NZNO's Blog

Kaiwhakahaere Kerri Nuku
Tōpūtanga Tapuhi Kaitiaki o Aotearoa NZNO

I’d like to start by acknowledging every member, nurse, midwife, health care assistant, tauira and Kai Mahi. The collective support and member action throughout the country shows not only the power in members’ collective action/kotahitangi but a strong need for change.

As I am writing the blog this week, our Te Whatu Ora workforce has been holding stop work meetings around the country. The momentum, energy and frustration was palpable. Power belongs in the hands of members including nurses and students who are work on the coal face because only then can we see the need and we can build the momentum and change. The organisation has shifted to a model where the devolvement of responsibilities that once upon a time sat in the central office is moving to locally driven initiatives where we have local members driving the need.

The issue with Ward 5 was a monumental turning point because it identified a local issue and members organised locally. Challenging a Goliath of a healthcare system and the victory was not just for Ward 5, but a win for every member of NZNO. What it means is that local concerns have national importance. The collective movement and the collective action of solidarity was phenomenal. We need to make sure that regardless of who takes the next action we continue to build a united collective movement. Whether the next Ward 5 comes from Wairoa, or Eketahuna is irrelevant because it’s just important as the next. Every time nursing is eroded, it impacts on all of us.

I reflect on the organisation that was and where we’re going. Building locally with local membership and leadership is what we need to make national change. Kia Kaha and let’s continue.

I acknowledge the pressure that nursing continues to experience has had a huge influence on where we are today. Nursing isn’t far from everybody’s mind that is why we continue to build the traction.

Fundamentally, at the heart of the issue in any health care system is the health and safety for our nurses. They need to feel safe at work to be able to deliver high quality care in a safe environment.

As we’ve seen in Ward 5, if those standards drop then we have a responsibility to our patients or consumers of the service to advocate and challenge the poorly functioning system. We have to ensure that these standards of care are lifted because ultimately at the end of that service delivery there is a patient. Any health care that is substandard ultimately impacts on the consumer receiving the service.

We do have a responsibility to ensure the health and safety requirements under the health and Safety at Work Act are upheld and we are not working and delivering substandard care because of the restrictions imposed by the work environment.

For a long time we have been calling on the Minister to acknowledge the crisis that exists within the nursing workforce for far too long the issue had been ignored, not for want of trying, not for want of persistence, but at that stage the voices of nurses wasn’t important. Now, once the health and safety of not just nurses but consumers are impacted, this becomes a state of emergency. The actions and what we must continue to do is call out whenever this emergency that impacts on the health and safety of not just nurses, but consumers of the service that deserve quality care and a high standard of service and care has been impacted this is the emergency.

Anne Daniels, President
NZNO Tōpūtanga Tapuhi Kaitiaki o Aotearoa

Misinformation is incorrect or misleading information. An example of this it the recent incorrect ED wait time data given to the Minister of Health to use in the media.

Hon Ayesha Verrall used the Northland ED figures to claim there was a huge improvement in the ED response times, when in fact, the opposite was true. (Te Whatu Ora admits figures used by Health Minister are ‘not accurate’ – NZ Herald).

Nurse shortages have put us in crisis mode, and decisions affecting nurse staffing vacancies could have been made on the back of the incorrect data, which has now been corrected.

Disinformation is the creation and distribution of intentionally false information, usually for political ends. I recently attended the CTU conference that focused on organising and campaigning. A misinformation expert and historian researcher Kate Hannah spoke there about the exponential rise in disinformation that originates from a small number of sources, often right wing. Reasons for people and groups to generate and spread disinformation include financial or political motivations, to increase distrust in Government, the media and experts, or just to generate discord.

Disinformation is a symptom of long-standing societal issues such as misogyny, racism, nationalism, distrust in government, and anti-intellectualism. Countering mis- and disinformation can be difficult because of the speed and scale at which digital information can be replicated and shared.
Accountability will only happen if people care enough to do more to actively resist the tide of disinformation. Kate Hannah has concerns as often “New Zealanders generally want to let things slide”.

Recently, I worked with several media outlets who had identified that the information regarding apparent similar rates of pay comparisons between New Zealand and Australian nurses were incorrect. This information had been posted on the Te Whatu Ora website.

Minister of Health Ayesha Verrall used that information and made inaccurate claims that the pay rates for nurses in New Zealand and Australia were now similar. A Kiwi nurse in Queensland was interviewed at the time and said there is nearly a $20,000 difference in base pay. He went to say the Minister had made a sad and unfair statement that was disingenuous. Kaitiaki did an in depth story to demonstrate the facts of the case.

But was it really the Health Minister’s fault? The disinformation came from a trusted source. Are they being held accountable? One must ask what vested interests were in play here? Misinforming the largest health workforce in the country, and the public can only have one outcome – a strengthening of NZNO members commitment to stand strong and act. Further, it is not okay that a Minister of Health is put in a position where an entity she should be able to trust is not doing right by her.

Going forward into election year, I expect disinformation to continue to rise particularly around our NZNO members. It will be up to every nurse, everywhere to stand up and counter disinformation, and be activists in demanding trust, truth, and accountability.

Anne, Daniels, President
Tōpūtanga Tapuhi Kaitiaki o Aotearoa NZNO

Metaphorically our NZNO national Day of Action was “a shot across the bow”. It was an action to warn our Government and nurse employers that if we (NZNO members) continue to be ignored, they can expect stronger, more direct action.

Why? As many who spoke at any one of the 20 rallies around the country, said, we can no longer wait. Our patients cannot wait and suffer, and we can no longer stand by and let that suffering continue. Their pain is our pain.

15 April 2023 was a historic day for NZNO. It was the first time, since the formation of our union, that members from every sector, stood together in solidarity, to demand one action – safe staffing.

In Wellington, we were led out by members of Te Poari and Te Runanga, walking proudly towards Parliament (and our various destinations throughout the country). I believe there would have been many silent tears shed.

For me, when members of the public stopped in their tracks and started clapping, filming, joining in, I knew we had the public with us in solidly with us. As a female-dominated profession, we have come a long way from the time of the Suffragettes, but we still have a long way to go.  Change does not come from those who hold the reins of power, it comes from you, our members and those who support us.

Every NZNO member everywhere must act. This is our future, our time. We will only succeed if we all challenge ourselves to be part of the change that we need to see. The rallies were successful as we gained strong and prioritised media attention.

However, less that 4 percent of our members attended these rallies. Why were the other 96 percent not there? Some were working. A few were in places where no rally was being held, but the vast majority of our members were not there. As a nurse, mother, grandmother (with grandchildren living with me), an ED nurse, and as an NZNO activist since the 1990s, I have always acted when change is needed. I have not left it to someone else and I have never acted alone. We need everyone. This is a challenge to all our members to “Maranga Mai!”, Rise Up and Act!

On Saturday, I laid down another a challenge to all political parties and individual Ministers to publicly commit the fixes of Maranga Mai! The media, in turn, asked each political party if they would do just that. All parties who responded said that their health policy leading into the election had not been finalised. What an opportunity for us!

Get together, go see your local politician and tell them why our fixes need to happen NOW. Then, challenge them to commit publicly. Let them know, that we won’t stop, until we get what we need and the nation needs – a public health system that is fit for purpose, safe to work in, and that retains and recruits the right number of skilled nurse/midwife/HCA/kaiāwhina/allied health workers that we need to provide the best of care. You can do this. We can do this. We must do this, NOW.

Kerri Nuku, Kaewhakahaere
Tōpūtanga Tapuhi Kaitiaki o Aotearoa NZNO

The health system is not meeting the needs of New Zealanders, especially Māori, and it’s also NOT meeting the needs of those who work within it. So what is the Government going to do to ensure the right resource goes to the frontline and not into endless restructures?

The response from the Prime Minister to this question was both respectful and insightful with an understanding of pressures across the system, but not a guarantee of resources to the frontline.

The extraordinary challenges across health both nationally and internationally have been unprecedented. The impact of Covid was always going to take years to recover from, but wave upon wave of challenges have continued to erode the energy and passion of the entire health workforce. Nurses voluntarily offered to be deployed to different regions to help spread the load in crisis areas during the latest flood events from Cyclone Gabrielle, but these short-term solutions are not going to be effective in the long-term.

Latest information from an Australian recruiting agency suggests that more than 5000 New Zealand nurses have registered with the Australian regulatory body and are contemplating working across the ditch. Even if half of this number were to leave, with the huge vacancies and reports of staff shortages on each shift, this would have a devastating impact on the health workforce left behind.

This week Rob Campbell, the former chairman of the Te Whatu Ora Board, has come out and supported the opportunity for change through the health reforms. We at NZNO were all hoping this was an opportunity to be brave and bold and develop models of care with the patient at the centre of the care and a responsive and well-resourced workforce. Like many I was sceptical about a reshuffling of the senior executive deck chairs, moving from being DHB executives on the 30 June to Te Whatu Ora on 1 July. Were we going to be able to see transformation rethink bold enough to change deeply entrenched practices?

Campbell also said that workers of the “frontline” need to be part of workforce planning, and we have echoed the same thing for years. You cannot develop a workforce plan without frontline workers, not just doctors or nurses but also kaimahi, health care assistance and allied health.

The National Day of Action is important to expose the health system that is broken and not fit for purpose. We will continue to bleed staff if we don’t protect and support staff with the resources they need to do their job. This is an action for all nurses everywhere to come together and send a message of solidarity. We need to be advocates for our communities who deserve to have a quality health care system that is free from discrimination, and is affordable, accessible, and culturally safe health care.

Naku te rourou nau te rourou ka ora ai te iwi (With your basket and my basket the people will live)

Kerri Nuku, Kaewhakahaere
Tōpūtanga Tapuhi Kaitiaki o Aotearoa NZNO

This week we marked International Women’s Day and the achievements of women seeking gender equality and a future where your gender is not a hindrance or an obstacle.

Aotearoa has had its own share of sheroes. Perhaps the most well documented are the women from suffrage movement in the late 1800s whose actions led to a landmark legislation that saw New Zealand became the first self-governing country in the world in which women had the right to vote.

The campaigners led by Kate Sheppard were extraordinary for their times. Her feminist acts have been immortalised on our $10 bank note, commemorative stamps, and the statue in the heart of Wellington, inspiring both young and old.

Meri Te Tai Mangakāhia, also an eminent campaigner and landowner, was the first woman to stand for the Māori Parliament, for the rights for women to vote and as a member of Parliament. She is noted for her contribution to Māori.

These women were not alone in their struggles. From the suffrage movement of the 1800s to Ihumatao and even our own fight for Pay Equity, these are still features of today. Strength, resilience and tenacity are the ingredients required to counter the stereotypes, racism, violence, misogyny, and discrimination that women continue to face while driving the equality agenda.

I have often personally struggled when someone calls themselves a feminist. Meri Te Tai Mangakāhia is not noted in history as being feminist, but she was a wahine toa. The language used to describe her mana is often minimised in comparison to others of the suffrage movement. So, feminism isn’t the act of burning the bra or how much or how little makeup, jewellery or the type of clothes you wear; it’s a reflection of the decisions, actions and choices you make to advocate against all resistance for the rights of women.

As a predominately female organisation and profession our own fights continue. While the attacks from politicians may not be as overt as the attacks against Pania Newton at Ihumato, the inaction and ignorance are just as brutal.

I wondered what we can learn from the history of the suffrage movement, the history of our wahine, to inform our future. Could the language I use be holding us back? As a profession I often draw the distinction between nurse and nursing, the role of the nurse is very well defined and articulated by the profession, but what of nursing? Doctors don’t talk of doctoring neither do any of the other health professional groups, so could the fact that the word nursing is used so commonly be contributing to one of our concerns around promoting the skilled role that nurses do.

A mother who breastfeeds is often referred to as nursing her baby, a sick person can be nursed at home, the use of nurse and nursing can be undertaken by people who may never have had any formal training.

We also talk about being “at the table” or being “invited to the table where the decisions are made”. This adopts a subservient approach, needing or seeking affirmation as opposed to doing as the pioneers continue to do, build strength and unity and have courage to stand on our own platforms. The coming National Day of Action on 15 April is our opportunity to do that!

I want to finish by acknowledging Georgina Beyer, her undeniable belief in herself, her strength and resilience, and who achieved so much and inspired many. She was, a member of Parliament who supported progressive policies including the prostitution law reforms, civil unions and anti-discrimination laws, as well as being an elected mayor.

Mate kotahitanga e whai kaha ai tātou.
In unity we have strength.

President Anne Daniels
NZNO Tōpūtanga Tapuhi Kaitiaki o Aotearoa

One of my first comments in Kaitaiki as President briefly looked at beginnings. Beginnings suggest there may be an end. It seems that organisations such as ours (NZNO), have natural life cycles. First there is a vision that becomes a reality or start-up when the organisation is formally founded. Next comes growth, followed by sustainability and relevance.

The last stage of an organisation is characterised by stagnation and renewal. It could be argued that NZNO has been at this stage. Our current organisation was founded when nursing was a very different profession than it is today. It reminds me of that feeling you get in spring and decide to clean out the cupboards and start afresh.

Thirty years ago (1 April 1993) NZNO was formed. The amalgamation of the Nurses’ Association and union was an attempt to reduce the dilution of our nursing voice. Disparate voices within our profession have allowed others to fill the void and speak for us in the past. Over the years NZNO work focused largely on beneficial change for its members within a health system structure imposed, dominated, and controlled by others.

Today we must ask ourselves where we need to go as a union from here on in. If we hang on to the old ways of being, and do not clean out our cupboards by challenging the status quo within and without, we will become less relevant as an influential professional group in the health care discourses that will shape our future.

I would like to ask members whether they believe that our current infrastructure, systems, policies, and processes are fit for purpose. For some time now, members representing different sectors of NZNO, have been calling for change. What that change might look like is another question but this all poses an opportunity to look forward. How we make it happen is yet another question.

What I do know is that we need leadership to grow at our grassroots i.e. within our membership. That leadership must also be insightful, able to learn from our past and present so they can be owners of nursing and the role we take, in shaping our health system. Our current health system is not fit for purpose as it is not delivering health care which meets the needs of our indigenous and diverse nation, it remains medical-model-centric, and is a long way from eliminating the social determinant inequities that lead to poor health for many.

Change and real leadership go hand-in-hand. Our current and future leadership must be inclusive, collaborative, consistent in demonstrating tino rangitatiratanga from the start and going forward so we can build a new vision for the future of nursing in Aotearoa/New Zealand. Our union can bring that vision to fruition if we have the will and commitment to do so.

Perhaps we need to think about how we grow our leaders, and develop clear pathways to succession planning (identification, development, and engagement of future leaders)? Where does ‘membership led’ fit into all of this, what does it really mean, and what does it look like?

These questions must be discussed, debated and decided. Above all, NZNO must have a compelling purpose and engage in the mahi that is meaningful and beneficial to our members and those we care for.

A wise woman (Frances Haugen) said not so long ago, “we solve problems together: we don’t solve them alone (Perrigo, 2021). The union is us. Being a member of our union means that every one of us must participate in these conversations and move forward together.

Christiaens, G. (2016). Current issues in Nursing Associations in Policy and Politics in Nursing and Health Care. (Editors: Mason, Gardner, Outlaw, & O’Grady.)

Perrigo, B. (2021). The making of a whistleblower. The Listener, December 6/December 13.

Kerri Nuku, Kaiwhakahaere
NZNO, Tōpūtanga Tapuhi Kaitiaki o Aotearoa

The grass is always greener on the other side (of the fence). In terms of Australia there is red dirt, heat, sand and surf. The slang is different, and Australian wildlife is something you can’t compare.

A nurse friend of mine recently returned from working on a short-term contract in Australia. When she first talked about going, the prospect of her leaving seemed far-fetched. I thought the “red tape” would be cumbersome and would surely cause delays. I was confident we could get in a few more lunches or as we refer to it: “space to catch our breath and talk”.

However, it was barely a week later when she confirmed that her tickets were booked, accommodation arranged, and she was off on her overseas experience. The process did not seem complicated at all.

Sitting there listening to her kōrero, I wait for her to catch her breath. I hear of all her experiences, new friends, colleagues and a healthier bank balance with a desire to return and do more.
This nurse has always been the warrior who would operate in stealth mode, doing what needs to be done, actioning things you won’t find in standing orders – and all done in stealth mode.

Nurses are often the people other health professionals take for granted. We personify the so-called “it takes a special kind to do the job”. Nursing requires more of the individual – and so we inherently bring more to the sector. Yet we don’t think about it; we do it because we can and therefore, we’re not valued for the evolved responsibilities.

The value of nursing continues to be challenged. In 2020 the International Council of Nurses theme: “The year of the nurse and midwife” was for the first time intended to profile the role of nurses, to showcase the invaluable asset of nursing while investigating the wealth of validity and expansion of the profession. But the pandemic dominated what should have been our time. Instead, every media outlet made like a virus, replicating the spread and destruction of Covid-19. Still the nurses went to war and did what they do best, silently dealing with the carnage, every now and again raising their voices only to be ignored.

So is it any wonder our nurses are leaving for other shores to experience new opportunities, to feel valued in their chosen area of expertise? We have to ask what it is going to take to abate the flow.

This whakataukī focuses on the importance of nurturing what matters to us. It’s about taking care of the things we hold dear to us so that they can thrive. If something in your life is not thriving, consider that you might not be giving it enough time, focus or attention.

The grass is only greener where you water it.

Kite kore ngā pūtake e makūkūngia e kore te rākau e tupu.
If the roots of the tree are not watered, the tree will never grow.

Anne Daniels, President
NZNO, Tōpūtanga Tapuhi Kaitiaki o Aotearoa

Kaiwhakahaere Kerri Nuku’s last blog (23 December 2022) includes a quote…“We have come too far not to go further, we have done too much not to more.” – Sir James Henare.

These words reflect the many challenges we (NZNO) are grappling with, right now. NZNO (members and staff) is invested in meeting members’ expectations around Pay Equity, Pay Parity, eliminating exploitation of a female dominated profession and securing a culturally safe work environment across the health care system.

Many of these campaigns started years ago, and some, such as the Pay Equity campaign, are tantalising close to becoming a reality. But we remain uncertain about the future. However, we can and must increase the likelihood of success through collective planning and action. As the election looms, NZNO members must decide what their priorities are in terms of our union and nursing as a profession. Why? There is no certainty that whoever wins the election will understand our needs or have them at heart unless we work together to influence what will be best for us and those we care for.

Now is the time to actively work in engaging every member to become informed about our priorities so that we can make sure every vote will count. Our large membership of more than 56,000 has the potential to make nursing and health key to influencing both our members and the public at large.

To do that every member, everywhere needs to be informed on the positions of the various political parties and every member everywhere must vote. Our current infrastructure of members, delegates, regional councils, Colleges, Sections, Te Rūnanga and many other specialty groups, working with NZNO staff, can make this happen, by working collectively.

Our priorities are clearly laid out in Maranga Mai! We cannot be certain we will have a Government willing to commit to NZNO’s priorities unless we make it clear that our votes will go where our interests lie. We must Rise Up and lead the debate about what is important for voters whilst making our politicians accountable for their positions on health and nursing.

Last year NZNO engaged a Director of Organising and experienced campaigners to support NZNO members everywhere to engage in the political process. Why? To challenge those in power to do right by us and the health and wellbeing of our nation.

Each one of us has a responsibility to understand the issues, know which politicians and political parties will commit to our Maranga Mai! priorities, and vote. More than that, we must all have conversations with our friends and family about the issues.

Currently New Zealand’s population is more than 5 million. That means there is approximately one NZNO member per 92 people living in New Zealand. Conversations with our families and friends have the potential to create a ripple effect. Our union is well positioned to influence the outcome of the election, but only if every one of us gets involved.

We must do this. Let’s make the uncertain, certain.