On the Road

I have always been fascinated listening to people who have visited the town of Cairns, situated in the north east of Queensland, Australia. It is a great favourite for tourists and backpackers but according to Cairns Regional Council it is also  ‘The only place in the world where two World Heritage areas meet – the Great Barrier Reef and the Wet Tropics Rainforest’. Although I had no official meetings planned further north than Brisbane I was intrigued to see this for myself, so I took myself off to Cairns. And I was not disappointed.

My room was about 20 minutes walk from the town centre. I walked along the esplanade everyday with its magnificent view out to the Pacific Ocean. There were always plenty of seagulls to see during the day and at night you could see and hear the fruit bats. A group of pelicans seem to occupy the same spot on the water (or the sand when the tide was out) day and night. The frightening thing for me was the warning sign on the esplanade walk!

It was only a 45-minute walk to the Botanic Gardens, which was really worth the visit. The entry is free, which is good, because you can spend a few days looking at everything. It was so interesting seeing trees and plants that I’d never even heard of before.

I also took a trip to the Daintree Rainforest. This is the oldest wet tropics rainforest in the world and has been a world heritage area since 1988, which has protected it from deforestation and building sites. It is home to some rare plants and animals. Information online states that some of the trees are over 3000 years old. Amazingly, I did manage to see some salt water crocodiles, a Ulysses butterfly and from Port Douglas a turtle swimming in the Pacific Ocean. Unfortunately, I wasn’t quick enough with my camera.

I had mixed feelings about visiting the Great Barrier Reef, but was able to choose a company that have environmental protection high on their agenda. We were told not to use sun tan lotion as this has been proven to be harmful to coral reefs. Instead we were issued with protective suits. It was a strange feeling swimming ‘in the middle of nowhere’ in the Pacific Ocean, but very worthwhile indeed. 

Whilst there I became a member of the ‘Citizens of the Great Barrier Reef’. This is a social movement, which aims to engage the world in the future of this World Heritage area.

Spending time in this area has made me realise just how fragile our environment is and how delicate the balance is of, on the one hand, creating strong economic economies i.e. through tourism and on the other hand, protecting the environment.

Next stop, Melbourne 🙂

Whilst attending a meeting at Tübingen University last year I was fortunate to be introduced to Patsy Yates, Dean of the School of Nursing at Queensland University of Technology in Brisbane. Among other things, we were there to discuss the role of the graduate nurse: we are just starting out in Esslingen and Tübingen but Australia has over 30 years of experience in graduate transition programmes. I mentioned my plan to come to Australia and she invited me to visit to further discuss the development and role of the gradate nurse and also to present the NurSusTOOLKIT. Unfortunately Patsy herself couldn’t be there due to other commitments.

The organisation of my visit was given to someone in the department. I received an ’Outlook Calendar’ request with the date and time of the meeting, which I accepted. At the time I did think it was really encouraging that staff were prepared to give up their Friday afternoon from 3.00-5.30 pm to listen to my presentation. As I wasn’t quite sure how to get to the school on campus I mailed the person who had been organising the meeting, with, unfortunately, no response. On the day in question I eventually managed to contact someone in the school who informed me everyone was ready and waiting for me to give my presentation …, but it was only 11 am???????

Now for all the mathematicians out there: the ’Outlook Calendar’ request stated 3.00. Brisbane was 8 hours ahead of Esslingen when the appointment was arranged, so 3.00 in Esslingen was actually 11.00 in Brisbane and not realising this at the time, I (wrongly) assumed 3.00 was 3pm. The meeting was actually planned for 11am. As there was no extra written correspondence, my assumption (3pm) remained, so I ended up being really late and rushing to get there on what was to be the hottest day of my travels so far, 36°C. Not really the temperature for such a stressful situation!

Although this is not the best start or preparation for a presentation, it went well as did the subsequent discussion. During the discussion I was asked if I had encountered climate change scepticism during my previous presentations in Australia and I answered I had. We discussed why this should be and came to the conclusion that the it might partly be because the Government are not really supporting the idea (by encouraging new mining areas and propagating ‘clean coal’) but also as in my previous blog, many livelihoods are dependent on industries which are causing global warming.

I also met Teresa Lewis, who was visiting QUT at the time. Teresa has a background in Green Hospitals and has been carrying out some work using the TOOLKIT. We had a chance to exchange ideas which was really good. AND her and her husband drove me back to my flat, so no chance of getting lost this time! Thanks again for that Teresa.

I’d also like to say a big thank you to Wendy who looked after me so well, she got me sorted out when I was running late with a taxi and some lunch and she also sent out a search party when the taxi dropped me off at the wrong place. Thanks again to Associate Professor Carol Windsor, Coordinator of Post Graduate Research who was so welcoming and chaired the session.

Next stop, Cairns 🙂

I was invited to visit the School of Nursing and Midwifery at Newcastle University by the Dean of School, Professor Sally Chan. Unfortunately, due to appointments abroad, she was unable to be there but I was very well looked after by School staff members.

Before meeting some of the department I had coffee in the university’s library. For me, having coffee in the actual library was a very unusual experience, but I thought it provided a very relaxed working atmosphere.

I first met with Acting Head of School, Associate Professor, Kerry Inder and the leaders of the Nurses and Midwives Master Programmes, Jed Duff and Eileen Dowse. We discussed the various Master programmes they run and courses on offer to the students. There are certainly a great variety of specialties on offer.

More colleagues joined us for a working lunch and I presented the NurSusTOOLKIT. The presentation and following discussion was again recorded via zoom for those who couldn’t attend the meeting. We discussed the importance and increasing relevance of climate change, health and sustainability and the integration possibilities of these topics within the nursing curriculum in Newcastle.

I was then very fortunate to meet up with Dr. Sara Geale, Director of Clinical Education. I spent a very interesting hour with Sara as she very patiently explained the student nurse placements: how and where these are organized according to level of training and specialty required. Again, only 800 hours are spent in practice and the actual placements, in public and private hospitals and care homes are very similar to those our students would visit during their training, although the students are supernumerary, something we’re a long way away from in Germany. However, one placement she mentioned really did catch my attention: some students are sent out on placement to the Royal Flying Doctor Service. This is a service providing primary health care and emergency services for people who, due to great distances, are unable to visit a primary health care centre or hospital. What a great experience! Again this highlights the complexity of providing health care and the effects this will have on climate change.

Following this I was able to spend another very interesting hour with Dr. Victoria Pitt, who is the Programme Convener of the Bachelor of Nursing programme. Victoria explained the curriculum and its’ philosophy, giving me a lot of insight into how the programme runs.

My day at Newcastle University was very informative, thank you to everyone there.

Thanks again Sally for giving me this opportunity and I hope next time to meet you in person!

Thanks to Jenice for all the organisation and help behind the scenes 🙂

Next stop, Brisbane!

I travelled to Newcastle by train. You can use your Opal Card for this. The two-and-a-half -hour train journey cost a ridiculous 8,95A$ (=approx. 5€)! This has to be a really good reason to leave your car behind and take the train!

In Newcastle I was lucky to meet up with a family friend. He took me on a 50-minute journey from Newcastle to Nelson Bay and Shoal Bay, pointing out the enormous sand dunes, which you can see for miles and the spots on the way where we might see Kangaroos. Unfortunately we didn’t see any. But what we did see really shocked me. Miles and miles of coal heaps waiting to be transported by container ships mainly to India and China. These coal heaps are being constantly sprayed with water to reduce the amount of coal dust in the atmosphere. I saw 4 container ships being loaded with coal in the harbour and that evening we counted thirteen ships waiting out at sea for their time to enter the harbour to load up with coal. Reflecting on this situation highlights again the links between sustainability, climate change and health. The coal mining industry in Newcastle obviously creates a lot of employment and investment. When livelihoods are dependent on work, which is actually damaging people’s health and the environment the situation becomes even more complex.

Long-term planning is vital so that the risk of unemployment is minimal. Janet Roden did some research funded by the Climate Action Network Australia looking at exactly this problem in the coal mining area of Muswellbrook and nearby communities, which demonstrates that it is essential to address these problems and plan for the future.

The visit to the ‘bays’ was really worth it, with stunning views of the Pacific Ocean. We didn’t spot any Koalas but we did disturb a Goana, who was having a little nap on the path we were taking!

Thanks again Josh to you and your sisters for your hospitality 🙂

I’ve been lucky to have some free time in Sydney and have used this to do some sight seeing. Travelling around Sydney is very easy with the Opal card, which is very similar to London’s Oyster card. It can be used on the trains, the metro, buses and ferries. However, unless it was really far out of the centre of town, I did most of my sightseeing on foot.

One of the first places I visited was Sydney Opera House.

Here I booked a tour, which takes you into the various theatres and the small and large concert halls. It also gives you a very good history of the area, the Danish architect Jørn Utzon, who in 1957 won the international competition to design the opera house at Sydney’s Bennelong Point, and the building of the opera house.

The opera house is not only home to classical concerts; on our tour we experienced the sound check from ‘Foreigner’ who were playing that evening.

There are lots of places to buy food and drink and souvenirs. The seagulls are out in force there and if you’re not careful they’ll snap your lunch right out of your hand!

At one of the restaurants I was really happy to find that everything in use was recyclable; the plates, napkins and cutlery were made out of Bamboo and the drinking glasses were made out of a plant substance.

Right next to the Opera House is the Royal Botanic Garden, full of fascinating plants and birds.

Another spectacular visit is to Sydney’s Harbour Bridge, again with a fascinating history. Here I did the night walk and it was fantastic to see the Opera House all lit up and of course the lights of Sydney. We were told by our tour guide that when the bridge was designed there were a total of three cars in Sydney. It was opened in 1932 and now, approximately 150,000 cars (give or take a few 1000) cross the bridge every day. There are eight lanes for cars, 0ne pedestrian-only footway, a cycleway and two rail tracks.

There are lots of things to see in and around the bridge area: ‘The Rock’ with it’s very old history and the Ferry Wharf, where I was able to get a Ferry to Manly, a beautiful little town with a spectacular beach. Of course the other beach to visit is the famous Bondi Beach, which is just a half hour bus journey from the centre of town.

The Anzac War Memorial was unfortunately closed when I was in Sydney. The building was widely cordoned off, but I did eventually see it, on television, when Prince Harry formally opened the new extension to the building. Photographs of the exterior of the Memorial show powerful figures of service men and women which evoke strong emotions. I’m sorry I missed it, but a good reason to visit Sydney again someday.

Next stop Newcastle 🙂

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!

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.

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!

I arrived at 6.30am to a cold, 14°C, and rainy Sydney (when I left Germany it was 26°C) and was met at the airport by the lovely Janet Roden and her husband David. Janet is the Professional Officer
 for New South Wales Nurses and Midwives’ Association, 
Australian Nursing and Midwifery Federation. I was fortunate to meet Janet in Plymouth this year and she introduced me to several of the people I’m going to meet in Sydney – Stacey from Western Sydney University and Amanda from the Australian Catholic University.

Sydney is a multicultural city with a population of approximately 5 million people.  All day I tried very hard to stay awake and followed all the advice I’d been given to fight jet lag. Sadly to no avail :(. One of the suggestions for combating jet lag, apart from taking melatonin, is to go out into the daylight so I decided it would be a good time to take in some of the local sights.

My first venture was to Sydney’s Fish Market. It’s absolutely huge with lots of shops selling every type of fish available – fresh or cooked, dead or alive. The market hall was very busy, bustling with people and I found it difficult to walk through. There are also plenty of restaurants, whether you want fish and chips or sushi, you can find it there.

My next visit was to Darling Harbour, including Cockle Bay. This old train shed harbour has been redeveloped over the years, in fact they’re still building, and has been transformed into the beautiful Chinese Garden of Friendship and lots of places to eat and drink. It is a fantastic place to walk through or sit and watch the world go by.

I walked across Pyrmont Bridge, one of the world’s oldest surviving electrically operated swing span bridges. The bridge was built over 150 years ago to connect the growing city but also allow ships to enter the busy harbour.

The International Convention Centre Sydney is also situated at Darling Harbour, as is the maritime museum. But my favourite feature at Darling Harbour is the Welcome Wall. This wall boasts about 7,000 names of people who’ve arrived in Australia over the past 200 years or so. It was lovely to read about their feelings on arrival and their first impressions were when they landed. Some really moving stories!

I didn’t really get the impression on my first few days that sustainability plays a big role in everyday life. Take away food and drinks at the fish market were all in plastic with plastic straws and coffee-to-go seems to be as popular here as everywhere else in the world. Everyone I saw coming from and the local supermarket was carrying their shopping in plastic bags.

However, as I said these are first impressions, let’s wait and see.

Next Stop – Western Sydney University