From nurse education, clinical, or workforce issues through to healthy living, Nursing Review has it covered.

From 1 July some caregivers will be earning the same as the nurses who supervise them. How will this impact on aged care nursing? FIONA CASSIE reports in this sneak preview from the next print edition of Nursing Review.

Associate Health Minister Nicky Wagner yesterday contradicted concerns about future shortfalls in aged care nursing numbers saying nursing numbers "were more than keeping pace" with growing aged care needs.

Nearly 70 per cent of aged care nurses are dissatisfied with their pay according to the New Zealand Aged Care Workforce Survey. And stress was the most common cause of work-related illnesses reported by both nurses and their managers.

The number of new nurses being employed by rest homes and aged care hospitals through mentored new graduate programmes has fallen this year, despite keen applicants still job-hunting.

Recent nurse graduate ROSALIE DAVIS shares a poignant nursing and life lesson she learnt from a wise healthcare assistant and a frail dementia patient.

A year ago Tairāwhiti nursing leader Dr Heather Robertson had started work on a draft advanced care plan when she had a traumatic car accident. She shares some hard won advice and thoughts on advanced care planning.

A survey confirming rest homes are employing high numbers of new graduates with no guaranteed mentoring is an "ongoing concern", says the nurses union NZNO.

After nursing patients with chronic kidney disease for more than two decades, Suzanne Joynt has seen the comfort and support that advance care planning (ACP) about end-of-life care can provide for patients and their families. So when her stepfather was diagnosed with a terminal illness, she hoped other nurses would be aware of its benefits too.

The summer is ending with 852 new graduate nurses in work but 547 remain in the talent pool still hoping for a new graduate placement.

Investing in a national prevention programme could save 30,000 New Zealanders suffering a pressure injury each year, recommends a major report. The KPMG report, The Case for investment in: A quality improvement programme to reduce pressure injuries in New Zealand, was released recently by the Health Quality & Safety Commission, ACC and the Ministry of Health.

Nurses' union NZNO is welcoming today's announcement that the Government will enter into pay talks for caregivers and support workers as a move towards fairer pay. Health Minister Jonathan Coleman said the Government was committed to seeing caregivers and support workers recognised for their valuable work. The announcement follows the Supreme Court and Court of Appeal last year backing an Employment Court decision to go ahead with Kristine Bartlett's Equal Pay Act test case.

Cardiology NP ANDY McLACHLAN shares his career-changing first experience of death and contemplates nursing, humanity and the ‘great circle of life-death’.

A funding boost for palliative care is warmly welcomed to help attract young nurses onto the palliative care nurse specialist pathway, says the Palliative Care Nurses New Zealand chair.

JANE HANNAH, a heart failure nurse specialist, says some families expect her to arrive in 'black robes and carrying a sickle' when referred for an 'end of life' discussion.  But she says anxiety falls and patients are more satisfied with their care after having a 'conversation that counts

Becoming a facilitator rather than a dictator of care…CHERYL CALVERT, a gerontology nurse specialist, shares the profound difference becoming an Advanced Care Planning facilitator has made to her practice

Initiating difficult conversations with the elderly or very ill about end-of-life care is very much the “bread and butter” of patient-centred nursing care.  April 16 is designated Conversations that Count Day to promote advance care planning (ACP) read on... 

Visas issued to migrant nurses coming to work in the aged care sector increased by nearly 25 per cent last year – despite advertised jobs decreasing by 22 per cent.

One of faith community nurse Noreen Wright’s flock jokingly calls her the “toe pruner”.

A review to consider closing New Zealand doors to overseas nurses  – because of homegrown new graduates struggling to find work  – has come out against taking that step.

Palliative care nurse advisor ANNE MORGAN asks whether feeding the dying is the right thing to do or simply the easiest option when faced with families who see withdrawing nutrition as "cruel" or "starving the person to death".

Nurses nationwide are invited to take part in a major online survey hoping to pinpoint the real differences between a staff nurse and a specialist nurse’s daily work.

Filipino nurses are fast becoming a mainstay of the New Zealand health and aged care sector. FIONA CASSIE gained some insights into the nursing culture in the Philippines – a country estimated to have up to a staggering 200,000 unemployed nurses – during a brief visit to Manila, including why we shouldn’t take this workforce for granted.

Moving a patient without harming them or yourself is basic, but not simple, care. Getting it right requires not only good training, equipment and bedside spaces but also a good workplace culture. Nursing Review finds out more.

Hawke’s Bay nurses were recently tested when Havelock North was hit by what’s believed to be the country’s worst ever waterborne disease outbreak – more than 5,000 people brought down with gastric illness. FIONA CASSIE shares the stories of some of the nurses involved and some of the lessons they learned.

Michele King shares a day of juggling finding respite beds, ward visits lunchtime meetings and working with frail older people and their sometimes tearful but grateful children.

A nurse is naturally often the ‘go to’ person when someone in the family or whānau is diagnosed with a long-term or chronic condition. PATRICIA McCLUNIE-TRUST explores the issues involved. 

Loneliness can be a precursor to depression in older people. NICKY DAVIES for her PhD thesis asked older people what they think loneliness actually is. FIONA CASSIE reports on the findings and the take-home messages for nurses working with older people who may be lonely… or just alone.

Every day around 24 New Zealanders –75 per cent of them aged over 65 – have a stroke. These 9,000 or so ‘brain attacks’ a year are the major cause of serious adult disability in the country, but stroke nursing is a specialty still relatively in its infancy in New Zealand. FIONA CASSIE finds out more from nurses working in the field.

Nursing Review reports on Professor Jenny Carryer’s recent study trip to the Netherlands to find out more about the Dutch approach to caring for older people – including the acclaimed De Hogeweyk dementia care village.

Critically Appraised Topic (CAT) looks at whether taking extra omega-3 makes a difference in slowing the progression of dementia.

Venous leg ulcers (VLU) are an ‘orphan disease’ in which nurse researcher Dr Andrew Jull has a longstanding interest. He talks to Nursing Review about his team’s latest VLU research project – Asprin4VLU – his first, and one of New Zealand’s first ever nurse-led, randomised, controlled trials of a drug treatment.

This Critically Appraised Topic (CAT) looks at whether getting on a bike or lacing up walking shoes improves the life, and life span, of people with coronary heart disease.

LYNDA LOVATT – a nurse turned personal trainer – shares tips on being ‘match fit’ for the physical demands of nursing.

Attempts to have pressure injury data regularly collected and reported as a nationwide quality indicator have been unsuccessful to date. But four district health boards decided not to wait for the rest of the country. FIONA CASSIE finds out about the Northern Region’s successful campaign to reduce harm from pressure injuries. 

Migrating to New Zealand saw JINSU SHINOY fall into a job in residential aged care and never look back.

It is now around eight years since funding for postgraduate nursing study was decentralised to district health boards.

From 1 July – after a somewhat hurried and harried introduction – interRAI will be the mandatory clinical assessment tool for nurses to use in residential aged care facilities nationwide. FIONA CASSIE catches up with some nursing leaders as facilities head down the home straight in a race to meet the deadline to train nurses in an already time and resource-stretched sector.

While interRAI is still the new, and sometimes unpopular, kid on the block in residential aged care, it is already well established in the DHBs’ Health of Older People community sector. FIONA CASSIE talks to a Nelson gerontology nurse and interRAI lead practitioner GABRIELLE STENT about why she thinks interRAI is worth getting to know.

Nursing-led research projects are being recommended for a share of the $14.6 million Ageing Well research challenge launched earlier this year.

Two years on, Canterbury’s Gerontology Acceleration Programme (GAP) is seen as having a positive impact directly and indirectly on the aged care nursing workforces involved.

Professional isolation was highlighted as an issue for the aged residential care sector in Waikato back in 2011.

After two decades in aged care without any study, Sabya Mohan is now enrolled for not one but two diplomas and is on the clinical nurse specialist pathway. She tells FIONA CASSIE how Waikato’s LARK leadership programme, and her change project on catheterisation, reinvigorated her career.

Keeping nursing procedures up to date can be a tedious and neverending task. For the past three years, however, the five Midland region DHBs have been using a ‘Kiwified’ online nursing procedure service that is shortly to go live across the South Island. FIONA CASSIE finds out more.

This edition’s critically appraised topic (CAT) looks at how best to reduce the risk of delirium in elderly patients without turning to drugs.

Nursing Review caught up with Minister of Health and former GP, Hon Dr JONATHAN COLEMAN, recently to talk about his plans to move more funding from the secondary to the primary health sector, and his views on the nursing and physician assistant roles.

Shiftwork isn’t natural, and long-term it isn’t healthy – but it is essential for modern health care. So the challenge is to minimise the risks and maximise any lifestyle benefits. FIONA CASSIE talks to a sleep physiologist and nurse leaders to find out how to do just that.

Can we do more to prevent readmissions after hospital discharge?

Rest home nurse manager SUE MILTON sewed the seed for her passion for gerontology during volunteer work as a school girl.

New Zealanders are more likely to die in residential aged care than most countries around the world. Some say our rest homes and hospitals could be called “de facto hospices” but without the resourcing or recognition to offer palliative care at the same level. FIONA CASSIE finds out more.

One of faith community nurse Noreen Wright’s flock jokingly calls her the “toe pruner”.

The frustration and isolation of suddenly becoming a 24/7 carer for her husband in an “ad hoc” and “failing” health system prompted long-standing Wellington local politician HELENE RITCHIE to tell her story and call for a Royal Commission inquiry into carer issues.

Do community exercise programmes for the elderly reduce injuries as well as falls?

NEWS BRIEFS including:Mid-year graduating nurses still job-hunting at year’s end/ interRAI funding/ Greens up ‘nurses in schools’ policy/ Registration medal shortage/Nursing Appointments

Jesse Lee Gamutan's working day begins with a frail patient falling and a crying caregiver.  Find out how the day progresses and about her nursing career path from the Philippines' Professional Regulations Commission to a Warkworth residential aged care facility.

Dr Anecita Gigi Lim backgrounds adverse drug events for the elderly and how to avoid them.

More than 150 children have been hospitalised this year with pertussis (whooping cough) and three babies in all have died since the outbreak began in August 2011. TRISH WELLS-MORRIS, education facilitator for the Immunisation Advisory Centre* puts the argument for all those caring for infants – be it as nurses, parents, or grandparents ­­– to be immunised against the disease.

PAULA MCKINNEL of the New Zealand Wound Care Society sets the scene for November 21’s worldwide Stop Pressure Injury Day.

We look to nurses as learners, educators, and leaders in this edition. Read on about teaching fledgling nurses in the classroom and on the ward, fostering leadership skills, nurses sharing their career tales, and milestones past and future in the recognition of competence and professional development.

The first NP employed by the residential aged care sector led to far fewer hospital admissions and reduced GP workloads, says an evaluation report. But in a sector always plagued by funding issues, the report also raises questions over the sustainability of the current funding model. FIONA CASSIE reports.

Aged care has one of the fastest ageing workforces. Getting new blood into the workforce is an obvious need and a pilot underway of providing extra support for new graduates entering residential aged care is one step being taken. FIONA CASSIE finds out more.

With a workforce crisis looming in aged care nursing, Christchurch is headhunting and helping the new generation of aged care nurses to fast track their careers. Fiona Cassie finds out more about the Gerontology Acceleration Programme (GAP).

Canterbury quakes saw Christchurch lose more than 650 residential care beds. One response was TotalCare – a collaborative approach led by community-based Nurse Maude to offer residential care in the home. Nursing Review reports on Sheree East’s recent presentation on the scheme to the Home Health Association conference.

In the last two years, 170 patients fell while in public hospital care and broke their hips, and 22 of those people died earlier than expected. FIONA CASSIE talks to Sandy Blake about the new national drive to reduce falls and her pilot of a bedside electronic falls risk assessment tool using TrendCare.

To celebrate International Nurses Day this year Nursing Review invited district health boards across the country to contribute stories on nursing ‘heroes’ in their region. We got stories back on just some of the unsung, innovative, compassionate, high achievers and dedicated nurses that make up the New Zealand nursing workforce.

Timely phone calls after discharge can help the frail elderly stay well and stay home. FIONA CASSIE reports on Dr Claire Heppenstall’s PhD research into the frail elderly recently presented to the College of Nurses symposium.

Extra support is to be offered to 24 new graduates entering the aged care workforce in 2013 in the trial of a new style graduate programme.

How the elderly fared in the Christchurch quakes was the focus for several presentations at the recent Baby Boomers & Beyond symposium held in the shaky city. FIONA CASSIE reports on a presentations by PhD student Michael Annear:

FIONA CASSIE reports on  Canterbury DHB nurse leader, Becky Hickmott's and researcher Dr Claire Heppenstall's presentations (to the Baby Boomers & Beyond Symposium) on how  elderly evacuees fared after the mass rest home evacuations that followed the  February 2011 quakes in Christchurch.

They rarely grab the headlines but thousands of New Zealanders each year get preventable pressure injuries – and some die. FIONA CASSIE looks at new guidelines, the new name, and new efforts to heal this health system scar.

FIONA CASSIE talks to New Zealand Wound Care Society president Wayne Naylor about his wound care career, fungating wounds, and a palliative approach to wound care.

CLINICALLY APPRAISED TOPIC (CAT): Can elevating the heels help prevent pressure injuries?

News briefs including: Nurse researchers seek more dementia carers/ Online cultural competency training/ Dementia Co-operative in action/ Nurse heads new Health Promotion Agency/Correction / Auckland DHB nurse shortages

Creating a veggie patch to encourage dementia facility residents to get gardening was a winner for enrolled nurse Pauline Anderson.

The Capital and Coast District Health Board (CCDHB) District Nursing Hospital Admission Prevention Project can now add to its list of achievements a reduction in rest home patients needing to be admitted to Wellington ED.

A joint care clinic launched last year at Palmerston North Hospital for patients scheduled for hip and knee joint replacement surgery has proved so successful that it has been extended to include shoulder joint patients, as well.

News briefs including: More nurses in schools/ Oz aged care package get nurses’ backing/  Innovative RNFSA and HCA training underway/ NZ hospital productivity ‘bucks trend’/ Toolkit to improve elective patient flow/  New ACC patient handling guidelines/ Strong cultural life enhances Māori elders

February 22 marked not only the first anniversary of Christchurch’s most devastating quake but also a farewell party for the red-zoned Radius St Ives rest home, which is being forced to close.

web 88852494 Taking practice nursing into the home – to ease the rehab of elderly patients – was the aim of a Nurse Practitioner Facilitation project by Rotorua NP-in-the-making Vicky Gaunt. Fiona Cassie reports.

web 103922163 Stroke is one of the first focuses for The Health Roundtable. Hilary Boyd, a consultant for the Australasian organisation which all our district health boards are signed up to, outlines the stroke initiatives and the Roundtable’s role.

Writing nurse practitioners into the residential aged-care services contract is being welcomed as a positive step forward.

More than 60 stroke nurse leaders from across the country attended the Ministry of Health’s stroke forum held in June. The ministry said nearly all 20 district health boards were represented, plus a number of aged-care facilities and organisations, and it was good to see nurses connecting and developing a strong stroke nursing network.

Registered nurses in aged-care struggle to deliver quality care as patients' needs get more complex, GP services decrease and education options remain limited, a recently-studied research paper found.

Standing orders consultation

FIONA CASSIE talks to DEB GILLON, one of the country’s newest NPs in one of the rarest roles – an aged care NP in the community

Unregulated caregivers are frequently being called on in residential aged-care facilities to do registered nurse tasks, a caregiver survey has found.