New leadership structure criticised and defended by FIONA CASSIE

1 April 2013
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The country’s once Magnet health service – Hutt Valley District Health Board – is being criticised for ‘eroding’ nursing power under its new merged leadership structure with neighbouring Wairarapa DHB.

Former Wairarapa nurse leader Helen Pocknall has been appointed the new executive director of nursing and midwifery (EDONM) position in a professional oversight and advisory role­ that is part of the new single executive team covering both DHBs.

Only nurse educators will directly report to the new leadership post, with other nursing leadership roles reporting to their hospital manager in a move strongly opposed by New Zealand Nursing Organisation members at Hutt.

NZNO organiser Jo Coffey said it was “unacceptable to downgrade” the voice of the largest workforce and ignoring nursing submissions had left nurses and midwives “out in the cold”. She said being unable to report directly to the nurse leader sitting at the executive table“diminished” nurses’ power and ability to influence the delivery of quality healthcare.

Pocknall said she understood the disappointment the Hutt nurses were feeling over the new reporting structures and part of her new role was “ensuring the voice of nursing remains prominent”.

She said she saw her role initially as ensuring that the “significant achievements and gains” made over the last 12–18 months, by nurses working in partnership with other clinical and management colleagues, were not lost. As well as ensuring the nursing voice was prominent and “the importance of the nursing workforce to the delivery of health services” was not diminished in any way.

Graham Dyer, joint chief executive of the two boards, has acknowledged the concerns and said the new reporting lines were not to be seen as a “demotion” or indicating a “lack of value” for nursing’s contribution.

He said he wanted to ensure that the executive director could focus on the professional and strategic aspects of the role and the risk with an operational and professional EDONM position was that professional and strategic issues were “crowded out” by operational issues.

Coffey believed that the “eroding” of the nurse leadership structure “was only the start” of cost-saving measures as the DHB grappled with government demands to reduce the two DHBs deficit by $5.3M.

Hutt Valley in 2007 became only the second hospital outside the United States to gain the “gold standard” nursing accreditation as a Magnet health service. The decision was made in 2010 to let the expensive accreditation drop but to continue to live up to the Magnet principles.

Hutt and Wairarapa DoNs ‘swap’ roles
Michele Halford, the executive director of nursing at Hutt Valley DHB since late 2011, has been appointed to the new nursing director role in the Wairarapa.

Pocknall is chair of the DHB directors of nursing group, is a member of the Health Workforce New Zealand board and a member of the Ngā Manukura o Apopo steering group.

Two other nursing leadership positions – Wairarapa’s associate director of nursing and Hutt’s perioperative nurse manager role – have been disestablished.