The Importance of Promoting Self Care to Nurses

Mrs Elaina Mullery1

1Happy Nurse AU, MINDARIE, Australia

 

Introduction: Nursing is a physically and emotionally demanding career.  Nurses are always there to care for a stranger as if they were one of their own.  One in four nurses is reported to experience burnout at some point in their career.

My Experience: Burnout / Compassion Fatigue impacts the nurse both professionally and personally and has a negative impact on patient care and the organisation in which they are employed.  Self care has a positive impact on the prevention of compassion fatigue and burnout in health professionals.  Education on the early signs of burnout and the encouragement of a  personal self care program is a matter of importance to the nursing profession in my opinion.

Conclusion : During my presentation, I will address what I believe is a holistic approach to self care.  I have developed a model of self care which addresses five social psychological aspects of self.  This model allows the nurse to develop a deeper level of self awareness whilst caring for their Mental, Physical, Emotional, Spiritual and Indulgent self care needs.

  1. Poghosyan, Lusine et al. (2010). Nurse Burnout and Quality of Care: Cross-National Investigation in Six Countries. Research in nursing & health, 33.4, 288 – 298.
  2. Maytum, J. C., Heiman, M. B., & Garwick, A. W. (2004). Compassion fatigue and burnout in nurses who work with children with chronic conditions and their families. Journal of Pediatric Health Care, 18, 171–179

Biography:

Elaina Mullery RN studied nursing at The Robert Gordon University, Aberdeen.  She spent the first ten years of her career in Scotland before moving to Perth, Australia in 2010.  Her clinical experience has been across a variety of settings including Orthopaedic Trauma, Operating Room, Endoscopy, Recovery and Day Surgery.  She currently works in PACU.

Elaina has first hand experience of stress and burnout.  It was this experience which led her to develop a passion for personal development. She has a diploma in Mindfulness and Meditation, is a certified hypnotherapist and a certified NLP Practitioner.

Connecting with Community – Champions4Change

Ms Diana Mosca1, Ms Vicki Wade1

1RHDAustralia, Darwin, Australia

 

Health care systems built on western ideologies and constructs, are multidimensional and fragmented making it difficult for many people to navigate. People with a lived experience of acute rheumatic fever (ARF) rheumatic heart disease (RHD) are well placed to provide comfort to people experiencing social and emotional hardships throughout their very complex health journey.

Many factors contribute to the higher prevalence of RHD in Aboriginal and Torres Strait Islander populations including, underlying economic and social disadvantage, delayed access to care, cross-cultural miscommunication, racism and discrimination. These factors present challenges in providing optimal health care for people most in need of early detection and prevention, secondary care, tertiary and ongoing management.

Aboriginal people with a lived experience of RHD and a desire to share their knowledge and experience have designed the RHDA Champions4change program.  Roles like these are not new to Aboriginal people, passing on and sharing knowledge is a part of traditional Aboriginal culture based on the kinship system. Mothers and grandmothers had a shared responsibility to look after all children in the community. Elders helped children grow into adults often in sacred ceremony. The RHDAustralia champions are encouraged to tap into their Aboriginal ways of knowing and being to help breakdown structural and cultural barriers in care. They can provide comfort to people who are experiencing social and emotional hardship throughout their often very complex health journey.

This presentation provides an overview of the Program and how it helps build the knowledge required to ensure Aboriginal and Torres Strait Islander peoples have the tools to live a good life by reducing the impact of RHD in their communities. It will explore the support and resources required for the champions to successfully develop a Champions4change program in their own community.


Biography:

Diana commenced as the Senior Nurse Advisor at RHDAustralia in January 2018 and is enjoying working in Darwin after 20 years.

She has held clinical nursing and education positions around Australia since the 80s, mostly in rural and regional areas. Her nursing experience spans education, paediatrics, public health and perioperative nursing. This range of nursing experience has been invaluable to inform projects and programs including education programs and quality improvement in acute and chronic health.

As well as being a registered nurse, she has qualifications in Public Health, Education, Perioperative nursing, Leadership, and Business Analysis.

Diana.mosca@menzies.edu.au

Drought – Helping hands in times of need

Mr Evan Morris1

1Hunter New England Central Coast Primary Health Network (HNECCPHN), Gunnedah, Australia

 

Introduction:

Approximately 75% of the Hunter New England region is experiencing drought with over 60% of people in the New England North West region experiencing intense drought. Identifying and supporting people and clinicians in drought-affected communities is a key priority for the Hunter New England Central Coast Primary Health Network (HNECCPHN). Clinicians in this area are very familiar with HealthPathways. Evidence from two evaluations and google analytics data have confirmed that the majority of general practice clinicians use HealthPathways on a regular basis to access relevant, up-to-date assessment, management and referral information.

What is happening?

In 2018 the HNECCPHN established a Drought Working Party to collaboratively engage with health professionals, organisations and community members to determine what was needed to support drought-affected individuals and communities. The Hunter New England (HNE) Community HealthPathways team liaised with this working party to develop a clinical pathway for clinicians to identify and care for patients presenting with mental health issues arising from disasters or adverse weather events. A Drought Support Services referral page was also developed which describes all the services and resources that patients and families can access for information and support to prepare for and manage drought conditions, including such things as animal welfare, financial support, administration, mental health and social well-being, and personal support and assistance. This referral page can also be publically accessed via our Patient Information portal.

Conclusion:

The HNE HealthPathways team has collaboratively contributed to the development and maintenance of healthier rural and remote communities by producing resources to support primary health clinicians in the care of patients adversely affected by drought. These resources can be easily adapted and applied to assist clinicians, people and communities in other rural and remote regions.


Biography:

Evan Morris has been employed as a Community HealthPathways Project Officer for the Hunter New England Central Coast Primary Health Network (HNECCPHN) for the past 5 years. He has worked in a rural setting for over 15 years and has extensive experience in project management, clinical reporting, service directory development and testing, and system integration. Email address: emorris@hneccphn.com.au

The strongest/weakest link of building connections

Krystle Lingwoodock

 

Reflection upon this years mantra, Embrace! Diversity! Build strong connections! Allows us to believe that we need to improve, grow, trust, build a rapport- now lets be honest that’s the basis of our work within Aboriginal and/or Torres Strait Islander communities. If we peel back the layers within a health service, all of us can identify that we can improve on each of these areas. At the core most services, are the Aboriginal Health Workers / Practitioners – as nurses come and go, these AHW/Ps are the constant – so why is this the most under-utilised, inconsistent workforce – no state is the same!

What are some barriers that are impacting AHWs

– lateral violence

– disconnected

– disempowerment

– organisational policies and procedures

– social and environmental issues

As managers, clinical leads, CEOs – all round game changers that are in the room today what can we do? How can we address, support encourage, empower this workforce? Do I have all the answers, definitely not – more so I have years of trial and error, frustration and heartache.

– are the AHW/Ps all the same throughout the states and territories?

– consistency around nursing staff

– models of care

– CPD

– traineeships and pathways

– QLD Health structure

– the dynamic and intricate social structures within Aboriginal communities

– finished training, what now?

For each of the frustrations we’ve experienced, please keep in mind, behind our angst there is a workforce that lives, breathes culture and community which are imperative to provide the highest standard of culturally appropriate health care. In order for us to build stronger connections with the community that we work in, we first must start with the workforce which will support and facilitate this.

Show me the money – Utilising the Health Workforce Scholarship Program to support continuing professional development for rural and remote primary health clinicians (case study)

Ms Tracey Lewis1Diane Bowden1

1NSW Rural Doctors Network, Newcastle/Hamilton, Australia

 

Introduction

The Health Workforce Scholarship Program (HWSP) provides scholarships and bursaries to help health professionals in rural and remote Australia retain and enhance their skills, capacity and scope of practice. The Program is an initiative of the Australian Government Department of Health, administered in New South Wales by NSW Rural Doctors Network (RDN).

RDN prioritises allocation of funding through the HWSP based on RDN’s Health Workforce Needs Assessment and gaps in service delivery in accordance with the National Health Priorities.

Rural clinicians are often isolated professionally and a barrier to accessing continuing professional development (CPD) can be both the cost of the course or conference, and the travel and accommodation, this is where HWSP can assist.

What is happening?

Diane Bowden is a Primary Care Nurse working in a general practice in rural Bungendore NSW for the past 5.5 years and has worked in primary care for 10 years. This is the only practice within 25km of Queanbeyan and services Tarago, Bywong, Womboin, Captains Flat and Carwoola, with 7692 active patients.  The practice has 9 GPs, 2 PNs, 1 PM (also a PN), and 4 administrative staff.

Diane enrolled to complete Master of Nursing and applied to HWSP for financial assistance.  This was inspired by attending the APNA Conference in 2018, also funded through HWSP.

Diane’s passion is health prevention, chronic disease management and plans to implement Chronic Disease Clinics and a Health Ageing Clinic. This aligns with RDN’s priority areas of access, quality of access and future planning.

Conclusion

This case study demonstrates the value of HWSP in supporting our rural clinicians to gain and develop skills to meet the gaps in service delivery to improve health outcomes in rural and remote NSW & how this can be supported through HWSP.


Biography:

Worked in primary health care over the past thirteen years across multiple organisations including Divisions of General Practice, Medicare Locals, Primary Health Networks and currently NSW Rural Doctors Network in regional and rural NSW.

 tlewis@nswrdn.com.au

Diane Bowden is an advanced RN working in general practice with over ten years experience. Passion for health prevention, CDM and Immunisation. Diane is currently completing her Master of Nursing to become a Nurse Practitioner.

dibazza@gmail.com

Women working in rural and remote Australia- a Primary Health Nurse Perspective

Miss Kristy James1

1RFDSSE, Broken Hill , Australia

 

Share my nursing journey from AIN to RN and beyond as a single parent in a rural mining town. To explore the different pathways in nursing and the barriers single women face to gain professional development and education opportunities when living in rural/remote locations.

Explain my job as a Primary Health Nurse for the RFDSSE based in Broken Hill. I would like to talk about my scope of practice and my professional development in line with the job. CRANAplus courses I have completed and of course the Graduate Certificate in Remote Health Practice. Explain the diversity of my work from the locations, the way I travel to work (plane), the teams I work with to provide holistic care to the South Eastern Section of the RFDS. From Broken Hill we provide 24 hour emergency retrievals, covering a land mass of approximately 640,000 km². And I am part of the network of primary health clinics where patients can access community health nurses, dentists, AHP, mental health and allied health professionals.

The cost of further education and having to work full time and do clinical placement for 8 week blocks. Working in Primary Health usually means the hours are family friendly. Shift work is a deterrent to single women with children choosing Nursing as a career. Unfortunately the clinical placements required to complete a Bachelors degree is unattainable for most women. University require students to travel from their rural/remote location to metropolitan hospitals which impossible if you’re are the primary carer.

Availability of affordable child care and the lack places available for children.

The increasing cost of travel to and from Broken Hill to visit family and friends.

The cost of the rental properties in Broken Hill that are substandard and older then the urban areas.


Biography:

42year old single mother to one child (15year old boy),lived in Broken Hill for 12 years- from WA(2006). Started studying as a mature aged student through the local TAFE (2007), completed Cert 3in  Assistant in Nursing which lead me to study a Cert 4 in Enrolled Nursing-2009 (first year in was offered in Broken Hill, as a working single mother this changed my life!) I then was accepted into University starting at CSU(2010) and transferred to UniSA (2013)Bachelor of Nursing and have a recently completed a Post Graduate Certificate in Remote Health Practice(2018) through Flinders University.

Curing loneliness, it’s a major health concern

Mrs Jannine Jackson1

1Frontier Services, PARRAMATTA, Australia

 

Frontier Services is experiencing the impact of health and social issues that are becoming more prevalent in remote Australia.  These social issues are often triggered by numerous stressors but they are made more complex by social isolation and loneliness. Loneliness is a real health issue with 1 in 4 Australian’s feeling lonely, 30% don’t feel like they are part of a group of friends and loneliness increases the likelihood of experiencing depression by 15% and leads to poorer overall quality of life and physical health.

Human beings by our nature are built for social connection and subconsciously are always seeking real, genuine and authentic relationships. Overlay that with the social isolation that people feel in remote Australia making face to face connection a greater challenge. Key health indicators for men in remote Australia are evidence of poorer mental health and social outcomes with men on average living seven years less and twice as likely to commit suicide than their city counterparts.

We know that social isolation leads to poorer mental and physical health outcomes.  This is also evidenced by higher rates of substance abuse, domestic violence, and family breakdowns.

Frontier Services has always believed in being the friendly ear that turns up at the farm gate and in the true value of mateship.

For 100 years we have been supplying Bush Chaplaincy in order to provide the community hub, the social connectivity, and the pastoral care. A bush chaplain never knows what to expect when they are visiting remote properties often their work is life-saving. It is more than being connected, it’s face to face contact an important key factor in reducing social isolation. It’s about providing real and practical solutions for people who may not have yet identified that they are in crisis.


Biography:

Jannine Jackson, CFRE, FFIA, Grad Dip Mgt is a senior leader in the nonprofit sector with over 20 years working for diverse organisations spanning human services in health, social, disability, and advocacy.  Working for organisations like Australian Red Cross, NSW, Mission Australia, Arthritis & Osteoporosis NSW During her career she has advocated for political and policy change in health, and fundraising legislation.  She has led organisations through large change management strategies and significant growth in complex environments. She currently works as the National Director for Frontier Services supporting those living and working in remote Australia.

Bridging the Gap between NDIS and Indigenous Participants in Rural and Remote Locations

Ms Danni Hocking1

1Northern Australia Primary Health Ltd (naphl), Townsville, Australia

 

We use a case study to demonstrate the diversity of program delivery required for clients who are of Aboriginal and Torres Strait Islander peoples being discharged from hospital to access equipment and services to support them to live independently  whilst waiting for approval to access funded programs.

Whilst newly introduced schemes such as the NDIS and My Aged Care funding are long term solutions to support people to remain independent within their homes and communities the hurdles required navigate eligibility can be complex and very long.  What happens to those people who fall within the gaps but need support but ineligibility due to their age, health condition being unstable or inability to f:f assessments needed to establish acceptance.

We will explore many gaps in service provision in rural and remote Australia particularly for Indigenous communities who don’t live in regional towns.  Cultural mistrust, access to relevant service providers, GP’s completing eligibility assessments, submission of forms, providing evidence that may not exist are just some of the challenges.  By working closely with a range of service providers at the beginning of the hospitalization process through the discharge journey, knowing what services are available we will demonstrate how to bring services together and offer a range of supports for clients who may potentially slip through the gap.

In this case study we examine a client who enters the hospital system and exists following life changing surgery, transforming their existence completely, impacting not only their physical & mental health but also their social/community integration. We explore  programs and services available to remote communities in FNQ ; how to identify the gaps in each so that services can be identified, solutions created which involve health providers, government and community so that and the client can return to their home safely and feel adequately supported.


Biography:

Danni Hocking, B App Sc OT/ Grad Dip Wellness; CPRM;

Danni has extensive experience in the management of people risk issues including the development of award winning corporate safety & wellness programs. As a Director of outreach Allied Health Services she has had experience in delivering innovative and cost effective programs to Indigenous, Refugee and Mainstream clients in rural and remote regions across North and Far Nth Qld.  Danni has spoken on International and National health and wellness forums and has developed award winning programs designed to improve health outcomes for large workforces.

Sepsis in rural areas with an atypical case from exposure to horses

Mrs Chris Freeman1

1Seymour Health, Seymour

 

Introduction:

This presentation will focus on current evidence based practice in sepsis management for rural and remote health workers with a focus on early detection and the appropriate initial management of these patients with specific reference to case studies presenting through the Seymour Urgent Care Centre.

What is happening in your project/ health service/or what has been your experience:

Seymour is a rural hospital with a small 5 bed urgent care centre managed by one Senior Registered Nurse with assistance provided by ward nurses and an on-call GP or NP. The management of sepsis has been a significant focus in the healthcare industry with improvements in early identification and treatment of patients. Seymour Health service uses the Primary Clinical Care Manual as the guide in the management of patients presenting with potential sepsis and septic shock. We have also invested considerable effort in ongoing education to staff on the management of potential sepsis. Recently staff have successfully identified several septic patients and initiated prompt treatment with good clinical outcomes. This presentation will highlight what was learned from these cases, and how good staff education and prompt clinical assessment from nursing staff was the key to successful management. Specifically the talk will discuss the case of an elderly patient who contracted an unusual bacterial sepsis from exposure to horses. The presentation will also discuss the difficulties encountered in managing patients in a rural area and strategies to deal with these issues.

Conclusion:

While sepsis management is not a new theme it is constantly evolving. This presentation will discuss the latest evidence based practice in relation to sepsis management with specific reference to clinical cases in a rural setting.


Biography:

  • Nurse Practitioner Candidate (NPC) Seymour Health Service Victoria
  • 20+ years of Rural/Remote area nursing and Emergency Nursing
  • Masters Emergency Nursing, currently studying Masters Nurse Practitioner, Graduate Certificate Education (Tertiary Teaching), Diploma Vocational Education and Training, Rural and Isolated Practice Endorsed Nurse (RIPERN).

The Joy Project – getting people to smile!

Ms Xaviera Farrell1

1Prison Health Darwin, Darwin , Australia

 

Purpose:

Demonstrate how colour in the workplace can change the way we connect with our patients and our colleagues.

Nature and Scope:

By examining how colour can effect mood and behaviour I explore how this has transferred into the design of our clinic by adding colour to moving works of art- staff, and how this has far reaching effects.

The issue under consideration:

Our community members at Darwin correctional precinct have complex behaviours,  are culturally diverse, have individual health needs and are generally suspicious of people in uniforms – and that’s just us health care professionals!  We wanted to make our space, for all the people within it, a place of healing and happiness.  The reality is that we are in a prison and we wanted to make the clinic a place of true rehabilitation.

Staff were not micromanaged on how they wanted to add some colourful ‘frosting’ to their uniforms.

We celebrated days of inclusion and recognition such as ‘Harmony day and NAIDOC week’ and included the inmates in the decorating of the clinic.

We also commissioned local artists to add colour to our clinic.

The outcome;

We have  reduced episodes of anti- social behaviour in the clinic.  We have a reduced amount of inmates ‘leaving against medical advice’.  We have a higher rate of smiles.  We have fewer staff sick days, improved retention and overall improved staff satisfaction.

Most important – when you enter our clinic you can not help but smile!  And when we smile we relax- the healing begins with colour!


Biography:

Xaviera Farrell RN, BA, BS (nursing), Grad Cert Clinical Nursing, Grad Dip Emergency Nursing.

Clinical Nurse Specialist and Patient Feed Back Coordinator.

Darwin Correction Precinct.

Xaviera.farrell@nt.gov.au