ANNUAL REPORT 2019/2020 ANMF ABOUT THE ANMF

The Australian Nursing and Midwifery Federation (ANMF) is Australia’s largest national union and professional nursing and midwifery organisation. In collaboration with the ANMF’s eight state and territory branches, we represent the professional, industrial and political interests of more than 290,000 nurses, midwives and carers across the country.

Our members work in the public and private health, aged care and disability sectors across a wide variety of urban, rural and remote locations. We work with them to improve their ability to deliver safe and best practice care in each and every one of these settings, fulfil their professional goals and achieve a healthy work/life balance.

Our strong and growing membership and integrated role as both a trade union and professional organisation provide us with a complete understanding of all aspects of the nursing and midwifery professions and see us uniquely placed to defend and advance our professions.

Through our work with members we aim to strengthen the contribution of nursing and midwifery to improving Australia’s health and aged care systems, and the health of our national and global communities.

ANMF Level 1, 365 Queen Street Melbourne VIC 3000 anmf.org.au

Graphic design: Erika Budiman Collective Work of the Federation Australian Journal of Advanced Nursing Australian Nursing &Midwifery Journal Education National Policy Research Campaign and Political Professional Industrial ANMF Federal Report 2018-2019 The Federation Federal Secretary’s Report Federal President’s Report ANMF Membership CONTENTS

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2019 3 ANMF ANNUAL REPORT 2019/2020 4 ANMF ANNUAL REPORT 2019/2020 progress the strategic goals of the ANMF. relationships relevantwith key stakeholders to and responsibility as we continue to foster strong values of integrity, courage, fairness, unity, inclusion occur. The Federation remains committed to our which strategic national discussions and planning Federal Council which provide the means through (albeit differently) of the Federal Executive and known, the ANMF remains committed to meetings amidst one of the greatest health crises we have met face to face, and itseems so long ago. This year, February inMelbourne isthe last time we have The first Federal Executive meeting of 2020 in being of the people inour jurisdiction and each other! contributed to the continued health outcomes and well- where our members work, each and every one of us has International Year of Nurse and Midwife as,no matter opinion, ithasbeen no more fitting year to celebrate were cancelled thewith progression of COVID. Inmy of national simultaneous events but allsuch things the State and Territory Branches to coordinate acouple MidwifeNurseandthe ANMFand was working with 2020 was designated the WHO International Year of have changed. work haschanged. Oursociety haschanged. And we IS no return to normal. Not even anew normal. Our business asusual. The challenge this time isthat there the emergency isover, we recuperate and return to effort, less sleep, food and family time. Usually, when emergency –longer hours, extra shifts, additional above and beyond, aspeople are inclined to do inan the pandemic hasbeen extraordinary. Everyone went every sector and work environment, our response to For our front-line heroes, nurses and midwives, in impact oftheCOVID-19pandemiconhealthcare, peopleandsociety. of digital technologies, and9/11 tonameafew, butnoneofthemcompare tothescale and been massive events suchasassassinationsofPresidents, numerous wars, massevolution to be year unlike any otherthat we can remember inourpersonalhistories? There have Who couldhave foreseen as we celebrated aNew Year on1January 2020thatthis was going REPORT FEDERAL

PRESIDENT’S PRESIDENT’S of all Australians.of are empowered to improve the healthand well-being united voice both professionally and industrially and ensure nurses, midwives and carers remain astrong to further advance the interests of our members to Federal Executive and staff over the coming year union movement. Ilook forward to working with the Federation and the broader They remain focused and committed to the goals of dedication, hard work and support over this past year. again thankallthe staff of the Federal Office for their and the ANMF membership, I would like to once On behalf of the Federal Executive, Federal Council nursing and midwifery. extend the professional and industrial interests of alliances, round tables and advisory groups to further newin ways ACTU with committees, taskforces, first response to COVID, the ANMF is still engaged Despite the initial hiatus innational meetings inthe submissions, and documents to support the cause. suffer. The Federal Office staff have continuedto write vulnerable citizens have suffered and continue to time…that the system isbroken and some of our most lifegiving and voice to what we have known for along evidence to the Commission –animportant partof families joined our Federal Secretary ingiving aged care. Many of our members, residents, and greater transparency and accountability inresidential ensuring mandated minimum staffing ratios and the National Aged care campaign, thewith goal of COVID related work, hasbeen continuing to progress The principle issue of focus this year, apartfrom Sally-Anne Jones Federal President 5 ANMF ANNUAL REPORT 2019/2020 6 ANMF ANNUAL REPORT 2019/2020 REPORT this year recommended mandated minimum staffing when Senior Counsel Assisting, Peter Rozen earlier understaffing in aged care. This wasfurther supported care sector, including the consequences of the chronic Commission on the significant failings of the aged support for the elderly and recognition from the Royal Throughout the ANMF continued to gain community workshops and conferences. and participated inthe Commission’s roundtables, on acomprehensive list of issues impacting the sector addition, the Federation made aseries of submissions interface between the health and aged care systems. In the aged care workforce, education and training and the evidence at the Commission’s hearings, including on until June 2020, both ANMF officials and members gave Over the course of the Commission’s activities in2019 Royal Commission. the union’s ongoing engagement thewith Aged Care progressing ANMF’s campaignfor aged care ratios and The ANMF’s key focus for the year hasbeen Australia’s largest union. and continues to do so, reconfirming the ANMF as to 284,272 members nationally, asof December 2019 while Iampleased to say ANMF’s membership grew leadership remained unchanged duringthis time, ANMF’s Federal and state and territory Branch and advocate for itsmembers on crucial issues. suddenly faced, the ANMF continued to campaign year. Despite these changes and the challenges we all priorities, particularly inthe second halfof the financial pandemic, the ANMF swiftly adjusted some of its and early 2020, followed by the global COVID-19 catastrophic bushfires across the country inlate 2019 Amidst a year of instability resulting from the extraordinary 12months we’ve ever had. overview oftheANMF’s activitiesandachievements over what hasbeenoneofthemost Nursing andMidwifery Federation (ANMF) 2019-2020AnnualReport andprovide an As ANMF’s Federal Secretary, itgives megreat pleasure topresent you with theAustralian FEDERAL

SECRETARY’S

issues facing frontline workers, including nurses emergency services summit, which explored critical services unions and participated inthe ACTU’s In response, the ANMF joined other emergency loss of life and property inthe worst affected areas. experiencing respiratory illnesses inmajor cities to or indirectly affected by the fires including those suggested more than75% of Australians were directly by devastating drought and bushfires, estimations In January 2020, muchwith of Australia gripped and midwives across allsectors. fair pay increases and decent conditions for nurses continued and won, their campaignsfor safe staffing, Additionally, ANMF branches across the country and discriminatory religious freedom bill. union-busting ensuring integrity bill and the unfair and supporting politicians, also worked to defeat the The ANMF otherwith unions, community groups financial gender gap, particularly in retirement. female membership, the ANMF lobbied for closing the the SDA and the ASU unions, who also have amajority included economic justice for women. Teaming up with Other priorities for the ANMF over the past 12months campaign for improvements inaged care. ANMF branches across the country continuing to forces thewith AMA callingfor urgent action, and older Australians inthe sector. This included joining to advocate and campaignfor aged care workers and achieving ratios inaged care, we needed to continue While this felt like ahigh point bringing us astep closer a registered nurse on duty at alltimes. levels and skills mix inaged care, including

Federal Secretary Annie ButlerAnnie

just one nursing home. residential aged care, almostwith occurring afifth at all Australia’s deaths from COVID-19 occurring in sector. This was despite more thanaquarter of confusion and inconsistency from the aged care Yet, unlike the health response, there was much never received such prominence. at the forefront, and the valuable work they do had All through the outbreak, nurses and midwives were their residents inthe most difficult of times. workers continued to go above and beyond to care for assist inintensive care ifneeded. Additionally, aged care than 20,000 nurses completed additional training to nurses signed upto return to the workforce and more could help. Consequently, more thanathousand retired carers instantly putting uptheir hands to ask how they This included thousands of nurses, midwives and governments, stakeholders and communities. the outbreak, working tirelessly alllevelswith of instrumental indeveloping this response to defeat health system. The ANMF and itsmembers were spread of the andvirus build capacity within our swiftly implemented measures to mitigate the Responding to the unprecedented crisis,the nation Australia. and bushfires, the COVID- 19 global pandemic hit Soon after dealing thewith fallout from the drought address climate change and bushfire risk. respond to emergencies and acomprehensive plan to adequately funded public services equipped to lobbying the government for swiftaction to provide This resulted inthe ANMF focusing itsattention on inaction hadcontributed to the crisis. Australians. Also evident was how the government demonstrating extraordinary leadership to help fellow rangers and electricians, showed the best inhumanity nurses, firefighters, paramedics, police, national park the summit, it was clear frontline workers including and midwives, responding to the bushfires. From dedicated to nurses, midwives and carers. strength to strength as Australia’s largest union in meeting the challenges ahead and going from We look forward to continuing to work memberswith follow. political, journals, education and policy research teams Federal Office industrial, professional, & campaign Professional Officer, to the team. Reports from the We also welcomed Naomi Riley, Federal Midwifery commitment to ANMF members over many years. Foley and Natalie Dragon and thankthem for their long staff serving members Anne Willsher, Elizabeth their ongoing work and take the opportunity to farewell We would also like to thankthe Federal Office stafffor ANMF members, particularly inthese difficult times. for their efforts in working for improvements for and Vice President, Sally-Anne Jones and James Lloyd, Council and particularly, the ANMF Federal President to take the opportunity to thankthe ANMF Federal In such aneventful year Lori-Anne and I would like public and health policy debates. to work to fullscope of practice and to be included in decision-making tables, to develop health care policy, and promote nurses and midwives as delegates at the ANMF has taken the opportunity to advocate to be clearly evident. Building on this recognition as leaders inpublic policy and dialogue continues carers to the community, healthcare systems, and Midwife, the importance of nurses, midwives and In the year of International Year of the Nurse and the priority. to acton these critical issues asamatter of immediate thewith government and imploring the community Accordingly, the ANMF elevated itsresponse meeting protective equipment. increased workloads and inadequate personal numbers of qualified staff with the right skill mix, reported cutsto nursing and care, insufficient Members working inaged care across the country 7 ANMF ANNUAL REPORT 2019/2020 8 ANMF ANNUAL REPORT 2019/2020 NORTHERN TERRITORY CAPITALAUSTRALIAN TERRITORY FEDERAL COUNCIL THE Northern Territory Australian Capital Sally-Anne Jones Federal President Secretary, ANMF Secretary, ANMF Matthew Daniel Territory Branch Yvonne Falckh Branch

FEDERATION Athalene Rosborough Federal VicePresident Northern Territory Branch (resigned 9 Australian Capital President, ANMF President, ANMF Territory Branch September 2019) Cath Hatcher James Lloyd NEW SOUTH WALESNEWSOUTH Secretary,New ANMF Branch South WalesBranch Northern Territory Federal Secretary President, ANMF September 2019)September Emil TabbadaEmil Brett Holmes Annie ButlerAnnie (commenced 9 QUEENSLAND President,New ANMF South WalesBranch Lori-Anne Sharp Assistant Federal Secretary, ANMF QNMU Branch O’Bray Smith Beth Mohle Secretary Sally-Anne Jones President, ANMF QNMU Branch VICTORIA AUSTRALIASOUTH Secretary,South ANMF Australian Branch Elizabeth Dabars Secretary, ANMF Victorian Branch Lisa Fitzpatrick President,South ANMF Australian Branch President, ANMF Victorian Branch Maree Burgess Gay Martin WESTERN AUSTRALIAWESTERN TASMANIA Western Australian Tasmanian Branch Secretary, ANMF Secretary, ANMF Emily Shepherd Mark Olson Branch Western Australian Tasmanian Branch President, ANMF President, ANMF Patricia Fowler James Lloyd Branch 9 ANMF ANNUAL REPORT 2019/2020 10 ANMF ANNUAL REPORT 2019/2020 Australian Capital Territory Branch Secretary, ANMF AUSTRALIAN CAPITAL TERRITORY Lori-Anne Sharp Assistant Federal Secretary Annie Butler Federal Secretary James Lloyd Federal VicePresident Sally-Anne Jones Federal President MEMBERS FEDERAL Mark Olson Secretary, ANMF Western AustralianBranch WESTERN AUSTRALIA Lisa Fitzpatrick Secretary,ANMF Victorian Branch VICTORIA Emily Shepherd Secretary,BranchANMF Tasmanian TASMANIA Elizabeth Dabars Secretary,South Australian ANMF Branch SOUTH AUSTRALIA Elizabeth Mohle Secretary, ANMF QNMU Branch QUEENSLAND Yvonne Falckh Secretary, ANMF Northern Territory Branch NORTHERN TERRITORY Brett Holmes Secretary, ANMF New South Wales Branch NEW SOUTHWALES Matthew Daniel

EXECUTIVE

FEDERAL 11 May 2020 28 February 2020 in writing 16 October 2019 10 October 2019 in writing FROM 1JULY 2019 TO 30JUNE2020 FEDERAL 29 May 2020 28 February 2020 15 January 2020 in writing 29 November 2019 FROM 1JULY 2019 TO 30JUNE2020 MEETINGS

EXECUTIVE COUNCIL

MEETINGS 11 ANMF ANNUAL REPORT 2019/2020 12 ANMF ANNUAL REPORT 2019/2020 mission forthenationalANMF. Council’sagreed values, and vision priorities sitalongsidetheFederal working towards achieving them. The strategies that will beundertaken in for thenext5 years anddetails the national ANMF’s sixStrategic Priorities in 2018. The Strategic Planoutlinesthe at theAnnualFederal Councilmeeting the ANMF’s 2018–2023Strategic Plan The ANMF Federal Councilendorsed PLAN ANMF OUR STRATEGIC PRIORITIES:2018– 2023 care in all settings and be midwifery professionsmidwifery to deliver safe and quality prepared for the future. Equip the nursing and

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2018–2023 STRATEGIC personal safety and wellbeing Ensure the professional and carers in all environments. of nurses,of midwives and 2 the health and well-being of all Australians. To empower nurses, midwives and carers to improve OUR aged care system. world-class, equitable and fully funded health and valued nurses, midwives and carers working ina the influential and respected national voice of highly The Australian Nursing and Midwifery Federation is OUR

VISION MISSION midwifery as as informed,midwifery expert commentators and advocates on health and social issues. Position nursing and 3 harassment, intimidation and violence. are committed to eliminating discrimination, from self-interest, prejudice or favouritism. We sexual preference, and ina way that isfree of their gender, ethnicity, religion, political or We treat allpeople inanequal manner, regardless FAIRNESS for our members and our communities. difficult situations to achieve better outcomes We challenge the status quo and work to overcome COURAGE and professional inallour interactions. We are consistently honest, ethical, respectful INTEGRITY OUR health and aged care policy, Develop to inform evidence and promote alternative and influence national policy wherepolicy needed.

VALUES 4 economically, environmentally future for all communities. Contribute to ensuring an and socially sustainableand socially 5 actions both inthe present and for future generations. environment. We are accountable for the results of our without waste or harmto any person or the interests of our members and our communities We transparently manage our resources inthe best RESPONSIBILITY of their identity to participate inour community. and dignity of those who are disadvantaged because We contribute to improving the ability, opportunity and opportunity for allto take partinour activities. We recognise allindividuals and provide equal access INCLUSION and international solidarity. communities and to strengthen internal, national achieve the best results for our members and our We work collectively and collaboratively to UNITY governance and democratic organisation through good involvement members. of Be an effective, efficient and accountable 6

13 ANMF ANNUAL REPORT 2019/2020 14 ANMF ANNUAL REPORT 2019/2020 PROFESSIONAL INDUSTRIAL FEDERAL OFFICE STAFF –CANBERRA FEDERAL Federal Professional Officer Senior Federal Professional Federal Education Officer Senior Federal Industrial (from 7 November 2019) Kristen Wischer Julianne BryceJulianne Naomi Riley Naomi Jodie Davis Officer Officer

Technical Assistant –Education Federal Professional Officer Federal Professional Officer Federal Industrial Officer

from 25 June 2020) Rebecca Aveyard Debbie Richards OFFICE Julie Reeves Bree Green (leave relief Research

Federal Professional Research Federal Professional Officer Federal Industrial Officer (until 27 Sept (until February 28 2020) Senior Administrative Officer and Librarian

and AJANOfficer Elizabeth Reale Elizabeth Foley Anne WillsherAnne STAFF Daniel CruteDaniel 2019)

STAFF –MELBOURNE Federal Secretary and Assistant Federal Professional Officer FEDERAL OFFICE Kerrie-ann Fitzpatrick Administrative Officer Administrative Officer Executive Assistantto (from 21 October 2019) Anna AmatangeloAnna Anastasia Shianis Federal Secretary Professional Tara Nipe Industrial

FINANCE CAMPAIGNSCOMMUNICATIONS AND JOURNAL ANMJ National Business Development Federal Political Director Kathryn AndersonKathryn Heidi Adriaanse (based in Sydney) in (based Sotiria Stefanis Sotiria Finance Officer ANMJ Editor Sue Bellino Manager

Digital and Social Media Officer TechnicalEditorial Assistant Nicole Foote-Lenoir Dorothy Abicic Finance Officer Cathy Fasciale Robert Fedele Journalist NATIONAL POLICY RESEARCH National Policy Research (until 17 January 2020) Technical Assistant (based in Adelaide) in (based Dr Micah Peters Natalie Dragon Kristy Male Journalist Adviser

(from 10 February 2020) Research Assistant (based in Adelaide) in (based Casey Marnie Ben Rodin Journalist

15 ANMF ANNUAL REPORT 2019/2020 16 ANMF ANNUAL REPORT 2019/2020 days’ notice on 11June 2020. opposition and was converted back to the standard 7 notice of the proposed variation. This met strong introduced allowing employers to give only one day’s changes to hours of work and work performed were Regulations relating to varying agreements to make now intended to cease operations on 28 March 2021. been extended, the temporary changes to the Act are on 28 September 2020. As the JobKeeper scheme has on 9 April 2020 and were initially scheduled to cease the scheme and their eligible employees. They started provisions apply to employers who have qualified for have been added to the Fair Work Act. These JobKeeper scheme, temporary JobKeeper provisions To support the implementation and operation of the AGREEMENTS UNDERTHEFAIR WORK ACT JOBKEEPER ENABLINGDIRECTIONSAND were made to the Act. Act 2009(the Act). In2019/20 the following changes and assistants innursing in Australia isthe law covering the employment of nurses, midwives Outside of state industrial jurisdictions, the principal INDUSTRIAL of the virus inthesecondhalfofreporting year. of theFederal industrial program towards responding totheindustrial implications and Branches. The outbreak oftheCOVID-19pandemichasdirected muchofthe work care workers. The industrial program alsosupportsthe work oftheFederal Office advancement ofthe industrial rightsofnurses, midwives andassistants innursing/ The 2019/2020 industrial program continuedtofocusontheprotection and REPORT FEDERAL

REGULATION

INDUSTRIAL Fair Work BILLS difficult to deliver. possibility to make patient safety and welfare more poorly drafted, promote discrimination and have the other Commonwealth anti-discrimination laws, are their current format because they are not inline with our concerns. The ANMF isopposed to the Bills in the first and second exposure draft which highlighted and associated bills. ANMF made submissions to both exposure drafts of the The Commonwealth Government haspublished two RELIGIOUS FREEDOMBILLS announced itdid not intend to reintroduce the Bill. in the Senate and inMay 2020 the Government Inquiry hearings. The Bill was narrowly defeated of Federal Office and Branches appeared at the Senate made submissions opposing the Bill. Representatives campaign across the union movement, Federal Office hearings inSeptember 2019. Inline aconcertedwith was referred to aSenate Inquiry which conducted to sanction and control union activity. The Bill powers for the Registered Organisations Commission measures intended to create significantly increased Integrity Bill, which sought to introduce arange of On 31July 2019, the lower house passed the Ensuring Ensuring Integrity Bill 2019 Fair Work Amendment (Registered Organisations) Religious Discrimination Bill2019

MF v Domain Aged Care (QLD)Pty Ltd T/A Opal Aged Care [2019] FWCFB 1716 5 4 3 2 1 leave upuntil at least 29October 2020. care have been varied to provide for paid pandemic Professionals Award asthey apply to workers inaged care. The Aged Care Award, Nurses Award and Health was appropriate to grant paid pandemic leave inaged in July, the FWC hassince become satisfied that it Following the rapid escalation of infections in Victoria achieve the modern awards objective.” the grant of the unions’ applications is necessary to balance…” they were “…not presently satisfied that rest of the economy…” however on “…afairly fine risk of infection by COVID-19 than workers inthe in the health and social care sectors are at ahigher MacIntyre …that, at ahigh level of generality, workers “based on the evidence, particularly that of Professor [2020] FWCFB 3561. The Full Bench was satisfied that On 8July 2020 the FWC delivered itsinitial Decision and community settings. the capacity for the tovirus spread quickly inhealth evidence about the risk to health care workers and Melbourne. Professor RainaMacIntyre gave expert Practice Nurse at asuburban medical practice in in anursing home inSydney and the other anRN evidence from two members, one anRN working due to COVID-19. The ANMF relied upon witness the increased risks faced by health care workers provision for paid pandemic leave inresponse to the Nurses Award and Aged Care Award to make to vary arange of health sector awards including health sector unions made applications to the FWC The ACTU inconjunction thewith ANMF and other PAID PANDEMIC LEAVE –AM2020/13 the earliest on 29October 2020. Subsequent events have meant that it expirewill at pay. This was originally to expire on 30 June 2020. for unpaid pandemic leave and annual leave at half- 2010 and the Aged Care Award 2010, which provides into arange of awards including the Nurses Award A week later, this led to Schedule Xbeing inserted COVID-19 pandemic. awards objective additionalwith measures during vary certain modern awards to achieve the modern Commission on itsown initiative indicated it would On 1 April 2020 aFull Bench of the Fair Work UNPAID PANDEMIC LEAVE -AM2020/12 INDUSTRIAL

fwc.gov.au/awards-and-agreements/awards/award-modernisation/variation- fwc.gov.au/documents/awardsandorders/html/pr719898.htm fwc.gov.au/health-sector-awards-pandemic-leave fwc.gov.au/awards-and-agreements/awards/award-modernisation/variation- AN applications/AM2020/1 applications/AM2020/12

MAJOR

CASES 2 1 Exposure Draft does not reflect the of Exposure Drafts, itbecame apparent that the In the course of the 4 Year Review and issuing THE NURSESAWARD (AM2020/1) AI GROUPAPPLICATION TO VARY employment terminates. than 7days after the day on which the employee’s added the requirement to pay the employee no later that kept the requirement to pay allamounts and to replace clause 18.3 of the Award a with version hearing inSeptember 2020. and public holiday penalties. The matter islisted for loading when calculating overtime and weekend ordinary rate of pay for casualsincludes the casual Act to vary the award. The ANMF maintains that the Ai Group rely on both s.157 and s.160 of the Fair Work May 2020 termination of employment. Initsdecision of 20 conditions respectwith to payment of wages on The ANMF was successful inkeeping the superior although these are nearly concluded. issues’ that relate to allor most modern awards, various FWC Full Benches dealing ‘commonwith Proceedings also continued to be conducted by COMMON ISSUES –PAYMENT OFWAGES NURSES c. b. a. employees: the Award such that itrequires inrespect of casual Ai Group seek adetermination retrospectively varying the Award. Ai Group made application inJanuary 2020 to vary After conferences held in2019 concerning the matter during overtime. for work done on weekends, public holidays and respectwith to how casualemployees are to be paid

separate casualloading. the Award and not on arate that includes the on the minimum hourly rate prescribed by The public holiday penalty rates are calculated loading. and not on arate that includes the separate casual minimum hourly rate prescribed by the Award The overtime rates are calculated on the that includes the separate casualloading. rate prescribed by the Award and not on arate Award are calculated on the minimum hourly The Saturday and Sunday penalty rates of the

3 the FWC found infavour of the ANMF

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AWARD decisionOpal

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17 ANMF ANNUAL REPORT 2019/2020 18 ANMF ANNUAL REPORT 2019/2020 language isadopted throughout the Rules. membership and ensuring gender neutral conducting elections, voting, operation of dual changes which included improvements to Work Commission approved arange of rule On 27May 2020 and 22June 2020, the Fair workforce and reflect contemporary standards. meet the needs of the nursing and midwifery the Rules remainwill compliant regulation,with review hasprovided the opportunity to ensure from Branches and the Federal Executive. The amendments and obtaining extensive feedback involving identifying areas of concern, drafting continued itsmajor review of the Federal Rules, Over the past twelve months the ANMF has ANMF • • • • midwives and assistants innursing, including: number of enterprise agreements covering nurses, of the ANMF was involved inthe negotiation of a During the 2019/20 financial year, the Federal Office BARGAINING

– ANMF Enterprise– ANMF Agreement2019 Calvary Home Care Services Ltd Nursing Employees Enterprise Agreement2019-2022 Australian Health Practitioner Regulation Agency Nurses’ Collective Agreement 2019 Serco - ADF Health Services Contract (AHSC) Enterprise Agreement2019-2022: Aged Care Quality and Safety Commission PUBLIC SECTOR ANDAGED CARE NURSING WAGE DISPARITY 2002–2020 $1, $1,200 $1,400 $1,600 $1,800 $200 $400 $600 $800 000

$- RULES 0220 0420 0620 0820 0021 0221 0421 0621 0821 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 $1,200 $1,400 $1,600 $1,800 $1, $200 $400 $600 $800 000 $- 0220 0420 0620 0820 0021 0221 0421 0621 0821 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 Public Sector Public Nursing Wage Disparity 2002-2020 Disparity Wage Nursing Public Sector and Aged Care Aged and Sector Public

Nurses AwardNurses rostering arrangements. development allowances and leave and shift and to patient ratios; qualification allowances, professional implementation of staffing mechanisms such as nurse improvements to employment conditions including Agreements commonly include arange of before general wage increases are applied. rates of pay and improved classification structures agreements provide for significant increases to base In addition to the wage increases detailed, several that apply over the 2019/2020 financial year period. expiry dates of public sector enterprise agreements The table below details the percentage increases and PUBLIC SECTOR AGREEMENT OUTCOMES conditions. (see table below) or significantly reduce the disparity in wages and than public sector outcomes and failto remove conditions outcomes are generally less favourable covered by collective agreements, the wages and 2171 out of 2478 facilities. While 90%of facilities are operate inthe residential aged care sector covering nurses inthe sector. Across Australia 717agreements to be asignificant barrier to attracting and retaining and nurses working inthe public sector continues The wages gap between nurses working inaged care AGED CARE WAGES Public Sector Public Nursing Wage Disparity 2002-2020 Disparity Wage Nursing Public Sector and Aged Care Aged and Sector Public EBA Aged Care Aged EBA Nurses AwardNurses EBA Aged Care Aged EBA to the majority of the nursing workforce. the private acute and aged care sectors, but also apply only establish abenchmark for ANMF negotiations in of the states and territories are important asthey not The outcomes achieved inthe public health sectors the country. cover approximately 90%of private hospitals across respective State/Territory Enterprise Agreements on average, similar to public sector outcomes inthe midwives employed inprivate acute hospitals are, Enterprise Agreement outcomes for nurses and PRIVATE ACUTE HOSPITAL SECTOR STATE NSW QLD ACT TAS WA VIC NT SA AVERAGE PAGE VIEWS PERDAY BY CALENDAR MONTH ANMF FEDERALOFFICE–‘JOIN THEANMF’ 2.5% for 1year (expires 30.06.20) 10% over 4years (expires 20.08.22) (new agreement pending) 31.03.20) 13.25%–35.25% over 4years (expires OUTCOME 9.3% over 4years (expires 30.06.22) 7.5% over 3years (expires 31.03.21) (new agreement pending) 7.5% over 3years (expires 01.09.19) $2000 over 2years (expires 11.10.20) (new agreement pending) 6.8% over 2.16 years (expires 31.12.19)

page since itscreation until the end of June 2020. The following graph highlight the popularity of this ‘Jointo ANMF’. had the ‘Contact ANMF’ on the home page converted In October 2019, Federal Office created a join page and join the ANMF through the Federal Office website. There was no simple way for potential members to JOIN THEANMFPAGE ANMF 43.9 years working on average 33.4 hours per week. and midwives; 89% were female; the average age was or midwifery. There were 333,970 employed nurses extended leave and those looking for work innursing includes those employed; nurses and midwives on and midwives were inthe nursing workforce which in the nursing workforce. In2018, 361,072 nurses However, not allnurse and midwife registrants are and dualregistrants, and 16% were enrolled nurses. registration, 84% were registered nurses, midwives non-practising registrants. Of the nurses generalwith and midwives generalwith registration and 5,420 registered in Australia. This comprises 386,618 nurses of Health shows there were atotal of 392,038 nurses published by the Australian Government Department The 2018 nursing and midwifery workforce data WORKFORCE NURSING

WEBSITE

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19 ANMF ANNUAL REPORT 2019/2020 20 ANMF ANNUAL REPORT 2019/2020 Australia (RA) awaiting final endorsement. Our process of review and isnow Reconciliationwith Action Plan (RAP)hasundergone itstwo-yearly In 2019/20 the ANMF Federal Office’s Reconciliation RECONCILIATION ACTION PLAN SOCIAL videoconference inMay 2020. Midwives Association (ANMF NSW Branch), and by October 2019, at the New South Wales Nurses and CoNNMO member organisations were held inSydney, face to face. Meetings of the representatives of the 57 to conduct meetings by videoconference instead of until the end of December 2020, allowing CoNNMO May 2020. This variation extends CoNNMO funding Australian Government Department of Health signed deed of variation to the funding agreement the with the pandemic, ANMF Federal Office negotiated a and the requirement for social distancing due to in June 2020. Due to the impactof travel restrictions current three year funding round was due to conclude conduct the Secretariat operations of CoNNMO. The of Health, the ANMF Federal Office continuesto Funded by the Australian Government Department MIDWIFERY ORGANISATIONS (CONNMO) COALITION OFNATIONAL NURSING AND medicinal cannabis. for policy formulation; climateandenvironmental health;alcoholandotherdrugs; and research aged care; mental health;digital health;disability; issues; medicinessafety; professional nursingandmidwifery theCOVID-19pandemic; practice bushfire support; that continuetoform ournationalprofessional objectives foractionin2019/20 included: strategies evidence-based nursingandmidwifery forsafe, practice. Professional issues Committee, toprovide advicetogovernments, key stakeholders andpolicy makers on involved working with state andterritory Branches, via theProfessional Advisory and wellbeing ofthecommunity. The mainfocusofthenationalprofessional program of ournurseandmidwifemembers, toadvance theprofessions andimprove thehealth In 2019/20 theANMF Federal professional teamcontinuedtorepresent theinterests PROFESSIONAL

JUSTICE

reiterated our support for the UluruStatement of the to good health for First Nations communities, and advocate for the removal of longstanding barriers communities from COVID-19. We also continued to in developing appropriate responses to protect those by NACCHO to listen to First Nations communities March 2020 communicationswith supporting calls Federal Office marked Close the Gap Day on19 representative. Nurses and Midwives (CATSINaM) to seek asuitable Congress of Aboriginal and Torres Strait Islander her replacement. Federal Office is liaising with the Clarke also departed her role and we are now seeking Lori-Anne Sharp. Our Aboriginal nurse adviser Faye now chaired by the Assistant Federal Secretary, of Federal Professional Officer, Elizabeth Foley,is Industrial and Journal Teams and, thewith retirement has expanded to include representation from the Office. Over the last year, ourRAP Working Group governance committees; and within the Federal ANMJ, Facebook and Twitter; through our national this via our maincommunication channels –the Strait Islander issues, events and activities. We do publicising and engaging in Aboriginal and Torres ANMF Federal Office to learning, participating, and Torres Strait Islander peoples. Itcommits the reconciliation to achieve health equality for Aboriginal RA Innovate-level RAPdescribes our vision for REPORT experiencing the debilitating health effects of poverty. their daily practice engage directly peoplewith of nursing and midwifery members who through despair. The ANMF supports this campaignon behalf all do something about it,and isone of hope, not was Poverty exists. Poverty hurts us all. We can a new look and approach in2019; the key message terms for more than25 years. Anti-Poverty Week had payments which have not been increased inreal Around amillion Australians are reliant on these Newstart and associated allowances by $75 a week. Services, which isaimed at increasing the rate of campaign led by the Australian Council on Social 2019, the focus of APW was on the Raise the Rate despite Australia being a well-resourced country. In within our community who struggle poverty,with This annual operation highlights the plight of people social media, and the provision of campaignfunding. through promotion in print-based publications and 2019, was supported by the ANMF Federal Office The Anti-Poverty Week campaign,held 13-19 October ANTI-POVERTY CAMPAIGN and ANTaR inMay 2020. and Reconciliation, hosted by Melbourne Law School Working Group Chairattended a webinar, Treaties health, justice and social issues. The new RAP members about Aboriginal and Torres Strait Islander journal and the website incommunicating with and continues to play animportant role via the print wrote about the theme for 2020, In This Together, range of books, films, forums and music. The ANMJ 2020, was marked online this year by publicising a Heart. National Reconciliation Week, 27May to 3June to human health from dramatically changing organisations who share aconcern for the threat (CAHA) the ANMF joins colleaguewith health care As amember of the Climate and Health Alliance CLIMATE CHANGE Regulation Agency(AHPRA). (ANMAC) and the Australian Health Practitioner Nursing and Midwifery Accreditation Council Midwifery Board of Australia (NMBA), the Australian associated with work conducted by the Nursing and committees, working groups and standing committees team participated on anumber of expert advisory During 2019/20, the ANMF Federal Office professional AND ACCREDITATION NATIONAL REGISTRATION PARTNERSHIPS PROFESSIONAL flexibility incare delivery; access inrural and remote in Australia. The priorities for the 10 Year Plan are: the priorities for the future of primary health reform Department of Health Consultation Group to discuss invited to participate inthe Australian Government 10 Year Plan. In November 2019, the ANMF were to develop and implement aPrimary Health Care National Health Plan, the Government hascommitted equitable. Under the first pillar of the Long Term more integrated, efficient, focused on patients and to modernise Australia’s health system to make it National Health Plan in August 2019 a with vision The Australian Government released itsLong Term PRIMARY HEALTH REFORM communities. and insurance; and human health, disasters and of climate change; sectoral impacts,infrastructure and May 2020 themeswith of: the physical impact Three roundtables were held between February Federation, and the World Wide Fund for Nature. Investor Group on Climate Change, National Farmers Aluminium Council, Business Council of Australian, Industry Group, Australian Energy Council, Australian Australian Conservation Foundation, Australian ACTU CAG, Australian Council of Social Services, which brought together representatives from the also involved inthe Australian Climate Roundtables season’s devastating bushfires. Federal Office were a larger role, particularly following the summer on worker safety and employment. Health hastaken on workers –the consequences of heat and drought fossil fuel industry, and the impactof climate change transition to renewables for those employed inthe main focus of this group was on the logistics of just to participate on the ACTU Climate Action Group. The In November 2019, ANMF Federal Office was invited expert speakers. to action were provided by the CAHA President and benchers and the Greens. Presentations and acall MP co-chairs this new group fellowwith cross which was held at Parliament House. Helen Haines Friendship Group for Climate Action for this event staff. CAHA partneredwith the Parliamentary Climate and Health for allMPs, Senators and their participants attended aParliamentary Briefing on Following the symposium, ANMF along selectedwith October 2019: ‘The health of our land and our people’. in CAHA’s 2019 Climate and Health Symposium on 14 environmental sustainability. The ANMF participated comprehensive policies to ensure Australia’s climate and human health which would encompass for the development of anational strategy on a commitment from the Australian Government government advocacy work, especially inseeking climate patterns. The ANMF contributes to CAHA’s 21 ANMF ANNUAL REPORT 2019/2020 22 ANMF ANNUAL REPORT 2019/2020 Groups by the Medicare Benefits Schedule (MBS) June 2018, asone of five Primary Care Reference Practitioner Reference Group (NPRG), established The ANMF was represented on the Nurse PRACTITIONER REFERENCEGROUP REVIEW TASKFORCE -NURSE MEDICARE BENEFITS SCHEDULE HEALTH NURSING services for people ID/Awith and their carers. access to, and outcomes from, mainstream health post-discharge nurse-led referral pathways to improve National Disability Insurance Scheme (NDIS) and resource for nurses to build their knowledge of the has commenced development of anon-line learning autism spectrum disorder (ID/A). The project team services to people intellectualwith disability and mainstream hospital and community based health project buildwill the capacity of nurses to deliver commenced inMarch 2020. This three year national Grant. The tender was successful and the project Agency (NDIA) Mainstream Capacity Building Cross University for aNational Disability Insurance participated inaproject tender led by Southern universities and four other professional organisations, In November 2019, the ANMF, along fivewith CAPACITY BUILDINGPROJECT COLLABORATIVE MAINSTREAM partnership forum meetings, asit’s circulated. the DVA’s work to members following and between of services. The ANMF hascontinued to communicate families, including improved access to agreater range aligned to the needs of military Veterans and their 19/20 funding are aimed at providing services better initiatives being implemented Federalwith Budget project, and DVA data assets and capabilities. The new on DVA programs, the DVA website improvement Officer and DVA Deputy Secretary and discussion included updates from peak bodies, the Chief Medical Providers Partnership Forum. Quarterly meetings the Department of Veterans Affairs (DVA) Health In 2019/20 the ANMF continued to participate on PARTNERSHIP FORUM DVA HEALTH PROVIDERS 2020 was postponed due to the COVID-19 pandemic. The Consultation Group meeting scheduled for April integration; and ahealth system ready for the future. community; continuity of care and whole-of-system equitable access and keeping people well inthe health. The consultation group explored three themes: Australia; workforce; future-focused; and mental

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PRIMARY the ADHA. comment inJune 2020 before being implemented by final version was presented to the Steering Group for November 2019 to review the proposed roadmap. The participated inalarge stakeholder forum held in being workforce and education. ANMF Federal Office National Digital Health Strategy (NDHS), pillarwith 6 and Education Roadmap. The project ispartof the communicating anational Digital Health Workforce provide strategic advice inrelation to developing and (ADHA) inJuly 2019. The group’s purpose was to established by the Australian Digital Health Agency Workforce and Education Steering Group which was The ANMF were invited to be amember of the ROADMAP STEERING GROUP WORKFORCE ANDEDUCATION in itsfinal stages of completion. Digital Medicines Safety Program roadmap which is focussed on the development of asector-wide ADHA implementation. Work of the Steering Group also of key elements that need to be achieved before the group, updateswith for members on anumber prescribing project also featured on the agenda for relates to medicines safety. Progress on the electronic of the My Health Record program, particularly asit on progress by the ADHA on the implementation (ACSQHC). Meetings for this period featured updates Commission on Safety and Quality inHealth Care Digital Health Agency (ADHA) and the Australian established asajoint initiative of the Australian Steering Group for the Medicines Safety Program, In 2019/20 the ANMF continued to participate on the STEERING GROUP MEDICINES SAFETY PROGRAM DIGITAL recommendations to the Federal Health Minister. the Taskforce are yet to submit the NPRG by the ANMF and other key nursing stakeholders, made inthe report. Despite consistent follow up the nursing profession for the 14 recommendations July 2019. There was overwhelming support from NPRG report was submitted to the Taskforce in community. Following public consultation, the final to improve health outcomes for the Australian contemporarywith clinical evidence and practice and recommendations making to alignthese items reviewing the MBS items for Nurse Practitioners Review Taskforce. The work of the NPRG involved

HEALTH and the number of services they provide. increase in number of nurses providing these services to the pandemic, there hasbeen afurther significant continue to increase. Since March 2019, inresponse and the number of telehealth services they provide the number of nurses providing telehealth services 2019/20, prior to the pandemic, again indicated both the Australian Government Department of Health in Medicare Benefit Schedule (MBS) data provided by across primary and secondary care, using telehealth. and Aboriginal and Torres Strait Islander communities on improving access to health care inrural, remote use of digital health technologies, anemphasiswith on supporting the implementation and meaningful digital innovation and telehealth. The group focuses associations and organisations aninterestwith in health professional groups, peak bodies, government, the RRDIG isacollaboration of more thantwenty Health through the Rural Health Outreach Fund, by the Australian Government Department of Remote Digital Innovation Group (RRDIG). Funded has continued to be represented on the Rural and Meeting quarterly over the last year, the ANMF INNOVATION GROUP RURAL ANDREMOTE DIGITAL May 2020, endorsement was recommended. and, following discussion at the PAC meeting held 20 final framework. PAC reviewed the final framework has requested ANMF endorsement of the attached These suggested amendments were alladopted. AIDH of the consultation suggesting minor amendments. The ANMF provided a written response to this part public consultation was undertaken inMarch 2020. registered nurses and midwives. The second round of structure and intention of the framework, that itisfor standard. Further, it was agreed that due to the be used asaneducative tool and not aprofessional useful. It was agreed that the framework should draft framework indicated that it was relevant and Professional Officers attended. The feedback on the stakeholder forums which anumber of Branch commenced inDecember 2019. The AIDH conducted bykit June 2020. Consultation on the draft framework nurses and midwives and anaccompanying resource of the project was to produce aframework for all Chair the Project Advisory Committee. The objective nurses and midwives. The ANMF were invited to national digital health capability framework for Institute of Digital Health (AIDH), to develop a Society of Australia (HISA), now the Australasian (ADHA) provided funding to the Health Informatics In May 2019, the Australian Digital Health Agency DIGITAL HEALTH CAPABILITY FRAMEWORK NATIONAL NURSINGANDMIDWIFERY (AHMAC). the Australian Health Ministers Advisory Committee The finaldraft standards are awaiting approval from designated registered nurse prescriber endorsement. Board of Australia (NMBA) registration standard for awaiting finalisation of the Nursing and Midwifery scheduled medicines. This work iscurrently on hold to endorsement for registered nurses to prescribe accreditation standards for programs of study leading 2019 to provide oversight for the development of Reference Group (PRG) established inJanuary Accreditation Council (ANMAC) Professional represented on the Australian Nursing and Midwifery for registered nurse prescribing. The ANMF was of both accreditation and registration standards team continued to be involved inthe development During 2019/20, the ANMF Federal Office professional REGISTERED NURSEPRESCRIBING last year. of medicines inallsettings. MSOC met twice over the policy, national medication safety and the quality use ACSQHC on the management of national medicines role of the MSOC isto provide strategic advice to the Medication Safety Oversight Committee (MSOC). The represents nursing and midwifery on the ACSQHC our nurse and midwife members. The ANMF also distribution of these evidence-based resources to to treat COVID-19. The ANMF hasassisted the with COVID-19 web resources; and experimental medicines COVID-19 medicine-related issues; asummary of a set of resources including: position statements on COVID-19 pandemic. The Commission hasdeveloped medicines management inthe context of the biosimilars and patient safety issues; and national safe practice advisory tool for hospitals; insulin opioid stewardship; neuromuscular blocking agents medication management plan; packaging similarities; prescribing; medicinal cannabis labelling; the national monitoring; high risk medicines courses; anticipatory analysis; oxygen prescribing –guidelines on use and medication chart (NSMC); anticoagulant incident data issues; 2020 national audit of the national standard medication safety standard; national tall manlettering prescribing; accreditation outcome results for the medicines safety issues including: active ingredient meets quarterly, provided advice on abroad range of Expert Advisory Group (HSMEAG). The group, which Health Care (ACSQHC) Health Services Medication the Australian Commission on Safety and Quality in In 2019/20 the ANMF continued to be represented on MEDICINES SAFETY COMMITTEES AND QUALITY INHEALTH CARE AUSTRALIAN COMMISSION ONSAFETY QUALITY

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MEDICINES 23 ANMF ANNUAL REPORT 2019/2020 24 ANMF ANNUAL REPORT 2019/2020 funding model. the potential implementation of this proposed being conducted, and other ongoing issues regarding have offered input to the model structure, future trials aged care. The working group meet quarterly and Classification (AN-ACC) funding model for residential Health on the proposed Australian National Aged Care ANMF hasprovided advice to the Department of otherwith aged care stakeholders on this group, the Aged Care Funding Reform Working Group. Along Commonwealth Department of Health Residential In June 2019, the ANMF were invited to join the REFORM WORKING GROUP RESIDENTIAL AGED CAREFUNDING of aged care reform. regulation and the development and implementation including community and residential care, funding, implementation. Agendas cover allareas of aged care, Government on aged care policy development and this committee provides advice to the Australian appointment. Independently chaired by David Tune, Aged Care Sector Committee. This isaministerial ANMF Federal Office on the Australian Government Officer Julie Reeves has continued to represent the Over the last year, ANMF Federal Professional CARE SECTOR COMMITTEE AUSTRALIAN GOVERNMENT AGED management of COVID-19 inaged care for 2020. focus of NACA’s discussions in2019/20. ashasthe into aged care quality and safety hasbeen astrong reviewers within the sector. The Royal Commission Government Department of Health, and experts and the Federal Minister for Aged Care, the Australian day meeting hasinvolved members engaging with has met four times over the last 12months. Each two determine apositive future for older people. NACA professionals, NACA members work together to of the sector: consumers, unions, providers and interest inaged care. Covering four mainareas (NACA), comprising 55 national organisations with and represented on the National Aged Care Alliance The ANMF continues to be one of nine sponsors NATIONAL AGED CAREALLIANCE AGED

CARE to the pandemic. Scientific Symposium postponed until May 2021 due the face to face NRHA 7thRural and Remote Health keynotewith speakers held inMay 2020 in place of participated inthe pre-symposiumvirtual session speed internet inrural and remote areas. The ANMF and do more to provide universal access to high- Government to invest indigital health infrastructure funding; and connectivity. The Alliance called on the the key themes of: education and training; flexible more than40Federal MP’s and Senators to discuss to health and wellbeing. Council members met with and connectivity inrural areas due to itsimportance several exemplars across rural and remote Australia); funding from the Federal Government to evaluate integrated health precincts or networks (seeking overcome market failure and provide holistic, aged care, disability and other social services to rural areas—that encompass health care, education, and business support for health precincts/networks in through to postgraduate education; flexible funding professionals inrural Australia, from vocational in education and training pathways for health on 3key policy priorities: additional investment September 2019, the 41member bodies agreed strategic planning and lobbying meeting, held in Alliance (NRHA). At the NRHA annual face to face Council and Board of the National Rural Health The ANMF continues to participate on both the NATIONAL RURALHEALTH ALLIANCE RURAL

HEALTH 25 ANMF ANNUAL REPORT 2019/2020 26 ANMF ANNUAL REPORT 2019/2020 retention bonus on behalf of their workforce. number of employers have chosen not to apply for the bonus. Despite these efforts, itappears that alarge around the country inattempts to gain access to the directly to employees. The ANMF assisted members for the retention bonus which would then be paid members. Aged care providers were required to apply Care Minister Richard Colbeck, so we could inform attempted to get information from the Federal Aged confusion from itsannouncement and the ANMF in aged care. The retention bonus was clouded in announced aretention bonus for direct care workers package to support aged care, the Federal Government In March 2020 aspartof the additional funding cuts to staffing, hours, rosters and in shifts aged care. Despite the pandemic, branches continued to report nursing homes are chronically understaffed. staff infacilitating regularvisits from families when of training ininfection control, and the difficulty for care, lack of personal protective equipment (PPE), lack to branches were the lack of staffing levels in aged during the COVID-19 pandemic. Of particular concern regularly, monitoring worksites in2019 and then The ANMF campaignteam continued to meet priorities. Parliament House inCanberra to discuss aged care meet newwith Ministers and Shadow Ministers at in May 2019, the ANMF commenced aprogram to Following the election of the Morrison Government AGED CAMPAIGN

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FinalReport.pdf reports/ANMFAgedCareCOVID-19Survey2020_ is available online at www.anmf.org.au/documents/ The final report presenting all results of the survey COVID-19 outbreak. supplies of PPE and general preparedness for a the COVID-19 pandemic, infection control training, Members were asked about the level of staffing during direct care to older Australians. COVID-19 from the perspective of those providing and major gaps inthe aged care sector’s response to put inplace as well asidentify the key challenges COVID-19 pandemic and the strategies that hadbeen of their employer’s preparedness to deal the with The survey aimed to assess aged care workers’ sense of 1,980 participants from allStates and Territories. conducted from 15 April to 6May 2020 atotalwith The National COVID-19 in Aged Care Survey was COVID-19 visitors. and information for aged care workers, families and sheets, Department of Health updates and resources, Branches, evidence briefs, response guidelines, fact to members including advice and information from COVID-19. This page provided all ANMF information advice to members seeking information regarding ANMF website inMarch 2020 to provide support and Information for Members page was established on the In response to the COVID-19 pandemic, an ANMF POLITICAL

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SURVEY inquiry and report, expected inlate November 2020. Senate Community Affairs Legislation Committee for Amendment (Financial Transparency) Bill 2020 to the 2020, the Senate referred the Aged Care Legislation The Bill was narrowly defeated. However, on 18 June • • The mainelements to the amendment were: the amendment. lobbied allFederal Senators seeking their support for (New Commissioner Functions) Bill 2019. The ANMF Senator titled the Aged Care Legislation Amendment an legislative amendment was introduced by the Following meetings Senatorwith Griff inCanberra, FUNDING ACCOUNTABILITY TRANSPARENCY

care facilities. Transparency of staffing number and ratios in aged medical products, etc.) supplements, accommodation, continence aids, amount spent, cost spent on food and food transparency including breakdowns of income, Transparency of Approved Providers (financial

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CARE at the Victorian Branch of the ANMF and members. thewith Leader of the Opposition Anthony Albanese, Parliament, the ANMF hosted amedia conference Following the defeat of the Ensuring Integrity Bill in November 2019. to the Ensuring Integrity Bill. The Bill was defeated in concerns nurses, midwives and carers hadinrelation arangewith of federal politicians to highlight the thewith ACTU and other union members and met The ANMF delegation spoke at the media conference November 2019. NSW and the ACT to Parliament House on Monday 25 Ensuring Integrity Bill, the ANMF sent 13 nurses from As partof the ACTU delegation to lobby against the ENSURING following sustained political pressure. withdraw the privatisation of ACAT, inFebruary 2020, The Federal Government announced itsdecision to oppose the privatisation proposal. to coordinate research, responses and messages to industrial and professional teams working together Assessment Teams,national campaigns, ANMF with against the proposed privatisation of Aged Care The ANMF was active inbuilding acampaign TEAMS AGED

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BILL 27 ANMF ANNUAL REPORT 2019/2020 28 ANMF ANNUAL REPORT 2019/2020 Nurses Day activities. International Day of the Midwife and International for nurses, midwives and aged care workers and following content for ANZAC Day, COVID-19 issues sharper growth duringlate April and into May COVID-19 in Australia. This trend continued with followers occurred inlate March thewith onset of Remembrance Day content. A dramatic spike in A smallspike ingrowth occurred inNovember with 52,374 followers. Our current audience base asof 30 June 2020 sitsat followers of our ANMF Federal Office Facebook page. Over the past year we have hadagrowth of 17% in message conversations. from our audience. We hadover 268 new direct in Facebook feeds and received 171,660 engagements year. These received over 11.13 Million impressions We had538 posts on our ANMF page over the past FACEBOOK social issues. expert commentators and advocates on health and position the ANMF, nurses and midwives asinformed, These are vital communications tools that continue to grow inreach and audience across multiple platforms. The ANMF Federal social media channels continue to channel on Twitter and one on Instagram. Staff For Aged Care. We also have an ANMF Federal ANMF Federal page and our campaignpage More channels. OnFacebook there are 2channels, the The ANMF Federal Office operates 4 social media SOCIAL –12% 165,14K LINK CLICKS

MEDIA 39,73K PHOTO CLICKS +39%

REPORT 35,73K VIDEO PLAYS +82% 552,7K OTHER CLICKS +58% stakeholder channels. video published collectively and simultaneously on all the eve of International Nurses Day. The vigil was a (NZNO) to honour fallen nurses and midwives on branches and the New Zealand Nurses Organisation Office coordinated acandlelight vigil withall ANMF to the COVID-19 pandemic, the ANMF Federal health care workers around the world inresponse With the extraordinary pressures being faced by CANDLELIGHT VIGIL interactions on our ANMF Federal Facebook page. people, had54K video views and received over 5.8K members’ work. This video reached over 165K sharing their experiences and appreciation of ANMF and midwives. Itfeatured Australian celebrities was created to highlight the important work of nurses and the Midwife, for International Nurses Day a video Organisation asthe international Year of the Nurse With 2020 being declared by the World Health – INTERNATIONAL NURSESDAY VIDEO 2020 YEAROFTHENURSEANDMIDWIFE the Australian nursing and midwifery workforce. audience which reflects the current gender levels in We continue to have aproportionally higher female 43,9K 7,82K 83.97% 14.96% Our fangrowth increased by 61.7% over the past year. Our Campaignpage isproportionally female. over the past 12months. engagements and over 63K reactions to this content page achieved 4.65 million impressions, 107,93K We had424 posts on our campaignpage. The FACEBOOK PAGE MORE STAFF FORAGED CARE people engaging thewith video insome way. 130.5K times 93.2Kwith unique views and 19.2K Collectivelybranches, with the video was viewed 2.4K interactions on the post. video reached over 63K people 17.4Kwith views and The ANMF Federal Office’s Facebook channel the +12% 183,75K OTHER CLICKS 0% 13,9K PHOTO CLICKS 11,97K 1,73K 86.34% 12.5% –1% 45,73K LINK CLICKS –9% 2,84K VIDEO PLAYS received more than4,000 engagements. We have posted 66pieces of content which have base of 2,444 followers. our fansby more thanhalfto reach our current fan as anew platform for ANMF Federal. We have grown Our Instagram profile hasgrown inthe past 12 months INSTAGRAM profile politicians, journalists and academics. Some of our new followers this year include high a 32% increase inour fansover the past 12months. We continue to grow our followers on Twitter with These have received: On Twitter we have created original media 712 posts. TWITTER 3,8K REACTIONS 7,43K REACTIONS

71,68K IMPRESSIONS 821K IMPRESSIONS

60,87K REACH 578,61K REACH

4,02K ENGAGEMENTS 12,1K ENGAGEMENTS

5.61% RATE ENGAGEMENT 1.47% RATE ENGAGEMENT

29 ANMF ANNUAL REPORT 2019/2020 30 ANMF ANNUAL REPORT 2019/2020 the approachesvirus, to transmission prevention/ resources focussing on arange of key issues regarding developing aseries of upto date, evidence-based quickly to the evolving pandemic in Australia by The National Policy Research Unit responded PANDEMIC SARS-COV-2 /COVID-19 to 1.0 FTE in2020. to the Unit’s portfolio of work hasincreased from 2019 and an Associate Editor of AJAN. Casey’s contribution Mr Casey Marnie isaResearch Assistant inthe Unit organisational strategy. based development and delivery of the ANMF’s policy changes and to contribute to the evidence- national health, labour, and funding policies and program for the ANMF to analyse the impactof key The Unit leads and conduct anational policy research academic literature. widely published and cited inacademic and cited in higher degree nursing and midwifery students and is Nursing, University of Adelaide. DrPeters supervises (RBRC), and Adjunct Senior Lecturer at the School of the UniSA Rosemary Bryant AO Research Centre of Advanced Nursing (AJAN), Research Fellow in Editor-in-Chief of the ANMF’s Australian Journal Dr Micah Peters isthe Unit’s inaugural Director, researchers toadvance new work onkey ANMF-relevant topics. administer aPhDstipend beginningin2020 tosupportnursingand/or midwifery 36monthsbeginningJuly forafurther (the Unit)andfunded 1,2020. The Unit will also was formally expandedtothenow ‘ANMF NationalPolicy Research Unit-Federal Office’ Office and Branches, thesingle0.8FTE roleofthe ‘National Policy Research Adviser’ Reflecting agrowing portfolioof work, and value, responsibility totheANMF Federal RESEARCH NATIONAL FEDERAL

OFFICE

POLICY UNIT regarding COVID-19 Government funding and stimuli. more broadly to engage ingreater depth issueswith and health hasalso enabled the Unit and ANMF the community. MrMarnie’s expertise ineconomics confirmed COVID-19 in healthcare, aged care, and responses and caringfor people suspectedwith or wider community aparticularwith focus on policy and wellbeing of members, the professions, and the Federal Office and Branches to advocate for the safety The work of the Unit hassupported the ANMF health, maternity, and aged care. thewith RBRC on a wider survey of members across regarding COVID-19 inaged care and iscollaborating Unit also authored anational survey of members Australian and international response efforts. The numerous key areas relating to the pandemic and assist the ANMF inarticulating itspositions across to the Senate Select Committee on COVID-19) to papers, reports, and submissions (e.g. Submission The Unit hasalso led and contributed to briefing carer workforce. members and the broader nursing, midwifery, and disseminated to and by the ANMF Branches to emergingwith evidence and have been widely were (and continue to be) regularly updated inline control, testing, and policy responses. These resources

REPORT in Australia and abroad. members, the professions, researchers, and academics the visibility of the journal and itscontents to ANMF and publishing policies and are working to increase Federal Office staff members, develop journal editorial The Unit and Editorial Team, which includes other Marion Eckert, Joseph Ibrahim, and Jill White AM. national experts including Professors James Buchan, including papers by esteemed international and The journal haspublished three issues over 2020 all communities and to be prepared for the future. professionals to improve the health and wellbeing of empower nurses, midwives, and other healthcare original research and scholarly work to inform and a forum to showcase and promote a wide variety of Editorial Board. The mission of AJAN isto provide Editor and Publisher) as well asanewly convened Peters and (Editor-in-Chief) Annie Butler (Executive was relaunched inDecember 2019 led by DrMicah – the ANMF’s peer-reviewed, scholarly journal The Australian Journal of Advanced Nursing (AJAN) OF THE the workforce,olderand Australians. perspectives on how to further advocate for members, ANMF’s work thewith Commission and brought new workforce, funding, and regulation hasenhanced the The Unit’s increasing expertise inaged care assessment and funding, workforce, and COVID-19. areas, interfaces healthcare,with program redesign, staffing andskillsdiversity, mix, regional and remote care; regulation of quality and safety, younger people, Commission focussing on the following issues inaged Unit hasled or contributed to submissions to the voices and perspectives of ANMF members. The available evidence from published research and the advocacy and positions are supported by the best Hearings, and reports to ensure that the ANMF’s thewith Commission, submissions to Commission to briefing papers to support the ANMF’s work ratios inaged care. The Unit leads and contributes and isthe focus of the ANMF’s ongoing Campaignfor Quality (the Commission) hascontinued from 2019 The Royal Commission into Aged Care Safety and SKILLS SAFE

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AND and the Australianand Automobile Association. Local Health Network, the Joanna Briggs Institute, Cancer Institute New South Wales, Central Adelaide Commission on Safety and Quality inHealth Care, Health and Medical Research Network, Australian Midwifery Board of Australia, the Spinifex Rural Health Practitioner Regulation Agency/ Nursing and International Council of Nurses ,the Australian of research reports. Groups include; the RBRC, the and policy and well asapplied evidence inthe form advice and guidance regarding research priorities health and aged care and beyond to provide expert The Unit hasengaged manywith groups within and aged care and the broader community. that impacttheir own workforces inhealth, maternity, to influence key clinical, political, and policy decisions nurses, midwives, and carers are optimally positioned multidisciplinary research is vital to ensuring that Relevant, high-quality, nurse- and midwife-led and COLLABORATION RESEARCH aged care sectors. adoption of policies on the health, maternity, and and effectiveness of the implementation or proposed evaluates and advises upon the impact,implications, evidence-informed decision and making proactively makers the Unit facilitates appropriate and effective international researchers, policy, and decision By engaging and collaborating localwith and policy and practice. policy research evidence into internal and external disseminate, and integrate nursing and midwifery ANMF regarding opportunities to develop, promote, The Unit’s work identifies, advances and advises the across health, maternity, and aged care. clinical, professional, and research policy and practice nursing, midwifery, and carer education, employment, evidence relevant to national and international and contribute to the development and use of rigorous The National Policy Research Unit continues to lead RESEARCH ANMF

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AND ADVICE 31 ANMF ANNUAL REPORT 2019/2020 32 ANMF ANNUAL REPORT 2019/2020 has also added this benefit for their members. Branch and now, the NSWNMA/ANMF NSW Branch part of their member benefits as does the ANMF NT the CPE website free of charge to their members as The QNMU Branch continues to provide content on increased PPE requirements. resources on skin care and mask etiquette due to COVID-19 Evidence Briefs and also access to further ensure members are kept upto date with ANMF The website now includes aCOVID-19 section to members pay afee to access the conference. available to members free on the CPE website. Non- Foot conference, available in3 parts,remains Diabetes and Diet. The 2019 International Diabetic Obesity Management, Health Eating for Adults and Power of Calm,Nutrition and PTSD, MeTs and Documentation, Advanced Documentation, the Medicinal Cannabis, Fundamentals of New content added to the website includes: validity and currency. ensure they reflect evidence based best practice, courses inthe new format have been reviewed to and this hasbeen well received by members. All now been transferred to the new interactive format titled). Almost allof the courses on the website have nurses, midwives and assistants innursing (however The CPE website continues to be popular with EDUCATION CONTINUING EDUCATION

(CPE)

PROFESSIONAL

WEBSITE JULY FOR COURSE in course purchases duringthe past twelve months. manifestation and treatment and hasseen anincrease of human anatomy and physiology,STEMS disease website for topics requiring detailed knowledge The BSTR remains the very best online learning ROOM BODY to be invaluable to learners accessing the website. COVID-19 updates are also inplace and have proven pandemic. Along thewith 60courses available, saw anincrease inenrolments duringthe COVID-19 ARE working inthe aged and community care sectors and Our ACTR remains popular nurseswith and AIN’s ROOM AGED the Telehealth suite of 9tutorials. Infection Control, Hand Hygiene inHealthcare and members for free. These include Manual Handling, * Free Member =courses available to all ANMF Corporate Non-Member NT Member QNMU Member Free Member* Member USER PROFILE

THE 2019 – 30

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PURCHASES

CPE 1,335 787 902 17,224 6,715 3,228 PURCHASES COURSE

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2020

REPORT 4 3 3 57 22 11 USAGE OVERALL % OF

1 2020, early 2021. for public consultation and endorsement by the end of content and qualifications should begin to be available process continues across allthese IRCs and revised hence extensions, due to COVID-19 however, the The latest review process hasseen many delays, and products prior to submission to the AISC for approval. industry sign-off on completed training package Skills Forecasts, Cases for Endorsement and provide The IRCs also work theirwith SSO to prepare Industry skills sets. These may be existing or emerging. full qualifications, individual units of competency and of training packages and this includes the review of; development. They oversee development and review industry intelligence to inform training product industry. IRCs also have responsibility for gathering development work to meet the skills needs of to request the commissioning of training package Organisation (SSO) indeveloping business cases responsible for directing their allocated Skills Service Industry and Skills Committee (AISC). IRCs are The IRCs operate ascommittees of the Australian • • • • • • Industry Reference Committees (IRCs): VETAC members are involved inthe following Training Packages. both the National Health and Community Services Organisation responsible for the maintenance of the VETAC work the Skills Service SkillsIQ, with developments inthe VET sector. Members of Advisory Committee (VETAC) closely monitors ANMFThe Vocational Educationand Training AND VOCATIONAL Executive inthe last quarter of 2020. the review be presentedwill to the ANMF’s Federal and professional development needs. The results of the ANMF canbetter meet members’ educational Branches. The review isdesigned to ascertain how education provided by the Federal Office and ANMF independent researcher to undertake areview of all In May 2020 the ANMF Federal Executive engaged an EDUCATION

Aged Services Dental Aboriginal and Torres Strait Islander Health Worker Technicians and Support Services Direct Client Care and Support Enrolled Nursing

TRAINING

REVIEW

EDUCATION

(VET)

SECTOR Eligibility List asper Federal Rule 5.1.2. recommendation, for inclusion on the Courses for VETAC examinewill their eligibility and subsequent and revised qualifications are released, the ANMF eligibility for membership thewith ANMF. As new any new qualifications released that could lead to training package reviews, 2019-2020 hasnot seen Due to unprecedented delays thewith current 2019-2020 COURSES ACTU VET Committee members. on the various industry sectors represented by the training package initiatives and their potential impact newly formed Emergency Response Sub-Committee’s at least monthly since March 2020 to discuss the ACTU VET committee hasmet via teleconference meets twice a year and asdeemed necessary. The the ACTU VET Committee. This Committee usually The ANMF Education Officer isalso a memberof beyond the COVID-19 to support economic recovery. products to meet longer term critical skills needs to continue itsrole infast tracking national training expanded by Skills Ministers inMay 2020 to enable it Further to that, the scope of the Sub-Committee was and skills needs duringthe COVID-19 pandemic. requirements to respond to areas of critical workforce adjustments to qualifications and training package COAG Skills Council to enable short-term and urgent Committee was established under the direction of the and the subsequent economic downturn. The Sub- challenges presented by the COVID-19 pandemic April 2020 thewith remit of addressing the workforce formed anEmergency Response Sub-Committee in ProfessorEmeritus TraceyHorton AO. AISC The The AISC welcomed anew ChairinNovember 2019, These discussions and projects are ongoing. reporting on the progress of Cross Sector Projects. of recommendations from the ‘Joyce Review’ and Discussions included proposed implementations meetings thewith AISC over the previous 12months. Chairs and Deputy Chairs Cross Sector Meetings and Direct Client Care IRC, attended anumber of SkillsIQ The ANMF Education Officer, asDeputy Chair of the

FOR

ELIGIBILITY 33 ANMF ANNUAL REPORT 2019/2020 34 ANMF ANNUAL REPORT 2019/2020 demographic. interest inthe Hub, particularly from the younger jobs, courses and scholarships. To date there hasbeen students, aCPD resource and portals to find, events, specialty profiles, specific resources for graduates and members. This site includes general career advice, launched to provide acomprehensive resource for Also this year, the Learning and Career Hub was and innovation. practice features, learning and career and research interviews, health and wellbeing, justice and action, Other key sections on the website include latest news, relevance of this material. traffic to the website, indicating the importance and June. At this time, there was asignificant upsurge of healthcare duringthe period between March and of COVID-19 issues pertinent to the professions and range of subject matter, including extensive coverage membership. Content uploaded hascovered abroad to ensure material iscurrent and relevant to the year, hascontinued to be developed and refined The ANMJ website, launched early 2018-2019 financial ANMJ WEBSITE of theANMJtoengage itsaudienceonlineandinhard copy. presence via the website, socialmediaandnewsletter. This report reflects theactivities Over thepast 12months, theANMJhascontinuedtobuildanddevelop itsonline PLATFORMS INCORPORATING MIDWIFERY AUSTRALIAN

JOURNAL AND

NURSING • • • • • • • • • PAGESTOP VIEWED: • • • • The number of sponsored content posts was 10. Over the past 12months, 415 posts were published. WEBSITE STATISTICS:

Top tips for graduate nurses (14,731) 14,822 views) Car crash risk higher after first rostered night ( shift nurse day (18,182 views) Shout out to theatre nurses: itsoperating room intensive care to fightCOVID-19 (19,183views) Government to train 20,000 RNs to work in To napor not to napon night shift (25,310 views) documentation views)(26,571 The coroner’s court- extracting tips for improved views) clinicians caringfor people COVID-19with (27,000 New national guidelines living for Australian Landing page (48,266 views) What to eat on night shift and why (63,933 views ) Pages per session: New users: Users: Page views:

JOURNAL DIGITAL

(ANMJ):

& 297,873 1,053,973 2.46 304,295

or blog was 2.0% 27.8% and referred from another source, i.e. website page) was 27.8 %. Views direct to the website was searches (clicking on afree listing inasearch results traffic to the website (61%). The number of organic Social media continues to be the primary driver of TRAFFIC SOURCES: Returning: 16% New: 84% VISITORS TO THESITE: years (27%);Secondary ages being 35-64 years (22%) Female 80%/Male 20%;Primary ages being 25-43 WHO VIEWOURWEBSITE: DEMOGRAPHICS OFPEOPLE Mobile: 73.2%, Desktop:21.0%, Tablet: 5.8% DEVICES USED: Board (1,347); Events (449). (1,846 views); Course and Scholarships (1,842); Job Graduate and Students (2,498 views); CPD resources Learning and Career Hub landing page (9,870 views); 22 MAR–15JUNE2020): PAGES (GOOGLE ANALYTICS: STATISTICS FORINDIVIDUAL HUB this, ithashadsteady growth since itsintroduction. end of March asthe COVID-19 pandemic hit. Despite The new learning and career hub was launched at the LEARNING AND CAREER HUB

aged25+ years. subscribers. The demographics are over 65% female the ANMJ website. The current database has2,500 subscriber base and remains anessential linkto The e:Newsletter continues to have arobust E:NEWSLETTER Average Click Unsubscribe Open Rate Average Average Rate Rate ENEWSLETTER 44.6% ANMJ 9.0% 0.1% PUBLISHING) AVE (MEDIA/ INDUSTRY 28.5% 6.4% 0.2% 35 ANMF ANNUAL REPORT 2019/2020 uRE fEAT

Darren Bradbrook at FMC, South Australia. Photo by James Elsby

specific coloured lids and signage to make them identifiable to the people collecting. We started to also look into the prospects of being able to divert from landfill PVC (poly vinyl chloride) which mostly consisted of IV fluid bags, Hudson masks and oxygen tubing. This stream however was with another waste contractor so I engaged them in conversations which Green crusader and anaesthetic nurse Darren Bradbrook has been eventually led to us also participating in on a sustainability campaign in the operating room at Flinders a PVC and aluminium recycling program Medical Centre (FMC) in South Australia since 2017. As a result, FMC independent but simultaneously with the has diverted over 60–70% of its operating room waste from landfill plastic streams.” to a number of renewable streams in just over 18 months. Over the next few months FMC introduced the system in the main operating theatres, Anaesthetic ANUM Darren Bradbrook talks to Natalie Dragon starting with PVC and then rolling to the larger stream being plastics. about what has been achieved to dateAs at the FMC. second largest hospital in the public sector in Adelaide, Darren says it was “We were the first hospital in South imperative that any sustainability initiative Australia to do PVC recycling. We started couldn’t add too heavily to the existing in PACU (recovery) first, as this space was “I was getting fed up with opening workload of staff. smaller and staff compliance was always packaging from companies who had a going to be simpler as educating this group “We have 350 people in SALHN perio- traditionally was easier,” says Darren. one size fits all motto. With the volume of operative and it couldn’t impact too heavily TOWARDS ZERO WASTE waste each day we use that goes to landfill on them. PVC recycling was being done in Education and promotion included in- I thought we have got to have a better hospitals in Victoria and New South Wales, servicing, and lots of visual aids such as solution to our problem. What can we do the structure was already established, we posters. ourselves?” says Darren, an anaesthetic were tapping into an existing framework. “We started to explain to people the ‘why’ nurse of 21 years. It was cost neutral to us which was a massive and to strongly empower and encourage So in early 2017, Darren embarked on a drawcard. everyone to be part of this change - that this project to make the operating theatres a “After a few months of negotiations, we was an important part of our practice and 9 greener place to work. finally decided on a twin stream for the “It all started with me contacting the key products which was both high and low Jul–Sep 2019 Volume 26, No.7 accounts manager for waste that services grade plastic waste. We had posters made the SA public sector. We met one day to up and bins (240ltr) were ordered with discuss some diversion from landfill options with me giving her samples of the kinds of products that we were aiming to have a solution with.”

SOCIAL MEDIA FEATURES

Stories have been consistently posted and shared on Features remained popular with the membership, social media. In addition to Facebook, the ANMJ team evident from responses through social media and has instigated social media platforms Linkedin and click rates on the ANMJ website. Twitter, which has significantly expanded ANMJ’s social media community while increasing engagement FEATURE ARTICLES IN 2019-2020: with the website. Jul-Sep 2019 • Going green ANMJ JOURNAL • Returning to the fold: Re-entry to nursing practice • In harm’s way (pill testing trials and national The ANMJ has continued its 56+4-page quarterly position statement on harm minimisation) publication, published in hard copy and online via ISSUU and PDF format, and housed on the ANMJ Oct-Dec 2019 website. Using the tools at our disposal, the ANMJ has • Freeze frame: The portrayal of nurses in pop culture kept abreast of the latest happenings in the nursing and midwifery professions with some significant • Closing the gap: A new partnership highlights in 2019-2020. Jan-Mar 2020 The ANMJ has reported on critical issues for the • ANMF’s 14th Biennial National Conference ANMF and the nursing and midwifery professions. • ANMF Priorities 2020 The year 2020 being International Year of the Nurse and Midwife, the ANMJ has highlighted • Taking a stand against occupational violence and recognised nurses and midwives working in Apr-Jun 2020 leadership roles and as trailblazer, including those who worked to support communities during the • International Year of the Nurse & Midwife: bushfires at the end of 2019 and early 2020. Aged Recognising our trailblazers care and the need for mandated ratios, Indigenous • In the line of fire (Australia’s bushfire crisis) health, gender issues and environmental health also remained prominent themes throughout the year. ANMF ANNUAL REPORT 2019/2020 REPORT ANNUAL ANMF

36 education

Nutrition and PTSD • • • • • • • FOCUS TOPICS 2019-2020: and geographically. in which nurses and midwives work, both clinically Focus topics this year reflect the diversity of the areas feedback. after publication often gets positive or constructive receives ahigh volume of submissions each issue and contributorswith and readers alike. The journal to write about their practice and isalways popular The focus section isanopportunity for members FOCUS

The following excerpt is from the ANMF’s Post-Traumatic Stress disorder (PTSD) and diet tutorial on the Continuing Professional Education (CPE) website.

By ANMF Federal Education Team Maternal &midwifery health Primary healthcare Education part2 Education part1 Maternal health &midwifery Medical/surgical nursing Aged care

30

Apr–Jun 2020 Volume 26, No. 10

T written by Peta Adams, an accredited practising dietician for over 10 years. Post-Traumatic Stress disorder (PTSD) his tutorial is a new addition to the is defined as ‘the lingering, persistent courses on the CPE website and was psychological reactions to traumatic events or experiences’ (Sareen & Mason 2018). It is characterised by revisiting, avoidance/ numbing and arousal symptoms. Also, hypersensitivity, hypervigilance, changes in mood and behaviours and aggression. PTSD is considered to be the most debilitating mental illness with higher rates of suicide. People commonly suffer from depression, anxiety and mood disorders. They are likely to have deficiencies in Neurotransmitters (NT) such as serotonin, dopamine, noradrenaline and GABA. It is a manifestation of traumatic experiences. It causes the sympathetic nervous system to go into overdrive and release the stress hormones, cortisol and adrenaline over long periods of time. Patients commonly suffer altered neural and cognitive behaviours, particularly related to food-brain areas of consumption (Sathyanarayana Rao et al. 2008). They tend to struggle with the cognitive inhibitions of food and also alcohol and therefore often over eat and drink alcohol to excess (Farr et al. 2014).

WHO IS AT RISK? Ex veterans• – it is the most common

Witnessing• death or severe injury

Involved• in a life-threatening event such

condition plaguing this population

18 Sexual• abuse (adults and children) (nurses)

The risk is increased in repeated stressful

the hospital population. population. hospital the

the increase in insulin administration in in administration insulin in increase the life-events.

needles are particularly problematic due to to due problematic particularly are needles as natural disasters, robbery, car accident activated (Mitchell & Parker 2014). Insulin Insulin 2014). Parker & (Mitchell activated There is often delayed symptom

used in the last five years, only 34.6% were were 34.6% only years, five last the in used development ~25% >6 months after the

of devices with safety mechanisms were were mechanisms safety with devices of

Oct–Dec 2019 Volume 26, No. 8 No. 26, Volume 2019 Oct–Dec

EPINet data indicates that although 35.3% 35.3% although that indicates data EPINet trauma (Sareen 2014).

syringes. syringes.

of NSI (28.1%) and 19.5% are from insulin insulin from are 19.5% and (28.1%) NSI of Signs and symptoms of PTSD normally

disposable syringes make up the majority majority the up make syringes disposable develop in a 3-6 month period after a

Network (EPINet) data, injuries from from injuries data, (EPINet) Network

Centre’s Exposure Prevention Information Information Prevention Exposure Centre’s traumatic event. However, sometimes it can

According to the International Safety Safety International the to According take years for the symptoms to develop.

occupational injury. injury. occupational

the largest HCP group experiencing this this experiencing group SymptomsHCP largest the include:

in the past 12 months’, with nurses being being nurses with months’, 12 past the in

Intrusive• thoughts NSI one least at had has Australia in nurses

MTAA (2013 p.3) stated that ‘one in nine nine in ‘one that stated p.3) (2013 MTAA Nightmares• injuries. stick needle of risk a presents which

Flashbacks• patients to injections insulin subcutaneous

Healthcare Professionals (HCP) administer administer (HCP) Professionals Healthcare

Detachment• p.1). 2013, (MTAA device’ or object sharp

piercing of the skin by a needle or other other or needle a by skin the of piercing

Irritability• and outbursts in results that injury percutaneous ‘any Needle stick injuries (NSI) are defined as as defined are (NSI) injuries stick Needle

Headaches• Disrupted• sleep or insomnia Feelings• of guilt Also: Hypersensitivity• including at least

two of the following: » » » » Epidemiological studies show >90% of Sleep issues

sufferers have at least one comorbid mental » Anger UPDATE CLINICAL condition (Sareen 2014). Poor concentration The burden of physical illnesses in Startling easily Australians of those suffering from Physical reactions (racing heart depression and anxiety, is around 43% or increased blood pressure). (Clarke & Currie 2009). (Sareen 2014). Studies have showed a distinct and significant association between PTSD, diabetes, psoriasis, thyroid conditions, cardiovascular disease and stomach ulcers (Britvić et al. 2015). PTSD can lead to central obesity and metabolic dysfunction Increase in Leptin and Adiponectin (the hunger and storage hormones respectively). educATIOn Stress hormones such as cortisol and

catecholamines further worsen this profile and contribute to metabolic dysfunction group largest the being nurses with professionals healthcare for hazard

(Sagud et al. 2017).

experiencing this occupational injury. Yet needle stick injuries can be be can injuries stick needle Yet injury. occupational this experiencing Medications for PTSD can also have an effect setting clinical the in injuries stick on nutrition.

Selective Serotonin Reuptake Inhibitors Needle stick injuries are the greatest occupational health and safety safety and health occupational greatest the are injuries stick Needle (SSRI’s) and Serotonin-Norepinephrine needle prevent to devices medical Reuptake Inhibitors (SNRI’s) are the medications of choice to treat and manage this condition, however they increase gastrointestinal symptoms. People are likely to experience irritable bowel syndrome (IBS) symptoms temporarily or long-term. They reduces GI tolerance to high fibre, high

fat meals and snacks.

length of hospital stay of 1.4 days, increased increased days, 1.4 of stay hospital of length They may increase appetite, but their effect

People with diabetes have an increased increased an have diabetes with People

condition to hospital having diabetes. diabetes. having hospital to condition on weight is person dependent (some gain, patients that are admitted with a medical medical a with admitted are that patients

others may lose weight). • • • • CLINICAL UPDATE TOPICS 2019-2020: other avenues of funding such asscholarships. clinical work/research published to secure grants or and more. Ithasalso enabled members to have improvements incare, new program developments, of new or evaluated clinical work on the ground, have provided dialogue amongst the professions for the clinical update section from members. These We continued to receive asteady flow of submissions CLINICAL UPDATE

system is substantial with 33% of all all of 33% with substantial is system The burden on the Australian healthcare healthcare Australian the on burden The PTSD is generally considered to be a

diagnosed with diabetes per day. day. per diabetes with diagnosed biochemical or emotional dysfunction in The study demonstrated that 280 people are are people 280 that demonstrated study The

The use of safety engineered engineered safety of use The

associated complications. complications. associated response to trauma but nutrition can play a

study conducted into diabetes and and diabetes into conducted study key role in the onset as well as the intensity

the most extensive Australian longitudinal longitudinal Australian extensive most the

The AusDiab study (Tanamas et al. 2012) is is 2012) al. et (Tanamas study AusDiab The and duration.

million Australians have diabetes. diabetes. have Australians million

Diabetes Australia (2019) states that 1.7 1.7 that states (2019) Australia Diabetes

PREVALENCE AND INSULIN USE INSULIN AND PREVALENCE

CLINICAL BACKGROUND OF DIABETES DIABETES OF BACKGROUND CLINICAL

Parker 2017). Parker

Larck, Schliesser & Jelic 2013; Mitchell & & Mitchell 2013; Jelic & Schliesser Larck,

needles or the insulin cartilage (Herdman, (Herdman, cartilage insulin the or needles

been exposed to a biological hazard in the the in hazard biological a to exposed been

non-patient end (back-end) also may have have may also (back-end) end non-patient

pens and pen needles. The needle on the the on needle The needles. pen and pens There is a dual risk when using insulin insulin using when risk dual a is There

room environment paediatric painprotocol within the recovery The development and implementation of a into practice inanurse-led eczema clinic family centred care and client-centred learning Best Practice Guidelines: Integrating person and prevent needle stick injuries inthe clinical setting The use of safety-engineered medical devices to hyper-acute stroke patients Out of hours presentations for

Apr–Jun 2020 Volume 26, No.10 Gartland Clare and McAlister Michelle By prevented.

31

obtaining a NSI (MTAA 2013). (MTAA NSI a obtaining

the clinical setting they are of a high risk of of risk high a of are they setting clinical the

al. 2014). When HCP administer insulin in in insulin administer HCP When 2014). al.

exclusively was collectively 53.8% (Bach et et (Bach 53.8% collectively was exclusively

diabetes medication and insulin or insulin insulin or insulin and medication diabetes

their diabetes managed with either oral oral either with managed diabetes their

targets. The number of inpatients that have have that inpatients of number The targets.

to assist achievement of these glycaemic glycaemic these of achievement assist to

(National Diabetes Services Scheme 2019) 2019) Scheme Services Diabetes (National

diabetes are self-administering insulin insulin self-administering are diabetes

Currently 414,640 people living with with living people 414,640 Currently

fasting and pre-prandial state 8-10mmol/L. 8-10mmol/L. state pre-prandial and fasting

be maintained between 6-8mmol/L in the the in 6-8mmol/L between maintained be

guidelines (2016) advising glycemic levels levels glycemic advising (2016) guidelines

levels into target range with the RACGP RACGP the with range target into levels

These aim to regulate blood glucose glucose blood regulate to aim These

and/or injectable diabetes medications. medications. diabetes injectable and/or

exercise, blood glucose monitoring and oral oral and monitoring glucose blood exercise,

of diabetes management are a healthy diet, diet, healthy a are management diabetes of

of diabetes complications. The principles principles The complications. diabetes of

Poor glycaemic control is the major cause cause major the is control glycaemic Poor

(Karahalios 2017). 2017). (Karahalios

and complications whilst hospitalised hospitalised whilst complications and

cost of stay, more admissions annually annually admissions more stay, of cost

rehabilitation programs. programs. rehabilitation

that provides both inpatient and outpatient outpatient and inpatient both provides that

Hospital B is a 30 bed rehabilitation centre centre rehabilitation bed 30 a is B Hospital

with a day procedure unit. procedure day a with

intensive care and coronary units together together units coronary and care intensive

theatres, 24 hour emergency department, department, emergency hour 24 theatres,

medical and surgical services including 12 12 including services surgical and medical

facility which provides a large range of acute acute of range large a provides which facility

Hospital A is a 359 patient-bed healthcare healthcare patient-bed 359 a is A Hospital

the administration of insulin. of administration the

traditional insulin needles and syringes for for syringes and needles insulin traditional

Both hospitals used a combination of of combination a used hospitals Both

as a concern. concern. a as

in metropolitan Melbourne was identified identified was Melbourne metropolitan in

This issue of NSI across two private hospitals hospitals private two across NSI of issue This

OPPORTUNITY TO PREVENT NSI PREVENT TO OPPORTUNITY

(SEMD) (Murphy 2014). 2014). (Murphy (SEMD)

available Safety Engineered Medical Devices Devices Medical Engineered Safety available

they could be protected through the use of of use the through protected be could they

health and wellbeing is placed at risk when when risk at placed is wellbeing and health

(Adefolalu 2014; Matsubara 2017). HCP’s HCP’s 2017). Matsubara 2014; (Adefolalu

human immunodeficiency virus (HIV) (HIV) virus immunodeficiency human

B virus (HBV), hepatitis C virus (HCV), and and (HCV), virus C hepatitis (HBV), virus B

at risk of viral infections such as hepatitis hepatitis as such infections viral of risk at

NSI occupational exposure places the HCPs HCPs the places exposure occupational NSI

disorder (Cooke and Stephens 2017). Stephens and (Cooke disorder

excessive concern to post traumatic stress stress traumatic post to concern excessive

psychiatric impact of NSI extends from from extends NSI of impact psychiatric

term psychological repercussions. The The repercussions. psychological term

of the effected HCP and potential long long potential and HCP effected the of

replacement of man hours, debriefing debriefing hours, man of replacement

The indirect costs are associated with with associated are costs indirect The

the individual if deemed not fit for work. work. for fit not deemed if individual the

if required and financial reimbursement to to reimbursement financial and required if

results, subsequent medical management management medical subsequent results,

the post NSI pathology screening, review of of review screening, pathology NSI post the

increase with time’. The direct cost relates to to relates cost direct The time’. with increase

potential and intangible costs which may may which costs intangible and potential

‘NSI generate significant direct, indirect, indirect, direct, significant generate ‘NSI

Mannocci et al. (2016 p. 644) stated that that stated 644) p. (2016 al. et Mannocci

repercussions for HCPs. HCPs. for repercussions

impact of NSI and health and wellbeing wellbeing and health and NSI of impact

This is remarkable given economic economic given remarkable is This

et al. 2011; Murphy 2014). 2014). Murphy 2011; al. et

education (Grayson & Russo 2009; Grayson Grayson 2009; Russo & (Grayson education

development, research and subsequent subsequent and research development,

has attracted government funding for policy policy for funding government attracted has

This is in contrast to hand hygiene which which hygiene hand to contrast in is This

(Mitchell & Parker 2017). Parker & (Mitchell

devices and the maintenance of a NSI record record NSI a of maintenance the and devices

facilities to utilise engineered needle safety safety needle engineered utilise to facilities

(modified 2000) which requires healthcare healthcare requires which 2000) (modified

the Needlestick Safety and Prevention Act Act Prevention and Safety Needlestick the

States of America that have legislated with with legislated have that America of States

Australia. This is in contrast to the United United the to contrast in is This Australia.

issue of NSI has been largely ignored in in ignored largely been has NSI of issue

The Occupational Health and Safety (OHS) (OHS) Safety and Health Occupational The

HEALTHCARE PROFESSIONALS HEALTHCARE

OCCUPATIONAL RISK OF NSI TO TO NSI OF RISK OCCUPATIONAL

s

4. Provision of supportive education education supportive of Provision 4.

of the sites. This reduced the hospital hospital the reduced This sites. the of

ongoing education provided at both both at provided education ongoing

was involved in the initial and the the and initial the in involved was

representative from the manufacturer manufacturer the from representative

from the manufacturer. The company company The manufacturer. the from

the near future. near the

launched onto the Australian market in in market Australian the onto launched

consistent with the 100 units/ml to be be to units/ml 100 the with consistent

types of a variety of concentrations not not concentrations of variety a of types

2018). There are plans for further insulin insulin further for plans are There 2018).

insulin pen and pen needle (Sanofi (Sanofi needle pen and pen insulin

should only be administered using an an using administered be only should

can occur. For this reason, U-300 insulin insulin U-300 reason, this For occur. can

calculation a substantial insulin overdose overdose insulin substantial a calculation

designed for U-100 and without proper proper without and U-100 for designed

an insulin needle. Insulin syringes are are syringes Insulin needle. insulin an

therefore cannot ever be given with with given be ever cannot therefore

formulation of 300 units/ml and and units/ml 300 of formulation

units/ml but with a more concentrated concentrated more a with but units/ml 3. The recent introduction of Toujeo into into Toujeo of introduction recent The 3.

types on the Australian market are 100 100 are market Australian the on types

as Lantus which like all other insulin insulin other all like which Lantus as

contains the same active ingredient ingredient active same the contains

with a duration of up to 36 hours. It It hours. 36 to up of duration a with

insulin that is the first insulin in Australia Australia in insulin first the is that insulin

the Australian market. Toujeo is a basal basal a is Toujeo market. Australian the

needles.

the needles at either end of the insulin insulin the of end either at needles the

to be undertaken by the HCP to shield shield to HCP the by undertaken be to

technique. There are no additional steps steps additional no are There technique.

needle as a component of the injection injection the of component a as needle 2. Dual end retraction and passive safety safety passive and retraction end Dual 2.

SEMD selected shields both ends of the the of ends both shields selected SEMD

and cartridge ends) (MTAA 2013). The The 2013). (MTAA ends) cartridge and

both ends of the pen needle (injection (injection needle pen the of ends both

device, the HCP are at risk of a NSI from from NSI a of risk at are HCP the device,

When administering insulin with a pen pen a with insulin administering When

activation as opposed to active activation. activation. active to opposed as activation

insulin (ADEA 2015). 2015). (ADEA insulin

profile of the absorption rate of the the of rate absorption the of profile

intramuscularly which affects the action action the affects which intramuscularly

reduce the risk of insulin being injected injected being insulin of risk the reduce

glycaemic control. The smaller needles needles smaller The control. glycaemic

stability of a person with diabetes’ diabetes’ with person a of stability

effect insulin absorption and therefore therefore and absorption insulin effect

lumps that form under the skin and and skin the under form that lumps

as lipohypertrophies are hard fatty fatty hard are lipohypertrophies as 1. 5mm needle length: According to to According length: needle 5mm 1.

the same sites. Tissue damage, known known damage, Tissue sites. same the

clinical need: clinical

caused by repetitive injections into into injections repetitive by caused

related to evidence based practice and and practice based evidence to related

needles reduce the tissue damage damage tissue the reduce needles

The selection criteria for the SEMD was was SEMD the for criteria selection The

recommendations (ADEA 2015) smaller smaller 2015) (ADEA recommendations

Educators Association needle length length needle Association Educators National Diabetes Scientific Meeting. Meeting. Scientific Diabetes National

the current Australian Diabetes Diabetes Australian current the introduced to a SEMD at the Australian Australian the at SEMD a to introduced

The Diabetes Educators (DE) were were (DE) Educators Diabetes The

management rehabilitation. management

cardiac, orthopaedic, trauma and pain pain and trauma orthopaedic, cardiac, The hospital has specialty programs for for programs specialty has hospital The

insulin during their hospital stay. stay. hospital their during insulin

the patient was unable to self-administer self-administer to unable was patient the

The SEMD was utilised by the HCP when when HCP the by utilised was SEMD The

SEMD when in the hospital. hospital. the in when SEMD

In theory the patient can be trained to use use to trained be can patient the theory In

self-injection. self-injection.

America the SEMD is cleared for patient patient for cleared is SEMD the America

in this setting. In the United States of of States United the In setting. this in

SEMD were designated for HCP use only only use HCP for designated were SEMD

nurses in the hospitals (Johnson & May 2015). 2015). May & (Johnson hospitals the in nurses

paramount to change the behaviour of the the of behaviour the change to paramount

instrumental in this process. Education was was Education process. this in instrumental

Educators Service and Education Team were were Team Education and Service Educators

technique was undertaken. The Diabetes Diabetes The undertaken. was technique

and then one-on-one observation of of observation one-on-one then and

This was initially undertaken as a group group a as undertaken initially was This

used to administer insulin using the SEMD. SEMD. the using insulin administer to used

with education on the correct technique technique correct the on education with

The nursing staff on one ward were provided provided were ward one on staff nursing The

apparent.

flexible as challenges of the change become become change the of challenges as flexible

The elements integral to these steps were were steps these to integral elements The

Moving and Freezing (Mitchell 2013). 2013). (Mitchell Freezing and Moving

were developed in the phases of Unfreeze, Unfreeze, of phases the in developed were

Oct–Dec 2019 Volume 26, No.8 No.8 26, Volume 2019 Oct–Dec clinical initiative, clear steps to the process process the to steps clear initiative, clinical

desired change. To ensure the success of the the of success the ensure To change. desired

circumstance to plan and bring about the the about bring and plan to circumstance

phase. Lewin’s model was utilised in this this in utilised was model Lewin’s phase.

behaviour following the introductory introductory the following behaviour

behavioural change and reinforce the the reinforce and change behavioural

These steps were taken to ensure ensure to taken were steps These

process was undertaken. undertaken. was process

The unfreezing, moving and refreezing refreezing and moving unfreezing, The

(Mitchell 2013) was applied to the scenario. scenario. the to applied was 2013) (Mitchell

facturer. Lewin’s change management theory theory management change Lewin’s facturer.

together with the support of the manu- the of support the with together

associated with the two departments departments two the with associated

consultant and diabetes resources nurses nurses resources diabetes and consultant

rolled-out by the clinical diabetes nurse nurse diabetes clinical the by rolled-out

initially in one of the sites. The product was was product The sites. the of one in initially

education and infection control initiative initiative control infection and education

The SEMD was introduced as both a diabetes diabetes a both as introduced was SEMD The

is shielded automatically. shielded is

the needle connected to the insulin pen pen insulin the to connected needle the

from the insulin pen, the second side of of side second the pen, insulin the from

the needle. When the SEMD is removed removed is SEMD the When needle. the

shielded, a red band appears at the tip of of tip the at appears band red a shielded,

of the needle has been shielded. When When shielded. been has needle the of

This indicates that the injecting side side injecting the that indicates This

releasing the needle from skin contact. contact. skin from needle the releasing 5. Ease of use of the SEMD. The technique to to technique The SEMD. the of use of Ease 5.

Then to listen for a second ‘click’ when when ‘click’ second a for listen to Then

the white sleeve is flush on the skin. skin. the on flush is sleeve white the

needle has pierced the skin and ensure ensure and skin the pierced has needle

‘click’ on injection, indicating that the the that indicating injection, on ‘click’

The HCP is taught to listen for an initial initial an for listen to taught is HCP The

using the selected SEMD was simplistic. simplistic. was SEMD selected the using

or questions arose. questions or

product and follow up when difficulties difficulties when up follow and product

man hours required to introduce the the introduce to required hours man

19 CLINICAL UPDATE CLINICAL 37 ANMF ANNUAL REPORT 2019/2020 38 ANMF ANNUAL REPORT 2019/2020 and Professor Joseph Ibrahim. Emerita Jill White (AM), Professor Marion Eckert, authored by esteemed experts including Professor individual manuscripts. Guest editorials have been published three issues to date atotalwith of 17 So far, the relaunched quarterly journal has and be prepared for the future. improve the health and wellbeing of allcommunities midwives, and other healthcare professionals to and scholarly work to inform and empower nurses, and promote a wide variety of original research of online databases. The AJAN seeks to showcase (Clarivate Analytics) and isindexed across anumber The journal hasa2019 impactfactor of 0.67 at www.ajan.com.au. policies and processes and anew-look online interface midwifery organisation updatedwith and improved as Australia’s largest professional nursing and and advances the ANMF’s overall strategic objectives continues the journal’s previous character and aligns The new, relaunched AJAN scholarly debate. of excellent nursing and midwifery research and new-look, online-only journal to carry on the legacy Nurse and Midwife, we were pleased to introduce the World Health Organization-designated Year of the Advanced Nursing( The ANMF haspublished the ADVANCED NURSING AUSTRALIAN JOURNAL OF OF THE RELAUNCH ADVANCED AUSTRALIAN AJAN ) since 1983. In2020, the journaland website Australian Journal of

NURSING

JOURNAL

• • • • • the future. To realise this mission, AJAN’s aims are to: wellbeing of allcommunities and to be prepared for healthcare professionals to improve the health and inform and empower nurses, midwives, and other variety of original research and scholarly work to to provide aforum to showcase and promote a wide journal’s mission and aims. The Mission of AJAN With the relaunch, we have revised and updated the JOURNAL MISSION ANDAIMS

care inallsettings. professions to deliver safe, quality, evidence-based Equip the nursing, midwifery, and wider health sustainable future for all communities. an economically, environmentally, and socially Maintain and promote values that underpin research, and practice. maternity, aged care, and public health policy, scholarly work to inform and influence health, quality, evidence-based original research and other Publish and disseminate a wide variety of high- across health and social issues. clinical and maternity care, research, and policy Support nurses and midwives to be leaders in care staff inall environments. wellbeing of nurses, midwives, and other health Promote the professional and personal safety and

(AJAN)

OF is is nursing and midwifery. personal narratives that convey the artand spirit of research methodology. Further, the journal publishes regulation, management, economics, ethics, and policy and funding, nursing and midwifery education, and aged- care delivery, public health, healthcare nursing and midwifery practice, health- maternity- practice guidelines, and commentary relevant to a wide variety of original research, review articles, The healthcare more broadly are significant. and debate on key issues for nursing, midwifery, and also welcome where their contribution to knowledge manuscripts regionalwith and international scope are audiences. Beyond clinical, research, education, management, and policy to national nursing and midwifery professional, showcasing scholarly material of principal relevance theof ANMF, broadened. As the official peer-reviewed journal collaboration and knowledge, In recognition of the importance of interdisciplinary JOURNAL SCOPE Australian Journal Advanced of Nursing AJAN is dedicated to publishing and AJAN’s primarily national focus, AJAN ’s scope hasbeen publishes Staff), and Lorna Hendry Staff), (external Layout Editor). Editors), Cathy Fasciale and Heidi Adriaanse (Journal team; Casey Marnie and Julianne Bryce (Associate The journal isalso supported by asmalleditorial • • • • • • • join the Board, membership currently includes: develops and grows. While new members are yet to Editorial Board to drive and shape the journal asit in-Chief. He works closely anewlywith convened Policy Research Unit (Federal Office) is Dr Micah Peters, Director of the ANMF National JOURNAL LEADERSHIPANDTEAM

Margaret University, Edinburgh) Editorial Adviser: Professor James Buchan (Queen (ANMF Federal Office, Melbourne) Executive Editor and Publisher: Annie Butler Canberra, Canberra) Midwifery and Public Health, University of Professor Karen Strickland (School of Nursing of Wollongong, Wollongong) Faculty of Science, Medicine, and Health, University Professor Tracey Moroney (School of Nursing, Institute for Urban Indigenous Health, Brisbane) Sye Hodgman (Organisational Development, Adelaide) Research Centre, UniSA Clinical &Health Sciences, Professor Marion Eckert (Rosemary Bryant AO New Orleans) Health Science Center, Louisiana State University, Professor Marsha Bennett (School of Nursing, LSU AJAN ’s Editor- 39 ANMF ANNUAL REPORT 2019/2020 40 ANMF ANNUAL REPORT 2019/2020 and review processes outlined below. & reports, and participated inthe policy development committees jointly produced the series of submissions During 2019/20, the members of the ANMF’s standing importance to nurses, midwives and carers. and participation inthe public debate on matters of profile of the national ANMF through engagement the interests of ANMF members and raises the The collective work of these committees promotes bmissions, reports and policies are available at the ANMF’s website: anmf.org.au 1 • • • • • • • ANMF COMMITTEES: standing committees are outlined below: across a wide range of topics. The ANMF’s current the collective work and national output of the ANMF of focus for each committee, who provide input into Office and Branches with expertise in the specific area comprise representatives from the ANMF Federal event such asthe Aged Care Royal Commission) and adhoc, i.e. committees convened for aspecific The ANMF’s key standing committees (permanent ANMF’s Federal Office. Executive andFederal Councilandtheseriesofstanding committees convened by the state andterritory Branches, which primarily occursthrough the work oftheFederal industrial andpolitical interests ofANMF membersincollaboration with theANMF’s In the year 2019/20, the ANMF Federal Officecontinuedto represent the professional, FEDERATION –2019/2020 COLLECTIVE

All su Aged Care Royal Commission Working Group Campaign &Communications Committee Committee Vocational Education & Training Advisory OHS Committee Governance &Compliance Committee Industrial AdvisoryCommittee Professional AdvisoryCommittee (Ad Hoc) (Ad 1

WORK AGED CARE SUBMISSIONS ANDREPORTS 11. 10. 9. 1.

the Aged Care System Navigator Measure Australian Healthcare Associates Evaluation of models for allocating residential aged care places Department of Health Proposed alternative module Service Standards (second edition) aged care ACSQHC National Safety and Quality Health h. g. f. e. d. c. b. a. Safety Royal Commission into Aged Care Quality and

the impactof COVID-19 in Aged Care Royal Commission Submission: Inrelation to Workforce to Counsel Assisting’s Submissions on Royal Commission Submission: Response Services for the Future Paper 1– Aged Care Program Redesign: Royal Commission Submission: Consultation System between the Aged Care and the Health Royal Commission Submission: Interfaces Regional and Remote Areas Royal Commission Submission: Aged Care in Workforce Royal Commission Submission: Aged Care Aged Care Royal Commission submission: Diversity in people inaged care Royal Commission Submission: Younger

OF

THE

PROFESSIONAL ANDEDUCATION 12. 11. 10. 9. 8. 7. 6. 5. 4. 3. 2. 1. 15. 14. 13. 12.

and midwives Digital Health Capability Framework for nurses competency and associated skill set consultation Skills IQ Enrolled Nursing qualifications, units of Management Working Group Report consultation Review(MBS)Schedule Taskforce Wound Department of Health Medicare Benefits the public Scheme for health professions to better protect the National Registration and Accreditation Health Council Consultation on Strengthening Council of Australian Governments (COAG) Framework AHPRA Draft proposed Practice Supervised regulated health service AHPRA Review of the Guidelines for advertising a notifications AHPRA Review of the Guidelines for mandatory students inrelation to blood-borne viruses and midwives and nursing and midwifery (NMBA) Draft Guidelines for registered nurses Nursing and Midwifery Board of Australia reporting guidelines (AHPRA) Preliminary consultation Mandatory Australian Health Practitioner Regulation Agency Council (ANMAC) Midwife Accreditation Australian Nursing and Midwifery Accreditation Future Nursing Education –Educating the Nurse of the Australian Government Independent Review of Medicationharm without Organisation’s Global Patient Safety Challenge – national response to the Third World Health Health Care (ACSQHC) consultation on Australia’s Australian Commission on Safety and Quality in and Aged Care Mission Roadmap. Medical Research Future Fund Dementia, Ageing Submission to the Department of Health’s Preliminary and Final Reports National COVID-19 in Aged Care Survey – Regulation Scheme Department of Health Aged Care Worker aged care: finer details of operation Scheme for Commonwealth funded residential Department of Health Serious Incident Reporting HEALTH, SOCIAL,POLITICAL INDUSTRIAL, OHS 6. 5. 4. 3. 2. 1. 16. 15. 14. 13. 5. 4. 3. 2. 1. 7.

Bill 2019 Organisations) Amendment (Ensuring Integrity) the provisions of the Fair Work (Registered Employment Legislation Committee on Submission to the Senate Education and Religious Discrimination Bill –Exposure Draft Submission to the Attorney-General’s Department Religious Freedom Bills -Second Exposure Drafts Submission to the Attorney-General’s Department Government Treasury for the 2020-21 Budget Pre-budget submission to the Australian Submission to the Retirement Income Review COVID-19 Submission to the Senate Select Committee on Draft report on Mental Health Submission on the Productivity Commission for digital mental health services ACSQHC National safety and quality standards Practice Registration Standard NMBA Preliminary Consultation Recency of Practitioner Registration Standard NMBA Preliminary Consultation Nurse and implementation plan Department of Health National stillbirth action dioxide and sulphur Quality) Measure standards for ozone, nitrogen National Environment Protection (Ambient Air Department of Health Proposed variation to the the 2018 Review of the model WHS laws Impact Statement (RIS) –Recommendations of Submission to the Consultation Regulation application for self-insurance licence Submission to Comcare re Ramsay Health Care’s Review Consultation on Skilled Migration Occupation List Skills and Employment inrelation to the Submission to the Department of Education, Temporary Migration Submission to the Senate Select Committee on 41 ANMF ANNUAL REPORT 2019/2020 42 ANMF ANNUAL REPORT 2019/2020 AND GUIDELINESDEVELOPED –2019/20 NEW POLICIES,POSITION STATEMENTS INFORMATION SHEETS GUIDELINES POSITION STATEMENTS • • • • • • • • • • • • • • • • • • • • • • POLICIES Guidelines reviewed –2019/20 Policies, Position Statementsand AND REVIEW POLICY DEVELOPMENT

(PPE) Position Statement –Personal Protective Equipment the newborn Position Statement –Midwifery staffing for careof Advertising for nurses and midwives Use of social media and online networking Voluntary assisted dying Self-employment/private practice Refugees and asylum seekers for nurses and midwives Professional practice framework Peace Nurse practitioners Medicare in nursing caringfor people inaged care settings Criminal history checks for nurses and assistants settings for nurses and assistants innursing Compulsory reporting of abuse inaged care Collective bargaining Child abuse and neglect midwifery and care work Casual employment innursing, ANMF representatives on national committees Aboriginal and Torres Strait Islander Health nursing injured and illnurses, midwives and assistants in Workers’ compensation and rehabilitation for Vaccination and Immunisation Assistants innursing Admission to and discharge from health services

COVID-19 EVIDENCEBRIEFS INFORMATION/FACT SHEETS 2. 1. 4. 3. 2. 1. POSITION STATEMENTS/GUIDELINES the COVID-19 pandemic. international organisations (on request), inmanaging Office to assist ANMF Branches and members, and The following materials were developed by Federal - 2019/20 RELATINGCOVID-19 TO RESOURCES PREPARED 5. 4. 3. 2. 1. 15. 14. 13. 12. 11. 10. 9. 8. 7. 6. 5. 4. 3.

COVID-19: Provisions for casualnurses COVID-19: Personal Protective Equipment Compassionate Entry into Nursing Homes Guideline #3–Principles for Safe and strategies and Principles for redeployment Guideline #2-Priorities for midwifery workforce strategies and Principles for redeployment Guideline #1–Priorities for nursing workforce Protective Equipment Position Statement –Personal and midwives for acute clinical care Fact sheet -Refresher courses for nurses Nurses inCritical Care Fact sheet -Upskilling for Registered Fact sheet -Pandemic response sub-register Information Sheet: Retention Bonus Information Sheet: Aged Care Support measures and health system preparedness in Australia to inform transmission reducing ModellingSummary: the impactof COVID-19 COVID-19: Relaxing social restrictions checking for respirators COVID-19: Fit testing and fit healthcare workeruniforms COVID-19: Laundering of suspected infection status COVID-19: Screening for workers from infection COVID-19: Protecting healthcare coverings for members of the public COVID-19: Masks (PPE) and non-PPE face COVID-19: Negative pressure rooms hospital surfaces and equipment COVID-19: Cleaning and disinfection of COVID-19: Modes of transmission and infection COVID-19: Hand sanitiser ingredients COVID-19: Testing for COVID-19 COVID-19: Social distancing and containment InParliament House inCanberra, December 2019. conference with ASU and SDA and members The Assistant Federal Secretary held amedia SUPERANNUATION House, Canberra 12November 2019. Secretary held amedia conference inParliament The ACTU President, Secretary and ANMF Federal ENSURING INTEGRITYBILL Parliament House, Canberra, September 2019. Federal Secretary held amedia conference in The AMA President, Dr Tony Bartone, and ANMF AGED CAREACTION MEDIA CONFERENCES: Embracing Diversity toBuildStranger Communities CRANA National Conference, September 2019 FOLLOWING PRESENTATIONS: SECRETARY DELIVEREDTHE THE ASSISTANT FEDERAL Biennial Meeting &Conference, March 2020 Commonwealth Nurses and Midwives Federation Day, February 2020 Australian Medical Association Strategic Planning thisis the answer? Panel: The agedcare workforce to –staff resident ratios– Aged Care Reform Conference, November 2019 September 2019 Global Nurses United –Solidarity Assembly – National Update Conference, September 2019 Australian College of Nurse Practitioners National Safety in AgedCare theThe impact of Royal Commission into and Quality Australian Association of Gerontology, August 2019 Panel: Cliniciansandthe Case for Change Healthcare Leaders’ Forum, August 2019 Panel: Challengingfor Change Conference, July 2019 National Tertiary Education Union National Women’s THE FOLLOWING PRESENTATIONS: THE FEDERALSECRETARY DELIVERED Conference Presentations –2019/20 FEDERATION OF THE NATIONAL REPRESENTATION

• • • • COMMITTEES ADVISORY ANDSTANDING • • following Senate Inquiry Hearings: The ANMF Federal Office providedevidence to the HEARINGS & ROYAL COMMISSION SENATE, PARLIAMENTARY • • • • • • • • • • • • • • • • • •

ACTU OHS & Workers’ Compensation Committee ACTU Women’sCommittee ACTU Growth &CampaignsCommittee ACTU Executive » Adelaide Quality: Royal Commission into Aged Care Safety and The Federal Secretary provided evidence to the » Federal Secretary appearing response to COVID-19 –June 2020 Senate Select Committee on the Government’s Climate and Health Alliance Nursing and Midwifery Strategic Reference Group NPS MedicineWise Nurse InsightGroup; National AgedCare Alliance; National Rural Health Alliance Council; Expert AdvisoryGroup; ACSQHC Health Services Medication ACSQHC Medication Safety Oversight Committee; Innovation Group; ACRRM Rural and Remote Digital Care Sector Committee AustralianGovernment Aged ANMAC Midwife Accreditation Standards Review Accreditation Standards ANMAC Registered Nurse Prescribing Accreditation Standards Review ANMAC Registered Nurse Advisory Committee ANMACStrategic Accreditation AHPRA Professions Reference Group ACTU Climate Action Group Commission (ROC) Group ACTU Registered Organisations ACTU TradeCommittee ACTU Industrial Legislation Committee

Workshop 1,February 2020.

43 ANMF ANNUAL REPORT 2019/2020 44 ANMF ANNUAL REPORT 2019/2020 December 2019 and 12and 13 February 2020 which met overwith 50politicians during3and 4 included members from each of the three unions, from the ASU and SDA formed ajoint delegation The ANMF Assistant Federal Secretary, and officials SUPERANNUATION Albanese, Leader of the Opposition. discrimination roundtable convened by Anthony The Federal Secretary attended areligious Melbourne. and Chris Bowen inSydney and Mark Dreyfus in Officer met withOpposition MPs, Tony Burke The ANMF’s National Political Director and Industrial RELIGIOUS DISCRIMINATION/FREEDOM BILL ENSURING INTEGRITYBILL briefings the with Attorney General The Assistant Federal Secretary attended COVID-19 Federal AttorneyGeneral POLITICAL COVID-19 Consultations RELATINGCOVID-19 TO NATIONAL REPRESENTATION • • • • • • • • • • • • • HEALTH &AGED CARE LOBBYING MEETINGS

Centre Alliance –Rex Patrick’s Office One Nation –Pauline Hanson’s Office SenatorMurray Watt Senator TimAyres Senator Stirling Griff Senator Jacqui Lambie Senator Rachel Seiwert Hon. Helen Haines, MP, Member for Indi for Skills & Aged Care Hon. GedKearney, MP, Shadow Assistant Minister Care Hon. Julie Collins, MP, Shadow Minister for Aged Hon. Chris Bowen, MP, Shadow Minister for Health Opposition Hon. Anthony Albanese, MPLeader of the Hon. Greg Hunt, MP, Minister for Health

COVID-19 outbreak. strategies inpreparation for management of the and develop nursing and midwifery workforce surge meetings thewith NMBA and ANMAC to discuss The Federal Secretary participated inregular MIDWIFERY ACCREDITATION COUNCIL AUSTRALIA/ AUSTRALIAN NURSINGAND NURSING &MIDWIFERY BOARD OF COVID-19 outbreak in Australia. of the NMSRG from the commencement of the The Federal Secretary attended weekly meetings REFERENCE GROUP(NMSRG) NURSING ANDMIDWIFERY STRATEGIC Health Minister’s Office. Commonwealth Department of Health (DOH) and the Federal Office staff attended briefings convened by the DEPARTMENT OFHEALTH BRIEFINGS COVID-19 Aged Care Forum –March 2020 The Assistant Federal Secretary attended the AGED CAREFORUM HEALTH –COVID-19 DEPARTMENT OF discuss matters arising from the COVID-19 outbreak. attended weekly meetings of national secretaries to The Federal Secretary and Assistant Federal Secretary UNIONS OF TRADE AUSTRALIAN COUNCIL 6 weeks from mid-April 2020. met regularly Senatorwith Colbeck for The Federal Secretary and Assistant Federal Secretary MINISTER FORAGED CARE Dept. officials for the following 4 weeks. maintained engagement thewith Health Minister and Health representatives, 30 March 2020. The ANMF Paul Kelly and Nick Coatesworth, and Dept. of Health, Greg Hunt, Deputy Chief Medial Officers ASMOF, UWUand ASU, met thewith Minister for The Federal Secretary and other health unions, HSU, MINISTER FORHEALTH

45 ANMF ANNUAL REPORT 2019/2020 46 ANMF ANNUAL REPORT 2019/2020 safe, quality care. environments they work inenable them to deliver The ANMF work will membersensurethe to with environments. and communities because of poorly resourced, unsafe the care they believe isnecessary for their patients They are also frequently prevented from delivering contribution to the health and aged care systems. to realise their fullpotential and maximise their Nurses and midwives are denied opportunities utilised. and midwifery workforce which islargely under- Australia hasahighly qualified and skilled nursing prepared for the future. deliver safe and quality care inallsettings and be Equip the nursing and midwifery professions to STRATEGIC PRIORITY 1 STRATEGIC

PRIORITIES c. b. a. j. i. h. g. f. e. d. STRATEGIES

their fullscope of practice. support nurses, midwives and carers to work to Advocate for innovative workforce models, which carerand workforce. to support the fulluse of the nursing, midwifery Lobby for national legislative and policy reforms focus on aged care. carers inallsettings, prioritising our national and safe workloads for nurses, midwives and Lobby and campaignnationally for safe staffing (CALD) nursing, midwifery, and carer workforce. Advocate for aculturally and linguistically diverse carerand workforce. a culturally safe and diverse nursing, midwifery, Commit to assisting the growth and training of Workforce. and Torres Strait Islander nursing and midwifery Commit to assisting the growth of the Aboriginal their skills current and relevant. accesswith to knowledge and resources to keep In collaboration branches,with provide members care needs. carers to meet Australia’s future health and aged programs that preparewill nurses, midwives and Participate inthe design and review of education be required. nursing and midwifery skills and work that will associated risks, including projecting the future and midwifery workforce and address the Identify the implications of the ageing nursing their practice standards are protected. registered nurse, enrolled nurse and midwife and Protect nurses’ and midwives’ work, the titles of g. f. e. d. c. b. a. STRATEGIES carers inallenvironments. safety and well-being of allnurses, midwives and The ANMF work will membersprotect to with the and groups arangewith of needs and preferences. linguistically diverse and ismade upof individuals and carer workforce isalso socially, culturally and nurses, midwives and carers. The nursing, midwifery, threats to the personal and professional safety of and workplace violence, these stressors canproduce shift work and the potential for occupational injury staffing and workloads. Coupled with the effects of and organisational and budgetary pressures affecting expanding use of complex technological innovations, such asincreasing patient acuity, ageing populations, They are faced multiplewith workplace stressors physical and psychological demands duringtheir day. Nurses, midwives and carers experience significant in allenvironments. and well- being of nurses, midwives and carers Ensure the professional and personal safety STRATEGIC PRIORITY 2

training. access to appropriate and effective cultural safety The nursing, midwifery, and carer workforce has required. by appropriate national policy and legislation as including flexible work arrangements supported life balance for nurses, midwives and carers, Advocate nationally for areasonable work- midwives and carers experiencing health issues. appropriate supports available for nurses, midwives and carers and ensure there are promote health and wellbeing among nurses, Engage allrelevant external stakeholders to bullying and harassment. including the responsibility to address workplace health and safety of nurses, midwives and carers, aware of their responsibilities to fully protect the Work to ensure employers and governments are for nurses, midwives and carers inallsettings. reform to improve workplace health and safety Advocate for national policy and legislative services inaconsistent and transparent manner. allocate sufficient funding to health and aged care Lobby federal governments and employers to midwives and carers inallsettings. reasonable working conditions for allnurses, Advocate at anational level for safe, fairand

a. STRATEGIES health and ageing policy on alllevels. development of appropriate and effective public, to planning and decision-making, and to the The ANMF work will memberscontribute to with people’s quality of life and access to appropriate care. placed to understand how policy decisions affect society. This means the professions are uniquely throughout their lifespans and across alllevels of way and seek to foster and advance people’s health from aframework that values allpeople inaholistic The nursing and midwifery professions operate and social issues. expert commentators and advocates on health Position nursing and midwifery asinformed, STRATEGIC PRIORITY 3 f. e. d. c. b.

Australians. and improving the health and wellbeing of all of nursing and midwifery to safeguarding to demonstrate to the public the contribution Use the ANMF’s knowledge, strength and profile health and ageing policy. strength to influence national and international both locally and nationally to build acoalition of Engage otherwith healthcare organisations relevant bodies and stakeholders. carers to governments, politicians and other critical national issues for nurses, midwives and Provide submissions, reports and briefings on health ageing policy. strength to influence national and international both locally and nationally to build acoalition of Engage otherwith healthcare organisations for Australia’s health and aged care system reputation of the ANMF asakey national voice Establish amedia presence that builds the public carers. positive outcomes for nurses, midwives and ANMF caninfluence political processes to achieve avenues at anational level through which the politicians and senior bureaucrats and develop and analysis on relevant health issues for Establish the ANMF asaresource for education

47 ANMF ANNUAL REPORT 2019/2020 48 ANMF ANNUAL REPORT 2019/2020 e. d. c. b. a. STRATEGIES midwives and carers. and aged care policy makers of the benefit of nurses, evidence that canbe used to inform national health members to develop and build abody of research and economicneeded. terms,is The ANMF work will with demonstrates their effectiveness in health and at political and policy levels sound evidence, which For nurses, midwives and carers to be influential policy whereneeded. health and aged care policy, and promote alternative Develop evidence to inform and influence national STRATEGIC PRIORITY 4

of research, evidence and policy into practice. Partner memberswith to support the translation research. the development and dissemination of their own nursing and midwifery and avenues to support access to new research and evidence relevant to broad range of research activities by providing Encourage ANMF members to engage ina improved policy. health care delivery and set the agenda for the development of new, expanded and improved midwife led innovations and practices that foster Identify, prioritise and disseminate nurse and which demonstrates failures to provide safe care. of safe care across settings, as well asevidence demonstrates the requirements for the delivery Identify, develop and disseminate evidence which ageing policy decisions. appropriate, to facilitate effective health and engaging inresearch co-production where majorwith internal and external stakeholders, Foster policy research networks of collaboration b. a. STRATEGIES an equitable and sustainable economy. as akey component of afunctioning democracy and public awareness and understanding of labour rights ANMF will work memberswith to create greater workplace, but also nationally and globally. The for ajust and democratic society beyond just the midwives, the ANMF hasaresponsibility to campaign upholding the code of conduct for nurses and As atrade union and the professional organisation for allcommunities. environmentally and socially sustainable future Contribute to ensuring aneconomically, STRATEGIC PRIORITY 5 g. f. e. d. c.

communities. for allto promote afairsociety and healthy justice, equality and humanitarian treatment Participate inactivities which support social issues that impacton people’s ability to live well. address social determinants of health and other approaches which reduce health inequalities, Support, develop and promote national policy disadvantaged backgrounds. socially, culturally, and linguistically diverse, and effective, and equitable care for all people from Contribute to ensuring safe, appropriate, peoples and other Australians. between Aboriginal and Torres Strait Islander Contribute to closing the gap inlife expectancy material and other mechanisms asrequired. national policy development, communication sustainability and social inclusion through our Provide leadership inenvironmental region and other regions asneeded. associations and unions, within the Asia- Pacific contribute to building capacity intheir nursing professions indeveloping countries, and Support and grow the nursing and midwifery and the health of communities. advance the interests of nursing and midwifery organisations, unions and other agencies to internationally nursingwith and midwifery Build strategic relationships nationally and

f. e. d. c. b. a. STRATEGIES achieving their common goals. their resources and transparently directed towards ANMF hasaresponsibility to itsmembers to ensure for the nursing and midwifery professions, the As amember organisation aleadershipwith role involvement of members. through good governance and democratic Be aneffective, efficient and accountable organisation STRATEGIC PRIORITY 6

knowledge, and meaning for allstaff. environment where there isshared respect, a supportive, inclusive, and culturally safe safety and security where allstaff act to foster Apply best practice inthe areas of cultural by investing intheir development. and recognise, value and support staff uphold and model the ANMF’s values, to attract and retain the rightpeople, who management and organisational development Apply best practice inthe areas of HR professions of nursing and midwifery. part of the national union inadvancing the members the benefits and value of being and members’ successes to demonstrate to Celebrate and promote ANMF branches’ work towards ashared national purpose. specific perspectives of the branches to activities asrequired, connecting the advice, assistance and support for branch success of ANMF branches by providing Contribute to the continued growth and involvement innational union activities. and members and facilitate member accurate, prompt, meet needs of branches brancheswith and members are processes to ensure communications communication structures and consultation Enhance the ANMF Federal Office’s through the effective use of resources. and environmentally sustainable manner operations inatransparent, and financially Conduct the ANMF Federal Office’s 49 ANMF ANNUAL REPORT 2019/2020