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]
Online: www.nmb.nsw.gov.au
ISSN: 1832-4800
12996 NMB Journal March 08 25/2/08 9:36 AM Page 1
From the President
Notice Board
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.
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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
Midwifery Forum
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
Tribunal Cases
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
this Case:
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
Nurses
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.
Offence Two
On the basis of his written
Offence One
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.
Applicant 1
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
Scholarship Reports
12th International Symposium in Paediatric
Neuro-Oncology
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.
trials research.
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
were met
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
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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
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