Nurse clinics: Collaboration and connectedness

Earlier this month the RACGP published their position on independent nurse-led clinics in primary health care. Many of the points made in this policy are compelling, including that to ensure whole-patient care and to avoid fragmentation of care, nursing services should be provided in a comprehensive and integrated primary health care setting wherever possible.

Over the next three years APNA will continue work initiating and supporting nurse clinics through the demonstration model to provide blueprints for the innovative delivery of clinical care by nurses in primary health care. The projects focus on developing nurse clinics in primary care in collaboration with primary health care nurses, the general practice or healthcare team, consumers and peak health organisations to address evidence-based, locally identified health needs.

  • What do you think of the RACGP’s position?
  • Are you interested in establishing a nurse clinic in primary health care to address your population health needs?
  • Have you found there to be barriers to operating a nurse clinic?
  • Have you worked out a successful nurse clinic model you’d like to share?

Leave a comment: log in with your APNA member number and password, or register your account if you are not a member of APNA.

Mental health of young people

On 7 August 2015, the Minister for Health, the Hon Sussan Ley MP, released The Mental Health of Children and Adolescents, a report on the second Australian Child and Adolescent Survey of Mental Health and Wellbeing. The report, described as the largest ever national survey of youth mental health of its kind in Australian history, follows on from the first national survey of the mental health of children and adolescent which was undertaken 17 years ago.

Some key highlights of the report are set out below:

  • One in seven children and young people experienced a mental disorder in the previous 12 months – the equivalent of 560,000 young Australians
  • Attention deficit hyperactivity disorder (ADHD) was the most common mental disorder in children and adolescents
  • Just over one third (35%) of 4-17 year-olds with a mental disorder had seen a general practitioner in the past 12 months
  • Schools provided services to 40.2% of the children and adolescents with mental disorders who attended them, and 5.6% had seen a school nurse
  • Around one in 10 12-17 year-olds (10.9%) reported having ever self-harmed
  • Females aged 16-17 years had the highest rates of self-harm, with 16.8% having harmed themselves in the previous 12 months
  • About one in thirteen (7.5%) 12-17 year olds had seriously considered attempting suicide in the previous 12 months.

While some of the information contained in the report is concerning, there are a number of positives, such as the large increase in the number of young people seeking help.

What is your experience of dealing with young people with mental health issues? Do you think there are adequate processes in place to identify mental disorders and provide the care and support needed?

On your behalf

On the 8th of July our President, Karen Booth and CEO, Alexis Hunt attended by invitation the MBS Review Stakeholder Forum in Canberra with a number of key industry leaders.

This forum is one of the three key initiatives currently being undertaken by the Department of Health to work collaboratively with health professionals to deliver a healthier Medicare. These priorities include the Medicare Benefits Schedule (MBS) Review Taskforce led by Professor Bruce Robinson, Dean of the Sydney Medical School, University of Sydney. The MBS Review Taskforce has been tasked with considering how services can be aligned with contemporary clinical evidence and improve health outcomes for patients.

The Primary Health Care Advisory Group (PHCAG), led by former AMA president and practising GP, Dr Steve Hambleton, will investigate options to provide; better care for people with complex and chronic illness; innovative care and funding models; better recognition and treatment of mental health conditions; and greater connection between primary health care and hospital care. Karen Booth has a lead role as a member of this group.

The third component of the Federal Government’s vision is a review of Medicare compliance rules and benchmarks, and will work with clinical leaders, medical organisations and patient representatives. The use of new techniques such as analytics and behavioural economics will provide more information to clinicians to enable them to better manage appropriate practices. As well, more information will be available to patients about fees charged by health professionals so they can make informed choices about their healthcare.

Some of the key outcomes of the MBS Review Stakeholder Forum included roundtable discussions on what major shifts will be required as part of the recommendations to the Review. The group identified a number of barriers to success which included a level of scepticism on the purpose and goals, financial implications of major changes, evidence or rather the lack thereof on more effective methodologies, inertia, workload and data availability. Some of the recommendations for overcoming these barriers as identified by participants included developing a clear case for change, high levels of consultation, robust commercial modelling, effective communication, connected systems and a well considered and designed implementation strategy.

We will provide updated information as we continue to work closely with these groups and forums.

We always want to hear from you on these matters and acknowledge you are the experts working in the field and have direct contact with patients and communities. We encourage you to provide us with your thoughts and feedback at every step of this journey so we can actively advocate on your behalf.

6 July 2015

Dear members, friends and colleagues,

APNA has achieved a significant win on behalf of our members, showing great recognition for the work you do for communities around Australia. APNA has been granted a contract to deliver the Nursing in Primary Health Care Program to 2018.

In making the announcement on Friday, the Government has focused on the outcomes of this program on people living in rural and remote areas, through the support of nurses in their communities.

The program will centre on enhanced nurse knowledge, skills and capabilities in chronic disease prevention and management, and in supporting healthy ageing in the community. The aim is to increase the contribution primary health care nurses can make to care for the chronically ill and elderly, delivering better and more cost-effective patient care, and reducing the burden on hospitals and the aged care system.

It will also be achieved through workforce sustainability. The program will focus on workforce recruitment and retention, to ensure Australia has an adequate supply of primary health care nurses to meet demand, and that general practice and other employers are supported to employ nurses and optimise their use. Our workforce sustainability program will be enhanced by the development of a transition to practice pilot to encourage new graduates to primary health care. Patients will benefit from good access to cost-effective care, and support for coordination delivered, as the Minister describes, by “having nurses in the right place at the right time”.

Effective primary health care can help keep people well and out of hospital and aged care. The challenge we face right now is to ensure our primary health care system can meet the challenges of ever-increasing demand, whilst maintaining affordability and quality.

Thrilled as we are, heads are already down and planning is underway. We look forward to sharing this journey with you.

Kind regards,

Karen

5 Ways People Stuff Up Mentoring and How To Make Sure You Don’t!

Mentoring is critical to career success and satisfaction and it offers significant benefits to both mentors and mentorees but mentoring is not always effective. When a mentoring relationship fails it leaves people disappointed. They can blame themselves, their mentoring partner, the mentoring program or the organization.It is a promise unfulfilled and can leave a lasting, poor opinion of mentoring and close people to new opportunities in the future.

Recent research in an academic setting identified 5 characteristics of failed mentoring relationships. The good news is they also revealed 5 characteristics of successful mentoring! I’ve listed them in the table below.

No one wants to fail. To set yourself up for success from the start, I recommend these 5 steps.

#1 Build Rapport

Make your early meetings as relaxed as possible, perhaps over coffee. Spend some time getting to know each other. Look for what you have in common in your personal as well as professional background including interests, hobbies or sport. Finding common ground makes it easier to build rapport, you feel like you’re on the same wavelength. It is the basis of a harmonious relationship. Building Rapport develops mutual respect, personal connection and identifies your shared values.

#2 Discuss Expectations

Share and clarify what you each want from the mentoring relationship. This is a very important step. An initial conversation can include:

Your purpose and goals – why are you each engaging in mentoring?
Scope and boundary of the relationship – what will and won’t be on the agenda?
Roles and Responsibilities – who does what?
Logistics – practical aspects, how often, where and when you want to connect?

Discussing Expectations helps deal with failure factors such as poor communication and lack of commitment and clarifies expectations .

#3 Create an Agreement

The beginning is the best time to negotiate the ways you will respect each other’s time, needs and differences. It’s good to agree on:

Ground rules or guidelines.
Etiquette – do’s and don’ts
Ethics – code of conduct

An agreement deals with most, if not all of the features of failure, demonstrates respect and makes explicit expectations

#4 Understand mentoring is 2-way

Mentoring is a partnership that benefits both mentors and mentorees. Each will develop and grow. It also helps to recognize that mentors are not expected to have all the answers. They will listen and ask as much (or more) than they show and tell.

Seeing mentoring as 2-way builds the reciprocity. It can also overcome a mentor’s lack of experience.

#5 Schedule a Review

After a few meetings have a conversation about:

What you’ve achieved
What’s working well
What you’d prefer to do differently

A review allows you to: Confirm your commitment to continue mentoring; seek additional support, guidance or resources; or, agree to exit the relationship without fault or failure.

Taking these 5 simple steps at the start is the best way to ensure your mentoring works.

By Ann Rolfe, Mentoring Works

Where is the nurse?

You might have seen an ad on peak time TV over the last week demonstrating a GP’s lifelong relationship with a family. It is the first of several to be rolled out as part of a community awareness campaign investment by the RACGP.

Who can help the warm and fuzzy feeling you get as the generational cycles progress and child becomes adult?

I congratulate our GP colleagues on celebrating their profession but the campaign, naturally given it is funded and driven by the RACGP, is singularly GP-centric and has elicited a mixed bag of responses. It does portray a nice, somewhat sanitised story, but for me it is an unfortunate lost opportunity to acknowledge the collaborative, multidisciplinary approach to general practice. Where is the nurse? Where is the whole team that makes up contemporary general practice that the health of multicultural Australia is so dependent on today?

For me what this campaign does identify is the pursuit of ongoing, quality professional learning across one’s career and the importance of a professional body supporting that career development.

The emphasis, ‘The good GP never stops learning’, can and should be parallel to the team working alongside them.

Nurses’ and midwives’ thirst and desire for lifelong learning is not new and has been part of our make-up since before Florence was a girl. In fact all the members of the wondrous multidisciplinary team that is general practice today are on a continuum of learning supported by their respective professional bodies.

APNA offers enough online learning to complete years of a nurse’s CPD requirement, and much of it free to members. Education is a paramount offering for APNA members. To ensure you as APNA members benefit from our stringency and dedication to the highest quality education for nurses to achieve lifelong learning APNA partners with peak bodies and experts and gathers the most current information to develop and update our online education.

For me APNA’s education offering is just the icing on the cake, not why I joined APNA. I joined to be part of a collective with the same mindset and purpose of supporting, learning and developing a profession I love and am very proud of. To be a small part of an organisation run for and by nurses, for me this is the is the true benefit in contributing to APNA as the peak body for nurses working in primary health care.

APNA exists to support its members and develop their profession, and for that reason alone. That’s why you should be an APNA member. That is why all GPs should be proud of their nurse colleagues and wholly support their ongoing membership of APNA.

Julianne

So, what do you think of the ad?

3 Ways Mentoring Leverages Learning

3 Ways Mentoring Leverages Learning
By Ann Rolfe, Mentoring Works

They say only 10% of workplace learning comes from formal education and training; 20% comes from observing, emulating and talking with other people; but a whopping 70% comes from experience.

But experience is the worst teacher! She gives you the test, then the lesson. That’s why we say: “I wish I knew then what I know now!” It’s hindsight, 20-20 vision in the rearview mirror!

Learning from experience only happens when you stop. Reflect. Get the lesson from the experience. That’s called insight. Without it, the person who says they have 10 years experience may really only have 1 year’s experience, repeated 10 times.

What mentoring does is use hindsight to create insight and turn it into foresight.

And that 20% observing, emulating and talking with other people? What if they are the wrong people?

When my youngest child was a teenager, I met a couple who told me they built a fire pit in their back yard. On Saturday nights their teenage kids and their friends would come around, everybody was welcome. They’d put on a BBQ for all of them and afterwards sit around the fire pit with the kids, getting to know them, telling stories and just talking, while they toasted marshmallows on the fire. The dad said: “I want to know where my kids are and who they’re with. If you want them to fly with the eagles you don’t let them hang out with the turkeys”.

You must choose who you’ll hang out with and pick your mentors.

Finally, the 10% formal education and training? This is the biggest investment for organisations and individuals, in terms of money and time and lost productivity. Sending people off-the-job in the hope that they will return and apply learning on-the-job is delusional.

Don’t get me wrong! I believe in life-long learning and I know the value of training and conferences. But I also know this: 80% of learning is lost – never gets applied – unless there is on-the-job coaching or mentoring .

The learning environment has evolved and mentoring is the key. Mentoring leverages the 70, the 20 and the 10. It adds value, extends and enhances all types of learning and when managers also mentor their people, learning can be applied on the job to make a real difference. That’s how mentoring works.

Next Live Webinar Tuesday 30 June 7.30pm

Mentoring – The Art of Feedback

Register Now!

It Takes Courage To Mentor

Mentorees make a courageous choice every time they divulge aspirations, goals or obstacles and difficulties. They put their confidence and trust in the mentor to treat them with respect and preserve confidentiality and privacy.

For mentors, it can take courage to embark on the role. After all, it usually the brightest and the best that want to be mentored, smart people who want to advance their career and professional development. Those that understand mentoring also recognise that there is a paradox in mentoring: you offer your ideas and experience and seek to inspire your mentoree, yet you encourage them to make their own decisions, knowing that their choices may not be the ones you’d make.

Both mentor and mentoree may find that their assumptions and normal way of interpreting the world are challenged as they gain different ways of looking at things. Both need to have the ability to give and receive feedback and that takes courage too.

To get the best from mentoring you need to step up and accept the challenges offered by this kind of relationship. Mentoring is a unique chance to look at yourself honestly. It is an opportunity to open your mind, question your thinking, consider alternatives and choose actions.

Mentoring can literally change your mind. Because it is an adventure into the unknown for both the mentor and the mentoree, it may be a bit scary. You have to prepare and build confidence before you jump into mentoring.

You need to create a safe space for your mentoring conversations. This means building trust in one another. That’s how mentoring works.

Don’t forget to register for the final Webinar 4: Mentoring – The Art of Feedback
Date: Tuesday 30 June 2015
Time: 7:30pm EST
Registration: https://attendee.gotowebinar.com/register/5559610543939154178

By Ann Rolfe, Mentoring Works

Message from Julianne: An international perspective on primary health care nursing

Hello APNA family!

I am filling in for Karen Booth who is taking a well-earned break.
APNA staff, Board and I’m sure delegates, are still riding the post Brave to Bold conference wave of euphoria. As Conference Chair I want to take this opportunity to thank the Conference Committee and the team who drove the conference. Well done, you are all amazing and now on to planning 2016 in Melbourne. For those of you who joined us, well done and congratulations for making the conference such a success.

Following on from our highly successful conference we took some of our international keynote speakers, Dr Sheila Tlou (Botswana), Dr Mary Moller (USA), Professor Sue Cross (UK) and Deb Davies (NZ), to Canberra to present at an APNA forum on Monday 18 May. In line with APNA’s ongoing determination to highlight and showcase the importance of primary health care nursing on both the national and the international stage, and to share this wealth of experience and knowledge outside our island home.

The forum – An international perspective on primary health care nursing: A cost and care effective force for change – was held just down from Capital Hill in Old Parliament House. The event was an opportunity to engage with nurses, health organisations and government on some of the key national and international issues affecting primary health nursing. The keynote presentations were very well received and picking up on the energy from the conference, we had a lively panel discussion which rounded off the morning. In case you missed it, the presentations from the event are available on APNA’s website.

Kind Regards,

Julianne Badenoch

25 May 2015

Dear members,

Each year APNA selects a conference theme that is meant to inspire. This year has been no exception. The Hon Ms Sussan Ley, Minister for Health and Ageing, opened APNA’s Brave to Bold conference held on the Gold Coast last week to share in the excitement and celebration of primary health care nursing. Brave to Bold brought together wonderful, enthusiastic nurses from all over the country, to meet, learn, teach, share, network, and inspire creative and innovative nursing practice. I can also tell that more than a few of you had a little fun too. The APNA members of the Conference Advisory Committee and the staff team are all to be congratulated on what I feel was our best conference ever. Our highly regarded and much loved Commonwealth Chief Nurse, Dr Rosemary Bryant, shared with us her brave to bold story, in what will probably be one of her last big appearances before she retires in a few months.

We had a sensational line-up of truly inspiring national and international speakers who really are brave and bold, encouraging nurses to lead the way in many areas of primary health care and career development. Thank you to our international guests Dr Sheila Tlou, Dr Mary Moller, Professor Sue Cross, Deb Davies and Brian Dolan, and to our very own Professor Megan-Jane Johnstone, who gave some of the most enlightening, inspiring and invigorating presentations that I have the pleasure of attending. For those of you unable to attend the conference I urge you to look at the bios on our conference web page and view their great nursing work. We were spoilt for choice for the abstract papers and workshops presented at Brave to Bold. Thank you to all our wonderful presenters.

Thank you to the APNA staff who pulled this together, helped members navigate the conference and whose tireless effort helped to make the Brave to Bold conference special and to keep some of us sane. A big welcome to Alexis Hunt in her new role as CEO and her first APNA conference. Most of all thank you to our members who also made this special – you are the reason for APNA moving from brave to bold!

Next year’s APNA conference will be in… envelope please… Melbourne! See you there.

Karen