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Look into my crystal ball: what the peaks see for 2019

Long hours, short staffing, workplace safety, higher salaries, bullying in the workplace. These are a few of the issues that are constants for the nurses of Australia.

In a federal election year, coupled with a Royal Commission into Aged Care, nursing and the wider healthcare industry will be in the spotlight.

Nursing Review sought out some of the most influential industry voices to find out what they see in store for the year to come.

AHHA's Alison Verhoeven

How we fund our health system is a concern for Australian Hospitals & Healthcare Association (AHHA) chief executive Alison Verhoeven; in particular, ensuring that private health insurance and out of pocket costs more affordable for individuals.

“I think what we're seeing already is both major parties making lots and lots of funding announcements in the health space because they're obviously very aware that health is on the electors' radar,” she said.

“Part of the challenge is ensuring that that spending is actually strategic and actually will improve the system, improve access to public services in particular, and improve affordability for private services. And the jury's still out on that one.”

And into 2019, Verhoven is working to ensuring value in the health system and “value-based care”.

“And by that, I mean not just cost, but also ensuring that outcomes are positive not only in the clinical sense but are important to patients,” she said.

“We’re doing a lot of work on value-based care, and this follows on from what we did during 2018 with our World Hospital Congress. So, a real focus on value, the cost and outcomes equation, and seeking to ensure that we get the best outcomes for the lowest cost.”

As for the Royal Commission, Verhoeven believes that while staffing levels are important, keeping people out of hospital with a strong system is important too. And in an important year, she hopes healthcare professionals make themselves heard.

“It's going to be a really interesting year with the election. The main thing I would like to encourage nurses to do is to have their say.

“And this is not just a political question. It's a question of good clinical practice as well, so encourage the nurses to get in and speak up,” she said.

ANMF's Annie Butler

Newly re-elected union boss Annie Butler is looking for a lot for nurses and midwives this year. And the theme is a recurring one.

“Riding on from the improvements in 2016 in Victoria, they had a very successful outcome with an industrial bargaining arrangement. So not only did they have legislative ratios in their public sector, but they also got significant pay increases at that time to bring them more into line with New South Wales. And on top of that last year, the Andrews government, [which was] subsequently re-elected, committed to ratios improvements,” she said.

“A New South Wales election is about to happen at the end of March. And they have a commitment from the current opposition that they will also implement ratios."

Along with the fight for ratios, a national strategy for midwives is in the offing – the National Strategic Approach to Maternity Services plan.

“That’s trying to look at a strategy for maternity services across the country," Butler said. "It's more acute for some states and territories than others, because there are some areas of significant midwife shortages still, particularly in rural areas."

Butler is serious about improvements for union members, but also wants the ANMF to have an all-round-community approach to its activism – her focus on climate change being one example of this. She points to the severe weather incidents this summer – floods in Townsville and prolonged heatwaves – as reasons for all health professionals to be concerned.

“Last year we actually joined with the Global Nurses United, a group of 22 unions, industrial bodies and campaigning bodies, on a statement about committing to what action we can take about climate change from a health professional perspective,” she said.

But the “big ticket item” for Butler and the union this year is the Royal Commission into Aged Care, but she wishes it hadn’t got to this point.

“We are disappointed in a way. We were disappointed when the Prime Minister announced the Royal Commission because we know the answers. We've known the answers for a long time. We have all the evidence so that it could just be implemented,” she said.

“We did say that this is potentially deferring it and not putting in solutions now that they could be putting in. Having said that, we've engaged with the Royal Commission.”

ACN's Kylie Ward

Australian College of Nursing (ACN) chief executive Kylie Ward wants ACN to build on a successful 2018. Ward points to ACN’s four inaugural policy chapters – workforce sustainability, healthy ageing, chronic disease and end of life care as a positive collaborative tool for government and stakeholders to effect policy.

Hundreds of ACN nursing submissions were made to government last year, and the body had its say about inquires on aged care, abortion reform and voluntary assisted dying, among others.

The NurseStrong campaign, launched last October and aimed at improving overall nurse wellbeing, is another scheme Ward is proud of.

“Fifteen-hundred nurses signed up for a 12-week FHIT Program by personal trainer Lauren Hannaford, and it has been great to see so many nurses from around the country joining forces to encourage each other, exercise together or share healthy eating and lifestyle tips – that is what NurseStrong is all about,” she said.

For the coming year, Ward pointed to the Government's review of nursing preparation as an important step to keep pace with a changing word.

“ACN welcomes the Commonwealth Government’s announcement of the first independent review of Australian nursing preparation since 2002, Educating the Nurse of the Future, which will begin later this year, ensuring education for the next generation of nurses matches the reality of practice in 2020 and beyond.

“It is vital nurse education and training keep pace with advances in practice and technology as well as changing patient needs and expectations,” she said.

Ward is also keen to close the gender gap in the nursing workforce. ACN has created a group for men working in nursing, with a view to let men know it is okay to care.

“As nursing is a predominantly female profession, it is well and truly time for us to work together to close the gender gap and attract more men into the workforce,” she said.

On top of all of these measures, ACN is also teaming up with the International Council of Nurses and the World Health Organization for its Nursing Now campaign, with a view to improve perceptions of nurses and increase their influence in society.

“As nurses are at the absolute coalface of health care, they are exceptionally well placed to understand and see shifts in care needs and help Australia respond in the most effective manner through policy development and implementation."

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