Kerri Nuku, Kaiwhakahaere
Tōpūtanga Tapuhi Kaitiaki o Aotearoa NZNO

National Nurses United Executive Director Bonnie Castello’s opening address to the almost 3000 strong members attending the National Nurses United convention in San Francisco this month acknowledged that “now is an extremely important time in our era”. For many of the same reasons our health workforce will be facing many of the same issues, political changes, failures to invest in health and errors of our nation’s past.

In the US, nurses are coping with the changes and increasing development of new technology and the upsurge of biotechnology and artificial intelligence (AI).

With the increasing shortages of nurses, compounding issues and challenging pay and working conditions, the role of the nurse becomes increasingly important. There is ongoing work in this area to ensure that the role of the nurse, the art of caring and the unique responsibilities and relationships nurses have with patients is not lost in the advancing world where artificial intelligence seems to be leading the way in other areas.

While I acknowledge AI has the potential to make nurses lives easier, especially with technical data and by reducing human error, according to many studies around the world, these projects often encounter hurdles such as data security, patient privacy and ethical breaches.

I fail to see how technology can replace observing a patient the way a human can. Is a machine capable of empathy towards a gravely ill or dying patient? I don’t think so. How does a machine determine how a patient with dilated pupils is haemorrhaging? These are life and death situations we face every day as nurses which come from watching and checking on our patients.

Nurses must continue to lead human interaction with communities valuing the art of nursing and relationships. They must also ensure that new technologies are used to enhance their health and not to dehumanise and alienate those who need the human touch in their recovery.

However, if it cannot be avoided, I think that when implementing AI in our processes, the nursing workforce must be closely involved. Applying AI into the education of nurses, midwives, kaimahi hauora, health care assistants and tauira should happen as soon as possible and should not be forced upon us in the workplace. Nurses need to be active in the selection process, collaborate with IT teams, and advise on solutions that prioritise patient safety. Nurses can also help ensure this technology is as accurate as possible.

At the end of the day, we’re only human, but I read somewhere recently that humans have the ability to imagine, anticipate, feel, and judge – that’s something I believe machines can never achieve – not in my lifetime anyway.

Maranga Mai!

Anne Daniels, President
NZNO Tōpūtanga Tapuhi Kaitiaki o Aotearoa

In a recent television debate between the “two Chrises”, promises were made regarding nurses. It was reported by RNZ (Newshub leaders’ debate: The new commitments and refusals to rule out | RNZ News) as follows:
Nurses’ pay: Both said they would make pay equal for nurses working at hospitals and GP clinics.

“And we put $200 million in just this year to achieve that but Christopher again is making a whole lot of promises with no money to pay for that,” Hipkins said.
Hipkins also committed to increasing nurses’ pay “when they next go into bargaining, yes of course”.

What concerned me about this debate was what was not said. Firstly, there were mixed messages. The usual line “that there is no money to pay for that” came out. Yes, $200 million was committed, but there was no acknowledgement that Primary Health Care nurse pay has not achieved parity with nurses working in public hospitals. There is a widening gap and no equitable parity for any nurse working outside of Te Whatu Ora, nor any timeline to deliver on the promises made.

New Zealand’s health funding is one of the lowest when compared to similar countries. There is money, just an unwillingness to spend it on the largest female-dominated health workforce that constantly delivers health care in an environment that is severely challenged in terms of safe staffing and high patient acuity.

The next Te Whatu Ora bargaining is set to occur in 2024. While there is a commitment to increase nurses’ pay at this time, once again there is no detail on whether it will be a pay rise over and above inflation and the cost of living. It can be done. Queensland nurses recently succeeded in such a campaign.

Lastly, pay increases are needed to improve recruitment and retention of nurses so safe health care can be delivered by experienced, knowledgeable, skilled and culturally safe nurses, where and when it is needed. This detail was absent. The fact that the lack of nurses, midwives, health care assistants and kaiāwhina is having a detrimental effect on our patients and their families, while adding huge costs in nurse turnover (estimated at over a billion dollars a year) and adverse patient outcomes (more billions), was not mentioned.

Other political parties have made different promises. Some have considered these recruitment and retention issues. Some haven’t. Comparisons of each political party’s promises have been captured by NZNO’s comms and campaigns team in a recently published political party policy scorecard and an NZNO Webinar involving Labour, National, the Greens and Te Pati Māori party health spokespeople, including Minister of Health Ayesha Verrall.

Every member, everywhere, all 60,000 of us, have a collective responsibility to vote. Our NZNO staff are supporting this vote with information that can be used to understand the difference between political parties’ positions regarding the health and wellbeing of our members.

Not voting is the loss of a real opportunity to influence the outcome of the health and wellbeing of our nation. And our power to influence is very real as we represent, at a minimum, one person for every 90 people in New Zealand, and that is not counting the influence we have with our whānau, friends and colleagues.

Nurses are respected and valued by those we care for. Vote for those who support out Maranga Mai! five fixes. Our voice counts more than it ever has and is being noted in the halls of power.

Use your voice. Vote.

Kerri Nuku, Kaiwhakahaere
Tōpūtanga Tapuhi Kaitiaki o Aotearoa NZNO

This has been an exhausting yet rewarding week for me. Our conference and AGM were very successful with some impressive guests.

On Wednesday we welcomed Minister of Health Ayesha Verrall, and after bringing Pay Equity over the line this year among other achievements, she was warmly received by our members, who acknowledged her mahi.

Our theme at the conference was Challenging the Health System. There is no doubt that patient health outcomes are influenced by what happens when a patient encounters or engages in any part of the health care system and influenced by the level of social needs of the individual. This is not a new phenomenon, COVID didn’t create the crisis, COVID exposed the fragility of the system, but COVID didn’t create the crisis, the crisis is that the system was never designed to serve the interests of the individual and communities.

Any health system that fails to address the social determinants of health or public health approach to address the health disparities will fail to address or respond to the needs of the community who will become reliant on health services. Our own definition of what failure looks like identified that more than 10 percent of people did not receive cancer treatment within 62 days from a diagnosis the in the lowest performing DHB’s nearly a third of people were still waiting for cancer treatment after 62 days. That persistent and marked inequities still exist and access and outcomes for Māori and Pasifika and low-income populations.

That the lack of progress and investment in sustainable Māori workforce despite various initiatives that to date have not delivered. That the system has failed to plan and respond to the shifting demands and failed to protect the safety of workers while they’re at work.
So, what is our role and how can we make some practical change? Firstly, we must learn to understand the system that we all work in. We must understand who and what drives change and who are the leaders in those positions of power and what is informing the desire for change. Financial funding and power are the designers of the system and not one based on the needs of community.

What is obvious is that there is much work to do to ensure that the role of nurses, kai mahi healthcare workers, midwives and students are equally recognised for the contributions that they make, and as an organisation we must take responsibility in leading that change for ourselves. We acknowledge that our own language and constant single us of the word “Nurse” discriminates and disregards other groups of healthcare workers for whom our organisation represents. Leadership and change are needed.

Maranga Mai!