It is essential that nurses and world leaders focus on the global nursing workforce as a key priority for achieving better health for all. So states the International Council of Nurses (ICN) in its latest manifesto for International Nurses Day.
This year, International Nurses Day focuses on nurses being both a “force for change” and a “vital resource” for health care.
It is a wide-ranging document looking at projected nursing shortages, migration and the downstream effect of the global financial crisis leading to governments and employers squeezing savings out of the workforce that make up the bulk of their health wages bill – i.e. nursing.
Nursing Review this edition looks at one other issue raised by ICN – that of role substitution or task shifting to make vital health professional resources stretch further.
In New Zealand, there have been some lively debates – sometimes a tug-of-war – between the medical and nursing professions about nurses wanting to work at the top of their scope and the resistance of some doctors at nursing moving “into their patch”.
But there has been less debate about the other end of the nursing scope and the resistance of some in the nursing profession to give up basic care tasks to health care assistants (HCAs).
One nurse I spoke to recently pointed out the irony of nurses protesting at doctors’ reticence at letting go of roles traditionally done by doctors but at the same time “kicking and screaming” if health care assistants start taking over some of the traditional care tasks of nursing. That reluctance is, of course, not helped by the United Kingdom’s Mid Staffordshire Inquiry showing the tragic consequences for patient safety, and dignity, if you go too far down the HCA path unheeded.
So maybe it is time for New Zealand to have that debate? And to look at setting national parameters for the training, qualifications and accountability of HCAs and their delegating registered nurses, now so we can make the most of a limited and vital nursing resource; and ensure patient safety is foremost in our minds rather than balancing the books.
Fiona Cassie
