the ASHHNA Newsletter

Volume 19
Number 2
December 2008
www.ashhna.org.au
Contents
•
Presidents Report………………………………………………………………. 3
•
Sub-branch report……………………………………………………………….. 4
•
Conference Report - Australian Sexual Health Conference Gold Coast……….. 4-5
•
Victorian NPEP Service phone line nurses do great work……………….. 6
•
Victoria’s endorses its first sexual health NP………………………………. 7
•
Women Decline Chaperone poster…………………………………………… 8
•
His Secret, Her Story……………………………………………………………. 9
•
The 7 Cs of Chlamydia………………………………………………………….. 9
•
The Wondrous Vulva Puppet………………………………………………….. 10
•
Kendra Sundquist Nurses Prize………………………………………………. 11
•
Report on Seminar Adolescent nursing science or art?.......................... 12-13
•
The NEW Practice Pap Smear & Chlamydia Postcard ……………………. 14
•
Improving Your Working Life: A Survey of Nurses and Midwives in Victoria… 14
•
Journal Watch……………………………………………………………………. 15
•
•
Advertisements…………………………………………………………………. 15-17
Executive Committee……………………………………………………………. 18
This newsletter is the official journal of the Australasian Sexual Health and HIV Nurses Association. Views
expressed in articles are contributor’s own and not necessarily those of the Editor or ASHHNA Inc.
Statements of fact are believed to be true, but no legal responsibility is accepted for them. All material
appearing in the ASHHNA Inc Newsletter is covered by copyright and may not be reproduced without prior
written permission. ASHHNA Inc takes no responsibility for advertising appearing herein and does not
necessarily endorse and products advertised.
Publishing:
This newsletter is published in July and December. Contributions should be forwarded to:
The Editor,
ASHHNA, LWCHC, PO Box 240, Leichhardt NSW 2040.
E-mail: [email protected]
Web Site:
www.ashhna.org.au
ASHHNA Inc. would like to thank
Novartis for their generous
thank you . . . .
The editor would like say
thank you to Stephanie Kyriakou
for her help with the design and
publishing of this newsletter.
support of this newsletter
ASHHNA Newsletter
2
Presidents Report
Annual General Meeting held on 7th November 2008
Advanced Competency Standards for Sexual and
Reproductive Health Nurses:
I am pleased to report on the past year and my last
report as President. This year has seen a great deal of
change to benefit members. The executive has shown
enormous commitment to finalising new initiatives and
maintaining core business activities. The AGM was
held by teleconference with links to Victoria, Western
Australia, Tasmania, Queensland and the Northern
Territory.
The revised edition can be down loaded from the
website and the executive is always interested in
member’s feedback.
The following is an overview of activities: ASHNA Inc; name change:
At a special general meeting held on the 31 July.
ASHNA Inc became the Australasian Sexual Health and
HIV nurses association Inc; (ASHHNA Inc:). The Model
Rules will also be amended to reflect this change.
Affiliated membership:
This was also passed at the special general meeting
and provides for related organisations to submit a
request to ASHHNA for consideration.
The Kendra Sundquist Nurses Prize:
The inaugural prize was presented to Ms Fiona Mac
Farlane from Melbourne Sexual Health Centre for her
oral presentation “Management of women diagnosed
with asymptomatic Chlamydia infection – Are pelvic
examinations necessary?” See the website for more
information. Congratulations Fiona.
Promotion of ASHHNA:
Promotional activities where undertaken at the
Australasian Sexual Health Conference in Perth. Thank
you to nurse’s for completing the survey which has
provided useful feedback and welcome to the thirty two
new members successfully recruited. Check out the
website for more information.
Regular features:
The Combined Conference formally the Biannual
“Sexual Health & Woman’s Health Nurse’s
Associations”:
No further progress to report this will be included on
the executive agenda for discussion in 2009.
ASHHNA Inc; Website: www.ashhna.org.au
The website has been redesigned enabling regular
updates. Feedback is welcome about additions to be
included on this site.
Email List server:
This facility enables members to disseminate and
share information and discussion across the
membership.
Nurse Practitioner:
Congratulations to David Lee from Melbourne Sexual
Health Centre, who currently has the honour of being the
first "Sexual Health" Nurse Practitioner in Victoria.
College of Nursing collaboration:
This partnership offers additional benefits for members
such as reduced membership fees for the College.
Nurse’s meeting at the Australasian Sexual
Health Conference Perth:
This is now a well established annual meeting providing
an opportunity for interstate discussion and networking.
About forty nurses attended the meeting hosted by
members of executive and nurses from Fremantle Sexual
Health Service.
GlaxoSmithKline Educational Award:
Congratulations to the 2008 Educational Award recipients
Cath Hakanson Women’s Health Kalgoorlie and Brad
Whitton Sexual Health Melbourne.
During 2008, ASHHNA Inc; represented our nursing
specialty at State and National level by attending the
following meetings: • The Coalition of National Nursing Organisations,
representative Jo Perks.
• NSW Aboriginal and Torres Straight Islander
Advisory Committee, representative was Brett
Dubois.
The 2009 Australasian Sexual Health Conference
will be held on 7- 9th September in Brisbane.
ASHHNA will be arranging another nurses meeting
in collaboration with Queensland nurses.
On behalf of the executive I wish to express thanks
to :♦ GlaxoSmithKline for their ongoing financial support for
the Educational Award.
♦ Novartis for their financial support for the Newsletter.
♦ Ms Stephanie Kyriakou for assistance with minutes
and administration duties.
♦ Ms Lauren Jennings for her bookkeeping duties.
A special thanks to Robyn Hately and appreciation for the
commitment and support she has demonstrated to
ASHHNA. Robyn has been a dynamic and vital executive
member since the inception and establishment of the
association. She has held and enhanced various positions
on the executive and I am fortunate to have worked with
her.
ASHHNA Newsletter
3
President’s Report (cont’d)
Therefore it is with regret that I inform you Robyn has
tendered her resignation from the executive committee.
We wish her luck in her future endeavours.
I would also like to thank Brett Dubois, Janine Issa, Wendy
Machin and Donna Muscardin who are standing down. I
wish to convey thanks to the 2008 executive team for their
commitment and hard work for ASHHNA business
activities.
Finally, thanks to members around Australia and New
Zealand for your continuing support of ASHHNA.
Best wishes for a Merry Xmas and Happy New Year!
Sue Porter, President 2008.
Sub branch report
ACT Report
We currently have 20 members of the ASHHNA ACT sub
branch which includes nurses working across the area of
sexual and reproductive health.
ASHNNA ACT likes to meet 4 times a year although we
missed the first meeting this year. We met in April and July
and we are planning a meeting in November.
•
We usually try to have a guest speaker attending to
provide professional development opportunities for
members. For the meeting in April we had a talk
about outreach services in sexual and reproductive
health called ‘Outreach Bound’. This was given by
two of our members, Elissa O’Keefe & Deb Morgan.
In July we had a guest speaker, Estelle Anderson who is a
disability and sexuality educator with Sexual Health and
Family Planning ACT give us a talk on “Talking about
sexuality and intellectual disability”.
For our next meeting we have a talk planned from people
in the sex work industry about working with clients who are
sex workers and responding to their particular needs.
The sub branch members initiated the idea of having a
seminar and update day, which was then organized by
Sexual Health and Family Planning ACT. This seminar,
entitled ‘Seminar in Sexual and Reproductive Health for
Nurses’ was run by Sexual Health & Family Planning ACT
on Saturday 25 October and was a great day, with 34
nurses working in the area in the ACT and surrounding
region attending. There are plans for another similar
seminar in the future.
The ASHHNA ACT Sub branch provides opportunities for
connecting, networking and professional development for
nurses working in the area of sexual and reproductive
health and HIV/AIDS in the ACT and surrounding area.
Conference Report
Thank you to ASHHNA for the scholarship to enable me to
attend the 2008 Australasian Sexual Health Conference.
The conference was very interesting and as usual quite
refreshing to generate discussion re topics of interest for the
sexual health workforce. Two points of interest for me were
some work on self collection of specimens and not
examining women at asymptomatic screen for Chlamydia.
It was great to see some work on the acceptability of client
self collection of specimens especially vaginal and anal
swabs. There isn’t much information around about this. The
team from Kirketon Road Centre outlined some data from a
study they conducted. Much discussion is usually generated
by sexual health workers over the validity of self collected
swabs so it was great to see some research leading into this
area. I’d like to see more research on the validity. The
research reported in a sample of clients that 50% of clients
preferred to collect their own specimens. 30% preferred
practitioner collection and 20% had no preference. They
also considered what we could miss by not examining
client’s genitals and concluded that rates of missing
something were very low in the asymptomatic client. Genital
warts were mentioned as something that could be missed.
KRC will continue to audit attending clients for their self
collection data. It’s probably important for us all to have very
clear guidelines, policy and procedure for the self collection
of swabs in our scope of practice when dealing with the self
collection method in asymptomatic clients.
The presentation by Fiona McFarlane on whether it’s
necessary to examine a woman diagnosed with
asymptomatic Chlamydia infection won the nurse’s
presentation prize for the conference.
This research concluded that women may have some
cervical inflammation at asymptomatic screen however the
treatment outcomes are the same. Again there is not a lot
of information around about this and this discussion will
more than likely generate more research in this area.
I was also interested to hear more about the work of the
NSW STI programs Unit and to chat with employees from
the unit. Chris Bourne (Head of the unit) gave a good
overview of the service. Great to see such an initiative to
support the existing Sexual health Services across NSW
along with support for GP’s. The STIPU weekly mail out on
the list server is well compiled and a great way to distribute
information and interesting websites etc. I would encourage
all ASHHNA members to be on the list server and read
these.
The duo from Auckland sexual health were very entertaining
in the presentation re community testing – “It’s a piece of
piss”. It was great to see some good old fashioned health
promotion teamed up with screening of the under 25s for
Chlamydia. Also refreshing to remind us of the great work
we can do when it comes to getting out amongst the
community and diagnosing and treating infections. Wouldn’t
it be great to have more time and resources to be able to do
this type of work?
Brad Whitton
Hilary Freeman
ASHHNA Newsletter
4
Conference Report
Australasian Sexual Health
Conference – 2008, Perth WA
The conference this year was a particularly interesting
one for me, and I am sure that the FPNSW delegation
also enjoyed it as much as I did – from both content and
a networking point of view. For those of your who were
not aware FPNSW had two poster presentations at the
conference – one by Mark Morris on the About HIV/AIDS
CD-ROM and one by Ellie Friedman on HPV testing ,
with lively interest in both.
Some of the key highlights and interesting presentations
were from:
James Ward from the National Centre in HIV
Epidemiology and Clinical Research, UNSW – Aboriginal
sexual health:
• Despite a high background STI rate , the HIV rate
is just under the non-Aboriginal BUT what is
worrying is the heterosexual transmission rates ~
29% compared to 12% and in injecting drug users
18% compared to 3%, with a 6 x greater risk for
Aboriginal women than non-Aboriginal women!
• Relative risk for STIs increases with location ~
Major city / → Remote • There is serious potential for HIV to escalate in
Injecting Drug Users.
• “If STIs were a chronic disease then our people
would be dead…because it is STIs it is less
important”.
Jorma Paavonen (Netherlands):
• European trends in cervical cancer - in young
women
• HPV persistence is associated with co-infection
with Chlamydia ~ causes a metaplasia and HPV
targets the damaged cells.
• Of concern is the data from Finland regarding
sexual debut and risk of exposure to HPV:
• 1998 – 12% of 14 year olds ♂♀
• 2002 – 17% with d sexual risk taking
• VIN is , and mean age is .
• HPV burden of disease (cancers):
• Cervical 100%, Anal 90%, Vaginal/vulval 50%,
Penile 50%,
• Oro-pharyngeal 20%, Larynx 10%.
Basil Donovan from the National Centre in HIV
Epidemiology and Clinical Research , UNSW:
• Fascinating and fast paced presentation on a 15
year study of work with sex workers – the bottom
line was remarkable work was done with Asian Sex
workers in Sydney leading to nearly 100% condom
usage and highly significant reductions in STIs, to
the point that Sydney sex workers who are working
in the decriminalised environment have the lowest
STI rates of anyone in NSW – barely measurable!
Fiona Macfarlane (Melbourne Sexual Health) ~ Are Pelvic
Exams necessary in asymptomatic ♀ Chlamydia? :
• PE was speculum / bimanual / or both
• Found that it is unlikely that important clinical findings
will be missed
• Abnormal pelvic findings are infrequent in ♀ with
asymptomatic Chlamydia
• Screening alone will suffice for time poor GPs.
Juliet Richters (Australia) A snapshot of information in
relation to circumcision:
• Protects against candidiasis
• Higher risk of NSU
• No evidence of women preferring the circumcised
penis
• Australian born men the most likely to be
circumcised.
• Has minimal effects on sexual well-being and
practice
• Not significantly protective from STIs.
• 50 -59 year olds had less trouble with erection when
circumcised.
• US study 10 years earlier found similar results!
M. Law (Australia):
• Since introduction of HPV vaccine in Australia there
have been >1000 adverse events reported , and of
those:
• 20% related to injection site, 15 % dizziness, 20%
headaches, 16% nausea, 7% vomiting.
• 12 cases of anaphylaxis ~ this is a comparable rate
to other vaccination program, 91 reports of hives,
and 3 pancreatitis.
• Lifelong immunity is not yet assured (follow up
research is taking place) and if needed, boosters will
be provided in the future.
• With high coverage rates there is limited benefits to
vaccinating boys – rates will be monitored as when
coverage rate is <70% then there is a benefit. This
has been determined using mathematical modelling.
• Although HPV is not eradicable with the vaccine ( as
it is so readily transmissible), there should be a
substantial reduction in prevalence in 5 years.
• The cost effectiveness of vaccinating boys - < 30%
reduction for double the cost!
I would highly recommend this conference to anyone
considering attending in 2009 in Brisbane!
Ms Shane Jasiak
ASHHNA Newsletter
5
Victorian NPEP Service phoneline nurses do great work
The Victorian NPEP Service was established in August
2005 in response to rising HIV notifications in Victoria.
NPEP stands for non-occupational post-exposure
prophylaxis, and is a course of antiretroviral medications
available for people in the community who are at
immediate risk of acquiring HIV, usually from a sexual or
injecting drug use exposure. NPEP needs to be
commenced within 72 hours of the HIV exposure and be
taken for 28 days.
The Victorian NPEP Service is a state-wide service
which is run on a hub and spoke model. The hub is the
Alfred Hospital where the service is co-ordinated by a
Clinical Nurse Consultant (CNC), and the spokes of the
model are select GPs, sexual health clinics and some
hospital emergency departments across the state where
NPEP is available. The service has 3 staff; the CNC, ID
physician and clinical psychologist.
The Victorian NPEP Service phoneline is staffed 24/7 by
registered nurses who are experts in HIV, sexual health
and NPEP. The phoneline nurses provide information:
• to callers who are concerned about possible HIV
exposure and triages those at high risk to the
nearest spoke clinic for prescription of NPEP;
• to people currently taking NPEP who may be
experiencing side effects or feeling stressed about
the possibility of contracting HIV from their risk
exposure. Being on NPEP can sometimes act as
daily reminder to people about their risk of HIV
infection. NPEP can also be the impetus to address
ongoing risk behaviours and the NPEP nurses can
offer callers referral to the NPEP clinical
psychologist where appropriate;
• about sexual health checks for those who may not
require NPEP, but need STI/HIV testing or have
symptoms of an STI;
• for GPs and health care workers about NPEP. The
NPEP nurses have access to HIV specialist doctors
for further expert advice when required.
In order to accurately assess individual HIV risk the
nurses on the phoneline need to be able to discuss
sexual activity in detail without embarrassment or
judgement. The phoneline is predominantly accessed by
MSM (men who have sex with men) often at a beat or
SOPV (sex on premises venue). If you don’t ask who put
what where, and how, it is impossible to make an
accurate assessment for NPEP. The nurses who work on
the telephone line are all passionate about the service
and all work in sexual health and HIV services in some
capacity.
Working on the NPEP
phoneline
is
very
rewarding, as not only can
nurses facilitate access to
medication which can
prevent HIV infection, we
have the privilege of
discussing the most
personal aspects of a
person’s being, their sexuality, with an open and nonjudgemental attitude.
Jude Armishaw
NPEP CNC
New Forensic Nurse Graduates
Three Victorian Sexual Health Nurses from Melbourne
Sexual Health Centre have been amongst the first to
graduate with a Graduate Certificate of Nursing
(Forensic) from Monash University.
The course aims to equip nurses with the skills to
conduct forensic examinations, write medico-legal
reports and if required, provide expert testimony in court.
The course is conducted in partnership with the Victorian
Institute of Forensic Medicine (VIFM) and consists of
units including Sexual Assault Nursing, Understanding
Injuries, and Nursing and the Criminal Justice System.1,2
The VIFM is establishing a Forensic Nurse Examiner
Network with funding from the Victorian Department of
Justice. 2
Lorna Moss believes the Certificate is relevant to her
current role, given that some of her clients are victims of
sexual assault. Ms Moss feels that it is important to be
part of new areas that are developing in nursing, and is
exploring working part time in the field as part of her
scholarship arrangements.
Fiona MacFarlane stated, “It is a fascinating area to get
involved in”. “The content and quality of the course and
the support from the lecturers was excellent.” Ms
MacFarlane also stated that whilst having experience as
a sexual health nurse is relevant to forensic medicine, it
also extends to areas beyond sexual assault...
Suzanne Wallis also enjoyed the new learning
experience and the insight the course provided into
forensic specimen collection and the justice system; an
area that Suzanne has had minimal exposure to.
ASHHNA Newsletter
6
Victoria’s endorses its first Sexual Health NP
Ms Wallis commented “The course was a lateral
extension to my scope of practice as a sexual health
nurse. It increased my understanding of the care and
follow up of victims of sexual assault and the process of
going to court”
All three graduates
highly recommend
the course.
Having completed
the 12 month course
which involved
distance education
and attendances at
workshops, the new
graduates feel well equipped and well supported to
undertake this exciting new role.
1
2
http://www.monash.edu.au/study/coursefinder/course/3884/
http://www.vifm.org/cfns1.html
By Matiu Bush
David Lee was endorsed by the Nurses Board of Victoria
(NBV) as the first Nurse Practitioner in Sexual Health
(SHNP) in Victoria. The process of endorsement began
with the employment of two SHNP candidates at the
Melbourne Sexual Health Centre (MSHC), in December
2006. As this was the first ever type of role in Victoria,
both candidates were provided with an almost ‘blank
cheque’ (within reason) in defining their scope of
practice. After an exhaustive process that included
medical mentorship, upskilling in pharmacokinetics and
pharmacodynamics (to within micrometers at the cellular
level), undertaking the s100 prescriber course and
networking with various NPs within Victoria and
interstate, and the final vive-voce examination with the
NBV 18 months later, the first endorsed SHNP came into
fruition.
Many of the outreach services are nurse-led including
Street-based sex workers, Sex-On-Premises Venues,
and Prisons outreach.
The challenge for both the NP candidates was to expand
their scope of practice to beyond the already advanced
and autonomous nursing practice of Sexual Health
Nurses at MSHC. This included the consultation of all
clients – whether symptomatic or asymptomatic, the
authority to prescribe, and referral to specialist services.
Over and beyond the clinical role, the NP was required to
demonstrate leadership in clinical nursing including
education as well as maintaining a research and
development role.
Both NP candidates developed their ‘Clinical Practice
Guidelines’ (CPG) which were approved by the MSHC
‘NP Steering Committee’ and the Alfred Hospital ‘Scope
of Practice Committee’ as well as the ‘Drugs and
Therapeutic Committee’.
These CPGs are available on line at http://
www.mshc.org.au/ManagementGuidelines/
NursePractitionerClinicalPracticeGuidelines/
David feels excited about the role that encompasses his
passion in clinical sexual health / public health nursing
practice but also allows him to expand his
epidemiological research skills. He is hopeful that there
will be more SHNP not only in Victoria but nationwide in
future but also appreciates that not all his nursing
colleagues would venture into such as role that requires
further and extensive studies towards a Masters degree.
Of course the endorsement would not have been
successful without the encouragement and support of
MSHC management as well as the support of his fellow
NP candidate Matiu Bush or his mentors, Dr Tina
Schmidt and all medical, nursing and administrative staff
at MSHC.
(Matiu Bush and David Lee)
The MSHC is the only publicly funded sexual health
centre in the state of Victoria with a throughput of 25 000
presentations per annum. Nursing (SHN) at MSHC is
well designed for the role of NP as all nurses employed
at the centre are required to hold credentialing as
‘prescribed person in HIV pre/post test counselling’;
endorsed Nurse Immunisers and endorsed Nurse Pap
Test providers as a prerequisite. In addition to this, the
centre offers an extensive training in Well Person’s
consultation and wart treatments. SHN are multi-task to
work in the different roles offered in the service – apart
from consultation, the SHN are also designated roles in
triage, in the Results & Information Line, Follow-up /
Contact tracing; Serology and respective projects.
Editor: Congratulations David
ASHHNA Newsletter
7
ASHHNA Newsletter
8
His Secret, Her Story
In recent years there have been increasing accounts in
the public domain of men in relationships with women
being same sex attracted or coming out as gay or
bisexual. However the experiences of the women in the
relationships with same sex attracted men have rarely
been heard.
A new Australian publication gives voice to the women
behind men’s coming out stories.
Compiled by the NSW Women Partners of Bisexual Men
Service ‘His Secret, Her Story' is the first comprehensive
Australian publication of its kind telling the stories of
Australian women, in their own voices, dealing with their
male partner's same sex attraction. The women eloquently
share their experiences of dealing with confusion about
their male partner’s same sex attraction, what the
discovery meant for them and their families and how they
coped with the disruption, emotional upheaval and need
for practical decision-making which most often ensued
after disclosure.
‘His Secret, Her Story’ can be ordered through Leichhardt
Women’s Community Health Centre www.lwchc.org.au
Ph: 02 9560 3011.
or www.lwchc.org.au/womenpartners
Roxanne Cameron,
Leichhardt Women’s Health Centre
The 7 C’s of Chlamydia
A partnership between Sydney Sexual Health Centre, NSW
STI Programs Unit and Australian Practice Nurses
Association has been successful in gaining a Nursing and
Midwifery Innovation scholarship for the project:
The 7 C’s of Chlamydia: A Simple Memory Tool for
Screening and Management of Chlamydia Infection.
Chlamydia is the most commonly notified sexually
transmitted infection in Australia and is most prevalent in
people under 25 years.
The project aim is to develop, disseminate and evaluate a
simple memory tool for health professionals designed to
assist in recall of the steps involved for screening and
management of genital Chlamydia infection.
The project, due for completion in June 2009, will involve
interactive online learning activities and will target practice
nurses, youth health nurses, women’s health, midwives,
community health care workers and nurses new to the
specialty of sexual health.
For further information contact Donna Tilley
Neil Poetschka
Manager
NSW STI Programs Unit
Nightingale Building, Sydney Hospital, Macquarie St.
Sydney GPO Box 1614 Sydney NSW 2001
T 02 9382 7527 F 02 9382 7475 M 0408210489
Email [email protected]
ASHHNA Newsletter
9
The Wondrous Vulva puppet
This is my latest toy and I am afraid to say
that I am in love! When you play with
genitals and talk about sex all day, you
become desensitised about the topic. I
hate genital diagrams because they are
clinical and aren’t really all that easy to
understand, irrespective of your background. This puppet
is an enormous vulva ie labia majora, minora, clitoris,
clitoral hood, g-spot, introitus and vagina. But it has been
softened with velvet and satins to become this enormous
big pillow. I use it for almost all my groups (all ages) in a
number of different ways. It is a great ice-breaker at the
start of a session where you plan to talk about genitals.
By the time everyone has had a laugh, you can then all
explore the cushion together. Curiosity about the pillow
tends to overshadow embarrassment and fear of showing
ignorance. I have used it in education about STIs,
contraception, menopause, sexual difficulty, and orgasm
to date. It also works as an opener into discussions about
the emotional aspect of sex (particularly important when
dealing with adolescents who have ‘done it all’ but have
no concept that sex can be special). I also use it clinically,
for example when discussing vaginismus, sexual pain,
explaining pap smear procedure to a first-timer. Basically,
I don’t think I will stop finding uses for this new toy.
I purchased mine from the website below, the price is in
USD but it is shipped within Australia. I paid about $150
AUD including shipping. They come in a range of colours,
and can even be custom made (if the budget
allows!).You can buy smaller ones which are cheaper in
price. www.yoni.com
Saucy Sex Scale – Brisbane Youth Service
This set of cards were originally developed as a
continuum risk game outlining a range of sexual
behaviours and their risk around disease transmission.
The sexual behaviours were chosen and created in
plasticine by Brisbane youth.
I mainly use these for education sessions with
adolescents. The range of behaviours are comprehensive
and have an explanatory description on the back (the
terms on the front are specific to current slang). I might
start off with discussing risky behaviour, and then get the
group to make their own genital collage. We then add in
what these genitals may look like if they had herpes –
great introduction into discussing STIs. I use them as they
are intended but also in other ways.
They are good to use when discussing the range of
sexual behaviours ie sex is not just about penetration.
Also a good introduction into peer group pressure, self
esteem, and ‘saying no’. Clinically, I use them with clients
who are limited in their sexual repertoire. They are a
humourous way to discuss the range of sexual
behaviours, and I still have to look at the back of some of
them to interpret them! I am still exploring ways to use
these cards.
You can purchase these laminated ($55) or unlaminated
($33) from www.brisyouth.org. An introductory booklet is
included with suggestions on their use.
The illustrated clitoris
This is a set of female genital illustrations that illustrate the
clitoris in all its glory. The main attraction for me is the fact
that you don’t have to have good anatomical knowledge to
work out what things are. I have lost count of how many
clients just nod in agreement when you use anatomical
illustrations. These illustrations are shown in context of a
real body and not the usual ‘medical model’ way ie
identifying markers are provided by way of flesh toned
buttocks or a leg.
I use these A3 drawings with all women (and men) of all
ages. They are also available in colour in the book ‘The
elusive orgasm’ by Dr Vivienne Cass. I have heard that the
author is producing a set that are ‘child-orientated’. I’ll keep
you posted on that one.
This Australian resource can be purchased direct from the
author at http://www.brightfire.com.au for $130.
‘The Bears’
These cards are not specific to sexuality but are an
essential item for any educators toolkit. I had the good luck
to have Lorel Mayberry as a lecturer, whilst studying
sexology at Curtin University. Lorel makes education fun
and memorable whilst also learning something new. She
introduced me to the use of cards
in teaching.
‘The bears’ are a set of 48 cards,
starring cartoon characters
depicting a range of emotions eg
happy, sad, confident, afraid, shy,
energetic, tired, noisy, caring,
grumpy,….
ASHHNA Newsletter
10
Kendra Sundquist Nurses Prize
There are no words on the card, allowing individual
interpretation of the emotions as well as facilitating their
use for low-literacy or non-english speaking groups.
I use them at the start of an education session. For
example, spread them on the ground and ask the group
to pick a card that depicts how they feel about coming to
the workshop. Invite the group to discuss the card they
chose and why. You can also use this method with any
topic you wish to explore eg infidelity, having an STI,
sexual difficulty, communication with partner. You can
also pick a card depicting your reaction now and how you
wish you would react in the future. This method allows
people to discuss and share their thoughts and feelings
about an issue.
Named in honour of Dr Kendra Sundquist, a nurse who
has made an outstanding contribution to sexual health
and HIV nursing, 2008 is the first year of this prize to
acknowledge and support nursing research.. Kendra has
played a key role in educating health professionals about
the need to discuss sexuality with cancer patients and
their partners, and is a prolific author and member of key
oganisations.
The 2008 Winner...
Announced at the Australasian Sexual Health conference
the winner is Fiona Macfarlane from Melbourne Sexual
Health Centre. Fiona has been working in sexual health
since 1983 and is currently employed as an Advanced
Sexual Health Nurse.
For evaluation, I ask them to find a card that shows how
they feel about what they have just learnt or how the day
went. Alternatively, pick a card at the start of the day to
depict how they feel about a topic eg unsafe sex (make
sure you then keep those cards separate). At the end of
the session, ask them to pick another card to depict how
they now feel about that topic. Then compare the before
and after cards – you should notice a big change in
emotions! This is a fun and easy way to evaluate –
especially for those groups where a questionnaire is
inappropriate.
"I started at a time when very few people wanted to work
in this area and have witnessed and participated in
numerous (r)evolutions in the role of a Sexual Health
Nurse. Now it is 'sexy' to be a Sexual Health Nurse!"
These cards cost $49.50 and can be bought direct from
the supplier. Postage is reasonable. Be warned though –
these cards are addictive and you will be heading back to
the website looking for your next set!
Fiona has been recently invloved in research and the
$500 prize was a great way to acknowledge her
commitment and expertise in the field. " I feel extremely
honoured to have received the inaugural ASHHNA
Kendra Sundquist Nurses Prize".
She holds the Post Graduate Certificate Public Health
(Sexual Health), University of Melbourne and is currently
studying a Graduate Certificate Nursing (Forensic)
through Monash Universityand will start as an on call
nurse for the Victorian Institute of Forensic Medicine in
2009. and is an Accredited Immuniser.
www.innovativeresources.org
Cath Hakanson RN, RM, MHP, PGDip Sexology
Goldfields Womens Health Care Centre
Kalgoorlie WA
Read the research presentation Management of
Women Diagnosed with Asymptomatic Chlamydia
Infection - Are Pelvic Examinations Necessary?
ASHNA Inc July 2009
Newsletter Deadline is
on
1 June 2009!
(from left) Shane Jasiak, Fiona MacFarlane, Sue Porter and Kendra Sundquist
ASHHNA Newsletter
11
Report on Seminar Attendance Adolescent nursing: science or art?
I attended a seminar @ Westmead
Children’s Hospital
on Wednesday 10th September 2008
with the aim of reflecting on my own
practice and developing new skills
for working in the Bondi Junction youth
outreach clinic
and increasing my knowledge about
resilience
and building social networks for young people.
The seminar was for the full day and the sessions were
focused on communication:
• Rebels and the cause: inside the teenage brain
• Deciphering the code: how to communicate with
adolescents
• Sad kids and how we manage
• It’s all in the mix: facilitating successful adaptation of
adolescents with chronic illness
• Sexuality: what does this mean?
• Finding hope and building strengths: caring for high
risk young people in the community
Adolescent development
The first session of the day was on the science of brain
development (too much information for this short article,
but well worth reading more about). What this adds up to in
our experience of young people is:
•
Their cognitive development is egocentric: they have
the ability to think logically, but don’t always do so
especially about themselves and they see
themselves as much more central and significant
than they actually are.
•
They can misread emotional signals and react to a
situation with incorrect assumptions eg. “my teacher
hates me”.
They actively seek experiences where they can create
intense feelings with greater risk taking and poor inhibition.
Some things we can do can we do to promote health
behaviour?
Provide structure, organise their time, guide them through
tough decisions, be respectful and patient, encourage
healthy choices and identify short term goals for immediate
success.
Three main themes emerged for me throughout the day
and I gained some really useful information from most of
the sessions.
http://www.caah.chw.edu.au/resources/gpkit/Complete_GP_Resource_Kit.pdf
ASHHNA Newsletter
12
Report on Seminar Attendance Adolescent nursing: science or art?
Melissa Kangs’ presentation drew attention to the
Adolescent Health GP resource kit published by CAAH
(Centre for the Advancement of Adolescent Health) and a
printout of a table outlining the stages of adolescent
development.
Reflecting on the central questions for young people at
their varying stages of their psychosocial development will
influence the way I ask sexual and drug history questions,
and what type of health information I will give. For example
in the 14-17 age group who’s central questions is “ who am
I and where do I belong,” questions will centre around peer
group risk taking activities and finding out what labels or
perceptions they have of themselves.
The seminar was well organised with information bags
given out at registration and the venue was in one of the
hospital’s well appointed lecture theatres. Between the
lecture sessions videos of young people taking about
there experiences of life, illness and wellness were on
screen providing a very real focus on the stories of young
people themselves.
Overall it was interesting and provided a refresher on
adolescent development theory and some ideas that I will
put into practice. I would have liked more focus on
community health issues and less on the chronic disease
management issues. However I would highly recommend
attending an adolescent health update in your local area.
Sex and sexuality
Alison Baker CNC outlined her research looking at how
adolescents with cancer or chronic illness are provided with
opportunities to discuss sexuality. Kylie Polgase, a youth
worker with a history of hospitalisation for CF spoke about
her experiences highlighting the need for clinicians in all
specialties to have knowledge and skills in addressing
sexuality and knowing the appropriate referral pathways,
particularly to community based services including: GP’s,
youth health, women’s health or sexual health.
Communication and resilience
Helpful tips on building report and engaging young people:
•
Explain terms of confidentiality – format a way to say Promotional Mural at Bondi beach for the nurse lead
it so that you give all young people this information
outreach Satellite Sexual Health youth clinic located
Ask questions that display care and concern
•
above the train station at Bondi Junction
•
Explain any clinical process and ask the young
Photo: Young African girl celebrates Refugee Week 2008 in the Botanic
person what they think before doing anything
Gardens of Coffs Harbour
•
Identify and complement areas they are doing well, Photographer: Susan Clarke for Coffs Harbour City Council
not just problem centred
http://www.ourcommunity.com.au/marketing/photobank/photo/?00118
Use a narrative approach rather than a direct focus on the
young person “ many young people have a problem with…
how do you feel about this”, “what does a young person
think about…”
Donna Tilley
Clinical Nurse Educator
Sydney Sexual Health Centre
‘What adults see as problems, adolescents often see
as solutions” Richard Mackenzie.
This statement got me thinking about applying it to condom
use. If the solution is to not use a condom….explore with
the young person what the problem for them is.
Melissa Kang also spoke about some cases from her work
at High St youth centre with a focus on the importance of
acknowledging strength and hope as factors in supporting
young people.
ASHHNA Newsletter
13
The NEW Practice Nurse Pap Smear & Chlamydia Postcard
This article is to inform ASHNA members about a new resource that is being distributed to
all Practice Nurses across the state.
The NEW Practice Nurse Pap Smear & Chlamydia Postcard is a great new eye-catching
resource designed specifically for practice nurses by NSW STI Programs Unit.
“Its handy size makes it easy for desktop placement & quick access. The Pap side has the
nursing Pap smear and health check items explained in a quick easy to read format. As you
know Chlamydia can be a silent, sexually transmitted infection which can lead to infertility if
left untreated. Taking a sexual history can be an uncomfortable task for the patient & the
nurse. The card not only helps prompt us to take a sexual history from our patients but also
sets out the questions to ask. Following a set format helps us get the same information from
each patient and can help overcome nerves of remembering which questions to ask.
Chlamydia is easy to test and treat. The postcard also sets out the protocol for testing &
treating Chlamydia. I think it’s a winner.” Karen Booth – Practice Nurse - Leichhardt General
Practice.
To view this postcard http://www.stipu.nsw.gov.au/pdf/PracticeNurses_postcard_web.pdf
or for further information contact [email protected]
Improving Your Working Life:
A Survey of Nurses and Midwives in Victoria
♦
Making a difference to the working conditions of nurses and midwives is the main
aim of this survey. Your views and preferences are crucial in helping to understand
what the issue are, how things could be changed, and what is needed to improve
your working life. If you are happy or unhappy working as nurse or midwife, we
would like to know why. This landmark survey is not just another academic exercise
as the results will be used by employers and professional organisations to develop
policies to improve your working life.
♦
If you are currently working as a nurse or midwife in Victoria and wish to take part
you can:
• fill out the survey online – go to www.melbourneinstitute.com/nurses, or
• print out a copy of the survey from www.melbourneinstitute.com/nurses, fill it out,
and post it back to us, or
• ask our Survey Manager Anne Leahy to send you a hardcopy in the post by
phoning 03 8344 2600 or emailing [email protected].
♦
The survey is being conducted by researchers at the University of Melbourne
(Professor Anthony Scott) and University Technology, Sydney (Professor Christine
Duffield), and is funded by the Australian Research Council. Further information is
available on the website.
ASHHNA Newsletter
14
Journal Watch
Howie, K. (2008). Sexual health: web based
sexual health education, Primary Health Care, 18
(6):12
Keefe, A. (2008). Development of nurse – led
clinics in genitourinary medicine, Nurse
Prescribing, 6(6): 246 – 50
Paxford – Jenkins and Kumar, U. (2008). Use of
touch screen technology to deliver user – focused
service improvements in a walk in sexual health
centre, Journal of Family Planning and
Reproductive Health Care, 34(4): 268
Peate, I. (2008). The health care needs of
bisexual people, Practice Nursing, 19(4): 197 – 8.
Author unknown, (2008). School sex clinics bring
in boys, Primary Health Care, 18(6): 5
The ASHHNA Listserver
As a member get onto the ASHHNA Listserver.
The Listserver is a great way to communicate
with colleagues in Sexual Health and HIV by:
• sharing interesting articles and documents,
• joining in online discussions on current and
relevant issues in Sexual Health & HIV
nursing
• Sharing resources and websites of interest
• Getting the latest job opportunities
• Receiving courses & conferences information
• Getting updated information from the
Department of Health and the STIPU unit
• or simply communicating with other ASHHNA
members around the world without having to
pick up the telephone !
Just enter the email address
[email protected]
and enter SUBSCRIBE ASHHNA.
If successful you will receive some information
about the server.
Membership drive at the
Australasian Sexual
Health
Conference - IPOD Winner
Remember if your email address changes you
need to re subscribe.
And get chatting on
[email protected]
Congratulations; Mark Rollason is a
Clinical Trial Coordinator at
St Vincent's
GlaxoSmithKline/ASHHNA Inc
Education Scholarship for 2009
A BIG THANK YOU and Congratulations
to Robyn Hately for all her hard work
over the life of ASHHNA Inc. Robyn has
been a member of ASHHNA Inc. since
it’s inception and has contributed widely
to the organization as an executive
member. Robyn has been awarded life
membership status.
Would you like $3000 toward your attendance at a
conference, your current or planned
research project, or an approved course of study
then why not apply for the
GlaxoSmithKline/ASHHNA Inc
education scholarship for 2009.
Closing date for 2009 is 1 July 2009
Contact Belinda Davis on (08) 8999 2680
Email: [email protected]
for your application forms and any queries
ASHHNA Newsletter
15
ASIDAustralasian Society for Infectious Diseases
It is our pleasure to invite you to the 2009 Australasian Society for Infectious Diseases (ASID)
Annual Scientific Meeting which is to be held from Wednesday the 25th to Saturday 28th of
March 2009. The venue for this event will be the Cypress Lakes Resort located amongst the
vineyards of the Hunter Valley, New South Wales.
As many of you will be aware, the ASID Annual Scientific meeting is a highlight of the
Infectious Diseases meetings calendar. In addition to clinical infectious diseases, this meeting
provides a forum for the presentation and discussion of a broad spectrum of basic science and
clinical research areas attractive to delegates practising in microbiology, public health &
epidemiology, infection control, international & travel medicine. Special Interest Group
Meetings in Mycology, Health Infection Control and Paediatrics are once again regular
features of the programme.
“International Health” will be the theme of the meeting and we are enthusiastic in providing a
programme with international and local speakers on topics of tropical infections, zoonoses,
viral infections and infection control, amongst others.
An exciting addition to the 2009 programme will be the inclusion of specialised half-day
workshops on Tropical Medicine and Infection Control to be held on Sunday the 29th of
March. These will include both local and international leaders in the field, and provides a
unique opportunity to enhance your Meeting experience.
The organising committee has the great pleasure in offering a tantalising social programme
which will capitalise on the viticultural and culinary wealth of the New South Wales Hunter
Valley. We wish to see ASID as a vibrant, stimulating and relevant society and thus encourage
you to enjoy the considerable local attractions as an attendee, presenter, or sponsor of the
2009 ASID Annual Scientific Meeting
For further information please contact:
ASID 2009 Conference
Locked Mail Bag 5057,
Darlinghurst NSW 1300 Australia
Ph: +61 2 8204 0770
Fax: +61 2 9212 4670
ASHHNA Newsletter
16
The theme of the 19th WAS World Congress – Sexual Health and Rights: A
Global Challenge – echoes the eight priorities that were set out in the WAS Sexual
Health for the Millennium Declaration in Montreal in 2005:
-
To recognize, promote, ensure and protect sexual rights for all;
-
To advance toward gender equity;
-
To condemn, combat and reduce all forms of sexuality-related violence;
-
To provide universal access to comprehensive sexuality education and information;
-
To ensure that reproductive health programs recognize the centrality of sexual health;
-
To halt and reverse the spread of HIV/AIDS and other sexually-transmitted infections
(STIs);
-
To identify, address and treat sexual concerns, dysfunctions and disorders;
-
To achieve recognition of sexual pleasure as a component of holistic health and well-being.
The Congress has invited some of the most prominent – and entertaining – international
speakers in the field of Sexuality to address these concerns, with plenary sessions and
symposia organized around two themes each day. These will cover critical issues related to
the medical and socio-cultural aspects of sexuality. For example, a morning will be devoted to
the theme of Sex and Love, an afternoon to Education, another day devoted to Women’s
Sexual Health followed by Men’s Sexual Health… Please visit the Congress website at
www.sexo-goteborg-2009 for a preview of the latest preliminary program.
The science of Sexology has made important strides over the last decade, and many exciting
new research methods and tools have been developed. The 19th WAS Congress will allow
participants to keep abreast of the latest findings in fields such as intersexuality and
transgender research; new traits in genetic sexology; hormones, transmitters and sexuality;
and the use of PET and fMRI in sexological research and environmental sexology.
Come to Goteborg to learn what’s happening in the world of sexual health!
www.sexo-goteborg-2009.com
[email protected]
ASHHNA Newsletter
17
ASHHNA EXECUTIVE FOR 2009
President:
Donna Tilley
Clinical Nurse Educator
Sydney Sexual Health Centre
Ph: 02 9382 7451
Email:
[email protected]
Scholarship:
Belinda Davis
PO Box 40596
CASUARINA NT 0810
Ph: (08) 8999-2680
Email:
[email protected]
Vice President :
Belinda Davis
PO Box 40596
CASUARINA NT 0810
Ph: (08) 8999-2680
Email:
[email protected]
Positions without portfolio
Sub Branch Liaison Officer: Sue Porter
Newcastle Sexual Health Service
PO Box 664J
NEWCASTLE NSW 2300
Ph: (02) 4923 6594 Fax: (02) 4923 6572
Email:
[email protected]
Treasurer:
Bradley Whitton
Melbourne Sexual Health Centre
Clinical Nurse Co-ordinator
580 Swanston Street
CARLTON VIC 3053
Ph: (03) 9347 0244
Email:
BWhittonmshc.org.au
Secretary/Membership:
Shane Jasiak
Family Planning NSW
328-336 Liverpool Road
ASHFIELD NSW 2131
Ph: 02 8752 4314
Fax: 02 9716 5073
Email:
[email protected]
Newsletter Editor:
Jo Perks*
Leichhardt Women’s Health Centre
55 Thornley Street
LEICHHARDT NSW 2040
Ph: 02 9560 3011
Fax: 02 9569 5098
Email:
[email protected]
*
NNO Representative and also at
Family Planning NSW
328-336 Liverpool Road
ASHFIELD NSW 2131
Ph: 02 875 42370
[email protected]
Email:
Jennifer Walsh
Parramatta Sexual Health Centre
Jeffrey House
162 Marsden St, Parramatta 2150
Ph: 98433124
Email:
[email protected]
Glen Curran
Clinical Nurse Counsellor
Tasmanian Sexual Health Service
23 Steele Street
DEVONPORT TAS 7310
Ph: 03 642 17759
Fax: (03) 6421-7767
Email:
[email protected]
John McCallister
Clinical Nurse Consultant - HIV/AIDS
St Vincent's Hospital
DARLINGHURST NSW 2010
Ph: 02 8382 2576
Fax: 02 8382 2576
Email:
[email protected]
Donna Keeley
Clinical Nurse Consultant
B2 clinic
Infectious Diseases Department B Block
Alma Street
Fremantle WA 6160
Ph: 08 9431 2874
Fax: 08 9431 2035
Email:
[email protected]
(Mon, Tues and Thurs)
Matiu Bush
Sexual Health Nurse Practitioner Candidate
Melbourne Sexual Health Centre
580 Swanston Street
CARLTON VIC 3053
Ph: 03 9341 6200
Email:
[email protected]
ASHHNA Newsletter
18
MEMBERSHIP APPLICATION FORM
Full membership is open to Registered Nurses
working in Sexual and HIV Nursing.
ASHHNA Inc. Membership Details
The delivery of sexual and reproductive health
services is an essential component of the health
system in Australia. Prior to 1991, there was no
professional organisation advocating on behalf of
nurses working in the field of sexual and
reproductive health. The call for a professional
body reflecting the needs of these specialist
nurses encouraged the establishment of The
Australasian Sexual Health and HIV Nurses
Association Inc. (ASHHNA Inc).
ASHHNA Inc. has members in all States and
Territories across Australia and fulfils the criteria
to be recognised as a National Nursing
Organisation (NNO). The NNO is a diverse range
of specialty nursing organisations from around
Australia.
The aims of ASHHNA Inc. are to:
• promote sexual and reproductive health
nursing as a professional specialty
• advance the standards and scope of sexual
and reproductive health nursing practice
• facilitate the exchange of professional
information
• ensure effective communication and
networking in the specialty
• act as the representatives of the Australasian
Sexual and Reproductive Health and HIV
Nurses in discussions with government and
non government bodies at the State, Territory
and Federal level.
As a speciality nursing group, ASHHNA Inc.
members are offered:
• a newsletter
• an education scholarship
• an Australasian Conference
• affiliation with other specialists nursing
organisations
• professional development
• a Website
• a list server
• access to a local area sub branch
Associate membership is open to Registered
Nurses with an interest in, but not working in the
field of Sexual and Reproductive Health Nursing
and to Enrolled Nurses working in the field of
Sexual and Reproductive Health Nursing.
Associate members will enjoy all rights and
privileges of membership except voting rights.
Life
Life membership may be conferred by the
Executive Committee upon members of the
Association who have made an outstanding
contribution to the work of the Association or
the field of Sexual and Reproductive Health and
HIV.
Honorary
Honorary membership may be conferred by the
Executive committee upon eminent persons who
have made an outstanding contribution to the work
of the Association or to the field of sexual &
reproductive health and HIV.
Admission of Members/Applications
The annual subscription fee is $A50.00. All
applications for membership must be made on the
prescribed forms. Please return your application
form with subscription fee to the secretariat at the
address below.
Please make cheque or money order payable to the
“Australasian Sexual Health & HIV Nurses
Association Inc.(ASHHNA Inc.) to the sum of $50.00.
Please do not pay cash.
(Subscriptions are due each July regardless of joining date)
For an application form you can download it
at www.ashhna.org.au
ASHHNA Inc.
328 – 336 Liverpool Rd ASHFIELD NSW 2131
Tel: 02 8752 4314
Fax: 02 87524393
Email: [email protected]
www.ashhna.org.au
ASHHNA Newsletter
19
December 2008
ASHHNA Newsletter
7