ncah issue 21 2013

www.ncah.com.auNursing Careers Allied Health - Issue 21

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Education Feature

Paramedics devastated at helicopter rescue death

ACT nurses reach pay deal

Australian physiotherapists want prescribing rights

Tasmanian graduate nursing positions disappointing: ANMF

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Take the next step, earn your MBBS atOceania University of Medicine.

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Midwifery & Maternal Feature

Grif�th to launch �rst primary maternity services course

Dietitian launches pregnancy weight plan

Tasmanian nurses threaten industrial action

Childhood behaviour problems can predict mental health disorders

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Achieving Success

Together.

Geneva Healthcare

If you’re after the best, forget the rest, put us to the test! For these jobs, or to see what else is available, contact us today. www.genevahealth.comAU 1800 123 900 | NZ 0800 900 801

Your Career. Our Passion.Geneva Healthcare is the market leader in health recruitment. From your first call to us, you’ll notice the Geneva difference. That means that we go the extra mile, giving you the warm and knowledgeable service you deserve, and offering career opportunities that meet your ambitions.

If you’re after the best, forget the rest, put us to the test!

means that we go the extra mile, giving you the warm and knowledgeable service you deserve, and offering career opportunities that meet your ambitions.

Just a snapshot of the opportunities we currently have available:

New Zealand

Midwives – Hamilton PICU Nurses - Auckland Mental Health Nurses - Auckland Physiotherapists - various locations Anaesthetic Technicians - Auckland

Australia

Midwives - Alice Springs Dual Registered Nurse/Midwives - Regional SA, QLD, NSW and WA Dual Registered Nurse/Midwives - Melbourne Midwives for Obstetric Led Units - Sydney Oncology RNs (chemo competent) - Melbourne Cardiothoracic Scrub and Cardiac/Thoracic Ward RNs - Newcastle

Middle East

Adult and Paediatric Oncology RNs - Saudi Arabia NICU Nurses - Saudi Arabia PICU Nurses - Saudi Arabia Laboratory Technologists - United Arab Emirates Executive Directors and Directors for various clinical areas in a

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PRESENTATIONS AND INTERVIEWS

MelbourneAuckland

5th & 6th December 2nd & 3rd DecemberIf you live outside Melbourne or Auckland CCM will arrange for representatives to SKYPE/Phone you. Please contact CCM to arrange.

Nurse Managers, Educators, Senior RN’s & RN’s all welcome to apply (except MHN)

Representatives will be coming from the King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh, Saudi Arabia. The Lead Rep is Diane Hopkins who is from NZ but currently working & living at KFSH&RC. She has �rsthand experience of what it’s like to relocate to Saudi Arabia from this part of the world. Interviews will take place on the spot and job offers will be issued within days, if interested. However, you will not be expected to travel for 3-4 months or later if you have �xed plans.

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Salary paid tax freeFree utilities

1 & 2 year contracts54 days annual leave

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www.ncah.com.au Nursing Careers Allied Health - Issue 21



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Achieving Success

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New Zealand


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Melbourne Auckland

5th & 6th December2nd & 3rd DecemberIf you live outside Melbourne or Auckland CCM will arrange for representatives to SKYPE/Phone you. Please contact CCM to arrange.



BENEFITS INCLUDE:

Salary paid tax free Free utilities

1 & 2 year contracts 54 days annual leave

Attractive Sign-on Bonus Relocation allowance

Free �ights Free medical coverage

Free furnished accommodation Severance pay



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0 | www.ncah.com.au Nursing Careers Allied Health - Issue 21 | Page 3

Page 6 | www.ncah.com.auNursing Careers Allied Health - Issue 21 | Page 27


LOCUM SUPPORT FOR MIDWIVES

“Having a NAHRLS midwife here is great.”

“Having a NAHRLS midwife

here is great. Every NAHRLS

locum has enjoyed their time

with us and learned a lot.

Wallaroo Hospital is a rural site

and many NAHRLS locums have

returned several times to provide

us with support for staff on leave.

The site is well equipped, the staff

are friendly and the

GP’s are supportive.

We look forward

to seeing more staff get

a rural experience that

is well supported.”

Find out more by visiting

nahrls.com.au or call

1300 NAHRLS

Carol Barnes Director of Nursing and Midwifery Wallaroo Hospital & Health Service, SA

Australian Government FundedNo Fees or Charges Apply

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Work and play in beautiful Western Australia

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| www.ncah.com.auNursing Careers Allied Health - Issue 21 | Page 5

| www.ncah.com.au Nursing Careers Allied Health - Issue 21 | Page 29

Careers withQueensland

Health

Registered NursesIntensive Care Unit, Division of Surgery, Princess Alexandra Hospital, Woolloongabba, Metro South Hospital and Health Service. Salary between $60 183 - $77 334 p.a (f/t) or $30.35 - $39.00 p.h. (p/t), (Nurse Grade 5) (Several full time and part time positions (hours negotiable) and several temporary full time and temporary part time positions (hours negotiable). (Applications will remain current for 12 months). Duties/Abilities: Provide direct and indirect client focused nursing care to patients as an independent professional nurse. Collaborate with peers and the multidisciplinary team to achieve high quality patient outcomes and maintain recognised clinical standards within timeframes.Enquiries: Jennifer Robertson/Nicky West (07) 3176 2718Job Ad Reference: H13PA10244Application Kit: (07) 3176 4301 or www.health.qld.gov.au/workforusClosing Date: Monday, 28 October 2013

A criminal history check may be conducted on the recommended person for the job. A non-smoking policy applies to Queensland Government buildings,offi ces and motor vehicles.

You can apply online at www.health.qld.gov.au/workforus

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Advertiser List

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CCM Recruitment International

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We hope you enjoy perusing the range of opportunities included in Issue 17, 2013.

If you are interested in pursuing any of these opportunities, please contact the advertiser directly via the contact details provided. If you have any queries about our publication or if you would like to receive our publication, please email us at [email protected]

+ DISTRIBUTION 34,488

The NCAH Magazine is the most widely distributed national nursing and allied health publication in Australia

For all advertising and production enquiries please contact us on +61 (0) 3 9271 8700, email [email protected] or visit www.ncah.com.au

If you would like to change your mailing address, or be included on our distribution, please email [email protected]

Published by Seabreeze Communications Pty Ltd Trading as NCAH.

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© 2013 Seabreeze Communications Pty Ltd.

All rights reserved. No part of this publication may be copied or

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advertisements contained in this publication is the responsibility of

those who submit the advertisement for publication.

Issue 17 – 26 August 2013

www.ncah.com.au

Next Publication: Education featurePublication Date: Monday 9th September 2013

Colour Artwork Deadline: Monday 2nd September 2013

Mono Artwork Deadline: Wednesday 4th September 2013

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Issue 21 – 21 October 2013

Advertiser List

AHN Recruitment

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Employment Office

Geneva Health

Koala Nursing Agency

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Next Publication: Aged CarePublication Date: Monday 4th November 2013

Colour Artwork Deadline: Monday 28th October 2013

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by Karen Keast

Physiotherapists need to understand the positive and negative impacts of electronic games on children’s health, according to a leading Australian research physiotherapist.

Curtin University School of Physiotherapy Professor Leon Straker, who is also a Senior Research Fellow with the National Health and Medical Research Council, said it was important physiotherapists understood the movement implications of e-games to help prevent and manage disorders.

“Together with TV and computer non-game use, playing e-games makes up the majority of leisure screen time for most children,” he said.

“Nearly all children in Australia now regularly play e-games, and do so for a sufficient amount of time each week to mean this may have an impact on their health.

“Physiotherapists need to be aware of this important part of many children’s lives.”

Professor Straker recently presented his research on the impact of e-games on children’s physical health at the Australian Physiotherapy Association’s Conference 2013, held in Melbourne.

More than 2000 physiotherapists are expected to gather for the biennial industry event which will focus on the new moves and innovation in physiotherapy.

Professor Straker’s first clinical job was as a paediatric physiotherapist at a major children’s hospital before he moved into community physiotherapy and in the past 15 years he has been researching the interaction of children and technology within an ergonomics framework.

Professor Straker said his research investigated the physiological and movement demands of traditional sedentary e-games, such as gamepad input devices, keyboards, joystick and steering wheels and also active e-games, including Song PlayStation 2 Eye Toy and Dance Mat, Sony Playstation 3 Move

and Microsoft Xbox Kinect and Nintendo Wii Remote.

“Children playing active e-games have a higher heart rate, respiration rate, limb and trunk movement, muscle activity and energy expenditure,” he said.

“We are currently comparing the movement of children playing e-games with the real world game to assess e-game fidelity.”

Research shows the negative effects of e-game use can potentially include acute trauma, overuse injuries and increased sedentariness.

Professor Straker said games like the Wii remote have resulted in contact injuries with players injuring themselves when accidentally making contact with another person or furniture in the real space.

He said delayed onset muscle soreness has been reported for active e-games where the player is unaccustomed to the device, while overuse can result in inflammation of joints or tendons from repeated similar actions.

Professor Straker said extensive use of sedentary e-games was comparable to lengthy computer use.

“Sustained poor postures during sedentary e-game use are similar to prolonged computer postures and likely to result in similar issues, for example neck/shoulder pain and back pain from raised shoulders and slumped sitting.”

Professor Straker said there are also potential musculoskeletal benefits of e-games, including enhanced motor coordination and physical activity.

“For active games involving stepping/jumping such as games with a dance mat or whole body games, (they) require muscle movement which may help with muscle fitness and joint/bone loading which may help with joint/bone development,” he said.

Physiotherapists assess impact of e-games

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Position Vacant – Nurse Unit Manager (Extended Care Unit) An opportunity has become available for a suitably qualified and experienced Registered Nurse to take up the Nurse Unit Manager position within our Extended Care Unit. The Extended Care Unit is currently in the planning stage for a new building with construction expected to commence in 2014 with resident occupancy in early-mid 2015. Post graduate gerentology qualification is essential and tertiary management qualification will be highly regarded. The Nurse Unit Manager has overall responsibility for resident care, accreditation, ACFI documentation and legislative compliance with the support of relevant departments/units of the Health Service.

The position includes an attractive salary, as well as salary packaging, entertainment allowance and a relocation allowance. Swan Hill District Health is also strongly committed to professional development.

Further information and position description is available from www.shdh.org.au or contact Mrs. Kathy Wright, Executive Officer – Clinical Services on (03) 50339250 or by email to [email protected]

Applications addressing the selection criteria and including the names of three referees should be forwarded to the Human Resources department, Swan Hill District Health, PO Box 483, Swan Hill 3585, Victoria or email: [email protected]. by COB Friday 1 November 2013.

Respect – Professionalism – Caring – Committed – Collaboration

| www.ncah.com.au Nursing Careers Allied Health - Issue 21 |



Health




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Advertiser List

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Advertiser List

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CRANAplus

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eNurse


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Advertiser List

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We look forward






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| www.ncah.com.au Nursing Careers Allied Health - Issue 21 |


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For the full article visit NCAH.com.au

by Karen Keast

Tasmanian nurses and midwives have warned they will resort to industrial action within weeks unless the State Government fails to deliver better work conditions.The move comes after more than 100 nurses and midwives at the Royal Hobart Hospital unanimously rejected the government’s offer amid negotiations for a new enterprise agreement for public sector nurses and midwives.At the time of publication, the Australian Nursing and Midwifery Federation (ANMF) Tasmanian Branch vowed industrial action would begin on October 21 unless an acceptable offer from the government had not been received before October 18.The branch and the government had agreed to a two per cent pay rise over three years but the branch argues the government’s proposal reduces current conditions equivalent to


cutting leave by a week or slashing salaries by two per cent.The branch says the government’s proposal includes reducing eight hour shifts to six hour shifts without mutual agreement, which would force part-time nurses to work an extra day a week and impact on patient care, along with mandatory leave rostering without mutual agreement.It also includes the removal of both the late payment of wage penalty and the right to receive 11.5 public holidays.“Nurses and midwives are propping up the public health system at the moment with incredible pressures in ED, acute wards and the primary health sector resulting from the budget cuts and increasing demand for health services,” ANMF Tasmania Branch secretary Neroli Ellis said in a statement.



A Brisbane mental health nurse is on the path to recovery after receiving a potentially fatal pit viper snake bite while on holiday in Nepal.

Delmae Ryan, 49, flew home following visits to two hospitals in Pokhara, the second largest city in the country, after being told there was no anti-venom in Nepal.

The endorsed enrolled nurse, who works at Logan House, endured three plane flights in pain to eventually arrive home and was admitted to Princess Alexandra Hospital, where emergency physician and clinical toxicologist Dr Colin Page embarked on a major search for the right type of anti-venom.

The search was hampered because Delmae was bitten in the dark and couldn’t identify the snake, forcing Dr Page to match her bite, from her bloods, to the suspected snake.

The drama unfolded on September 29, the final day of Delmae and her husband’s 10-day trip to Nepal to visit her mother, an aid worker.

Delmae and her husband were getting into a car at night, after having dinner with her mother, when her husband felt something “roll under his foot” in the dark.

“He said it felt just like a pencil or something and then I came to get in behind him…I felt like something smacked my foot and there was this pain,” she recalled.

“I knew something had bitten me and when I got into the light I could see these two blood spots on my foot.

“I thought I was going to get some sort of respiratory reaction but I didn’t get any nausea or any respiratory issues whatsoever.

Nurse survives terrifying snake bite ordeal

by Karen Keast


The Australian Physiotherapy Association’s renowned Journal of Physiotherapy will move online, becoming an open-access publication in January.

One of the world’s leading physiotherapy publications, the quarterly journal will make the transition in a bid to increase its readership while attracting more authors to publish their ground-breaking research in the journal.

Up until now the journal’s content has been limited to paying subscribers but major research funding bodies are increasingly requiring authors to grant open access to ensure publically-funded research is available to everyone.

“The Journal of Physiotherapy is always striving to be the best of its kind by publishing the highest quality physiotherapy research out there,” Journal of Physiotherapy editor Mark Elkins, an Associate Professor at the University of Sydney, said.

“The open access model will help the journal continue to do this.”

Assoc Professor Elkins said the open access format will also encourage more researchers to publish their findings in the journal.

“By introducing free open access to its research papers, Journal of Physiotherapy offers physiotherapists a high-ranking, English-language publication in which to publish their research, with wide readership and listing on 20 major bibliographic databases.”

Assoc Professor Elkins said for the past 60 years the journal has published high-quality evidence of the effectiveness of physiotherapy interventions for many conditions, ranging from sporting injuries to Parkinson’s disease, pain during labour, osteoarthritis and cystic fibrosis.

He said one of its key findings have included how greater benefits in functional exercise capacity can be achieved among people with chronic obstructive pulmonary disease, with

simple walking training on flat ground compared with training on exercise bikes (Leung 2010).

Other research has shown how treadmill training increases the likelihood of achieving independent ambulation for people who cannot walk after stroke (Ada 2010), while producing significant and lasting improvements in walking speed and distance, once stroke survivors can walk (Polese 2013).

APA CEO Cris Massis said the new format will enable anyone world-wide to access the journal’s cutting-edge research and information and to share it through social media.

“The online model will not only open up current research to the public but archive articles will be easy to find and access,” he said.

“Journal of Physiotherapy is facilitating the spread of physiotherapy related knowledge and research throughout the world, which is truly special.”

The journal will become open access from January 1, 2014. Paper copies will be available to APA members on request.

Physiotherapy journal moves onlineby Karen Keast

Official Journal of the Australian Physiotherapy Association

Editorial

143 Towards evidence-based physiotherapy

Research

145 Physiotherapy management of hip osteoarthritis

159 Alternative exercises and urinary incontinence

169 Course length for 6-min walk test in COPD

177 6-min walk distance in systolic heart failure

189 Incidence and prediction of recovery post-stroke

199 Activity coaching in neurological rehabilitation

Appraisal

207 Critically Appraised Papers

211 Clinimetrics

213 Clinical Practice Guidelines

214 Media

© Luurn Willie Kew, 2008. Licensed by Japingka Gallery 2013.

VOLUME 59 • NO 3 • SEptEmbER 2013


Editorial


Research







Appraisal


211 Clinimetrics


214 Media




Editorial


Research







Appraisal


211 Clinimetrics


214 Media






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THEN OXFORD AUNTS CAN HELP YOU WORK AND TRAVEL IN THE UK!

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by Karen Keast

Nurses and midwives suffer the highest rate of needlestick and sharps injuries among Australian healthcare workers each year.

Needlestick and other sharps injuries remain the most common and potentially most dangerous injuries that face nurses and midwives in Australia.

Australian Nursing and Midwifery Federation (ANMF) federal secretary Lee Thomas said while there are an estimated 180,000 reports of needlestick and sharps injuries to nurses, midwives and other healthcare workers occurring each year across the nation – the figure could actually be much higher.

“With approximately half of all injuries not reported, this means the actual number of injuries to nurses and other healthcare workers could be as high 36,000 cases a year,” she said.

“We’re obviously very concerned about the potential harm to nurses, exposing them to the risk of contracting HIV/AIDS and Hepatitis B or C.”

As part of National Safe Work Australia month, the ANMF and the Alliance for Sharps Safety and Needlestick Prevention in Healthcare have renewed calls for state and federal jurisdictions to mandate the use of safety engineered devices (SEMDs).

The ANMF estimates it would cost $50 million to equip Australia’s public hospitals with safe needle use education and safety equipment but only a small number of hospitals have introduced the safety devices.

“We are pleased that some individual hospitals are making an effort to improve safety for nurses through their own practices but overall, there continues to be slow progress in rolling-out safety devices through workplaces for nurses,” Ms Thomas said.

“Employers have an obligation to ensure safety in the workplace.”

The ANMF also wants conventional needles to be replaced where possible with lock syringes or retractable syringes.

Ms Thomas said while it was important to educate and train nurses about the every-day dangers of needles and other sharps, employers also need to take vital preventative action.

“Employers also need to be reminded of their obligations to health and safety legislation in developing and implementing safety control plans for nurses and healthcare workers,” she said.

“Needle disposal containers should be placed close to where nurses and midwives are carrying out procedures and the containers should never be overfilled.

“Needles should never be recapped. Nurses must always report any needle or sharps injury.”

Ms Thomas said unlike other western countries, including the United States and Canada, Australia has no nationally mandated approach to the utilisation of safety devices to prevent needlestick injuries to nurses and other healthcare workers.

“We continue to call on Federal and State Governments to work together with key stakeholders to ensure that protocols are aligned with the mandatory use of safety engineered devices and education of healthcare workers – so that Australia is brought into line with other countries.”

Alliance chair Professor Cathryn Murphy said every needlestick or sharps injury at work was a foreseeable hazard to healthcare workers.

“International experience has proven that the risk of occupational exposure to bloodborne pathogens from a needlestick or sharps injury can be eliminated through the mandatory use of safety engineered devices, education of healthcare workers and mandatory reporting of injuries.”

Nurses and midwives bear the brunt of sharps injuries


corrected copy

Are you keen to utilise ALL of your nursing skills?• Attractiveremuneration• Diversecareeropportunity• BasedinPortAugusta,SouthAustraliaTheRoyalFlyingDoctorServiceofAustralia(RFDS)isoneofthelargestandmostcomprehensiveaeromedicalorganisationsintheworld.WeareseekingregisterednurseswithGeneralandMidwiferyNursingCertificateswhoarecurrentlyregisteredwiththeAustralianHealthPractitionerRegulationAgency.Youwillalsohavecomprehensiveexperienceand/orpostgraduatequalificationsinacriticalcarearea,togetherwithhighlevelcustomerservicesskillsandaprofessionalapproachtoservicedelivery.Workinginadiverse,fulfillingandrewardingenvironment,RFDSnursesareattheforefrontindeliveryofaeromedicalhealthservices.If you are keen to progress your career with an organisation that makes a real difference to all Australians, apply now.Please direct your confidential enquiries to Greg McHugh Ph: (08) 8150 1313Applications to: HR Coordinator RFDS Central Operations PO Box 381 Marleston DC SA 5033 Email: [email protected]

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Have you always dreamed of working for Australia’s famous aeromedical health service but do not meet the Flight Nurse position requirements to be endorsed as a Midwife?TheRoyalFlyingDoctorService,CentralOperationsisnowprovidinganexcitingopportunityforsuitablyqualifiedRegisteredNursestoaccessalimitednumberofMidwiferyScholarships.TheScholarshipswillprovidefinancialsupporttothoseNursessotheymaygainthisimportantqualification.ThesescholarshipsaretobeusedforcostsassociatedwithyourstudytowardsaMidwiferyQualificationin2014/15suchascoursefees,textbooks,etcSelectionCriteria:•RegisteredGeneralNursewithAHPRARegistration;•EmergencyNursingorCriticalCareCertificate/experience;•Significantrelevantpostgraduatenursingexperience;•AustraliancitizenshiporpermanentresidencyinAustralia.The approved course, leading to endorsement as a Midwife and any other post graduate midwifery program requirements, may be completed in any state of Australia. Employment post registration as a Midwife will be with RFDS Central Operations.For further information and to request an Application Package please contact:Kate Guerin, HR Coordinator PO Box 381, Marleston BC SA 5033 Email: [email protected]

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Page 24 | www.ncah.com.au Nursing Careers Allied Health - Issue 21 |


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Are you keen to utilise ALL of your nursing skills?•Attractiveremuneration•Diversecareeropportunity•BasedinPortAugusta,SouthAustraliaTheRoyalFlyingDoctorServiceofAustralia(RFDS)isoneofthelargestandmostcomprehensiveaeromedicalorganisationsintheworld.WeareseekingregisterednurseswithGeneralandMidwiferyNursingCertificateswhoarecurrentlyregisteredwiththeAustralianHealthPractitionerRegulationAgency.Youwillalsohavecomprehensiveexperienceand/orpostgraduatequalificationsinacriticalcarearea,togetherwithhighlevelcustomerservicesskillsandaprofessionalapproachtoservicedelivery.Workinginadiverse,fulfillingandrewardingenvironment,RFDSnursesareattheforefrontindeliveryofaeromedicalhealthservices.If you are keen to progress your career with an organisation that makes a real difference to all Australians, apply now.Please direct your confidential enquiries to Greg McHugh Ph: (08) 8150 1313Applications to: HR Coordinator RFDS Central Operations PO Box 381 Marleston DC SA 5033 Email: [email protected]




Flight Nurses>











Healthcare Postgrad Press (125x85).indd 3 24/09/13 10:35 AM


Health



To apply for the positions above:Enquiries: Mark White (07) 4162 9205.Application Kit: (07) 4616 6258 orwww.health.qld.gov.au/workforusClosing Date: Monday, 18 November 2013. B

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Childbirth has been defined as the culmination of the pregnancy period with the expulsion of one or more newborn infants from a woman’s uterus. Childbirth is also one of life’s essential journeys, writes Karen Keast.

Any midwife will tell you there is nothing more incredible in this world than witnessing childbirth and assisting a mother as her baby is born into our world.

University of Western Sydney Professor Hannah Dahlen, a privately practising midwife and spokesperson for the Australian College of Midwives, once shared her early memories of watching her mother, a midwife, support women in childbirth at a missionary clinic in Yemen, in the Middle East.

“When I was 12, my next door neighbour gave birth and I helped the midwife catch her,” she says.

“I held this baby as the dawn was breaking over the Middle East and I thought - there can be no other job on this earth, as being at the beginning of a new life.”

The latest statistics on childbirth in Australia show the number of childbirths has been increasing since 2001, with a total of 294,814 women giving birth to 299,563 babies in 2010.

The figures from the Australian Institute of Health and Welfare’s Australia’s Mothers and Babies 2010 report, provides a snapshot of childbirth in Australia.

Most women - 201,613 women or 68.4 per cent - had a vaginal birth and 82.4 per cent of those did not involve the use of instruments.

It also shows 93,157 women or 31.6 per cent gave birth by caesarean section, while 18.6 per cent had a caesarean section without labour

and ongoing health care benefits for women, their babies and their families.

Throughout labour, midwives will continually monitor the woman’s progress while making sure the environment, including the woman’s partner or family at the birth, supports the woman’s needs.

Griffith University Professor Jenny Gamble, a practising midwife of 30 years, says midwives will often dismiss their actions as being “just there or just present” during the labour and childbirth.

“They are not ‘just present’,” she says.

“I think what a good midwife does, what a competent midwife does, what an expert midwife does is extremely subtle.

“It’s an intense assessment, an ongoing assessing process carried out in a way that makes the woman feel both safe and secure and not watched and observed.

“When a woman is in labour she needs a degree of privacy within a cocoon of safety.

“The midwife’s job is to watch and assess and guide where needed and facilitate the birth.”

And it’s up to the woman giving birth as to who “catches” the baby in childbirth – be it the

and 13 per cent had a caesarean section with labour.

Overall, 56.4 per cent of women had a non-instrumental birth while about one in nine mothers had an instrumental delivery where either forceps or vacuum extraction was used.

A normal vaginal childbirth involves three stages of labour, beginning with the early and active phases in stage one.

The early, or latent, phase is when regular uterine contractions begin and the cervix begins to open and widen.

The labour then moves into the active phase where the accelerated cervical dilation occurs, opening the cervix from 3 or 4cm to 10cm.

Once the cervix is fully dilated, the labour moves into the second stage - childbirth.

With the head fully engaged in the pelvis, pressure on the cervix increases and the woman begins to push.

The baby’s head continues the descent into the pelvis, below the pubic arch and out through the vaginal opening.

The third and final stage of labour is when the placenta is expelled.

In Australia, midwives assist in childbirth in a variety of settings from hospitals to birthing centres, community centres and in women’s homes, and are either self-employed as privately practising midwives or employed through health services or organisations.

The continuity of care model, also known as caseload midwifery, where women have the same midwife from early in their pregnancy through labour and childbirth until around six weeks after birth is increasingly becoming recognised in Australia for providing improved

midwife, the partner, a friend or family member, Professor Gamble says.

A leading researcher whose work has focused on issues such as the rising rates of medical intervention in childbirth, as well as workforce and practice development, Professor Gamble says the midwifery profession is gradually advancing in Australia.

Midwives now have access to Medicare funding, insurance and can prescribe PBS medicines, however many hospitals continue to keep their doors closed to privately practising midwives seeking clinical privileging arrangements.

Professor Gamble says midwifery still remains a “nursing industrial model” in much of the hospital system, where the sense of normality in childbirth has largely been lost.

“To some extent, hospital staff have just become institutionalised and many of those people have lost a really good understanding and sense of what normal birth looks like,” she says.

Professor Gamble says one example is where the third stage of labour can become managed in hospitals, with the use of a serotonin injection into the leg to ensure the placenta separates from the wall of the uterus.

“Many don’t have an idea of what that third stage of labour looks like if you don’t have that drug,” she says.

Professor Gamble describes midwifery as a “wonderful job” and likens the role of midwives in childbirth to that of palliative care nurses working in end of life care.

“It might seem strange but it’s about essential life journeys,” she says.

“One is going out of the world and one is coming into the world.

“If we don’t get those both right, we are not going to get anything else right.”

The childbirth journeyby Karen Keast


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Queensland’s Griffith University is preparing to launch Australia’s first course focusing on the provision of maternity services in primary health care.

Griffith University School of Nursing and Midwifery Professor Jenny Gamble said the Master of Primary Maternity Care will be offered in 2015 in line with the National Maternity Services Plan’s commitment to continuity of care, demedicalising birth and providing women with more options for maternity services.

“We are working on demedicalising birth and bringing it back into the community,” she said.

“Rather than a hospital-centric system, it’s got to be about community-based care as needed.”

Professor Gamble said the course will suit midwives, as well as allied health professionals, policy makers and middle managers who work in maternity services.

“It’s for managers and policy makers and midwives who have worked in the hospital sector for all of their lives and have never experienced providing continuity of care,” she said.

“People need education to enable them how to do it differently and what it looks like.

“That component is only one of the barriers. I think there are other political barriers and cultural barriers.”

Professor Gamble said the course will cover the ‘how to’ of remodelling service delivery.

“Lots and lots of Directors of Nursing say midwives don’t want to change their shift work to an annualised salary,” she said.

“It’s quite common for people not to want to change their way of working. It’s about putting strategies in place.”

Professor Gamble said the program will be based on evidence in practice, with international and Australian research showing continuity of care is cost-effective, safe and provides better birth outcomes.

“It’s better for midwives, it’s better for women and it’s better for the babies.”

The course will also cover midwifery prescribing and business skills for midwives wanting to move into private practice.

Griffith University was recently recognised for its clinical training for midwives and its commitment to driving Australia’s national maternity reform agenda.

Its Bachelor of Midwifery program, introduced in 2010, was a finalist in the Workforce Council’s Workforce Innovation Awards.

The university this year also became the second university in Australia to offer a course enabling midwives to prescribe.

Its Screening, Diagnostics, Pharmacology and Prescribing for Midwives course is a one semester online course.

Griffith to launch first primary maternity services courseby Karen Keast

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by Karen Keast

Childhood behaviour problems are a robust predictor of future physical and mental health problems, according to a preeminent Australian psychologist.

University of New South Wales Professor of Psychology, and

director of the university’s Child Behaviour Research Clinic, Mark Dadds said early intervention and putting in place partnerships with parents could steer many children with early onset conduct problems away from a life of physical and mental health issues.

“It’s time to stop ignoring these kids as being hyperactive and the problem of schools and juvenile justice and saying we need to think of these kids as an opportunity to intervene early and make a difference to the health of Australia,” he said.

Professor Dadds discussed the issue as one of the key note speakers at the 48th Australian Psychological Society Conference, titled Psychology for a Healthy Nation, recently held in Cairns.

Professor Dadds, whose current research involves mapping early developmental and intervention pathways with aggressive and antisocial children, said the early signs of future mental health problems could often be found in common childhood non-compliance behaviours ranging from aggression to tantrums, fighting, swearing, stealing and lying.

But Professor Dadds stressed while every child could go through a phase of behaviour problems, it was a major concern in the estimated five per cent of children, especially

boys, who have behaviour problems that are interfering with their lives.

“Those problems every child does. What we are looking for here is a child who is stuck…and the parents and teachers can’t cope.”

Professor Dadds said children with concerning behaviour problems are at high risk of entering the juvenile justice system and are also at greater risk of substance abuse and depression.

He urged psychologists to consider children with behaviour problems as an important group within the psychological mental health zone.

“It’s a sign of the potential mental health problems through the lifespan. Some kids grow out of it, not all,” he said.

Professor Dadds hopes his message will also get across to other health professionals, including psychiatrists, GPs and paediatricians.

“A lot of those kids are getting diagnosed with ADHD when they are not - they have got conduct problems,” he said.

“Importantly, if we get it early and you put in place these partnerships with the parents to give them some of the best evidence-based programs for managing these kids - that has a really good success rate.”

Professor Dadds, who also practices as a child and family therapist, urged health professionals to learn to differentiate between conduct problems and ADHD, to investigate what the best evidence-based treatments are and to discover what local resources are available.

“At the moment, only one in four children that need this kind of help receive it in Australia,” he said.

“We all need to make a big effort. We need to be sensitive to children with behaviour problems – they can be identified and they can be helped early.”






The effectiveness of nursing and midwifery activities undertaken at the Sunshine Coast Hospital and Health Service (SCHHS) in Queensland looks set to benefit from a reinforced relationship with the University of the Sunshine Coast (USC).

Four USC academics have been appointed Visiting Fellows in Nursing and Midwifery at the hospital. They are Professors Marianne Wallis and Jeanine Young, Associate Professor Margaret Barnes and Dr Amanda Henderson, who received the honorary positions in a ceremony last month.

They will undertake research and collaborate on educational and clinical leadership projects involving nurses, midwives and other health professionals. It is understood each fellow will bring a different expertise to the Sunshine Coast Hospital and Health Service, ranging from maternal and child health to acute hospital care for adults and sub-acute areas such as palliative care.

SCHHS Nursing and Midwifery Services executive director, Adjunct Professor Graham Wilkinson, confirmed the four would work with SCHHS staff to foster new research programs.

USC’s Professor Wallis reportedly described the initiative as “a first step in developing international best practice in nursing and midwifery research, education and clinical practice” on the Sunshine Coast, ahead of

University link to enhance hospital’s midwifery offerthe opening of the Sunshine Coast Public University Hospital.

Projects that currently involve the Visiting Fellows include: Staying Connected – a study to help new mothers bond with their babies and breastfeed for as long as possible; the SAVE Trial – trialling different devices for securing drips in hospital patients; the RSVP Trial – comparing the impact of intravascular device administration set replacement at four days versus seven days on infective, clinical and cost outcomes;

the Pepi-Pod Safe Sleep Space project – exploring a strategy that supports cultural infant care practices while reducing the risk of sudden infant death in Aboriginal and Torres Strait Islander communities; and the National Standards Assessment Program, Collaborative Improvement Program Support for Carers (Palliative Care Australia) – which evaluates the national standards project. 321-022 1/4PG PDF


Midwives, Midwives, MidwivesLooking for a rewarding rural experience in the horse capital of Australia?

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You may like to consider this as an opportunity to trial a rural lifestyle with a view to relocating more permanently or simply wish to gain exposure to a rural setting.

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Hervey Bay allied health workers have passed a motion to formally reject the Queensland State Government’s latest pay offer and are in the process of deciding whether to take industrial action.

With allied health workers having held mass meetings outside the Fraser Coast’s two major public hospitals over the latest pay negotiations with the Queensland State Government in recent weeks, a motion to reject the latest pay offer was passed at a mass meeting outside Hervey Bay Hospital on Thursday 10 October.

The offer made by the Queensland State Government was for 5.9 per cent over three years, with a 1.5 per cent increase in the first year and a 2.2 per cent increase in each of the next two years.

The Together union, one of the largest unions in Queensland, which unites and represents employees across a broad range of industries including allied health workers, said the motion

QLD allied health workers reject pay offer

included an agreement to fight the offer from the State Government.

According to Together Union organiser Donna Webster the offer, which affects a broad range of allied health workers including occupational therapists, dentists, mental health workers and pharmacists, came with significant cuts to entitlements, including reductions to rural and student allowances and reduced leave for some roles.


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the Pepi-Pod Safe Sleep Space project – exploring a strategy that supports cultural infant care practices while reducing the risk of sudden infant death in Aboriginal and Torres Strait Islander communities; and the National Standards Assessment Program, Collaborative Improvement Program Support for Carers (Palliative Care Australia) – which evaluates the national standards project.

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www.ahnr.com.au




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OUM is proud to announce an even more attractive fee structure from 2013.Applications are now open for courses beginning in February and August. �New facilities, greater capacity and over 150 students currently enrolled.

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�OUM Graduates are eligible to sit for the AMC exam or NZREX.

�OUM Graduates are employed in Australia, New Zealand, Samoa and USA.




























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by Karen Keast























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Maari Ma Health Aboriginal Corporation Improving Aboriginal Health and closing the gap

Regional Primary Health Service Further information about Maari Ma is available on our website www.maarima.com.auSelect ‘Publications’ to view or download our Strategic Plan, Chronic Disease Strategy and other documents.

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Community MidwifeFull time or part timeWork collaboratively with Aboriginal Primary Health Workers to implement the Aboriginal Maternal Infant Health Strategy integrated within the Healthy Start Program. Providing community based ante-natal care for Aboriginal women of the region to achieve healthy pregnancies, good birth outcomes and healthy babies.

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by Karen Keast

Most Australian women are eating the kilojoules for two while pregnant, not the nutrition for two, according to leading dietitian Melanie McGrice.

The renowned Melbourne dietitian has taken her passion for weight management to print with the recent launch of her book, The Pregnancy Weight Plan.

An Advanced Accredited Practising Dietitian (AdvAPD) and director of one of the nation’s largest dietetic companies, Nutrition Plus, Ms McGrice said many pregnant women are confused when it comes to what and how much they should eat during pregnancy.

“They often don’t know how many additional kilojoules they can have and in what form they should have them,” she said.

Ms McGrice said she realised many of her clients began struggling with their weight during pregnancy, which was impacting on both the mums and their babies in the short term and also long term.

“It’s a really big issue,” she said.

“The recent figures are that 74 per cent of Australian women are gaining too much weight during pregnancy.

“I would really encourage every woman who is pregnant to have at least one consultation with an APD while they are pregnant.”

Ms McGrice said extra weight gain during pregnancy increased the risk of complications with obese mums having double the chance of miscarriage and stillbirth, double the risk of their baby having a birth defect, triple the risk of pre-eclampsia and a higher risk of caesarean birth.

She said mums gaining too much weight are also putting their babies at risk – significantly increasing their risk of childhood obesity.

“By making sure you are gaining the right amount of weight during pregnancy, mums can have a huge impact on...two generations.”

Ms McGrice said overweight women also have less chance of falling pregnant while those undergoing IVF have almost double the risk of miscarriage as women of a healthy weight.

She said her book was not just for mums and those wanting to boost their fertility but was also a resource for other APDs and health professionals.

“I really see in the industry at the moment there’s a lot of physicians, GPs, midwives and obstetricians, who aren’t weighing their clients, the mums, during pregnancy,” she said.

“They aren’t talking to them about nutrition at all. I would really like to see other health professionals either refer pregnant mums to see a dietitian or to suggest to mums to have a copy of the book.”

The Pregnancy Weight Plan includes customised weight management plans for before, during and after pregnancy and includes nutritional information, food diaries, safe and sensible exercise programs, meal plans and 33 healthy 30-minute recipes.


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OUM is proud to announce an even more attractive fee structure from 2013.Applications are now open for courses beginning in February and August. �New facilities, greater capacity and over 150 students currently enrolled.

�Study from a Home Base under faculty from top international medical schools.

�Receive personalised attention from your own Academic Advisor.

�OUM Graduates are eligible to sit for the AMC exam or NZREX.

�OUM Graduates are employed in Australia, New Zealand, Samoa and USA.




























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by Karen Keast































the Pepi-Pod Safe Sleep Space project – exploring a strategy that supports cultural infant care practices while reducing the risk of sudden infant death in Aboriginal and Torres Strait Islander communities; and the National Standards Assessment Program, Collaborative Improvement Program Support for Carers (Palliative Care Australia) – which evaluates the national standards project.

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www.ahnr.com.au












the Pepi-Pod Safe Sleep Space project – exploring a strategy that supports cultural infant care practices while reducing the risk of sudden infant death in Aboriginal and Torres Strait Islander communities; and the National Standards Assessment Program, Collaborative Improvement Program Support for Carers (Palliative Care Australia) – which evaluates the national standards project. 321-022 1/4PG PDF










































www.ahnr.com.au




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OUM is proud to announce an even more attractive fee structure from 2013.Applications are now open for courses beginning in February and August. � New facilities, greater capacity and over 150 students currently enrolled.

� Study from a Home Base under faculty from top international medical schools.

� Receive personalised attention from your own Academic Advisor.

� OUM Graduates are eligible to sit for the AMC exam or NZREX.

� OUM Graduates are employed in Australia, New Zealand, Samoa and USA.




























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by Karen Keast





























Healthcare Postgrad Press (125x85).indd 3 24/09/13 10:35 AM


Health



To apply for the positions above:Enquiries: Mark White (07) 4162 9205.Application Kit: (07) 4616 6258 orwww.health.qld.gov.au/workforusClosing Date: Monday, 18 November 2013. B

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by Karen Keast



















Editorial


Research







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211 Clinimetrics


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211 Clinimetrics


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Research







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211 Clinimetrics


214 Media















































by Karen Keast





















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Are you keen to utilise ALL of your nursing skills?•Attractiveremuneration•Diversecareeropportunity•BasedinPortAugusta,SouthAustraliaTheRoyalFlyingDoctorServiceofAustralia(RFDS)isoneofthelargestandmostcomprehensiveaeromedicalorganisationsintheworld.WeareseekingregisterednurseswithGeneralandMidwiferyNursingCertificateswhoarecurrentlyregisteredwiththeAustralianHealthPractitionerRegulationAgency.Youwillalsohavecomprehensiveexperienceand/orpostgraduatequalificationsinacriticalcarearea,togetherwithhighlevelcustomerservicesskillsandaprofessionalapproachtoservicedelivery.Workinginadiverse,fulfillingandrewardingenvironment,RFDSnursesareattheforefrontindeliveryofaeromedicalhealthservices.If you are keen to progress your career with an organisation that makes a real difference to all Australians, apply now.Please direct your confidential enquiries to Greg McHugh Ph: (08) 8150 1313Applications to: HR Coordinator RFDS Central Operations PO Box 381 Marleston DC SA 5033 Email: [email protected]




Flight Nurses>














































by Karen Keast





















corrected copy

Are you keen to utilise ALL of your nursing skills?• Attractiveremuneration• Diversecareeropportunity• BasedinPortAugusta,SouthAustraliaTheRoyalFlyingDoctorServiceofAustralia(RFDS)isoneofthelargestandmostcomprehensiveaeromedicalorganisationsintheworld.WeareseekingregisterednurseswithGeneralandMidwiferyNursingCertificateswhoarecurrentlyregisteredwiththeAustralianHealthPractitionerRegulationAgency.Youwillalsohavecomprehensiveexperienceand/orpostgraduatequalificationsinacriticalcarearea,togetherwithhighlevelcustomerservicesskillsandaprofessionalapproachtoservicedelivery.Workinginadiverse,fulfillingandrewardingenvironment,RFDSnursesareattheforefrontindeliveryofaeromedicalhealthservices.If you are keen to progress your career with an organisation that makes a real difference to all Australians, apply now.Please direct your confidential enquiries to Greg McHugh Ph: (08) 8150 1313Applications to: HR Coordinator RFDS Central Operations PO Box 381 Marleston DC SA 5033 Email: [email protected]




Flight Nurses>











Healthcare Postgrad Press (125x85).indd 324/09/13 10:35 AM


Health



To apply for the positions above:Enquiries: Mark White (07) 4162 9205.Application Kit: (07) 4616 6258 orwww.health.qld.gov.au/workforusClosing Date: Monday, 18 November 2013.B

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by Karen Keast
















by Karen Keast



















Editorial


Research







Appraisal


211 Clinimetrics


214 Media




Editorial


Research







Appraisal


211 Clinimetrics


214 Media




Editorial


Research







Appraisal


211 Clinimetrics


214 Media




















We look forward






1300 NAHRLS



321-018 1PG FULL COLOUR CMYK PDF320-015 1PG FULL COLOUR CMYK PDF1319-015 1PG FULL COLOUR CMYK PDF (typeset)

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Health




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Advertiser List

AHN Recruitment

Ausmed

Austra Health




CQ Nurse

CRANAplus

Employment Offi ce

eNurse


Medacs Australia

No Roads to Health



Oxford Aunts Care

Pulse Staffi ng

Queensland Health



TR7 Health










ABN 29 071 328 053.








www.ncah.com.au





Advertiser List

AHN Recruitment

Ausmed


CCM Recruitment


CQ Nurse

Employment Office

Geneva Health



Medacs Australia





Oxford Aunts Care

Pulse Staffing

Queensland Health





TR7 Health







by Karen Keast






























Health




Blaze02

3226



Advertiser List

AHN Recruitment

Ausmed

Austra Health




CQ Nurse

CRANAplus

Employment Offi ce

eNurse


Medacs Australia

No Roads to Health



Oxford Aunts Care

Pulse Staffi ng

Queensland Health



TR7 Health










ABN 29 071 328 053.








www.ncah.com.au





Advertiser List

AHN Recruitment

Ausmed

Austra Health




CQ Nurse

CRANAplus

Employment Offi ce

eNurse


Medacs Australia

No Roads to Health



Oxford Aunts Care

Pulse Staffi ng

Queensland Health



TR7 Health










ABN 29 071 328 053.








www.ncah.com.au





Advertiser List

AHN Recruitment

Ausmed


CCM Recruitment


CQ Nurse

Employment Office

Geneva Health



Medacs Australia





Oxford Aunts Care

Pulse Staffing

Queensland Health





TR7 Health







by Karen Keast












































We look forward






1300 NAHRLS



321-018 1PG FULL COLOUR CMYK PDF 320-015 1PG FULL COLOUR CMYK PDF 1319-015 1PG FULL COLOUR CMYK PDF (typeset)

corrected copy












qeb=_bpq=mblmib=fk ebîqe=^ka=pl`fî=`ôb ïïïKéìäëÉàçÄëKÅçã

Make mripbyour first choice and the rest ofyour journey to the UK will be easy:qW+61 (02) 9965 9411 bW=Öê~ÅÉ]éìäëÉëí~ÑÑáåÖKÅçãK~ì

√cobbG=mripblîÉêëÉ~ë=kìêëáåÖ=mêçÖê~ãJ=ElkmF=J=kçí=çÑÑÉêÉÇ=Äó=~åó=çíÜÉê=~ÖÉåÅó

√Extensive and varied work opportunities on a temporary agency, longer term contract orpermanent basis.

√Full assistance with NMC registration.√UK Starter package.





www.ncah.com.au Nursing Careers Allied Health - Issue 21



BENDIGOVIC 3550

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Education Feature





Issue 1809/09/13

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Melbourne Auckland

5th & 6th December2nd & 3rd DecemberIf you live outside Melbourne or Auckland CCM will arrange for representatives to SKYPE/Phone you. Please contact CCM to arrange.



BENEFITS INCLUDE:

Salary paid tax free Free utilities

1 & 2 year contracts 54 days annual leave

Attractive Sign-on Bonus Relocation allowance

Free �ights Free medical coverage

Free furnished accommodation Severance pay



www.ncah.com.auNursing Careers Allied Health - Issue 21



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Education Feature





Issue 1809/09/13

fortnightly








In AU 1300 665 343 or NZ 0800 99 01 01






Issue 2121/10/13

fortnightly


Achieving Success

Together.

Geneva Healthcare






New Zealand


Australia


Middle East





BOOK NOW

!


MelbourneAuckland

5th & 6th December 2nd & 3rd DecemberIf you live outside Melbourne or Auckland CCM will arrange for representatives to SKYPE/Phone you. Please contact CCM to arrange.



BENEFITS INCLUDE:

Salary paid tax freeFree utilities

1 & 2 year contracts54 days annual leave

Attractive Sign-on BonusRelocation allowance

Free �ightsFree medical coverage

Free furnished accommodationSeverance pay



ncah issue 21 2013

Documents

career opportunities

colour cmyk pdfsaudi

health recruitment

sights onsaudi arabia

change of address

correct address

knowledgeable service

extra mile