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“APEX is a force for good”

An interview with Kerry Hughes, one of two radiation therapy delegates at Palmerston North Hospital.

Kerry and Angela, APEX Midcentral radiation therapy delegates.

Where do you work and what do you do?

I’m at Midcentral, Palmerston North Hospital, working as a radiation therapist. I did work at the Royal Prince Alfred in Sydney for a little while, and then I did a short stint in Wellington when they were short staffed, but mostly my work has been at Midcentral.

Our work encompasses radiation treatment and patient care from the first radiation specialist appointment, CT scan, planning, dosimetry and the delivery of the radiation treatment. We also can specialise in roles focusing on patient education and specialist clinics and involvement in new developments in cancer care.

How did you become end up becoming a radiation therapist?

I’ve been a radiation therapist for a long time. When I was fifteen or sixteen, I was driving my grandmother to Palmerston North Hospital to have cobalt treatment. I sat with her in the waiting room -a few chairs in the corridor- and noticed people passing by mostly looked concerned, and almost pityingly at my grandmother and other people waiting there under the cobalt sign. We didn’t mention the word cancer in those days, but cobalt meant cancer treatment. I thought, surely there’s got to be a more sensitive way to care for people waiting for treatment. From that I began thinking about a working in a hospital area with a patient focus.

I did another year of school, and then I applied for some hospital positions and was accepted to be a radiation therapist. We trained by correspondence then doing the British qualification. It was very hands on working in the department from day one.

What does a good day at work look like?

A good day at work looks like, no breakdowns on the machines and everything flows well, and we can take care of our patients and one another in a timely way. The workload is appropriate to the number of staff you’ve got. All those sorts of things all come together to make a good day for us.

How did you first become involved in APEX as a member and then as a delegate?

When I first started in radiation therapy, we didn’t have a union, I worked for eleven years and then left for about fourteen years to be at home with our children. The very week I came back, I found that there was some industrial action going on for the RTs. I got to have a little look at that and what the union was doing, and I could see it as a force for good.

So, I joined as a member, and I think probably within a few years I became a delegate. It fits with what we do as a patient caring profession. Looking after one another and our profession is good for our patients. The official things that happen away from the workplace, are of vital importance, all the action that happens through APEX, representing our profession and other allied health professions at a national level means that we don’t have to do this ourselves and can concentrate on what we do best as radiation therapists. This activity at national level is pivotal to how our profession progresses in the future. That is why I see unions as a force for good.

Palmerston North radiation oncology service has been under pressure with understaffing over the last few years. What have you been involved in as a delegate to help protect staff during the understaffing? 

Through APEX we’ve taken issues and initiatives to discuss with management when the pressure has been getting too high. There’s been a lot of looking at different processes to see if they could be streamlined. What was essential to get done to take the pressure off our staff. The more pressure there was on staff, the higher the risk of incidents. You lose staff eventually if you keep them under pressure for too long. So, it’s about management and APEX working together or sometimes it’s about APEX calling and naming the issues and highlighting them to management, who may already feel they’re dealing with it, but they don’t always have their finger on the pulse of exactly how members are feeling.  

There’s that power imbalance between management and staff members in a hierarchical system, and while it is ideal to have a conversation with managers first, sometimes people want to go through their union to address concerns or seek clarification on the contract. APEX can speak for or support our members if they want this.  

The union helps people to look at things more objectively, to be aware that the care of the patients is a responsibility of the hospital and Te Whatu Ora, and that they are funded to provide that care.  We’re part of that funding and part of that service. We as staff can’t always deliver on everything all the time. 

Initiatives our department has used for some years has helped with high workload when understaffed. Being able to swap patients from any linac to another linac in a heartbeat. This means in practice you can see if a linac is falling behind schedule and help by taking one or two patients. It streamlines the day when there are challenges and reduces overtime. It helps balance staff workload and the department to meet targets. I think it is a very underrated capability. The use of QCLS to reduce time loss to emails and improve communication processes is another efficiency used. Employing RTAs and training them to support RT work. I feel good about the work our team achieves in Palmerston given our workload and historic reduced staffing. 

Taranaki – the radiation oncology site is about to come online at the end of the year, which is very exciting. What are you thinking about in terms of the impact that it’s going to have on how you are delivering services as radiation therapists in Palmerston North and Taranaki, and how you’re going to look after them from the standpoint of being a delegate? 

I agree it’s very exciting. I think it’s exciting for people in Taranaki who could have treatment closer to home, and it’s exciting for us as a department to be branching out and providing most of the same services there as in Palmerston North.  

On being a delegate for members in Taranaki – I think there will be little change for members in relation to their delegates as we will be able to communicate as we do now. We will work with management in terms of members views/needs on the staffing model and any support and remuneration for people who work away from their home base. 

I think IT will be very important for us to function well in Taranaki. Most of the work will be digitally managed between Palmerston and Taranaki, so we can’t afford to be losing IT people. We will also need Medical Physics support. 

What is also important is that more staff will be recruited to cover the additional linac at the Taranaki site which will be run from Palmerston North. 

I think successfully running the Taranaki site will be about maintaining our productivity and patient care with the same supports that we have now in Palmerston North and transferring that same model to Taranaki. We expect around about 16% of our workload will go to the new site. The linear accelerator in Palmerston North that was intended for Taranaki will stay in Palmerston North to maintain capacity for our workload.  Taranaki will have a new linear accelerator which is very exciting for them as well. 

Thinking about the future of radiation therapy provision and also, where things will where things will and could go. What would you like to see APEX protecting more, or advancing more for radiation therapists and in our future work? 

I think it would be good for APEX to continue to raise nationally the urgency of lifting our profile as a profession to compete for staff. Our income’s not high enough to compare internationally, and we need to bring people into the country and particularly into provincial areas, Palmerston North and Taranaki and in time, Hawke’s Bay, I think just keep promoting our profession as much as we can.  

APEX does really good work following up on all the various innovations/changes governments toss into the mix or with our professional groups, that may have ideas about how things can be done differently. And unless the union is consulted and has input, there’s a whole section, a whole perspective missing. Because the union looks at things from the perspective of, “How will this affect our workers on the on the floor or in the workplace?” So, it is very important for members to engage with APEX on the opinions an ideas for the future in radiation therapy. 

You once told us that you were the youngest woman in New Zealand to get a pilot’s license. 

Yes. That’s right. I was for a time. It was a long time ago. 

What things are similar and different between flying and radiation therapy? 

In both, spatial awareness is very important. The concepts of where things are in 3D and 4D, how angles work. So, there is a parallel in scanning, planning and treating, how we look at and locate where we are treating, what’s affected, what else is on the horizon, just simple things like LEFT and RIGHT, SUP and INF, Forward and back, vertical, setting in apposition. These are applicable to flying as well. Precision, engineering, risk – all of those things have a similarity. 

We don’t have to deal with the weather in radiation therapy, and when flying you don’t have to deal with too many rules beyond civil aviation or we never used to then. The rules in flying light aircraft were mostly about safety and not so much about cost cutting or process change. 

What do you enjoy doing when you’re not at work? 

Family time and gardening 

Any message to the laboratory workers at Medlab Palmerston North and elsewhere around the country who are currently taking strike action? 

Absolutely – stay strong! And from our own recent experience in bargaining, do not accept the first string of no!  Just hang in there and keep going. Trust the bargaining process.