So what do nurses want from this election?
College of Nurses Aotearoa (NZ)
Underpinning the college’s key concerns going into the 2012 election is its vision of 100 per cent access and zero disparities and its strategic plan that drives all college activities. Ensuring every New Zealander has access to affordable and acceptable primary healthcare requires politicians and health professionals to work together to address social and health determinants.
The college mostly supports the well-developed and articulated NZNO manifesto, especially the call for universal primary healthcare. Not only do we wholeheartedly agree that primary healthcare is the most cost-effective means of reducing future health and social service demands, but we also strongly support the belief that nursing is intrinsic to achieving population-wide improvement in health.
Four key areas are identified as pivotal to addressing health inequalities and ensuring all New Zealanders have access to healthcare as and when they need it.
Releasing the potential of nurses in primary healthcare
Since the release of the primary healthcare strategy in 2001, nurses have worked tirelessly to provide primary healthcare to people, families and communities. And yet huge health needs remain; growing health concerns related to diabetes, heart disease and family violence are a few of many. Nurses have the capacity to address these in a cost effective and acceptable way. Recognising the capabilities and skills of the largest health workforce would progress the health of all New Zealanders sooner rather than later.
Releasing the potential of nurse practitioners in rural healthcare
Rural communities and health organisations are increasingly concerned by the amount of health dollars being spent on expensive and unnecessary medical locums. Nurse practitioners offer a viable and acceptable alternative, not only for their capabilities, skills and expertise, but also for their understanding of the complex needs of often peripatetic rural communities. With health organisations, nurse practitioners can provide a cost effective, accessible and affordable health service to rural communities.
Releasing the time for nurses to care and address comfort; quality and safety for hospital-based nurses
An increasing number of stories from disillusioned families about poor treatment for their loved ones in the public hospital system are being heard. Nurses in under-resourced wards treating acutely unwell patients are finding it difficult to provide the nursing care and comfort integral to their practice.
Nurses must be involved in workforce planning
Addressing significant health inequalities will
only succeed when all health professionals, especially the largest group, nurses, are legitimately consulted and involved in healthcare workforce planning at all levels.
Source: College of Nurses Aotearoa (NZ) executive director Professor Jenny Carryer, with co-chairs Judy Yarwood and Taima Campbell.
Te Ao MÄramatanga New Zealand College of Mental Health Nurses
Mental health nurses are a vital workforce component in meeting increasing population mental health and addiction needs.
The college sees a number of key issues in mental health that would help the sector and mental health nursing improve outcomes for people with mental health and addiction issues across the care continuum.
Maximising the potential of the mental health nursing workforce requires:
- Agreed national mental health and addiction competencies within undergraduate nursing programmes.
- Ongoing investment to strengthen post-registration NESP (new entry to specialist practice) programmes and other postgraduate, clinically-focused, skills-based education and training programmes.
- Adequate resourcing of mental health services including acute inpatient areas.
- Compulsory completion of postgraduate NESP programmes in order to work as a specialist mental health nurse.
- Mental health nurses to have prescribing authority to authorise and review medications.
- Innovative programmes such as the Australian MHNIP (Mental Health Nurse Incentive Programme) where mental health nurses work alongside GPs and psychiatrists to provide interventions for people with serious mental illness.
- A specific strategy for developing mental health nurse practitioners in identified areas of need, i.e. rural, addiction, plus child and youth. This could be a Health Workforce New Zealand strategy and involve the funding of nurse practitioner intern positions.
Ongoing support for the role of the Mental Health Commission
Ongoing support for the functions of the Mental Health Commission – particularly in light of the Australian government’s support for such a body.
Addressing alcohol-related harm
A call for all parties to declare their intentions in regard to alcohol-related harm strategies:
- raising alcohol prices;
- raising the purchase age;
- reducing accessibility;
- reducing advertising and sponsorship;
- increasing drink-driving counter-measures;
- increasing treatment opportunities.
Increased access and responsiveness to the needs of people with mental health and addiction issues
Stigma and discrimination result in people with mental health and addiction issues comprising a vulnerable population. In addition to a nurse practitioner strategy, the college strongly supports:
- a continuing priority for Whänau Ora, children and youth;
- increasing the role of generalist primary healthcare staff in identification, brief assessment and interventions;
- addressing mental health and addiction issues amongst the increasing older population;
- increased consumer input to services, peer support roles, consumer advisors and peer led services;
- recognise that people with mental health and addiction problems frequently have co-existing physical health problems;
- enable mental health nurses and other practitioners, including peer support workers/systems, to work collaboratively across health service boundaries and public sector boundaries, i.e. welfare, justice and education.
Source: Te Ao MÄramatanga New Zealand College of Mental Health Nurses.
New Zealand Nurses Organisation
Universal access to primary healthcare
Make publicly funded nursing services the key entry point to primary healthcare, to ensure all New Zealanders have access to comprehensive primary healthcare, including primary aged and mental healthcare.
Support the Wha¯nau Ora model in principle as an appropriate means of supporting families and communities to address their health and social needs.
Prioritise wrap-around services for mothers and children to give the best start in life and reduce future health needs.
Invest in the nursing workforce
Remove legislative and other barriers to advanced and innovative practice to ensure a flexible nursing workforce able to meet population health needs.
Ensure nurses have equitable access to funding for postgraduate education, clinical training and leadership opportunities.
Ensure that Nursing Entry to Practice positions are available to all graduates, and that these positions include appropriate places for Ma¯ori and Pacific graduates and ENs.
Subsidise return-to-work programmes to maximise recruitment.
Affirm that new models of care that are inclusive of the broadened enrolled nurse scope of practice. Protect and enhance employment opportunities for enrolled nurses in primary, mental health and aged care, and in DHBs.
Ensure qualifications for all health workers are consistent with the public safety standards of the Health Practitioners Competence Assurance Act.
Ensure safe clinical environments
Ensure that staffing in all nursing environments meets the patient requirement for care by implementing care capacity demand management (developed by the Safe Staffing and Healthy Workplaces Unit) and ensuring access to nationally consistent acuity assessment tools.
Recognise that healthy work environments promote productivity, quality and safety, and protect workers’ rights by including a healthy workplaces clause in all employment contracts.
Facilitate the development of clinical frameworks and guidelines for responsibility of care that clarify the interface between regulated and unregulated workers, particularly in aged care and mental health.
Ensure that culturally and clinically appropriate care in all settings is provided by the appropriate person in the healthcare team.
Establish a single agency for the recruitment of overseas health professionals to minimise exploitation, protect Aotearoa New Zealand employment conditions, and maximise the use of workforce resources. This includes finding alternative safe clinical pathways for overseas-trained Pacific nurses living in Aotearoa New Zealand to gain New Zealand registration, to address critical health workforce shortages in Pacific communities here.
Increase equity
Address the social determinants of health through the coordination of social, health, environmental and employment government strategies across all sectors.
Raise the minimum wage, return the minimum hours defining full-time work to 35 hours per week, reinstate the Pay and Employment Equity Unit, and repeal amendments to the Employment Relations Act and the Holidays Act that promote inequitable industrial relations.
Stop moves to privatise and restrict ACC and health and education services.
Facilitate union representation and integrative (interest-based) bargaining.
Develop genuine and nationally consistent indicators of activity, output, quality and health outcomes, to facilitate sound planning.
Protect public health
Protect public health by continuing to fund smoking cessation strategies; implement the ‘5+ Solution’ to the misuse of alcohol; re-prioritise oral health and healthy eating/healthy action programmes; and remove GST on healthy foods.
Retain the capacity to deliver coordinated public health programmes and services to improve population health, and address the increase in diseases of poverty, such as rheumatic fever and tuberculosis.
Ensure safe aged care
Set minimum mandatory staffing levels in aged care, which take into account the right skill mix, and develop robust measures for acuity assessment, safety and quality in aged care.
Ensure that access to home support is assessed face-to-face by a regulated health practitioner, and that care is provided by the most appropriate person/team in all settings, i.e. enrolled nurses, registered nurses, nurse practitioners, healthcare assistants.
Improve access to mental health services
Ensure access to primary mental healthcare, including culturally and clinically appropriate community-based and residential alcohol, drug, and gambling addiction and rehabilitation services, and alternatives to Police management of acute care episodes.
Source: NZNO 2011 Election Manifesto summary of recommended actions.
