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House of Assembly - Fifty-Third Parliament, Second Session (53-2)
2015-05-07 Daily Xml
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Motions

International Nurses Day

Ms DIGANCE (Elder) (11:30): I move:

That this house—

(a) recognises International Nurses Day celebrated annually on 12May 2015;

(b) acknowledges this year's theme, Nurses: A Force for Change: Care Effective, Cost Effective; and

(c) congratulates South Australian nurses for their dedication and professionalism and the pivotal role they play in the advancement of all South Australians' health.

Today I am pleased to recognise International Nurses Day, which is celebrated annually on 12 May. I welcome to parliament some special guests—nurses. These are nurses from diverse backgrounds of many and varied areas of the profession. This group shares experience amassing over 1,000 years of practice and expertise.

In the public gallery are nurses from so many places: The Queen Elizabeth Hospital, where I trained to become both a registered nurse and midwife; Flinders Medical Centre; Royal Adelaide Hospital; Lyell McEwin Hospital; Repatriation General Hospital; Modbury, Noarlunga and Mount Barker hospitals; Western Hospital; Keith hospital; Mental Health Services; Southern Adelaide Local Health Network; CaFHS; CAMHS; ASEPS nursing agency; Flinders University; Noarlunga TAFE; SA Health; ANMF; South Australian School Nurses Association; SA Prison Health Service; community, private and country work places. Welcome to you all.

The DEPUTY SPEAKER: Who is minding the shop?

Ms DIGANCE: I would also like to recognise my fellow parliamentary colleagues from the profession of nursing, minister Gail Gago from the other place and the member for Fisher of this place, who has been a wonderful addition to our side of government. For over three decades, International Nurses Day has been celebrated on the anniversary of the birth of Florence Nightingale—

There being a disturbance in the strangers' gallery:

The DEPUTY SPEAKER: If I could ask that there be no flash in the gallery. If you could turn the flash off on your cameras, that is fine, and no photos of people in the gallery. Thank you.

Ms DIGANCE: —a courageous and visionary woman and nurse, who is widely considered the founder and pioneer of the profession of modern nursing. I am sure it is no surprise to us all when the United Nations reports that the cost of health care is rising rapidly, presenting a worrying responsibility for budgets, communities and consumers at large. This cost increase is driven by a number of factors, including the rapidly growing burden of disease, such as mental health conditions, obesity and diabetes, to name a few. It is also exacerbated by an ageing society, with its increasing frequency of associated multiple morbidity chronic health problems. Innovations and expensive lifesaving treatments and techniques, and an increasingly raised expectation by outpatients and clients, is also adding budgetary stress.

This year, as International Nurses Day acknowledges the importance of nurses, the International Council of Nurses has nominated the theme as Nurses: A Force for Change: Care Effective, Cost Effective in response to these pressures which are occurring globally on healthcare systems. Healthcare systems are under financial strain to deliver high-quality care within the boundaries of limited and shrinking budgets. This is our profession's call to arms. It is our call for a commitment to action. The tension of better health outcomes, increased costs and increased expectations sees the need for nurses to advocate, innovate and challenge the status quo.

In South Australia this pressure is amplified with the abandonment of the national health agreements and the associated slashing of our state's healthcare funding. To be blunt, although the South Australian Weatherill government continues to lobby, it is an unyielding federal government that sees South Australia facing financial budgetary pain in the health budget.

Nurses are the single largest cohort of the healthcare workforce, and the International Council of Nurses recommends them as being ideally positioned to make major contributions to shape and drive health policy, policy that is underpinned by equity, quality and cost effectiveness and that is based on foundations of professionalism, patient advocacy and patient care expertise, all while focusing on healthier communities. Close interaction with healthcare consumers in a variety of settings gives nurses expert understanding of health needs—how factors in the environment impact the health of clients and their families, and how people respond to different services and interventions—yet nurses often lack support and understanding from policymakers to introduce these innovations in care.

As nurses we must take charge of our profession to directly influence government and policymakers, management and economists on health care and the needs of those who use our healthcare system. Achieving quality care at reduced cost requires leadership by nurses to ensure this change is cost effective, care effective and safe. Knowledge and understanding by nurses of the processes and mechanisms of health financing is fundamental to our leadership and advocacy for health equity and universal health coverage. I urge us all to acquire knowledge in this area.

In South Australia we are in the process of a groundbreaking healthcare system change, marked by Transforming Health. Transformation is not an endgame but a continual process, a process I encourage you all to be part of. It is a process that is understandably frightening for many but exciting and exhilarating for some. The principles of Transforming Health are sound, based on patient-centred, safe, effective, accessible, efficient and equitable care first time, every time. For this strategy to succeed patient care must be at the heart of all we do.

Being involved is paramount and, recently, with my experience as a registered nurse and registered midwife and my expertise in child, maternal and infant health, I was hesitant about the proposed relocation of the Level 6 Neonatal Intensive Care Unit of Flinders Medical Centre to the Women's and Children's Hospital. However, before closing my mind to the proposition I invited those recommending the plan to convince me of its merits. I was not convinced, and gladly note that, with lobbying, that plan is now off the table and the Level 6 Neonatal Intensive Care Unit at Flinders Medical Centre stays.

Today, in the gallery, I draw attention not only to the collective professionalism of nursing but also to the diversity and innovation of nurses. First, and in the interest of demonstrating the diversity of the profession, I recognise Ali, who is a registered nurse working in the prison system as a prison nurse. Prison nursing presents a very different experience within a very different environment, and nursing staff work closely alongside many other services in a multidisciplinary approach. As patients, prisoners are a group at their most vulnerable and fragile, often being emotional, volatile and, in many cases, withdrawing from substance abuse.

Many prisoners are flagged as high risk, presenting with acute medical and mental health issues and, increasingly, more prisoners present with drug-related crimes and illnesses. Prescribed medications are a highly sought-after commodity with the associated increased dangers of prisoners selling their medications or being stood over for them. Prison health nursing is varied, interesting and challenging, and I am told that while nurses may never receive chocolates and flowers from their clients, they can always expect the unexpected.

Today I will highlight but two innovative projects driven by fellow professionals in their pursuit of seeking improvements in care while achieving financial savings. First, I recognise school nurses Petria, Liz, Anne and Sonya who work in the independent school system. In South Australia school nurses are currently employed only in the independent school sector with no nurses in government schools. These four nurses are so passionate about their roles and about student wellbeing that they set themselves a goal to promote their model of care to the wider community.

The wellbeing of the student is paramount. The role of the school nurse is extensive and varied, from first aid, counselling on all matters (such as bullying and eating disorders, to name but a few), management of chronic and acute illness, education of teachers and students alike, infection control and immunisation. I know this list could go on for quite some length.

After hearing Premier Weatherill speak at a conference on education and health budget challenges, this group of four presented a proposal demonstrating the benefits of implementing school nurse programs to South Australian government schools. The plan highlighted opportunities for improved healthcare outcomes for school students through primary healthcare strategies with associated predicted cost savings.

As a result of their passion and lobbying, a 90-day project to explore the benefits of this service is now being trialled and underway to test if it is applicable for government schools. The project will conclude in June. I look forward to the evaluation of this project, and I am hopeful that we will see the implementation and rollout of school nurses in government schools. I applaud their initiative and wish them well with the venture.

The second program of innovation was initiated by registered nurse Rebecca Pearl, who, after winning a Premier's Nursing and Midwifery Scholarship in 2013, visited St Michael's Hospital, Toronto, Canada, and brought back a unique best practice program that she had witnessed firsthand. The program empowered ward level nurses to lead the best practice changes as opposed to having them led by those in administration.

Back in her workplace, Rebecca, along with other colleagues, including Vanessa Owen, found that the promotion of ownership, along with the celebration of success, rewarded and motivated the staff as they gained increased job satisfaction. This in turn continued to drive them to achieve even better outcomes. She focused on client-centred care and compliance of care, significantly improving outcomes for both. Also, incidence of mechanical restraint became almost non-existent. These improved care outcomes led not only to a decrease in length of stay but also to associated cost savings.

As I recognise and applaud the great work of all nurses, I pose the challenge to all of us: what can we as nurses do to improve the health system through nurse-driven efficiencies and evidence-based practice within finite budgets? Nursing is our profession, and we are close to the needs of patients and our community. I urge and encourage all of us to take ownership and drive our areas of care. It is easy to be sceptical. The following quote from a nurse of 40 years sums up how many of us have felt and still may feel about the system we work in. She says:

I've been a nurse for 40 years in ICU and I'm a damned good nurse. To me nursing hasn't really changed that much from the day I started doing it. Sure we have new technology and a few new and better meds but that is about it. In the early 80s there was a mad rush by MBAs into the hospitals because they could not find jobs anywhere else and things haven't been the same since. Suddenly, profits and productivity were everything. Management measured this and that and almost everything they came up with didn't fit the practice of nursing…We are no longer in control of our profession or our work environment. We have lost our voice. People who are telling us how to do our jobs can't do our jobs.

However, we know from community surveys that nurses rate number one as the most trustworthy and valuable profession in our community. Nurses are not defined by their workplaces alone. Nurses are always on call, always on duty. A free consultation for a family member, a quick fill-in as a first aider at an event, and what should be a quick Saturday morning shop can turn into a four or five or six-hour community consult, as everyone you come across is pleased to give you an update on their health status since you saw them last.

In contrast, I do not recall the last time I saw my bank manager—and apologies to the member for Davenport—in the supermarket running a quick community update on the price of the Aussie dollar, current home loan deals and the status on terms of trade. Nurses are the rare profession who can be with life as it comes into the world with the first breath and at the final end with the last breath—overwhelming or inspiring, confronting, emotional and privileged. So, be proud of who you are, be proud you are a nurse, stand up and be heard, make that difference, embrace progress, drive change, and be the change you want to see, and on 12 May know that you are important.

To you all, I am pleased you are here today for this historic event in the South Australian parliament. On 12 May I invite my colleagues and all South Australians to take time to pay tribute to all our hardworking and dedicated nurses and wish you all happy International Nurses Day.

Honourable members: Hear, hear!

Ms COOK (Fisher) (11:45): I apologise for my back but I have been in trouble before for turning around and speaking to the audience so I will have to face the front.

An honourable member interjecting:

Ms COOK: Very naughty, thank you. I rise to speak in support of the member for Elder's motion recognising the work of our nurses. I am a very proud nurse and I feel extremely honoured to be able to recognise my profession and, indeed, my colleagues in this house. Welcome to my nursing colleagues in the gallery today. I would by no means consider myself old, but as I reflect on my career which spans 29 years, I realise just how much has changed in the nursing world during this time.

Nursing is not just a job; it is a lifestyle. My husband has always been amazed by the tenacity, the intestinal fortitude and perhaps the strength of stomach of my nursing friends. Nurses are one of the only groups of people who can savour the taste of fine food and wine while talking about the size, shape, colour and, of course, the smell of each bowel action that they have encountered during their last shift. Not to be put off by these conversations, they usually then ease their way into a colourful comparative of the best vomit that they have seen or the craziest trauma or surgery witnessed.

Very soon after finishing year 12—and this may give you a little understanding as to how we are very tenacious—I secured a job in a nursing home while waiting to begin my hospital-based training at The Queen Elizabeth Hospital in Woodville. My actual introduction to nursing at this fine western suburbs institution was during our first study block, and some of the members in the gallery may remember study block. These blocks were a crash course in theory where your best study was done staying up until 4am in the nurses' quarters between short-shift changeovers and usually a quick trip into the city.

During study block we would venture to the hospital and attach to a more senior student nurse. I was placed for two hours on the vascular ward with people whose blood supply was letting them down, particularly in their extremities, so they were admitted for either grafting of their vessels or amputation. I was sent behind closed curtains, alone with a bowl of water, soap and towels—and I am sure people can relate to this. It was terrifying. I was 17 and he, the patient—well, he was older—of course, seemed incredibly old, but he may well have only been what my age is now.

Of course, he asked me to wash his feet. He had none. I did not know what to say. I must have looked horrified as I pulled back the sheets. He just laughed, I laughed, we made a connection and instantly there was trust. This was a patient without underpants—nobody was allowed to wear underpants back in those days—without legs. Patients are vulnerable, there is trust, an instant rapport. My next patient had a terrible respiratory condition and his cup of mucus ended up in my shiny new nursing shoes. It was not a good day. I did tell my mother I lost those shoes, but I was not going to touch them again.

Each and every nurse has a story. These stories are shaped by bravery, and the will and tenacity of their patients. The spirit of a nurse is built by the relationships they form with their peers also. I can honestly say that every day of nursing would bring me new knowledge. I have not worked a day without learning something new. There are not many careers that can attest to this.

Our nurses must be cared for also. The life of a nurse is difficult emotionally as well as physically and often confronting. If the hours are not draining enough, then the sights seen certainly are. In spite of this, nurses are there when people are at their time of most need. They are there when people are afraid and uncomfortable. Nurses can ease the pain, if not totally, then at least a little, and that in itself is vital. We must care for them.

Nurses must constantly challenge themselves and care for people who are faced with unthinkable choices without judgement. Nurses are the most progressive people I know, whether it is during the arrival of a new life, while the most difficult choices are being made, or as they support the terminally-ill patient as they take control of their final journey, nurses embrace differences and they embrace change.

It will be nurses at the coalface who lead us through Transforming Health reforms with vision and leadership. I will be here, as will my colleagues in this house and the other place, for nurses as a voice to help them through contemporary challenges facing our profession. I will be here to ensure that excellent health outcomes are achieved because our work force is supported in its delivery. My friends, my colleagues, I thank you and commend the motion to the house.

There being a disturbance in the strangers' gallery:

Mr SPEIRS (Bright) (11:50): I hope that I get applause when I finish my speech as well because, as members of this house would know, it is very unusual for that sort of behaviour to occur in the gallery. I will only be making a few brief remarks this morning on this item, which I support very deeply. I am not using notes, so members of the gallery will note that it comes straight from the heart.

My wife is a nurse. She recently graduated in nursing from Flinders University, and she has taken up a graduate year placement at Flinders Private Medical Centre, working in the intensive care unit there, which is a phenomenal opportunity for her to learn the skills of critical care, which is a passion of hers. I am continually exposed to the challenge she faces. We often say in our household that I attend events for a living and she keeps people alive.

It is quite a stark difference; we both have important jobs, of course (all members of parliament have important jobs), but it really comes home to me each night when we sit down for a cup of tea and I ask, within the bounds of patient confidentiality of course, what her day involved. I am continually taken aback and continually amazed, and my respect is continually stretched, at the work she and her colleagues do at the Flinders medical precinct at Bedford Park.

My respect for nurses and the nursing profession is very deep and eternal in many ways. I know how difficult the nursing profession is with the practical hands-on activities that have to be undertaken. As the member for Fisher eloquently put it—regarding bowel movements and things like that, vomit, blood and all manner of substances ending up on nurses' clothes and bodies—it is a job which is at the absolute coalface of public service. I believe it is one of the best forms of public service, and we in this house continually should remember the people we are to serve, the members of the public, and the members of the public who actually serve us in positions like police officers, firefighters, doctors, nurses, teachers—people who are at the front line of public service.

Here we work in public service as well, but we do not often get our hands dirty, for better or worse. I pay tribute to my wife, Hannah, for her involvement in the nursing profession as something she has wanted to do since she was a five or six year old, following in the footsteps of her hero, her Auntie Cheryl, who has now passed away. I respect hugely people involved in the nursing profession. I thank the members for Elder and Fisher for their contributions.

It is very important that, when it comes to professions and people who work in public service, we try to be bipartisan in our approach to maintaining their working conditions and to maintaining the quality of the workplaces. It disappoints me when political jibes and comments drift into debate about front-line public service. We should steer away from that and look to protect and enhance the industry whenever we can. Thank you for your service, and I wish you all the best in your ongoing careers and also in the marking of the 2015 International Nurses Day.

Mr TARZIA (Hartley) (11:54): If you save one life you are a hero, if you save 100 lives then you are a nurse, as the saying goes. I also rise today to commend this motion to the house which recognises International Nurses Day, which is celebrated annually on 12 May, and which acknowledges this year's theme, Nurses: a Force For Change: Care Effective, Cost Effective, and congratulates all South Australian nurses on their dedication, professionalism and the pivotal role they play in the advancement of the health of all South Australians.

My sister, Therese, is a nurse at the Royal Adelaide Hospital. Like many members in the chamber who have members of their families who are nurses, I too can share in some of the tales and the experiences and the empathy that is required by nurses in doing the fantastic job they do in the community every single day, as well as the compassion they need to deliver in their jobs and their professionalism. The job they do is not always rosy, as has been alluded to, and I have heard that firsthand from my sister. Nurses are wonderful people and we could not do without their great work in our community.

There has been a little bit of political talk here, but I will try to keep it apolitical. One thing I will ask is that with Transforming Health, which the government is putting in place, the government considers the submissions that nurses have made. We are kidding ourselves if we think that everyone is content out there in the nursing industry because they are not. There are nurses who are not happy with the fact that they are being forced to work longer hours than they have in the past.

Nurses' conditions in Australia are not the best that they can be. We need to continually strive to make sure that nurses have the best conditions reasonably possible to do the fantastic work they do. I encourage and implore the government in its Transforming Health strategy to take that into consideration and make sure that nurses get what they deserve because they play such a fundamental role in our society.

I also want to pay tribute to some of the areas in my own electorate of Hartley that employ nurses. The North Eastern Community Hospital in Campbelltown is a wonderful little hospital that does fantastic work in the community and provides a fundamental service. Of course, we need to accept that the state government cannot absorb the whole strain on the health system; it needs the public system and the private system to work hand in hand with each other where they can. It is the same with education: we would be silly to think that the state could absorb the whole thing.

It is important that we also acknowledge the private health providers, and I have one in my electorate of Hartley. They play a fantastic role in the community, and I really do pay tribute to the great work they do, as well. Do not forget that there are also many retirement villages and nursing homes in our electorates that have on-call nurses and sometimes permanent nursing staff, and I also acknowledge the wonderful work they do. It is fantastic to see the care, the professionalism, the empathy and the compassion of the nurses in my electorate in those roles.

I was told that 12 May was Florence Nightingale's birthday, and I think that is where this date comes from. We should absolutely acknowledge the wonderful work she did and pay tribute to her on this special day. I understand that the Australian Nurse of the Year is also announced at a ceremony at one of the state's capital cities each year. I also understand that each of the Australian states and territories conduct various nursing ceremonies, as the member for Elder drew to our attention.

All in all, it is an absolute pleasure to see so many nurses here in the gallery today. I applaud the work they do and congratulate them on their wonderful efforts, and I commend this motion to the house today.

There being a disturbance in the strangers' gallery:

The Hon. P. CAICA (Colton) (11:59): Thank you very much—

The DEPUTY SPEAKER: And you haven't done anything yet!

The Hon. P. CAICA: —for that very kind introduction. I am going to be very brief, but I am absolutely compelled to stand here today, firstly, to congratulate the member for Elder on bringing this motion to the house, and to acknowledge the contribution of the member for Fisher and also to acknowledge those other speakers.

I want to congratulate and recognise the role that nurses play in our community. I think the member for Elder talked about the length and breadth of their duties and the roles that are undertaken by nurses in very many areas. Of course, it almost goes without saying—but I am going to say it anyway—that the most effective person at any birth is a midwife. Not that the little children coming out can recognise it, but certainly the parents who are in the room recognise the role that midwives play.

It is a wonder, in fact, that the kids do not start following them around because they are the first person they see. That is not true either because what we know is that we see doctors come in and take the credit for the birth, when in reality, in my experiences at childbirth (the birth of our two children), it is the outstanding role and the function and the professional service that is provided by midwives during those births, and then the doctor comes in on the grouter and takes the credit for it at the end. I recognise the work done by midwives, but across all the—

An honourable member interjecting:

The Hon. P. CAICA: I remember my wife just telling me to back off and get the midwife in there. We still have contact with those midwives from time to time, and that is a bond that continues to exist. As was mentioned, I think, by one of the members opposite, there are other areas where nurses work. My mum passed away two years ago, and the role of the nurses there during the palliative stage—and that is another debate, about what happens at the end of life—was absolutely incredible, and I thank them very much for that.

I am not married to a nurse; I am married to a schoolteacher, but my wife, Annabel, her mother was a nurse. I remember going through the pictures of her time as a nurse (she has passed away as well), and she finished up becoming a matron, but you don't call it that any more—pretty scary, sometimes, too—but she did not forget where she came from. I think they transitioned to 'directors of nursing' or something like that later on. She never forgot where she came from, never forgot the profession, and some of her friends, up until her dying days, were those she had worked in the hospitals with.

As a firefighter, I remember one of the best calls that most of the firefighters enjoyed going to was when we got a call from the nurses' residence, when they lived on site.

An honourable member interjecting:

The Hon. P. CAICA: No, I can just say that some of my colleagues were a little bit more anxious, but we enjoyed a very good relationship with nurses, I will say that. The only time we were ever probably a little bit disappointed was when the paper brought out the most trusted professions, because each and every year, and it was certainly justified, the No. 1 most trusted profession was nurses. We would rank third or fourth, behind ambulance officers. We were still up there, but we were never able to get to the pinnacle. It is so sad, that there I was in a profession that was so highly regarded, but it was not as highly regarded as nurses, and of course today I am down here now, along with—not that I disrespect them—dog catchers or car salesmen, at the bottom end of the spectrum.

On a more serious note, the member for Bright made a very good contribution, and he spoke about his wife, saying that he goes to functions and she keeps people alive. The serious point of this contribution is that we can be responsible as members of parliament and members of government in making sure that we contribute to keeping people alive. We do that by making sure that as a government, as a parliament, as a community, we continue to provide the level of support that is required for nurses to be able to do their jobs the best and most effective way they can. That comes from the commitment of government to make sure that the terms and conditions of employment and the resources that are provided to nurses are more than adequate at the top end for you to be able to do the job as best you can.

The other point that I would like to make is that I see great opportunities in Transforming Health. I think it was a comment made by the member for Hartley who talked about submissions of nurses and I think that it is very important that nurses continue to make submissions on Transforming Health. It provides great opportunities. I was not being flippant about the role that is played in midwifery, but I think there is an abundance of roles that are held by other people within the medical profession that can easily be discharged expertly and professionally by our nursing personnel.

I would say that the government will only ignore submissions made by nurses at their peril because they will be part of the way in which we do successfully prosecute Transforming Health, which will be the most significant reformation of the health system in this state. Nurses, and the role that nurses play, are central to the transformation of health.

With those few words, I want to finish off by again congratulating, thanking and showing my respect for the role of nurses in this state. Long may you prosper and long may you keep up the very good work.

Mr VAN HOLST PELLEKAAN (Stuart) (12:06): It is a pleasure to support the member for Elder and bring this fantastic motion forward that we recognise International Nurses Day and that we recognise this year's theme—Nurses: A Force for Change: Care Effective, Cost Effective—and that we congratulate South Australian nurses for their dedication and professionalism and the pivotal role that they play in the advancement of all South Australians' health. This is a fantastic example of a very genuine heartfelt motion being brought to parliament by a person who knows firsthand what she is talking about and it is fantastic to listen to all of the contributions from both sides of this house because it is genuinely heartfelt from our own particular perspectives.

I do not have the perspective of the member for Colton; I have never been inside nurses' quarters anywhere, but I am pleased, as others have been, to brag about the fact that I am married to a nurse. The theme for this year—Nurses: A Force for Change: Care Effective, Cost Effective—is the way Rebecca contributes to our household and in many other ways as well. It really is a very apt description, not just about nurses and not just about the way they go about their work and about the profession overall, but about the people as individuals.

In my electorate of Stuart—which runs from Kapunda, through the Mid North, a little bit of the Riverland, and all the way up to the Northern Territory/Queensland/New South Wales borders—nurses are contributing absolutely everywhere. Whether it is the largest hospital in our electorate at Port Augusta or whether it is essentially a medical centre at Oodnadatta, nurses are the backbone of those establishments and so I thank them. I thank the ones who do that in our electorate and I thank nurses across the state for their contribution to our state's health. It is a very important thing that you do and it is appropriate that it is recognised by this house so, again, thanks to the member for Elder for bringing it forward.

Of course, as others have said, there is a very wide range of nursing that can be done. My wife, Rebecca, is a theatre nurse and works in cardiac, orthopaedic, and major accident and emergency nursing. She assures me that there is no blood and guts at all in those things. She actually says, 'If you see blood, there is a problem.' It is generally a very clean, very well organised, very thorough area of work and she thoroughly loves it. But, of course, there are lots of enormously wide areas that people can work as a nurse. One of the great attractions of the profession is that there is a huge range of directions that a person—man or woman—can take their career if they want to embark upon a nursing career. They could stay in all sorts of mainstream health. They could end up in administration. There is an enormous array of choices and I think that is very important.

Rebecca tells me that hospital-trained nurses are much better than the current tertiary-trained nurses. Those in the room who know about these things will have their preferences. Those in the room who know about these things will also know that that gives her age away as well, but she has a strong view that that is the case. I also have a view that the work that has evolved over the last several years with nurse practitioners is something that could be developed further and used more for the benefit of our community.

There being a disturbance in the strangers' gallery:

Mr VAN HOLST PELLEKAAN: Thank you.

The DEPUTY SPEAKER: The sound of one hand clapping.

Mr VAN HOLST PELLEKAAN: I am sure the others agree; they are just very polite. Particularly from my perspective in a country electorate where it has become harder and harder to find GPs and other doctors who want to come and visit or live and work in our electorate, I think there is a huge role for nurse practitioners that could be expanded to help us, but I am sure it is true in metropolitan Adelaide as well.

I get back to something that the member for Colton discussed about trust. Nurses are extremely well trusted. It is very normal for a patient, after the doctor has left, to want the nurse to actually explain what was really said, what they were really told. 'What does it really mean? Can you get away from the strict medicine and the technicalities of it, put it into layman's language and, perhaps more importantly, tell me what it means for me, my life, my family, and what I am going to do for the next five minutes, five hours, five weeks or five years?' That is the sort of thing that people go to nurses for probably more than they do to doctors, on average.

A bit has been spoken about nurses' hands-on work. I think it is a two-way street. I think that people who are attracted to the nursing profession are typically caring, nurturing, practical, hands-on people, but then of course people who stay with that career, by definition, must be caring, nurturing, practical, hands-on people.

If you then add to that the realities of shift work and what that brings for lots and lots of people, you have got to be a practical person to be prepared to work all day, all night, start early in the morning, start early in the afternoon—whatever it happens to be. You need to be a hands-on, down-to-earth sort of a person to be dealing with patients, dealing with the practicalities of the work and dealing with the time constraints that the work can put on you.

The trust that comes out of those types of people doing that work very well means that not only does the community trust nurses about their own personal and their own immediate family's health needs, they actually trust nurses about their views on health and health policy. The member for Elder touched on the fact that for some nurses it is very hard to go to the supermarket without having to interpret, diagnose or share personal views, and that must be very hard at times.

I would just like to add to that the fact that the broader community trusts nurses with regard to their views on health policy. I think it is well and truly in line to remind this house that the health minister, Jack Snelling, said here in parliament that any SA Health professional was welcome to share their personal view on health policy without any fear of retribution from him or from the department.

I give him great credit for having said that. I think that is a very important statement, and I think it is a statement that needs to be shared far and wide across metropolitan Adelaide and across our entire state. From Mount Gambier to Marla to Port Lincoln, people need to know that the health minister has said that government employees, public servant health professionals, are entitled to share their views on government policy. I think it is particularly important that nurses do that because they are probably the most trusted of all the people who work in health.

Again, it is a great pleasure to support the member for Elder and others. The member for Fisher has a personal nursing background. I do not think we have a nurse on our side, but I think you will find that we have an enormous number of people who are immediately connected with nurses, as I am with my wife, Rebecca. I will just finish by again saying thank you to those present, and thank you to those who are not present who work as nurses, because you are the ones, more than anyone else—not exclusively but more than anyone else—who keep all of us in South Australia healthy. Thank you.

Mr PICTON (Kaurna) (12:14): I would like to add some comments supporting the motion from the member for Elder. I congratulate her on moving this motion, mainly because she has invited this enormous number of fantastic, hardworking nurses to the house today, and not just because you are applauding every speech that is being made—and I hope to receive the same treatment—but also because it is an honour for us to have you here to see the parliament, and for us to be able to repay in our speeches our gratitude for the hard work you do.

I would just like to make a few comments about some of the policy issues around nursing—in particular, broadly looking at health policy generally. I think that we need to value the voice and opinion that nurses have in devising those policies. Nurses are the people on the coalface of our health system. I have nothing disparaging to say about some the consultants in our hospitals, but sometimes they will go home at night and it will be the nurses who are actually there, running the ship and making sure that the patients are being looked after. You have a tremendous amount of expertise and value to add in all areas of planning in our health system, and the more that we can listen to you I think the better the outcome will be.

I know this from seeing it firsthand in our hospitals. Recently, I was with a family member at the Flinders Medical Centre emergency department. When you are there as a family member you instantly think, 'Oh, we had better wait to hear what the doctor has to say.' When the doctor eventually came around, the nurse was telling the doctor what instructions should be given for the patient, and the doctor said, 'Oh, yes; okay, let's do that.' I think that probably happens a lot more than people would realise. Given your experience and your indepth clinical understanding, you really are the backbone of the whole system.

Likewise, I think it is really important that we, as people involved in the running, management and oversight of our health system, to look after your rights at work, in terms of your pay and conditions (which need to protected) and also in terms of issues such as security at work and the resources that you need to carry out your work to the best of your abilities. That is something that I know we on this side of the house will always have in mind.

I would like to echo the words of some of my other colleagues in terms of how we can further the ability for nurses to provide a greater level of clinical expertise in the work that they do. We have seen in recent years more nurse practitioners, and I absolutely think that this is something that we can expand. I know that the health minister, in his work on Transforming Health, believes it is a key priority to expand the role of nurse practitioners.

We have seen a huge number of leaps forward in terms of prescribing rights for nurses, which is a fantastic thing. It used to be that the only way that nurses could progress their career was by going into management roles, but now there are good clinical pathways for you to progress your career, which is good for the system but also good for nurses.

I also wanted to quickly raise an issue in terms of workforce numbers for nursing, which is going to be very important over the coming years for us as a state and also as a country. As the population ages, we are going to need more and more nurses to look after the number of people who are going to be needing services in our hospitals, in the community and in aged care. That is also going to coincide with the fact that a large number of nurses will be retiring and will want to receive some of those services themselves. That is a critical problem that we need to grapple with as a country.

While we have seen a large increase in the number of nursing places at universities, that has not necessarily been able to keep up with the limitations on places for clinical placements or graduate positions at the moment. This is because we have not yet reached that period in which the large number of retirements are happening. I know that is something that the government here is well aware of. Federally, there was a lot of work being done with Health Workforce Australia to try to address some of those issues. Unfortunately, that body has now been scrapped, so I think there is more work that needs to happen federally on trying to address that.

Lastly, I would like to comment that I think nurses are very lucky to have a very strong union, both nationally and in South Australia—the Australian Nursing and Midwifery Federation. I am always told not to say 'the ANF': it is the ANMF now. I see Associate Professor Elizabeth Dabars up there in the chamber. It is great to see her. We did have the occasional sparring match when I was chief of staff to the health minister in South Australia—

An honourable member: Surely not!

Mr PICTON: Surely not—no. We had very cordial relations. I always knew that she was very in tune with what was happening on the ground for her members and always had her members' best interests at heart. I think we should also pay credit to Rob Bonner from the ANMF and the previous secretary, Lee Thomas, with whom I also had some dealings federally and who is also very well respected around the country. I congratulate the member for Elder and pay credit to the member for Fisher for her speech as well. I look forward to celebrating with you on International Nurses Day.

Mr PENGILLY (Finniss) (12:20): I rise to say a few words in relation to the motion of the member for Elder, of which I am supportive. Let me put on the record that, as I indicated earlier, my wife is a nurse and has been for some 39 years. My daughter is also an RN, and they both boss me around, so there is a fair bit to be said for that.

I would also like to make a couple of other comments. Someone (I think it was the member for Stuart) talked about Florence Nightingale, but I would like to particularly put on the record the contribution the nurses made in World War I. I think that is important, given the events of a week or two ago. Particularly on the island of Lemnos and on the hospital ships off Gallipoli, I have read, the boys—and they were all boys—who were wounded badly used to cry for their mothers on the shoulders of the nurses when they were trying to recuperate. So many died and the last person who was holding them as they died was, more often than not, a nurse. I think it is really important to remember that. We have all been inundated with material lately on the Gallipoli centenary, but I put that on the record here.

The other thing I do not think any other member has talked about this morning is the increasing numbers of male nurses. When I was a boy in the bush and there were very few girls around, any new nurse or any new female schoolteacher was fair game. It is possibly still the case; I am not sure. They play an intrinsic role in the community. I mentioned World War I earlier. When I went to boarding school, the matron was a lady called Patsy Darke. She was a nurse in World War II who went overseas, and she still wore her Army nursing uniform to chapel in boarding school in those days back in the sixties.

I have fond memories of Patsy. Actually, we could not put one over her. If you wanted to get a day off school, the idea was to have breakfast and a hot cup of tea, keep your mouth shut and shoot down to Patsy and say that you were feeling unwell and had a temperature. She would put a thermometer in your mouth and say, 'Oh, yes, you have.' She would send you off to sit in a room and come back and test you. By that time, the cup of tea had worn off and it was back to school.

The member for Stuart also indicated what his wife thinks about training. My wife actually started off as an enrolled nurse and did all her training in a hospital. She went on, in her 40s, to study off campus and did her RN training. I have to say that she was pretty horrified working in a hospital with young nurses who had done very little training in hospitals. They had done all academic achievement and, for all practical purposes, in her words, were really not up to the job when they were put in a hospital situation. They had all the academic, but no practical, training.

I mention my wife because she used to keep our farm on the straight and narrow during the crashes in wool and so forth. She provided the income and, even when each of our three children were born, she always went back to work. I have never forgotten what happened before our first child was born. It was a Sunday night. My wife had to drive 30 kilometres to get home. She came home in absolute tears and sat on the end of the bed. It was midnight or something. A local pastor had been standing behind a car and another car, a drunken driver, came in and severed one leg, and it was hanging on by a lump of skin. She had to sit there with him for several hours. I think that was the most shattering experience she ever had.

My wife, Jan, has done an enormous job. She is now a practice nurse and she thoroughly enjoys that, sticking needles into people and everything else. Her days of hospital nursing are over as far as she is concerned. There are others who want to speak, but I am pleased to have made a small contribution in support of the motion.

Mr TRELOAR (Flinders) (12:25): I do acknowledge the gallery today and I understand that our contributions are brief because lunch beckons. There are still a couple more members here who would like to make a contribution in support of this wonderful motion and I do need to declare an interest. In fact, I am wondering if there is anybody in this place who is not married to a nurse, because I too am married to a nurse and have been for the last 27 years. She has been a wonderful wife, mother and nurse.

She too trained in the old days, when you could train at the local hospital. In fact, my dear wife Annette trained at the hospital at Tumby Bay and spent one year training as an enrolled nurse. In fact, years later, when we had four very young children, she went back and did her degree and became a registered nurse, so my congratulations to her. She has worked the whole time we have been married: first as an enrolled nurse, then as a registered nurse, and now she has had enough of shiftwork and has actually gone into community nursing, which she is enjoying very much.

The point has been made that there are so many different roles that nurses undertake in our communities. In the electorate of Flinders, I think I counted up to eight hospitals, and of course there are all of the associated nursing professionals who work in and around hospitals, not just providing the patient care but also the community care and aged care that is so necessary in all of these communities; and, of course, aged care is going to become much more a part of our health care in years to come.

I have always believed in my own mind that nursing is more than a profession, it is actually a vocation. It is a vocation in a way very few jobs are, and the dedication and professionalism that nurses bring to their vocation has been mentioned and recognised a number of times today. The caring contribution that they make to our society is extraordinary.

If I can just digress for a moment, in country areas, many nurses married farmers, of course, and farmers were able to keep those nurses in their community at their local hospitals, and many nurses kept the farm running as well. The member for Stuart—what was it that you said your wife does?

Mr van Holst Pellekaan: Theatre nurse.

Mr TRELOAR: She's a theatre nurse. I was going to say that not only does my wife keep the family functioning but she also keeps the farm running as well when I am not there—what a girl. They are very trusted, of course, and it is often said that the last words on this earth that many of us will utter are, 'Goodnight, nurse.' I make light of that because they almost certainly will be for me.

Mr van Holst Pellekaan: And he's probably said it many times before.

Mr TRELOAR: Indeed. Luckily, they have gone, member for Stuart. There will be challenges. Members have mentioned the challenges that arise from the development of healthcare policy and, of course, Transforming Health is underway at the moment. I too would recommend wholeheartedly that the government and the Minister for Health take on board and note very seriously the comments and the contribution that nurses will make to this discussion, because, after all, they are at the coalface, they are the ones who know what is going on, and they are the ones who know how the system works or does not work.

Congratulations to all those who have spoken. Congratulations to the member for Elder for moving this motion and to all of those who have dedicated their lives to the care of others. Today we recognise International Nurses Day and acknowledge this year's theme, Nurses: A Force for Change: Care Effective, Cost Effective, and congratulate the South Australian nurses for their dedication and professionalism, and the pivotal role they play in the advancement of all areas of South Australian health.

Mr PEDERICK (Hammond) (12:29): I rise to support the motion:

That this house—

(a) recognises International Nurses Day celebrated annually on 12May 2015;

(b) acknowledges this year's theme, Nurses: A Force for Change: Care Effective, Cost Effective; and

(c) congratulates South Australian nurses for their dedication and professionalism and the pivotal role they play in the advancement of all South Australians' health.

With some members declaring their interest in nurses today, I can indicate that I have not had a personal interest—as far as a relationship goes—with a nurse for over 20 years because I have known my wife that long and she is not a nurse.

There has been some light made of whether someone had been in a nurses' home. In the early 1980s, I was doing on-farm training around Murray Bridge. We were going to train for a couple of days in Mount Gambier and we asked, 'Where are we staying?' 'Oh, you're going to stay in the nurses' quarters, but on a different floor.' I thought that was like putting the foxes in charge of the henhouse. Back then we had to be careful we got out on the right floor so that our studies were not diverted onto other things.

I would like to express appreciation for the work that nurses have always done, and the member for Finniss talked about the contribution of nurses on Lemnos Island and on the hospital ships during World War 1 off Gallipoli. Well before then, and over time, nurses have played and continue to play a great role in maintaining the health of this state and this country.

As you get older and as time goes on, you seem to run into more nurses, professionally. I was in Griffith Rehab at Hove having had surgery for an artificial left hip, and being a bit allergic to pain I hit the buzzer and the nurse came in and said, 'What would you like?' I said, 'I would like some more Endone please.' Of course, Endone is heavily regulated—it is morphine. She said, 'You've already had 95 milligrams today.' I said, 'Can I have some more?' She said, 'Yes'. I said, 'Well, okay, let's go.' As I said, it is heavily regulated, and for that very reason that it is morphine. When you have a tablet, there are two nurses: one recording and one watching you take it to make sure you are not storing it under your pillow (or something) for a later date. So that is a good thing. The professionalism there was just fantastic, as it has been in all the hospitals I have had to visit over my life.

I had reason to attend the Repat a few months ago for a couple of days and it was interesting talking to the nurses there. The government's aim is to shut down the Repat, essentially. And yes, it was in an older ward, but it was clean and well looked after, and the nurses and doctors and health professionals were fantastic. The discussion I had with one or two of the nurses about the EPAS—the electronic recording of all your data—was interesting. I did not tell them who I was or where I was from.

It is interesting just how much work goes into trying to make that work. I understand the government has spent $400 million for a recording system that is really going nowhere. I think the intent is great, but I think we obviously have the wrong program. The EPAS is going to be rolled out in the new Royal Adelaide Hospital and I think we are up for major cost blowouts unless this is really tightened up. It is something that needs to be looked at, and an electronic monitoring system for all your health needs will never work unless it is connected to all GPs, all hospitals, and everyone, at least, has a handle on how to operate it.

In saying that, I again thank all nurses for their dedication, their work efforts and ethics over all the years not just in hospitals but in aged-care facilities and right across the board. If we did not have nurses, life just would not be the same.

Mr GRIFFITHS (Goyder) (12:34): I also want to put on the record some very brief comments, particularly about my mother, who was a nurse for 50 years. Nursing is something I grew up with; indeed, my earliest memory is of mum being a nurse. She retired only three years ago, after 50 years. She has aged a bit in the last three years, I must admit. I do not know how she managed to do it; she was working as a nurse seven days a fortnight up until the age of 69. I have the utmost respect for her.

I have had to use hospitals myself when illness has hit me, but every day I have ever talked to mum there has been a reference to what she dedicated her life to. I have been so impressed by the fact that she is an example of so many people, both men and women, who serve others, often with complete dedication, forsaking everything else, understanding that what they say and do can often make a difference to the longevity of a person or, indeed, make a difference to their last hours, moments and days. I support the motion, and I put on record the respect I hold for the profession, a profession that is more than just a job; it is an absolute commitment they make.

Growing up, as a young child I saw the impact it had on our family structure. My parents were divorced when I was only four years of age, so mum was my parent. I saw what she did as a nurse and the dedication she brought to it. I think the greatest honour I have ever had in my life was when a person on Yorke Peninsula said to me, 20 years after mum had moved from the peninsula and was working at the Flinders Medical Centre, in ward 5F, 'Your mother was exceptional because it was as though she was born to it. Her total commitment was to ensure that the patient was looked after, cared for and given the support they needed.' I think it is a wonderful thing that this motion has been brought forward, and I commend it—and 12 May will be a very special day indeed.

The Hon. T.R. KENYON (Newland) (12:36): On behalf of the member for Elder, I rise to close the debate and to mention my support for the motion and my gratitude for the work of nurses in this state. I thank all members for their contribution, and I urge the house to support the motion.

Motion carried.

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