Energy Policy 31 (2003) 393–403 The Seven Brothers Public Service International Research Unit, School of Computing and Mathematics, University of Greenwich, 30 Park Row, London SE10 9LS, UK in 2002 to form the sixth largest company. There is thena drop in size to the Italian company, ENI and the In 1975, Anthony Sampson wrote a book, ‘The Seven Spanish company, Repsol. As in 1975, the top three
Sooner or later, every man in Australia runs into problems with impotency viagra australia like other bodily functions, must be in order.
12996 nmb journal march 08
12870 NMB Journal March 08 Cover 19/2/08 5:03 PM Page 3 Cover photo: Anita Sandstrom, Clinical Nurse Educator
Paediatric Recovery, Sydney Children's Hospital Nurses and Midwives Board of New South Wales
PO Box K599, Haymarket NSW 1238 Australia
Level 6, North Wing, 477 Pitt Street, Sydney, NSW 2000
Telephone: +61 2 9219 0222 Facsimile: +61 2 9281 2030
Rural: 1800 241 220 Email: [email protected]
12996 NMB Journal March 08 25/2/08 9:36 AM Page 1 From the President
Poisons and Therapeutic Goods Amendment (Midwives) Regulation 2007 Chairperson of the Australian Nursing and Midwifery Council Inspections under the Nurses and Midwives Act Discrimination – Race and Disability Advanced Diploma in Nursing at UNE Refusals of Registration Nurses and Midwives Board Annual Report Nurses and Midwives Tribunal Cases
Prosecution of Persons Falsely Claiming to be
Registered or Enrolled Nurses
Schedule 1B Inquiries
Research and Development Scholarship Reports
12th International Symposium in Paediatric Neuro-Oncology The Australasian Professional Society on Alcohol and Other Drugs (APSAD) Annual Scientific Conference
12996 NMB Journal March 08 25/2/08 9:36 AM Page 2 From the President
Dear Nursing and Midwifery ColleaguesNursing and midwifery practice can sometimesbe demanding and stressful, but it can also besatisfying and rewarding. Our education andexperience allow us to assess and respond to thehealth needs of others and to provide safe care.
Some people, not nurses or midwives, may envy our professional recognition, status in thecommunity, access to employment, salaries etcetera. Some people, who have not had theappropriate education, may not appreciate theintricacies of practice and may presume thatthey could undertake the professional dutiesand responsibilities of nurses or midwives.
In this issue of nmb: update there are two items about unqualified people holding themselves out as being registerednurses. From reports received in the Board's office, there are otherinstances also occurring in our community. Where possible, an inspectorfollows up reported instances and offenders are prosecuted in court in theinterests of public safety.
Those of us who have management roles play an important part in ensuring that the nurses and midwives, for whom we have responsibility,hold current registration or enrolment in the appropriate category. Modern photocopying technology is so good that it can sometimes be difficult to tell if a document is an original or copy. It is suggested thatyou should insist on seeing and examining original "authority to practise"cards. While it can be good administrative practice to retain a photocopyfor your records, it is important to insist on seeing the original.
Further, it cannot be guaranteed that the person possessing an "authority to practise", in a particular name, is in fact that person. It issuggested that prospective employers also need to see appropriate originalidentification documents such as birth and marriage certificates orpassports in order to help satisfy you that job applicants are who theyclaim to be. It is good practice also to check education qualifications,especially if particular expertise is being sought.
12996 NMB Journal March 08 25/2/08 9:36 AM Page 3 Sometimes the registration of a nurse or midwife may have been cancelled or conditions may have been imposed on registration orenrolment. Therefore it is recommended that periodic checks be made tomonitor that nurses and midwives continue to be registered or enrolled,and that any conditions have been identified and implemented.
In this issue, you will also note a summary of visits by inspectors to ensure that people, practising as nurses and midwives, hold currentregistration, authorisation or enrolment as applicable. The inspectorsundertake an important monitoring and educative role regardingcompliance with legislation.
The Board's website provides a search facility to check for names in the Registers and Roll. If you have any concerns, you should telephone the Board's office. Sometimes there may be a simple explanation for adiscrepancy. However sometimes, what starts as a casual enquiry, mayend up leading to someone who is holding out as a nurse or midwifebeing identified and appropriately dealt with under the law.
Nurses and midwives require appropriate knowledge, skill, judgement and care in undertaking their professional roles and an unqualified personmay potentially do serious harm to a trusting patient, client or woman andeven jeopardise the safety of the nurses or midwives with whom they work.
As nurses and midwives, we are collectively responsible for the provision of safe nursing and midwifery services in our community. An employer or consumer, who believes she or he is engaging the servicesof a registered health professional, is entitled not to be deceived.
If you have any concerns about this matter, I suggest you contact the Board's office and follow up your concerns. The community deserves ourdiligence in these matters.
The Board receives generally positive feedback about nmb: update. I trust you will find the articles in this issue, including the ones I havementioned, interesting and informative.
Warm regardsProf Jill White President Issue 10, March 08 12996 NMB Journal March 08 25/2/08 9:36 AM Page 4 Poisons and Therapeutic to nursing and midwifery regulation. The Nurses and (Midwives) Regulation Midwives Board and its equivalent organisations in Her Excellency the Governor, other States and Territories with the advice of the Executive each nominate a Director of the Council, has made the Poisons and Therapeutic Goods Professor Mary Chiarella is a Amendment (Midwives) Member of the Nurses and Regulation 2007 under the Midwives Board of New South Poisons and Therapeutic Goods Wales and was elected as Chairperson of ANMC on 28November 2007 for a period of The object of this Regulation is to provide for registered three years. Mary is midwives to have the same congratulated on her election.
responsibilities and functions Inspections Under the as registered nurses under the Nurses and Midwives Act Poisons and Therapeutic GoodsRegulation 2002 in relation to Section 77A of the Nurses and the supply and possession of Midwives Act 1991 provides for restricted substances and the Board to appoint inspectors drugs of addiction. Previously to carry out certain functions the Regulation did not permit relating to compliance of the registered midwives to administer Schedule 8 drugs in Routine inspections of hospital settings unless they various health and aged care were also registered as nurses. facilities and medical centresare undertaken by inspectors to Chairperson of the ensure that the nurses and Australian Nursing and midwives working in these Midwifery Council facilities hold current The Australian Nursing and authorities to practise.
Midwifery Council (ANMC) is the All nurses, midwives and peak body established in 1992 employers are encouraged to to facilitate a national approach monitor compliance with the 12996 NMB Journal March 08 25/2/08 9:36 AM Page 5 requirements of legislation so prosecution for breaches of the that a visit by an inspector will Act. Where a person was not cause any undue concern.
previously registered or enrolled Section 77A provides for and has practised following inspectors to enter premises cancellation of registration or where nursing or midwifery is enrolment, the Board may practised. Full details of the refuse a subsequent above may be found by following the link to the Act In instances where there are from the "legislation" page on no other concerns and there the Board's website.
may have been an unintended From 1 January 2007 to 31 oversight by a nurse or midwife, December 2007 there were 72 the Board may consider that a facilities visited across New cautionary letter to the nurse or South Wales. From these midwife is adequate to deal inspections the registration and with the matter. However, in enrolment of 7,475 nurses and such cases, any repeated midwives was checked. These offences would be viewed more figures included: Registered nurses Discrimination – Registered as a nurse Race and Disability The Crown Solicitor acted for Registered midwives the Nurses and Midwives Board (NMB) and the Health CareComplaints Commission Of these, the following were (HCCC), who were the second practising while not registered and third respondents to proceedings brought by Registered nurses Christine Yee, in the Federal Registered midwives Magistrates Court. Ms Yee's employer had suspended her The Board considers the from clinical duties due to circumstances in each instance concerns about her psychological to decide whether to initiate condition and the case was Issue 10, March 08 12996 NMB Journal March 08 25/2/08 9:36 AM Page 6 referred to the Board for The full details of this matter assessment of her capacity to can be read on the practise as a nurse.
Australasian Legal Information Ms Yee failed to attend for a Institute website at medical assessment and the matter was referred to the HCCC. Ultimately the Nursesand Midwives Tribunal heard Advanced Diploma in the matter and ordered that the nurse's name be removed from The University of New England, the Register of Nurses for a Armidale (UNE) offers an exit 6 period of two years.
pathway from its Bachelor of Ms Yee made a complaint Nursing (BN) course, which will to the Human Rights and Equal qualify students to work as Opportunity Commission enrolled nurses after their first (HREOC) that each of the two years of study, as well as respondents had subjected her registered nurses at the to racial and disability completion of the three-year discrimination. The HREOC degree course.
terminated her complaint and People entering the BN she applied to the Federal course could either complete Magistrates Court under the the three years of study and Human Rights and Equal gain a Bachelor of Nursing Opportunity Commission Act degree and eligibility for 1986, alleging unlawful registered nurse status, or graduate with an Advanced On behalf of the NMB and Diploma in Nursing (and HCCC, it was submitted that enrolled nurse status) after two they are independent statutory years. Diploma graduates authorities and had fulfilled could, when they wished, return their obligations under statute to UNE to upgrade their and Federal Magistrate Raphael diploma to a degree.
accepted this submission, The new program has concluding that Ms Yee had flexible entry as well as exit failed to draw the required points: TAFE-qualified enrolled causal connection between the nurses will be able to go actions of the NMB and HCCC straight in to the second year, and her race and alleged enabling them to gain the BN degree and qualify as His Honour summarily registered nurses after two dismissed the application and years of study.
ordered she pay therespondents' costs.
12996 NMB Journal March 08 25/2/08 9:36 AM Page 7 Refusals of Registration Nurses and Midwives Board In the period July to December 2007, five (5) applications for The Nurses and Midwives registration as a nurse were Board is listed in Schedule 2 refused from persons who had to the Public Finance and Audit qualifications in nursing from Act 1983 and is a statutory universities in New South body within the meaning of the Annual Reports (Statutory In one of those instances, it Bodies) Act 1984. was identified that an applicant Each year the annual report had been granted two years is tabled in the New South academic credit towards a Wales State Parliament and Bachelor of Nursing degree for distributed to the NSW prior nursing studies completed Department of Health, at secondary school level in another country. education institutions and Two applicants were persons nursing organisations. It is who, although holding nursing also available on the Board's qualifications from Australian universities in addition tointernational qualifications,had been referred to undertakethe competence assessmentprogram at the College ofNursing and both were unableto demonstrate safe practice in that assessment. One applicant held a nursing degree from a university in thisState in addition to internationalqualifications and the applicationwas refused because of theapplicant's inability todemonstrate English languageskills adequate for nursingpractice.
Issue 10, March 08 12996 NMB Journal March 08 25/2/08 9:36 AM Page 8 Nurses and Midwives Board
The Nurses and Midwives Board (NMB) held a MidwiferyForum at Darling Harbour in October 2007. Over 50participants attended the day with representation from theNSW Department of Health, university faculties, professionalmidwifery organisations, authorised midwife practitioners andmembers of the NMB and the Midwives Practice Committee.
The objectives of the forum were to inform and seek comment from the stakeholders about the draft Guidelines forCurricula Leading to Registration as a Midwife in NSW and toclarify the scope of practice of midwife practitioners andidentify criteria and standards for midwife practitionerauthorisation. The morning session was discussion and group work by the participants regarding the curriculum, the implications andchallenges for education providers, students, service providersand consumers. The afternoon session focused on the area ofmidwife practitioners, their scope of practice and critical issuesrelated to the authorisation of midwife practitioners.
The proposed changes to the guidelines for midwifery courses are being reviewed and refined further, with benefit offeedback from the forum participants. The Board sought broad consultation regarding the scope of practice of midwife practitioners to clarify the objectives foreducation and criteria for assessment of midwife practitioners.
Four presentations were made prior to group discussion and these were given by: Caroline Homer, President of the NSW Midwives' Association Liz Harford, Principal Advisor, Nurse Practitioner Project,NSW Department of Health Rosalie Nunn, authorised midwife practitioner Anne Fry, NMB Professional Officer
12996 NMB Journal March 08 25/2/08 9:37 AM Page 9 Issue 10, March 08 12996 NMB Journal March 08 25/2/08 9:37 AM Page 10 Nurses and Midwives
The primary function of the professional conduct within Nurses and Midwives the meaning of section 4 of Tribunal is to protect the public. Other matters to be • Complaint Two was that he considered are the maintaining was guilty of professional of discipline within the misconduct within the profession and maintaining of meaning of section 4 of the public confidence in the • Complaint Three was that Whilst it is an established he was not of good principle of law that the Tribunal should impose the • Complaint Four was that least possible restrictive orders he had been convicted of the circumstances warrant, the protection of the public is circumstances of which paramount and outweighs the render the nurse unfit in onerous burdens that orders the public interest to may place upon a nurse or practise nursing.
The particulars of the first Described below are two three complaints related to cases that have been before possession of child the Nurses and Midwives pornography and the Tribunal in the past 12 particulars of Complaint Four were that the nurse wasconvicted of one count of Case 1 – Possession of
possession of child pornography under section The Nurses and Midwives 578B(2) of the Crimes Act Tribunal conducted an inquiry 1900, being 188 images of into complaints made in females apparently under the accordance with section 44(1) age of 16 years.
of the Nurses and MidwivesAct 1991 in relation to an enrolled nurse.
The nurse was employed as an There were four complaints enrolled nurse from 1975 to against the nurse: 2005. In 2004, acting on • Complaint One was that he information that the nurse was guilty of unsatisfactory may have accessed internet 12996 NMB Journal March 08 25/2/08 9:37 AM Page 11 sites containing images of term of three months, and child pornography, police placed on a bond for 12 made a search of the nurse's months, the conditions of which home and located a number of included supervision by the items of computer equipment Probation and Parole Service.
including a personal computer,extra hard drive and numerous CDs and floppy discs.
Following referral of thematter to the Nurses and Midwives Board and, in turn, In statements given to the the Health Care Complaints police, the nurse admitted to Commission (HCCC), a notice accessing websites but of complaint was sent to the maintained a belief that the nurse in accordance with persons depicted were females section 28 of the Health Care between 18 and 30 years.
Complaints Act 1993 (NSW).
In 2005 a qualified officer In his written response the of the NSW Police forensically nurse described his shame and examined the computer hard humiliation and admitted that drives, CDs and floppy discs he had accessed the sites in seized from the nurse's home.
question. In a subsequent During the examination the letter to the Health Care officer located 2386 Complaints Commission, he pornographic images on one advised that he would not be of the CDs, approximately contesting the matter and half of which depicted children who appeared to be that it would be appropriate under 16 years of age.
for his name to be removed The nurse participated in a from the Roll of Nurses.
further interview with police The Tribunal was satisfied and was shown four of the that the nurse's conduct was seized images that he agreed of a sufficiently immoral, were pornographic and that outrageous and disgraceful they depicted young girls. He character to make the admitted to downloading the determination that he does not possess the requisite The nurse pleaded guilty in knowledge or judgement court to possessing child expected of him as a nurse.
pornography, an offence The Tribunal was satisfied against section 578B(2) of the that the nurse's conduct Crimes Act 1900 (NSW). He constituted professional was convicted, given a suspended sentence for ninemonths with an additional Issue 10, March 08 12996 NMB Journal March 08 25/2/08 9:37 AM Page 12 Nurses and Midwives Tribunal Cases As a further consequence of Case 2 – Theft and
the nurse's conviction he became a ‘prohibited person' In August 2007 the Nurses under the Child Protection and Midwives Tribunal (Prohibited Employment) Act conducted an Inquiry into 1998. Under that classification complaints against a registered there are statutory nurse. The four complaints set impediments to his out by the Health Care undertaking "child related Complaints Commission employment" which may (HCCC) alleged that the nurse: impact upon his ability to 1. Was guilty of unsatisfactory work. Also as a result of his professional conduct within conviction the nurse was the meaning of section 4(2) required to register as a sex of the Nurses and offender pursuant to the Child Midwives Act 1991 2. Was guilty of professional Registration) Act 2000.
misconduct within themeaning of section 4(1) The Tribunal, taking all the 3. Has demonstrated by her evidence into account, found conduct that she is not of that the nurse was guilty of professional misconduct; that 4. Suffers from an impairment the nurse was not of good within the meaning of character and that the nurse section 4A of the Act.
had been guilty of a seriousoffence, which had been Particulars of
particularised and which Complaints One and Two
offence renders the nurse unfit 1. On or about August 2004, in the public interest to whilst employed as a nurse practise nursing.
at a private hospital, the The Tribunal ordered that nurse stole a credit card the nurse's name be removed from the Roll of Nurses in 2. On or about August 2004, New South Wales for a period the nurse attempted to of two years. It was further purchase a quantity of ordered that following this alcohol using the credit period the nurse may make card that had been stolen.
application to restore hisname to the Roll and that Particulars of
such application is considered under s.68 of the Nurses and 1. On or about August 2004, Midwives Act 1991, by a whilst employed as a nurse newly constituted inquiry.
at a private hospital, the 12996 NMB Journal March 08 25/2/08 9:37 AM Page 13 nurse stole a credit card drug overdose and migraine headaches. In November 1996 2. On or about August 2004, she was found to have the nurse attempted to committed larceny but dealt purchase a quantity of with under s.556A of the alcohol using the credit Crimes Act 1900 with no card that had been stolen 3. The nurse had been She undertook a Bachelor charged with a number of of Nursing degree between criminal offences between 1996 and 1998 and was first 2000 and 2007 and these registered as a nurse in included several counts of January 1999. The nurse shoplifting, obtaining goods declared the larceny offence to by deception, having goods the Board on her application suspected of being stolen, for registration and the matter offensive language and went to the Board's Conduct driving under the influence.
Committee, which deemed These convictions were that as no conviction was heard in local Sydney courts, recorded, her application for however a number of the registration could proceed.
charges were dismissed under She was employed as a s.32 of the Mental Health registered nurse at a large (Criminal Procedure) Act 1990.
private hospital from February1999 to May 2002. Between Particulars of
September 2002 and May 2003 she was employed with The nurse suffers from mental a nursing agency and in May conditions or disorders, 2003 began working on a namely, a mental illness, casual basis at a private which detrimentally affects hospital. In July 2004 the or is likely to detrimentally nurse's employment at the affect her mental capacity to private hospital was changed practise nursing.
to a permanent part-time basis. In September 2004 the The nurse is said to have nurse was given a written suffered a number of medical warning by the Deputy CEO conditions including spina of the hospital concerning her bifida occulta, childhood "unsatisfactory job dyslexia, adolescent anorexia performance related to nervosa, severe glandular fever professional behaviour" in and viral encephalitis, head particular her manner of injuries from assaults, speaking to patients.
epileptic seizures following Issue 10, March 08 12996 NMB Journal March 08 25/2/08 9:37 AM Page 14 Nurses and Midwives Tribunal Cases On 9 November 2004 the Over a period of time Deputy CEO wrote to the dating from 2000 to 2006 the nurse again stating that the nurse had admissions to at "issue of professional least five health facilities with behaviour" had not been a range of diagnoses including addressed despite the major depressive disorder, implementation of an poly drug abuse, overdose, education plan in mid- severe personality disorder September. The nurse was and postnatal depression required to attend a meeting following the neonatal death on 15 November to discuss of her second child.
her "inappropriate andunprofessional communication with other staff" and "failure Because of the nature and to respond to directions from extent of evidence in this case Nursing Unit Managers". She concerning psychiatric and/or was issued with a formal physical illness or conditions warning on 17 November in suffered by the respondent relation to "unsatisfactory nurse, the Tribunal considered attitude" and behaviour in it appropriate to deal first relation to her "unprofessional with Complaint Four relating and inappropriate to impairment.
communication to other staff".
The Tribunal noted that On 15 December 2004 the many, if not all of the Deputy CEO wrote to the references to possible organic nurse noting that she had told causes of brain damage and her Nursing Unit Manager on many other references to a 9 December that she was variety of medical conditions resigning from her position said to form part of the and that she failed to report nurse's history apparently rely for duty on 13 and 14 upon her own account. The December. On 21 December main exceptions to this are in 2004, after receiving no the discharge summaries from response from the letter sent the hospitals to which the to the nurse, the hospital nurse had been previously terminated her employment.
admitted and the report from From October 2005 the the neuropsychologist who nurse was employed casually sighted ‘various CT and MRI at a private hospital but once brain scans' and conducted again following a performance her own testing.
review conducted in February The Tribunal noted that it 2006 and a further review in was of particular concern that March, her employment was the history given by the nurse terminated in June 2006.
of her periods of hospital 12996 NMB Journal March 08 25/2/08 9:37 AM Page 15 treatment included substance been appropriate for the abuse including the Tribunal to make a finding in intravenous use of heroin and relation to the relationship of cocaine. Indeed, the Tribunal the conduct complained of to noted that on one of the professional standards. admission in 2004, In the absence of clarity as approximately three weeks to the appropriate diagnosis after the events which form or diagnoses in this case, it the subject of Complaints One was not possible for the and Two, the nurse was Tribunal to be comfortably recorded as having made satisfied that the nurse was occasional use of heroin affected by a "dissociative during those three weeks. On episode" or some other a subsequent admission the impairment of her functioning following year she is recorded at the time of the acts, which as having used heroin form the basis of Complaints sporadically since adolescence One and Two. Because of the and daily between September lack of clarity, and the lack of 2004 and December of that peer review evidence the Tribunal found that it could Taking the evidence of the not be comfortably satisfied medical history of the nurse as that Complaints One and Two a whole, the Tribunal was could be made out.
comfortably satisfied that The Tribunal was not whatever the nature of the comfortably satisfied that condition or conditions from Complaint Three had been which she suffers, it was clear made out despite the long and that these have had a ongoing history of detrimental effect on her involvement with the police.
nursing practice and are likely The ongoing nature of the to continue to do so until nurse's forensic history is adequately assessed and treated.
nevertheless relevant to the The Tribunal did not accept Tribunal's findings as to the the submission on behalf of appropriate sanctions. In the HCCC that a finding of particular, the Tribunal notes mental impairment prevents that there is no evidence the tribunal from making before it that the nurse has findings of unsatisfactory insight into the nature of professional conduct or her problems. Nor is there professional misconduct. In evidence of any contrition this case no peer review had on her part.
been presented and on thisbasis alone it would not have Issue 10, March 08 12996 NMB Journal March 08 25/2/08 9:37 AM Page 16 Nurses and Midwives Tribunal Cases The Tribunal noted the importance, particularly in the The Tribunal was satisfied context of this forensic that the conditions as history, of the role of the proposed are appropriate, Tribunal in the protection of the public and the reputation 1. The Respondent not be of the nursing profession. The permitted to apply to have Tribunal gave careful her name restored to the consideration to the extent of Register of nurses for a its powers under section 64 of period of two years from the Act given that the nurse the date of the orders has ceased to be a registered 2. If the Respondent applies nurse by reason of a to the Board to have her cancellation of her registration name restored to the in April 2007 in accordance Register, the following with section 33 of the Act.
condition is to be imposed Section 33(3) allows the on her registration Board to cancel the pursuant to section registration of a nurse for failure to pay the annual a. The Respondent is not to practising fee. Even though be permitted to practice the deregistration in this case nursing until she has is one brought about by an been assessed by a Board administrative procedure at appointed neurosurgeon the Board level under section or neurologist and by a 33 of the Act, the Tribunal accepts that at the present neuropsychiatrist and time, the nurse can not be then a Board appointed described as a person who is registered in the relevant 3. The Tribunal also sense. Therefore the Tribunal recommends the Nurses accepts that its powers are and Midwives Board only to limit the re-registration consider imposing of the nurse in accordance conditions on any re- with section 64(1)(b), (d), (e) registration of the nurse or (f) of the Act.
based on its considerationof the reports from theabove specialists.
12996 NMB Journal March 08 25/2/08 9:37 AM Page 17 Comment Regarding
By the time this matter was
heard by the Tribunal, the
Board had cancelled the
nurse's registration due to her
failure to pay the annual
practising fee. It was still
advantageous for a Tribunal
decision to be made with
regard to this nurse, in the
event that she may apply for
registration in another Stateor Territory of Australia.
Pursuant to section 70 of theAct, the Board is authorisedto inform any body which,under the law of another Stateor a Territory, is responsiblefor the registration, enrolmentor authorisation to practise ofnurses or midwives, of adetermination of the Tribunalunder section 64. If in the future the nurse wishes to apply to have hername restored to the Register,the Board may utilise theSchedule 1B inquiry processto consider whether she iscompetent to practise nursing.
Issue 10, March 08 12996 NMB Journal March 08 25/2/08 9:37 AM Page 18 Prosecution of Persons
Falsely Claiming to be
Registered or Enrolled
One of the ways in which the undertake risk profiles with Nurses and Midwives Board respect to nominated medical works to protect the public is conditions, requiring an through the prosecution of understanding of the manner persons who are falsely in which medical conditions claiming to be registered or impact upon each other.
enrolled nurses or registered When the person applied for employment early in 2007,his resume claimed status as a registered nurse, having The Board received a completed a nursing degree notification in regard to a and been employed as a person, Trent Edward Tame, clinical nurse specialist at a who had been employed by a major Sydney referral hospital travel insurance company on for a period of eight years. the basis of being a registerednurse.
On the basis of his written
application and assertion to The travel insurance company, being a registered nurse, the through an employment person was interviewed by the agency, had advertised for an employment agency. During the interview the person Nurse' and an essential confirmed he was a registered requirement of the position nurse and stated he had also was that the applicant had a worked as an ‘acting nurse minimum of three years' unit manager'. As a result he experience as a registered was short-listed for the nurse, and recent hospital experience. The travelinsurance company only employed registered nurses as The medical underwriting ‘underwriters' because the manager of the travel nurse is required to use insurance company then healthcare knowledge to interviewed the person, during 12996 NMB Journal March 08 25/2/08 9:37 AM Page 19 which time the he made oral the second and third representations regarding his offences, the defendant is background and experience as required to complete a registered nurse. Based on community service for 50 his performance and qualifications he was (iii) the defendant is considered suitable for ordered to pay professional employment and commenced costs in the sum of $500 work with the company in with 28 days to pay." February 2007 and wasterminated in May 2007. On searching the Roll and In June 2007 the HumanResource Manager of Hunter Register there is no listing ofthis name as being either Integrated Care Inc (HICI) registered or enrolled in NSW. contacted the Nurses and The Board referred the Midwives Board in relation to matter to the Crown an employee, Donald Luigi Solicitor's Office, which Thorn, who had led his organised for an investigation employer to believe he was a of the alleged incident and the registered nurse throughout NSW Police Force Liaison his employment from 2002 Officer attached to the Crown until 2007. Mr Thorn had Solicitors Officer undertook been employed by the that investigation. organisation as a Team The Crown Solicitor's Office advised that the matter The Aged and Disability was listed before Magistrate Services Manager had, during Freund on 20 August 2007.
the course of a routine check The following Orders were of the Nurses and Midwives Board website, discovered "(i) in relation to the first there was no listing for a offence, the defendant is person named Donald Thorn.
convicted and is ordered to A check of the registration enter into a bond under s.9 number provided by him in of the Crimes (Sentencing fact referred to the Procedure) Act 1999 for 18 registration in respect of months…accept the another registered nurse. The supervision of the Manager then brought these Probation and Parole discrepancies to the attention Service and any counselling of management and telephone that Service requires that he inquiries were made to the Nurses and Midwives Board (ii) in relation to each of in an endeavour to clear upthe matter.
Issue 10, March 08 12996 NMB Journal March 08 25/2/08 9:37 AM Page 20 Prosecution of Persons Falsely Claiming to be Registered or Enrolled Nurses The registration documents Magistrate Bartley noted tendered to HICI by Donald that this was a serious offence, Thorn were then forwarded to and persons holding the Board. It was evident that themselves out pose a the documents were altered potential threat to the health and there were a number of of patients. General deterrence discrepancies in the is of considerable importance.
documents to substantiate On the other hand, this case such belief. The Board was at the lower end of the advised HICI of their concerns spectrum as there was no as well as referring the matter holding out in a clinical to the Investigations and context and Mr Thorn was of Inspections Unit of the Health generally good character and entered an early plea of guilty.
Boards for investigation. His Honour imposed a fine of When HICI was apprised $1000, court costs of $70 and of the situation the Chief professional costs of $500.
Executive Officer wrote to Mr Thorn notifying him thathe was suspended fromfurther duties and that theregistration documentationprovided by him appeared tobe invalid. On the 26 June MrThorn tendered his resignationfrom the organisation.
A Court Attendance Notice charging Donald Thorn with abreach of s.5(1)(b) of theNurses and Midwives Act1991 was filed at theDowning Centre Local Courtin Sydney. The matter waslisted for the entry of a guiltyplea on 14 December 2007before Magistrate Bartley. 12996 NMB Journal March 08 25/2/08 9:37 AM Page 21 Schedule 1B Inquiries
Schedule 1B to the Nurses and Midwives Act 1991 provides aprocess for inquiries to be held regarding an application forregistration or enrolment. An inquiry may include considerationof the applicant's competence to practise nursing or midwifery.
appointment with a Board- Mr A was previously approved psychiatrist who registered as a nurse. In 2003 provided a report for the a complaint was made to the Board that Mr A had stolen In relation to good character Schedule 8 medications from the inquiry considered Mr A's his employer.
The complaint was referred • theft of Schedule 8 to the Health Care medications from his Complaints Commission (HCCC) for investigation. In • past heroin use the interim, Mr A's • injecting heroin whilst at registration was cancelled for work in 2003; and non-payment of the annual • fabrication of a story about practising fee and Mr A a dying friend to hide his advised the Board that he no illicit drug use.
longer wished to practise. As Mr A reported to the Mr A was no longer registered as a nurse, it was considered and the inquiry that he had that no further action was not used any substances since required, at that stage, to protect the public.
In relation to physical and In 2006 Mr A applied for mental capacity the HCCC his name to be restored to the investigation (2004) had Register of Nurses. In view of found that Mr A suffered the previous unresolved issue, from chronic low-grade the Board decided not to grant depression or dysthymia, restoration but to treat this as which developed into major an application for registration and convene an inquiry into The Board-approved his eligibility for registration psychiatrist reported that Mr and competence to practise as A had put in place a number of safeguards and appeared to Prior to the inquiry Mr A have a great deal of insight was required to attend an into his substance misuse Issue 10, March 08 12996 NMB Journal March 08 25/2/08 9:37 AM Page 22 Schedule 1B Inquiries issues and regarded him as boundaries by selling goods to being at relatively low risk of her clients and was involved relapse and saw no in the theft / fraud of money contraindication to Mr A and goods from her returning to a nursing role.
workplace and other places The inquiry members, as an outside of work. The alternative to refusing complaints were referred to registration, decided to the HCCC for investigation.
register the applicant subject Ms B's registration as a to the conditions including: to nurse was cancelled for non- abstain from using illicit payment of the practising fee substances; not to self- which had been due shortly administer any S4D and S8D after the receipt of the drugs or narcotic derivatives; to attend for twice weekly During 2006 the Board urinalysis; to establish a received notification from her therapeutic relationship with a employer that Ms B had been general practitioner, of his working as a registered nurse choice, at a frequency to be whilst unregistered and had determined by the been asked not to return to practitioner; to continue a work until she was returned therapeutic relationship with to the Register. Soon after his counsellor, at a frequency this notification Ms B made to be determined by the an application to the Board practitioner; to advise his for restoration of her employer (and/or supervisor) registration as a nurse in New of the conditions placed on his South Wales. The Board registration as a registered refused her application for nurse; to adhere to any restoration of registration as a restrictions imposed by the nurse and decided to treat her Pharmaceutical Services application as an application Branch following the for registration as a nurse.
withdrawal of his drug The HCCC investigation authority; and to attend for report, received late 2006, review by the Board nominated indicated that Ms B: psychiatrist in six months.
• although not observing and maintaining appropriate Applicant 2
Ms B had previously been a professional boundaries in registered nurse. In 2005 a her dealings with clients, number of complaints were did not personally gain made to the Board that she from any transactions and had ‘overstepped' her her actions were primarily therapeutic and professional supportive of her clients; 12996 NMB Journal March 08 25/2/08 9:37 AM Page 23 • although convicted on were at the root of the 63 counts of fraudulently misappropriating money, • her current mental capacity this was not viewed as demonstrated sufficient rendering Ms B unfit to resilience and robustness to practise as a registered be sure that she would cope with the challenges of • had held herself out as a clinical practice registered nurse whilst • she has sufficient unregistered for a period knowledge and skills in of seven month in early – relation to her ability to manage her professional After consultation with the boundaries for future HCCC and considering advice from the Crown Solicitors • she has demonstrated that Office, the Board resolved not she is able to hold a to prosecute Ms B for position of trust since "holding out" as a registered refusal of restoration to nurse whilst unregistered but the Register.
to convene a Schedule 1B The inquiry advised Ms B inquiry to consider her that possible strategies to application for registration as address the concerns of the inquiry would include Ms B attended the inquiry, psychotherapy to assist her to which was held during 2007 gain greater insight into the and gave evidence about the nature and seriousness of the complaints, her mental health convictions and allegations and social and marital against her; a demonstrated ability to hold down a job and Following hearing of the grow a position of trust and evidence and discussion the some ability to maintain a inquiry members were not level of currency in patient • the criterion of good Her application for character could be met.
registration as a nurse was This was due to the fact that there were significant It is noted that there is no anomalies in her verbal and statutory impediment on Ms B written evidence in relation re-applying for registration as to the allegations against a nurse. The inquiry suggested her and no evidence to to Ms B that she would be demonstrate to the inquiry free to re-apply at any time that she had taken steps to but it might be wiser to re- address any problems that apply after a period of six to Issue 10, March 08 12996 NMB Journal March 08 25/2/08 9:37 AM Page 24 Schedule 1B Inquiries 12 months has elapsed so that Ms C was ‘holding out' as an she is able to address some of enrolled nurse during the the issues of concern brought Enrolled Nurse Refresher to her attention by the course undertaken.
members of the inquiry. Ms C attended the inquiry If she elects to re-apply for and gave evidence about her registration as a nurse the previous experience as an application would be treated enrolled nurse in 1971-1972, as a new application.
her employment history since However, the inquiry expects that time, her experience of that Ms B would be required, the Enrolled Nurse Refresher at that time, to address Course and intentions for her identified issues of concern.
return to nursing practice.
In summary the inquiry Applicant 3
was of the opinion that During 2007 Ms C applied to although Ms C appeared to the Board for restoration of have insight into the changes her enrolment as a nurse in in nursing practice and her New South Wales.
motivation to return to Ms C completed her practice and commitment to nursing education nursing were well expressed approximately 36 years ago in and well intentioned, it was 1971. Her enrolment had not satisfied that: been cancelled in December • the refresher course for 1972 for non-payment of the enrolled nurses is adequate annual practising fee and she in the circumstance of an had not worked as an enrolled application with an initial nurse in 35 years.
qualification of a nurses In support of her aide (1971) and little post- application Ms C submitted enrolment clinical evidence of completing the Enrolled Nurse Refresher • the clinical and theoretical Course at TAFE NSW for assessment within this which a course entry refresher course would requirement was current provide sufficient assurance enrolment as a nurse with a to the Board that the safety of the public would be The inquiry was convened protected if Ms C were to to consider Ms C's application for enrolment. The main • Ms C has a sufficient level issues for the inquiry were of knowledge and skill to whether Ms C had the protect the public safety.
knowledge and skill topractise nursing; and whether 12996 NMB Journal March 08 25/2/08 9:37 AM Page 25 As an alternative to refusing Since early 2006 Ms D has enrolment the inquiry decided been employed as an assistant that Ms C may be granted in nursing at a local facility enrolment subject to satisfactory involving both clinical care completion of a Board approved and case coordination for 25 Competence Assessment clients in the community. She Program for enrolled nurses, indicated her intention, if such as is currently offered by granted registration, to the College of Nursing.
undertake a refresher courseand a ‘reconnect' program for Applicant 4
re-entry to the workforce.
Ms D applied for restoration Following hearing of the of her registration as a nurse evidence the inquiry and as a midwife in early 2007.
deliberated its decision. The Ms D completed both her inquiry was satisfied that: general nursing course and her • Ms D would be prepared to midwifery course in hospitals undertake the necessary in metropolitan Sydney. Ms D refresher course prior to was initially registered as a general nurse in NSW in • Ms D had demonstrated a October 1980 and was willingness and ability to registered as a midwifery learn new skills related to nurse in NSW in May 1985.
the contemporary workplace Ms D indicated that her last • Ms D appeared to have employment as a registered insight into the changes in nurse occurred in 1988 and nursing / midwifery that she last practised as a practice since her previous midwife in 1987.
employment as a registered The inquiry was convened to consider Ms D's • Ms D understood the need applications. Ms D attended for on-going study and the inquiry and advised that professional development although she had not and knowledge of current practised as a nurse / midwife, standards and the she had undertaken a course professional and legal in lactation counselling frameworks for practice through the Nursing Mothers • Ms D appeared to have an Association in 1996. Ms D awareness of her own also stated that she ran the ability to cope with stress local Nursing Mothers group and the demands of the for a period of five years and provided telephone lactation-counselling services over aperiod of two years.
Issue 10, March 08 12996 NMB Journal March 08 25/2/08 9:37 AM Page 26 Schedule 1B Inquiries As an alternative to refusing Standards for the registration as a nurse the Registered Nurse. The inquiry decided to grant report must be supplied by registration as a nurse subject Ms D to the Board: to a number of conditions. In i) within 3 months of first summary these are that Ms D: a) must undertake the Refresher Program for ii) at the time of Registered Nurses at a particular identified major employment (if less than Sydney hospital or the three (3) months).
College of Nursing and In relation to registration as a provide the Board with a midwife the inquiry refused report as soon as possible her registration. This does not following completion of the preclude Ms D from applying program which indicates for registration as a midwife the outcome of the at a later date. The inquiry program and details of Ms suggested to Ms D that she D's practice as rated against wait at least 12 months from the ANMC Competency commencing employment as a Standards for the registered nurse before making Registered Nurse (2006) such an application to allow b) until the subsequent her to consolidate her return condition is concluded Ms to nursing practice.
D be employed only in apublic hospital serving as areferral hospital which willallow exposure to a widerange of services includingan emergency departmentand acute medical / surgicalservices c) may practise in nursing only if a nominated nursemanager provides adetailed written reportregarding Ms D'scompetence and safety inpractice as a registerednurse. The detailed reportmust address each of theANMC Competency 12996 NMB Journal March 08 25/2/08 9:37 AM Page 27 Research and Development
12th International Symposium in Paediatric
The 12th International basic by any means), quality Symposium in Paediatric of life in children with brain Neuro-Oncology (ISPNO), tumours, nursing and which is held every two years, multidisciplinary care, was held in Nara Japan from epidemiology and specific 6th to 9th June 2006. It is the tumour groups, including past largest meeting of its kind and novel therapies.
where professionals from alldisciplines within paediatric Significant Conference Papers
neuro-oncology can come All the themes of the together to showcase and symposium were of particular discuss their research and, significance. Those I found to in a united forum, share their be particularly salient hopes and dreams for the explored in depth the quality of life issues in children with There were over 500 brain tumours as well as delegates from nursing, allied overall survival and the health, paediatric oncology, nursing and multidisciplinary radiation oncology, care needs of brain tumour neurosurgery and other patients. The several key note medical specialities, scientists lectures that addressed the and pathologists dedicated to advances that have been made the field of paediatric neuro- towards our understanding of oncology and representing the genetics of brain tumours, many countries.
and finally, the importance of Over the four days there good clinical research in were a total of 109 oral neuro-oncology were also presentations, five lunchtime seminars and 156 poster The chairman of the presentations. Throughout the Paediatric Brain Tumour symposium there was an Foundation (PBTF), a leading excellent and diverse array of charity in the USA, spoke at presentations addressing the length about the needs of this ‘basic science' of paediatric patient group and outlined brain tumours (although not two key members of the Issue 10, March 08 12996 NMB Journal March 08 25/2/08 9:37 AM Page 28 Research and Development Scholarship Reports multidisciplinary team – the A leading paediatric paediatric oncology nurse and oncology consultant from the the social worker, and their UK presented on the roles. It was recognised that controversies and challenges children with brain tumours of brain tumours in very need nurses with a higher level young children, especially of cancer specific knowledge those with aggressive types of and clinical expertise, which tumours. His paper and others goes beyond that of a basic reviewed the cooperative trials nursing program. It highlighted that have been done in the how fundamental this is for past and outlined factors which delivering quality care in contribute to poor survival or paediatric neuro-oncology and survival with a decreased IQ how it lasts longer than the and a poorer quality of life. period(s) of being in hospital.
It was very clear that Moving personal accounts throughout the world there's were given by a survivor and an increasing need to know a parent of a child with a brain more about tumour biology tumour. In particular they and researchers at some described the difficulties they institutions are looking at the faced in daily life and how genetics of brain tumours.
they were overcoming them.
Nurses are in a prime position An international multisite to assist with conducting study reported the findings of clinical research, as they are a project titled ‘Quality a constant at the patient Family Life for Children with bedside, clinics and other Brain Tumours'. The departments, constantly researchers found that translating the medical children who underwent language to patients, radiotherapy and those that recording events and were off treatment and lived following through with further away were reporting medical orders.
more school difficulties andappeared to report more Relevance of the Conference to
emotional support needs.
Nursing in New South Wales
Their findings indicated that All the themes of the quality of life and support Symposium were of particular needs appear to be influenced significance to me in my role by the child's treatment phase as a clinical nurse consultant and the type. Therefore, and care coordinator in resource allocation and paediatric neuro-oncology and interventions should be taking my special interest in clinical these factors into account.
12996 NMB Journal March 08 25/2/08 9:37 AM Page 29 The ISPNO was especially Ideas, strategies, procedures
relevant to nurses who which could be introduced in
regularly care for children New South Wales
with brain tumours, It is important to recognise particularly nurses in New that paediatric neuro- South Wales tertiary referral oncology isn't just about one hospitals since the majority of discipline - it's a collection of patients are predominantly many to provide holistic managed within one of these optimum care, may enhance hospitals. However, as shared the quality of care.
care for paediatric oncology New South Wales might patients with rural and consider undertaking a needs regional hospitals increases, analysis of all its neuro- children with brain tumours oncology patients, irrespective will regularly access their local of the treatment modalities hospital and / or community used. This would be nursing services for assistance particularly important as we to meet their healthcare needs.
study the longer-term effects Unfortunately I was the only of childhood brain tumours.
nurse in attendance fromAustralia and one of Benefits of informal
approximately 20 specialist interchanges with other
participants at the conference
nurses from around the world. I found the Symposium Since returning from the promoted and provided Symposium I have been able superb opportunities for to disseminate up-to-date interaction and exchange of information on childhood information. The informality brain tumours, during several of the poster display allowed study days pertaining to me the opportunity to talk paediatric oncology nursing.
with several authors about These were attended by nurses their research into quality of from my institution and life (QoL) and the key factors tertiary referral hospitals and in getting their projects off the it gave them the opportunity ground. This gave me the to increase their understanding impetus to consider putting of paediatric neuro-oncology, forward a QoL and outcomes the salient points in research proposal at my multidisciplinary care, hear institution following the about what is happening on implementation of the brain an international level and tumour program at my hospital.
importantly, how they can From this meeting I have translate this knowledge to made several new contacts the bedside to help deliver with specialist nurses from the quality care in their areas.
Issue 10, March 08 12996 NMB Journal March 08 25/2/08 9:37 AM Page 30 Research and Development Scholarship Reports UK and the USA and they Evaluation of the experiences
shared how they have been derived from the Conference
able to manage their outcomes It was a humbling experience clinic. The meeting also gave to be amongst eminent me the opportunity to meet international experts and get to know, on a personal and professional clinicians and allied health level, the clinicians from whom professionals) in paediatric my department seeks second neuro-oncology. It was opinions and with whom we reassuring to hear many work collaboratively in delegates speaking of similar clinical trials. experiences regarding patients' It was an ideal time to raise needs and the complexities of queries relating to complex neuro-oncology at their protocols and discuss institution. It made me suggestions regarding the recognise that my unit is timing of specimen collection delivering optimum care and and chemotherapy so that it is is aspiring, through national consumer friendly. I was able and international research and to establish definite time collaboration, to be amongst points for the collection of the leading facilities for specimens for research and children with brain tumours.
confirmed that we were During the Symposium I correctly interpreting the made a conscious effort to protocol. This was then observe the way papers were communicated to the clinical presented and the different research personnel at my styles that were used.
institution. It was reassuring Observing and hearing how to hear that some challenges presenters got their message are universal and that my across has encouraged me to department's approaches are further develop my own style consistent with best practice.
and skills in presenting.
Assessment of whether
the objectives of attendance
I had anticipated that the
conference would give me an
opportunity to increase
specific knowledge, skills and
understanding of cancer
related issues and gain
12996 NMB Journal March 08 25/2/08 9:37 AM Page 31 exposure to new research and Dissemination of the
new approaches to care. On information and experience
reflection I believe I achieved gained at the conference
what I had set out to do by I have been able to present at attending the Symposium.
several journal clubs I believe I am now aware of throughout my hospital, and what is current best practice also at the College of Nursing.
in nursing and this in turn has I have also made more time helped me provide better for bedside teaching guidance for the nursing and addressing each patient's allied health needs for this different needs. patient group at Sydney Specific departments with Children's Hospital and Sydney Children's Hospital beyond. I have refined the are in the process of patient algorithm for the organising their introductory referral of patients to the programs to paediatric brain tumour rehabilitation neurosciences, oncology and program. It not only paediatric nursing. It is encompasses the newly anticipated that I will be diagnosed, but now there is providing several talks on also an option for surveillance paediatric neuro-oncology and assessments and for reviewing the implications for nursing the needs of long term and allied health management.
Previously this group may Elizabeth Bland have had their needs neglected Clinical Nurse Consultant because of the lack of services, Care Coordinator but now they can be assured that they will have access to Sydney Children's Hospital help as the need arises, and atanytime or point in their Elizabeth received a Nurses and Midwives Board Category I feel that my knowledge 4 Scholarship to support her base of paediatric neuro- attendance at this Symposium.
oncology is not only broaderbut much deeper and that Ihave a better understanding ofwhat some of the clinical trialshad attempted to do. I alsofeel I am much more confidentin my ability to criticallyappraise the literature.
Issue 10, March 08 12996 NMB Journal March 08 25/2/08 9:37 AM Page 32 The Australasian Professional Society on
Alcohol and other Drugs (APSAD)
Annual Scientific Conference
The Australasian Professional Society on Alcohol and other Alternative self-help treatment Drugs (APSAD) was held in options such as Self Cairns Queensland from 5th – Management and Recovery 8th November 2006 and is an Training (SMART) groups important information – were very well received, as gathering event in the field of were initiatives for GPs to alcohol and other drugs, both work more with alcohol and in Australia and also other drug patients. Several internationally. Held in a sessions each year are devoted different State of Australia to addressing alcohol and other each year, the conference drug treatment for prisoners, offers a wealth of information indigenous issues, consumer for health care professionals, perspectives, new models of researchers, consumers, care and co-morbidity.
government and non-government organisations, Significant Conference Papers
politicians, corrective services The conference commenced and law enforcement agencies.
with Christopher Pyne MP, Each year international and then Parliamentary Secretary local research in best practice, to the Minister for Health and Ageing, speaking on the illicit drugs trends, workforce public health benefits of development, new treatment options and consumer Dr Frank Vocci, Director perspectives are presented in of the Division of the constantly expanding area Pharmacotherapies and of alcohol and other drugs.
Medical Consequences of Held over three days, the Drug Abuse, American depth of information and the National Institute on Drug many concurrent sessions give Abuse (NIDA) presented on participants many choices pharmacotherapies for depending on their areas of cannabis dependence. Many of the subjects in treatment Topics this year covered trials in the US are young current trends in people who are referred from the court system as an for opiates, cannabis, nicotine alternative to gaol. Hebroached possible approaches 12996 NMB Journal March 08 25/2/08 9:37 AM Page 33 such as cannabinoid agonists and 40 attended. To date as well as the antagonist approximately 25 have started rimonabant. Other interferon and ribavirin possibilities are lithium, treatment, mostly with antidepressants or other drugs excellent responses and to counter withdrawal modest to moderate side effects.
symptoms as well as reduce Of 29 biopsies performed, 24 cravings in dependent subjects.
showed at least moderate Professor Wayne Hall from fibrosis, consistent with recent Brisbane addressed smoking advice to allow treatment to and nicotine dependence proceed without a requirement issues. He discussed the area to do a liver biopsy.
of genetic studies to determine Louisa Degenhardt from susceptibility to dependence to the National Drug and Alcohol nicotine and / or available Research Centre presented treatment. He also looked at "Are we the biggest users of ‘vaccinating' children where ecstasy in the world, and how appropriate risks were high, worried should we be if we yet we were told of major are?" She emphasised the ethical concerns here. While dangers of ecstasy but put parents would always have them in perspective with regard the right (and responsibility) to the large proportion of to choose, he would not young people who use the advise such moves under any drug regularly, often with few foreseeable circumstances. apparent adverse effects and Dr Andrew Byrne and Dr low mortality compared with Richard Hamilton from heroin, cocaine, tobacco and Sydney presented their practice approach using The Australian Injecting community prescribing of and Illicit Drug Users League opioid treatment and a shared (AIVL) advocated allowing a care model with liver clinical bigger input from consumers referrals. They found that into opioid maintenance 75% of injectors from delivery, as is now standard Redfern were Hep C positive practice in other areas of and 75% of those patients health care, urging managers had chronic hepatitis, half of to take heed of the needs of which had high risk factors drug users in treatment and for cirrhosis. Out of 250 involve them in decisions patients seen over a three-year affecting them.
period at the practice, 70 wereat risk, 50 were referred to ahepatitis shared-care service Issue 10, March 08 12996 NMB Journal March 08 25/2/08 9:37 AM Page 34 Research and Development Scholarship Reports A presentation from National Opioid Treatment veteran criminologist and Program Managers (NOTPM) researcher Don Weatherburn Annual General Meeting outlined the alarming figure of (AGM). The meeting was well ‘deaths in custody' despite attended and a panel of enormous efforts and experts from NSW and expenditure. He reminded us Victoria discussed various that the indigenous differences in both community community is over-represented dispensing and in correctional 10 fold or more in the prison system and that almost 50% Lisa Maher spoke about of the crimes involved are the changes regarding alcohol related. He argued hepatitis C sero-conversions that we need to address among injectors recruited alcohol and other drugs more from three city sites including seriously as being causal in outreach services following indigenous detention, given the heroin drought of 2000.
that the significant investments She found dramatic reductions in addressing the broader social (50%) in heroin use and and economic circumstances corresponding increases in had not reduced the harms cocaine use with higher risk associated with indigenous taking behaviours after imprisonment to date.
December 2000. There was a The Self Management and trend to higher rates of Recovery Training (SMART) hepatitis C following the self help group for addicts of change in heroin availability.
all kinds held a workshop todemonstrate this concept, Relevance of the Conference
which originated in the US.
to Nursing / Midwifery in
SMART is based on cognitive New South Wales
behavioural therapy using Nurses are an essential part of peer support and providing the workforce in alcohol and strategies for participants to other drugs, providing use on a daily basis. The focus expertise in both physical and of the groups is on what is mental health, which is happening ‘now' as opposed synonymous with this field.
to looking at their history of addictive behaviour. This type are an integral part of of group is working treatment options that also particularly well for require the expertise of nursing staff.
Following the day two The APSAD conference sessions, I hosted the 2nd provides essential informationand up-to-date research for all 12996 NMB Journal March 08 25/2/08 9:37 AM Page 35 working in the alcohol and based on current findings.
other drug field and therefore Due to the increase in is the most relevant methamphetamine use, it is conference for nurses to essential that models of attend. Topics especially focus care be developed on pharmacotherapy specifically to cater for treatment, working with co- users of this drug morbidity issues, initiatives in the prevention and treatment of HIV and Hepatitis C.
for methamphetamine As a Nursing Unit Manager users, again to address the of an alcohol and other rise in use of these drugs service I encourage nurses to and offer a treatment attend this conference as part alternative for patients not of their professional responding to psychosocial development. Networking is invaluable and my own • Rolling out of SMART professional development has alternative self help groupoption for treatment of Ideas, strategies, procedures
which could be introduced in
• Introducing smoking New South Wales
cessation into alcohol and As always there is much other drug services. Services knowledge to be gained and are now seeing an ageing initiatives to be considered in population of drug and alcohol and other drugs alcohol users, smoking services. Some of the related illness is becoming following initiatives are more evident with this relevant to treatment in NSW, population. Many patients as was most of the presented do not have the resources to use smoking cessation • Encouragement for GPs to aids therefore services need treat patients with alcohol to seek funding to provide and other drug issues by the nicotine replacement providing a comprehensive package outlining financialincentives and also support Assessment of whether the
networks for working with objectives of attendance
this patient group • Setting up a specific Informal interchanges are a program of psychosocial huge part of attendance at the APSAD conference, both on a methamphetamine users daily basis through workshops Issue 10, March 08 12996 NMB Journal March 08 25/2/08 9:37 AM Page 36 Research and Development Scholarship Reports or at structured social events Dissemination of the
run by the conference information and experience
organisers. The highlight for gained at the conference
me was hosting the NOTPM The dissemination of AGM and meeting my information is being achieved counterparts from all over the through the networks in country. This was very which I am involved – NSW encouraging in terms of its OTPMG, the NOTPM AGM, ongoing commitment to bring network meetings throughout managers and coordinators the area and locally from across the country throughout the St Vincent's together for networking and Hospital Alcohol and other Dug Service in Sydney.
The experience is exceptionalin terms of professional Carolyn Stubley development and seeing the Nursing Unit Manager big picture of the alcohol and Alcohol and Drug Service other drug field.
St Vincent's Hospital, Sydney All objectives were met by attendance at this conference, Carolyn received a Nurses and as usual there was so much Midwives Board Category 4 information that it was Scholarship to support her difficult to pick which attendance at this Conference.
presentations to attendwithout feeling you weremissing out on other valuableinformation at concurrentworkshops.
12870 NMB Journal March 08 Cover 19/2/08 5:03 PM Page 4 COPYRIGHT NOTICE State of New South Wales (Nurses and Midwives Board) 2008 You may copy, distribute, display, download and otherwise freely deal with this work for any purpose, provided that youattribute the Nurses and Midwives Board as the owner. However, you must obtain permission if you wish to (i) charge othersfor access to the work (other than at cost), (ii) include the work in advertising or a product for sale, or (iii) modify the work.
12870 NMB Journal March 08 Cover 19/2/08 5:03 PM Page 1 nmb website
You have the ability to search the Registers or Roll to check if a nurse or midwife is currently registered or enrolled; or if there are conditions on registration or enrolment.
MAYO CLINIC HEALTH LETTER VOLUME 27 NUMBER 3 MARCH 2009 Deep vein is only one of the many situations thatmay increase your risk of DVT. Inside this issue People who develop DVT are often predisposed to quicker clotting. HEALTH TIPS . . . . . . . 3 That's often coupled with some cir- Luggage without pain.