Motions

International Nurses Day

Ms COOK (Fisher) (12:20): I move:

That this house—

(a) celebrates International Nurses Day held annually, and this year on 12 May;

(b) acknowledges this year's theme, 'Nursing: A Voice to Lead—Achieving the Sustainable Development Goals';

(c) commends the leadership of the profession in the evolution of new frontiers for nursing and midwifery in advancing practice; and

(d) thanks South Australian nurses for their dedication to the advancement of all South Australians' health.

It is my pleasure to lead the celebration of International Nurses Day, when we reflect on the incredible contribution nurses make to our Australian way of life. I welcome my many nursing colleagues present in the gallery: as stated, members of the Australian Nursing and Midwifery Federation (SA Branch), representatives from the University of South Australia, Flinders University of South Australia, SA Health, a diverse range of acute care/aged care/community nurses from both the private and public sector. Thank you for coming today.

I would also like my colleagues present in the house today to recognise the many nurses currently on duty in our hospitals and out in the community. In this place we often hear complaints about parliament sitting late, but it is truly nothing when compared with the sacrifices that many nurses on rotating shifts make every week. I am sure the union members seated in the gallery enjoyed the hearty debate on the previous motion, and I hope they have something to take home and consider over the next nine months. Unions are not just our safety net, they are the mesh that holds us together when we need the most support, and I thank the union for that.

While most South Australians are at home with their families, having dinner or sleeping, thousands of nurses are working around the clock, so it is important that we remember that we need to stay firm and steadfast in our fight for penalty rates. I recognise my fellow parliamentary colleagues from the profession: the member for Elder in this place and the Hon. Gail Gago in the other place, herself a legend of the Australian nurses federation union movement. Nursing is a profession that can take you many places, and we are proof of that.

We celebrate International Nurses Day on 12 May in tribute to Florence Nightingale's birthday, the founder of modern nursing. On this day we recognise nurses around the world for their contribution to health care. Today is the closest parliamentary sitting day to International Nurses Day, so today I would like to, on the record, wish nurses around this state and around the world a very happy International Nurses Day.

The theme, 'Nursing: A Voice to Lead—Achieving the Sustainable Development Goals', aims to promote leadership qualities shown by nurses and their contribution to the United Nations sustainable development goals. Nursing is the largest professional cohort in health care, and the impact that our profession makes to driving outcomes in health cannot be understated.

On top of the clear impact nurses make to the lives of patients and their families, nurses influence policymakers in the management and direction of health care to improve practice. Nurses, as the primary providers of health care to all communities in all settings, are key to the achievement of the Sustainable Development Goals. These goals were adopted by the United Nations in 2015 to replace the Millennium Development Goals. Member states have agreed to achieve these goals by 2030. Those of you not familiar with these goals would do well to read through all of them and ask yourself what you can do, indeed what are you already doing, to support achieving the 17 goals needed to transform our world. When addressed, we would have achieved a level of humanity and decency needed for an equitable, safe and humane global community.

Undoubtedly, nursing takes a lead in the delivery of these goals throughout the world. Some, like good health and wellbeing, are obvious, but the work of nurses also makes a major contribution to the delivery of other goals, like education and poverty, which are social determinants of health. Social determinants of health are the conditions in which people are born, grow, work and live, and they impact on the conditions of health and daily lives. If I mention other key elements of these goals to you —like sustainability, clean energy, climate action, equality, sanitation and justice—just maybe the theme would be clear. It is about decency. I could keep going on, and anything said about these goals links back to the fundamentals of sound nursing practice.

I think back more than 30 years to my first block of study—PTS I think it was called—and on the late night when I was considering what I would say today I could not even remember what PTS stood for (I think 'post-traumatic stress' might be one of the options I could string together). I really cannot remember what it stood for, but what I do remember is learning about Maslow's Hierarchy of Needs. I remember that without each step, each layer, each part of the foundation, we did not achieve our full potential, and we were not able to experience wellbeing. We have moved forward in time, but we are still aiming towards the same things through another language, simple concepts much more clearly defined: nurses lead.

Of course nurses are at the front line of the health service, helping people achieve their peak health, but they frequently work to address social determinants of health, as nurses understand the links between lifestyle conditions and individual and population health. Nursing encompasses the promotion of health and the prevention of illness as well as the care of the physically and mentally ill so, as nurses, we are therefore concerned about where children are born, where people grow up, where they live, work and grow old.

The theme 'A Voice to Lead' refers not only to the advantaged few. Every nurse on the planet has a voice they can use to make a difference. The experiences and personal knowledge of nurses in providing care impacts beyond the patient experience. There is no doubt that nurses should engage in policymaking, particularly when it addresses issues of resource allocation, outcomes and expectations, and access to health care for vulnerable communities.

Judith Shamian, the president of the International Council of Nurses, calls this collaboration a shared responsibility. A great example of this has been the commitment of the ANMF (SA Branch) to supporting evidence-based practice through a collaboration with the state government to adopt the Registered Nurses Association Ontario (RNAO) Best Practice Spotlight Organisation Program (BPSO). The program's goal is to influence the uptake of best practice guidelines across healthcare organisations, enable practice excellence and achieve positive client outcomes.

In South Australia, Central Adelaide, Northern Adelaide and the Women's and Children's Health Network are part of the Australian BPSO program. This proven, nurse-led program has resulted in significant improvements in client, patient or resident outcomes such as reductions in falls, pressure ulcers and length of stay, and promotes early intervention for people with behaviours of concern, as well as promoting healthy work environments for all. It has provided the opportunity to promote the nursing and midwifery profession as one where evidence informs the best practices in care. It is very important, and it is something that our patients need to know about and something that the public needs to know about.

Building on the RNAO's experience, we have also demonstrated significant and sustained improvements in performance and in reduction in costs after implementation and concrete savings for health systems: $64,000 for each nurse remaining in a role, $35,000 for every fall prevented, up to $80,000 for every amputation averted and $9,000 for every pressure ulcer avoided through consistent care and ongoing evaluation of nursing and midwifery practice. To put it simply, it is like printing money.

To support nurses to implement and embed practice change, you need to have the right culture and you need leaders prepared to take the risk. By introducing this program, which has already been tested in Canada and across the world, we are saying that in the nursing profession these things do work. There are some contemporary challenges that stand in the way of nurses achieving excellence, and violence is one of them—sometimes triggered organically, sometimes chemically and sometimes as a side-effect of another condition. I know only too well the cost of violence, and sometimes there is simply no explanation. Nowhere should we tolerate violence, but particularly when it is towards workers.

The ANMF has been working in collaboration with SA Health to implement the recognising and responding to challenging behaviour strategy to address violence in emergency departments. Following the success of the 'Hands off our Ambos' campaign, which saw a 13 per cent reduction in violent incidents against ambos, SA Health released the 'Waiting is not an Emergency' campaign this year, and I was lucky enough to go to the launch. I have shared it on social media with the hashtag 'letuscare', and this video has had more than eight million views on the Facebook site alone. I am sure that this campaign is helping people not only in South Australia but worldwide.

The horrific death of outback nurse, Gayle Woodford, in remote South Australia during March 2016 really woke us up to the dangers and the risks that our outback angels face every day. The state government operates only one remote healthcare service in Oodnadatta, and I have asked many questions about that. I am assured that the policies and the practices that have been changed and implemented now ensure that all people access patients with another person with them. Nobody is attending anything in isolation. This is not the end of Gayle's legacy. We, the nurses left behind, must ensure the legacy is enduring.

Ongoing review and active participation in policy development by nurses engaged in leadership is also leading to the development of things, such as advanced practice roles. It is an active process. The emergence of these roles has accelerated in recent times. Not long ago, I spoke to patients undergoing chemotherapy at Burnside War Memorial Hospital and asked them about the processes there and reflected on my work at the chemotherapy unit 20-something years ago, and how I was supported by progressive leadership of the CNC, Marg Smith, and also Michael Chia, a doctor who treated patients with respiratory cancers, a doctor who knew these patients could not afford the additional $100 per callout for an insertion of an IV cannula—and we are talking only two decades ago.

Along with those people, I developed from scratch a package to educate and implement IV cannulation. They are still doing that today in private hospitals, but it was quite new back then. That is very small and dwarfed by the titanic extended practice roles, such as those we are rolling out now in terms of nurses being able to perform endoscopies, which will really change healthcare processes. When nurses and midwives and other health professionals end up around the policy table together, we make a difference—we lead.

I would like to take this opportunity to commit to you, my colleagues, my unrelenting commitment to ensure that we do all we can to stop elder abuse in the community and in institutions. Last year, I triggered a parliamentary inquiry into elder abuse on the background of the public airing of the vision of Clarrie Hausler being treated in the most appalling manner in his bed at the Mitcham residential care facility. Clarrie passed away late last year. Many of us here today know Clarrie's daughter, Noelene Hausler, a very dedicated neonatal nurse. I have also felt very much sickened by the stories coming out of Oakden, and we have now moved to include the investigation of the report on Oakden into our inquiries.

All staff looking after our vulnerable elderly and mentally ill patients need care and support themselves. They need an intensive staff development framework in place to ensure best practice is understood and delivered. They need a supportive and proactive clinical leadership team and governance framework. The patients or residents and their families need a program of staff screening and registration that is accountable, transparent and meaningful. This review, along with any reforms, needs to be a patient process. I am a patient person, sometimes, and I will ensure that this process is rigorous and that the recommendations are sustainable.

I have gone on far too long. I am very sorry to everybody else who wants to speak, but I put on the uniform and felt like I needed to get moving. I feel reinvigorated. If anyone needs anything attended to, I am here and wearing the scrub shirt. You are all good and you are in safe hands—there are lots of nurses around. Thank you to all my nursing friends here for your service. Thank you for your inspiration and your leadership, but thank you most of all for your friendship. Happy International Nurses Day.