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.

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

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).

Strengthening the Remote Workforce in the NT

Mr Paul Connolly1, Mrs Heather Keighley1

1Northern Territory PHN, Winnellie, Australia

 

Strengthening the Remote Nursing Workforce in the NT

The purpose of this presentation is to provide an overview of the initiatives being implemented by Rural Workforce Agency NT (RWANT) to develop the rural and remote workforce in the Northern Territory. There are significant challenges in establishing and maintaining a quality health workforce in remote Northern Australia. These challenges span from fragmented career pathways, to recruitment, retention and skills gaps. RWANT has adopted an integrated needs assessment approach to identify and address specific requirements to provide a sustainable and quality primary health workforce. Solutions are documented and addressed through the development and execution of an activity work plan which outlines priority needs and the activities that will be delivered to address those needs. This presentation will outline the needs assessment process and showcase some of the key results and strategies that have been achieved in the NT thus far. Some of the key activities that will be showcased include:

  • A Nursing and Midwifery Career Pathways Mapping Project which comprises a detailed research paper identifying current pathways and a strategic workshop involving industry leaders and peak bodies such as state government and local universities, to develop agreed strategies to strengthen and expand the career pathways into nursing and midwifery and subsequently into remote practice
  • A new integrated approach to career development and education support for health professionals designed to facilitate further education/upskilling and subsequently retention
  • A number of activities designed to map and strengthen career pathways into primary health for Aboriginal and Torres Strait Islander people

The intended outcome of the proposed presentation is to highlight the innovative work being done in the NT to optimise the primary health workforce and provide delegates the opportunity to engage and consider whether similar strategies may be relevant to them.


Biography:

Ms Heather Keighley BN, MIHM, AFACHSM, MACN

Heather Keighley is a Registered Nurse and Midwife who leads the Rural Workforce Agency NT and Primary Health Care Outreach Services, providing strategic guidance for teams that implement PHC Workforce Strategies and services throughout the NT.

Heather appreciates the importance of strong professional and organisational partnerships across the PHC and Education sectors both nationally and within the NT, in achieving workforce reform to meet health and community needs into the future.

Transforming Grief and Self Care for Midwives

Mrs Stacey O’Brien1

1A Kiss From An Angel, Glasshouse Mountains, Australia

 

Background

Stillbirth and Miscarriage are devastating events of childbirth which leaves everyone involved shattered from this heartbreaking loss.  After the stillbirth of her first son, Finn, in 2002, Stacey O’Brien used writing as a healing tool and created her book, “A Kiss From An Angel”.

Stacey has spent 15 years offering this inspirational education through workshops and is so passionate that she wrote her second book “The Healer’s Workbook” to answer many of the questions that midwives have asked her.  This book also offers many self care practices for Midwives to help sustain this demanding career and offers support to the industry which cared for her so well.

Focus of discussion

Through education we can learn to transform grief, to process it, feel it and learn how to allow it to visit our life without destroying our hearts.  Grief’s best friend is anger and part of the transformational journey of grief is managing this beast and learning ways to feel, revisit and manage the destructive way it can develop in your days.  Learning how to turn pain and resentment into gratitude and love can be a valuable transformation.

Implications

This brave and very rare insight into grief and loss has offered midwives a depth of understanding that has transformed the level of compassion they can offer bereaved parents.  Stacey offers in depth practical healing tools which help midwives capture memories and honor the families during this time of crisis.

Stacey’s next project is to create an educational video series that will support and sustain the midwifery workforce into the future.

Leadership with Love and Healing.


Biography:

Stacey O’Brien is an Inspirational Speaker and Author of 2 Books – “A Kiss From An Angel, an inspirational journey through grief and the loss of a child” and “The Healer’s Workbook”.

Dedicated to Transforming Grief and Self Care for Midwives, Stacey has created “The Midwife’s Insight” an e-learning platform for midwives to gain a glimpse into Stillbirth and add to their skill set with invaluable confidence in supporting parents and the child affected by stillbirth.

Stacey is a Gifted and Intuitive Healer, Massage Therapist and Fitness Instructor with Training in Mental Health and Suicide Prevention.

Leadership with Love.

akissfromanangel02@gmail.com

NSW Rural Doctors Network provides services and support for rural and remote nurses and midwives, come and hear what RDN’s strategies are for the sector and what they can do for you

Ms Carolyn Ripper1

1NSW Rural Doctors Network, Hamilton, Australia

 

The purpose of the presentation is to raise awareness of the strategies NSW Rural Doctors Network (RDN) are undertaking to address nursing and midwifery workforce needs and challenges in rural and remote NSW.  RDN is the designated Rural Workforce Agency for health in NSW whose aim is to ensure the highest possible standard of healthcare is provided to rural and remote communities through the provision of a highly skilled health workforce and assisting communities, general practices and health services to find suitably skilled and qualified General Practitioners (GPs), nurses, midwives and allied health professionals to work in their towns.  Nurses and midwives, being the largest and the most geographically dispersed workforce in Australia are highly skilled to provide communities with access to health care across all age groups and RDN aim to ensure nurses and midwives are embedded in workforce solutions.

RDN’s vision for nursing and midwifery is that community and primary health care nurses and midwives work to their full scope of practice to enable more effective use of skills and experience to improve patient management and outcomes to meet the needs of rural, regional and remote communities in NSW.  This vision requires a number of RDNs pillars working on objectives and strategies such as;

  • Grow the community and primary health care nursing and midwifery workforce to meet the health needs of rural, and remote NSW communities.
  • Planning for the health workforce as a unified system with locally developed, innovative approaches to the delivery of primary health care that meets communities’ needs
  • Health workforce planning needs, incorporate practitioner scope of practice matched to community health needs.
  • A mechanism for dissemination of effective approaches to improved patient centred, team-based care exists
  • Improved capability and wellbeing of primary care nursing and midwifery workforce

Biography:

Carolyn Ripper is a registered nurse and midwife who has a background working in rural and regional communities in primary care roles, health care redesign, project and change management and program implementation.  Carolyn is leading NSW Rural Doctors Network’s (RDN) Nursing and Midwifery Strategy, working with key stakeholders to implement RDN’s Nursing and Midwifery Workplan objectives to embed nursing and midwifery solutions to ensure rural, remote and regional communities have access to quality primary health services.

Tasmanian Rural Hospitals – Safe Staffing Project

Ms Karen Schnitzerling1, Ms Fiona Young1, Ms Cate Pel1

1Tasmanian Health Service, Australia

 

Tasmania has 13 small Rural Hospitals which are all unique in regard to regional characteristics, bed numbers, bed types, emergency activity, medical support, outpatient presentations, community services, and visiting health services.  One thing our Rural Hospitals do share is the passion and commitment of staff and the support and investment of the local communities.

With the competing demands on our health system we have needed to maximize the use of our Rural Hospitals to assist with patient flow throughout our health system and to have the ability to accept patient transfers from metropolitan sites particularly in periods of high demand.  To manage this patient flow, we have had to review the clinical staffing of Rural Hospitals and have embarked on establishing a ‘Safe Staffing Model’.

With no identified comparative staffing model that would transpose across the Rural Hospitals, a state-wide working group was formed in February 2018 to define a proposed model.  I will outline how we defined a staffing model, how we consulted, the outcome, and the next steps.


Biography:

Karen Schnitzerling is the Director of Nursing for Beaconsfield District Health Service and George Town Hospital & Community Centre in northern Tasmania.   Both sites have small rural hospitals.

The Role of the Female Rural Generalist

Dr Maria Capoluongo1, Dr  Sundar  Thavapalasundaram

1Royal Flying Doctors Service South Eastern Section, Broken Hill, Australia

 

What role does the female rural generalist play in the landscape of rural generalism?

What role do we play if anything in shaping the provision of primary care?

Being a female GP who works remotely I can say that we add so much to our communities we serve. It is so important to be representative. Im lucky enough to work for the RFDS who unashamedly fly the flag for this cause. I am also lucky enough to work with some great female colleagues.

Female medics account for half the general practice work force if not more and our numbers are growing.

How do we attract more female GP’s to these rural roles , I will explore some of these ways in this presentation and hope to find new ways to help fill the gaps we are facing in medical workforce in the bush.

  1. Talent finding- novel ideas, advertising, recruitment drives, conferences, courses, sending questionnaires out to city GP’s- offer sabbaticals in rural areas.
  2. Proactive – medical schools, promotional work, target newly qualified GP’S
  3. Incentives – financial, relocation, childcare for mothers, childcare very important, spousal employment opportunities
  4. Stigma professional isolation talking this, discussions, forums, rural generalist pathway- stream lining this

5 Retention- professional development, work life balance. lifestyles choices.

  1. Leadership Roles- offering more to females, management roles teaching and academic.

A general push is needed in this area at a local and government level, we need more GP’S and we will soon be facing crisis in primary care provision. Something needs to be done.


Biography:

Dr Capoluongo MBBS, BSc, MRCGP, FRACGP

Uk traine GP, interest in mental health and service development, moved to Australia with family to work for RFDSSE. Currently GP with RFDS, delivering primary to the outback

 

How the NP and RN-led ATC in a small rural hospital is fulfilling the needs of their local community

Ms Jodie Cameron1, Ms Michelle  Cruse1

1Southern NSW Local Health District, Pambula District Hospital, Australia

 

Across Australia, many rural health regions are facing the dilemma of providing safe high quality health services to their populations in the wake of hospital downgrades and/or the loss of medical practitioners in rural small hospitals. Evidence, and service description supporting or describing the implementation and outcomes of Nurse Practitioner services in Australian rural small hospitals with no on-site medical staff is lacking. In addition, public health policy to close or downgrade small hospitals and concentrate services in main centres often causes community angst and significant hardship in rural areas where people have previously relied on their local community hospital and GP services to provide for their health needs.

This presentation describes the first 6 months of data post successful addition of Nurse Practitioners to a nurse led Assessment and Treatment Centre at a small downgraded NSW rural hospital. With no doctor on site or available on call, and with a limited Scope of Practice for the RN-led service, the addition of NPs has improved ATC patient numbers, improved community confidence, filled a service gap between overloaded local GP services and the regional hospital ED, and has significantly reduced the load on the regional hospital by reducing transfers and presentations, particularly important in periods of high tourist activity.

To date the service has demonstrated safe, cost effective, community based care and is proving to be an excellent alternative to GP or ED presentation, including collaboration with the GPs and ED to co-manage their scheduled re-presentation patients. There is potential for growth and development for the RNs to further increase their scope and work satisfaction, and provides a potential training pathway for aspiring NPs. The success of this service has positive implications for many smaller rural and remote services needing innovative solutions for provision of safe and cost effective care.