Palawa partnering: developing effective partnerships between mainstream and Aboriginal health services

Carol Jackson1, Belinda Fenney-Walch1, Emma Shanahan2

1Public Health Services, Department of Health, 2Tasmanian Aboriginal Centre

The National Safety and Quality Health Service Standards (edition 2) require accredited health service organisations to work in partnership with Aboriginal communities to meet their healthcare needs. What does this mean for Tasmanian health organisations?

Where health services cannot effectively be provided by Aboriginal community controlled health services, effective collaboration between those organisations and mainstream health services is vital to support accessible and culturally safe services and improve health for Aboriginal people.

Tasmanian health organisations are embracing the need to improve Aboriginal cultural respect. This presentation will provide examples of what has been achieved through effective partnerships, and guidance for working effectively with Tasmanian Aboriginal organisations.

Examples of achievements through collaboration between Aboriginal and mainstream health organisations in Tasmania over recent years include:

  • the Aboriginal Midwifery Outreach Program
  • development of the draft Action Plan for Improving Aboriginal Cultural Respect Across Tasmania’s Health System
  • easier access to Aboriginal cultural awareness training
  • better parking arrangements at the Launceston General Hospital for Aboriginal Health Workers.

Working in partnership with Aboriginal Community Controlled Health Services provides inspiration for a future characterised by culturally safe health services, equity in health outcomes and recognition of those services as best practice health service providers.


Biography:

Belinda has worked across the Tasmanian health sector for over thirty years in nursing, policy, communications and project roles, with a focus on population health and health equity. Belinda is coordinating efforts to improve cultural respect for Aboriginal people across Tasmania’s health system and wrote the well-received Aboriginal Cultural Respect in Tasmania’s Health Services Community Consultation Report (Department of Health Tasmania, 2018).

Emma is an Enrolled nurse and palawa (Tasmanian Aboriginal) person, mother and wife. In 2012, she was a State Finalist for the Aboriginal and Torres Strait Islander Student of the year, and became the first Enrolled Nurse employed by the Tasmanian Aboriginal Centre, where she continues to enjoy the privilege of working with her community. She has continued training since then, including gaining a graduate certificate in chronic disease self-management and a Certificate 4 in Alcohol and Other Drugs. She has enrolled to complete a Bachelor degree in nursing.

Carol has had the privilege of working with Tasmanian Aboriginal people for over twenty years mainly in the area of public sector employment and career development and more recently within the health sector including the development and implementation of the Aboriginal Midwifery Outreach Project.  Carol is currently working with Public Health Services assisting in efforts to improve cultural respect for Aboriginal people across Tasmania’s health system.

Clinical Midwifery Educator Network (C.M.E.N) – A community of practice. From small things, big things grow!

Mrs Judy Parish1, Ms Yvette Story1, Mrs Megan  Parr1, Mrs Evelyn  Larcombe1, Mrs Deb Clay1, Mrs Mandy Gleeson1, Mrs Andrea Vout1

1Tasmanian Health Service, Hobart/Launceston/North-West Coast, Australia

Abstract:

Tasmanian midwives can achieve better outcomes by sharing resources and strategy. Whilst recognising the regional differences in Tasmania, our goals are very similar.  By communicating regularly, benchmarking, sharing ideas, planning and with co-operation, the THS Clinical Midwifery Educators have achieved significant learning outcomes for health professionals who work with pregnant women in Tasmania.

Significant achievements to date:

  • PROMPT facilitator training in 2015 was our first combined activity. The success of this program as a State-wide initiative showed what could be achieved by working together.
  • Still Aware the roll out and workshops South, North, North West with participants from across the state at all workshops
  • Support of midwifery students through a united approach, all hospital sites
  • The sharing of resources including guideline development, teaching tools.
  • Water immersion for labour and birth workshop offered state-wide
  • The development of the Tasmanian Health Service (THS) Midwifery Education Hub which has enabled midwives across the state to access educational resources and opportunities in one convenient location.
  • The identification of specific clinical skills in perineal repair held by Megan Parr Clinical Midwifery Educator Launceston General Hospital (LGH) – leading to the facilitation of Perineal Suturing workshops in the North, North West and South.

Biography:

Megan Parr undertook midwifery training in the United Kingdom and has continued to work in midwifery roles since that time.  This includes working in rural GP led units to tertiary units, providing midwifery led care in an MGP model and volunteering as a midwifery educator to support trained birth attendants in a refugee camp the Thai Burma border. Professional qualifications include Master of Midwifery and International Board Certified Lactation Consultant.

Yvette Story who completed her midwifery training also in the UK and has also worked as a midwife in a variety of setting, for example public tertiary referral hospitals, private maternity units to rural and remote setting throughout WA and the NT.

Currently Yvette is a Clinical Midwifery Educator at the RHH and a LINC Coordinator /Clinical Midwifery facilitator for the University of Southern Queensland

Tasmanian Immunisation Strategy 2019-24: A collaborative approach

Ms Fran Tiplady1

1Department Of Health

Abstract:

The Tasmanian Immunisation Strategy 2019-24 will guide our approach to publicly-funded immunisation in Tasmania over the next 5 years. The Strategy has been developed in the context of the National Immunisation Strategy for Australia 2019-24, national policy, local needs, and with extensive stakeholder consultation.

The Strategy identifies 5 strategic priorities, each with underlying objectives and key actions:

  1. Improve immunisation coverage
  2. Ensure an adequately skilled immunisation workforce
  3. Enhance monitoring and evaluation of immunisation programs
  4. Strengthen governance and engagement with our partners
  5. Maintain community confidence in immunisation.

Collaboration of a range of healthcare professionals providing vaccines in a variety of settings in Tasmania is key to addressing each of these priorities.

The Tasmanian Poisons Regulations 2008 enable Authorised Immunisers to independently administer certain vaccines without a medical order. Authorised Immunisers are registered nurses, midwives and pharmacists who have completed an approved educational qualification in immunisation and practice in accordance with an Immunisation Program Approval from the Department of Health.

Medical practitioners, Authorised Immunisers, and the Department of Health have collaborated in developing and are now involved in implementing this Strategy, to maintain and expand safe and trusted protection of Tasmanians from vaccine-preventable diseases.


Biography:

Fran Tiplady is a registered nurse and has worked in the acute clinical setting in Victoria, New South Wales, the Northern Territory and Western Australia. She undertook a Masters of Public Health at the University of Sydney and began working at the Victorian Department of Health in 2014, initially as a Public Health Officer, then as the Manager of Investigation and Response in the Health Protection Branch.  Fran moved to Tasmania in April 2019 to take up the newly created role of Nurse Manager in the Communicable Disease Prevention Unit of the Department of Health.

“By Heart” – how an art project improved patient and nurse experiences on an acute cardiac ward

Mrs Georgia Headley1, Jennifer Codee1

1THS, Hobart, Australia

Abstract:

Ward 2D at the Royal Hobart Hospital has lost all natural sunlight due to the construction of K Block. This has had a negative impact on mood and morale for staff, patients and visitors.

2D clinical nurse educators and nursing staff collaborated with Inscape (a not for profit arts health organisation that works in partnership with the RHH to support art programs in the health care setting) to enliven the space with the “By Heart Project” through art and music.

Patients and nurses were encouraged to make anything they liked to creatively express what they knew “by heart”, a theme in keeping with our ward’s core business, cardiac care. This included one-on-one art making with patients, resulting in several art pieces involving moving stories of the patient’s lives which had a positive impact on nursing care provided to the patients.

By improving the aesthetics of the space through personalised art making and the acquisition of suitable uplifting art work in the rooms, patients and nurses reported improved levels of wellbeing.


Biography:

Georgia is a Clinical Nurse Educator for Cardiac Services at the Royal Hobart Hospital. She has over 15 years of experience as a cardiac nurse and has also worked as a Clinical Facilitator for student RNs for the University of Tasmania. She is currently Secretary for the Australian Resuscitation Council – Tasmanian Branch.

Jennifer completed her Bachelor of Nursing at the University of Tasmania in 1996. Cardiology and cardio-thoracics have been the specialties that she has worked in most consistently over that time due to its ever changing, unpredictable and rewarding outcomes. Jennifer currently works as Clinical Nurse Educator for Cardiac Services at the Royal Hobart Hospital. She is passionate about a holistic approach to wellbeing for both patients and staff.

Introducing a Post Graduate Emergency Nursing Program in a specialist tertiary hospital

Mrs Vanessa Gorman1, Ms Grace Currie1,2

1The Royal Women’s Hospital Melbourne, Parkville, Australia, 2The Royal Melbourne Hospital, Parkville, Australia

Abstract:

Introduction:
An evolving workforce, increasingly complex and diverse patient population and an increase in acuity of presentations prompted nursing leadership to consider how the nursing workforce could be “future proofed”. It was suggested that the introduction of an emergency nursing post graduate certificate would enrich the current skill set of a midwifery led Emergency Department and improve knowledge and skills.

Objectives:
Introduction of Graduate Certificate in Nursing Practice (GCNP) – Emergency in a specialist tertiary in emergency department in metropolitan Melbourne. Future proof the nursing/midwifery workforce by aiming to introduce a skill mix of up to 30% critical care trained staff within a largely midwife led department.

Methods:
The Nurse Unit Manager collaborated with the Clinical Education team to implement a pilot program for post graduate emergency nursing in a specialist Emergency Department in Feb 2019.

Results:
Successful implementation of the pilot program evidenced by both students successful completion of the course with successful recruitment for 2020 completed to continue the program. Collaboration with precinct partners and academic providers resulting in stronger professional relationships, working towards a more diverse staff base across campuses.


Biography:

Vanessa Gorman commenced her emergency nursing career in 1996 at Austin Hospital, Melbourne. Across her 23 year career in emergency nursing she has held positions such as Associate Unit Manager, Nurse Unit Manager, Project Manager, Senior Policy Advisor – Department of Health & Human Services, Bed Access Coordinator, Nursing Educator and State Trauma Manager. Vanessa holds post-graduate qualifications in Emergency Nursing having completed a Masters in Speciality Nursing (University of Tasmania) and a Graduate Diploma in Health Services Management through Monash University. Vanessa is the Chair of the International Advisory Council for the Emergency Nursing Association (USA), which aims to make improvements within emergency nursing globally. Vanessa is dedicated to improving nursing work conditions with a particular interest in fatigue management. In 2015 she was co-lead in a Worksafe Victoria project with a focus on fatigue management for Emergency Nurses. Vanessa also has a passion for workforce management and importantly around what the future of nursing, and in particular emergency nursing, may look like. She recently presented to the largest Emergency Conference in the world in the USA where over 4000 delegates attended. Vanessa currently works in a speciality emergency department in Melbourne Victoria as she continues her drive to improve emergency care and support emergency clinicians.

Seizing opportunity too good to miss!! Answering a call to action to embed wellness and reablement in community nursing

Ms Linda Proietti Wilson1, Ms Annette Barrett2, Ms Jan Coull2, Ms Chrissie Williams2

1Department of Health, Launceston, Australia, 2Tasmanian Health Service, Launceston, Australia

Abstract:

In late 2018 the Launceston Community Nursing Service faced a significant challenge. National aged care reforms were driving adoption of wellness and reablement services within community nursing services however there was confusion regarding the practical application of this approach within a community nursing setting and the service had limited capacity to fund the needed workforce upskilling and service changes.

But then planets aligned!  A community nurse with experience in motivational interviewing and chronic disease self-management support joined the team and was eager to champion and support changes in practice.

And around the same time TasCOSS was offering assistance with assessing organisational readiness for wellness and reablement and training and support of staff in a wellness approach.

So, when opportunity came knocking the service acted quickly!

A successful submission for grant funding to the Tasmanian Wellness Framework Project allowed for the implementation of a 12-month program of activity designed to reorientate community nursing practice through practical support and mentoring.

In addition, LCNS seized the opportunity to advocate for wellness and reablement to be embedded in a new state-wide Tasmanian Health Service community nursing skills pathway and the configuration of the new electronic interRAI nursing assessment, risk screening and care planning tool.

Agile thinking and a coalition of willing collaborators has enabled LCNS to resource and implement a multi-level strategy designed to embed wellness and reablement in routine processes and practice.


Biography:

Linda Proietti Wilson is an Assistant Director of Nursing within the Department of Health, Tasmania.  Linda is currently leading a project to develop a ‘wellness’ framework, which aims to support a greater focus on working in health promoting ways across the spectrum of health care including hospitals and community care.

Jan Coull is a Senior eHealth Project Manager for the Tasmanian Health Service and has led local and statewide eHealth Projects since 2010.  Jan also has more than 30 years Nursing experience in the acute, rehabilitation and outpatient sectors. Jan’s eHealth experience includes a project clinical advisory role and clinical lead of a statewide Patient Flow Manager system and an Oncology electronic Medical Record project.  Jan’s work focuses on change management, re-engineering business processes and streamlining workflows. Jan is currently Project Manager for the statewide implementation of the interRAI assessment, risk screening and nurse careplanning tools for Community Nursing, the Acute sector and three pilot  district hospitals.

Chrissie Williams is a Registered Nurse, Bachelor of Science (Honours), with a diverse range of experience within acute and primary health, Local Government and Education settings inclusive of wellness and reablement both at grass roots and strategic level. Chrissie is currently working as clinical lead on the LCNS Wellness & Reablement Project whilst studying for her International accreditation as a Health and Wellness coach.

Annette Barrett is the Assistant Director of Nursing for Primary Health North. She has over 35 years nursing experience and is very passionate about the practical application of Primary Health Care principles as well as promoting increased recognition of the value of community health services and ongoing innovation in community health service delivery.

Journal club: but not as you know it

Ms Fiona Swinton1

1THS – N, Launceston, Australia

Abstract:

The implementation of a ‘nursing journal club’ in an Acute Medical Unit took an unconventional path, resulting in positive outcomes for staff and patients.

Feedback from staff of inconsistent education and not feeling consulted on practice changes was contributing to low morale. After research into ideas to improve work satisfaction and nurse well-being, a journal club was proposed.

Consultation with healthcare improvement experts recommended the inclusion of staff in the development, structure and content of the club. It was integral to ensure that nurses controlled the club rather than it being ‘forced’ upon them by senior staff.

Guidance was provided on how to locate articles and lead a presentation for critical appraisal first, with nurses in non-leadership roles invited to present relevant articles.

Positive dialogue and collaboration were occurring around the content of the articles rather than in their analysis, leading to the development of nurse initiated working groups. The link to evidence-based practice and peer learning was also enhanced with personal experiences. The nurses subsequently reviewed the purpose of the group and nominated to rename this a ‘journal discussion group’, reflecting that the article content was more valuable to them.

Encouraging nurses to have input into a project devised to improve their work satisfaction has led to its success. Abandoning a traditional structure of the journal club for one that suits the needs of the nurses has resulted in positive changes to practice and personal well-being.


Biography:

Fiona has practiced as the Clinical Nurse Consultant in the Acute Medical Unit (AMU) at the LGH for the previous 6 years. She has a background as a diabetes nurse educator but her main passion is in quality improvement and  promoting a positive culture, particularly by encouraging her team in the AMU to be actively involved in decision making.

Mentoring our early career nurses/midwives – inspire them for the future!!

Mrs Sue Hughes1

1Tasmanian Health Service, Hobart, Australia

Abstract:

Hospitals and health systems across the world are facing shortages of skilled nurses/midwives. There is an exodus of experienced nurses & midwives leaving the workforce mainly through retirement and those having mid-career changes. Nursing and Midwifery leaders are having to rely on the influx of novice nurses/midwives entering our workforce to fill vacant positions. Added to this scenario is the rise in the complexity of care, increase in the older patient population, chronic co-morbidities and a  growth in mental health issues. These are compounding to the problems facing the workforce. As a result, it is becoming more multifaceted for the novice nurse/midwife, transition to practice.

New graduates, are abruptly exposed and challenged to adapt to the demands of nursing work, including shifts, mental and physical tensions, culture differences, exposure to traumatic situations, time pressures and new situations, daily. Without a supportive environment these new graduates are vulnerable to leaving the profession and wasting their dedicated years preparing for their career.

According to Maslow’s hierarchy of needs, individuals cannot reach their full potential if they are struggling with basic needs. Studies have shown that burnout and compassion fatigue are major reasons why early career nurses, transitioning to practice, leave the nursing profession, due to the stressful process of change. (Chang and Daly, 2012). Consequently, developing resilience and confidence in practice early in a graduate’s life is important for their health and wellbeing, and for keeping them within the profession. We need them!!

There are many strategies that can put into place to support their transition into the workforce. This presentation provides an insight into being a mentor and a mentee, building a collaborative relationship to support an early career nurse. It challenges all nurses/midwives to take up this critical role and invest in novice nurses/midwives. The importance of building resilience in the early stages of their career is vital to ensure that the graduate is inspired to stay in the profession and be part of the workforce for the future.

*Chang E., Daly J. (2012). Transitions in Nursing Preparing for Professional Practice 34th Edn., Chatswood, NSW: Elsevier.


Biography:

RN, RM, M.Ed., FACN, MACM

Having started her career as a paediatric nurse at Great Ormond Street Paediatric Hospital, in London, Sue moved to Tasmania and has diversified her roles and experiences into education, management and project work, across all facets of practice.

In 2010 Sue was awarded “Australian Institute of Project Management Tasmanian Award for best Tasmania Small Project”

‘The Neonatal & Paediatric Intensive Care Enhancement Project’

Some of her main experiences have included:

  • Nurse Educator, Program and Staff Development Coordinator for the Women’s and Children’s Services
  • Operationalising workforce reforms including scopes of practice, workforce planning & development
  • Nurse representative on the Nursing and Midwifery Board of Australia (Tasmania)
  • Program Officer for the Clinical Redesign Program in partnership with the Tasmanian Health Service and the University of Tasmania.
  • Management, coordination and facilitation of implementing the 2016 Nurses and Midwifery Enterprise Bargaining Agreement across Tasmania.
  • Currently she remains in the Office of the EDONM assisting the Nursing and Midwifery Executive apply state-wide consistency in practice and operational policy.