December 2002 - January 2003 Season's Greetings Once again we have come to the end of an extraordinarily busy year (not much different from 2001 really!). With all the EBAs, reviews, senate inquiries and liaison with employers, we have hardly had a chance to catch our breath. But we are also mindful that our members right across the Territory have also had a long hard year, as the nursing shortage continues. We take our hats off to you, and thank you for your contribution to the Branch, not to mention your workplaces. On behalf of Branch Council and office staff we sincerely hope that you all have a happy, safe Christmas and New Year - we look forward to continuing to represent your views and interests in 2003. The Branch Office will be closed from 23 December 2002 until 2 January 2003. A staff member will be on call during this period, and the answering machine will be checked daily. Staff will be available to respond to any urgent matters. Membership fee increase Unfortunately due to costs associated with an increase in our Professional Indemnity Insurance premium and a number of other cost imposts on the Branch, membership fees will rise by 4% on 1 January 2003. This decision was a very difficult decision for the Branch Council to make but was ultimately unavoidable. Like all other branches, the NT Branch is an autonomous self-funding organisation. We do not receive any funding from governments or employers, and rely on membership fees to provide the full range of services to members. As you can imagine it is an expensive challenge to provide support to members across the vast distances in the Territory. The fee increase will put the NT Branch in the mid range compared with other smaller branches and enable us to continue our level of service to members across the Territory. Professional Indemnity Insurance After a long struggle, the ANF (NT Branch) has been able to secure professional indemnity insurance cover for the vast majority of members. This has been very difficult in the current climate. Unfortunately the policy excludes independently employed practising midwives and self-employed nurses (annual income greater than $20,000). All other members are fully covered by the policy. Members who are excluded from this policy still have access to all other Membership benefits. If you require further information or clarification on the policy, please contact the Branch. On Call Review The ANF listed the failure to progress the payment of On Call with the Industrial Relations Commission again in October 2002. The ANF was forced to do this because OCPE and the Department of Health failed to honour the timetable set out in the Nurses EBA of 2001. The outcome of the commission hearing will be communicated to members in the New Year. Thank you to those members who took the time to send in their submissions for this important review. THE BALI DISASTER The Terrorist attack in Bali was right on Darwin's doorstep. Just about every nurse in the NT has visited Bali on holiday with friends and family. In the next couple of newsletters, the ANF will bring you excerpts from staff in the Top End who responded without hesitation to assist those in need. In this newsletter, ANF Organiser Angela Wallace talked to nurses from Ward 2A and ICU at RDH about their experience. When the initial phone call came through on Sunday, Wendy Bigg CNC 2A (which can at times have 5-6 burns patients) knew this was going to be a huge exercise: the ward, which houses the one and only designated burns bed, would have to be immediately prepared for the influx of patients from the Bali bombings. Within two and half hours the ward was cleared. All the rooms were set up with equipment needed for the burns dressings: Anaesthetic Technicians increased the O2 outlets in each room and extra staff was brought in. According to Maureen Brittin CNC ICU, 60 patients had to be relocated - 38 were relocated within the hospital or discharged and 22 were transferred to DPH. Although an enormous task in itself, all went smoothly because ward staff throughout the hospital who would not be directly involved with the front line care, did their utmost to ensure the smooth and organised discharge and transfer of patients. Then came the waiting. The night duty staff had doubled in numbers, nurses' families were bringing in food, but the patients were not arriving. They knew the burns would be extensive but what was to come would all seem surreal in the days after. Julie Rattenbury was one of the ICU nurses who met the plane on its arrival. "The quietness of the airport tarmac was unnerving. Everyone was just getting on with their jobs and the only real noise was the plane engines. Even in the plane, there was an eerie quietness as the RAAF nurses helped the patients as best they could while decisions were made about who should go first from the stretches." Inside the plane, Julie was shocked to see so many stretchers hanging from the sides of the plane walls but the sight that affected her the most and still affects her today, was the walking wounded, who made their way in silence to the waiting ambulance despite their horrific burns and injuries. Another ICU nurse, Stephanie Frame, was overwhelmed at first by what she saw in ICU. "I thought the media reports may have been exaggerated, I thought that the wounds would not be so severe, the media always exaggerates, so my initial response when I arrived at work was one of shock and an overwhelming sense of disaster. I had not prepared myself mentally for what I was seeing - major burns, shrapnel wounds and haemorrhaging". "But as I became focused on my patients, I was amazed at the incredible strength the patients were showing - there was no screaming or yelling, they were just thankful to be on home soil and receiving help. Our main role was to resuscitate the patients and stabilise them enough to be move to specialized burns units around Australia". Sarah Ladd RNL1was amazed by the patients' strength during the removal of loose skin and the dressing changes. "They did not make a sound, it was not the usual response we expect from a patient with burns, their strength was inspirational and most of these patients had only received minimal if any pain relief in Bali." Sarah originates from the UK: "I worked with blast victims before with a team effort in the UK, but what I experienced here with camaraderie and the team work was just fantastic, better than anything I had experienced before in the UK. Doctors were helping nurses with the dressings, collecting equipment and making cups of coffee when needed, as a whole from the cleaners to the Doctors we worked as one, with no complaining". Due to the substantial skin loss, ward air conditioning had to be decreased to help with the regulation of the patients' body temperature and everyone was working in very hot conditions. 2A played a huge part in the intensive care of the Bali patients dealing with injuries well beyond what they would normally deal with. The ward usually deals with the burns patient, but the extent of the injuries on the arrival of the first six patients with burns ranging from 15% to 40 %and compounded by shrapnel and blast wounds, was just the tip of what was to come. By midnight Monday, 2A had twenty burn victims with up to 62% burns. The nurses from 2A believe this experience has drawn the ward staff closer together. In confronting a tragedy of this scale, where so many young Australians with enormous injuries arrived in the ward over a 24 hour period, what stands out most is the camaraderie, professionalism and team work throughout the hospital, the coordinated effort put in by all hospital workers, the eerie quietness of the patients and the staff, the incredible bravery of the patients and the tremendous support from outside the hospital. Despite debriefing sessions, the nurses still feel they lack a sense of closure for some of the patients who died or were transferred to other hospitals. One young man who was unable to be identified remains in their minds - they would like to be able to tell his family that he was cared for and that they did their very best to save his life, to let them know he was not alone. Management is attempting to contact the hospitals patients were transferred to, in an attempt to help alleviate this sense of loss. The ANF NT Branch thanks Maureen Brittin CNC ICU, Julie Rattenbury CNS ICU, Stephanie Frame ICU, Wendy Bigg CNC and Sarah Ladd RNL1 for sharing their experience with NT members.