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Healthcare Unit of the Year finalists: L-R Manager, Integrated Aged Care in Tamworth Richard Williams is pictured with team members Rhonda Asbury, Nadine Pevy, Tracy McCouat and Shirley Broadley.

In pictures: Calvary Mater opening

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A celebration of excellence

On Thursday 10 September, more than 200 Hunter New England Health staff will come together at the Area Health Service's night of nights, the annual Achievement Awards Gala Dinner. The awards aim to celebrate clinical excellence, innovation and staff achievement. The highlight of the evening will be the announcement of the winners of the 2009 Staff Achievement Awards and the 2009 Hunter New England Health Quality Awards. The annual Staff Achievement Awards are an important way of recognising and rewarding individuals and teams for outstanding performance. This year, there are eight categories of Achievement Awards up for grabs and the competition for these prestigious awards is strong. The Integrated Aged Care Team from Tamworth/Nundle Community Health Service (pictured) is among the finalists for Healthcare Unit of the Year. Tamworth Community Health Manager Melissa Mills said the team had embraced change and was clearly focussed on improving client and customer services. continued on page 4

Lifesavers: Lending our expertise where it's needed

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Web of information: New site for Aboriginal health

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Million-dollar partnership reaches out to forgotten allies

Carers and loved ones are often the forgotten allies in the battle against depression. However, that is about to change with a new national program developed through the Hunter Institute of Mental Health. Partners in Depression is a partnership project between the Institute and nib foundation, which is providing $1 million funding through its National Grants program. The Institute has received the first ever national grant to be made under the program, which was launched in March this year. Partners in Depression is a six-week evidencebased, psycho-educational group program that aims to provide information and support to families and friends of people experiencing depression. The project and funding was announced at a function in Newcastle last month. Supporter Lucy Brogden, who was a guest speaker at the launch, said such programs were vital in helping carers to be more informed in providing support for their loved one and also better prepare them to address their own needs. "Caring for someone living with depression can be frustrating. There were times I felt totally exasperated, not knowing where to turn for help or support. However, with help the family can learn to live again, laugh again and love again." nib foundation Chairman Terry Lawler said he was delighted the foundation was partnering with a Hunter-based organisation that is making such a positive impact on the lives of people right around Australia. "What attracted the nib foundation to this program was the unique approach it was taking and the support it is providing to those people whose needs are so often forgotten ­ the carers," Mr Lawler said. "This funding will allow the Institute to roll out the program across the country over the next three years and make a significant difference to the lives of the loved ones and carers of people living with depression." nib foundation is a not-for-profit charitable organisation established by nib health funds in 2008 to support programs aimed at improving the health and well being of all Australians.

Phone it in: Coaching helps prevent falls

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Insight: A personal story of coping with dementia

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Guest speaker Lucy Brogden, with mental health advocate and ABC Radio sports broadcaster Craig Hamilton. Mrs Brogden is the wife of former NSW politician John Brogden, whose own battle with depression came to light in 2005 while he was the NSW Opposition Leader. "When your partner is battling depression they can undergo dramatic behavioural changes, and there are many times when you sit back and think, `this isn't person I know'. This can place enormous pressure on the relationship and the family," Mrs Brogden said.

Regular features

From the Chief Executive p 2 Love Your Work HMRI News In Your Community Two's Company p6 p6 p9 p 11

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Our Vision: Healthier Communities: Excellence in healthcare Our values: Teamwork, Honesty, Respect, Ethics, Excellence, Caring, Commitment, Courage

Message from the Chief Executive

This really is a time of celebration and reflection within Hunter New England Health. I was proud to join NSW Minister for Health John Della Bosca and a host of other dignitaries for the official opening of the $200-million Mater redevelopment last month. This was a culmination of many years of dedication and hard work from everyone involved and it was wonderful to see the successful outcome at the official opening. More than 200 people attended the event to celebrate the enormous effort and teamwork required to bring the vision of Calvary Mater Newcastle and Hunter New England Mental Health Services together at one location. As you will see from the photographs on this page, there were a range of highlights from the day. Congratulations to all involved. But of course, the major cause for celebration this month within HNE Health is the announcement of the annual Staff Achievement Awards and Quality Awards. Finalists have been announced in recent weeks, and on Thursday 10 September, I will join them at a Gala Dinner awards night at the Newcastle Jockey Club to reveal the winners. I am looking forward to the opportunity to celebrate with these exceptional individuals and teams, who have Dr Nigel Lyons Chief Executive Hunter New England Health excelled in their particular roles, whether they be frontline clinical roles, support staff or volunteers. I will notify everyone of the winners via a special announcement to all staff following the awards. In other positive news, the Hunter Institute of Mental Health has been successful in winning $1million in grant funding from nib foundation for the Partners in Depression program (see stories page 1 and 4). This is a major achievement and good news for all of their carers and supporters of people in our communities living with depression. Finally, a word on `Caring Together'. HNE Health continues to work hard to deliver the recommendations from Caring Together: The NSW Health Action Plan. See page 3 for an update on this important initiative.

Long-standing staff members Anne Granger and Dennis Skinner had the honour of cutting the ribbon to the new facilities.

Above: (L-R) HNE Health Chief Executive Dr Nigel Lyons, Area Manager HNE Mental Health Jude Constable, NSW Minister for Health The Hon. John Della Bosca, Wallsend MP Sonia Hornery, NSW Premier The Hon. Nathan Rees and Calvary Mater Newcastle General Manager Colin Osborne.

Right: Under Construction, a Mental Health Consumer Choir moved some of the guests to tears with their performance.

Right: More than 200 people turned out on a warm winter's day to celebrate the opening of `two hospitals at the one location'.

Above: The Mater official opening organising committee takes time to celebrate. Clockwise from back left: Nicole Latham and Alan Boyd (Medirest), Scott Lusted (Novacare), Frances Holz and Kristy Waddell (HNE Health), Ingrid Grenell and Laura Jackel (CMN).

Left: Awabakal Elder Aunty Sandra Griffin delivered the Welcome to Country. Sister Jennifer Barrow LCM Province Leader and Minister assisting the NSW Minister for Health (Mental Health) The Hon. Barbara Perry unveil the plaque.


HNE Health Matters is produced by the Communication Unit of Hunter New England Health. This monthly newsletter is distributed to staff across the organisation and to supporters across the region. If you're a community member who would like to be added to the mailing list for this newspaper, please call (02) 4985 5522 and we'll add your details to the database. Stories are written by Communication Unit staff from across the Area. Contributions by staff are welcomed, please contact the editors or your local Communication Officer. Editors: Tamaryn Curry and Gemma Smith, Communication, Hunter New England Health Postal Address: Locked Bag 1, New Lambton 2305 Phone: (02) 4921 4801 Email: [email protected] Letters to the editor: We would love to hear what you think about HNE Health Matters. Send your feedback via the contact details above. Advertising enquiries: Phone (02) 4921 4801


Our Vision: Healthier Communities: Excellence in healthcare Our values: Teamwork, Honesty, Respect, Ethics, Excellence, Caring, Commitment, Courage

This month we asked staff...

What's the worst movie you have ever seen?

Helen Turnham Community Health Nurse, Guyra MPS "The worst movie I have even seen is Four Weddings and a Funeral. The movie was actually great in its own right, however, there was far too much swearing!" Barbara Morris Admin Officer, Belmont Hospital "The worst movie I have ever seen is Surfer Dude starring Matthew McConaughey. There was no storyline and all the way through the movie whenever Matthew spoke it sounded like he was drunk." Luke Sams Health Service Manager, Quirindi District Health Service "For me the worst movie that stands head and shoulders above all others is Doom - the movie of that famous video game. It's just really, really terrible." Carole Young Health Service Manager, Gunnedah Health Service "I'm the only one in the world who thinks this - The Shawshank Redemption, it made me cry because it was awful, just so violent."

Lending our expertise to make a real difference where it's needed

By TANYA CARLYLE Australia is colloquially known as the `Lucky Country'. From a health perspective we have ready access to healthcare, and communicable diseases such as malaria and tuberculosis (TB) are rare. Many Australians will never be touched by these illnesses. But can you imagine a life where just seeing a doctor takes an entire day travelling in a canoe? Or having neighbours, friends and family regularly struck down by serious illnesses, many of them dying without treatment. This is the situation for many people in Australia's closest neighbour Papua New Guinea (PNG). But what can we do about the situation in PNG here at Hunter New England Health? Staff from HNE Health's division of Population Health are trying to make a difference to the lives of thousands of PNG residents by lending our expertise in developing public health programs. Leading our efforts is Health Protection Manager Peter Massey, who's based in Tamworth. HNE Health has joined forces with our public health colleagues at James Cook University in Queensland and an unlikely ally ­ an oil company. Oil Search is PNG's largest oil and gas producer and operates all of the country's actively-producing oil and gas fields. The group's goal is to develop a sustainable TB control program in two provinces ­ the Southern Highlands and the Gulf district. "TB is a serious infectious disease that is spread person to person and if left untreated results in up to 60 per cent mortality. Rates of tuberculosis in the Gulf area may be four times higher than for PNG as a whole. TB is a disease of poverty," Peter said. But what's in it for the oil company? "Unless a concerted effort is made there will continue to be a devastating impact on the health and welfare of many parts of the PNG population, and that's Oil Search's workforce," Peter said. The partnership is seeking $2 million from the Global Fund and the World Health Organisation to provide funding with the National Department of Health PNG to support this program. The Global Fund to Fight AIDS, Tuberculosis and Malaria was created to increase resources to fight three of the world's most devastating diseases, and to direct those resources to areas of greatest need. "The program we want to set up is called DOTS or `Directly Observed Therapy Short-course' and it is the first stage of the widely acclaimed six-stage Stop TB Strategy," Peter said. "One problem with TB is that sufferers have to be on the medication for six months. Part of our program is capacity building at the village level and having medication supervisors to ensure that people are continuing to take their medication." Peter will head back to PNG to assist in setting up the reference group that will guide the program. "Being a public private partnership between the oil company, health services and a university, the World Health Organisation is very interested in seeing how this project evolves and whether HNE Health's Peter Massey (second from right) with Prof Glen Mola (PNG Obstetrician), Paul (driver from OilSearch), and Keith (Regional church health services) visiting PNG to undertaken the TB analysis.

it can be implemented in other developing countries," Peter said. "One major benefit of partnering with an oil company is that they have very effective logistics and supervision systems in place. The PNG Government struggles with this in the more remote areas. Getting medication to a remote village will be achievable through the oil company systems. "I've really enjoyed being part of a project that is taking what we know here at HNE Health and putting it into place in a country much worse off than ours. "We are hoping we can make a difference in these peoples' lives. People are dying from a lack of a system. Whole communities can benefit from a good TB protection system being in place. "Hopefully sharing our knowledge and skills can make a difference in PNG and for us here in HNE Health," Peter said. It is hoped the program can be rolled out mid-2010.

Respecting patient dignity: Gender-based rooms

Left: John Hunter Hospital Division of Medicine Service Manager Carmel Peek and Nurse Manager Roz Everingham with patient Irene Piper. Being sick in hospital is never a pleasant experience but much can and is being done to make it all that more bearable. One of the improvements listed in the Caring Together: The NSW Health Action Plan is placing patients (where possible) into rooms where the `roommate' is of the same gender. Hunter New England Health is currently developing its `Mixed Gender Accommodation' policy for roll out across the Area. This policy will apply to rooms with two or more beds, which have not been designated as observation, high dependency or other specialised areas such as emergency or ICU. John Hunter Hospital's Division of Medicine has had a program in place to provide same gender rooms since March this year. Division of Medicine Service Manager Carmel Peek said the aim is to provide gender based rooms to patients within a 24 hour period, if possible. "Across the Division of Medicine we have a lot of older patients. Our philosophy is to provide dignity and respect for people and for a lot of our patients this means trying to provide them with an environment which they feel comfortable. That's what we are striving for," Carmel said. "We've implemented our program across six wards and 128 beds, and our nursing staff undertake a daily review to ensure patients are provided same gender accommodation wherever possible. "The focus of this program is to promote a culture in hospitals where the care and treatment of the patient is at the centre of everything we do. We have gone back to the basics and are listening to our patients. "The cornerstone of this program is nursing staff speaking to the patient and their family or carers and ensuring they are aware of the same gender rooms project and that we will try to move them as soon as possible if they are currently in a mixed gender room." John Hunter Hospital has implemented a program to deliver gender-based rooms to improve patient comfort.

New hotline

NSW Health has established a hotline for people to register complaints if their issues about being accommodated in with patients of other genders have not been resolved. The hotline will forward all complaints to the relevant manager who will be required to address the matter and report back to the department on the outcome. It is hoped that as we change our practices, the calls to this hotline will diminish and we will have demonstrated that we are providing a service that respects the privacy, safety and dignity of all of our patients. The hotline phone number is 1800 700 830.

Nurse Manager Roz Everingham was one of the driving forces behind the program along with Sally Milson-Hawke, Acting Director of Nursing and Midwifery JHH/RNC. "We try to achieve a benchmark of 80 per cent of patients in same gender rooms across the division every day," Roz said. "It can be a daily juggling act and can mean lots of movement of beds. We have to move

some patients multiple times as patients come and go and the gender mix changes across the ward. It can mean increased workloads for the nurses as well as the patient support staff who help move the patients. "But we believe that the benefits for patients far outweigh the negatives. It's a work in progress but we have definitely taken a step in the right direction."


Our Vision: Healthier Communities: Excellence in healthcare Our values: Teamwork, Honesty, Respect, Ethics, Excellence, Caring, Commitment, Courage

Helping hands through dark days

By FRANCES HOLZ Katie McGill is uniquely placed to project manage the Hunter Institute of Mental Health's new national Partners in Depression program. As a psychologist she has a clinical knowledge of depression, an understanding of an all too common condition. But it is her own experience as a carer and in providing support for someone with depression that has given her even greater insights. She understands the difficulties and frustrations they face. She knows the fear. And she knows how important it is for those facing the vicarious trauma of someone else's depression to take time out to care for themselves so that they don't burn out or, worse, slide into depression or develop anxiety. Those three elements ­ knowledge, shared experience and self-care ­ are the cornerstones of the Partners in Depression program, which will be rolled out across Australia over the next three years thanks to a $1 million grant from the newly created charitable trust, the nib foundation. Partners in Depression is no personal healing project but is based on sound evidence. "We know from the research that carers of people with mental illness are at high risk of themselves having depression, anxiety and stress," said Katie, who joined the project in 2007 when the team was looking for funding. An earlier pilot project, developed with the help of the beyondblue organisation, proved the program's value. Participants reported significant decreases in depression, anxiety and stress and significant improvements in their relationship with the primary person experiencing the depression. "It is a relatively simple intervention program but potentially very effective," says Katie. There was nothing like it when Katie was dealing with her own dilemmas. Katie was nearing the end of high school when she Mother and daughter joke now that it might be `superwoman syndrome' and Helen admits that she has "always been a world-fixer". She understands her condition and herself much better these days, and is much kinder to herself. "When you are depressed you look at things as if it is somehow your fault, that you should be just able to pull yourself together. "But when you get truly depressed you can't pull yourself together. Real depression is much more than feeling a bit down. "I work very hard at staying well because I never want to go there again." Katie, who lives nearby, helps her stay well ­ often picking up early signs of stress before they can manifest into something more, encouraging her mother to do more, or less, as the situation requires. Katie is direct in her assessments ­ or "sometimes a bit too protective", jokes Helen, who nevertheless has learnt to listen and who respects her daughter's counsel, "on most things". "Mum wanted to give everything to her patients, everything to her family, but gave nothing to herself." Katie says she is much better at looking out for herself. Experience has taught her that, although it wasn't always the case and in the early period of supporting her mother, she says she just muddled through like everyone else. Armed with knowledge and her own experience, Katie will begin training other health professionals early next year to deliver Partners in Depression. They in turn will potentially provide many thousands of Australians with information and important self-care strategies to help them cope with their vital but often forgotten support role. To register interest in the project (as participant or facilitator) please email: [email protected]

Katie McGill's own experience supporting her mother Dr Helen Tolhurst has given her special insights into the needs of people caring for those living with depression.

first began to realise that her mother, a successful doctor and academic, was not necessarily the picture of a quiet, hard working, self-contained woman that Katie had imagined throughout her youth. Dr Helen Tolhurst, still a busy and successful Hunter GP, has lived with depression for many years. She considers it a chronic illness that, like any other chronic illness, she needs to manage if she is to stay well. She is ever vigilant now against the warning signs and in maintaining balance and the good things and often simple things in her life that help keep her `black dog' at bay. But it wasn't always the way.

Dr Tolhurst first shared her experience of depression with colleagues in 2004 in a personal and moving account published in the Medical Journal of Australia. The article reveals a highly intelligent, committed and caring woman struggling to cope, hiding her feelings from those around her, ashamed of her perceived inability to cope which she took as a sign of weakness. She believed others would too, and was unable to talk with her colleagues or seek help. "I felt guilty about my inability to cope with work and family life and my failure to be the perfect doctor, perfect wife and perfect mother," she revealed then.

Million-dollar partnership to help carers and loved ones

from page one The Hunter Institute of Mental Health was named Hunter New England Health's Support Unit of the Year in the 2008 HNE Health Achievement Awards. Director Trevor Hazell said the Institute was excited to now have the funding to conduct a large-scale rollout of what has already been an effective and successful pilot program. "Research has shown that carers and loved ones of people experiencing depression can themselves be at risk of developing mental illness," Mr Hazell said. "This prompted the development of a successful pilot Partners in Depression program in 2007, co-funded by HIMH and beyondblue, to provide carers with relevant information and self care strategies to significantly reduce the stress in this important support role. "The funding provided by nib foundation will now enable the Institute to provide free training to 400 qualified health professionals across Australia who will become Partners in Depression accredited facilitators." These facilitators will be provided with professional resources and a range of clinical and administrative support to deliver the program to up to 4500 friends and family members of people with depression Australia-wide over the next three years. Training for facilitators will begin in the Hunter area from January, 2010.

Finalists exemplify Values

from page one "Exemplifying Hunter New England Health's values, the Tamworth/Nundle Community Health Integrated Aged Care Team demonstrates commitment and teamwork and as such has improved their response and timeliness of aged care assessments, resulting in meeting or exceeding KPIs," Ms Mills said. Area Clinical Director of HNE Oral Health Service Dr Lanny Chor is a finalist for the Clinical Leader of the Year award. Oral Health Service General Manager Leanne Martin nominated Dr Chor on the basis of the effort and contribution he makes to the team and his profession. "Dr Chor values the staff within HNE Oral Health and provides leadership and mentoring of dental clinicians. He extends his role to include active involvement in the appointment and orientation of every new dentist recruited to Hunter New England Health," Leanne said. Manager of the Clinical Systems Team Ian Schumacher has provided HNE Health with clinical systems rivalled by few across Australia, from designing to implementation. Ian's commitment to his work is being recognised as a finalist for the Tomorrow's Leader award. PA G E 4 - H N E H E A LT H M AT TE R S W W W. H N E H E A LT H . N S W. G O V. A U Our Vision: Healthier Communities: Excellence in healthcare Our values: Teamwork, Honesty, Respect, Ethics, Excellence, Caring, Commitment, Courage Chief Information Officer, Warren Laurence nominated Ian for his ongoing commitment and drive to further improve clinical services. "Ian works constantly to engage with and motivate his peers to effectively and efficiently design and use clinical systems to improve healthcare performance," Warren said. These three finalists will be among a further 23 Staff Achievement Award finalist individuals and teams and 25 Quality Award finalist project teams attending the Gala Dinner at Newcastle Jockey Club. HNE Health Chief Executive Dr Nigel Lyons said he was pleased with the positive response to this year's Achievement Awards and Quality Awards, and the high calibre of the nominations received. "Congratulations to everyone who was nominated and a big thank you to those staff who took the time to recognise their colleagues by submitting nominations," Dr Lyons said. "This process has reinforced how much talent and commitment exists among staff across our organisation - I look forward to joining the finalists at the Gala Dinner to celebrate their success."

Decisions, decisions

More than 100 people attended the fifth annual New England dementia forum, aptly titled Dementia Decisions. Held at Tamworth Hospital's University Department of Rural Health on 29 July, the forum attracted residential aged care workers, staff from acute and community health services, as well as community service providers. Hunter New England Health organised the event, in partnership with the New

England and North West Slopes Divisions of General Practice, the Department of Ageing Disability and Home Care, as well as Home And Community Care. Guest speakers (pictured from left) included Palliative Care Clinical Nurse Specialist Penny Abbington, NSW Guardianship Tribunal President Diane Robinson, and Consultant Psychiatrist Dr Sid Williams.

Be informed. Shake a leg to help keep our kids healthy Help close the gap

As health workers, we all have a responsibility to help close the gap between the health status of Aboriginal and non-Aboriginal people in our region. Being well informed on the current health status of Aboriginal people is the first step. A website has been designed to provide a one stop shop where people can access a wide range of information relevant to Aboriginal and Torres Strait Islander health. au brings together reports, resources, questionnaires and services in the HNE Health region specific to Indigenous health. For example: in the HNE Health region between 2002 and 2005, Aboriginal residents (61.9 per cent) reported a greater prevalence of overweight and obesity when compared to nonAboriginal residents (56.7 per cent). Chairperson of the committee that developed the website Todd Heard said evidence suggests that such poor health commences early in life, which prompts the need for early intervention. This is particularly relevant across the HNE Health region where 48.2 per cent (2005) of the Aboriginal and Torres Strait Islander population are aged under 20 years (www. > Health Profiles > Health of Aboriginal People in Hunter New England > Demography). If we look at the current overweight and obesity issue amongst the Aboriginal population (which you can find in `A picture of Australia's children 2009', located on the website under Reports and then Child and Youth), there is support for the need to respond to overweight and obesity issues at an early age. "The report states that overweight and obese children are at risk of serious health conditions, including asthma, cardiovascular conditions and Type 2 Diabetes," Mr Heard said. An initiative that has responded to the need for early intervention is the Shake A Leg program, which was awarded the top honour in the Strengthening Aboriginal Families and Children category in the 2009 Aboriginal Health Awards. Shake A Leg aims to reduce the morbidity for targeted health conditions prevalent in Aboriginal children and is featured on this page of HNE Health Matters. "Shake a Leg has shown commitment to helping Aboriginal children get the best start to life and help close the 5.2 per cent gap between Aboriginal and nonAboriginal people in our region in terms of overweight and obesity," he said. The website also includes information sourced at HNE Health regional, state, national and international levels, provides health profiles, questionnaires and surveys, reports, policies and frameworks, and information about health services and upcoming events. Be informed ­ check out www. and help close the gap. It's great that health professionals can clearly see the statistics at ­ which tell us that Aboriginal people are more likely to be overweight and obese. But let's take a look at what some of our staff are doing to combat these worrying numbers. It's inspiring to see staff put their heads together and design a program that reaches into our schools and engages kids in fun activities, while teaching healthy behaviours and life skills. That's exactly what the team at Hunter New England Aboriginal Health did when they created the Shake A Leg program, in conjunction with Awabakal Aboriginal Medical Service. Shake A Leg is a school-based health promotion program specifically aimed at reducing the prevalence of preventable diseases and illnesses in Aboriginal children. Kristy Crooks, who was the project leader for Shake A Leg, said the program came about after a joint planning day between Aboriginal staff of HNE Health and Awabakal in March 2005. "Shake A Leg is delivered by Aboriginal Health workers from both HNE Health and Awabakal directly to kids during school lessons," Kristy said. "It's provided in 40-minute lessons, once per week throughout an entire school term. "The lessons are aligned with the school curriculum and cover key topics such as nutrition, oral health, otitis media, physical activity, identity, bullying, self esteem and drugs and alcohol," Kristy said. The program has been so successful that it has now been extended across three child health networks, with the program running in Newcastle, Taree, Armidale and Moree.

Aboriginal Health Worker Michelle Wilkes, from Taree gives a Shake A Leg lesson to a class of school children.

It has also been the subject of a number of awards, most recently taking one of the top honours at the 2009 Aboriginal Health Awards.

Shake A Leg is just one example of how our staff are being informed, becoming empowered and acting to help close the gap.

National pandemic survey learnings

Just over two years ago a group of passionate Population Health staff decided to undertake a national survey. They wanted to know just what the Australian population knew about pandemics and how ready the community was to cooperate with control measures should an influenza pandemic occur. Jump forward to today and the situation is very different. H1N1 Swine flu hit Australian shores and thousands of people have been struck down with the virus. But that survey conducted in 2007 helped Hunter New England Health prepare for what was to come. The team, which included epidemiologist Keith Eastwood, public health physician Professor David Durrheim and statisticians Lynn Francis and Edouard Tursan d'Espaignet has had their work recently published in the World Health Organisation's prestigious online Bulletin. David Durrheim said the survey's findings were important in light of the current H1N1 Swine influenza pandemic. "We need to continue to focus on equipping people with simple and accurate information to minimise their risks as we continue to learn about this novel influenza strain," Professor Durrheim said. "In the survey we found that only 23 per cent of the respondents demonstrated a clear understanding of the term `pandemic influenza'. "Of those interviewed, 94.1 per cent said they were willing to comply with home quarantine, while 94.2 per cent that they would avoid public events. "However we found that compliance increased significantly after brief pandemic information had been provided to interviewees," Professor Durrheim said. "We also found that of those who reported being unfamiliar with the term `pandemic influenza', male respondents and employed people not able to work from home, were less willing to comply. "We believe our survey indicated compliance with containment measures could be enhanced through a public education program conveying key messages," Dr Durrheim said. "The team is very pleased to have our study published in the WHO Bulletin. It is great recognition for the pandemic planning we have been doing at HNE Health." Meanwhile the National Health and Medical Research Council (NHMRC) has awarded funding to the team to conduct a followup survey to explore current community perceptions of pandemic influenza, success of communication strategies and public willingness to receive the swine influenza vaccine that is currently under development.

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Our Vision: Healthier Communities: Excellence in healthcare Our values: Teamwork, Honesty, Respect, Ethics, Excellence, Caring, Commitment, Courage

Love your work Dr Catriona `Treeny' Ooi

Director of Sexual Health

Why did you want to work in Sexual Health? What's the appeal? I enjoy working with a multidisciplinary team and seeing a wide variety of people. I also like being able to make a difference for people in a short time. Can you describe your day to day? It changes from day to day - I see patients for sexual health concerns, sexually transmitted infections, HIV and other genital presentations. I also teach undergraduates and postgraduates, manage a team and write papers and present. What is the most challenging part of your job? The most challenging part of my job is trying to raise awareness for the field of sexual health medicine. Helping patients overcome fear of judgement and seek help for common yet very intimate concerns. As a child what did you want to do when you grew up? Have telekinetic powers, somehow. If you weren't working in health, what would you be doing? Not sure if reality and fantasy are going to meet here, but I really wanted to be an author (who can do acrobatics) while constantly travelling around the world. What are some of the things you want to see achieved in your role?

Local researchers change lives

Advances in research are enabling people to live longer with cancer, yet half still die from the disease. Dr Jennette Sakoff, a Senior Hospital Scientist at Calvary Mater Newcastle, aims to develop more effective treatments that are tailored to the individual patient, by examining how cancer reacts to different therapies in the laboratory. "Being able to target only cancer cells while not affecting healthy cells is the holy grail of cancer research," Jennette said. "Up until now it has been very difficult to find a treatment that is selective enough to treat the cancer without inducing adverse side effects on the patient. "If we can understand how this phenomenon is occurring we can exploit this information to design new drugs for the treatment of cancer, or to enhance the effectiveness of older drugs." Due to the complex nature of cancer, chemotherapy will always involve drug combinations or a "cocktail" of treatments. Jennette is working to identify new drugs that interact in a positive way with standard treatment, a vital step in the development of new cancer therapies. Jennette's team has also established collaborations with industry partners for the commercial development of small molecules which could lead to new treatments and therapies for cancer and other diseases. "We have a greater understanding of how cancer cells respond to various chemotherapy treatments. As a result we are now better at designing new compounds and identifying the best drug combination strategies," she said. "While the ultimate aim is to find a cure for cancer, a more realistic goal is to find treatments that allow people to live longer with cancer and still maintain quality of life. That is, they may die with cancer but not of cancer."

Dr Treeny Ooi, HNE Health Director of Sexual Health.

Dr Jennette Sakoff, a Senior Hospital Scientist at Calvary Mater Newcastle, is researching how cancer reacts to different therapies. Jennette's research has been supported by HMRI grants funded by corporate and community donations, the Lions Club of Stroud, the Williams Bequest and PULSE. To find out more about how HMRI is supporting local health and medical researchers, visit

I want to see increased access to sexual health services for marginalised populations, particularly in rural and remote areas. I would also like to see more work done in decreasing discrimination and stigma associated with STIs and HIV.

What has been your most rewarding experience as a doctor? It's all rewarding somehow. What do you do in your free time that helps you create a work/life balance? Run, swim, and I am learning to play the harmonica.

Make this: Tuna salad in Turkish bread

8 minutes preparation 5 serves of vegetables in this recipe Serves 2 Ingredients 2 small round Turkish breads, split open and toasted 2 tablespoons low-fat cheese (eg. cottage cheese) 1 tablespoon capers, rinsed and dried (optional) 185g can tuna in spring water, drained Rocket, baby spinach or lettuce leaves 2 tomatoes, sliced 1 tablespoon fresh herbs (parsley, dill and/or mint) Freshly ground or cracked black pepper, to taste Method Spread the warm bread with cheese and sprinkle two halves with capers. Spoon the tuna, leaves and tomato on top. Season with herbs and pepper. Cover with remaining bread halves. Serve immediately. Variation Canned sardines or salmon can be used instead of tuna. For more easy and healthy ideas visit Recipe from Healthy Food Fast (C) State of Western Australia 2009 reproduced with permission.

Hunter New England Health would like to thank the following sponsors for their generous support of the 2009 Achievement Awards gala dinner

PA G E 6 - H N E H E A LTH M AT TE R S W W W. H N E H E A LT H . N S W. G O V. A U Our Vision: Healthier Communities: Excellence in healthcare Our values: Teamwork, Honesty, Respect, Ethics, Excellence, Caring, Commitment, Courage

Win the war on tax by salary packaging

Every fortnight when pay day arrives it's not uncommon to scowl at your pay slip when you check the amount of tax paid. What many HNE Health staff aren't aware of, is how they can benefit from their taxable income. Salary packaging was implemented by HNE Health as a recruitment and retention strategy for employees, allowing legitimate use of tax concessions. Staff in Werris Creek know only too well how beneficial salary packaging can be, as the majority of staff utilise the service. Health Services Manager Kylie Marquart is one of the Werris Creek staff members who believes salary packaging is a great way to go. "I've got a Novated lease, it's my second now, my costs are all paid for such as registration, insurance, servicing and fuel, I don't have to worry about anything," Kylie said. "I'm now waiting for my Meal Entertainment card I have just signed up for; it just makes so much sense. "Using salary packaging means I don't pay anywhere near as much in tax as without it because my taxable income is reduced. Basically, because all the car expenses are paid for it means I have extra money each fortnight." Kylie also used to salary package her mortgage before beginning her novated motor Vehicle Lease. Salary packaging works on an employees gross income (before tax), with the arrangement being that the employee will forgo a portion of their wage and in return HNE Health provides benefits of a similar value. HNE Health provides a number of benefits to employees such as meal entertainment, novated motor vehicle lease and living away from home expenses to name a few. Meal entertainment allows an employee to salary package the costs of food or drink purchased at a social gathering, including the costs of your guests, it's even possible to salary package the venue hire, food and drink expenses at a wedding. A novated motor vehicle lease may suit you more or in addition to another salary packaging arrangement, as Kylie from Werris Creek noted all running and standing costs are paid for with a motor vehicle lease, the most difficult choice is deciding what car to choose. If you have had to move away from home to carry out your employment with HNE Health your living away from home expenses can also be salary packaged, the types of expenses include accommodation, storage and additional food expenses. Potentially employees can make quite considerable savings when salary packaging, For further information visit http://intranet.hne.

Breaking the silence surrounding workforce carers

"There are good and bad days. Carers do what we do because we love the person we care for, even though at times we feel burdened and at times even burnt out." ­ Anonymous carer Caring can be a demanding and difficult role. Carers deserve respect, recognition and support for the work they do, and assistance in reducing the often unidentified secondary stresses that come with the caring role. `Workforce-Carers' endure the added pressures associated with juggling employment with their unpaid caring responsibilities. The impact of caring and the associated costs for carers are well documented, and show that carers tend to have: · · · Higher levels of stress and anxiety than non-carers; Difficulties with work and study; Restricted social and recreational opportunities; and Feelings of grief, resentment and emotional upheaval. Carers Action Plan Project officer Annie Atkins with Aged Care and Rehabilitation Services Clinical Manager Viki Brummell. · The Carers in Our Midst Manager's Toolkit is aligned with the NSW Carers Action Plan. It focuses on supporting managers by addressing Workforce-Carer issues. Links to resources such as the Employee Assistance Program (EAP) and external services are located within the Toolkit, with HNE Health having the overall aim of improving the health and wellbeing of workforce carers through: · A more consistent approach to responding to carers' needs; Better coordination between service providers; A strategic, planned approach to funding and resource allocation; Participation by carers at all levels of policy development and services planning; and Greater recognition and support for carers by the wider community.

· ·



HNE Health staff who also shoulder carer responsibilities have been the focus of a project being developed by the Aged Care and Rehabilitation Services (ACARS) Clinical Network. A key priority of the HNE Health Carer Action Plan is to ensure that HNE Health WorkforceCarers are supported to combine caring and work. WorkforceCarers are defined as a member of the workforce who provides unpaid support for a family member, friend or neighbour who has a disability, mental illness, chronic condition, terminal illness or who are frail. The person may or may not live with the carer. Strategies of the HNE Health Carer Action Plan include the

promotion of carer-friendly practices in the workplace, as well as the provision of flexible services to support working carers. These strategies will be grouped under the HNE Health program title of Carers in Our Midst. Carer Action Plan Project Officer Annie Atkins hopes to launch the HNE Health Carers in our Midst program during 2009 Carers Week in October. The development and implementation of a `Manager's Toolkit' will be a key component of Carers in our Midst.

"Most people don't choose to be a carer; the role may have evolved due to changing circumstances. Carers often feel invisible (hidden carers), and they are usually reluctant to reveal their own health and support needs," Annie explained. "During consultation for the development of this toolkit, HNE Health Workforce-Carers have shared some of their most personal stories in discussing their challenges and issues, which had added significant value to the content of the `Manager's Toolkit'."

"The Manager's Toolkit aims to create an improved environment of recognition, respect and value of Workforce-Carers throughout the HNE Health, with a subsequent increase in staff satisfaction. It also aims to help managers and co-workers better understand the impacts of caring; emotional, physical and financial," Annie said. "It is important that we ensure alignment of our strategies for managing Workforce-Carers with Hunter New England Health's Values: Caring, Respect and Teamwork." For more information about the Carers in Our Midst Manager's Toolkit, contact Annie Atkins on 0414 312 821. To view the HNE Health Carer Action Plan go to: http://intranet.hne. assets/pdf_file/0017/52145/ CarerActionPlanJune08.pdf

Practically academia: Stevo brings a fresh approach

HNE Health's Nursing and Midwifery Services has another ally in innovation with the appointment of Professor Steve Campbell as Head of the University of New England's School of Health. The accomplished Professor Campbell, or "Stevo" as he's been dubbed by his UNE counterparts, moved to Australia from the UK this year to shift the way nursing students approach their study and its application in the clinical setting. A self-confessed academic, Prof Campbell has held a number of positions in England including Director of Nursing of a 1000-bed facility, head of a medical equipment evaluation company and Foundation Chair of Nursing Practice at Northumbria University. It sounds like a life of pomp and ceremony, but it's the stereotypical paper-pushing side of academia that this Professor's encouraging his students to shun. Health's culture of continual innovation. "Our existing nurses and midwives are keen to embrace ideas that improve patient care, so if UNE can foster that same attitude in our student nurses from the very beginning of their training it will prepare them as professional nurses to meet the continually evolving models of care," Mr Kewley said. Professor Campbell said UNE was a university with a strong identity, making it an ideal place to nurture and foster his ideology and prepare them for a culture like HNE Health's. Professor Steve Campbell "Definition of academia is `of no practical use' but if we want to be useful health academics we should be focusing on making a difference in the workplace," Prof Campbell said. "Essentially I believe a scholarship should impact on practice. Instead of paperpushing and plodding along, we should be designing development programs that improve practice, form partnerships and foster a patient-voice approach." HNE Health Director of Nursing and Midwifery Chris Kewley said Professor Campbell's philosophy on nursing practice was well-aligned with HNE "It's a great way to prepare the UNE students to come to HNE Health," Prof Campbell said. "I've seen that HNE Heath is fertile ground and has a willingness to provide open forums for improvement in care. Our organisations are a good fit because we share the same philosophy." Professor Campbell will be a keynote speaker at our 2009 Quality Expo and Scientific Program on 10 and 11 September.

This month we asked staff...

What's the worst movie you have ever seen?

Lucy Coggan, Social Marketing, Good for Kids "Embarrassing but true, my ex-boyfriend actually made me sit through a movie called "Dumb and Dumberer: When Harry Met Lloyd". It was the B-grade sequel to the original, and the movie's quality. I quite funny "Dumb and want that 85 minutes of Dumber". The title gives my life back. Minus 5 an excellent indication of stars."

Vicki Resch Executive Assistant, Corporate Services "Waterworld with Kevin Costner. Not sure why I don't like it, I just could never sit through the whole movie."

HNE HE A LT H MAT T E R S - PAGE 7 W W W. H N E H E A LT H . N S W. G O V. A U Our Vision: Healthier Communities: Excellence in healthcare Our values: Teamwork, Honesty, Respect, Ethics, Excellence, Caring, Commitment, Courage

One step closer as Narrabri tender process complete

The tender process for construction of the new Narrabri District Health Service is now complete, bringing us one step closer to the redeveloped hospital. Four prospective tender teams visited the site and met with local health service managers and the tender process is currently underway. At this stage it is anticipated that a preferred tenderer will be on site to start construction by the end of October. The first step will be the construction of an earth pad for the new building to sit on to make sure it is above flood level. The new single-storey building housing the hospital and the community health services will then be constructed. The ambulance station, staff accommodation and helipad will be built in stages after the main building is completed. This is to allow the existing hospital to operate with minimal disruption during construction. Once the new building is constructed the old hospital will need to be demolished safely to allow the next stages to occur. The design of this project has involved extensive consultation with local staff, from cleaning and maintenance staff to nursing, administration, medical and community health clinicians. The local Hospital Auxiliary has also been involved in the design of the kiosk coffee shop which will be located at the front door of the new building. There has been a strong emphasis placed on the design of the new health service to fit with Narrabri's climate and the use of environmentally sustainable design features. This has included consideration of the way the building faces, right through to the finishes used. The bricks from the former nurses' quarters will be re-used to build the earth pad to form the foundation of the new main building. When the existing hospital is demolished, these bricks will be used in the construction of the helipad and other areas that need to be built up.

Talking about dying in acute care

By PETER SAUL* Death in the 21st Century remains as inevitable as ever. But the way we die ­ where we die, at what age and how ­ has changed dramatically. We have yet to come to terms with the implications this has for the provision of health care, and particularly for acute care. Death for us in the Noughties is usually from increasing frailty or intractable multiple organ failure. In NSW, as in the UK, we are more likely than ever to die in acute care, and less likely than ever to die at home. This trend appears to be accelerating, and final year of our lives will most likely be punctuated by repeated admissions to acute care. In our last illnesses we will be unable to make decisions for ourselves, and will rely on expert strangers and unprepared friends to make decisions for us. All of which, of course, applies much more imminently to our parents and elderly patients. We have a clear choice: are we going to talk about (and plan for) this, or hide under the blankets and hope it goes away? There is clear evidence, with three papers showing this in 2009 alone, that talking frankly about death and dying in advance results in less suffering for patients and their families. In one of these studies, cancer patients did not experience increased worry or depression when told the truth, and had a better quality of life than those not as fully informed. Furthermore, their bereaved relatives subsequently shared the better quality of life and had a reduced risk of depression.

(PSDM). The law in NSW (Part 5 of the Guardianship Act 1987) identifies the default (the "person responsible"), but research in our ICU shows that this legislation comes up with the best person for the job in less than 50 per cent of cases. People at risk of incapacity or terminal illness should be made aware of the important role of the PSDM, given a chance to pick somebody suitable and encouraged to speak to them. Improving the "no-CPR" policy to include options other than simply CPR. Clearly there are many more choices to be made than this. At present the no-CPR order in acute care is best seen as a means of kick-starting an important and ongoing conversation. Embedding the above in routines of care (admission, transfers to transitional or aged care and so on).

But there is considerable reluctance to have these difficult conversations. Evidence from a study at John Hunter Hospital suggests that patients are quite happy to talk ­ but clinicians appear unwilling to initiate such discussions. Perhaps we are concerned not to upset people, though the evidence is clear that more upset arises if we are silent. Perhaps we are not sure who we should be talking to, or what we should say. We need some support in identifying those at risk of dying in acute care, and in initiating a frank and helpful conversation. Top priorities are: · Identifying those at risk. The current best prognostic tool is provided by the Gold Standards Framework in the UK (at goldstandardsframework.nhs. uk). This helps to identify a group of patients at imminent risk of developing incapacity and terminal illness. Identifying a Preferred Substitute Decision Maker



But in the end it comes down to the willingness of individual acute care clinicians to leave the comfort zone associated with confidence of cure. The alternative, an uncertain world where our own fears and those of our patients overlap in uncomfortable ways, is initially scary. But it is the world where our elderly and chronically ill patients have to go, and we should be prepared to go with them. Peter Saul is an Intensive Care Unit Specialist at John Hunter Hospital.


Healing strokes of art

Creativity and artistic flair don't necessarily spring to mind when you think of a person who has been affected by stroke. But for some people, their paints and pencils are painting them a brighter future. StrokeArt 2009 is a collaborative project between Greater Newcastle Cluster Community Stroke Team and John Hunter Hospital Arts for Health, and it is proving to be a useful form of rehabilitation for stroke patients. The focus of the group is to provide people with an opportunity to explore recreational options, reintegrate into the community and explore their own journey of recovery. And it's not just the stroke patients who are required to dip their paint brushes and tap into their creative side. John Hunter Hospital Arts for Health Coordinator Pippa Robinson said staff and patients involved in the StrokeArt classes worked as a team. "There is equality within the group as staff are challenged to be artistic along with clients," Pippa said. Participating in the artwork with patients gives staff a unique bonding experience. "Supporting the clients according to their needs develops a remarkable relationship with, and understanding of, the participants," Pippa said. "It is wonderfully exciting to see everyone in the class grow in confidence and skill through the development of their artwork." Marcia Johnston suffered a stroke in 2007 and has been a participant of the art program. "A program such as StrokeArt gives us so much more than just pictures," Marcia said. "We all share a common experience and even though our journeys are vastly different it is comforting to learn how others cope, how they fall and get up again, how they grieve and rejoice." And because of StrokeArt, Marcia has found colour through some dark days. "I suffer a great deal of neurological pain as a result of the stroke and my world felt void of colour and pleasure. The StrokeArt program has given my husband Ken and myself both an enormous amount of satisfaction," Marcia said. Marcia accepts that since her stroke she can no longer do everything for her family, however since StrokeArt, life has become a brighter shade of grey. "I now revel in the moments of silence and stillness," Marcia said. The StrokeArt group exhibition will remain in the corridors of the Royal Newcastle Centre until November. StrokeArt unleashed Marcia Johnston's artistic side.

Relay for Life: Get involved! First conference a

Relay For Life is about bringing together members of our local community who share a drive and determination to fight back against cancer. It is a time when the community joins together to celebrate cancer survivorship, honour those lost to cancer, and raise money for the Cancer Council. It is an outdoor, team event where teams of 10-15 people take turns to walk or run around our local sports ground. A festival atmosphere is created with entertainment, food, ceremonies, team games, market stalls, kids' activities, prizes, colour, fun and community spirit. The Cancer Council invites you to be involved in this community event. For more information or to register your team of friends, family or colleagues visit or call your local Cancer Council office. · Merriwa 5 and 6 September, ph 4923 0700 · Maitland 12 and 13 September, ph 4923 0700 · Walcha 19 and 20 September, ph 6763 0900 · Muswellbrook 24 and 25 October, ph 4923 0700 · Gunnedah 30 and 31 October, ph 6763 0900 · Singleton 31 October and 1 November, ph 4923 0700 · Newcastle/Lake Macquarie 7 and 8 November, ph 4923 0700

`Rosey' outlook

A month of hard work by a local couple means Gloucester Soldiers Memorial Hospital now has a new rose garden. With supplies donated by local businesses, Marianne and Bruce Paynter were able to prune the existing roses back, and plant new ones. Gloucester Health Service Manager Peter Barber said the rose garden, which has been a feature of the hospital for over 50 years, was in need of some expert care. "The roses that were dug up need a little tender loving care and will then be replanted in appropriate areas. They have significance to the local community as many of them were donated by the families of long-term residents," Mr Barber said. "It really brightens up the entry to the hospital."


The inaugural Armidale Medical Conference (AMCON) has been deemed a great success. More than 150 clinicians and medical students from across the North West and Queensland attended the event, hosted by Armidale's Department of Medicine staff in partnership with the UNE School of Rural Medicine and the New England Division of General Practice. Ten Armidale and Tamworth staff specialists, GPs and VMOs presented on a wide range of topics, all focusing on the rewards of overcoming the challenges that come with practicing in a rural environment and how that experience shapes our doctors into valuable, highlyskilled health practitioners. Armidale Hospital staff specialist physician Dr Sudheer Ahmed said events like these would continue to attract talented clinicians to rural areas and support them by offering a chance to maintain their skills and broaden their education.


Our Vision: Healthier Communities: Excellence in healthcare Our values: Teamwork, Honesty, Respect, Ethics, Excellence, Caring, Commitment, Courage

Nurses enjoy benefits of simple acronym

Last year a 12-month project known as ISBAR - an acronym that stands for Introduction, Situation, Background, Assessment and Recommendation - was launched with the aim of improving effective clinical handover in interhospital transfer situations. ISBAR is a communication tool, used for communicating often complex information succinctly in both verbal and written form. The structured approach was implemented by Clinical Governance to overcome sometimes inadequate communication within inter-hospital transfers that can put patient safety at risk. The Manager of Cessnock Community Health Services, Sue Buckman, believes that both staff and patients will benefit as a result of the introduction of ISBAR. "Communication between palliative care nurses and the team at Calvary Mater Hospice will improve through a standardised feedback form. The information provided will be sharp and concise, leading to better communication between the services," Sue said. During training for ISBAR, palliative care nurses attending the course voiced their appreciation at the value this type of standardised communication will have. Changing the forms will improve the continuity of care for patients. "As a result of the training a draft form has been developed, not only for the palliative care service but also the community nursing team, in particular a new weekend handover sheet following the ISBAR principles," Sue said. "For community nurses, using the standard format will give a busy medical practitioner a much clearer understanding of the patient's condition." Employing the ISBAR approach is aimed at providing respectful and courteous communications between clinicians, which will minimise assumptions and is quick to the point. HNE Health is currently developing plans to rollout ISBAR to all sites and facilities.

Palliative Care Nurses from Greater Newcastle, Lower and Upper Hunter Clusters and the Calvary Mater Newcastle, smiling at the prospect their jobs will be made that little bit easier.


170 years and still going strong

Nine members of Singleton Hospital Auxiliary were recognised recently for their ongoing volunteer work for the local health service ­ racking up a combined total of 170 years service. Singleton Health Service Manager Wendy Mason-Jones praised the ladies' achievement and ongoing commitment to helping the local hospital and community when she presented the women with medals of service at a special ceremony. Pictured left (L-R): Barbara Flanagan, Vera Smith, June Kill, Elma Rae, Val Smith and Margot Baker (all 10 years service); Lola Robinson (40 years service) and Joan Ball (30 years). - Photo courtesy of the Singleton Argus. Pictured right: Wendy Mason-Jones presents Zetta Matthews with her medal for 30 years service. Absent from photos is Bea Stockdale, who also received a 30-year service award.

`Ooo Ahh' sports pink for Armidale Oncology

Cricket legend Glen McGrath donned his best to support the Armidale Oncology Unit at the inaugural Pink Tie Ball recently. The event, organised by Elders Armidale, raised $25,000 for the Armidale Oncology Unit and gave Armidale Hospital staff a chance to meet the sporting great. Pictured with Glenn McGrath are (l-r) Nicci Mortimer, Barbara March, Anna Keys, Wendy Lam, Anita March and Dona Withnell.

News in brief... Catching up on a lifetime of education

Ready, steady...

Multicultural Health Week (27 - 31 July) was celebrated on the John Hunter campus with a "Ready, Steady Cook-off" held in the Starlight Express Room between the John Hunter Children's Hospital School and Captain Starlight. Multicultural Health Officer Eunice Hsu declared Captain Starlight's spectacular "World Sandwich" the winner. A group of Sudanese and Burundi women have taken on an air of empowerment thanks to an education program that's helping them catch up with a lifetime of health education. The African Refugee Women's Health Project, run from Hamilton's Penola House, is in its second year, teaching the women about important health topics such as sexual health, family planning, mental health, nutrition and the safe consumption of alcohol, among others. Program Coordinator for 2009 and Multicultural Health Liaison Officer for Mental Health and Drug and Alcohol Services, Dubravka Vasiljevic said the project is giving refugee women the confidence to keep themselves and their families healthy. "Many of these women have lived in refugee camps and most refugees have limited or no access to medical services, immunisation, health education or preventative health programs," Dubravka said. "That's why this program has become so important to these women ­ we've tailored the education to their needs so they can still keep their cultural norms and discuss health in context to their African culture and experience. "For instance, the Sudanese women were reluctant to speak about alcohol, because in Sudan women do not drink until they are 50 years old and men until they are 30. However, they recognise that their children are now living in Australia where the legal drinking age is 18, so they understand the importance of learning about the safe consumption of alcohol. "I've noticed a real change in their approach to health, they are more confident and empowered, they recall conversations we've had about different topics, but best of all they have learned to ask for more information about the services available to them." Dubravka said the Project was not only a learning experience for the African women, but was a chance for the HNE Health presenters to take away some learnings too. "In speaking with the women, learning what they are interested in and hearing the refugees' cultural

Manning apprentice wins top prize

Manning Hospital apprentice electrician Shane Orphin won TAFE's `Most Outstanding Student Certificate 3 in Electro Technology Systems' award in Port Macquarie recently. Shane Orphin started work with HNE Health as an apprentice electrician in 2005. Manning Hospital General Manger Tim Mooney congratulated Shane on his award. "Shane's commitment and hard work throughout his apprenticeship has resulted in his receiving this award acknowledging him as an outstanding performer among his peers," Mr Mooney said. Shane has been appointed to a permanent position with the health service upon completion of his apprenticeship.

Burundi women involved with the African Refugee Women's Health Project perform traditional dance during a Multicultural Health Week celebration at Penola House.

attitudes and issues, our staff can learn how they might tweak services to provide more culturally appropriate care for refugee communities," Dubravka said. Following the success of the program Burundi and Sudanese

project, which is attracting more participants each year, the next step will be to investigate the specific needs of refugees from other countries, so discover if a similar program can be run for women of different nationalities.


Our Vision: Healthier Communities: Excellence in healthcare Our values: Teamwork, Honesty, Respect, Ethics, Excellence, Caring, Commitment, Courage

Director hired to oversee Tamworth redevelopment

The Tamworth Health Services redevelopment has reached a major milestone with the appointment of a Project Director, Planning to oversee the next stages of the plan. Coffey Projects has begun work on the Service Procurement Plan and Project Definition Plan, due to be completed by the end of March 2010. While the winning tender for the Project Director Planning was being finalised, HNE Health Senior Facility Planner for the Tamworth redevelopment Jennina Porter has been hard at work meeting with Tamworth services and staff to begin collating information about how services are currently housed. "It's been great to get around and meet lots of the staff," Jennina said. "Everyone's been enthusiastic making a contribution to planning so I'm looking forward to hearing more from the staff in coming months." The purpose of the extensive consultation is to find out what changes could be made to Tamworth facilities to provide the best possible service delivery in the future. Tamworth and Armidale hospitals General Manager Fergus Fitzsimons said Tamworth staff were pleased about the step forward in planning. "It's given the staff a feeling of ownership, and a tangible reminder that in a couple of years they will be working out of a refreshed facility." Meanwhile, planning has also begun for the Armidale Health Services Plan. The first meeting was held in July and allowed all members of the committee to define the scope and terms of reference for the planning process.

Coaching helps people put their best foot forward

Falls prevention is a topic that has gained a considerable profile in recent years due to our ageing society and the related burden that falls injuries place on our health system. One HNE Health project is using something as simple as a telephone in an effort to help older community members stay on their feet and reduce their falls injury risk. The aptly-named Falls Phone Coaching program targets nonadmitted people aged over 50 who have presented to Emergency Departments (ED), and refers them to strategies to reduce their falls injury risk. The participating EDs include those at John Hunter, Belmont and Calvary Mater Newcastle hospitals. Enrolled Nurse Tony Lewis telephones clients one week after they present to the ED. A short, straightforward survey addresses a range of questions which identify risks and personal preference. An individual falls injury prevention plan is then prepared, with clients directed to appropriate care outlets such as Active Over 50, home-based exercise, and falls clinics. According to Tony, part of the program's success is due to one basic factor: the art of conversation. "The clients think the program is fantastic. They are often really glad that I have taken the time to call them and ask them how they are feeling after their fall," Tony said. "Just conversing with clients, getting a feel for their personal situation and having some empathy really has an impact on people's willingness to accept a falls injury prevention plan. If I didn't take the time to build a rapport with the client, I don't think the project EN Tony Lewis says clients of the Falls Phone Coaching program are often grateful someone has taken the time to ask them how they are coping after a fall. would be as successful as it has been." Since commencing, the project has so far made follow-up contact with 397 clients from John Hunter, Belmont, and Calvary Mater Newcastle hospitals. Of these, 48 per cent accepted intervention at the first phone call. Of those who agreed to support, 19 per cent were referred to an Active Over 50 Program and Heartmoves, 51 per cent to a home-based exercise program, 26 per cent to falls clinics and 4 per cent were referred to other services.

A stroke of good luck

Hunter New England Health's vision is creating healthier communities and delivering excellence in healthcare - and Belmont Hospital is embodying that vision with the introduction of a new stroke rehabilitation research program. Getting to hospital quickly after suffering a stroke is vital in order to achieve the best possible recovery. For patients at Belmont Hospital, those who get to hospital within 24 hours of a stroke may be eligible to undergo a new stroke rehabilitation program called AVERT (A Very Early Rehabilitation Trial). The program is an initiative of Austin Health in Victoria and provides stroke patients with early exercise therapy by nurses and physiotherapists. Belmont Hospital Stroke Unit Physiotherapist Owen Katalinc said that early intervention is important in recovering from a stroke. "Not only is this an exciting new concept for patients, but the stroke team at Belmont Hospital will benefit too," Owen said. "The clinical aspect of the trial will involve three physiotherapists and five nurses, as well as support from Belmont Hospital administration and the department directors for Physiotherapy, Nursing and Rehabilitation Medicine. The trial will compare two weeks of early intensive rehabilitation versus standard care." This new program is still in its early stages, with patient screening commencing on Monday 10 August.

Read all about it: Nursing grand rounds online

Staff across Hunter New England Health Area now have the chance to be part of Nursing Grand Rounds ­ even if they can't be there in person. Presentations at The Maitland Hospital's weekly Nursing Grand Rounds are now available to all staff via the HNE Health Intranet and also the internet through the Gardiner Library Service website. Just go to and go through the `What's New' section to Grand Rounds, and then into Nursing Grand Rounds. The presentations are available in three formats ­ as a screencast combining Powerpoint presentation and audio, as a stand-alone Powerpoint presentation, or as an MP3 audio file, which means staff can chose the format that best meets their needs. The presentations are not being filmed. Maitland Hospital's Education Co-ordinator Carolann Aartsen said being able to upload presentations to the library site makes Nursing Grand Rounds accessible to all, though not in real time. "Initially we thought we might set up a link via video conferencing or web stream, but now we have a software package that enables us to capture the presentations in those three formats," Ms Aartsen said. "It is more cost effective and it is also better in that we can provide an edited version of the presentation, including question and answer sessions that follow. "And staff can access it at the time that best suits them." A trial of Nursing Grand Rounds was held at The Maitland Hospital last year and has since become a popular weekly feature. More than 350 people attended Nursing Grand Rounds between March and

Good for Kids wins grant

Hunter Water continues its generous support of the Good for Kids program with the recent awarding of a community grant of $20,000 to provide water bottles for kids. Hunter Water has previously supplied more than 20,000 water bottles for the program. Water bottles will be provided to kids through schools, general practitioners and at relevant community events. The initiative is designed to encourage kids to drink water instead of sweetened drinks. Good for Kids Program Director John Wiggers said the support provided by Hunter Water was a valuable way to enhance program activities and reach. Hunter Water's Kate Farmer said she was pleased to be able to support Good for Kids. "Hunter Water is committed to improving the health and wellbeing of our kids, and is excited to be able to support the Good for Kids program to do this," she said.

Librarian with the Gardiner Library Julia Gollan and Maitland Hospital's Education Co-ordinator Carolann Aartsen.

June this year, with presentations rotated between all clinical areas. The presentations provide de-identified case studies across a wide range of clinical subject areas and aim to promote reflective and improved practice and critical decision making. "I think too they can give nurses a window into other

areas and roles that might be purely of interest or might lead to career development," Ms Aartsen said. "It has been extremely successful, and it also allows staff to grow in terms of their presentation skills." The Gardiner Library is based at John Hunter Hospital and has branches at Maitland and also Belmont Hospital.


Our Vision: Healthier Communities: Excellence in healthcare Our values: Teamwork, Honesty, Respect, Ethics, Excellence, Caring, Commitment, Courage

A great team, at work and play

Muriel Dell

Executive Assistant, Tablelands Cluster

When I began working with Wendy in 2004, it was like a breath of fresh air. At the time Wendy was in the role of Primary and Extended Care Manager. I had never had a female boss before and I wasn't sure how it would go. But as it turned out, Wendy is by far the best manager I have worked with in 29 years in the public service. During our time working alongside each other, there have been many challenges, but we have been fortunate to have continuity together, which has enabled us to keep the systems we've set up chugging along. We are always looking at ways to improve our systems. Our working styles and personalities probably couldn't be more different. Put it this way ­ I'm the quiet, shy one. Wendy and I have never really had any disagreements since working together, but then again, I let her believe that she's always right. It's easier that way. Wendy has the ability to resolve issues straight away before they escalate into something bigger. She acts quickly in an open and honest way and everyone knows exactly where they stand. She listens and is firm but very fair. It isn't easy, and I respect her immensely for that. Wendy's energy and enthusiasm amaze me. I don't know where she hides that reserve tank! Wendy is so passionate about what she does. She is highly motivated and keeps us all motivated as well. I'd describe Wendy as being energetic, caring, generous and encouraging. One of Wendy's funny quirks is her love of clothes shopping. Whenever we visit other towns, I get dragged into every boutique in town; I secretly think it's a little fetish (but that's just between you and me). Outside of work, we've been known to have several drinks, tell a few jokes, and of course, go shopping in every clothes shop in town. I let her win at Pictionary once, and I also recall a rather unsavoury event involving red fishnet stockings and a man named Howard...

Two's company

Executive Assistant Muriel Dell and Tablelands Cluster General Manager Wendy Mulligan, pictured with the "Wendy Doll" which sits on Muriel's desk. had a disagreement because Muriel says I'm always right... but we do have discussions which involve compromise on both our parts. Sometimes being an Executive Assistant to a General Manager is not all it is cracked up to be. There have been times when people have had a go at Muriel because of a decision or directive I have given. To save Muriel from such people, I have given her a "Wendy Doll" which sits on her desk. If people are not happy or are rude to her, I have given her instructions to tell them to "speak to Wendy Doll about it". So far I think it has protected her. I'd describe Muriel as professional, capable, loyal, funny and dedicated. When I think of Muriel I smile because I know she will have organised something before I even ask for it. She has a habit of sending funny little comments in emails, which actually means I have more work to do because I like to respond to her messages! In some ways Muriel and I are similar, but in other ways we are very different. We are both perfectionists who like to do things exactly right, although I am an extrovert and like to talk things through, while she is the introvert or thinker. Between us I think we make a good team.

Wendy Mulligan

General Manager, Tablelands Cluster

Muriel and I both have different personalities which seem to complement each other. We both know how the other person thinks and works, and because of our history working together, we have been able to develop efficient systems and extend on them. This makes managing the Cluster easier. Muriel is very competent, she manages herself and others well, she follows up deadlines, and she has great skills in developing innovative ways of doing things. During our five years together, we have never

Irene's story: An insight into dementia

By CARISA GREEN Irene Hobden's story is about how life can change from what it was, and what it was going to be. It is about the journey Irene has shared with her husband Roy, and the emotional rollercoaster they both endured as Roy was overtaken by a little-known brain disease called Lewy Body Dementia. Over two decades Irene watched as Lewy Body Dementia slowly transformed Roy from an intelligent, positive and decisive man with a passion for life, into a man who is lost, distant, frail and unable to care for himself in any way. But instead of shying away from the realities of her shared experience, Irene embraced the challenges, the heartbreak and the uncertainties, and wrote a book reflecting her struggles. Where Did That Man Go? is a true account of day-to-day life with someone suffering from Lewy Body Dementia. It's about what can happen to a person who develops a brain disease, how one cares for that person, and how one painfully watches the disintegration of someone they love. Carers of those with a brain disorder or dementia ­ especially Lewy Body Dementia - were Irene's target audience. "I hope that carers reading this book may relate to my story and be helped in some way; that it somehow helps them recognise and cope with the changes occurring to their loved ones," Irene explained. "There can be various stages of dementia, and unfortunately there is no set pattern, or any kind of marker we can refer to when things change. Every dementia has its own criteria, and every patient is different. I wanted to share my experiences, and perhaps this will give some certainty and comfort to people in relationship are very hard and it takes quite a while to adjust. Some days you wonder if you can get on top of it all and accept the change. But we must never waste a minute, or sit and think about the fact that our partners will never be able to return to the home we always shared. The trick is to stay focused and active." Irene also attends a monthly carer support group based at Narrabri Neighbourhood Centre, led by Narrabri Community Health Dementia Support Advisor Dot Craig. She launched her book Where Did That Man Go? in June, since which she has received an ongoing, positive response from readers. And in July she was one of the guest speakers at the annual New England Dementia Forum held in Tamworth. Irene Hobden, 82, has self-published a book about her husband's struggle with Lewy Body Dementia. a similar situation." Lewy Body Dementia is a specific condition that combines Parkinsonisms - physical symptoms such as slow movements, stiffness of limbs and difficulty walking - with dementiatype symptoms, specifically visual hallucinations, fluctuating confusions and agitation, as well as memory and thinking difficulties. Up to 30 per cent of people with dementia may have Lewy Body Dementia. "In the early years when I first noticed the changes to Roy, I thought I may have exaggerated the happenings, that perhaps I was imagining the changes taking place to the man I spent more than half my life with," Irene said. "I first noticed small things happening, like Roy mixing up the days, forgetting things, misplacing things. But it continued and became more prevalent, and as I was to learn, it was only the start of a long climb." Over 20 years, Irene would see Roy suffer from memory loss, sleep disturbance, hallucinations, and personality changes. In 2007, after some years of needing 24-7 care at home, Roy went into full-time nursing home care. Irene has since lived alone on her small farm with her dogs and horses, and with her spritely ways, chatty manner and seemingly boundless supply of energy, you could be forgiven for underestimating her 82 years. She credits keeping busy as being one her coping mechanisms, and still rides horses when time permits. "I have always been a busy person and always will be. Since Roy was admitted to care ­ after many years of needing so much attention at home ­ there has been an extraordinary change to the pattern of my life," Irene said. "The early stages of a divided "In actual fact, I never really intended to write a book. But knowing I had found it difficult to source information about Lewy Body Dementia during the early year's of Roy's onset, and also experiencing first-hand the benefits one can get from sharing experiences with other carers, I thought `why not write a book?'. "I only hope that in some way this story will have been of help to someone. If it helps just one person it is worth it, but I wish it to help many. "I now approach life armed with three phrases: Accept what has happened to us all; Accommodate the changes; and Adjust to never being able to keep a daily routine. "Lewy Body is progressive and relentless, and has robbed Roy and I of our last years, which I hoped we would share together. But even though Roy and I live solo lives now, we are always together in my thoughts." * Where Did That Man Go? is selfpublished by Irene Hobden and is available through Seaview Press.

Dementia projections

A report released in May this year by Access Economics highlighted the massive prevalence of dementia throughout the nation. Currently, there are 230,000 Australian diagnosed with dementia. Access Economics projected the figure would increase to 465,000 in 2030, and even further, to an astounding 730,000 or more by 2050. Access Economics has also forecast that dementia will become the leading disability burden in Australia by 2016. These staggering figures were reiterated by the recently-released National Health and Hospitals Reform Commission Report, which predicted that over the next 30 years there will be a 200 per cent increase in the numbers of people with dementia. The latest Australian Bureau of Statistics figures have found that deaths from dementia and Alzheimer's disease have more than doubled in a decade, and that it is already the fourth leading cause of death in the country, behind heart disease, stroke and lung cancer.


Our Vision: Healthier Communities: Excellence in healthcare Our values: Teamwork, Honesty, Respect, Ethics, Excellence, Caring, Commitment, Courage

Breastfeeding gets thumbs-up from jet-setter

Despite the odds: Getting better with age

By KELLIE O'SULLIVAN * Celebrating the big 5-0 is a milestone for anyone. But for James Brooks, living for 50 years is something close to a miracle. At a celebratory morning tea at the John Hunter Hospital, surrounded by doctors and nurses who have cared for him over the years, James relived the past 50 years. At just three weeks of age, James was diagnosed with Cystic Fibrosis and spent much of his early childhood in hospital.

Rebecca and Julian spent three carefree weeks in France thanks to confident breastfeeding

Doctors and nurses became his family and the hospital became his home. "Until I was about eight years old, I knew hospital staff better than I knew my own parents," James said. Cystic Fibrosis (CF) is an incurable genetic condition that affects mainly the lungs and digestive tract by clogging them with thick, sticky mucus. Sufferers can have difficulty breathing which usually becomes progressively worse over time. This leads to physical activity becoming increasingly challenging for people with CF. But the symptoms associated with his CF didn't stop James enjoying childhood with his brothers. When he wasn't in hospital, he was doing all the normal things boys like to do. Motor-biking in the bush with his brothers and enjoying time in the great outdoors were activities he enjoyed most - and things he never thought he'd have the chance to do. At the time James was diagnosed, the life expectancy of a CF sufferer was just six years old. He wasn't even expected to reach 12 months old, but after surpassing that hurdle, he was told he probably wouldn't make it to five years of age. He did. Doctors didn't expect him to reach 10, 14, or 19 either, but again he proved the doctors wrong. "I guess I'm getting better as I get older," James said with a laugh. "Growing up, I didn't know any different. I just tried to lead a normal life." And perhaps it was James' outlook on life, combined with advancing treatments that enabled him to enjoy 50 great years.

James Brooks, pictured in the corridors of the hospital that has been such an integral part of his life for the past 50 years.

Breastfeeding gives babies the best possible start to a healthy life, but as Gunnedah mum Rebecca Health discovered it's also a great way to take baby jet-setting across the globe. Rebecca and her family, including six-month-old Julian, took in the sights of France with ease earlier this year thanks to confident breastfeeding. "It is just so convenient ­ I don't have to wash or sterilise bottles," Rebecca said. "I didn't have to worry about finding the correct formula or carting bottles and other gear with me, which meant we could really use our time well to enjoy all the fine things France had to offer." The support and guidance from midwives and child and family health staff at Gunnedah Health Service meant she had a smooth transition to breastfeeding after her first baby Olivia was born, and she'd been a big advocate for breastfeeding since.

"The support they gave me was wonderful and I haven't had any trouble since," she said. HNE Health is hoping to hear more success stories like Rebecca's with the work of HNE Health's Women's Health and Maternity (WHAM) Network. The network is focusing on how services can be improved to give women, among other things, improved access to education and support for breastfeeding. It will build on work already happening thanks to Nursing and Midwifery Services, which are providing an online breastfeeding education course to staff called the Breastfeeding Baby Friendly Hospital initiative. Since its inception at HNE Health, more than 600 frontline staff have demonstrated their commitment to breastfeeding by signing up to learn how to educate and support mums continue the practice.

The treatment options have come a long way since James was a child. "In the beginning, we were given two antibiotics and one of those could make your teeth fall out," James remembered. "When we were in hospital, we weren't allowed out of bed, we weren't allowed to go to school, and we couldn't even have any toys," he said. Not only was CF painful, so was the rehabilitation. "In those days, nursing staff used to put you over a chair and hit your back to clear your lungs. "They didn't think they were doing any good unless they left bruises," he laughed, still amazed at how things have changed. "I would refuse treatment from some physios," he said. "But not the good-looking ones, I never refused them!" Improved health care facilities and treatments are assisting in prolonging the life of CF patients. Respiratory Clinical Nurse Specialist Jon Clarke is one member of the multidisciplinary team caring for James.

"Multi-disciplinary outpatient clinics have improved patient outcomes and helped raise patient awareness of how they can better self-manage their chronic disease," Jon said. Until 15 years ago, these multi-disciplinary teams were not available. Jon believes it is the self-management that has seen James live such a long life. "James has good knowledge of his disease," Jon said. "When he's sick, he doesn't ignore it, he comes to hospital to receive treatment. It's all about how you take care of yourself." Self-management works well for James. He is healthy, happy, loves a chat and you'd be hard pressed to stop him laughing. For his 50th birthday, James was given a bass guitar - it's hard to imagine him not rocking out in another 50 years. "I'd like to think so. I reckon I've got another 100 in me," he laughed, along with the staff who have made this celebration possible. * Kellie O'Sullivan completed an internship with the HNE Health Communication Unit.


Enrol your children into The Forum Swim Academy today to receive your free gift*.

Term 4 commences 19 October 2009. The Forum Sports & Aquatic Centre, University provides a leading swimming program that allows swimmers to easily progress through all the stages of swimming from safety and survival to stroke correction and onto swim speed and fitness training. For more information call The Forum Sports & Aquatic Centre, University on 4921 7001.

The Forum Swim Academy is for children 6 months of age right through to those who want to swim competitively. Please come along to a free assessment on either Wednesdays 5.30pm or Saturdays 11.30am to find out more.

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Our Vision: Healthier Communities: Excellence in healthcare Our values: Teamwork, Honesty, Respect, Ethics, Excellence, Caring, Commitment, Courage



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