This will be my last newsletter message as Chair of the NMBA, as I hand over to the new NMBA Chair Adjunct Associate Professor Veronica Casey AM. Veronica is a highly experienced nurse and midwife and I’m certain she will be an excellent Chair.
It has been a pleasure and privilege working with you all to maintain high standards of nursing and midwifery for people in our care across Australia. This year, the Year of the Nurse and the Midwife, has shown more than ever how much our communities need their nurses and midwives. I’d like to thank you all once more for the incredible job you have done during this pandemic.
Please remember to look after your own health and use the free, independent health support service available to you – Nurse and Midwife Support.
With best wishes for the future,
Associate Professor Lynette Cusack, registered nurse and midwife
Chair, Nursing and Midwifery Board of Australia
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Associate Professor Lynette Cusack’s term as the NMBA Chair ended in October after six and a half years in the role. The NMBA and Ahpra thank Professor Cusack for her leadership of the National Board. Here she speaks about her reflections on nursing and midwifery, Ahpra and the NMBA.
What initially drew you to working on the NMBA? What has kept you committed to it?
I had several colleagues involved in regulation and when the Chair role became available on the former Nursing Board of South Australia, I was asked if I would put in an application and I was successful.
I soon realised that while I thought I understood the whole of the nursing and midwifery professions – I had been a member of the union for many years, I was active in a professional association – I didn’t really understand regulation and how that fitted into the professions. I found it to be such an important part of what we do and another way that as a nurse and midwife I could work to keep the public safe. It was in a regulation role that I could contribute, particularly to safeguarding very vulnerable people in the community.
Which achievements of the NMBA have you been most proud of in your time as Chair?
The way that the NMBA is using the data and evidence that we now have available to us to inform our decision-making – we’re making well-informed, evidence-based decisions as a Board.
The huge consultation with the public and the professions that we carried out to update the codes of conduct for nurses and midwives was a big achievement, particularly our work with CATSINaM and the definition of cultural safety for the nursing and midwifery professions.
I’m very proud of the establishment of Nurse and Midwife Support, which is a wonderful initiative of the Board that’s there to support nurses and midwives who in turn look after the public.
I’m also proud of the close collaboration we have had with our Commonwealth and state and territory Chief Nursing and Midwifery Officers. We’ve worked on joint projects that benefit the nursing and midwifery professions as well as the public. An example of that is the registered nurse prescribing project, which is still in development.
We’ve also established strong networks with international regulators who have similar regulatory systems to us, which has allowed us to share knowledge and look towards the future and the impact of globalisation on the professions.
What do you think the biggest challenge that the National Scheme has been over your time as Chair?
I think the biggest challenge has been moving from separate silos of different professions and organisations into seeing ourselves as all being part of a national scheme. In that process, we’ve needed to be open to exploring where we have similarities and can work together, while at the same time managing the differences between the professions. It’s so important for all National Boards and Ahpra to work together with our accreditation partners.
What innovations in healthcare have you seen during the pandemic?
I’ve heard of so many amazing things that nurses and midwives have done that I can’t just identify one innovation. I want to acknowledge that when the challenge of this pandemic was set, it was once again nurses and midwives who rose to the occasion and did what they had to do. Whether that’s what educators have done to continue to deliver programs, or what nurse and midwife leaders have had to do, or those providing direct person- and woman-centred clinical care.
What changes do you see resulting for the future of nursing and midwifery? What changes would you like to see?
Having researched in the area of disaster response, I think that the pandemic has raised people’s awareness in terms of preparedness for something catastrophic and made people aware of the vulnerability of our communities and environment and that we can do more to be prepared.
What do you think the major challenges are for nursing and midwifery as workforces in Australia in the next 10 years?
Nurses and midwives must continue to move and innovate with the bio-psychosocial needs of people, women and the community – to continue to be innovative with how we provide care. We need to use research to stay ahead of those trends so we’re prepared. One challenge will be the integration of new technology initiatives into our practice environment while ensuring they’re in the interest of the public and that they’ll provide person- and woman-centred care – that must always be at the forefront of nurses’ and midwives’ minds.
Another challenge is to continue to effectively partner with Aboriginal and Torres Strait Islander Peoples to improve their health outcomes. In particular, I encourage those who follow after me to actively support and encourage more young Aboriginal and Torres Strait Islander people into our professions.
If you could say one thing to nurses and midwives for the Year of the Nurse and the Midwife, what would it be?
No matter what your context of practice, whether it’s education, policy, management or clinical work, it’s important to continue to maintain the trust the public has in us as nurses and midwives and to do that we must know and use the NMBA’s professional practice framework. These documents support and guide nurses and midwives with the public’s interest at heart.
As nurse and midwife educators and leaders, we need to advocate to ensure that appropriate resources are available in the workplace and education system to enable our nurses and midwives to meet the standards of care that are expected by our community.
Major Lee-Ann Pine started her career as a care worker in Adelaide and after graduating as a registered nurse, worked at Flinders Medical Centre on the neuro-stroke ward before moving into the operating theatre environment. In 2008, Major Pine decided she wanted to do something different and joined the Army Reserves. She spent four years as a reservist before going full-time in the Australian Defence Forces (ADF).
‘I didn’t want to regret not having done it,’ said Major Pine. ‘Worst case scenario was I wouldn’t enjoy it – but I did and I’m still here!’
Image: ADF personnel at a COVID-19 testing site
What did a normal day look like for you pre-pandemic?
Within the ADF you get posted to different areas. When I initially joined fulltime in 2013, I was posted in the Brisbane area performing my peri-op nursing role for the field hospital. I spent five years there before moving to Sydney in 2018 to take on a clinical governance role for the whole brigade.
This year, I moved down to Albury-Wodonga to the Army School of Health – a tri-service training centre. As the Compliance Officer, I’m responsible for all the courses we deliver from the school, as well as the training packages we export out to units. I’m also the Senior Nursing Officer, so I ensure there’s compliance with the ADF nursing officer’s code of conduct. I advocate for, mentor and support nurses and students and provide technical feedback to them.
I still get out and do my clinical time as well – I think that’s really important.
What has your experience of the COVID-19 pandemic response been? What has that looked like for nursing in the ADF?
Initially when COVID-19 first hit in March, I did a lot of training with the staff and students about how to use PPE. I assisted with the development of an online COVID-19 and PPE training course. In late June, the request came through for personnel who could deploy to Melbourne at short notice to help with the crisis. I became part of that team and was initially put in charge of the metro-south Melbourne area, running COVID-19 testing at the Frankston site. As the response requirements changed, I moved into the aged care sector and helped in nursing homes that were in crisis. It was a pretty full-on three months.
What were the most challenging and rewarding parts of those three months?
One of the most challenging things was working with a virus that was not fully understood and was ever evolving. And wearing full PPE for 13 hours a day! Challenging things like during drug rounds; for every room you went into you then had to change your gown and gloves when you came out – everything just took longer.
Victoria’s health system, like most, is complex with many layers so understanding it was a challenge in itself. The most rewarding part was integrating and working within that complex health system – we were there providing support when they needed it the most and it was a collaborative approach.
It was rewarding working to ensure the residents and staff in the aged care facilities were safe. One facility was in crisis after having to stand down 100 per cent of their staff due to COVID-19 positive infections. A whole team, including civilian nurses from around the country as well as ADF nurses, went in to help care for residents. We helped the management by providing direct care to the residents as well as working in clinical lead roles with the civilian clinical leads to implement infection control practices. A really important part of this process was attempting to influence other staff by demonstrating best practice behaviour at all times.
Unfortunately, quite a few residents lost their lives due to COVID-19 while we were there. Making sure that their end of life was the best it could be was so important. It was very sad at times, but we were really making a difference. Many of the residents hadn’t left their rooms since March, so it was important to make them feel less isolated. This was challenging for the residents with new people in full PPE coming to look after them.
How has the pandemic changed people’s perception of nursing?
I think the COVID-19 pandemic has brought nurses to the forefront – even more so as it’s the Year of the Nurse and the Midwife – it’s shown now more than ever how much we are needed. I think the community is seeing the job that nurses and healthcare workers do and that they put themselves and their families at risk to do their job when something like this pandemic comes along. I think people’s perception has also changed about life in general – like how important family and friends are and how quickly your life can change.
How has people’s perception of the role of the ADF changed?
At the COVID-19 testing site, I’ve never had so many people thank us for what we were doing. To me, I was just doing my job and I didn’t think it was special, but they thought it was something really special that we were out there helping them.
Part of the role of the ADF is to help the local community, but we often assist overseas rather than here in Australia. The role the ADF has played in the pandemic response has put us out in the local community more. The community has a better understanding now of what the ADF does and what we’re capable of – there are ADF people working on the borders, in hotel quarantine, in logistic roles – there’s a multitude of ways we’re helping. It’s continued from the bushfires earlier in the year where the ADF helped as well.
What changes have you seen in healthcare and what changes would you like to see?
Infection control has never been so important. I think a lot of funding will go to that, not just in healthcare but in offices, restaurants and beauty salons – all environments will have to think more about infection control as a result of the pandemic.
In aged care facilities, staffing requirements are being reviewed and aged care demographics have changed considerably over the years. People are living longer and have more co-morbidities. Aged care residents have more complex care needs, the current reviews will hopefully result in the needed changes.
Death can be very confronting for those who have never witnessed it before, or cared for a patient at the end of their life. We need to give our nurses support so they’re more resilient.
Consolidation of basic nurse skills is also more important than ever – sometimes there’s a heavy focus on specialisation in nursing but we need to be able to practise core nursing skills as well. As an ADF nurse, when we deploy overseas and work with coalition forces, we have smaller teams with fewer resources so we all have to be able to perform different roles. Even though we may specialise in one area, we still have to step in and provide primary healthcare. The pandemic experience has expanded the breadth of clinical experience for nurses – it’s enabled nurses to be more resilient in the ever-changing healthcare environment.
Mental health in nursing and midwifery is the focus of the latest episode of Ahpra’s Taking care podcast, as we celebrate the International Year of the Nurse and the Midwife in 2020.
Liz Wilkes, an experienced midwife; Diane Lee, a nurse working at the Nurse and Midwife Support; Cassandra Jovic, who also works at Nurse and Midwife Support; and new mum Kirsty join host Tash Miles for this episode. They speak about the mental health challenges for new mothers and the support that is needed for practitioners and those they care for.
Download and listen to the latest Ahpra Taking care podcast episode today. Ahpra releases a new episode every fortnight, discussing current topics and the latest issues affecting safe healthcare in Australia. You can also listen and subscribe on Spotify, Apple Podcasts and by searching ‘Taking care’ in your podcast player.
Each month the NMBA makes decisions on approved programs of study leading to registration and endorsement. To see the up-to-date, searchable list of approved programs, please visit the Approved programs of study of the NMBA website.
The NMBA and Ahpra are asking nurse and midwife immunisers to complete a survey about their vaccination education.
The information gathered from the survey will help state and territory health departments with preparations for a potential Australia-wide rollout of a COVID-19 vaccine.
Currently in each state and territory, registered nurses (and midwives in some jurisdictions) who have completed the required education are able to administer vaccinations in accordance with the Australian immunisation handbook (2018) without the need for the vaccine to be individually prescribed.
At present there is no central database of nurse and midwife immunisers – this survey will be used to develop a database.
Nurse and midwife immunisers are invited to participate in this short survey which should take 3-5 minutes to complete.
The NMBA and Ahpra will share your responses to the survey (including your contact details) with the relevant state or territory health department in which you practise. That health department may use that information to plan and implement arrangements to carry out a COVID-19 vaccination program, including to contact you regarding those arrangements. The health department may engage third parties to help with this and may disclose your information to those third parties for that purpose, in a way that protects your privacy.
Please complete the survey by 13 November 2020.
Take the survey here.
The purpose of the nurse and midwife immuniser survey is to provide baseline data regarding currently qualified nurse and midwife immunisers across Australia. This information will enable workforce planning by state and territory health departments as part of the very early stages of preparing for a potential COVID-19 vaccination program.
The NMBA is unable to provide specific information regarding recognised immuniser programs of study to individual nurses and midwives as each jurisdiction has its own set of recognised immuniser programs of study and these may or may not be recognised across multiple jurisdictions as they are dependent on each state/territory’s drugs and poisons legislation. You may wish to contact your relevant health department directly to see if they are able to assist.
The NMBA is however working with state and territory health departments to compile up-to-date lists of recognised immuniser programs of study for each jurisdiction. Once available these lists will be published on the COVID-19 guidance page of the NMBA website. We will also provide an update regarding the availability of these lists in an upcoming e-newsletter.
Final year students − view our recent webinar to help you correctly complete the application process and avoid delays with first-time registration. Although this webinar was targeted at nursing students, the information applies to graduates of midwifery, too.
If you’ve completed your course or you’re set to complete in the next three months, you can apply for registration now.
The webinar covers:
Watch the webinar on the Graduate FAQ section of the Ahpra website.
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The NMBA publishes summaries of tribunal decisions about nurses and midwives as professional learning case studies. All information in these summaries has been made publicly available by the relevant tribunal before the NMBA publishes its summary.
A tribunal has disqualified a former registered nurse from applying for registration for three years for professional misconduct concerning misappropriated drugs.
For more information, read the news item.
A tribunal has suspended a registered nurse’s registration for three months for professional misconduct after he dragged an elderly patient who had been diagnosed with dementia to her room.
Ahpra and the National Boards appreciate the importance of a vigorous national debate on public policy during the COVID-19 pandemic. However, we remind all registered health practitioners that their obligation to comply with their profession’s Code of conduct applies in all settings – including online.
The codes of conduct emphasise that practitioners must always communicate professionally and respectfully with or about other health care professionals.
We have received concerns about the conduct of some health practitioners engaged in online discussion, including in semi-private forums.
Community trust in registered health practitioners is essential. Whether an online activity can be viewed by the public or is limited to a specific group of people, health practitioners have a responsibility to maintain professional and ethical standards, as in all professional circumstances.
In using social media, you should be aware of your obligations under the National Law and the NMBA's codes of conduct. For more information see Social media: How to meet your obligations under the National Law.
Anyone with concerns about the online conduct of a health practitioner can contact 1300 419 495 or make a notification.
Ahpra and National Boards have released results from the second annual survey of stakeholder understanding and perceptions of our role and work. The results help us to better understand what the community, regulated health professions, and our stakeholders think and feel about us, particularly in areas of understanding, confidence and trust. The insights gained will inform how we can improve our engagement with both the professions and the community.
The report provides the results from anonymous surveys conducted in late 2019 of a random sample of registered practitioners and a random sample of members of the public across communities in Australia. There were nearly 6,000 responses from practitioners and 2,000 from the broader community. Both surveys were managed by an independent consultant.
Overall, the results show positive perceptions of Ahpra and National Boards. The surveys were, in the main, the same as ones carried out in 2018 and enable comparison of changes in awareness and sentiment over the period. The reports in PDF format are available in the news item.
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