Report concerns or risks......

Mandatory reporting is not only in Australia.... the UK is calling for more health professionals to blow the whistle...
NHS staff told to 'report concerns or risk investigation'

Health regulators should warn nurses, doctors and midwives they may be investigated if they fail to report concerns about colleagues, MPs say.

The General Medical Council (GMC), which regulates doctors, said it was committed to doing more in this area.

It is interesting that not many doctors report each other, the old school boy tie mentality is alive and well.... this is evident by the following statement;

The GMC is currently investigating doctors at Stafford Hospital whose own work was blameless, but who allegedly failed to report colleagues.

It seems though no one has a problem about reporting nurses and midwives.....
maybe the culture will change and there will be fairness about reporting all unsafe health practitioners or health practitioners that put the public at risk....

We have to remember it is about professional responsibility, being aware of professional codes and guidelines and aware of what is good and poor clinical practice. It is also about employers being open and transparent about what occurs within its institution and taking appropriate steps to rectify any untoward activities and not turning a blind eye. Clients have to be protected and advocated for by the health professional, not bullied or manipulated into receiving treatments they do not understand or want.

Lamenting about the lost art of nursing care:

This is a plastic slipper-pan....mine was papermache...even more lightweight...

I have recently been in hospital, nothing serious but none the less needing/requiring some nursing care: There is nothing like a bit of firsthand experience to relay to nursing and midwifery students the importance of a caring attitude..... I also say that people generally complain about staff that are rude and give the impression of not caring ...that is a distinct difference to the nurse who just doesn’t give a shit.

I do have to say that I find being a patient extremely difficult because I do not want to relinquish any sort of control of my life.....to someone else particularly someone who really doesn’t care. On the whole my care was good..... However it is always the little things that make life all the more difficult..... like your tray being placed out of reach and you can’t move....emmm a little difficult.... and ringing the call bell to use...yes the dreaded bedpan... and it takes 20mins for the nurse to appear....then a further 15mins before you get the slipper pan.... oh no..... you can just feel your bladder is about to burst...and then you have this ridiculous looking slipper pan and you know it’s just not going to happen....at this point I wished I had a penis...it would be so much easier....but alas no we take a deep breath and ask to be left alone to contemplate emptying your bladder lying flat on your back and trying not to be in any pain.... it seems a fate worse than death...trying to pee in these conditions.... remembering you have done this all about 4hours ago and wet the bed in the process...then you have to go through the embarrassment and the changing of the bottom sheet.......anyway about half an hour later I think yes... I’m done.... ring the bell... by now the slipper pan is well and truly stuck to my buttocks... the nurse comes in “are you finished” yes thank you... Ok let’s get it out then.... lift up.... tummy muscles work frantically and lift.... as the nurse manoeuvres the pan out .... oops yes you guessed it.... a spillage...but of course... how can this flimsy product hold several litres of fluid without having a mishap......oh did I mention it is the middle of the night....the nurse says “oh that’s good....it didn’t spill did it?” emm... I lament and say...” I think that the bed is wet”....no says the nurse it’s your perspiration... it will dry very quickly....and slips out the room very quickly carrying her overladen slipper pan.... and me... well she doesn’t know that I am a nurse / midwife educator and am totally blown away by this blatant lack of insight into poor care....now here I am the patient....at this stage a not well patient who has pain, now lying in a wet bed and wondering is it worth the trouble to ring the bell wait another 20mins and complain about my care , have the sheet changed creating more pain or shall I just lay here and hope that I fall asleep as I am still affected from the anaesthetic... to which I do just that (I have to say this only happened once, not all the staff were like this).

I should think it is equally as difficult for a man to pee lying down.....

In the next bed was an elderly frail lady whom I had not met but could hear through the curtains that she had some sort of facial surgery and could only swallow. I came to this conclusion because I could hear her trying to swallow her drinks and her meals came in a bowl, she had hardly any visitors and was very quiet. It is interesting trying to assess someone you have not seen by the care she received from the nursing staff. Some nurses would come in very chirpy “Good morning, I have some pills for you, oh your poor darling, that looks uncomfortable let me crush your pills”....to, hello here are you pills.... Patient “oh I find it hard to swallow can you crush them” nurse – just try; patient; ok..... Cough; splutter; splutter; tears........oh Ok I will be back...... surprisingly it was the younger nurses that showed less caring....this occurred at least 4 times a day all with differing responses.... On the second day when the nurse came in and said “here are your pills and asked her to swallow them after the patient had asked for them to be crushed...... I could not bear to hear the patient again try to swallow....that I yelled through the curtains..if I could have got up without causing myself pain I would off.... why don’t you just crush or give her dissolvable paracetamol......the nurse scurried out the room and came back with dissolvable pills.... I know there is nothing worse than a busy body not minding their own business..... but it just had to be done...later when I got up ...the elderly lady said thank you to me for asking the nurse to crush her pills...and explained she had two sons lived away and it was difficult for them to visit...but they would say something if they knew.... and said I don’t know why some of the nurses won’t crush my pills.....she became teary and wondered whether it was all worthwhile.... I sat with her talking about life and I was saddened that none of the nurses found time to spend any time with this frail lonely woman who has had some remarkable facial surgery and how any nurse could possibly ask someone to attempt to swallow when visibly it was obvious that this was an onerous task for the elderly woman....

I know we all use the excuse that we as nurses and midwives are overworked, but please, caring and compassion is what we are about... it is a basic human need.....everyone is so busy with the task that there was absolutely no caring or compassion ......

My dilemma as an academic is how we teach our students to be caring and compassionate in a world that demands tasks to be completed in unrealistic timeframes.... and why are we producing young nurses that do not have a caring philosophy.....

Tip to nurses.... you never really know who the person you are looking after.... therefore be kind, caring and professional to all.... treat your patients like you would like to be treated yourself... and if you are having a bad day stay home..... don't inflict it on your patients.....

My Road to Meditation:

I dabbled in meditation back in the nineties and met the Dalai Lama when he came to Perth…. I subsequently read his autobiography and thought that if I was to have my time over again I would be a Buddhist. I continued to be a part time practicing Catholic and turned more to being spiritual rather than religious. I read books about quantum time (physics), Road less travelled, You Can Heal Your Life, My Mother Myself, A Course in Miracles and many more…..trying to find a sense of spirituality… life got busier and busier and both religion and spirituality took a back seat…. Never leaving… always at the back of my mind but never that priority.

My recent trip to Tanzania I was touched by the strength of the ordinary Tanzanian, the courage in the face of adversity…. The pain that people suffered and accepted as part of their life….what was unbearable for me was to see children suffering in hospital… from the baby that was crying and needed comforting and no staff to do this, his nappy changing and there was no nappy…. Or the toddler that was screaming because he was being bathed in Potassium permanganate dissolved in warm water to come up with a nice pink colored solution, having his burns debrided with no pain relief, it brought tears to my eyes…… I was both humbled and frustrated…. The disparity between rich and poor was at times palpable. The health issues seemed so insurmountable, that I need a way to stop my mind from churning…… I realized that my spirituality was missing… it was not even dormant it had gone……

Last year was very busy and stressful particularly then end of the year was even more so, after I came back from Canberra, I was at breaking point and realized I needed to stop….. I had decided to either go back to church on Sundays or start meditating….I usually go to midnight mass, have for the last 30 yrs… there was a new Parish priest at the church I usually go to… and it was the worst service I have been to for a very long time….no inspiration…… there was nothing….I was like a stranger, I came away knowing I was not going back….


I did an Internet search for a Buddhist retreat starting in January…and would you believe it one was starting on the 2nd January…. I booked in for the week and I have not looked back since then….. I felt like I had found my way home……very strange…. Time will tell how I go….. I feel calmer…. My mind is less chaotic and I now have strategies to slow it down…..I have set myself some boundaries as far as work is concerned…. And am working on my discipline to continue with my meditation on a daily basis with a quarterly retreat to keep me focused…I found a meditation centre here in Singapore and went this afternoon, which was a great end to my teaching weekend……watch this space...


Happy Chinese New Year "Rabbit" Happiness and Prosperity to all....

New website for Nurses & Midwives to navigate: Changes for 2010

The year has began and for me it is going to be a very busy year with all the expected legislative changes affecting Nursing and Midwifery for Australia with National Registration being one of them.

The Australian Health Practitioner Regulation Agency Website:

This will be the website for updated information relating to National Registration for July 2010.

Here are some key points from Louise Morauta Project Director:for the full report see Australian Health Ministers’ Advisory Council
National Registration and Accreditation Implementation Project
PROJECT UPDATE DECEMBER 2009
The national law has now been passed in Queensland and adopted in New South Wales and Victoria. The adopting legislation has also been introduced but not yet passed in Tasmania, ACT, and NT. What is happening to WA? we have to wait until Parliament re commences for the New Year. The expectation is that the legislation will be passed in all jurisdictions in time for commencement day on 1 July 2010.

The boards commenced work with their first meeting on 20 September 2009.
Work commenced in November on the data migration project which transfers information from the existing boards to the new national boards.
The Agency announced Martin Fletcher as its inaugural CEO on 18 September 2009.
Martin commences on 21 December 2009.


Nursing and Midwifery Board of Australia

From 1 July 2010 Nurses and Midwives across Australia will have to meet the same requirements to be registered and their registration will be recognised in all States and Territories. Wow I have been waiting for this for about 20 years... that's a long time for change to occur......these things move very slowly and this just proves it.

The Board was established under the Health Practitioner Regulation (administrative arrangements) Act, 2009. From 1 July 2010 the Board will operate with its full range of functions under the Health Practitioner Regulation National Law (the national law) where adopted in a jurisdiction.

Members of the inaugural Nursing and Midwifery Board of Australia were appointed by the Australian Health Workforce Ministerial Council for a period of three years on 31 August 2009 and here they are if you don't already know.

Ms Gillie Anderson - Appointed as a community member
Ms Angela Brannelly - Appointed as a practitioner member (registered nurse and midwife) from the Northern Territory
Professor Elizabeth (Mary) Chiarella - Appointed as a practitioner member (registered nurse) from New South Wales
Ms Anne Copeland - Appointed as Chair and a practitioner member (registered nurse and midwife) from Queensland
Dr Lynette Cusack - Appointed as a practitioner member (registered nurse) from South Australia
Professor Denise Fassett - Appointed as a practitioner member (registered nurse) from Tasmania
Mrs Lynne Geri - Appointed as a practitioner member (enrolled nurse) from Victoria
Ms Louise Horgan - Appointed as a practitioner member (registered nurse) from Western Australia
Ms Mary Kirk - Appointed as a practitioner member (registered nurse and midwife) from the ACT
Dr Christine Murphy - Appointed as a community member
Ms Heather Sjoberg - Appointed as a community member
Ms Margaret Winn - Appointed as a community member

There are some familiar names here for me and I even know a few....don't know what that says about me....for that's enough information.... keep watching for more...

Should nurses & midwives be allowed to work as a health professional once they have committed a criminal offence?

Nine msn reported on an interesting story in Victoria, regarding nurses found guilty of serious offences. This information was found through The Freedom of Information,the offences included manslaughter, sex offences and torturing animals.

Nurses in Victoria found guilty of serious offences including manslaughter, sex offences and torturing animals have been given approval to care for sick and vulnerable patients.

Nursing authorities in Victoria have in the past three years approved registration of more than 100 nurses who had admitted being found guilty of crimes including stalking, drug trafficking, possessing child pornography and manslaughter, News Limited newspapers said.

This raises several questions, what was the crime? have they repaid society for the crime? and are they now trustworthy?

Have they by the very nature of the crime, forfeited the right to work as a nurse? one could also argue,that the nurse has bought the profession into disrepute therefore should not be allowed to work as a nurse again.
Would you like this person looking after your mother, father, son, brother etc.

Off course there is the other side of the coin - they have paid the price to society for the crime, whether it be a fine or goal time and they have proven to be trustworthy. Is it then unreasonable to allow them to work as a health professional again? However, It does seem bizarre that a nurse convicted of sex offences and torturing animals would be allowed to work as a nurse again?

Do we allow policeman who have been convicted of a crime and gaoled to be re-employed as a policeman?

What do you think? should nurses & midwives who have committed a serious criminal offence be allowed to re-register and work as a nurse?

Client Confidentiality: Is it time to use PDA's

A UK community midwife lost her diary that contained 350 names and details of all her clientele. As you are aware this could be catastrophic for some of these women. The hospital wrote to all the women apologising for the mishap and assured the women it was not their records however acknowledged how serious this incident was in terms of breaching client confidentiality. You might be asking is this easy to do? I can think of several high profile cases lately of leaked/lost information for example; what about the AFL footballers whose medical records were allegedly found in a public place, and politicians who have misplaced sensitive information/documents on the train. I am sure you will be able to think of many more examples.
We all acknowledge that confidentially is the corner stone of our Code of Ethics and we do our up most to protect patient/client confidentiality within the scope of our practice. No part of any patient/client records can be photocopied or taken home by nursing/midwifery staff. However community and independent midwives have a different set of rules, also in this category are Nurse Practitioners and Remote Area Nurses.


May be we need to embrace the technological age and we should be using PDA's (personal data assistants or organisers) - you can have it password protected and synchronised with your computer, personal and hospital. There are many different types and prices on the market, off course it means the hospital has to invest in the package deal for all computers/systems. The question is will they?

I know that Silver Chain Nurses use PDA's very effectively and to my knowledge have not had breaches with confidentiality and if you do misplace your organiser it is backed up to the main computer and password protected. I have also noticed more and more restaurants use them as well to improve communication and legibility for their staff.

I personally use a HP iPAQ 112 and find it brilliant, you can get all sorts of programs to upload, for example; due date and pregnancy progress; dictionaries, you can upload policies and have them at your finger tips etc. I also believe this is the way of the future, yes I know that there are very clever hackers out there but for the most part they are not interested in our health details, I hope this is not a naive view.

1. Let me know if your area uses a PDA?
2. What do you think about using a PDA?


http://www.manchestereveningnews.co.uk/news/s/1062554_midwife_loses_patient_details