Kerri Nuku, Kaiwhakahaere
NZNO Tōpūtanga Tapuhi Kaitiaki o Aotearoa

As the world faces a major nursing shortage it’s timely that the International Council of Nurses is included in the revision of the ILO 149 – Nursing Personnel convention 1977, standards framed in co-operation with the World Health Organization promoting and securing the applications of these standards.

At the time these standards were being developed many countries were short of qualified persons and existing staff were not always best used.. This was considered an obstacle to the development of effective health services with general concerns around employment and conditions of work, such as: discrimination; on freedom of association; the right to bargain collectively; on voluntary conciliation and arbitration; on hours of work; holidays with pay and paid educational leave; on social security and welfare facilities; and on maternity protection; and the protection of workers health.

While the world is a much different place the definition of “nurse” has remained suspended in time, while our practice may have evolved – the unique role of nurses has not been realised.
There is no doubt that from the 1900s to now the role of the nursing personnel as agreed in the ILO standards are recognised as “being vital, together with other workers in the field of health, in the protection and improvement of the health and welfare of the population”.

However, its these words that make it difficult for nurses, how are nurses vital in the health field? What is it about nurses that makes us different from other workers in the field of health? What is unique about nurses, what is it that we do that no one else can do?

We can often describe the technical roles, or tasks that we undertake – we know these are important and make a difference to people’s lives but, but with the advantaging roles of the unregulated workforce, introduction of physician assistants etc, as more and more roles take on jobs that are “repeatable and trainable “these are narrowing the scope and role of the nurse.

During the outbreak COVID-19 we witnessed some significant changes the Health Act 1956, namely in provision that provided options to allow nurses who had test positive but had no or minimal COVID symptoms to work in COVID settings with restrictions only applying to work, outside of the workplace normal COVID restrictions applied. But also important for nursing is that impact that extending the scope of an unregulated workforce to undertake tasks that were “repeatable and trainable “such as the task of vaccination.

It is understandable that in a “state of emergency” decisions must be made, especially where lives and endanger, we would expect changes to be effect, quick acting and temporary for as long as the crisis exists, or the emergency has subsided or managed. I am not intending to debate the merits of this, but the changes have not been temporary, and the politicians have taken an opportunity to refine what was once a highly specialised role into a task orientation process.

The concerns of 1977 are echoed years later with the emergency we currently have with nurses nationally and internationally, the answer is not to replace a qualified workforce but for nurses to continue to define what makes the profession distinct from any other profession and the fight to maintain and grow.

Maranga Mai!