A national conversation on what nurses need to do differently was started at the Nursing Strategy Day in April.
The National Nursing Organisation group (NNOg) decided in late 2016 that it would be useful to host a strategic planning day to look at the rapidly changing future and address the goals of the New Zealand Health Strategy. The Office of the Chief Nursing Officer provided significant support in arranging the 20 April forum in Wellington that was generously facilitated by a Ministry of Health staff member.
Those invited included all members of the NNOg, all members of Health Workforce New Zealand’s (HWNZ) Nursing Governance Taskforce for Nursing and a range of nurse leaders from different practice and service locations around the country. Medical colleagues and consumers were also present. We were limited by space so regretfully could not invite all of the possible candidates. But the strategy day was regarded as just a beginning conversation that will now be developed more extensively and in an inclusive manner.
The strategy day began by reviewing the significant achievements of the last decade including the developments in postgraduate education, the move to nurse prescribing, the passage of the Health Practitioners (Replacement of Statutory References to Medical Practitioners) Bill, establishment of the nurse practitioner role and much more. (I also personally acknowledge here the many nurses currently working under intolerable pressure who may not be in any way affected by these achievements.)
The 2016 Health Strategy has a strong emphasis on primary prevention and early intervention to ensure New Zealanders live well, stay well, get well. Key drivers of this strategy are persisting inequalities, a growing and ageing population, and the need to support people to be active participants in their own health care.
The purpose of the day was to consider what the 2030 world would look like to a healthcare customer and how policy direction and the Health Strategy could influence this.
The discussion was stimulated by a number of the presentations, particularly those focusing on the exponential rise in technology. It is clear that there will be significant changes in who provides services and how they will be provided.
The day was separated into two parts:
- What will the future look like?
- What does nursing need to do differently to anticipate that future constructively?
The extensive deliberations of the day are still being analysed and a fuller report will follow after the NNOg has considered the analysis on 7 June.
However, in brief, nurses present recognised the:
- degree to which nursing has already worked with limited funding to achieve a flexible, fit-for-purpose workforce able to flex up at many levels and in many settings
- need for a far more pre-emptive health service that works to protect, restore and maintain wellness from birth to death in line with the Health Strategy
- need to put consumer views and needs to the forefront of decision-making
- role of nurses in managing the consequences of poor health literacy, complex health systems and increasing disparity. Many present considered the notion that as technology increases disparities may be exacerbated.
Nurses present noted that:
- as a discipline focused on health, it is difficult to influence a system focused and funded from an illness perspective
- as a discipline, we struggle within current funding models and policy levers to achieve appropriate leadership and control over the direction of our own practice in many settings
- in a 2003 document (Investing in Health) we identified the need to better align nursing practice with community need. It remains a pressing agenda.
A tentative conversation was started about what we need to do differently. This is a conversation that will be continued with urgency.
Professor Jenny Carryer is executive director of the College of Nurses Aotearoa and chair of the NNOg.