating body. To meet the aims and

objectives of the ARC, the council develops

and publishes guidelines, reviews and updates

guidelines by consultation with member bodies

and other experts, reviews world literature and

research in resuscitation and acts as a resource

for anyone wanting authoritative material on

resuscitation (ARC, 2016).

Can you please highlight any issues/benefits

arising for the profession as a result of this

working group?

Being one of four nursing representatives on the

council, membership gives me the opportunity to

stay up to date with the latest research in the field

of resuscitation. I also have the opportunity to

contribute to the review of guidelines and to help

disseminate the latest updates to the nursing

profession locally and further afield in Australia.

How important is this ACN representation

opportunity to you or how has this opportunity

benefitted you and/or your career?

This ACN representation opportunity has given

me the chance to sit on a council made up of

members with a wealth of experience, knowledge

and expertise from a number of different

backgrounds. The opportunity to learn from these

extraordinary men and women is truly a privilege.

I also have the opportunity to share from my

unique background and nursing experiences.

It has given me insight into internationally

generated research and an appreciation for

the rigour involved in thorough reviews of the

published literature.

If you are interested in future

representation opportunities with ACN,

please email engagement@acn.edu.au

“This ACN representation opportunity has given

me the chance to sit on a council made up of

members with a wealth of experience, knowledge and

expertise from a number of different backgrounds."

A guide for the general practice team

NURSING IN GENERAL PRACTICE

The handbook contains details about employing and supporting RNs and ENs, the current regulatory environment, how to maximise the benefits, including the Practice Nurse Incentive Program and the range of MBS items that support nursing services in general practice.

Order your FREE printed copy or download a PDF version.

If you are a nurse working in a general practice setting, the Nursing in General Practice (NiGP) Handbook is essential reading, and it’s FREE.

23Advertorial @ACN

Aged care homes endorse new palliAGEDnurse app Residential aged care organisations have started to

endorse the recently released palliAGEDnurse app

and advocate its use amongst nursing staff.

Meanwhile more than 800 palliAGEDnurse apps were

downloaded by nurses across Australia in less than

four weeks following the mid-May launch of the app

by Decision Assist, an Australian Government funded

program to better resource palliative care throughout

the nation.

The free smartphone app is designed for nurses

caring for older people near the end of life and

enables them to access clinical advice at the point

of care.

Aged care provider, BaptistCare, has already

incorporated the app into its internal Palliative

Approach toolkit for senior nursing staff.

Debbie Kable, Care Development Manager –

Residential for BaptistCare said her team would be

promoting the app across the 18 homes BaptistCare

operates in New South Wales and the ACT.

‘’The app will be promoted by our care development

unit – I see the app as another tool for our staff to

help them make palliative care decisions,’’ she said.

Available through Google Play and the Apple

Store, the palliAGEDnurse app has been developed

as part of the Decision Assist program for aged care

staff in residential and community settings.

It provides clinical advice based around three key

areas – advance care planning, case conferencing,

and terminal care.

The app was developed by the CareSearch Project

Team at Flinders University, following production last

year of the palliAGED app for General Practitioners

(GPs). Decision Assist is marketing them as a suite

of two apps – one for GPs and one for nurses.

App keeps up to date and works anywhere

CareSearch has designed the app to constantly

update the advice that it gives nurse users.

Being web based, the app goes to the website –

where new evidence is published – to read

its content.

The linked website has a responsive design so that

if nurses are using older smartphones or want to

view the content on a computer or tablet the app

presentation will adjust to their particular devices.

Nurses working out of internet range can use the

app as it holds a version locally in the phone.

CareSearch Director Associate Professor

Jennifer Tieman, identifies several reasons for

the palliAGEDnurse app development.

“With the rapidly expanding knowledge base for

clinical practice it can be challenging for health

professionals – including nurses – to keep their

knowledge and skills up to date,’’ she says.  

“While continuing professional development is an

important professional responsibility to invest in new

skills and knowledge, nurses also need to be able

to access knowledge at the point of care, that is,

where they practice. The locations in which nurses

are providing care to older people are increasingly

varied, which also raises the need for portable

resources.

“Web based resources are helpful for this, and the

growing use of apps prompted Decision Assist to

explore different ways to share clinical knowledge

and encourage its use in practice.”

A palliative care approach

Being able to recognise that an older patient may

die within the next 12 months is an opportunity for

nurses to plan for changing care needs.

Using a palliative care approach, the palliAGEDnurse

app provides four key sections:

• Understanding a palliative approach (and

identifying older people needing a palliative

approach)

• Advance care planning

• Palliative care case conference

• Terminal care planning

A free smartphone app for clinical advice about

end of life care

decisionassist.org.au

Available from

‘’The palliAGEDnurse app will be promoted by our care

development unit,’’ Debbie Kable, Care Development Manager – Residential, BaptistCare

24In Memory @ACN

In memory: Jeannie Ross Fraser FACN, 1923-2016

Jeannie Ross Fraser FACN was a devoted

Christian, nurse and philanthropist who was caring,

compassionate, consistent, courageous and

committed to the nursing and Glen Innes communities.

Born in Lillydale, just north of Glen Innes NSW, in

1923, Jeannie spent her first four years living in camps

round Coolatai and Yetman where her father, David

John Fraser, was a successful water boring contractor

on such properties as “Myall Downs” and “Blue

Nobby”. Their portable camp home was a large tent

surrounded by a wooden frame covered by fly wire.

In 1926, her family bought part of “Yallaroi Station” at

Warialda and named it “Kerrowgair” after David’s

mother’s home in Ross-shire in Scotland. Jeannie’s

early schooling was completed via correspondence

lessons while she assisted her parents on the property.

After completing her final four years of school at

the New England Girls School in Armidale, Jeannie

went on to follow the career path of her mother,

Margaret Pearl Chaffey, who was the first nurse to

graduate from Glen Innes Hospital and a matron of

Inverell Hospital.

Sadly, Jeannie’s father died in October 1942 and

her mother 10 months later, just a few days before

Jeannie’s 19th birthday. Her guardian, Gordon Fraser,

supported her through her last two years at school

before she graduated and began her nursing training

at Royal Prince Alfred Hospital.

After completing four years of training, Jeannie

graduated in 1948 and went on to complete

midwifery studies at the Queen Victoria Hospital,

Launceston. She later nursed at the Port Macquarie

Base Hospital and the Western Suburbs Hospital in

Croydon, Sydney.

In 1951 Jeannie moved to London and worked

at Westminster Hospital, which provided staff for

Buckingham Palace. When King George VI died,

Jeannie was one of the first nurses on duty at his

lying in state in St Stephen's Hall, Westminster.

After returning to Sydney in 1954, Jeannie started

working at the Royal Alexandra Hospital for

Children (also known as The Children's Hospital at

Westmead) and completed further study at the NSW

College of Nursing (now ACN) in Operating Theatre

Management and Research Methods.

As Second in Charge of the operating theatres for

many years, Jeannie was committed to the care

of children in the operating rooms. No matter how

busy, it is reported that she would leave other duties

to comfort and console the small waiting patients.

She clearly made an impression on one little boy – a

frequent visitor to the hospital – who said, “I hope

Sister Fraser is doing me today!”

Jeannie would never accept anything but the best for

her small patients. She was a very practical and well

organised nurse and always tried to pass on these

skills to those who worked with her. She worked for

31 years at the Royal Alexandra Hospital for Children

until her retirement in 1985.

Upon her retirement, Jeannie returned to her

hometown of Glen Innes where she continued to

touch people with her generosity and kindness as

a supporter of many organisations, including, but

certainly not limited to, the Red Cross, the Church of

England congregation, the Glen Innes Art Gallery, the

Cemetery Trust, Meals on Wheels, the National Trust

and the Glen Innes Writer’s Group.

She was a patron and life member of the Glen

Innes & District Historical Society and curator of the

medical section at the museum, which is now known

as The Jeannie Ross Fraser Memorial Medical Wing.

Jeannie was also a devotee of music and opera and

a Foundation Member of the Elizabethan Theatre

Trust. She loved the beauty of music and said the

artistic colour filled the imagination.

“Jeannie would never accept anything but the best for her small patients. She was a very practical

and well organised nurse and always tried to pass on these skills to those who worked with her.”

ACN would like to thank Eve Chappell,

Manager and Research Coordinator at

Glen Innes & District Historical Society and

dear friend to Jeannie, for her contribution

towards this article.

25NMBA update

NMBA pleased to announce nat ional heal th suppor t ser v ice for 2017The Nursing and Midwifery Board of Australia (NMBA)

is pleased to announce to nurses and midwives that

a national health support service will be available

across Australia from 2017. The service will offer

nurses, midwives and students confidential advice and

referral for health issues related to their nursing and or

midwifery practice.

The Australian Health Practitioner Regulation Agency

(AHPRA), on behalf of the NMBA, has appointed

Turning Point to deliver the service.

The service will offer support for nurses and midwives

with a health impairment or at risk of a health

impairment regardless of where they work and live

across Australia. In addition, the service will provide

education and awareness about health impairment

as defined in the National Law for nurses, midwives,

students, educational providers and employers.

The NMBA Chair, Dr Lynette Cusack RN, said that

the service would offer nurses and midwives greater

access to support on health impairment issues.

“It’s important that nurses, midwives, students and

employers can access confidential advice on issues

related to their health anywhere in Australia,” Dr

Cusack said.

“No matter where nurses and midwives are living,

working or studying, they will be able to consult with

a professional about a health impairment, particularly

where it may affect their ability to practise, and get

confidential advice and referral to specialist treatment.

“As the regulator, the NMBA is continuing to engage

with nurses and midwives to ensure they are supported

to provide safe care to the public. The national health

support service will be funded by the NMBA, but will

be an independent service.”

Over the coming months Turning Point will be

developing the infrastructure to deliver the national

health support service. It is expected that services will

be offered from early 2017.

For more information

Visit the NMBA website:

www.nursingmidwiferyboard.gov.au

For registration enquiries:

1300 419 495 (within Australia)

+61 3 9275 9009 (overseas callers) 

For media enquiries: (03) 8708 9200

“It’s important that nurses, midwives, students and employers can access confidential advice on

issues related to their health anywhere in Australia.”