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SAS Staff health care procedures dispute update

  13 May 2016

SAS Staff health care procedures dispute update – May 2016 (PDF version)

The É«ÀÇÉçÇøcontinues to be contacted by concerned members who feel pressured into performing heath care procedures. In particular, members are being requested to perform catheterisation under ‘special considerations’ applications.

Many of our members may have read the past two bulletins on this issue available at the following links:

• Bulletin 10 March 2016 – /psa-secures-positive-progress-on-draft-health-care-procedures-manual/

• Bulletin 17 March – special consideration. /school-administrative-and-support-staff-school-enrolment-process/

The bulletin on 10 March 2016 informs the membership that the É«ÀÇÉçÇøhas notified a dispute in relation to health care procedures. On 7 April 2016, the É«ÀÇÉçÇøattended a second dispute meeting with the Department on the health care procedures. At the meeting two crucial developments occurred:

1. The Department conceded the NSW Nurses and Midwives Association (hereafter ‘NSWNMA’) are a key stakeholder to this matter and will be invited to future dispute discussions.
2. The É«ÀÇÉçÇøwas presented with a snapshot of the health care procedures training and kit used in delivering the training. The É«ÀÇÉçÇøbecame extremely concerned regarding the lack of information on the risks associated with health care procedures particularly catheterisation. SLSOs must be given all the information about what they are volunteering to do and the possible risks associated with these medical procedures.

The É«ÀÇÉçÇøwrote a letter to the Department following on the meeting. To read this letter please HERE.

The risks of catheterisation

The É«ÀÇÉçÇøhas sought medical advice from the NSW Nurses and Midwives Association (NSWNMA) regarding the potential risks of undertaking catherisation. The NSWNMA has provided a copy of the Clinical Guidelines available HERE.

Page 10 of these guidelines refers to the complications of catheterisation. The NSWNMA have also provided an explanation of these complications and risks in plain language. Some of the risks include (but are not limited to):

• Pressure necrosis – when pressure is applied to an area for too long, it can cause an ulcer or sore to form.

• Long term catheterisation can lead to urethral trauma – due to having a catheter in place for some time the irritation caused by the catheter causes injury to the tube that carries urine from the bladder to outside the body.

• Erosion or tearing primarily of the urethral meatus – a rubbing or contact irritation from the presence of a catheter, causing the skin to wear down or tear at the opening of the urethra (which is a tube that carries urine from the bladder to outside the body).

• Pain and discomfort – pain and discomfort is an unpleasant physical sensation of varying intensity, as an alarm in response to injury.

For further information on the meaning of the terminology used on page 10 please click HERE.

Member feedback to the É«ÀÇÉçÇøsuggests the Department is not fully disclosing the associated risks with volunteering to undertake these procedures. If at any stage you feel uncomfortable about volunteering to perform health care procedures you are within your rights to withdraw. The É«ÀÇÉçÇøreminds you this is not part of your core duties and the É«ÀÇÉçÇøis here to support members if required. If you have concerns please contact the É«ÀÇÉçÇøon the dedicated schools email: .

The É«ÀÇÉçÇøwishes to ensure members are educated and understand what they are volunteering to do and the risk factors associated. Members are encouraged to contact the É«ÀÇÉçÇøif they feel pressured or bullied into undertaking these procedures or if they feel their employment is at risk if they don’t volunteer.

Health care procedures and indemnity

The É«ÀÇÉçÇøalso advises members to consider the potential legal issues when undertaking health care procedures. While members are told they are protected from legal repercussions it comes with exceptions. Exceptions to vicarious liability (i.e. when the employer is liable for you) include actions that are not in the course of your employment. The question of what is in the course of one’s employment can be a complex legal question and varies from case to case. Questions to consider are whether an SLSO acting without the supervision of a teacher is protected. Also, if an SLSO does not participate or follow training instructions, this also raises questions of whether the exceptions to liability apply. Before you agree to undertake health care procedures, ask yourself: am I confident the Department will indemnify me?

É«ÀÇÉçÇøreminder to members regarding health care procedures

Health Care Procedures are voluntary and no SLSO can be directed to undertake any health care procedures unless they are willing and comfortable in doing so.

In addition, the É«ÀÇÉçÇøreminds members that prescribed medications and first aid are also voluntary. As previously mentioned, you cannot be directed to undertake these duties.

If members choose to volunteer to undertake first aid, prescribed medications or health care procedures they must be in receipt of the allowance and be trained.

Related development – student injections

The É«ÀÇÉçÇøhas been made aware some SAS staff have been asked to administer injections to students. The É«ÀÇÉçÇøstrongly objects to this and advises members NOT to perform this task. The only exception to this is administering Epi-pens, which are a whole-of-school staff responsibility. The É«ÀÇÉçÇøhas written to the Department requesting consultation on this issue. The letter can be viewed HERE.