11 May, 2009
Speech for International Nurses Day
Thank you for inviting me here today. I am honoured to help mark International Nurses Day - which is tomorrow - and to celebrate the people who are part of the backbone of our health system.
Nursing has been a profession with high standards and a strong sense of public service for over 150 years. Nurses are amongst the most respected of all of our professions. There are few New Zealanders whose lives have not been touched by the care and reassurance that nurses provide, every hour of the day, every day of the year.
It is the future of nursing as a profession - not its past - that makes me confident about the young women and men undertaking their nursing education today. Nursing will play an even greater role in delivering a better, sooner, more convenient health care service for New Zealanders.
There are around 45,000 nurses currently practising in this country - you are a massive resource which the government intends to safeguard and strengthen.
In Primary Health Care alone, due to the pressures on our GP workforce and the drive to meet patient demand for more convenient healthcare, you as nurses are already making a much greater contribution as part of the family health team - and that will increase.
Nurses are also reaching new levels of competency as the demand for more complex nursing care increases. There are now 53 highly skilled nurse practitioners with a further five in the pipeline.
Despite its constant restatement as a policy objective, the role of nurse practitioners in primary care has not progressed as far as many originally envisaged. There are a number of reasons for this, and the new government is looking at these.
Our nursing graduate numbers are also on the rise.
The Minister of Education Anne Tolley and I are discussing increasing the numbers of places for nurses in tertiary institutions.
Since we came to office, the nursing agenda has had a lot of attention:
The new Government has asked the Nursing Council to work with District Health Boards and the Ministry of Health to expand the role and training of enrolled nurses in New Zealand.
Modern nursing and healthcare teams need another level of nursing expertise than is currently allowed for Nurse Assistants, who primarily work in aged care and rehabilitation facilities.
Many nurse assistants have argued that their scope of work and training can be broadened, which would allow them to play a stronger role in nursing care, with supervision from Registered Nurses
I have asked the Council, with support from the Ministry and DHBs, to review these positions, the education requirements, scope of practice and guidelines to reflect a strengthened role. This is a good opportunity to strengthen enrolled nursing, and it is expected the work will take around six months.
There are also positive signs pointing to a resurgence of interest in nursing. Applications for return-to-work programmes are rising, with many nurses looking at returning to the profession after several years in other roles.
While this will go some way to lessening the shortage of nurses,
the Government is also addressing the problem of a shortage in 'hard to staff' nursing specialities.
In February we launched the Voluntary Bonding Scheme which aims to attract graduate nurses into the hard to staff specialties of theatre, ICU and cardiothoracic nursing.
Nurse graduates who work in those areas, will get a lump sum payment against their student loan - or a cash incentive - after 3 years to the value of $8499 net. Then they can receive $2833 a year for two years after that.
The aim is for nurses to be able to pay their student loans off completely in a few years while they stay and further their careers at home.
I'm pleased to tell you we are getting a great response to this. I'll be able to announce more about the uptake for this scheme soon.
Improving the health service with greater numbers of more widely qualified nurses is not the whole answer.
Nurses also need time to be nurses. To focus properly on safe, quality care, you want to spend the maximum time caring for patients, rather than massaging keyboards and endless paperwork.
Nurses tell me how frustrated they feel being diverted from caring for patients by unnecessary bureaucracy. Nurses need more time to do what they were educated to do.
When I was opposition spokesman for health I visited Flinders Medical Centre in Australia where nurse-led initiatives have doubled the amount of time nurses spend with patients. And it's a picture being repeated at Middlemore and a number of other wards around the nation. The most important aspect of all this is that rather than being something imposed by innovation-crazed management consultants, the improvements are something that nurses on the ward wanted to do. This is the reason why it works.
With the difficult financial times ahead, we can provide more service for patients with a stronger emphasis on quality and improving patient contact time. Nursing is pivotal to this sea change of thinking. The new Government wants to work with the health professions to achieve these improvements.
It is the new Government's strong belief that nurses and doctors and other health professionals in New Zealand should have a much greater say in the way health services are delivered.
Globally, clinical leadership and engagement is recognised as a fundamental driver for better patient outcomes.
A better, sooner, more convenient public health service will need more people who are prepared to go above and beyond the call of duty, who will find more innovative ways to work within financial constraints, help each other with heavy workloads and look for ways to perform the job more effectively. And they will do that if they feel engaged and empowered.
The new Government has instructed District Health Boards to institute effective clinical leadership and we are expecting them to demonstrate this.
Clinicians themselves will have to step up and take on the responsibility that goes with a much greater leadership role. The principle is clear: if nurses and doctors are being held accountable for the quality of the care they deliver, they should have the power to engage in how those services are delivered.
This will not mean getting rid of good management in our health services. After all, many nurses make very good managers.
And our nation's best health managers know that clinical leadership is key to the health services' success.
The government also believes front line nursing staff should have more say in the regulation of their own profession.
From later this year, nurses on the nursing register can elect members of the Nursing Council.
This move is an important step towards giving nurses greater say in decisions affecting scopes of practice, competence and safety.
This Government is committed to greater clinical leadership, and this includes trusting nurses to elect members of the Nursing Council.
The nursing profession has come a very long way since the achievements of one of its greatest - Florence Nightingale whose birthday it is tomorrow on International Nurses Day. The future of your profession is very bright.
Thank you New Zealand nurses - thank you for everything you do.