Anne Daniels, President
NZNO Tōpūtanga Tapuhi Kaitiaki o Aotearoa

The “personal is political”.

Most understand this saying to mean that our personal experiences are founded in our political circumstances and inequality. An example of gender-based inequality is violence which currently affects one in three women in their lifetime. Violence and aggression are defined as “physical assault, verbal abuse, threats and aggressive behaviours”.

New Zealand research is consistent that violence and aggression towards nurses and other health care worker is common. A 2011 workplace violence report identified that the health sector had the highest rate of assaults and violence. As most nurses, midwives, health care assistants and kaiawhina are women, it is clearly a gender inequality issue, and it is very personal too.

Everyone who goes to work has the basic human right to return home healthy and safe. Laws exist to protect individuals and communities from harm by other individuals, organisations, employers and governments. To accept otherwise is to accept intolerable injustice. But it is very much accepted by the very institutions we depend on to keep us safe.

Nurse shortages were predicted, and avoidable but successive governments did nothing. The shortage now affects those nurses at work and at home when violence occurs.

Nurse shortages have created tensions between those who are there to care and those who wait far too long for that care, whose anger and frustration often morphs into violence and abuse. Recent media has commented on the increase in police call outs to emergency departments at times that correlate to patient wait times.

Depression, post-traumatic stress disorders, hypertension, dissatisfaction and high rates of attrition are the outcomes of violence and abuse that have been accepted for far too long and normalised by nurse employers and governments.

The risk of normalisation at work and within society is that it not only hides the true extent of the problem but also serves to excuse, and by default, validate the behaviours that lead to unsafe work environments. These attitudes seem abhorrent but are very real.

Recently, Te Whatu Ora took NZNO to court when Gisborne nurses fought for the right to strike. Te Whatu Ora challenged safety concerns by saying the workplace was safe. This was rejected by the Judge who said Te Whatu Ora’s case was “weak at best” and there was clear evidence that the workplace was indeed unsafe. Why did Te Whatu Ora believe it was ok to suggest an unsafe work environment was safe in a court of law? Where does that attitude come from? Why is it accepted?

Last week the Otago Daily Times reported that a nurse had been severely assaulted by a patient. The nurse took the patient to court and the judge decided the patient’s behaviour was excusable and further that they needed their mana and dignity upheld. The patient was given a suspended sentence. For the nurse, nothing.

In the context of the “It’s not OK’ campaign that states clearly that no violence is excusable or the law which makes hurting someone a criminal act, where health legislation requires everyone to manage and eliminate risk, how was this ok? What message does it send to the perpetrator of violence and to nurse employers? That nurse shortages are okay? That violence towards nurses, who are mostly women, is okay?

Individuals will not take action if they feel the wider social environment doesn’t support the view that violence is not okay. So, we must act to change attitudes and outcomes for ourselves.

Our CE Paul Goulter recently said: “We cannot improve conditions for our nurses unless we take on the current health system. That’s why we must be political.” It is up to every NZNO member, everywhere, to make it so.

Maranga Mai!

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.