Hr Orientation Handbook 2004

Orientation Handbook – Interim Version January 2006

Compiled by: Employee Relations Unit Waratah Health Campus (02) 4952 9119

TABLE OF CONTENTS WELCOME ................................................................................................................. 1 ABOUT HUNTER NEW ENGLAND HEALTH ............................................................ 2 OUR STRENGTHS ..................................................................................................... 3 OUR STRENGTHS ..................................................................................................... 4 OUR VISION FOR STAFF .......................................................................................... 4 HOW DO WE KEEP YOU INFORMED?..................................................................... 5 NSW HEALTH CODE OF CONDUCT ........................................................................ 6 DISCRIMINATION, HARASSMENT AND BULLYING ............................................... 7 CONDITIONS OF EMPLOYMENT............................................................................ 11 ZERO TOLERANCE ................................................................................................. 14 PERFORMANCE MANAGEMENT ........................................................................... 14 COMPLAINTS / GRIEVANCES ................................................................................ 14 DISCIPLINARY PROCESS ...................................................................................... 15 EMPLOYEE ASSISTANCE PROGRAM (EAP) ........................................................ 16 EQUAL EMPLOYMENT OPPORTUNITY................................................................. 17 FREEDOM OF INFORMATION ................................................................................ 18 INFORMATION PRIVACY ........................................................................................ 18 STUDY ASSISTANCE LOAN SCHEME................................................................... 21 OCCUPATIONAL HEALTH AND SAFETY .............................................................. 22 OCCUPATIONAL HEALTH AND SAFETY COMMITTEE........................................ 28 NO SMOKING POLICY ............................................................................................ 28 SAFETY RULES AND SAFE WORK PRACTICES.................................................. 29 NUMERICAL PROFILE AND EQUIP ....................................................................... 30 HAZARD IDENTIFICATION AND REPORTING ...................................................... 31 INFECTION CONTROL ............................................................................................ 32 STAFF HEALTH ....................................................................................................... 34 MOTOR VEHICLE SAFETY ..................................................................................... 36

NOISE INJURY PREVENTION................................................................................. 37 WASTE MANAGEMENT OPERATIONS.................................................................. 37 ACCIDENT AND WORKERS’ COMPENSATION .................................................... 38 OCCUPATIONAL REHABILITATION POLICY ........................................................ 39 CULTURAL AWARENESS ...................................................................................... 41 Migrant Health .............................................................................................................. 41 Aboriginal Health .......................................................................................................... 42

LEARNING AND DEVELOPMENT SERVICE.......................................................... 46 TRAINING, APPLICATION AND APPROVAL SYSTEM (TAA)............................... 47 CHILD PROTECTION............................................................................................... 48 Important Contact Details............................................................................................... 49 Risk of Harm .................................................................................................................... 50 Assessing risk of harm.................................................................................................. 50 Definitions of Abuse and Neglect .................................................................................. 50 Child physical abuse..................................................................................................... 50 Child sexual abuse ....................................................................................................... 50 Neglect.......................................................................................................................... 51 Emotional abuse ........................................................................................................... 51 Domestic violence......................................................................................................... 51 Indicators of Abuse and Neglect ................................................................................... 51 Indicators of sexual abuse ............................................................................................ 52 Indicators of possible physical abuse ........................................................................... 52 Indicators in parents or caregivers................................................................................ 53 Indicators of possible emotional abuse or physiological harm...................................... 53 Indicators of possible neglect ....................................................................................... 53 Dealing with Disclosures................................................................................................ 54 Roles of Agencies ........................................................................................................... 54 Role of NSW Health ..................................................................................................................... 54 Role of NSW Police ...................................................................................................................... 54 Role of Department of Community Services ................................................................................ 55

Reporting ......................................................................................................................... 55 Reporting information ................................................................................................................... 55 Who to report?.............................................................................................................................. 55 How to report? .............................................................................................................................. 55 Protection for reporters................................................................................................................. 56

Information Provision ..................................................................................................... 56 Best endeavours ............................................................................................................. 57 Flowchart for dealing with Requests for information from DoCS .............................. 57 Flowchart for dealing with Best Endeavours Request for DoCS................................ 58

UNION DETAILS ...................................................................................................... 59

WELCOME Welcome to Hunter New England Health. Hunter New England Health was created on 1 January 2005 when Hunter, New England health and Lower Mid North Coast health services merged. So we're a new organisation covering an enormous area. In fact, we're the size of England! We stretch from Tenterfield in the north to Morisset in the south. This year our 14,500 staff will care for around 840,000 people. We'll do this at our hospitals, community health centres, polyclinics and out in the community. But we don't just look after sick and injured people. We are always promoting good health and encouraging people to better take care of themselves. There are a number of health issues that we're focusing on at the moment, including mental health, chronic conditions, aged care and cancer, and with 20 per cent of the State's Aboriginal population living in the Hunter New England Health area, we're also working hard to improve the health of Indigenous people. Our head office is in Newcastle, and we have a regional office in Tamworth. As a new organisation, we're going through a lot of changes and entering a new era in providing health services. I welcome you on this journey. Whether your role is directly caring for patients or supporting those who do, you are an important part of making us successful. It's by working together, by being innovative and passionate, that we'll be able to meet our goal of improving people's health. Good luck and we hope your stay with Hunter New England Health is enjoyable and rewarding for you.

Terry Clout Chief Executive

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ABOUT HUNTER NEW ENGLAND HEALTH Hunter New England Health is unique - it is one of four rural health services in NSW, but it is the only one with a metropolis (Newcastle/Lake Macquarie) within its borders. This is one of Hunter New England Health's strengths, with greater opportunities for sharing ideas and best practice across the rural and metropolitan parts of our health service. Hunter New England Health will: • • • • • • • • • •

Provide care for a population of approximately 840,000 people Cover a geographical area of over 130,000 square kilometres - the size of England! Have around 14,500 staff Have 1500 medical officers Have 1600 volunteers Provide health services to 12 per cent of the State's population Provide health services to 20 per cent of the State's Aboriginal population Span 27 local government areas Spend $1.3billion per annum Have a head office in Newcastle and a regional office in Tamworth

Hunter New England Health includes public hospitals and community health centres at: Armidale Ashford Barraba Belmont Beresfield Bingara Boggabilla Boggabri Bulahdelah Bundarra Caroona Cessnock Clarence Town Denman Dungog East Maitland Emmaville

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Forster Glen Innes Gloucester Gresford Gunnedah Guyra Gwabegar Harrington Hawks Nest Inverell Tambar Springs Kurri Kurri Maitland Manilla Merriwa Moree Morisset

Mungindi Murrurundi Muswellbrook Narrabri Nelson Bay New Lambton Newcastle Nundle Pilliga Premer Quirindi Raymond Terrace Scone Singleton Stroud Tamworth Taree

Tea Gardens Tenterfield Tingha Toomelah Toronto Uralla Walcha Walhollow Wallsend Waratah Warialda Wee Waa Werris Creek Windale Wingham

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OUR STRENGTHS Our organisation has the following strengths: • • • • • • • • • • • • •

High quality, safe patient care Skilled, hard-working and valued staff An understanding of and commitment to rural communities Experience providing health service across a broad geographical area The best immunisation rates in the State A commitment to the health and wellbeing of our Indigenous communities Highly developed telehealth and information technology services Dedicated and loyal volunteers Effective models of community participation Expertise in health promotion and prevention Successful strategies to improve staff safety A focus on innovation Teaching and research

OUR VISION FOR STAFF • • • • •

Feel proud and committed to Hunter New England Health Treat each other and our patients/clients with respect Feel supported in innovating to improve services Are satisfied and safe in their work environment Are receptive to the opportunities this merger will bring

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HOW DO WE KEEP YOU INFORMED? The Latest • • •

Chief Executive Terry Clout’s newsletter to all staff Sent to you each Monday via email or placed on your notice board by your manager Main channel for communicating important information from across our area so you should read it each week. • To view previous copies, visit http://intranet.hne.health.nsw.gov.au/news/latest.htm • Comments and story suggestions are welcome and can be sent to [email protected]

What’s Up Doc? • • • • •

Monthly area-wide newsletter for senior clinicians Distributed in hard copy via internal mail Contributions from clinicians are encouraged. Previous copies are at http://hal.hunter.health.nsw.gov.au/drnet/whatsupdoc.htm . Contact [email protected] for more details.

Hospital Newsletters Many hospitals and services have their own staff newsletters. If you want to contribute a story to a newsletter, contact the editor at your hospital or if you don’t know who they are, call the Executive Support Unit on 4985 5522.

Email • •

Common communication tool within Hunter New England Health. You should not send emails to all of Hunter Health without the approval of your manager and the IT manager. • The Chief Executive sometimes sends information to staff on email about organisation-wide news. • Managers print out copies for staff not on email and put these on notice boards and hand them out in team meetings.

Media • •

Our Communication team lets the local media know about the great work we do. If you have a good story, contact the Communication team at [email protected] • If you get any enquiries from the media, you must firstly contact the Communication team before responding. Just ask the journalist if you can take a message and get someone to call them back. The Communication team also provides Patient Condition Reports to the media. For example, a radio station might include details in their news about the condition of a motorcyclist after an accident. This information is only given to the media if the patient agrees to give it out. It is their choice. Always talk to a Communication staff member before giving patient details to the media.

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NSW HEALTH CODE OF CONDUCT The NSW Health Code of Conduct is a framework for decisions and actions that relate to conduct within Hunter New England Area Health Service and is applicable to staff working in any permanent, temporary, casual, termed appointment or honorary capacity. You should have received your copy of the Code with the letter of job offer. This Code supersedes any prior codes. Your contract of employment is based upon your compliance with the NSW Health Code of Conduct so make sure you understand it. Any violation of this Code by any Employee may result in disciplinary action, including termination of employment. All new employees are required to sign the Acceptance of Employment form and return this to Recruitment Office prior to commencement of work. As stated in your letter of offer with this signature you are indicating that you have received, read and understood the NSW Health Code of Conduct and you do understand that you must abide by all of its requirements and boundaries. If you have not received a copy of the NSW Health Code of Conduct or you have some questions on the issues outlined in this document you need to discuss this with your immediate supervisor. The NSW Health Code of Conduct is also accessible through Hunter New England Health’s Intranet Site.

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DISCRIMINATION, HARASSMENT AND BULLYING Staff members must not harass, discriminate or support others who harass and discriminate against colleagues or members of the public on the grounds of sex, pregnancy, age, race (including their colour, nationality, descent, ethnic or religious background), marital status, disability, homosexuality or transgender. What is harassment? • Any behaviour which is not asked for and not wanted and that happens because of a person’s sex, race, (including ethnic or religious background), age, marital status, disability or homosexuality Some forms of physical harassment • Unnecessary physical contact (pinching, patting, brushing up against a person, touching, kissing, hugging against a person’s will) • Indecent or sexual assault or attempted assault • Pushing, shoving or jostling Forms of verbal harassment • Making fun of someone • Sexual or suggestive remarks • Propositions (sexual invitations) • Spreading rumours • Offensive jokes • Threats or insults • The use of language that is not suitable in the workplace • Name calling Forms of non-verbal harassment • Putting sexually suggestive, offensive or degrading/insulting material on walls, computer screen savers, email and so on • Suggestive looks or leers • Unwelcome practical jokes • Not sharing information • Wolf whistling • Continually ignoring or dismissing someone’s contribution to a meeting/discussion What is bullying? • Being constantly criticised - explanations and proof of achievement are ridiculed, dismissed, overruled or ignored • Forever being subject to nit-picking and trivial fault-finding • Being undermined, especially in front of others; doubts are expressed over a person’s performance or standard of work - however the doubts lack substantive and quantifiable evidence, for they are only the bully’s opinion • Being overruled, ignored, sidelined, marginalised, ostracized • Being isolated and excluded from what’s happening (this makes people more vulnerable and easier to control) • Being singled out and treated differently

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•

Staff who engage in the bullying of another staff member will be subject to disciplinary action in accordance with Hunter New England Health’s disciplinary procedures • The focus is often on competence, or rather alleged lack of competence of the bullied person

Public comment and disclosure of official information Individuals have the right to make public comment and publicly debate political and social issues. Staff should make it clear that other than in the course of duty or when giving evidence in court, they are not making an official comment nor representing an official position of Hunter New England Health. Use of official resources Official resources are not to be used for non-official purposes without the approval of the Chief Executive or his/her delegate. Staff members using official resources for non-official purposes without getting prior approval could face disciplinary and/or criminal action. Outside employment • Seek approval of the Chief Executive or delegated officer if you are a full-time employee of Hunter New England Health and you wish to engage in paid employment or other business activities outside your official duties • If you are a part-time or casual employee you must advise the Chief Executive or delegated officer, of any real or potential conflict of interest Party political participation • Carry out your duties in a party political neutral manner • Party political activities should not be undertaken in paid Health Service hours • For contesting State or Federal Elections special arrangements apply. For more information contact your Health Service Manager or a member of the Senior Executive Security of official information •

Staff members are to make sure that confidential and sensitive information in any form (eg documents, computer files) cannot be accessed by unauthorised persons • Staff members must make sure that confidential information is only discussed with people who are authorised to have access to it Criminal Record Checks Probity checks are conducted for the following convictions: • sexual offences • serious offences involving a threat or injury to another person and • other serious offences but only where directly relevant to the duties of the position (eg embezzlement and larceny) for financial positions

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Corrupt conduct Corruption can take many forms including: • official misconduct • bribery and blackmail • unauthorised use of confidential information • fraud and theft Maladministration Maladministration is defined as conduct that involves action or inaction of a serious nature that is: • contrary to law • unreasonable, unjust, oppressive or improperly discriminatory or • based wholly or partly on improper motives Serious and substantial waste • Serious and substantial waste refers to any uneconomical, inefficient or ineffective use of resources, authorised or unauthorised which results in significant loss/wastage of public funds or resources Reporting • Report any instances of possible corrupt conduct, maladministration and serious and substantial waste of public resources to the Chief Executive or other delegated officer • The Chief Executive is required to report all instances of suspected corrupt conduct to the Independent Commission Against Corruption The Protected Disclosures Act 1994 Protects staff who make disclosures against corrupt conduct, maladministration and serious or substantial waste of public money Disclosures not protected by the Act include: • those that question the merits of government policy • those that are frivolous or vexatious or • those that are motivated solely or mainly to avoid dismissal or other disciplinary action Breaches of the Code of Conduct • Staff members should note that breaches of certain sections of this Code of Conduct may be punishable under legislation • Breaches of the Code of Conduct may also lead to disciplinary action In summary As a staff member of the Hunter New England Health you must fully accept that you must: • behave honestly and with integrity • obey any lawful direction from a person who has the authority to give that direction • follow the policies of NSW Health, whether or not you approve of those policies

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• • • • • • • • •

deal with issues or cases consistently, promptly and fairly follow the safety and security directives of management never commit a corrupt or unethical act in the course of your duties report any corrupt or unethical conduct avoid financial and other conflicts of interest and seek advice when in doubt comply with the rights of the clients you serve not harass or discriminate against any person for any reason not solicit or accept gifts or benefits outside official policy guidelines never act outside the limitations of authority given to you through your statement of duties and other delegated authority • not engage in private conduct which brings discredit to the Hunter New England Health • protect confidential information • have written permission before accepting secondary employment If you manage other staff, you must ensure their work-related needs are met and that they behave in accordance with the Code of Conduct. If you fail to comply with this Code you are subject to a range of management options and remedies up to removal from the Hunter New England Health.

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CONDITIONS OF EMPLOYMENT As an employee of Hunter New England Health, the conditions of your employment are regulated by: • • • • •

Health policies NSW Department of Health policies Award and Enterprise Agreement provisions related to the position you occupy Acts of Parliament Code of Conduct

Further information regarding your entitlements is available from the following publications: • • •

Human Resources Manual Leave Matters Procedures Manual for Public Hospitals Relevant Industrial Award or Enterprise Agreement

The above documents are all available on the intranet. There are also some frequently asked questions available that may be of some assistance. From time to time, awards, policies, legislation etc are updated or a new one introduced. Systems are in place to keep you informed of these changes. Payment of salaries The provision of all NSW Public Awards provide for the direct deposit of your salary to your nominated financial institution. Superannuation Compulsory Superannuation Guaranteed Contributions (SGC), employer funded, are made to any SGC compliant superannuation fund at the employee’s request. If no fund is elected by the employee funds will be automatically paid to First State Super on their behalf. The contribution is 9% of the employee’s base ordinary rate of pay. An employee may also elect to make personal contributions to their elected fund or First State Super by way of regular salary or wage deductions or salary sacrifice (pre-tax). Offer of employment You should have received a written offer of employment prior to commencing duty with Hunter New England Health. The offer would have included details of the award under which you are employed and your status within that award i.e. permanent, temporary, part-time, full-time. If you have any questions or concerns regarding details of your offer of employment please discuss them with your department manager/supervisor. Resignation If you wish to terminate your employment, you need to check the amount of notice you are required to give with your supervisor or the Human Resources department. The amount of required notice will vary dependent upon which award you are employed under.

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Changes to personal details Any changes to your personal details, such as your address or taxation, must be notified to Pay Office as soon as possible. Relevant forms are available from the intranet, Pay Offices (located in Inverell, Waratah and Mater Hospital) or your ward or unit. You are responsible for completing the appropriate forms and ensuring that your current contact details are provided. Payroll number This is your unique identification number with the organisation. Please ensure that you have a record of your number in a place that is easily accessible for you. This is essential when making payroll enquiries. Leave entitlements All permanent and temporary staff on contracts are entitled to many different types of leave. Casual staff are paid a loading on their hourly rate and are not entitled to paid leave. Sick leave Officers absent on sick leave should notify their supervisor as soon as possible and where appropriate indicate the duration of the absence. Immediate supervisors monitor reasons for absences and a medical certificate must be provided for sick leave absences of three or more consecutive days. All awards provide for two (2) weeks cumulative sick leave per annum, with entitlement commencing on completion of three (3) months continuous service. Annual leave Approval for annual leave should be requested on the appropriate form from supervisors giving adequate notice so that where necessary relief can be arranged. Arrangements should be made with your supervisor with regard to method of payment. All employees (except casual, temporary or relieving staff) are entitled to four (4) weeks annual leave per annum. Shift/weekend workers can accrue additional leave and public holiday leave above the base entitlement. Salary packaging Salary packaging allows health staff to take home an extra $1500 a year on average. Salary packaging is available for all employees except casuals and SES. Salary packaging is a means of paying/reimbursing financial commitments by way of using your pre-tax dollars. Before considering salary packaging please seek independent financial advice from your accountant, tax agent or financial planner. For further information please contact Prosperity on 02 4929 6855. Maternity leave / Adoption leave Fourteen weeks on full pay or 28 weeks on half pay after 40 continuous weeks of service. Parental leave The one week of paid parental leave replaces the current one week unpaid paternity leave but extends to a partner of the same sex.

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Long service leave Approval for long service leave should be obtained from your supervisor. Employees are eligible for two (2) months long service leave after ten (10) years of service. After ten (10) years service leave accrues at fifteen (15) calendar days per annum. Access will be permitted to pro-rata extended leave (i.e. long service leave) after seven years of service. This is available to be taken as leave or on resignation. There is no requirement for pressing domestic or other necessity to be granted this pro-rata entitlement. Family and Community Services (FACS) leave FACS leave is available: • For a range of personal reasons encompassing family responsibilities • For the performance of community service • For cases of pressing necessity Personal/Carers leave Personal/Carers Leave is available: • to provide care and/or support for sick members of the employee’s family or household • to provide for the flexible use of other entitlements • With Personal/Carer’s Leave employees are able to access current and up to three years accrued sick leave entitlements to care for a sick dependant Additional FACS leave for bereavement purposes May be granted where FACS Leave has been exhausted, additional paid leave of up to two days may be granted on a discrete “per occasion” basis to an employee on the death of a family member. Accrued days off Full time employees are entitled to an accrued day off (ADO) every four weeks to a maximum of twelve per year. Full time employees employed as tradesmen are entitled to an ADO every four weeks to a maximum of 13 per year. Study leave Provisions are available for staff to access study leave. These will vary dependent upon the type of course you are doing and the requirements of the course eg. level of face to face, residential etc. Transfer from other public service organisations If you have come to Hunter New England Health from another health service or public service organisation you may have an entitlement for leave and service that can be transferred. Please contact Payroll at either Waratah, Inverell or Mater Hospital who will be able to assist. ** Should you require any information regarding any type of leave talk to your line manager. Line managers if need be will contact the relevant Human Resources Department. ** For any information regarding leave balances or payment details contact the Pay Office on 1800 220 245 (Inverell), 1800 853 400 (Hunter) or 49 211 336 (Mater Hospital).

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ZERO TOLERANCE The Zero Tolerance policy is an important aspect of ensuring the rights of all people working in or utilising the NSW Public Health System. It is aimed at the prevention and management of aggression and violence in the workplace. NSW Health defines aggression as: 'Any incident in which employees are abused, threatened or assaulted in circumstances arising out of, or in the course of, their employment including verbal, physical or psychological abuse, threats or other intimidating behaviours, intentional physical attacks, aggravated assault, threats with an offensive weapon, sexual harassment and sexual assault'. NSW Health policy covers incidents of aggression or violence by patients and clients of the health service toward staff as well as bullying and harassment from fellow staff members.

PERFORMANCE MANAGEMENT Hunter New England Health supports the use of performance evaluation systems that provide employees with constructive feedback on their performance and incorporates performance, training and development plans for the ongoing benefit of the employee and the organisation. Performance Enhancement is an ongoing process in which employee’s job performance and development needs are discussed and reviewed with respect to defined job goals. This occurs via a formal structured Performance Enhancement system as well as dayto-day feedback given informally. Formal performance review feedback can be expected after three months of employment, then annually thereafter. The system consists of the employee and manager identifying and actioning a personal performance and development plan, with subsequent feedback and progress reviews.

COMPLAINTS / GRIEVANCES Sometimes in the course of our employment we may feel aggrieved that we are being treated unfairly or that an injustice has taken place. This could be related to matters such as employment conditions, staff selection practices, work allocation, safety, harassment, team relationships etc. If you believe that you have a genuine complaint or grievance you can access the Grievance Procedure. A formal grievance can be verbal or in writing and, in the first instance, should be taken to your immediate supervisor (where possible). A process will be undertaken to understand the nature of the grievance then put actions in place to resolve the grievance. A fair and objective process will be taken in an effort to resolve the grievance. For further information about this process, talk with your supervisor or Human Resources representative. If necessary, staff may be referred to the Employee Assistance Program for additional support.

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DISCIPLINARY PROCESS The vast majority of Hunter New England Health staff perform effectively and conduct themselves in a professional and ethical manner at work. However, there will be occasions when, in order to maintain the proper and efficient functioning of a health service, effective disciplinary procedures are required to address serious or on-going performance problems, misconduct or inappropriate workplace behaviour. All alleged breaches of discipline relating to misconduct, serious performance issues or inappropriate behaviour involving staff of the health service needs to be addressed and resolved within the context of the relevant legislation, industrial instruments and the principles of procedural fairness. Policies have been developed in line with NSW Department of Health and other relevant legislation, industrial instruments and the principles of procedural fairness to assist, human resource practitioners and line managers to meet legislative, contractual and common law requirements in the area of discipline. These policies apply to serious breaches of discipline or repeated smaller offences, and should not be used for matters best dealt with by performance management strategies, grievance procedure, conciliation/mediation, counselling, or training. Disciplinary matters may include: • • • • • • • •

Poor attendance record Unacceptable work (ie, work that is consistently below standard) Attitude to work, staff, customers Failure to carry out reasonable requests Lack of reasonable productivity Disruptive behaviour Activities in conflict with the Code of Conduct and Ethics Breach of Hunter New England Health policy

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EMPLOYEE ASSISTANCE PROGRAM (EAP) What is EAP? The Employee Assistance Program (EAP) is a confidential counselling service available to all staff of Hunter New England Health. This counselling service is available for both work and non-work related issues. The service offers assistance in areas such as: • relationship difficulties • alcohol and drug-related problems • financial worries • emotional problems • interpersonal conflicts Together, the employee and a counsellor can examine the nature of the problem and develop an appropriate course of action. When appropriate, the counsellor may refer the employee for ongoing assistance. Counselling is: • confidential • voluntary • free, and • available Staff may use the service in work time or their own time. Their supervisor will approve the absence from the department if required, BUT has no right to know why the employee is contacting EAP. How to access EAP Any member of staff can access EAP in any number of ways: • • • •

directly on an individual basis through their manager, team leader or Health Service Manager through union/association delegate through co-workers and friends

Whichever way is chosen, the first contact needs to be made through one of the following: • • • •

your local manager your Human Resources Department in New England on 6767 7165 your EAP Coordinator in the Hunter on 4921 2822 your Human Resources Department on 6592 9417 or 6592 9715

The employee will then be transferred on to a suitable counsellor who will help with their problem. EAP for staff working at the Mater Hospital is provided by Corporate Health Services and is available 24 hours, 7 days per week. Contact number is 1800 811 951.

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EQUAL EMPLOYMENT OPPORTUNITY Hunter New England Health has a policy of Equal Employment Opportunity (EEO). The twin aims of EEO initiatives are, on one hand, to promote employment policies and practices which are based on the principle of merit and on the other, to introduce and pursue programs of affirmative action designed to encourage people traditionally disadvantaged in the workplace because of discrimination or prejudice. In summary, Equal Opportunity Involves: • • •

the selection of the best person for the job ensuring that conditions of service and career opportunities are fair and equitable assisting all employees to achieve their full potential with respect to their positions

Legislative Base For EEO EEO groups are people affected by past or continuing disadvantage or discrimination in employment. These groups are: • • • •

Women Aboriginal people and Torres Strait Islanders Members of racial, ethnic, and ethno-religious minority groups People with a disability

Discrimination is treating someone unfairly or harassing him or her because they belong to a particular group. Under the Anti-Discrimination Act 1977, it is against the law in NSW for any employer, to discriminate against an employee or job applicant because of their: age, sex, pregnancy, disability (includes past, present or possible future disability); race, colour, ethnic or ethno-religious background, descent or nationality; marital status, carer’s responsibilities; homosexuality; transgender. Both direct and indirect discrimination is against the law. Direct discrimination means treatment that is obviously unfair or unequal. Indirect discrimination means having a requirement that is the same for everyone but has an effect or result that is unfair to particular groups.

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FREEDOM OF INFORMATION The Freedom of Information Act of New South Wales came into effect on 1 July 1989. It is based on three essential principles of democratic government - openness, accountability and responsibility. The spirit of the Act is to enable people to have access to documents produced by Government agencies, authorities etc including the Hunter New England Health. Agencies are encouraged to voluntarily release information. Documents fall into two categories. • Personal (e.g. patient /client files) • Non-personal (e.g. policies, protocols, planning documents) There are fees associated with requesting documents. Documents can be released in full, in part, in some cases deferred or not released at all.

INFORMATION PRIVACY Good work practices can help to ensure that client/patient information is properly protected. Observing simple procedures can make all the difference. By phone Take care that you convey personal information by telephone only when it is needed urgently. In most cases this will be for client/patient care. Make sure that the person you are calling is authorised to receive the information. If they are not personally known to you, confirm their identity, for example by ringing back. Avoid conveying personal information by mobile phone. intercepted.

Conversation may be

Do not leave personal information about a client/patient on voice mail. By mail or courier When sending personal health information by post or courier, it is a good idea to take some extra precautions. For example: • •

Use some form of recorded delivery such as registered mail. Send lists of names separately from health information, along with link numbers or codes. • Make sure that envelopes do not disclose the source of the information where this may be sensitive, for example a drug and alcohol service. • Mark envelopes “confidential” or for the attention of a particular person. Make sure packaging is secure and take care that addresses are complete and correct.

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By e-mail If you send any personal health information by e-mail, names or other identifiers should be: • removed; or • encrypted; or • sent separately from health information, with link numbers or codes Do not forward personal information you have received by e-mail. Separate access for each individual needs to be authorised. If you receive e-mail containing personal information by mistake, you should delete it immediately and promptly inform the sender. In conversations Avoid discussing clients/patients in public area such as corridors of lifts or indeed anywhere you may be overheard. By fax Fax personal information only when it is urgently needed. Make sure that the person you are faxing to can guarantee the confidentiality and security of the information. Confirm the destination fax number and the identity of the receiver, and check that an authorised person will be waiting to collect the document. It is a good idea to take some extra precautions when faxing personal information. For example: • where practicable, delete names and addresses prior to transmission (health record number can be used as an identifier) • double check fax numbers or use autodial • confirm that the document has been received If you receive a fax containing personal information by mistake, you should promptly inform the sender. Printing and copying Unless required for client/patient identification, you should block out names on paper records before copying. Make sure that you personally remove documents containing personal information from printers. Training and demonstrations Take care to protect the anonymity of clients/patients during case presentations, consultations with colleagues, presentation of research results and at seminars and conferences. Use fictitious data for all demonstrations and training sessions. Do not use photos, slides or other visual aids, which allow individuals to be identified unless you have prior written consent from the identified person.

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Storage All paper records should be kept in lockable storage when not in use. Basic precautions such as not storing records containing personal information in a public area should not be overlooked. Unattended documents Take care not to leave documents containing personal information on workbenches or anywhere people in passing may see them. Computer screens Position your computer screen, particularly if you work in a public area such as an emergency department, admissions or outpatients area, so that it cannot be seen by passers by. Make sure information is not left on an unattended screen, or activate a screen saver. Disposing of personal information Paper records containing personal information are best disposed of by shredding or burning. For large volumes it is advisable to employ services, which specialise in the safe disposal of confidential material.

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STUDY ASSISTANCE LOAN SCHEME As an incentive to staff, Hunter New England Health has approved an interest-free Study Assistance Loan Scheme (SALS) designed to help staff who may wish to undertake relevant undergraduate and certain post-graduate tertiary studies at a college of TAFE, a university, or another accredited education provider. It should be noted that a fringe benefit might arise when an employer provides a loan to an employee free of interest or at an interest rate that is less than the statutory interest rate (currently 6.05%). Staff who have entered into salary packaging arrangements and/or who have private use of a health service motor vehicle will need to consider any potential fringe benefit tax liability which may accrue to them as a result of accepting a study loan offer. The SALS will enable ‘up-front’ payment by Hunter New England Health to the Higher Education Contribution Scheme (HECS), or course fee to be made on behalf of eligible staff who: • • •

gain support from their senior manager concerning their proposed study program have a study program which fits within the relevant criteria are prepared to pay 25% of total cost to Hunter New England Health with the balance of funds being repaid over a maximum of 20 pays • have been permanent employees of Hunter New England Health for at least six months • provide evidence of necessary course fees (tax invoice) The Scheme is available to any full-time or part-time member of staff, but cannot extend to casual employees.

To meet ‘relevant criteria’ a proposed study program will need to be demonstrably advantageous to the individual’s career within the health service and will be at either undergraduate level or clinical/technical/professional graduate certificate or diploma level, masters or PhD, in a discipline directly related to the applicant’s work. If necessary, prior to implementation, applicants may discuss the practical impact of repayment with staff of Human Resources. This discussion will be confidential. For New England employees: Forms may be obtained from the Division of Nursing and Organisation Development (phone 6767 7230 or fax 6766 7918) or email [email protected]. For Hunter employees (including Lower Mid-North Coast): Forms may be obtained on the Hunter New England Health Intranet site at http://hal.hunter.health.nsw.gov.au/docs/HR_HECS%20form.pdf Mater Hospital employees Wishing to apply for financial assistance to undertake tertiary study should contact their Manager or the Human Resources Department (phone 49 211 256).

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OCCUPATIONAL HEALTH AND SAFETY Policy Statement: Hunter New England Health is committed to securing the highest level of health, safety and welfare of patients, employees and any other persons within its premises. Hunter New England Health requires compliance with legislative responsibilities and general duty of care by all persons associated with the management and operation of the Health Service. Hunter New England Health is committed to ensuring that resources are made available to enable compliance with all relevant Acts and regulations and will hold managers and supervisors accountable for taking all practical measures to ensure that work areas under their control are safe and without risks to health. It is also expected that all employees will cooperate with Occupational Health and Safety policy and procedures and fulfill their duty of care. Mandatory Procedures Managers, supervisors and team leaders 1. You must ensure that Occupational Health and Safety Committees, comprising management representatives and elected employees, are established and maintained as required by legislation. You must ensure that committee members have the support, resources and training necessary to allow the effective discharge of their duties. 2. You must be responsible and accountable for the health and safety of all persons, employee or otherwise, who may be affected by the activities under your control as required by legislation. 3. You must ensure that you implement a hazard control program in areas under your control, which will identify, assess and control hazards that could be a risk to health, safety and welfare of any person. 4. You must audit work areas under your control to identify hazardous conditions, equipment or processes. Where hazards cannot be eliminated safe work practices and safety rules must be developed and prominently displayed. 5. You must provide information, instruction and training to the staff under your control to enable them to understand their rights and responsibilities under the legislation and ensure safe work practices. 6. You must enforce all Occupational Health and Safety rules and procedures, but not penalise an employee for attempting to address a safety issue. All employees must 1. cooperate with all reasonable measures implemented to ensure your own health, safety and welfare and that of others, and work in such a manner as to protect persons who may be affected by your acts and omissions.

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2. attempt to remedy a hazard once you become aware of it – immediately if possible – or ensure all persons at risk from the hazard are protected (isolation, danger tags or signs) then notify your supervisor. 3. be responsible and accountable for your compliance with safety requirements as required by legislation. Contractors You must establish work practices designed to prevent injury or illness arising from your acts or omissions and comply with all safety rules, safe work practices and other requirements implemented by the Hunter New England Health to ensure health and safety. First Aid and Other Emergency Procedures Staff members who suffer a work-related injury or illness requiring urgent medical treatment may see their own Medical Practitioner or may initially attend the Emergency Department/Section of their hospital or facility. Where necessary, procedures for claiming workers compensation are outlined in the Rehabilitation section of this booklet. All staff are reminded that it is a condition of their employment that they attend certain compulsory in-service safety training sessions. These sessions revolve around emergency procedures and include CPR, fire safety training (lectures and practical), emergency evacuation practice, manual handling (or back care) lectures. Attendance at these sessions should be discussed with your supervisor during your annual performance appraisal. Fire Orders and Disaster Plan All staff must recognise that by the very nature of the work performed in hospitals there is great potential risk for a fire to occur. Booklets providing comprehensive information regarding action to be taken in the event of a fire or disaster are available in your department or ward. They are also available from your hospital or facility fire safety officer. Members of the staff must familiarise themselves with these booklets as soon as possible after commencing employment. The inside cover of the Fire Emergency Handbook contains instructions regarding immediate action in the case of fire. Generally speaking the recommended action to be taken in the event of a fire is the same in hospitals throughout New South Wales -

R - Remove patients/staff from immediate danger. A - Alert other staff and the NSW Fire Brigade, advising exact location of the fire. C - Confine the fire and smoke by shutting doors and windows. E - Extinguish the fire if safe to do so. Use the correct extinguisher. As mentioned previously ALL staff must attend a course of lectures in relation to fire safety and a practical evacuation exercise every 12 months.

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Know how to prevent fires: 1. ATTEND - Attend the fire drills regularly. 2. OBSERVE - Observe No Smoking rules and remind others to do the same. 3. AVOID - Avoid piling rubbish and other flammables. Keep exits, hose reels and extinguishers clear. 4. USE CAUTION - use caution around gas, flammables and oxygen equipment. 5. KNOW - Know what to do in an emergency. 6. KNOW - Know the types of extinguishers to use. For further information please contact your facility Fire Safety Officer. Security Whilst security is not a serious problem within Hunter New England Health, it must be recognised that breaches in security do occur from time to time. Often the greatest threat to our security is the lack of conviction by staff that a security problem exists. We should all recognise that firstly we need to protect ourselves, secondly our coworkers, patients and visitors and thirdly the assets and property of the Hunter New England Health. Security awareness is in fact crime prevention and is based on the Crime Risk Triangle. There are three basic elements necessary for a crime to occur. The DESIRE and ABILITY to commit a crime and a victim who provides the OPPORTUNITY for a criminal act. Security awareness by all staff breaks this Crime Risk Triangle most effectively by reducing the OPPORTUNITY for the crime to occur. There is little we can do to control the desire of someone wishing to commit a crime. However reducing the opportunity has the flow-on effect of reducing someone’s ability to commit the crime. Some hospitals/facilities within the health service have dedicated Security staff whilst security duties are also performed on a part- time or contract basis in other hospitals or facilities. Security personnel are recognisable by their security guard insignia over the left breast pocket. If you have not already done so you should discuss your hospital security procedures with your supervisor, including finding out the hospital internal emergency phone number. Do not hesitate to ask for an escort when, for example, going from your building to your car at the completion of your shift. Where there are security staff on duty please use them, they are only too willing to help.

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In relation to security we need your help. If you see or suspect anything of a criminal nature please report it as soon as possible. If you suspect someone is of ill intent you have the right as a staff member to ask for identification. You are not expected nor encouraged to physically intervene in any situation. Vandalism Experience has shown that if vandalism is to occur it is most likely to occur in the hospital car park. Every facility of Hunter New England Health has dedicated illuminated after-hours parking. Where Security staff are employed or contracted the car parks are routinely patrolled during the dusk to dawn hours. Theft Lock your money, personal items, draws, filing cabinets and office when not in use. Also, log off your computer when you leave your workstation or office. The Health Service cannot accept responsibility for any loss of personal effects that may occur. If any article is lost or presumably stolen please report it to your supervisor immediately. Identification badge If you do not already have a hospital identification badge you can obtain one through the security staff or your supervisor. Staff at smaller sites may have to wait for one of the regular visits from the Area Security Manager. All staff are required to wear their identification badge in a position that allows easy recognition. All keys and identification badges are to be returned to your supervisor if you leave the employ of the Hunter New England Health. Assault: Regrettably in today’s climate the threat of an assault, either physical or verbal, is always with us. Assault can happen anywhere - be it on the way to or from work or in the workplace itself. Again where possible staff should try to reduce the opportunity for assault to occur. There are some simple precautions you can take to reduce the threat of assault occurring: ⇒ Avoid poorly lit or unlit areas of the hospital when parking your vehicle or walking. If you have to travel from building to building after hours use a pathway that is well lit. Where possible avoid bushes and shrubbery. ⇒ If your shift finishes after dark, park in the after-hours car park of your hospital or facility or where there is sufficient or increased lighting. ⇒ When you leave your workplace travel in pairs or request security staff to escort you to your car. Before you leave the hospital or facility have the correct car key ready to gain access to your car. Before you enter your car view the area behind the driver and passenger seats. ⇒ Lock all doors and windows both while in your car and at work. Do not leave valuables such as your wallet, purse, mobile phone, etc., visible in your car. If they have to be left in the car, lock them in the boot. ⇒ Avoid waiting in the open if someone is picking you up at the completion of a shift.

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Within the workplace itself there are a number of precautions that staff members can take to lessen the chance of assault. Try to pre-empt a possible flaring of a situation, seek assistance, and control your emotions and deal with the problem in a quiet manner. Do not allow outside distractions such as relatives or other patients or visitors to become involved. Speak calmly using simple wording that is easily understood. If possible contact security staff or your immediate supervisor. If an assault or attempted assault takes place then you must report it. Seek assistance from your supervisor or department head as soon as the threat has subsided. In some circumstances it may be necessary to contact the police on 0-000. If you become a victim of assault report it immediately. Do not suffer in silence. Hospital lockup and unlock times As a staff member you should be aware that all doors, with the exception of the entrance to Emergency, are locked at certain times each night. The time varies from hospital to hospital but is normally dusk to dawn. You should find out these times from your supervisor. As we are in public hospitals we cannot deny entrance to anyone who needs medical treatment. Members of the public who come to any entrance, other than Emergency Department entrance, must be viewed with caution. It is preferable that you address these people in the presence of another staff member or security staff. Unless it is an emergency situation you should encourage those people who wish to see a patient to observe visiting hours. Only admit people to your area after proper identification has been established. As you would at home, lock doors and windows as you leave. Manual Handling Manual handling is defined as “any activity requiring the use of force exerted by a person to lift, lower, push, pull, carry or otherwise move, hold or restrain any animate or inanimate object” (National Standard for Manual Handling, 1990, p. 11). In line with the National Code of Practice for Manual Handling the Hunter New England Health Manual Handling Policy addresses the principles of risk identification, risk assessment and risk control. Wherever possible these three principles are considered in consultation with employees. By definition these three principles do not remain static. Staff members of different height, weight and strength lift or carry the same object. The same size box may have different weights depending on its contents and how often you have to move it and of course the ability of a patient to assist with a lift or carry will depend on their medical condition and so on. All of these factors should be taken into account when performing any manual handling task. In the past it was thought that manual handling problems could be overcome with “how to lift” training. Whilst greater emphasis is now placed on job redesign and mechanical lifting devices staff are still required to attend a manual-handling lecture on an annual basis. Staff are also required to use mechanical handling equipment (such as trolleys, patient lifting devices) where it is provided.

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To assist preventing accidents resulting from lifting: 1. CHECK - Check the object to be lifted. Make sure it’s not too heavy or too awkward. Check for sharp edges. Can you use a mechanical lifting device? Plan your lift. 2. STAND CLOSE - If you have to lift, stand close to the object with feet apart for balance - make sure footing is secure. Position yourself correctly. 3. BEND KNEES - Bend your knees. Keep your back as straight as possible. 4. GRIP WELL - Get a good grip and keep weight close to your body. 5. LIFT SLOWLY - Lift gradually, straighten knees and stand. Use leg muscles. Avoid quick jerky motions. Do not twist your body. 6. PATIENT MOVES - Moving a patient? Use the same precautions. Can you use a mechanical lifting device? Get someone to help you lift / move the patient. Slips, trips and falls Slips, trips and falls aren’t just a danger to staff who work on scaffolds, ladders and roofs. Most falls actually occur on the same level and are caused by just tripping over an object or slipping on something. Here are some ways to prevent falls: • • • • • •

Keep walkways and floors free of obstacles such as boxes, cords and litter. Even objects such as pencils on the floor have caused serious falls. Flooring surfaces must be even and secured. Watch for obstacles such as loose tiles and carpeting. Close cabinet drawers and doors as soon as you are finished with them. Many serious injuries have occurred when people fall over unexpected obstacles such as an open bottom drawer on a desk. Don’t run or walk too fast. Wear safe footwear, with low heels and a good fit. Keep your shoelaces tied. Avoid slippery soles and be sure to wear shoes with adequate tread when walking on icy, greasy or wet surfaces. Keep shoes in good repair. Make sure you can see over or around any load you are carrying.

Take your near misses seriously. Let’s say you have just skidded across a wet floor or tripped over an extension cord. You are not injured, but just a little shaken and embarrassed. Take the time to find out why that near accident occurred in the first place and identify what can be done to prevent it from happening again to you or someone else. It is important to stay alert to slipping and tripping hazards in your work area and the routes, which you travel in the course of your shift. Watch out for hazards, which might put you in danger of a fall. Think of other staff and patients too, as they may become an unsuspecting victim to these hazards.

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OCCUPATIONAL HEALTH AND SAFETY COMMITTEE Under the Occupational Health and Safety Act and Regulations all hospitals are required to have an Occupational Health and Safety Committee. Hunter New England Health welcomes and encourages your input into the committee to make the workplace healthier and safer for everyone. The committee consists of employer and employee representatives. The employer representatives are nominated by management and cannot exceed, in number, the employee representatives. Fellow staff members elect employee representatives for a period of two years (you may stand for re-election if you wish). The chairperson of the committee is elected from and by the employee representatives. Information regarding your local committee should be available on an OH&S notice board in your Hospital. Contact your OH&S Chairperson to ask how you can help.

NO SMOKING POLICY Hunter New England Health has instituted a “No Smoking” policy throughout the Health Service. Smoking is prohibited in all buildings, vehicles and facilities, including staff quarters. Patients, clients, visitors and staff are requested to cooperate with the “No Smoking” policy.

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SAFETY RULES AND SAFE WORK PRACTICES If you are unsure of the correct and safe method of performing a task you should ask your supervisor. Much of the equipment and many of the tasks within the health service have recently had Safe Operating Procedures (SOP) documented for them. For example many electrical items have SOP attached to the piece of equipment or pinned to the wall in close proximity so that staff can read them before they operate equipment or machinery. Chemicals are a widely used tool in our hospitals. The first step in getting health and safety information on the chemicals you use in the workplace is reading the label. It is important to recognise symbols and read labels so that you can take steps to protect your health. The second step in getting health and safety information on chemicals is to read the Material Safety Data Sheet (MSDS). Having identified the substance from the label, you can ask for the MSDS, which applies to it. Your hospital has easily accessible copies of MSDS for each product used. The MSDS tells you • the ingredients of the product • the health effects of the product and first aid instructions • precautions to follow when you use the product, and • safe handling and storage information. Make sure that you and your staff are familiar with the contents of the MSDS for products used in your area. With harmful and/or flammable liquids remember: 1. DON’T OVERSTOCK - Your legal limit is five liters per floor. 2. LABEL RIGHT - Don’t hold harmful or flammable substances in incorrectly labelled or unlabelled containers. 3. CONTAIN SAFE - Check with your supervisor to ensure safe storage and dispensing containers are used. 4. SIGNPOST - All flammable and harmful liquids must be clearly highlighted. Remember no naked flames near flammable liquids and gases.

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NUMERICAL PROFILE AND EQUIP Once a year each hospital and facility within Hunter New England Health has a Numerical Profile conducted by NSW Health accredited profilers or auditors. The audit is occupational health, safety and rehabilitation specific and is designed to measure the existence of these policies, procedures and systems in five main areas of the workplace: • • • • •

organisation and administration hazard control fire control and occupational hygiene participation, motivation and training post injury management

The Numerical Profile does not measure OHS & R in minute detail under these main areas, but is based on the premise that good or best practice in the essential areas will indicate good or best practice overall. The EQuIP process is usually conducted every four years and whilst it is a dynamic accreditation process based on continuum of care there is an element pertaining to occupational health, safety and rehabilitation. Conducted by external accreditors from the Australian Council on Healthcare Standards the accreditors will gauge your hospital’s effectiveness in relation to topics under the broad umbrella of “safe practices and environment.” All staff are expected to participate in the Numerical Profile and EQuIP process by attending compulsory safety lectures, knowing safe operating procedures for their roles or tasks and so on. It is not unusual for auditors or accreditors to quiz individual staff on fire safety, security, emergency procedures, infection control, manual handling and other safety related issues.

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HAZARD IDENTIFICATION AND REPORTING To protect yourself and other employees, patients and visitors to your hospital please report anything that you consider could cause an accident or that appears unsafe. The importance of all staff reporting hazards cannot be over emphasised. Each hospital/facility has its own reporting form that should be available from your supervisor or safety officer. Prompt action should be taken to investigate your report and you should be advised of the outcome of your report. It is also possible to report hazardous situations to a member of your Occupational Health and Safety Committee. To help prevent electrical accidents: 1. INSPECT CORDS - See that plugs are not broken. Keep cords away from rough, sharp, hot or greasy surfaces. Remove plug at power point - do not pull cord. 2. GROUNDED - Make sure it is grounded. All equipment should have three-prong plugs or be double insulated. 3. WARNING SIGNS - Be alert for trouble signs. If a machine overheats, smokes or sparks, or if you feel a slight shock - unplug it! Attach a danger tag and ensure that it is repaired by a qualified person. 4. WET SPOTS - Water plus electricity equals trouble. Don’t touch electrical equipment with wet hands or if you are in or near wet spots. 5. DOUBLE TROUBLE - No double trouble. Switch all appliances off at power point when not in use. Don’t use double adaptors. 6. PLAY IT SAFE - Attach a danger tag to any machine you suspect is faulty and call the maintenance workshop.

Check plugs and cords…..

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INFECTION CONTROL Irrespective of diagnosis or perceived risk, the blood and body substances of all persons are to be considered as potential sources of infection. Protective apparel, such as gloves, masks, eye protection and gowns/aprons should be worn if there is the likelihood of contact/splash with blood or body fluids. These are called Standard Infection Control Precautions. Further precautions may be required for other diseases or multi resistant organisms; these are called Additional (transmission based) precautions. Hand hygiene is a key measure to prevent cross-infection. It can be performed either by hand washing or the application of alcohol gel onto dry hands. Visibly soiled hands require washing rather than gel. Hand hygiene must be attended: • before and after patient contact or contact with equipment • after removal of gloves • before handling food • at the commencement and completion of work • after going to the bathroom, and • if skin is contaminated with blood or body fluids Intact skin is a natural defence against infection. Any breaks in the skin should be covered with a waterproof occlusive dressing. Frequently moisturise hands with hand lotion to prevent the skin from drying out. Fingernails should be kept short, clean and free from nail varnish. Staff caring for patients should not wear artificial fingernails. Jewellery should be limited to one significant ring (usually a wedding band) and wristwatches are discouraged in clinical areas as these usually harbor microorganisms. Neck ties and identity badge slings worn by clinical staff are unhygienic unless laundered weekly. Waste should be appropriately disposed of into the designated colour containers. Sharps are to be placed into puncture resistant sharps containers. These containers should not be overfilled. Do not bend, break or reuse needles. Do not carry waste bags close to the body and care should be taken not to drop waste bags. No matter how trivial all sharps injuries, lacerations or splashes of blood or body fluids should be reported to your supervisor and Staff Health as soon as practicable. Immunisation for Hepatitis B is offered free to all Hunter New England Health staff. At the earliest opportunity, all new staff should contact Staff Health (Infection Control staff in New England) for assessment of their personal immunisation requirements that are recommended by NSW Health (see NSW Health Circular 2003/91).

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Exposure prone procedures (EPPs) are those procedures where there is potential for contact between the skin (usually finger or thumb) of the healthcare worker and sharp surgical instruments, needles or sharp tissues (splinters/ pieces of bone/tooth) in body cavities or in poorly visualised or confined body sites including the mouth. Staff who perform EPPs must comply with NSW Policy PD2005_162, which requires that the staff member arranges annual testing of their HIV, Hepatitis C and Hepatitis B status and withdraws from practice in the event of demonstrated infection with or significant exposure to one of these blood borne viruses. In the event of personal illness, please consult your GP or Staff Health for diagnosis and treatment. Certain illnesses (eg. whooping cough or influenza) can be potentially harmful for some patients and staff should not continue to work until recovered. Information on more detailed work restrictions related to personal illness can be obtained from Staff Health, Infection Control personnel or the intranet. Annual influenza vaccination is offered free to all staff and is strongly recommended both for personal protection and to avoid the possibility of transmitting influenza to a susceptible patient. When to contact infection control personnel • When a patient has or is suspected of having an infectious/communicable disease or multi-resistant organisms that may require additional (transmission-based) precautions • For staff, patients, carers and family requiring advice, information or clarification on infections, exposure events or correct procedures • Education in relation to Infection Prevention & Control practices

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STAFF HEALTH (FOR HUNTER STAFF ONLY AT THIS STAGE) What Is Available: • Assessment and referral for all work-related injury • Assessment of illness at work (conditions apply) • Hepatitis B immunisation and blood test • Tetanus/Diphtheria immunisation • Measles, Mumps, Rubella immunisation • Varicella screening and immunisation • Influenza vaccination • Hepatitis A screening and immunisation (conditions apply) • Body substance exposure management and follow up • Cytotoxic blood screen • Glutaraldehyde screen • Screenings for Hep B, HIV, Hep C (work related) • Latex screening and referral as required. • Debriefing • Skin care education (for dermatitis sufferers) • Mantoux checks (TB screening) • Chest X-rays Contact the Staff Health nurse on your campus. Work-related injury and illness should be referred in all cases to the Staff Health Clinic for first aid, assessment and referral if appropriate. Hepatitis B Immunisation Hepatitis B virus is transmitted via blood and other body substances. Hepatitis B immunisation is offered free of charge to all health care workers whose work involves participation in tasks or activities with exposure or contact with blood or body fluids, including human tissue. The course consists of three injections given over a six month period, a blood test is attended three months following completion of your course to check immunity. NSW Health policy requires you to show documentation and be aware of your Hep B status. Contraindications Hepatitis B vaccine should be deferred in the case of febrile illness. Side Effects Reported side effects are transient and mild, and include pain at the injection site (9-10%), low grade fever (3%), nausea, dizziness, myalgia and arthralgia. Tuberculosis Screening Tuberculosis is an infectious disease that usually affects the lungs but may affect other parts of the body.

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How is it spread? Active TB infection in the lung spreads through the air when coughing or sneezing. The germs are in the droplets of moisture are coughed or sneezed out. Sharps Management The person using the sharp is responsible for its safe disposal. Do not bend, break or manipulate a sharp. Sharps must not be re-sheathed except in special circumstances. Dispose of sharps into puncture resistant sharps container, as close as possible to point of use. Never overfill a sharps container. When 3/4 full, secure the lid and remove to waste collection area. REPORT ALL SHARPS INJURIES NO MATTER HOW TRIVIAL Blood and Body Exposure Management First Aid - bleed it, wash it, cover it, rinse eyes, mouth or nose with water. Report it - to your supervisor/NUM and Staff Health Clinic without delay to arrange management, counselling and documentation on exposure management form. After hours contact Emergency Department or after hours Resource / In-charge. Reportable exposures are: needle sticks; cuts; blood/body fluid; splashes to eyes, nose or mouth; and contamination of non-intact skin. Confidential follow-up – The Staff Health Nurse will notify you when your blood test results are available. The blood and body substances of all persons are potential sources of infection independent of diagnosis or perceived risk. All laboratory specimens are handled as potentially infectious. Specimens are to be transported in recommended leak-proof containers/bags. All staff practicing exposure-prone procedures must be aware of their HIV, Hep B and Hep C status annually. Also see: • Amendments to Professional Act regulations 1995/96. • NSW Health 2002/45 Infection Control Policy. • NSW Health 99/88 HIV & Hep B Infected Health Care Workers. • Occupational Screening and Vaccination against Infectious Diseases 2002/97. • Management of Health Care Workers Potentially exposed to HIV, Hepatitis B&C 2003/39 YOUR SAFETY IS YOUR RESPONSIBILITY!

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MOTOR VEHICLE SAFETY Depending on your role within Hunter New England Health you may at some stage be required to drive a Health service vehicle. The first requirement is that you produce a copy of your driver’s licence to your supervisor or Motor Fleet representative. This is an annual requirement. Many new staff are also new to the Hunter New England district. It must be recognised by all staff that driving in our large geographic area can be quite hazardous. Long distances are involved and much of the travel is done at the maximum allowable speed. Road conditions can vary from place to place with weather conditions changing dramatically within the same day. What may have been safe on a trip in the morning may be quite hazardous on the return trip the same afternoon/evening. Whilst the majority of motor vehicle travel is uneventful at some stage you may have to drive in difficult conditions remember you should always drive to the prevailing conditions. The other major driving hazard over which only you have control is fatigue. On long trips it is strongly recommended that driving duties be shared where possible and you break your trip every two hours. This is especially so on return trips. Remember ALWAYS wear your seat belt and report any maintenance or tyre problems.

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NOISE INJURY PREVENTION Whilst most areas in hospitals and health care facilities are not likely to cause damage to hearing, Hunter New England Health has identified some areas where staff may be at risk of sustaining a noise injury. Those staff are likely to be employed in the following areas: • • • • •

workshop / maintenance boiler room gardening plaster room (physiotherapy) mortuary attendants

As a condition of employment within these areas staff are required to have a hearing test with the closest Nurse Audiometrist within three months of commencing employment. You should ask your supervisor/manager to arrange your hearing test with the nearest Nurse Audiometrist as soon as possible after commencing. If you are working in any of the above areas you may be required to use personal hearing protection when undertaking some tasks. All staff are reminded of their obligation to comply with the Occupational Health and Safety Act and follow all safety requirements of the job.

WASTE MANAGEMENT OPERATIONS In August 1998 NSW Health issued the “Waste Management Guidelines for Health Care Facilities”. This document is available from your manager or supervisor and should be read as soon as possible as it describes the safe procedures for handling, storing and disposing of all hospital waste. The guidelines are designed to focus on key strategies of waste management in health care facilities and enable those facilities to attain a structured, committed, consistent and economically sustainable approach to waste stream management. They represent the result of consultation with WorkCover, Environment Protection Agency, the Waste Industry and health care workers. Within Hunter New England Health each facility has completed a generic Hospital Waste Management Plan and formed a local Waste Management Committee. Once this system is fully operational it is expected that a very accurate monitoring process will result allowing for improved waste stream management protocols. These protocols will satisfy the corporate aims of NSW Health as well as the legislative requirements of the Environment Protection Authority.

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ACCIDENT AND WORKERS’ COMPENSATION In NSW there is specific legislation covering Workers’ Compensation called the Workplace Injury Management and Workers Compensation Act 1998 (and associated legislation). The legislation requires the employer to pay compensation to workers for losses associated with legitimate work related illnesses or injuries. Employers are also required to provide rehabilitation for injured workers, and to encourage and support a return to productive work. If you experience a work-related injury or illness, you may be entitled to Workers’ Compensation. Compensation payments aim to recompense the injured or ill worker for out of pocket expenses including medical and hospital expenses, loss or damage to personal items, lost wages, permanent impairment, and the costs of rehabilitation. If you need to make a claim for Workers’ Compensation you must: • Inform your supervisor as soon as possible about the injury or illness. This will ensure that the injury is recorded. Delay may make it difficult to prove the injury was work related. This may delay or prevent your claim being accepted. • Consult a doctor to have your injury or illness assessed. You can see a doctor in emergency, or you may see your own doctor, or both. • If the doctor indicates you require time off work, or you wish to claim medical expenses, you must ask the doctor to provide you with a WorkCover Medical Certificate. • You must obtain a Workers’ Compensation Claim Kit from your supervisor or Human Resource Consultant, or the Risk Management Unit. Complete and submit the claim forms together with your medical certificate to your supervisor. • Once notified of your injury or illness contact will be made to assess your needs for rehabilitation. You may be required to attend an interview with qualified staff to enable this assessment to be done. • The claim forms must be submitted as soon as possible. Most claims will take up to 21 days to be accepted or denied. Since Workers’ Compensation benefits are not payable until the claim is accepted, you will initially need to take Sick Leave or Annual Leave. As soon as the claim is accepted these entitlements will be reimbursed to you. • Once the claim is accepted, Workers’ Compensation payments will start. • If the claim is not accepted, you will be advised about dispute resolution procedures. The resolution of a dispute about liability for a claim will require a formal conciliation process. Originals of all documents including accounts pertaining to your injury must be forwarded immediately to the Workers Compensation Claims Manager, c/- Tamworth Base Hospital (for the former New England AHS) or Workers Compensation Claims Officer, Waratah Health Campus PO Box 70 Waratah 2298 (for the former Hunter AHS or Lower Mid North Coast employees).

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OCCUPATIONAL REHABILITATION POLICY Policy Statement: Hunter New England Health is committed to the provision of a safe and healthy work environment and will so far as is possible ensure the restoration of any staff member suffering a work related injury or illness to the fullest physical, psychological, social, vocational and economic usefulness of which they are capable. Hunter New England Health is also committed to the provision of information and education to staff on their rights and responsibilities in relation to rehabilitation and an appropriate mechanism to resolve any disputes. Mandatory Procedures Managers, supervisors and team leaders 1) You must ensure that a Rehabilitation Coordinator is appointed for your facility, that they are appropriately trained, clearly identified, accessible to all staff and are supported in their endeavours to find suitable alternative duties for injured staff. 2) You must ensure the effective implementation, promotion, support and evaluation of the occupational rehabilitation policy and program in your area of responsibility. 3) You must ensure that staff under your control understand and follow associated procedures including those related to injury reporting and workers compensation. 4) You must provide training in the process, recognising in it the role of industrial unions. 5) You must initiate, with the assistance of the Rehabilitation Coordinator, an appropriate rehabilitation program for injured employees whose medical advice enables them to return to work. Rehabilitation Coordinators You must coordinate and monitor the rehabilitation and return to work program through suitable alternate duties where available and practicable. You must coordinate the referral to liaise with accredited rehabilitation providers where required. You must maintain the confidentiality of rehabilitation records. All employees must 1. take all reasonable care in the performance of your work so as to prevent workrelated injuries to yourself and others and cooperate with Hunter New England Health to enable legislative requirements imposed by the Act, Regulations and Guidelines to be met. 2. comply with relevant workers’ compensation and rehabilitation legislation and participate in any rehabilitation program to meet your needs and circumstances.

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3. notify your Manager/Supervisor of any occupational illness or injury as soon as possible. 4. notify your Manager/Supervisor of any problems regarding your rehabilitation program. 5. cooperate in reasonable workplace changes and rehabilitation programs to assist your rehabilitation or that of your fellow employees. 6. note that even though participation in a rehabilitation program is voluntary if you do not cooperate reasonably you may compromise your access to ongoing weekly compensation payments. Outcome sought Employees who have suffered workplace illness or injuries are engaged in a cooperative process with their employer in which, through a planned program of rehabilitation, they are restored to the fullest work role of which they are capable. You should seek out your hospital/facility Rehabilitation Coordinator for a copy of the rehabilitation process flowchart. This flowchart outlines the steps injured workers and managers need to follow in order to have a successful rehabilitation program.

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CULTURAL AWARENESS Migrant Health Hunter New England Health provides services to many patients with a non-English speaking background. The health service aims to ensure the right of equality of access to health care services regardless of a person’s cultural origin and language skills. It is the responsibility of all employees to treat patients in a way that demonstrates respect for them as individuals. Should you feel you need more awareness of how to deal with a patient of another culture, discuss this issue with your supervisor. The Migrant Health Unit, located in Newcastle, provides a resource for employees in the health system in its dealings with patients of a non-English speaking background. The Migrant Health Unit’s resources, which may be of help to you, include: •

The Health Care Interpreter Service, which provides interpreters in over fifty (50) languages including an after-hours emergency service. Consultation with interpreters on cultural matters is encouraged, support visits can be arranged and short translations organised.

•

Migrant Health Education Officers, who work with health professionals to design appropriate programs in community languages, develop multi-lingual education resources, provide cultural awareness training, and have charge of the multicultural resource materials.

•

Ethnic Health Workers whose role involves community development, health education programs, basic counselling and information and referral.

You can contact the Migrant Health Unit on (02) 49 246286. For after-hours emergencies, contact the Interpreter Service through Lifeline on (02) 49 615353.

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Aboriginal Health Aim NSW Health gives a high priority to ensuring that service provision not only provides access, equity and a quality of service to improve the health status but also has the capacity to respond to the cultural needs of the Aboriginal community. It is essential that Hunter New England Health staff understand the diverse nature of the Aboriginal community and be sensitive to the needs of both the individual and the community. Background Hunter New England Health has the highest number of Aboriginal people of any health area in NSW (ABS 2001 Census - first release figures). Aboriginal males Aboriginal females Aboriginal persons Total Population Aboriginal proportion of total local government area population

6,075 6,110 12,185 172,862 7%

• •

Aboriginal people are the least healthy of all Australian people Statistics show that Aboriginals in the Hunter New England Health area have lower living standards than other residents • The unemployment rate for Aboriginals is more than double that of non-Aboriginal population

POVERTY CYCLE

Education

Health

Employment

Housing • • • •

Without an education it is hard to find employment Without employment you can not afford proper housing Without proper housing our health suffers Without good health you can’t continue your education, therefore the poverty cycle will continue to go round and round for generations

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Social differences Murri

Non-Aboriginal

Family

Extended

Nuclear

Community

Inter-Dependent

Individualistic

Material Possessions

Shared by all

Owned by individuals

Sharing

Almost everything is shared

Keep it yourself

Money

Spend today

Save for the future

Education

Non-competitive Hands on

Competitive Futuristic

Death

Whole communities Whole towns Whole regions

Immediate family and friends

Employment

Lifestyle Present

Lifestyle Futuristic Materialistic

Religion

Spiritual Land

Ceremonies Rites

Physical Contact

Sign of acceptance Natural

Keep to yourself

Time

Take things as they come Seasonal

Governed by the clock

Land

Sacred Religious significance

For profit

Language

Aboriginal English

English

Social attributes Eye Contact

Male/female communications

Tone of voice

Name sharing

• • • • • • • • • • • •

To some Aboriginal people it is culturally unacceptable to look others straight in the eye Don’t force eye contact Listening doesn’t necessarily mean having to look at you Some cultural lifestyles don’t allow men and women to discuss issues freely Referred to as men’s business or women’s business Keep this in mind when discussing issues of a sexual nature Pay attention to your tone of voice Be encouraging and conversational Try not to use big words Act wisely educated Aboriginals will often share the same name It is not uncommon for Aboriginal people to be admitted to hospital under a completely different name to the one they are commonly known by in the community

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Deaths and funerals

Illiteracy

Registration of Births, Age Verification and Proof of Identity Change of address

•

Aboriginal people place a lot of significance on attending funerals of people in their community • To not attend a funeral is to lose face with the family of the bereaved • This also applies when someone is seriously ill or involved in a car accident Some Aboriginal people have literacy problems. This could be why they haven’t: • • • • • •

completed a form correctly attended a clinic kept an appointment followed directions for medications Carrying documents was never considered necessary Identification was usually established through family networks

•

Aboriginal people often travel long distances to visit family and friends and they sometimes stay for indefinite periods. • This can lead to problems with follow-up. • Reinforcing people’s obligations when changing address is one way of countering this problem.

Hospital attitudes Attitudes by hospital staff tend to upset many Aboriginal patients in Accident and Emergency and if they are left unattended for long periods, with no communication the patient feels unwanted and leaves without receiving medical assistance. They are then very reluctant to return and the condition deteriorates. The only time they will go back is when they are very sick and have to be transported by ambulance and admitted. Hospitals are really frightening to Murris • • • • •

they cannot relate to the isolation unfamiliar surroundings they feel withdrawn and uncomfortable the medical jargon with no explanation leaves them confused

Displaying posters, pamphlets and having Aboriginal staff helps to put Aboriginal patients at ease. All hospitals should have adequate waiting rooms with comfortable facilities. This would minimise the disturbance to staff and other patients. At times of death Aboriginals will travel long distances to be with the person concerned before they die. This may cause conflict with staff, however the patient will not be left to die alone. To die alone is foreign to Aboriginal culture. Page

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All of the previous attitudes also apply to Doctors surgeries and unless they are known to the surgery, Aboriginals can feel: • • •

alienated ignored intimidated

The Aboriginal flag The Aboriginal flag has been adopted by all Aboriginal groups and is flown or displayed permanently at Aboriginal centres throughout Australia. The Torres Strait Islander flag The Torres Strait Islander Flag - designed by the late Bernard Namok - stands for the unity and identity of all Torres Strait Islanders.

Aboriginal Flag

Torres Strait Islander Flag

Who is an Aboriginal or Torris Strait Islander person An Aboriginal or Torres Strait Islander person is someone who: • • •

is of Aboriginal or Torres Strait Islander descent identifies himself or herself as an Aboriginal person or Torres Strait Islander, and is accepted as such by the Indigenous community in which he or she lives

Each requirement must be satisfied!

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LEARNING AND DEVELOPMENT SERVICE (FOR HUNTER STAFF ONLY AT THIS STAGE) The Learning and Development Service is located on the Waratah campus in Turton Road, Waratah. The unit provides learning and development opportunities for staff and community partners. NSW Health is a Registered Training Provider and the Learning and Development Service offers a number of Vetab and WorkCover accredited training programs. The Waratah campus has a number of training rooms, three computertraining rooms and meeting rooms that can be made available to staff groups. The unit also provides specific consultancy and development activities at the requests of Hunter New England Health units and external clients. This includes customised programs such as customer service, dealing with difficult people and various aspects of safety training as well as facilitation of business planning groups and team development activities. A number of staff within the unit are accredited to administer the Myer-Briggs Type Indicator, a tool that can be used for individuals or teams to look at preferences in behaviour. Training programs are advertised twice per year via a calendar available by email or hard copy. Information regarding course learning outcomes and relevant course information can be obtained directly from the intranet site or from the Learning and Development Service by telephone on (02) 49 853230. Course fees are generally not paid by staff to attend courses at the Learning and Development Service. In some cases, a minimal charge is payable for learning materials. To apply to attend courses at the Learning and Development Service: •

• • • •

Complete a course application form - these are available to all staff with access to the intranet via the TAA (Training Administration and Approval system) or from the Learning and Development Service. If you do not have intranet access, your line manager can print out an application form for you. The applicant’s manager must authorise applications. Approval can be completed on-line. Completed forms should reach the Learning and Development Service as soon as possible and successful applicants for all courses will be notified by mail three weeks before course commencement. If a course is cancelled due to insufficient numbers of applications (a minimum of eight), applicants will be notified of alternative courses. Applications received less than three weeks before course commencement may be allocated course placement providing vacancies exist.

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TRAINING, APPLICATION AND APPROVAL SYSTEM (TAA) The Training, Administration and Approval System was designed and developed in response to the need to provide a more innovative and efficient method of collecting and processing standardised information about staff accessing all types of development opportunities. The system was designed to complement existing reporting systems and to manage the workflow associated with the application and approval of staff requests for study leave, conference/seminar leave, as well as learning and development course attendance. The system interfaces with Workforce and the Learning and Development Training record software system register. When an application is entered into the Training Administration and Approval system the software interfaces with Workforce. The applicant is identified and the relevant information pertaining to that individual is down-loaded into the application. The system also has the capacity to transfer and store the training records of health staff into the register, where an accurate and up-to-date record is maintained. It is the responsibility of each new employee to become familiar with using TAA. Operating guidelines, a manual and education can be obtained by contacting the TAA System Administrator on 4985 3239.

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CHILD PROTECTION Topics Page Important Contact Details ....................................................................................50 Risk of harm ........................................................................................................51 Assessing risk of harm .............................................................................51 Definitions of abuse and neglect .........................................................................51 Child physical abuse .................................................................................51 Child sexual abuse ...................................................................................51 Neglect .....................................................................................................52 Emotional abuse .......................................................................................52 Domestic violence ....................................................................................52 Indicators of abuse and neglect ..........................................................................52 Setting the context ....................................................................................52 Indicators of sexual abuse ........................................................................53 Indicators of possible physical abuse .......................................................53 Indicators of possible emotional abuse or physiological harm ..................54 Indicators of neglect .................................................................................54 Dealing with disclosures ......................................................................................55 Roles of Agencies ................................................................................................55 Role of NSW Health .................................................................................55 Role of NSW Police ..................................................................................55 Role of Department of Community Services .............................................56 Reporting .............................................................................................................56 Mandated to Report to DoCS ...................................................................56 Reporting information ...............................................................................56 Who to report? ..........................................................................................56 How to report? ...........................................................................................56 Information DoCS may require when making a report ..............................57 Protection for workers ...............................................................................57 Information provision ...........................................................................................57 Best endeavours .......................................................................................58 Requests for Service under s.17 and s.85 of the Act ................................58 Flowchart for dealing with Requests for information from DoCS ..............58 Flowchart for dealing with Best Endeavours Request for DoCS ...............59 Documents to be aware of NSW Health Services Frontline Procedures for the Protection of Children and Young People, December 2000. NSW Interagency Guidelines for Child Protection Intervention, 2000 Edition. 2001/123 - Notification of Suspected Child Abuse and Neglect and Exchanging Information in Child Protection Investigations.

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Important Contact Details Department Of Community Services Mandatory reporters Helpline: ............................................................133627 Public Helpline: ..................................................................................132111 DoCS fax number: ..............................................................................9633 7666 Sexual Assault Services Coordinator Northern Region .............................................................6766 2555 Moree .................................................................................................6757 3632 Narrabri ..............................................................................................6799 5100 Gunnedah ..........................................................................................6740 2888 Armidale .............................................................................................6776 4738 Glen Innes ..........................................................................................6730 2166 Inverell ................................................................................................6728 8411 Tamworth ...........................................................................................6766 2555 Taree ......................6551 5443 or ring Community Health 6592 9315 & ask or a Sexual Assault Counsellor. After Hours Crisis 6592 9111 then ask to have the Sexual Assault Counsellor paged Coordinator Southern Region ..............................................................4924 6333 Lower Hunter ......................................................................................4933 4422 Upper Hunter ......................................................................................6542 2050 PANOC Services Coordinator Northern Region .............................................................6757 3647 Armidale .............................................................................................6776 4738 Tamworth ...........................................................................................6766 2555 Coordinator Southern Region .............................................................4924 6294 Muswellbrook .....................................................................................6542 9123 Taree ............................................................................6592 9698 or 6592 9699 Aboriginal Child Protection ....................................... 6592 9696 or 0409 783605 Employee Assistance Program (EAP) Northern Region .................................................................................6767 7165 Southern Region ..............................................................................4921 2822 Taree .............................................................................6592 9417 or 6592 9715 Mater Hospital ...............................................................................1800 811 951 Sydney Rape Crisis Centre For adults who have been recently sexually assaulted ..................02 9819 6565 NSW Country .................................................................................1800 654 119 TTY ................................................................................................02 9181 4349 Dympna House For adults who were sexually assaulted as children ......................02 9797 6733 NSW Country .................................................................................1800 654 119 TTY ................................................................................................02 9716 5100 Lifeline

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Risk of Harm The Children and Young Persons (Care & Protection) Act 1998 states that a child or young person is at risk of harm if current concerns exist for the safety, welfare and wellbeing of the child or young person regarding: a) The child or young person’s basic physical or psychological needs b) Necessary medical care c) Physical abuse, sexual abuse or ill-treatment d) Domestic violence and serious physical or psychological harm e) Serious psychological harm Assessing risk of harm Risk of harm refers to the likelihood that a child or young person may suffer physical, psychological or emotional harm as a result of what is done (physical, sexual or emotional abuse) or not done (neglect) by another person, often an adult responsible for their care. Agencies and practitioners are required to make judgments about risk of harm to a child or young person from abuse or neglect. Elements to assist in decisions about risk of harm to children and young people may include: • •

The age, development, functioning and vulnerability of the child or young person. Behaviour which suggests they may have been or are being harmed by another person. • Behaviour from another person, that has had, or is having, a demonstrated negative impact on their healthy development, safety, welfare and well-being (for example, drug and alcohol abuse or domestic violence). • Contextual risk factors, for example, recent abuse or neglect of sibling, or a parent recently experiencing significant problems in managing behaviour. • Emotional, physical or psychological well-being is significantly affected as a result of abuse and neglect. (Adapted from the Interagency Guidelines for Child Protection Intervention, 2000)

Definitions of Abuse and Neglect Child physical abuse Assault, non-accidental injury or physical harm of a child or young person by a parent, care giver or other person responsible for the child or young person, or a sibling or other child or young person in the household. It includes injuries or harm which are caused by: excessive discipline; beatings or shakings; bruising, lacerations or welts; burns; fractures or dislocations; female genital mutilation; attempted suffocation or strangulation. All of these may result in the death of a child or young person. Child sexual abuse Any sexual act or sexual threat imposed on a child. Adults and adolescents who perpetrate child sexual abuse exploit the dependency and immaturity of children. Coercion, which may be physical or psychological, is intrinsic to child sexual abuse and differentiates such abuse from consensual peer sexual activity.

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Neglect Where there is risk of harm or actual harm to a child or young person caused by the failure to provide the basic physical and emotional necessities of life. Neglect may be an ongoing situation and can be caused by a repeated failure to meet the basic psychological needs of a child or young person. Emotional abuse Emotional abuse covers a range of behaviours that may cause psychological harm to a child or young person by a parent, care giver or older person that can damage the confidence and self esteem of a child or young person resulting in serious emotional deprivation or trauma. Emotional abuse includes a child or young person living in a situation of domestic violence. Serious psychological harm involves an impairment of, disturbance or damage to a child or young person’s cognitive, emotional, behavioural or social development. Domestic violence Violence, abuse and intimidatory behaviour perpetrated by one person against another in a personal intimate relationship. It is partnership violence that includes violence perpetrated when couples are separated or divorced. It occurs when one person has power over the other causing fear, physical and/or psychological harm. It can have a profound effect on children and young people and constitutes a form of abuse. (Source: Interagency Guidelines for Child Protection Intervention, 2000)

Indicators of Abuse and Neglect One indicator in isolation may not imply abuse or neglect. Each indicator needs to be considered in the context of other indicators and the child’s or young person’s circumstances. The lists are not in hierarchical order. Setting the context The following factors in the life circumstances of the child or young person are relevant when considering indicators of abuse and neglect: • •

History of previous harm to the child or young person Social or geographic isolation of the child, young person or family, including lack of access to extended family or supports • Abuse or neglect of a sibling • Family history of violence including injury to children and young person • Domestic or dating violence Physical or mental health issues for the parent or caregiver affecting their ability to care for the child or young person: •

The parent or caregiver abuse of alcohol or other drugs affecting their ability to care for the child or young person

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• • • • •

Deficiency in functional parenting skills required to provide for the safety, welfare and well-being of children and young people The parent or caregiver is experiencing significant problems in managing the child’s behaviour The parent or caregiver has unrealistic expectations of age appropriate behaviour in the child or young person The parent is experiencing significant problems relating to the young person The parent has a mental illness

Indicators of sexual abuse Indicators in children and young people: • describing sexual acts • directly or indirectly disclosing self-destructive behaviour eg. drug dependency, suicide attempts, self-mutilation • bruising or bleeding in the genital or anal areas • sexually transmitted diseases • adolescent pregnancy • child or young person being in contact with a known or suspected perpetrator of sexual assault • unexplained accumulation of money and gifts • persistent running away from home • regressive behaviour eg. sudden return to bed-wetting or soiling • sexual knowledge or behaviour inappropriate for the child's age Indicators in parents or caregivers: • exposing the child or young person to inappropriate sexual material, eg, pornographic magazines • exposing the child or young person to prostitution or child pornography or using a child or young person for pornographic purposes • intentional exposure of child or young person to sexual behaviour of others • ever committed/been suspected of child sexual abuse • coercing the child or young person to engage in sexual behaviour with other children • denial of adolescent's pregnancy by family

Indicators of possible physical abuse Indicators in children and young people: • facial, head and neck bruising • lacerations and welts • explanation offered by the child, young person or carer, is not consistent with the injury • other bruising and marks which may show the shape of the object that caused it eg. belt buckle, hand print, bite marks and scratches • multiple injuries or bruises • fractures of bones, especially in children under three years • burns and scalds

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•

head injuries where the child may show signs of drowsiness, vomiting, fits or retinal haemorrhages, suggesting the child may have been shaken • general indicators of female genital mutilation which could include: having a special operation associated with celebrations, difficulties in toileting and reluctance to be involved in sport or other physical activities where the child or young person was previously interested

Indicators in parents or caregivers: • direct admissions by parents or caregivers that they fear they may injure the child or young person • family history of violence including previous harm to children • history of their own maltreatment as a child • repeated presentations of the child or young person to health or other services with injuries, ingestions or with minor complaints Indicators of possible emotional abuse or physiological harm Indicators in children or young people: • expressing feelings of worthlessness about life and themselves • inability to value others • lack of trust in people • lack of people skills necessary for daily functioning (eg. communication) • extreme attention-seeking behaviour • other behaviours eg. bullying, aggressiveness, violence • exposure to domestic violence Indicators in parents or caregivers: • constant criticism, belittling, teasing of a child, or ignoring or withholding praise and affection • excessive or unreasonable demands • persistent hostility and verbal abuse, rejection and scapegoating • belief that a particular child or young person is bad or 'evil' • using inappropriate physical or social isolation as punishment • exposure to domestic violence Indicators of possible neglect Indicators in children or young people: • poor standards of hygiene eg. child consistently unwashed • scavenging or stealing food • reluctance to go home - extended stays at school, public places, others' homes • extreme longing for adult affection • flat and superficial way of relating, lacking a sense of genuine interaction • self-comforting behaviour, eg, rocking, sucking • anxiety about being abandoned

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Indicators in parents or caregivers: • failure to give adequate food, shelter, clothing, medical attention • failure to provide the child or young person with appropriate supervision • lack of appropriate emotional interaction with the child or young person • abandoning the child or young person • depriving or withholding physical contact or stimulation for prolonged periods (Adapted from the Interagency Guidelines for Child Protection Intervention, 2000)

Dealing with Disclosures Disclosure can be a time of crisis for children or young people, or for adults disclosing situations of abuse or neglect. • Remain calm • Discuss in private • Listen to the child’s story • Do not question the child (further) • Reassure them that they have done the right thing and that it is not their fault • Use appropriate language • Avoid confronting the suspected offender • Explain to the child what you are going to do to arrange help • Ensure the child is comfortable and not left in a position where they may be pressured to change their story • Consult as appropriate • REPORT TO DOCS and consult them about what action to take • Seek help for yourself

Roles of Agencies Role of NSW Health • Recognise and report children and young people who are suspected of being at risk of harm from abuse and/or neglect • Provide crisis counselling, ongoing counselling and medical examinations for children and young people who have experienced abuse and/or neglect • Offer preventative and educational programs for health workers and communities • Offer special programs for children, young people and families who have experienced abuse and/or neglect Role of NSW Police • Recognise, report and investigate child abuse and neglect – through Local Area Command or Child Protection Investigation Team • Initiate legal proceedings for child abuse and neglect offences under the Crimes Act 1900 and the Children and Young Persons (Care and Protection) Act 1998 • Designated authority for applying for AVO’s on behalf of children and young people

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Role of Department of Community Services • Provide or arrange services when a request for assistance is received • Receive and assess reports of children and young people and investigate when there is a likelihood of risk of harm • Conduct joint investigations of CSA and serious physical abuse, with the Child Protection Investigation Team • Undertake risk and needs assessments • Gather evidence and initiate care proceedings before Children's Court • Monitor the child, young person and family • Provide out-of-home care and support services to children and young people.

Reporting Mandated to Report to DoCS All Health workers are also ministerially directed to report children at risk of harm. Concerns about safety, welfare and well-being should be “current” at the time of making the report, eg. • •

Concerns about child’s current contact with an alleged offender A child’s current reaction to past abuse

Reporting information A report is information given to DoCS relating to a concern on reasonable grounds about the safety, welfare or well-being of a child or young person. •

Persons in the course of professional work, or paid employment delivering health care to children • Or who hold a management position • And have reasonable grounds to suspect that a child is at risk of harm Who to report? Health workers MUST report children under 16 years if there are reasonable grounds to suspect they are at risk of harm, health workers MAY report: • • • • •

Young people aged 16-17 years A class of children or young people Pre-natally Homelessness of a child Homelessness of a young person – only with their consent

How to report? • Consider the risk of harm • Where possible consult with manager/supervisor • Arrange for child, young person and/or family to participate – if safe • Have key information ready when calling • Call the DoCS Helpline on 133627 • Complete required documentation • Feedback to reporters Hunter New England Area Health Service Orientation Handbook

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Information DoCS may require when making a report • The name or description of the child or young person, or class of children • The current whereabouts of the child or young person • Whether “risk of harm” is related to a staff member of an organisation • When the child was last seen • The name and address, if known, of the person suspected of abusing the child or young person and if possible occupation • Whether a language or sign interpreter may be required, or support is required for a person with a disability, or an Aboriginal agency should be involved • All available information relating the safety, welfare and well-being of the child or young person • The reasons for concerns about “risk of harm” • The child or young person’s views about the report, if known • Events, conversations and observations that lead to concern – these should be recorded and available for reference • Information about the child’s or the young persons’ s history, current circumstances and their views • Information about the parent or family • Information about relationships • Information about the agency’s role and relationship with the child, young person and family Protection for reporters Protection is afforded to a health worker making a report in good faith, or providing information to DoCS. It does not constitute: •

a breach of professional etiquette, ethics or departure from accepted standards of professional conduct • grounds for liability for defamation • grounds for civil proceedings for malicious prosecution or conspiracy • and cannot be admitted in evidence against the reporter in any proceedings. Information Provision Section 248 – Provision and exchange of information • DoCS can request information from Hunter New England Health to progress investigations, assessment and case management • DoCS may also provide Hunter New England Health with information – if in the best interests of child or young person • Information requests must go through central contact point, unless in an urgent situation • Information must not be given over the phone • Information should only be provided which is relevant to the safety, welfare or wellbeing of a child or young person Entire medical records files should not be photocopied, unless all material is relevant.

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Best endeavours •

DoCS can request a service from Hunter New England Health, asking that “best endeavours” be used. • It means “to exercise a genuine and considered effort to respond to a request for services to promote and safeguard the safety, welfare and well-being of the child or young person” Requests for Service under s.17 and s.85 of the Act should be met unless: • The service requested is not currently provided by the service • The service requested is not consistent with the service responsibilities • Providing the service would prejudice the discharge of the service functions If a service is at capacity, priority should be given to “best endeavours” requests on any waiting list unless there are demonstratable acute clinical reasons for other referrals to take precedence. s.17 – D.G’s request for assistance from other agencies s.85 – Provision of services to facilitate restoration Flowchart for dealing with Requests for information from DoCS Request for information from DoCS

Area PANOC Coordinator

Health Service Health Worker

Request sent to Health Service/s

Forward request to Area PANOC Coordinator

Response prepared using form

Response sent to Area PANOC Coordinator

Response checked and sent to DoCS

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Flowchart for dealing with Best Endeavours Request for DoCS Best Endeavours Request from DoCS

Sent to Manager of Health Service

Sent to Health Worker

Respond to request using "Response form for Best Endeavours"

Send to Manager of Health Service

Indicate acceptance or non acceptance Indicate reasons

Return response to DoCS

Forward a copy of Request and response to Area PANOC Coordinator

Provide update 6 weeks later to PANOC Coordinator

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UNION DETAILS New England Employees

Hunter Employees

Health Services Union (HSU) Local Organiser - Mr Bob Frank

Local Organiser - Mr Bob Hull

Mr Bob Frank Organiser Level 3, 437 Peel Street TAMWORTH NSW 2340

Mr Bob Hull Organiser Summerland Centre, Suite 3, Level 1 68 Nelson Street WALLSEND NSW 2287

Phone:

Phone: Fax:

02 6766 9499

02 4955 0055 02 4955 0044

NSW Nurses Association Local Organiser - Robyn Starkey

Local Organiser - Robyn Starkey

PO Box 40 CAMPERDOWN NSW 2050

PO Box 582 HAMILTON NSW 2303

Phone:

Phone: Fax:

1300 367 962

1300 367 962 02 4969 2927

Australian Salaried Medical Officers Association (ASMOF) Local Organiser – Sim Mead Locked Mail Bag 13 GLEBE NSW 2037 Phone: 9212 6900

Suite 46, Level 3, 330 Wattle Street ULTIMO NSW 2007 Phone: 9212 6900 Fax: 92126911

Construction Forestry Mining and Energy Union Local Organiser – Steve Lobb Locked Bag 1, QVB Post Office 44 Market Street SYDNEY NSW 1230 Phone:

9394 9494

Devonshire House, Devonshire Lane NEWCASTLE NSW 2300 Phone: Fax:

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02 4926 2188 02 49262202

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Electrical Trades Union Local Organiser – Rob Alexander Level 5, 370 Pitt Street SYDNEY NSW 2000 Phone: 9267 4844

Suite 305, 3rd Floor, Iron Workers Centre 161 Maitland Road MAYFIELD NSW 2304 Phone: Fax:

02 4968 2488 02 4968 3466

Plumbers Association Local Organiser – Steve McCarney PO Box 250 PARRAMATTA NSW 2124

161 Maitland Road MAYFIELD NSW 2304

Phone:

Phone: Fax:

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9893 7822

02 4968 0933 02 4968 0955

Hunter New England Area Health Service Orientation Handbook

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Hunter New England Area Health Service Orientation Handbook

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