SPRING 2015 Northern The Health Times

northernhealth times

theSPRING 2015

NEWS FROM NORTHERN ADELAIDE LOCAL HEALTH NETWORK

2 | Northern Adelaide Local Health Network

From the CEO 3

Oh baby! Lyell sets new birthing record 3

New technology a game changer for detecting precancerous lesions 4

Cancer patients among first to test immune-boosting therapy 5

The power of music and volunteering 6

Introducing the Northern Health Network 6

Strengthening support for Aboriginal women and children 7

Unlocking the preeclampsia and heart disease connection 8

Mother’s milk, the best medicine 9

Emergency Nurse Practitioner earns national praise 10

Nursing duo bid fond farewell 11

Our People 11

Lift ‘em Foot for City to Bay 12

ContentsNorthern Adelaide Local Health Network The Northern Adelaide Local Health Network (NALHN) provides care for approximately 350,000 people living in the northern metropolitan area of Adelaide, as well as providing services for people from regional areas. NALHN will service almost half a million South Australians by 2016.

More than 4000 staff provide high quality patient care, education, research and health promoting services. Our health services include:

• Lyell McEwin Hospital and Modbury Hospital

• Primary health, sub-acute and transitional care services including GP Plus Health Care Centre Elizabeth and GP Plus Super Clinic Modbury with a satellite site at Gilles Plains

• Watto Purrunna Aboriginal Primary Health Care Service sites Muna Paeindi, Kanggawodli, Maringa Turtpandi and Wonggangga Turtpandi

• Northern Mental Health services across community and hospital settings, including youth, adult and older persons mental health services. Community services include a walk-in service, community rehabilitation centres and a 24 hour emergency response team. Forensic mental health services are also provided at James Nash House.

For more information about our services visit www.sahealth.sa.gov.au/NALHN

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The Northern Health Times is published by the NALHN Media and Communications team.

If you have a news story, feedback or wish to be added to our mailing list, please email: [email protected]

Hello and welcome to the Spring issue of The Northern Health Times.

It gives me great pleasure to open this edition by sharing a significant milestone celebrated by the Northern Adelaide

Local Health Network in recent months. As you will read in the adjacent article, our Women and Children’s Division – which is centred at Lyell McEwin Hospital and receives valuable support from Modbury Hospital – recently recorded its highest yearly total of deliveries. This rising figure is indicative of the rapidly growing community we work so diligently to serve and I would like to acknowledge all staff from our Women and Children’s Division for delivering such exceptional care to local families.

As the weather continues to improve, I would also like to recognise the efforts of all staff in managing another extremely busy winter period. The increased demand on hospital services has been challenging and I am very proud of our Network for coming together to manage this demand with such resilience and professionalism. Our Network is committed to ensuring our community receives timely access to emergency care and I am pleased to share, that as a result of our whole-of-organisation approach to improvement, patients are now spending less time waiting in our emergency departments (ED). Average ED visit times at Modbury Hospital have decreased by 68 minutes when compared to the same time last year, while the Lyell McEwin ED has achieved a 34 minute reduction. These are significant achievements, as they have very tangible benefits for our community, and I would like to commend all staff, particularly our emergency colleagues, for their ongoing efforts.

As the state’s health complexities continue to change, our Network is focused on adopting new ways of working to ensure people get the right care, at the right time, in the right place. We strive to make sure patients progress efficiently through their hospital experience, ensuring both the patient and broader community receive improved access to care. We are working towards amalgamating NALHN’s two hospital-based bed manager roles into a single Network-wide position, providing a strategic ‘aerial view’ of beds across our system. Operating out of a new Central Flow Unit, our Hospital Flow Manager will ensure beds at both sites are used as efficiently as possible for our community.

Jackie Hanson Chief Executive Officer Northern Adelaide Local Health Network

From the CEO

The 2014/15 birthing tally topped the 2013/14 count of 3489, and marks a staggering 65 per cent increase on the total number of babies born in 2006/07.

Lyell McEwin Hospital is now one of the state’s largest service providers for pregnant women, operating as the primary maternity hospital for Adelaide’s northern suburbs, the Barossa, Clare Valley and Yorke and Eyre Peninsulas.

Northern Adelaide Local Health Network Executive Director of Nursing and Midwifery, Adjunct Associate Professor Vanessa Owen, said Lyell McEwin was situated in a rapidly growing community, with a dedicated team of staff assisting with the birth of nine babies on average per day.

“This is a fantastic achievement and I would like to acknowledge the hard work of all staff involved,” she said. “This skilled team provides women and their families with high-quality care to ensure babies born at Lyell McEwin get the best start in life.”

“Our hospital provides world-class maternity care for pregnant women and is regarded as one of the most innovative maternity hospitals in the state. We are also among a handful of Australian hospitals that have held Baby Friendly Hospital accreditation through the World Health Organisation for more than 15 continuous years.

“I am proud of our efforts, our staff and the quality of our facilities, which assist us to deliver the best outcomes for our patients.”

Vanessa said the hospital’s Special Care Nursery had recently undergone a significant change in service, now offering

a comprehensive program of new treatment options for babies born with acute respiratory complications.

“Over the past 12 months, our Special Care Nursery staff have enthusiastically embraced both theoretical and practical education and training to enhance our specialist program of services,” she said.

“This has resulted in many babies remaining at Lyell McEwin, instead of being retrieved by MedSTAR and taken to the Women’s and Children’s Hospital or Flinders Medical Centre for care. This means more mothers and babies are being kept together, strengthening their parent-baby bond and reducing stress related to separation.”

First-time mum from Mawson Lakes Rhea Jacobs gave birth to her daughter Evie May Johnston at Lyell McEwin in August. Evie was one of 313 babies born throughout the month.

“Evie’s dad and I found the staff at Lyell McEwin to be fantastic, which made the whole process as new parents so much easier,” Rhea said. “They were really supportive and helped me stick to my birth plan to achieve the birth that I wanted which was great.”

For more information or to arrange a tour of the hospital’s state-of-the-art birthing facilities and postnatal wards, please contact Lyell McEwin’s Parent Educator on 8182 9431.

A record 3581 babies were born at Lyell McEwin Hospital in 2014/15, marking the highest number of yearly births since the hospital’s founding in 1959.

Born in August 2015, Evie May Johnston is one

of a growing number of babies born at

Lyell McEwin Hospital.

Oh baby! Lyell sets new birthing record

www.sahealth.sa.gov.au/NALHN | 3


New technology a game changer for detecting precancerous lesions

Lyell McEwin Hospital is one of just two locations worldwide trialling a new ‘super-magnifying’ camera system, which could dramatically change the way doctors diagnose patients with precancerous conditions.

Pictured (from left) are Eduardo Munsayac,

Dr Cheong Kuan Loong, Janice Miller, Dr Hanna

Ruszkiewicz, Angelie Ashby and Associate Professor Raj Singh.

Live-footage of the gastrointestinal tract displayed on the high-definition video monitor.

The new technology could offer a faster way to detect early signs of cancer, potentially without the need for a biopsy. The new Endocytoscope – a flexible digital device used to look inside the body – has a more than 450-fold magnifying power on a video monitor.

This world-leading research is being undertaken by Head of Gastroenterology at Lyell McEwin Associate Professor Raj Singh.

“This is an exciting time for the hospital,” Raj said. “This is a brand new technology developed in Japan and it is a privilege to be the only hospital in Australia to test it.”

“The Endocytoscope can be used to assess patients presenting with not only premalignant lesions but also for conditions such as coeliac disease and inflammatory bowel disease.”

Currently patients are diagnosed with a condition using a biopsy, which involves removing a sample from the body and sending it to the lab for a pathologist to examine. The patient is then called back to the clinic at a later date to review the results, explained Raj – a leading Australian gastroenterologist.

“The new scope will enable us to magnify the lining of the gastrointestinal tract 450 times and allows us to look at living cells in ‘real time’ similar to what a pathologist sees using a microscope,” he said.

“For the patient this will mean an accurate diagnosis can be made in line with what the pathologist will tell us, potentially negating the need to obtain a biopsy.

“The Endocytoscope will allow gastroenterologists to look for any abnormal changes in the gastrointestinal tract and see if we can diagnose and treat the condition right away.

“Diagnosis and treatment could potentially take place in one sitting which could be hugely beneficial for our patients.”

While doctors at Lyell McEwin Hospital are already diagnosing precancerous conditions using ‘magnification’ scopes not commonly used in Australia, Raj said this new technology was a significant advancement.

“Present scopes we have been trialling enable us to magnify specific areas of interest by about 70 to 80 times,” Raj said.

“This is good but we are only predicting microscopic cell structures whereas the

Endocytoscope enables us to see the structures with the ultra-high magnification it offers.”

Fifteen patients have been assessed using this technology so far at Lyell McEwin Hospital. Initial results are promising with similar diagnoses drawn using the Endocytoscope and biopsies – the current gold standard for diagnosis.

““This is a brand new

technology that has been developed in Japan

and it is a privilege to be the only hospital in

Australia to test it.


The Northern Adelaide Cancer Centre includes a dedicated chemotherapy area, six clinic rooms

and two linear accelerators.

Patients referred to the Northern Adelaide Cancer Centre at Lyell McEwin Hospital are trialling immune based treatments in addition to, or as an alternative to, current lung, kidney or urinary bladder cancer therapies such as chemotherapy.

Lyell McEwin is one of just two hospitals in Australia trialling immunotherapy medication among patients with advanced urinary bladder cancer, and the only hospital in South Australia testing the medication to treat kidney cancer.

This new type of treatment is fast becoming known as a game-changer in the fight against cancer, promising greater potential than current treatments.

Director for Cancer Research and Clinical Trials Dr Rohit Joshi said this ground-breaking treatment had been well received by patients across the state, with more than 30 people electing to participate in the various trials so far.

“Starting in 2014, our lung and kidney cancer trials have seen strong interest from patients where current treatment is not optimal,” Dr Joshi said.

“We are the only hospital in South Australia trialling this medication for patients with small cell lung cancer and kidney cancer.

“We are also one of only two centres in

Australia undertaking an advanced urinary

bladder cancer study, with the only other

site located in New South Wales. This has

resulted in both public and private patients

being referred to us, which is a first for Lyell

McEwin Hospital.”

Patients receiving the immune-based

treatment visit the hospital once every two

to three weeks where the medication is

administered via an intravenous drip.

“Ultimately we are trying to find treatments

to improve the standard of care for cancer

therapy as a whole,” Dr Joshi said.

“Patients are here for about an hour and

then get on with life. There is no hair loss

and the side effects are relatively minimal,

unlike chemotherapy.”

Nivolumab is the immunotherapy drug

being tested at Lyell McEwin. The drug

targets a protein known as “programmed

death one” (PD-1), which stops the immune

system from recognising and attacking

cancer cells.

“The new class of medications alter the

PD-1 receptors and re-activate the body’s

defence system to kill the cancer cells,”

Dr Joshi said.

“Immune based treatments may also offer longer-term protection against the disease.

“The hope is that by next year, this research data matures and these medications will become standard care throughout the world.”

For more information about cancer trials and studies, please contact Dr Rohit Joshi or Dr Julie Rowe at the Cancer Research Unit on 8182 9494.

Northern cancer patients who have exhausted existing treatments are now among the nation’s first to trial a new class of medications which harness the body’s own immune system to attack cancerous cells.

• Cancer research has been occurring at Lyell McEwin Hospital for over 15 years, with the hospital initially working as a satellite site of The Queen Elizabeth Hospital.

• The Cancer Research Unit started working independently in 2013 and has developed a diverse portfolio of cancer studies including lung, kidney, bowel, breast and renal cancers.

Fast facts...

Cancer patients among first to test immune-boosting therapy

Director for Cancer Research and Clinical Trials Dr Rohit

Joshi, pictured with patient Elinor Sedman of Lyndoch.

RESEARCHING FOR THE FUTURE


Hospital volunteer Glenyss Barker has been playing the hand-made instrument to palliative care patients at Modbury for more than three years.

The sound is powerful and soothing, explained Joan Prinnz – the wife of a former patient, her husband of over 30 years.

“My husband Klaus was taken to the Emergency Department for testing due to illness and had slipped into a coma-like state. He was then transferred to the palliative care ward,” Joan said.

“I was with my husband, family and his best friend when I suddenly heard music being played. I was holding my husband’s hand tightly when to our amazement, he opened his eyes, smiled and uttered the word ‘Beautiful’ – it was such an emotional experience and it gave us all a glimmer of hope.

“Arrangements were made for another visit that week and Glenyss played for Klaus in front of our family and friends. Klaus again clutched my hand tightly and uttered the word ‘Beautiful’ as tears rolled down his cheeks. He did not open his eyes this time but he said the words ‘Going home’ in reference to the composition being played.”

Music had been a very important part of Klaus’ life, explained Joan.

“While it was playing Klaus’ fingers were moving as though he was playing the cello and we were all so stunned,” she

said. “News of this incident spread quickly

among staff and patients, and although it

did not bring recovery, we now have fond

memories of an amazing event – we should

never underestimate the power of music

and especially the power of volunteering.”

Glenyss was inspired to play for patients

after watching a television program on

Peter Roberts, Australia’s only fully

qualified music thanatologist –

a professional field which unites music

and medicine in end-of-life care.

“I went and did a course in Melbourne,

purchased a harp and I have been playing

ever since. I really do believe it helps not

only the patient but those who are left

behind,” she said.

“I play a variety of music hoping that at

least one piece will resonate, from classical,

Celtic, folk and even Waltzing Matilda.”

“I have had people say that it must be sad

playing in the palliative care ward but I

don’t find it so, as the place is full of love.

The staff and volunteers do an amazing job

for people who are going through one of

the hardest times of their lives. They give

more than you can believe.”

Advanced Clinical Services Coordinator for

the Northern Adelaide Palliative Service,

Alice Every, said medical, nursing and

allied health staff worked alongside

chaplains and volunteers to help patients

feel at ease during their final moments.

“We have had such positive feedback from

families and visitors about our volunteers,

and of course about Glenyss and her harp

playing,” Alice said.

“The universal appeal of music makes it

possible for nearly every individual to relate

to, and there is a growing base of research

which validates the physical and emotional

benefits of music among palliative care

patients, including pain control, lowering

blood pressure and stress, assisting

caregivers with bereavement and boosting

the morale of patients, their families and

hospital staff.”

Glenyss is among over 60 volunteers

providing more than 8000 hours of service

each year to hospice patients and those in

the community through Modbury Hospital’s

Palliative Care Volunteer Program.

Amid the busy hum of doctor’s rounds, nurse’s checks and visitor’s feet, the gentle notes of a Celtic harp reverberate against the walls of Modbury Hospital’s palliative care ward, washing over the clinical sounds.

The power of music and volunteering

CELEBRATING OUR VOLUNTEERS

Volunteer Glenyss Barker performs fortnightly for patients and their loved ones in Modbury Hospital’s palliative care ward.

Introducing the Northern Health NetworkFrom 1 July 2015, all health services and programs previously delivered by Northern Adelaide Medicare Local (NAML) transitioned to the Northern Health Network.

Services facilitated by the Northern Health Network include mental health programs for all ages, Closing the Gap health advocacy and care coordination, General Practice support, as well as health education, events and projects, including the Living Well with Persistent Pain Clinic.

The Northern Health Network continues to operate from the former NAML office located at 2 Peachey Road, Edinburgh North.

For more information about services provided by the Northern Health Network, visit northernhealth.net

Alternatively, email [email protected] or call 8209 0700.


Amy is one of four Aboriginal Health Practitioners within the Northern Adelaide Local Health Network and the organisation’s newest Aboriginal Maternal and Infant Care (AMIC) Coordinator.

The 29-year-old works in partnership with midwives at Lyell McEwin Hospital to provide culturally respectful antenatal, birthing and postnatal care to Aboriginal women or non-Aboriginal women having an Aboriginal baby.

Social, emotional and clinical support and service advocacy are all central to Amy’s role, which aims to address the heightened risks Aboriginal women face during pregnancy and childbirth, including higher rates of low infant birthweight and maternal death.

“It’s about constant communication, because you need to build that rapport with the women,” she said. “If you don’t have the rapport, you don’t have their trust, and the less likely they are to attend appointments, which is a big issue nationally.”

“It’s really important that women attend their antenatal appointments so we can support them, identify any complications and ensure their baby has the best possible start in life.”

Amy works closely with midwife Jodi Murdock who introduces her to expectant mums at their first appointment. From here Amy identifies and coordinates the necessary

services and supports, such as health checks, immunisations, counselling and referrals to drug and alcohol services.

“It’s a really great partnership because the midwives teach us the clinical way and we teach them the cultural way,” Amy said.

A midwife of over 15 years, Jodi has witnessed a significant turnaround in the number of Aboriginal women attending antenatal appointments since the AMIC position commenced at Lyell McEwin in 2010.

“The benefits of the Aboriginal Maternal and Infant Care role are huge,” she said. “The AMIC role acts as a cultural consultant, putting women at ease almost instantly.”

“It is very apparent that having Amy there makes the women feel more comfortable because she can relate to issues that are affecting them from a cultural perspective.”

Since taking on the Aboriginal Maternal and Infant Care Coordinator role in January 2015, Amy has supported more than 60 women through their pregnancy and beyond.

“My main focus is having a woman and her immediate family physically and emotionally well before the end of her gestation,” she said. “If that family unit is healthy then it is much easier to bring a new baby in and provide the love, care and education that baby needs.”

To find out more about the Aboriginal Maternal and Infant Care Coordinator role, please call 8182 9206.

As a proud Kaurna Narrunga woman with two young children, Amy Graham knows only too well the challenges that face Aboriginal women in successfully engaging with traditional hospital maternity services.

Strengthening support for Aboriginal women and children

Aboriginal Maternal Infant

Care Coordinator Amy Graham (right)

with local mum Kala Agius and daughter Ava.

AMIC Coordinator Amy Graham (left) pictured with expectant mum Kirsty Ahmatt of Craigmore

and Lyell McEwin midwife Jodi Murdock.

• AMIC workers form part of the state’s Aboriginal Family Birthing Program, which began in Port Augusta and Whyalla in 2004 before being introduced into metropolitan Adelaide in 2010.

• More than 20 AMIC workers now partner with trained midwives and doctors across SA to offer continuous care for Aboriginal women leading up to and six weeks beyond birth.

Fast facts...


Preeclampsia is a leading cause of maternal and infant death worldwide, affecting 5-10 per cent of all pregnancies in Australia, however the causes remain poorly understood and treatment options are limited.

Locally, the incidence of preeclampsia is increasing, with one in 10 expectant mums in Adelaide’s north diagnosed with the life-threatening disease, characterised by high blood pressure which – in severe cases – can lead to organ failure.

The local increase is due to the rising prevalence of preeclampsia risk factors including obesity.

While studies continue across the globe to better understand the condition, Cardiologist Dr Yann Chow is focused on discovering how to pre-empt future cardiovascular events among preeclampsia patients.

“We know that expectant mothers with preeclampsia face lifelong increased rates of cardiovascular disease,” she said. “Studies have shown that women who have had preeclampsia are twice as likely to develop heart and vascular problems later in life, but how this relates to preeclampsia – a condition that only occurs during pregnancy – is currently not well understood.”

Dr Chow is leading a three-year study which will see more than 100 expectant mums (including an even number without

preeclampsia) undergo an extensive program of tests to detect subtle heart and blood vessel changes.

“My early research has already shown preeclampsia patients suffer from a subtle decrease in heart function even during their pregnancy, with further deterioration among women who have had preeclampsia previously,” she said. “However, we are unsure if these changes resolve once the baby is born, as is the case with other preeclampsia symptoms.”

“To this end, we will study small and large blood vessels, as well as heart function and structure, to see if we can detect any changes in preeclampsia that might carry on even after women are finished with the disease. We will then correlate these findings with common

signs of heart disease found in the blood, saliva and urine.”

Tests ranging from photographs of the retina to ultrasounds of the heart will be undertaken at two junctures - the point of diagnosis and at six months after delivery - to identify if any decrease in heart function is ongoing. Dr Chow said being able to detect future cardiac problems would improve health outcomes significantly.

“If we can identify after the birth of a baby that a woman may be at risk of future heart problems they are then able to be monitored closely,” she said.

Dr Chow hopes to validate the use of an UltraSonic Cardiac Output Monitor – an ultrasound device – as a simple bedside tool to assess cardiovascular changes in preeclampsia patients. She is also working towards developing a better way to classify preeclampsia patients to ensure those at high risk of developing future cardiac problems are monitored long-term.

In late September Dr Chow presented her preliminary findings at the European Congress of the International Society for the Study of Hypertension in Pregnancy in Budapest.

For more information about this study, contact Research Assistant Melanie Wittwer at [email protected]

The puzzling link between a potentially devastating pregnancy disorder and the heightened risk of future heart disease is being investigated at Lyell McEwin Hospital.

Unlocking the preeclampsia and heart disease connection

• Approximately 300 women are diagnosed with preeclampsia each year at Lyell McEwin Hospital.

• A pregnant woman is suspected of having preeclampsia when she has high blood pressure coupled by protein in the urine, usually after the 20th week of pregnancy.

Fast facts...

Racheal Aikman of Para Hills is among a growing number of women from

the northern suburbs to be diagnosed with preeclampsia. She is pictured

with Cardiologist Dr Yann Chow.

RESEARCHING FOR THE FUTURE


The hospital’s Diabetic AnteNatal Care and Education (DANCE) Clinic offers an extensive program of support for pregnant women, including an initiative helping women express and freeze their breastmilk prior to labour and birth.

The colostrum – or ‘first milk’ – is stored at the hospital in case midwives need to stabilise a baby’s low blood sugar levels immediately following birth.

Antenatal Educator for the Women and Children’s Division, Helen Weinel, said Lyell McEwin was among a growing number of Australian hospitals supporting the practice.

“This is an exciting initiative for women and their babies in the North,” Helen said. “As a result of antenatal breastmilk expression, we have seen a big reduction in admissions to our Special Care Nursery and a significant decline in the number of babies who need to be supplemented with artificial formula.”

Of the 170 diabetic women who have accepted support with antenatal breastmilk expression since the DANCE program’s inception in August 2013, over 60 per cent of babies born avoided admission to the Special Care Nursery and a further 77 per cent did not require artificial formula.

Previously, almost all babies of diabetic mums, particularly those on insulin medication, were admitted to the Special Care Nursery, where their sugar levels would be stabilised with artificial milk or intravenous therapy. As a result, many of these babies would then struggle to breastfeed successfully.

“It is wonderful that we can help keep mums and babies together,” Helen said. “Avoiding separation alleviates a great deal of stress and really gives women and babies a head start.”

“If mum and baby can stay together in the first hour following birth, the skin-to-skin contact helps stabilise a baby’s vital signs, including the newborn’s heart rate, breathing rate, blood pressure, temperature and blood sugar.

“When a baby is with their mum in the first hours, they also display typical behaviours which help them go on to breastfeed successfully, such as opening their mouth, making sucking movements and touching and licking the breast.”

If a baby is able to avoid formula in the first six months, they are less likely to develop diabetes and will suffer from fewer allergies and gastrointestinal infections due to the immunity that breastmilk provides, explained Helen.

Para Hills mum-of-two Sarah Kirk elected to take up the technique when she was diagnosed with diabetes at 30 weeks gestation. She said having the milk on standby instilled feelings of confidence.

When her daughter Emerson failed to take to the breast following birth, the newborn was given colostrum to stabilise her low blood sugar.

“The program is brilliant. I keep telling all the mothers about it,” she said. “It gave me so much reassurance to have about 40 millilitres of milk in case she needed it.”

Lyell McEwin Hospital’s antenatal breastmilk expression initiative has attracted significant interest, with Helen invited to present at the Australian College of Midwives Conference in May 2015, the University of South Australia’s Babies and Families Research Symposium in July 2015 and the Australasian Diabetes in Pregnancy Society Annual Scientific Meeting in August this year.

Antenatal Educator for the Women and Children’s Division Helen Weinel demonstrating how to hand express breastmilk.

Mother’s milk, the best medicineA program supporting expectant mums with diabetes is significantly reducing the number of newborns admitted to Lyell McEwin Hospital’s Special Care Nursery for urgent treatment.

Lyell McEwin Hospital registered midwife Lucy King (far right), and Clinical Service Consultant for the Birthing and Assessment Unit (Low Risk) Linda Campbell (middle) pictured with local mum Sarah Kirk and daughter Emerson.


Whether on deployment in the Norwegian waters with Queen Alexandra’s Royal Navy Nursing Service or on expedition in Chile with aid organisation Raleigh International, Stuart has relished the opportunity to provide leadership and acute care in unpredictable and turbulent settings.

Hailing from the United Kingdom, the 44-year-old is now one of 76 emergency nurses at Modbury Hospital, including two Emergency Nurse Practitioners.

In September this year, Stuart was among just five Nurse Practitioners Australia-wide to be awarded a Fellowship with the Australian College of Nurse Practitioners.

“I joined the Royal Navy at 18 years of age, it was my first nursing role,” Stuart said.

“They expected you to operate more independently than nurses typically would. There was an extra level of responsibility and you had to take ownership of that added risk.

“I spent seven years in the armed forces and that really led me to become an Emergency Nurse Practitioner. I needed to go that extra step.”

Stuart began working as an emergency nurse in the United Kingdom 20 years ago. After four years of practice at several large teaching hospitals in Oxford and London, he craved a more autonomous role, and in 1998 joined a growing number of Nurse Practitioners.

In 2007, Stuart relocated to Australia and began working at Lyell McEwin Hospital – the origin of South Australia’s first Emergency Nurse Practitioner, before relocating to Modbury in January this year.

Today in excess of 1200 Nurse Practitioners work in Australian hospitals, providing some of the care that previously only doctors could offer.

“For many people, the Nurse Practitioner role remains a new concept. In a nutshell, we have the authority to independently manage a variety of patients without them seeing a doctor,” he said.

“There can be a misconception that Nurse Practitioners only care for lower acuity patients, however about 50 per cent of

people who present to an ED can be looked after by a Nurse Practitioner, including our higher Category 2 patients.

“From patients with acute muscular skeletal problems, lacerations or head injuries to an 80-year-old with a dislocated limb or a child with a sore throat, we manage a diversity of challenges.”

Nurses must complete a Master’s degree to become a Nurse Practitioner, allowing them to diagnose conditions, prescribe drugs, write specialists referrals and order and interpret diagnostic tests like x-rays.

Stuart said Emergency Nurse Practitioners had been instrumental in reducing waiting times at both the Modbury and Lyell McEwin Hospital emergency departments.

“Given the nature of emergency departments, there is a necessary focus on the critically ill,” he said.

“However the patient group I care for still have very legitimate presenting complaints that need appropriate and diligent assessment. I am able to fast-track their treatment, ensuring they are seen quicker and return home sooner.”

Fellowship of the Australian College of Nurse Practitioners aims to recognise exemplary Nurse Practitioners who make a substantial contribution to the College and profession.

For Emergency Nurse Practitioner Stuart Smith, his passion for nursing has led him to some of the most unexpected corners of the world.

• 30 per cent of Australia’s Nurse Practitioners work within emergency departments and more than 70 are located in South Australia.

• In 2004, the LMH Emergency Department became the first in South Australia to employ an Emergency Nurse Practitioner.

Fast facts...

Emergency Nurse Practitioner earns national praise

Emergency Nurse Practitioner, Stuart Smith, says he was first inspired to join the profession when cared for by a male nurse following a toe operation at 10 years of age.

Our People

Dr Peter MacIsaac Interim Director of Medical Services Northern Adelaide Local Health Network

Dr Peter MacIsaac has been appointed as interim Director of Medical Services for the Northern Adelaide Local Health Network. Commencing 27 July 2015, Peter will fulfil this role until recruitment for a permanent placement is finalised.

Peter is an innovative and experienced health practitioner and clinical informatician, with some 15 years of national and international experience in developing major health information systems, alongside 20 years in healthcare professional and leadership roles.

Peter previously served as a senior medical and informatics advisor for the Commonwealth Department of Health and Aged Care and as a clinical information systems architect for Queensland Health. He has had an extensive career as a rural GP and visiting medical officer in various specialties and has held several academic posts in community medicine, rural health and clinical epidemiology.

Scott McMullen Chief Operating Officer Northern Adelaide Local Health Network

Scott McMullen commenced as Chief Operating Officer for the Northern Adelaide Local Health Network on 31 August 2015. Scott comes to NALHN from Queensland where he served as Executive Director of Corporate Services and Performance at the Metro North Health and Hospital Service.

Scott brings with him significant experience in senior executive health service roles within the government, non-government, university and business sectors. His career has primarily focused on providing clinical, strategic, commercial and operational leadership in organisations undergoing rapid change and reform.

Scott is a graduate of the Australian Institute of Company Directors, has a Master’s in Health Management, Management and Business Administration, as well as a Bachelor of Social Work and Social Policy and a Bachelor of Arts (Psychology).

Scott’s leadership, management skills and patient focus will be a great asset to NALHN.

Devoting 30 years of service to Lyell McEwin, Gail said the discipline of nursing had changed significantly over the years.

“I started my nursing career back in 1966 and remember undertaking my training with the first male nurse in South Australia,” said Gail, most recently Clinical Discharge Coordinator for Surgery.

“I have watched the profession evolve, from changes in nursing uniforms to practice reforms. I was even here when they introduced computers into the profession.”

Departing in July, both Gail and Carole have witnessed many changes throughout the hospital and remember working together as registered nurses some 15 years ago on Wards 2C and 2B.

“I always wanted to work at Lyell McEwin and I am glad I was able to watch it grow from a small country-like hospital to what it is now,” Carole said. “It has always kept its warm, family-friendly feel which is what I love most about it. My mum worked here, along with my daughter, son-in-law and future daughter-in-law, so it’s like a little Lyell McEwin family.”

Starting as an enrolled nurse in 1991, Carole worked in various areas of the hospital before finding her love of anaesthetics and watching the department grow from having three staff to more than 30.

“I love the feeling of being there when the patient is most vulnerable,” said Carole,

who became a registered nurse and completed her career as a Clinical Service Coordinator for Anaesthetics.

“It’s a scary time for patients. They have just gone under anaesthetic and the rooms are clinical, so just being there for them is very rewarding.”

Gail, like Carole, has worked in various positions during her career at Lyell McEwin from a registered nurse in the surgical wards, to specialist roles supporting stroke patients, enhancing infection control, trialling new emergency department information systems, and supporting rural and remote patients.

“Over the years I have really enjoyed the interaction with patients, families and staff,” she said. “I was able to meet such a diverse range of people and each person has a unique story.”

“Lyell McEwin has always maintained a friendly, patient-focused environment and I don’t think that will ever change.”

Northern Adelaide Local Health Network Chief Executive Officer Jackie Hanson wished the long-serving nurses farewell.

“On behalf of the Network and staff at Lyell McEwin Hospital, I would like to thank both Gail and Carole for their wonderful contribution to both our hospital and our community,” she said. “I wish you both well as you embark on the next chapter of your lives.”

Lyell McEwin Hospital nursing duo Gail Sloan and Carole Williams have farewelled the profession after more than 70 years of combined service, including over 50 years of care for the northern community.

Nursing duo bid fond farewell



Offered through the Network’s Watto Purrunna Aboriginal Primary Health Care Service, Lift ‘em Foot promotes active lifestyles and regular health screenings among Aboriginal people in Adelaide’s north.

Director of Aboriginal Health Kurt Towers said the local uptake of Aboriginal health screenings had improved by more than 40 per cent in the past year thanks to a targeted education campaign, including the Lift ‘em Foot program.

“We know that higher rates of chronic disease among Aboriginal people are contributing to an unacceptable gap in healthcare outcomes, including higher levels of mortality,” Kurt said.

“Lift ‘em Foot is an engaging health program which aims to reduce the prevalence of chronic disease by promoting an active lifestyle and uptake of Aboriginal-specific Well Health Checks.

“Prior to registering for the race, all participants were required to undergo a Well Health Check, which includes an assessment of the person’s physical, psychological and social wellbeing, and identifies what preventive health care and education should be offered.”

As a result of the Lift ‘em Foot program, up to 50 Well Health Checks are now being carried out each month by Watto Purrunna.

Kurt said this was the second year Watto Purrunna had registered for the City to Bay fun run, following great success with the pilot program in 2014.

“This year the Lift ‘em Foot program expanded to include tailored fitness programs designed by students from the University of South Australia’s School of Health Sciences,” Kurt said. “In 2015, we have also partnered with the Aboriginal Drug and Alcohol Council of SA and Office for Recreation and Sport to offer greater education and support.”

NALHN Chief Executive Officer Jackie Hanson said the program’s success was testament to the Network’s commitment to bridging the health divide.

“With the largest Aboriginal and Torres Strait Islander population of all metropolitan areas, it is essential that we put the health and wellbeing of this community at the forefront of our thoughts and actions,” Jackie said.

“This year, our Network has taken some significant steps to contribute to health equality and reconciliation in Australia. In June 2015, the Northern Adelaide Local Health Network saw its very first Reconciliation Action Plan endorsed by Reconciliation Australia.

“Our Reconciliation Action Plan will increase local uptake of health care services through

the creation of culturally supportive services that promote a sense of belonging, effective engagement with Indigenous Australians, and strong partnerships with Aboriginal and Torres Strait Islander organisations.”

Under the plan, NALHN will also investigate opportunities to incorporate Aboriginal traditional healing services within acute areas, offer cultural awareness training to all staff, increase the presence of Aboriginal culture across all services and provide greater employment and training opportunities.

NALHN’s Reconciliation Action Plan is available to view on the Reconciliation Australia website: www.reconciliation.org.au

A 100-plus team of Aboriginal community members took part in this year’s City to Bay fun run as part of the Northern Adelaide Local Health Network’s newly expanded Lift ‘em Foot program.

Lift ‘em Foot for City to Bay

Watto Purrunna staff (from left) Dudley Ah Chee, Joel Tessman and Kiera King promoting the Lift ‘em Foot health message.

Pictured gearing up for City to Bay are Suzhanna Bostock-Stuart and Partima Fielding.

BRIDGING THE HEALTH DIVIDE

SPRING 2015 Northern The Health Times

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