Professional Responsibility and Legal Ethics in Queensland

With the commencement of the Legal Profession Act 2007 (Qld) and the establishment of the Legal Services Commission, the legal profession and legal services market in Queensland has experienced significant changes to its regulatory environment. Professional Responsibility and Legal Ethics in Queensland provides a detailed explanation and analysis of these changes. The book will assist lawyers to plan for successful practice within this new environment by examining such topics as: • The scope and application of key provisions within the Legal Profession Act; • The role, functions and policies of the Legal Services Commission; • The ethical and regulatory implications of operating as an Incorporated Legal Practice or as a Multi-Disciplinary Partnership; • Developments affecting trust accounts and client money dealings more generally; • Recent case law, Tribunal decisions and Legal Services Commission guidelines in relation to the new conduct standards of Unsatisfactory Professional Conduct and Professional Misconduct; and • The impact of the new legislation and regulatory environment on a range of traditional ethical duty categories such as the duty to communicate, costs and billing practices, as well as the paramount duties to the court and to the administration of justice. An invaluable reference for legal professionals, this book is also an important resource for law students grappling with questions raised by legal ethics and their application to the workplace.

Book review : "Community engagement in contemporary legal education : Pro Bono, Clinical legal education and services learning"

The result of a forum on community engagement held in November 2008 at Bond University, Community Engagement in Contemporary Legal Education is a compilation of papers presented at the forum by academics and professionals throughout Australia. Although found initially to be a topic of legal interest, it was not until the reviewer came across the Council of Australian Law Deans (CALD) “Standards for Australian Law Schools” (adopted 17 November 20093) then the full importance and potential of this book was revealed. Clause 2.2.4 of the CALD Standards recognises the importance of “experiential learning opportunities” for law students and cites examples such as clinical programs, internships, practical experience and pro-bono work. Clause 2.3.3 acknowledges the need to develop professional ethics and again cites pro-bono obligations as an example. Clause 9.6.2 encourages interaction of law schools with the profession and the community and again, pro-bono community service is identified as one method of doing so. Yet nowhere in the document are there any uniform standards or binding obligations that law schools must commit to. In the current climate where the importance of practical experience is continually emphasised and student numbers exceed the number of available paid legal positions, there should be more focus on the details of how these commitments should be converted to be included in a law school’s curriculum.

Interest from Tertiary Educated Persons in Fostering Children with Higher Care needs under a Professional (Paid) Model Compared with General Foster Care

The number of Australian children requiring foster care due to abuse and neglect is increasing at a faster rate than suitable carers can be recruited. Currently increased numbers of foster children are presenting with higher care needs. Evidence suggests carers with a higher education could contribute to placement stability and ultimately provide more positive outcomes for this group of children. This paper explores the level of interest by tertiary educated persons toward a model of fostering for children with higher needs. Using a descriptive survey methodology, a convenience sample of 644 university undergraduate and postgraduate students within faculties of health sciences, and education, arts and social sciences was employed. Psychology students in the 17-26 year old age group showed greatest interest in a professional foster care model and this was statistically significant (p=0.002 955 CI .000-.010) when compared to other health professionals and other age groups. Education students held the highest interest in general fostering although not statistically significant. When these survey results were extrapolated to the total number of health professionals in Australia there could be 8,385 potential recruits for a model professional foster care. Focused campaigns are required to source professional as recruits to fostering with the benefit of servicing the placement needs of higher care needs children and contributing to general foster care resources.

The social work & human services workforce : report from a national study of education, training and workforce needs

This report analyses the national curriculum and workforce needs of the social work and human services workforce. Australia’s community and health services are among the fastest growing sectors of employment in the nation but the sustainability of an appropriately qualified workforce is threatened. Yet there is little integration of education and workforce planning for the community services sector. This contrasts markedly with the health services sector, where key stakeholders are collaboratively addressing workforce challenges. Our research confirmed rapid growth in the social work and human services workforce and it also identified: • an undersupply of professionally qualified social work and human service practitioners to meet workforce demand; • the rapid ageing of the workforce with many workers approaching retirement; • limited career and salary structures creating disincentives to retention; • a highly diverse qualification base across the workforce. This diversity is inconsistent with the specialist knowledge and skills required of practitioners in many domains of community service provision. Our study revealed a lack of co-ordination across VET and higher education to meet the educational needs of the social work and human services workforce. Our analysis identified: • strong representation of equity groups in social work and related human service programs, although further participation of these groups is still needed; • the absence of clear articulation pathways between VET and higher education programs due the absence of co-ordination and planning between these sectors; • substantial variation in the content of the diverse range of social work and human service programs, with accredited programs conforming to national standards and some others in social and behavioural sciences lacking any external validation; • financial obstacles and disincentives to social work and human service practitioners in achieving postgraduate level qualifications. We recommend that: • DEEWR identify accredited social work and human services courses as a national education priority (similar to education and nursing). This will help ensure the supply of professional workers to this sector; • VET and higher education providers are encouraged to collaboratively develop clear and accessible educational pathways across the educational sectors; • DEEWR undertake a national workforce analysis and planning processes in collaboration with CSDMAC, and all social and community services stakeholders, to ensure workforce sustainability; and • COAG develop a national regulation framework for the social and community services workforce. This would provide sound accountability systems, and rigorous practice and educational standards necessary for quality service provision. It will also ensure much needed public confidence in this workforce.

Mapping the ethical journey of experienced nurses now practising in rural and remote hospitals in central and south-west Queensland and in domiciliary services in Brisbane : a grounded theory approach

The aim of this thesis has been to map the ethical journey of experienced nurses now practising in rural and remote hospitals in central and south-west Queensland and in domiciliary services in Brisbane. One group of the experienced nurses in the study were Directors of Nursing in rural and remote hospitals. These nurses were “hands on”, “multi-skilled “ nurses who also had the task of managing the hospital. Also there were two Directors of Nursing from domiciliary services in Brisbane. A grounded theory method was used. The nurses were interviewed and the data retrieved from the interviews was coded, categorised and from these categories a conceptual framework was generated. The literature which dealt with the subject of ethical decision making and nurses also became part of the data. The study revealed that all these nurses experienced moral distress as they made ethical decisions. The decision making categories revealed in the data were: the area of financial management; issues as end of life approaches; allowing to die with dignity; emergency decisions; experience of unexpected death; the dilemma of providing care in very difficult circumstances. These categories were divided into two chapters: the category related to administrative and financial constraints and categories dealing with ethical issues in clinical settings. A further chapter discussed the overarching category of coping with moral distress. These experienced nurses suffered moral distress as they made ethical decisions, confirming many instances of moral distress in ethical decision making documented in the literature to date. Significantly, the nurses in their interviews never mentioned the ethical principles used in bioethics as an influence in their decision making. Only one referred to lectures on ethics as being an influence in her thinking. As they described their ethical problems and how they worked through them, they drew on their own previous experience rather than any knowledge of ethics gained from nursing education. They were concerned for their patients, they spoke from a caring responsibility towards their patients, but they were also concerned for justice for their patients. This study demonstrates that these nurses operated from the ethic of care, tempered with the ethic of responsibility as well as a concern for justice for their patients. Reflection on professional experience, rather than formal ethics education and training, was the primary influence on their ethical decision making.

Emergency health services : demand and service delivery models. Monograph 1: literature review and activity trends

Emergency Health Services (EHS), encompassing hospital-based Emergency Departments (ED) and pre-hospital ambulance services, are a significant and high profile component of Australia’s health care system and congestion of these, evidenced by physical overcrowding and prolonged waiting times, is causing considerable community and professional concern. This concern relates not only to Australia’s capacity to manage daily health emergencies but also the ability to respond to major incidents and disasters. EHS congestion is a result of the combined effects of increased demand for emergency care, increased complexity of acute health care, and blocked access to ongoing care (e.g. inpatient beds). Despite this conceptual understanding there is a lack of robust evidence to explain the factors driving increased demand, or how demand contributes to congestion, and therefore public policy responses have relied upon limited or unsound information. The Emergency Health Services Queensland (EHSQ) research program proposes to determine the factors influencing the growing demand for emergency health care and to establish options for alternative service provision that may safely meet patient’s needs. The EHSQ study is funded by the Australian Research Council (ARC) through its Linkage Program and is supported financially by the Queensland Ambulance Service (QAS). This monograph is part of a suite of publications based on the research findings that examines the existing literature, and current operational context. Literature was sourced using standard search approaches and a range of databases as well as a selection of articles cited in the reviewed literature. Public sources including the Australian Institute of Health and Welfare (AIHW), the Council of Ambulance Authorities (CAA) Annual Reports, Australian Bureau of Statistics (ABS) and Department of Health and Ageing (DoHA) were examined for trend data across Australia.

Apps and attitudes : towards an understanding of the m-librarian’s professional make-up

This chapter will discuss a research project that identifies the skills, knowledge and attitudes of the m-librarian. Six library and information professionals engaged in the provision of m-library services throughout Australia were interviewed. Six themes emerged as being critical for the m-librarian: technology, personal traits, user focus, communication, collaboration, research and development. The research is significant because it establishes an open dialogue between current industry professionals, library science educators and the professional association on the evolving skills and knowledge required by information professional in a world of rapidly changing technology. This dialogue will guide the development of current and future education of library and information professionals.

Prisons, dietetic services, research and training : win win

Learning Outcome: Gain knowledge in the area of dietetic training in Australia and the benefits of collaborative partnerships between government and universities to achieve improvements in dietetic service delivery, evidenced based practice, and student placements. Prisoners have high rates of chronic disease, however dietetic services and research in this sector is limited. Securing high quality professional practice placements for dietetic training in Australia is competitive, and prisons provide exciting opportunities. Queensland University of Technology (QUT) has a unique twenty year partnership with Queensland Corrective Services (QCS) with a service learning model placing final year dietetic students within prisons. Building on this partnership, in 2007 a new joint position was funded to establish dietetic services to over 5500 prisoners and support viable best practice dietetic education. Evaluation of the past three years of this partnership has shown an expansion of QUT student placements in Queensland prisons, with a third of final year students each undertaking 120 hours of foodservice management practicum. Student evaluations of placement over this period are much higher than the University average. Through the joint position student projects have been targeted on strategic areas to support nutrition and dietetic policy and practice. Projects have been broadened from menu reviews to more comprehensive quality improvement and dietetic research activities, with all student learning activities transferrable to other foodservice settings. Student practice in the prisons has been extended beyond foodservice management to include group education and dietetic counseling. For QCS, student placements have equated to close to a full-time dietitian position, with nutrition policy now being implemented as an outcome of this support. This innovative partnership has achieved a sustainable student placement model, supported research, whilst delivering dietetic services to a difficult to access group. Funding Disclosure: None

Teachers’ detecting and reporting child abuse and neglect : research into the determinants of complex professional behavior

Child abuse and neglect is prevalent and entails significant costs to children, families and society. Teachers are responsible for significant proportions of official notifications to statutory child protection agencies. Hence, their accurate and appropriate reporting is crucial for well-functioning child protection systems. Approximately one-quarter of Australian teachers indicate never detecting a case of child maltreatment across their careers, while a further 13-15% admit to not reporting suspected cases in some circumstances. The detection and reporting of child abuse and neglect are complex decision-making behaviors, influenced by: the nature of the maltreatment itself; the characteristics of the teacher; the school environment; and the broader legislative and policy environment. In this chapter, the authors provide a background to teachers’ involvement in detecting and reporting child abuse and neglect, and an overview of the role of teachers is provided. Results are presented from three Australian studies that examine the unique contributions of: case; teacher; and contextual characteristics to detection and reporting behaviors. The authors conclude by highlighting the key implications for enhancing teacher training in child abuse and neglect, and outline future research directions.

Professional development in the contemporary educational context : encouraging practice wisdom

Preparing social work students to be effective practitioners is a complex and challenging task undertaken in a dynamic environment both in terms of the field of social work and the higher education sector. There have been recommendations that self knowledge, empirical knowledge, theoretical knowledge and procedural knowledge are the keys to high standards of social work practice. This paper suggests that the concept of practice wisdom is a useful focus for integrating these different aspects of informed practice and for focusing educational programmes for social work. As practice wisdom is more about process than possessed characteristics then there are important motivational and value-based considerations in developing wise practitioners. This discussion considers motivational and personal narrative aspects of practice wisdom so that it can be integrated into social work teaching.

Development and testing of an iPad application for teaching self-management to heart failure patients. (Nursing/Allied Health Professional Investigator Award)- Abstract

Purpose: Heart failure (HF) is the leading cause of hospitalization and significant burden to the health care system in Australia. To reduce hospitalizations, multidisciplinary approaches and enhance self-management programs have been strongly advocated for HF patients globally. HF patients who can effectively manage their symptoms and adhere to complex medicine regimes will experience fewer hospitalizations. Research indicates that information technologies (IT) have a significant role in providing support to promote patients' self-management skills. The iPad utilizes user-friendly interfaces and to date an application for HF patient education has not been developed. This project aimed to develop the HF iPad teaching application in the way that would be engaging, interactive and simple to follow and usable for patients' carers and health care workers within both the hospital and community setting. Methods: The design for the development and evaluation of the application consisted of two action research cycles. Each cycle included 3 phases of testing and feedback from three groups comprising IT team, HF experts and patients. All patient education materials of the application were derived from national and international evidence based practice guidelines and patient self-care recommendations. Results: The iPad application has animated anatomy and physiology that simply and clearly teaches the concepts of the normal heart and the heart in failure. Patient Avatars throughout the application can be changed to reflect the sex and culture of the patient. There is voice-over presenting a script developed by the heart failure expert panel. Additional engagement processes included points of interaction throughout the application with touch screen responses and the ability of the patient to enter their weight and this data is secured and transferred to the clinic nurse and/or research data set. The application has been used independently, for instance, at home or using headphones in a clinic waiting room or most commonly to aid a nurse-led HF consultation. Conclusion: This project utilized iPad as an educational tool to standardize HF education from nurses who are not always heart failure specialists. Furthermore, study is currently ongoing to evaluate of the effectiveness of this tool on patient outcomes and to develop several specifically designed cultural adaptations [Hispanic (USA), Aboriginal (Australia), and Maori (New Zealand)].

Access to Cardiac Rehabilitation does not Equate to Attendance. (On Behalf of the Cardiac ARIA Project. Winner Nursing/Allied Health Professional Investigator Award)

Background/Aims Timely access to appropriate cardiac care is critical for optimizing positive outcomes after a cardiac event. Attendance at cardiac rehabilitation (CR) remains less than optimal (10%–30%). Our aim was to derive an objective, comparable, geographic measure reflecting access to cardiac services after a cardiac event in Australia. Methods An expert panel defined a single patient care pathway and a hierarchy of the minimum health services for CR and secondary prevention. Using geographic information systems a numeric/alpha index was modelled to describe access before and after a cardiac event. The aftercare phase was modelled into five alphabetical categories: from category A (access to medical service, pharmacy, CR, pathology within 1 h) to category E (no services available within 1 h). Results Approximately 96% or 19 million people lived within 1 h of the four basic services to support CR and secondary prevention, including 96% of older Australians and 75% of the indigenous population. Conversely, 14% (64,000) indigenous people resided in population locations that had poor access to health services that support CR after a cardiac event. Conclusion Results demonstrated that the majority of Australians had excellent ‘geographic’ access to services to support CR and secondary prevention. Therefore, it appears that it is not the distance to services that affects attendance. Our ‘geographic’ lens has identified that more research on socioeconomic, sociological or psychological aspects to attendance is needed.

Mobius markets : professional families in rural educational markets

Australia has many isolated communities that require human services provided by qualified professionals. Maintaining a viable and equitable spread of such educational capital across space as a public good is a challenge. Reports investigating this problem repeatedly point to ‘family issues’ such as limited options for children’s education, and limited access to ongoing professional development, as deterrents for rural/remote employment despite lucrative incentive schemes. This paper draws on semi-structured interviews with 30 parents of school-aged children, who work as doctors, nurses, teachers and police in six rural/remote towns in Queensland. We asked them how their family units reconcile career opportunities with educational strategy for family members over time and space. This paper considers these issues as a sociology of education problem in a context of educational marketisation and spiralling credentialism. This paper offers the concept of ‘mobius markets’ to capture the cyclical and intergenerational process underway in middle class professional families of investing in educational capitals, maintaining or maximising their value and profiting from them. A mobius strip is the topological anomaly of a single loop with one twist in it, whereby the loop becomes one continuous surface, not the double-sided shape it appears to be. This project is interested in how the middle class professional family is similarly on a constant circuit, investing in educational capitals, upgrading their currency/value, and profiting from them. This elaborated sense of educational markets extends the more usual sociological focus on school choice.