Chronic Care, Aboriginal Health Service, NSW

And now for something completely different!
Janet Richardson and I met Molly whilst taking part in the Planetary Health Alliance meeting at Edinburgh University this year. We were there to present posters and carry out a workshop on the TOOLKIT.

I was very lucky to meet up with Molly again, this time at the Northern Sydney Health Centre. Molly is a Clinical Nurse Consultant working in the department for Chronic Care, Northern Sydney Local Health District, Aboriginal Health Service in NSW. She is part of a small, very dedicated team who are working together to improve the health and life of their clients. One of the most difficult things is actually getting their potential clients to come and talk to them. From what Molly told me this sometimes takes a long time and often works by word of mouth and building up an awful lot of trust.

A big chunk of Molly’s work is coordinating and creating various health pathways for her clients. She spends a lot of time listening to people’s problems, even when these are not being said out loud, then she takes action and doesn’t stop until things get done. When she sees a need for a link in the care pathway she works to create it, whether it is with individuals or whole departments. She works very hard to get the specialties her clients require on board. She’s even managed to get specialty areas, which do not belong directly to health, to give their support.

We discussed the use of the NurSusTOOLKIT and if it would be possible to integrate it somehow into her work. In particular, we discussed the themes and topics dealing with the social determinants of health and how these might be used as a starting point for some of the areas she’s involved with. We also looked at topics on mental health and green spaces. It became very clear to me, that our TOOLKIT is very European! There’s very little about indigenous peoples and links between the elements and lifestyles. This is definitely an area where Molly could bring in her expertise when the TOOLKIT is adapted for use in Australia.

I spent a great afternoon and was absolutely amazed by Molly’s energy and dedication. She is so enthusiastic when she’s talking about her work, it’s infectious.

Thanks Molly for the short but really interesting glimpse into your work!

Australian Catholic University

Janet Roden also organised for me to visit the School of Nursing at the Australian Catholic University’s North Sydney campus. There are two parts to this campus; one situated in a residential area and the other (only 5 minutes walk away) is a very modern building situated a bit more downtown. Here we met with Prof. Amanda Johnson who is State Head of the School of Nursing, Midwifery & Paramedicine and Dr. Peta Drury, the Deputy Head of School, to discuss curriculum development. It was planned later in the day that I would present the NurSusTOOLKIT and, for those who were interested, I would carry out a workshop, which would take place in the skills labs.

 

Amanda and Peta were very interested to hear about nurse training in Germany and especially about our new BSc in Nursing in cooperation with the university of Tübingen. In turn, Amanda and Peta explained their curriculum and the philosophy behind it, the timing and format of the practical placements and the challenges of organising 6,500 nursing student over campuses in Ballarat, Brisbane, Canberra, Melbourne and North Sydney. It was really fascinating listening to all of this.

Australia, like many countries, is experiencing a nursing shortage. This however, is not to be compared with the shortage of nurses in Germany. Perhaps this is because the government is aware of the situation and have introduced methods to not only attract student nurses but also ways for retaining trained nurses in the workforce.

Nursing in NSW has a very transparent system with nursing aids, enrolled nurses and registered nurses making up the workforce. Student nurses are supernumerary. Each role has designated duties which I’m sure must make life on the wards much easier. The registered nurse will have a diploma or a degree. Those with diplomas can advance to degree level through taking various courses. Enrolled nurse are often seconded by their employers to complete a Bachelor Degree and then to return to their employer when they’ve finished this. Enrolled nurses have direct entry into second year of the Bachelor course. This is also a good way of retaining staff. AND, the level of your qualification is also one of the criteria required for promotion.

After lunch I presented the TOOLKIT, again as a Zoom Conference, with colleagues from Canberra taking part. A technician set up the Zoom Conference and the remote controlled camera and was on hand to give full support throughout the presentation. We were able to discuss the use of the TOOLKIT and the possibilities for adapting it for use in Australian nursing curricula.

We then visited the skills labs and were able to put the monitors at each bed to good use by demonstrating access to the website and the TOOLKIT. We had quite a bit of fun carrying out some of the activities from the TOOLKIT too!

Thanks again Amelia (Amanda’s PA) for looking after us and for your support behind the scenes J

 

Interesting point: The ACU originated from the amalgamation of several colleges. The original College in Mount Street was established to train the Sisters of Saint Joseph of the Sacred Heart, an order founded in the 1860s by Mary MacKillop, as teachers. Mary MacKillop was canonised in 2010 and is Australia’s first Saint.

 

 

University of Western Sydney, School of Nursing and Midwifery

I was invited by Dr. Stacey Blythe to present the NurSusTOOLKIT at the University of Western Sydney, School of Nursing and Midwifery. Janet Roden accompanied me there and we set off together in her car.

The presentation took place at Campbelltown Campus, which is roughly a one hour drive from central Sydney. The School of Nursing has approximately 6000 students!

I presented our NurSusTOOLKIT via Zoom Conferencing, so that those interested in the TOOLKIT but working at other campuses could still take part. Afterwards, we had a short discussion on nursing, sustainability and limited resources and also on the implications of climate change on health. We briefly discussed the use of the TOOLKIT with the head of curriculum development, Stephen McNally.

I was then invited to visit the nursing labs. On the way there we discussed the Bachelor degree programme at the university and the sheer logistics of coordinating not only the theoretical part of the programme but also the practical placements for 6000 nursing students. During their placements the student nurses are supernumerary with a mentoring ratio of 1:8. Therefore, one of the difficulties of having so many students is finding placements where the students can be mentored and also get all the opportunities the placement has to offer. Student nurses must complete a total of 800 hours of nursing practice. I was informed there is no evidence for the students having 800 hours of clinical practice, but that it was pragmatism, due to the vast number of students in training.

The student nurses gain their skills prior to observing/working in practice in the clinical skills labs. The labs are set up for teaching and practice by technicians and the set up is in accordance with the students’ year of study. In the labs, a lecturer who is often a nurse in practice supervises the students. First year students begin by learning different basic skills, which become more complex and require increased critical and analytical skills as the students progress through second and third year. The bed space is set up exactly as it would be found on the ward. Between the labs are storerooms, which are also a replica of what the students will find in practice. To minimise waste, all the equipment, tubing, syringes etc. are recycled after the teaching session.

Each bed space has a camera mounted to the ceiling and a monitor so demonstrations can be filmed and the student can see exactly what is happening. A mannequin occupies each bed and these mannequins also become more complex as the students progress through their training.

Toward the end of the programme, highly complex scenarios are coordinated and simulated by a technician who follows protocols from behind a one-way window. The technician can, for example, raise or lower blood pressure, blood sugar, respirations, heart rate, etc. and the student nurses have to react as required.

Thanks again to Stacey and the other lecturers I met at Western Sydney, it was very interesting indeed!