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Why not make your life a bit easier?

2015-09-28 Member advantageNZNO knows how life can be expensive and complicated to manage sometimes.  That’s why, as a member, you and your family can enjoy exclusive discounts on a range of quality lifestyle and financial services. In addition to the NZNO negotiated benefits, Member Advantage, NZNO’s partner, offers you unlimited use of all products and services, and provides the opportunity to save money on everyday expenses and special purchases. Your benefits include special offers on:

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Click here and log in using your NZNO membership number to discover the benefits available to you.

 

 


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Memo Musa – conference address

Memo Musa AGM4Last week NZNO held its AGM and conference. This year around 300 delegates and college and section members met at the Museum of New Zealand Te Papa Tongarewa to discuss and make decisions about our organisation, nursing and the wider health sector. We learned new skills, to celebrated our successes and took up the challenges that were laid down.

Our new elected leaders were welcomed and our our departing leaders were thanked for their mahi. One of the highlights of the AGM and conference were the wonderful speakers, from within NZNO, around the motu and throughout the world. 

Here is the address given by NZNO chief executive, Memo Musa on the morning of the first day. 

Tēnā koutou, tēnā koutou, tēnā koutou katoa

I am Memo Musa, Chief Executive of NZNO.

It gives me great pleasure to welcome you all to NZNO’s 22nd Annual General Meeting. And to our exhibitors and sponsors who are here today and for conference tomorrow, welcome. I know that Marion and Kerri have welcomed you already but it is important that I do so too.

This is my second report to the AGM on NZNO’s performance during the past financial year.

I hope you have had the opportunity to read our Annual Report 2014/15 and reflect on our operational and financial performance as well as our achievements.

I would like to take a few minutes to take you through some of the key highlights of the year. Before I do so, I would like to comment briefly about the AGM today. You will have seen from the information you received that we have a total of seven remits and twelve policy remits. These should provide us today an opportunity to fine tune some aspects of the constitution as well as debate or discuss policy matters that are important to you and require our collective action as an organisation. I accept that it is a democratic process to amend aspects of the constitution. I would like to sound alarm bells that this can equally create a state of inertia as it makes it difficult to work within rules that are continually changing. That said, some improvement are required.

Back to key highlights from the past year:

We started the year with five priorities.

  • To increase and maintain membership
  • To increase the visibility of NZNO’s role as a professional association of nurses
  • To promote nurses and the nursing profession
  • To contribute to health sector workforce planning
  • To improve organisational health

Strong operational management and transparent reporting are critical to the long term success and creation of value. This is why, with support from the Board, during the past two years we have completely revamped the Annual Report to give you more information, detailed highlights, successes and challenges. This provides us an opportunity to celebrate successes and face up to what we could have done better. Often we hear that we do not celebrate or showcase our successes enough.

Now the key highlights. I will only pick a few to illustrate key points.

Increase and maintain membership

The biggest challenge for any member organisation is maintaining membership, let alone increase it. Membership levels have a big impact on the viability and sustainability of NZNO.

The solid work you are doing, including the work by our organisers, industrial advisors, professional nurse advisors and other staff through our organising ethos, models and approaches, including our communication, has resulted in us maintaining our membership numbers at above 46,675 based on 2013/14 year with a very modest increase of 103 members to 46,778 members.

Our biggest growth was in the registered nurse members were we saw an increase of 918 members from the previous year totalling 35,275. This makes up 72 percent of practicing registered nurses. According to the Nursing Council there are 48,406 registered nurses practicing.

However we had challenges with student nurse membership which declined from 4,225 in 2011 to 2,700 by the end of March this year a drop of 36 percent. This a concern we must address.

Fellow colleagues, we cannot ‘rest on our laurels’ when it comes to membership, as during the past five years union membership in New Zealand has been in decline.

In 2010 there was a decline of 2.1 percent

2011 it fell by 1.3 percent

Then 1.4 percent in 2012

By 2013 it had fallen by 2.0 percent and at the end of March 2014 this had fallen by 1.8 percent. I am waiting for the 2015 figures to be published. My guess is that the same trend will continue.

Whilst overall we are doing better than some unions and professional associations we have room to improve.

Increasing NZNO’s role as a professional association

Promoting nurses and the nursing profession

At our AGM last year some of you may recall my report and reflections. I stated that advocacy and lobbying are at the core of what we do to advance the agenda for nursing teams both from an industrial and professional perspective. Being an election year, I observed that on one hand there is a sense that we are not visible, not adversarial or political enough, that we need to be out there and showing leadership on key issues, on the other hand some argue and lament that we are politically biased or in favour of a particular political leaning whilst others say we are negative and adversarial, whilst other say we are doing ok.

The profile of our role as a professional association, promoting nurses and the nursing profession is critical to our future existence at the same par as membership.

Demonstrating relevance and value add to patient outcomes, healthy families and communities should be the cornerstone or platform upon which we build our profile as an association and by promoting nurses and the nursing profession.

I am pleased to report that during the last year we continued to push forward our agenda to promote NZNO, nurses and the nursing profession by increasing our clarity of relevance and value add.

On Wednesday 28 August 2013 the main headlines in the Dominion Post read “Nurses ration patient care” “Families pitch in as staff stretched”. This article reported nursing shortages at Wairarapa and Hutt Valley hospitals stating that nurses are ‘rationing’ their care to patients. It referred to essential care being prioritised over patient ‘comfort’ or ‘non-essential’ tasks.

The following day Thursday 29 August 2013 the main headline read ”Rationed care cuts deep says patients” reporting that ‘care rationing in understaffed hospitals is affecting basic medical needs as well as comfort, patients say.”

There was the usual follow up discussion and debate in the media and between nurse leaders with attention being on nurses’ decisions and actions about patient care when faced with nursing shortages or the wrong skill mix.

What was missing in all the dialogue was the fact that in reality it was not nurses rationing care, it the public health system; the way it is funded resulting in not having enough nurses, inadequate time, and the right skill mix to provide complete care.

Our policy and research teams, with member input and consultation, developed a position statement on Care Rationing which was presented to all District Health Boards, the Ministry of Health and the Minister of Health. This helped change the dialogue and inform the debate on this very complex area which often is very emotive.

You will hear about this more this afternoon.

We also embarked on a project to increase the visibility of nurses of which the first phase establish a theme which is “Nurses – Making the Difference in Healthcare”. A website has been set up where nurses can share stories. You can access this through our website under the campaigns banner. The second phase involves identifying and training nurse champions. A third phase to promote and increase the visibility of nursing is yet to commence.

You will hear more about this in more detail this afternoon.

Another highlight is our work is with the Service and Food Workers Union Ngā Ringa Tota on the campaign for equal pay “All the way for equal pay”. The sterling legal defence work which saw the Court decline Terranova’s leave to appeal on and directing the Employment Court to establish equal pay principles to resolve the equal pay claim.

Again we will hear about this in more detail this afternoon.

One last key highlight under this section is the work we do to represent members, whether it be through Health and Disability Commissioner investigations, employment related matters, Professional Conduct Committee and Health Practitioner’s Tribunal hearings. Approximately 237 ‘events’ were taken up involving more than about 3000 members. We noticed an upward trend in the request for representation and the number of complaint against nurses which are being made to the Health and Disability Commissioner. We have also noticed an increase in the number of nurses that the Health and Disability Commissioner finds in breach of the Code of Health and Disability Services Consumer Rights. Last year we challenged the Commissioner by asserting that some of the breaches could be at the system level not the individual nurses’, and primarily caused by inadequate funding which leads to poor staffing levels impacting on patient care. We asked him what approach he intended to take to address some the breaches we considered to be at a system level. His response was that his concern was “primarily to assess the quality of health and disability services” and the system issues I had raised were better addressed by District Health and and/or the Ministry of Health’. This I found astounding.

Fellow colleagues, I will make no apologies for saying that if we fail to show relevance and to add value it will be to our detriment. Some antagonists might think what we do is ‘all about us’. Clearly that is not true. Promoting the profession of nursing and nursing standards is a key foundation to strive for recognising the mutual interdependency with our industrial focus and that getting the balance right is very critical.

Contribute to health sector workforce planning

I am going to tell you something you already know.

Nursing is the biggest workforce in the New Zealand public health and disability system. According to a report on health workforce released by the Ministry of Health and Health Workforce New Zealand in November last year, nursing makes up about 54 percent of the regulated health workforce in New Zealand, based on annual practicing data of all regulated professions. Internationally there are between 16 and 19 million nurses according to estimates by the International Council of Nurses.

We are the backbone of the public health and disability system. We nurses are everywhere, in patient’s homes, general practice, clinics, hospitals, prisons, community homes, residential care, education, research units, management and leadership, policy development and regulation.

After many years of advocating and lobbying for a national workforce plan for nursing, last year we were successful, together with other nurse leaders, in convincing Health Workforce New Zealand to set up a national nurse workforce programme. Whilst progress continues to be slow, a joint governance group and working group have been put into place. The areas agreed to be given priority attention are:

  1. Improving the integrity of nursing workforce information and data
  2. Graduate nurse employment
  3. Nurse retention
  4. Nursing workforce plan

This is a major step forward. However results are yet to be evident.

On the New Graduate Employment front the online petition urging the Minister of Health to fund a one year Nurse to Entry Practice Programme for every graduate nurse drew more than 8000 signatures in a week. Thank you to all who contributed to this petition. This resulted in two key achievements as steps in the right direction:

  1. Additional funding of $2.8m per annum from this year was granted by the Minister of Health to fund an additional 200 places.
  1. The eligibility period was increased from one year to two years.

This firmly remains on our horizon with a goal of 100 percent funded places by 2018.

We got behind, supported and were involved in the proposal by Auckland University for a funded nurse practitioner education programme linked to employment. It took a long time for this to work its way through the bureaucracy of Ministry of Health and Health Workforce New Zealand. Eventually funding was granted for a programme to commence in March 2016. Auckland and Massey universities will run this programme.

We supported the Nursing Council’s application for nurse prescribing. This is important as an enabler for us to work at the top of our scopes of practice; which in time will result in an increase to access to nurse-led services for vulnerable populations and those with long-term health conditions.

Working with the Fiona Unac, Chair of the Perioperative Nurses College we saw Auckland University endorse a new Certificate of Proficiency for Registered Nurse Assistant to the Anaesthetist.

The work by the Enrolled Nurses Section to develop a dedicated Supported Entry to Practice Programme was completed. Now the challenge that lies ahead is to advocate and lobby for this to be funded.

Lastly we successfully got onto the Governance Group for the Kaiāwhina Workforce Action Plan. This was in response to concerns raised by the Enrolled Nurses Section. We argued that the Kaiāwhina workforce is a continuum of the nursing team, and that it is important that the action plan be developed within that context. This will remain a challenge but we will continue to influence, advocate and lobby.

Workforce development is complex with multiple strands to which we need to be tuned into all the time. There is no ‘one size fits all’ and our messages on these areas going forward need to be targeted at getting results for you.

Improve organisational health

Improving organisational health is controversial and a challenging philosophical concept.

From a financial perspective we are making in-roads into recovering financial losses from the past. We ended the year with a positive financial result which David will present to you later. The Board has worked hard with me and the Management Team to tackle a few areas to manage costs.

We should always be mindful and keep an eye on our financial reserve and not to use them to support organisational operational structures. Alarm bells should ring if we head in that direction.

Our staff are key to the achievements and the highlights I have reported on and those in the annual report. I applaud their commitment and relentless effort, their willingness to go the extra mile to do what is right for members. In response to key pressures we supported our staff by putting more resources into the following areas;

  1. Professional Nurse Advisors, an increase from 7.7 FTEs to 9.1 FTEs with a focus on Hamilton and Christchurch.
  2. Industrial Advisor increase of 0.5 FTE
  3. Finance Office 1.0 FTE

These organisational growth areas are in response to our commitment to get to member issues quickly.

Fellow colleagues from time to time you will hear all sorts from people about what is happening within the organisation.

I will stress to you that you need context and background to know what is going on and sometimes what you hear may not be correct and other times it may be. It pays to contact me directly on operational matters.

In conclusion,

My assessment is that NZNO has done well during the past year. Some of you may say not enough in some areas, and I acknowledge that.

We can never do enough!

Acknowledgements

I would like to place on record my sincere appreciation of the work you have done in the past year and will continue to do this year, the work done on your behalf by our staff and the support of the Board and Management Team.

I will mention again the point I made at last year’s AGM

“What we do comes with its own challenges and tensions but let us remember and work together as united we stand, divided we fall. We are one profession with many roles and voices, we are a collective and together we can continue to make a massive influence. Together we make an effective team.” Together we can be effective in shaping healthcare in New Zealand.

Lastly but not least I would to thank all our exhibitors and sponsors at this AGM and conference tomorrow.

I hope you enjoy the AGM and conference and that you get the best networking opportunities, so you can take away important ideas to innovate and to champion for changes in whatever health setting you work within.

No reira tēnā koutou, tēnā koutou, tēnā koutou, tēnā koutou katoa.

 


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Perioperative Nurses College Annual Conference

Role 2 Light Manoeuvre (R2LM) Hospital Exercise at Linton Camp

Role 2 Light Manoeuvre (R2LM) Hospital Exercise at Linton Camp

Kia ora koutou katoa, I’m Fiona Unac, Chair of the Perioperative Nurses College, NZNO. Perioperative nurses provide care to patients and their families/whānau across the perioperative continuum. We work in a variety of settings including, outpatient departments, day surgery units, intervention and investigative units, radiological departments, surgical inpatient units, operating rooms, post anaesthetic care units and more.

Our College supports and promotes the safe and optimal care of all patients undergoing operative and other invasive procedures. We promote high standards of nursing practice through education and research.

One of the ways we work towards these goals is by hosting an annual conference. From 24-26 September 2015 we’re celebrating our 42nd, and it’s shaping up to be really great! With a theme of “Reflection and Action” we guarantee there will be something for everyone.

Bringing perioperative nurses together from around the country gives us an opportunity to share our skills and knowledge, hear about innovations and improvements in practice and celebrate the important work we do.

Organising the conference is a big part of PNC college activities, which is supported by an energetic team and financed by sponsors and NZNO.  The conference committee aim to make sure this years’ conference is going to be better than ever.

One of the highlights for me so far – and I’m sure it will for attendees too – is the chance to acknowledge nursing’s role during 100 years of New Zealand at war. Our conference is being held in Palmerston North and we’re taking advantage of the links that Palmerston North has with Linton Military Camp.

We have some presentations scheduled that will give you an insight in what it means to work as an army nurse with… (drum roll please!) a fully functioning deployable hospital that is constructed to operate anywhere around the world. The deployable surgical team has been to the Awapuni Racecourse to locate the best site for the deployable hospital that they will put up for the duration of our conference – it will be hard to miss at 40 x 40 m²! This is a huge set up – with Resus, X-ray, Lab, Theatre, Sterile Services, Post surgical care (for all levels of acuity) and storage areas all within air conditioned shelters.

Other highlights include a history of NZ military nursing, an introduction to the NZNO “Nurses – making the difference in healthcare” campaign and a keynote speech by Dr Swee Tan.

If you’re a perioperative nurse and you haven’t already registered for the conference, now is the time to do it. Check out the conference website here: www.periop2015.co.nz.

I can’t wait!


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My NZNO korowai

Debbie PaperaDebbie Papera is an NZNO staff member who works in the Wellington Regional Office. She is involved in the Māori staff group Te Whakaruruhau and is on Te Ara Reo Māori at Te Wānanga o Aotearoa. Debbie is a supporter of NZNO’s bi-cultural model and walks the talk of tikanga in her work every day.

On Friday and Saturday last week I attended the NZNO and Te Rūnanaga o Aotearoa, NZNO Indigenous Nurses Conference in Tāmaki Makaurau.

It was amazing, truly amazing. How can I explain? For me it was like my korowai hugging me; with each feather symbolising my tipuna and every single person present at the hui. I feel quite emotional about the experience, still. There aren’t many times I can really connect like that with my people.

It’s the best two days I have had in a long time. I was lucky to be able to attend as an NZNO Māori staff member and to catch up with two of my colleagues at the hui too, from Rotorua and Tauranga. Kia ora sisters! Thank you for going on this journey with me.

There were over 300 Māori health workers at the conference and I noticed that many young nurses, students and new grads found the whanaungatanga really beneficial, in terms of building relationships with other nurses and their connection to NZNO and Te Rūnanga.

There were wonderful speakers. A couple of presentations that really moved me were by Dr Misty Wilkie-Condif, and Janine Mohamed and Dr Roianne West.

Dr Misty Wilkie-Condif is an American Indian of the Turtle Mountain Band of Chippewa Indians. She talked about how similar American Indian practices are to Maori tikanga, for example both Maori and American Indians place great importance on leaving this earth with our full physical bodies in place.

One way that is encouraged to happen in the American Indian communities where Dr Misty works is led by midwives.

Community midwives go out and all around the villages talking to hapū wahine and new mamas. When pēpe is born part of the midwives job is to make sure the whenua is wrapped and ready to go home with the mamas for burial.

This deep connection between our culture and the American Indian culture is special.

The other presentation that has stayed with me was by our sisters from across the ditch. Janine Mohamed is a Narrunga Kaurna woman from South Australia and Roianne West was born and raised Kalkadoon on her mother’s country in North-West Queensland.

They were representing an organisation that travels out through the outback encouraging young people to become nurses.

They say they need the new generation to be educated as nurses so they can look after the elders who are suffering from diabetes and other diseases relating to their poverty and colonisation.

It’s a kaupapa based on whanau and community.

For me the hui left me with a feeling of positive-ness. As Māori we have had a hard road culturally and because of colonisation. It was wonderful to see so much work happening to fix the structural discriminations and improve the health of my people.

My message to our rūnanga throughout NZNO is: stay true to your tikanga and never forget that your tipuna are always with you and have your back.

To end this article I would like to share something that keynote speaker Moana Jackson said. “If we don’t know who we are, we won’t know where we’ve come from or where we’re going.”

Mauri ora!


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Nurses – making the difference in healthcare

IND resources_Page_2International Nurses Day is my favourite day in the nursing calendar. May 12th is Florence Nightingale’s birthday, and the day on which we celebrate the importance of nurses around the world. It’s a day to celebrate our achievements, give each other a pat on the back and reflect on our proud history/herstory and look forward to our future with hope and determination.

Thank you for your work, thank you for your tenacity, thank you for your care, thank you for your grit and determination. Together we can change the world.

The theme for International Nurses Day this year is ‘Nurses: A Force for Change: Care Effective, Cost Effective’. The theme could not be more timely. The Government’s 2015 Budget is on the 21st of May and NZNO members around the country are considering whether to accept the DHBs’ collective agreement offer or not.

Countries around the world are facing similarly constrained health budgets following the global financial crisis, at the same time as rising healthcare needs with aging and increasingly sick populations. This has resulted in both a global shortage of nurses, and at the same time, higher nurse unemployment.

While it is nice to know that some of the problems seen in New Zealand are not unique, International Council of Nurses (ICN) research shows that when nurses are supported to work creatively, innovatively and to their limits of their scope – there are economic benefits.

The ICN says “Evidence shows that nursing is a cost effective yet often undervalued and underutilised health care resource”.

We know you work incredibly hard every day, and the advice from ICN is that the general public and policy makers need to see the impact of nursing work so that it is in the forefront of their minds. This year they call for nurses’ engagement in policy setting and transforming healthcare systems to be safer, more efficient and more effective in ways that only nurses can see.

We’re taking up their advice too, which is why we are very excited to announce the launch of our new website sharing nurses and their patient’s own stories about how nursing makes the difference in healthcare. You can add your story to the collection right now at nurses.org.nz.

I hope you enjoy reading each other’s inspiring stories, as we make a difference in healthcare together.

Yours in nursing solidarity

Memo Musa
Chief executive
New Zealand Nurses Organisation


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An ordeal with the flu

Kate and Sam Pohe

Sam Pohe (on the right) with her sister, Kate.

Community clinic nurse Sam Pohe’s job was to endorse the flu vaccine to her high-risk patients but, as she lay in a coma at death’s door, her body riddled with complications deriving from influenza, it became obvious she’d forgotten to get one herself. She shares her ordeal with Jodi Fraser.

The Whangarei 45-year-old was usually one to practise what she preached but, last year, got so busy vaccinating her patients, she forgot to get immunised herself.

Sam recalls leaving work early one day in August, thinking she had a cold.

“I was just feeling rather poorly. I left work early and went home to bed. I think I slept for three days. On the third day I woke for some reason, went to the bathroom, as I knew something wasn’t right, and I was blue.

“I text my friend to say ‘Why am I a blue colour?’ I called the ambulance and was taken to hospital ED. My oxygen sats (oxygen-saturated) were about 70 per cent and dropping.”

She was admitted to ICU soon after and placed on a bipap machine to help her breathe.

“I was struggling to breathe for six or seven days – it was terrifying. I never want to experience that again.”

A day later Sam’s doctor told her ‘We have to talk’.

“I remember looking at him and saying: ‘This is it? I’m going to die? … I need to make a few calls.’

That was Sam’s last lucid memory for the next three and a half weeks as she sank into a coma with multi organ failure.

While her beloved dogs pined for their mistress at home, her family and friends rallied round her bedside where she had been flown to Auckland, with her best friend flying over from Australia.

Sister Kate says she was shocked when she saw the state of her close sibling.

“There were tubes and wires everywhere. Just seeing Sam like that – it was awful. It was the worst experience of my life but Sam is stubborn and strong-minded and I never had any doubt that we would lose her.

“We had a family meeting and, despite being told we shouldn’t get our hopes up, looked into all the options.

“A lot of research doctors came in and I just signed her up for everything.”

While doctors considered placing Sam on the ECMO (heart and lung) machine, Kate spent the long tough days giving her sister foot and head massages, singing and reading to her.

“We all handled it differently – our nephew, who is usually really tough, just sat in the corner sobbing his little heart out. I’d wake in the middle of the night and hear dad crying which would set me off.”

While her family fretted and grieved, Sam was off in India having crazy exploits which still give her nightmares today.

“I remember having many vivid dreams while in the coma. I think I was in India with random people and we were at this place praying for forgiveness. I was paying penance I think, but I’m not sure what for. Another time I was in a bus and the oxygen was running out – I kept reaching for the handle to get out but I couldn’t move my arms. It was horrific. Other things happened but I won’t talk about them – they are too freaky.

“After I came out of the coma, a spiritual friend of mine asked me who Renee was. That is my aunt who’s passed so I believe I met with her.”

As Sam came out of her coma she remembers everyone peering down at her.

“I don’t remember what my thoughts were but my nephew told me the first thing I said was **** off to the nurses. I was shocked. I was terrified, frustrated, hallucinating. I could not walk or talk. I had a tracheostomy in situ. I was literally a dead weight. I couldn’t even lift my arms they felt so heavy. My hair was a mess, I hated being turned and my bottom wiped, I was on dialysis, I had double pneumonia, H1N1, influenza A – you name it, I had it all. I was one sick puppy.

“My emotions were all over the place and I heard I was a bit of a struggle for the nurses but I felt hopeless, useless and trapped against my own will. I just wanted to get out of bed and walk home. I said to my brother, ‘Just back the car up and I’ll pull all these lines out’ and I was trying to do just that.”

Despite the odds, Sam made a miraculous recovery and, cited a ‘medical mystery’, was finally told she could go home seven weeks later.

“I would have run if I could. “My dogs were so happy to see me, they were doing somersaults.”

Since then, she has pushed her limits every day, despite a damaged lung capacity which causes shortness of breath – the only long-lasting physical effect.

After four month’s rehabilitation, Sam has returned to work, albeit in a different less stressful job and says she absolutely advises her patients to get the flu vaccine.

“Sometimes they say to me, ‘But it’s just a little chest infection’ and I say, ‘Yeah? I had a little chest infection and it nearly killed me’.”

And there is no way Sam will get too busy to have the vaccine herself.

“Life is different now. I live like never before. I don’t feel as stressed anymore and I’m happy to be alive.”

Nine months later Sam still gets emotional while recalling her experience.

“When I was in hospital and I’d see the helicopter come in, I’d just cry because they are awesome, just awesome,” she says, tearing up. “I’m into raising money for the helicopter now – they are so good.”

A pioneer in setting up rural health clinics for vaccination, Sam is a strong advocate for making sure that health services are accessible for Northlanders.

“We used to find out which children hadn’t been vaccinated and go out and search for them.  It would be like, down this dirt road, hang a right, down a gully to find the brown house.

“I knew the people from a whanau perspective and they trusted me. Very often they didn’t have a car so they welcomed us to go to them and vaccinate their children. I will never forget sitting in a paddock with sea views, surrounded by babies playing in the dirt, while we watched them for 20 minutes after they had had their vaccinations.”

Her advice to others, having come so close to death?

“Make sure you get your flu vaccination because life is for living – oh and don’t sweat the small stuff.”


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Patients’ rights, nurses’ rights

stress-feature01NZNO delegate, Erin Kennedy asks an important question: “Is unsafe staffing a breach of the Code of Health and Disability Services Consumers’ Rights?”

Like most nurses, I am not easily shockable, but I found myself almost speechless last week on learning that three nurses had been forced into the position of caring for 40 patients overnight on a heavy orthopaedic ward. (A pool nurse also came to help for part of the shift.)

NZNO organisers and delegates have argued strongly for safe staffing for years now, but unfortunately, the level of permanent and pool staffing means that staffing levels including skill mix are often unsafe, with sick staff unable to be replaced. The constant push to avoid financial penalty when the 6-hour Emergency Department rule is breached also leads to patients being moved from the Emergency Department to areas where there are simply not enough nurses to care for all the patients safely.

Under the Code of Health and Disability Services Consumers’ Rights, patients have a number of rights, including the right to co-operation amongst providers to ensure quality and continuity of services, and the right to informed consent. The right to be fully informed means information must be conveyed to the patient in a way that enables the patient to understand the treatment or advice. Right 6 of the code states that every consumer has ‘the right to the information that a reasonable consumer, in that consumer’s circumstances, would expect to receive’. Specifically, it states that patients are entitled to an explanation of his or her condition and an explanation of the options available, including an assessment of the expected risks, side effects, benefits, and costs of each option.

Given the unsafe staffing levels at some of our DHBs, it is high time that explanations around surgery, for example, go further than simply outlining the procedure and its risks and benefits. Patients should ask, and should be told, whether their post operative care will be safe. A “reasonable consumer” clearly has the right to know whether their recovery might be hampered because of unsafe staffing. Certainly, if I have surgery any time soon, I will be asking whether there are enough nurses rostered on to provide all of the care I and other patients require. Will there be enough staff to ensure that I can obtain analgesia or other medications on time? Will the nurses be able to check my vital signs often enough to notice if I am bleeding, or have arrested or need medical intervention? If I need help mobilising to the toilet, will there be someone to help me or will I risk a fall and further injury? Will there be someone to answer my call bell if I need help?

Nurses do not like being forced to ration care, but until all DHBs accept that in many instances staffing levels are unsafe (for both patients and nurses), it is a fact of life and one which can seriously impact patients’ wellbeing and recovery. Not warning patients that their post-operative care may not be optimal, and could be downright dangerous, is, in my opinion a breach of the code.

 

 

 


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What does the DHB MECA mean to me?

20150310_154113Kimberley McAuley is an NZNO delegate at Waikato Hospital. She was asked to speak at the event held there yesterday celebrating 10 years of the DHB MECA. This is her speech. We think it’s fantastic!

To be truly honest with each of you present today, when I was first asked to present a small talk on what the MECA means to me, at the birthday party celebration of the 10th anniversary of the MECA, I was a little taken back because: a) public speaking is not one of my strongest points, and b) I was actually going to have to really contemplate and reflect on this question.

Firstly, before I let you in on what ‘the MECA means to me’, I will introduce myself to you all. My name is Kimberley McAuley. I am a registered nurse, I work in the main operating theatres for Waikato District Health Board and I am an NZNO delegate for my workplace and have been for the past 6 months.  I have been a registered nurse for only three years, so less time than the MECA itself has actually existed.

To be quite frank, for my first two years of practice as a registered nurse, or at least the first year anyway, I had no idea what the MECA was about, let alone what it meant it me. I’m not actually sure if I knew the MECA even existed. However, over the past year I have really come to develop a deeper understanding and appreciation surrounding the MECA and the value that the MECA has not only for nurses, but additionally for our HCA and midwife colleagues as well.

For me personally, the major underpinning of the DHB MECA is the element of unity. The MECA is what holds us all, as nurses, together. The MECA works to ensure that we, as nurses, are ALL looked after.  The MECA ensures that we have decent pay, and decent conditions of work. The MECA ensures that we, and all nurses in DHBs throughout New Zealand, work under the same terms and conditions.

Personally, I can vouch and admit that at times, I don’t feel that I get the salary that I deserve when I think about the hard work that I invest into my role as a theatre nurse; the extra hours that I do, and the heart, soul, dedication and passion that I put into my tasks and responsibilities on an everyday basis. I can additionally vouch for the fact that often, and very often of late, feel that I do not have adequate conditions in my workplace. However, without this unifying MECA that we all belong to, I believe all of our workplaces and related factors to our workplaces would be a lot worse of without our MECA. This multi-employer collective agreement, in my eyes is the glue that sticks us all together, and what unifies us all.

So, to conclude, I would just like to say a big happy birthday to our MECA and long may it prevail and be there for us!

 


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Employment law changes – the long answer

ERA changesA couple of days ago, on Facebook, a member asked what NZNO were actually going to do about the changes to employment law, apart from posting stuff on Facebook.

Well, good question. The short answer is lots! The long answer is… longer – I’ll make a start here and see how far I get today.

The first thing I want to stress is that NZNO is its members. We are a member-run organisation. That means staff are essentially employed by members, through their membership fees. The strength of our organisation comes entirely from how many members there are, and how willing those members are to get involved in the work of the organisation.

Thousands of NZNO members are workplace delegates, thousands belong to Colleges and Sections. Thousands are active sharing information and having discussion about our issues on social media. Many inform themselves and their colleagues by reading our monthly publication Kai Tiaki Nursing NZ. We have a Board of Directors and a Rūnanga elected by NZNO members. You can be as involved as you want to be.

NZNO is as strong as its membership. 

So – the next bit of the answer is about the changes to employment law. They are wide ranging changes that have been touted by the Government as fair, reasonable and just “tweaking” things. If only!

These changes have the potential to drive wages down, increase poverty and tip the balance of power between workers and employers firmly into employers’ hands.

We have been fighting these changes for a long time. In 2013 over a thousand NZNO members wrote submissions against the Employment Relations Amendment Bill to the Transport and Industrial Relations Select Committee. Over 10,000 submissions were received by the committee. I can’t remember the exact numbers but something like 98% of the submissions received were against the changes being proposed.

The Government didn’t have the numbers to pass the legislation last year, but it was first on their agenda after the Election.

We have been working hard along with the Council of Trade Unions and other health unions over the last 18 months to mitigate some of the worst changes of this new employment legislation.

Our risk assessment when the changes were first signaled showed us that our vulnerabilities were most focused around three key areas of the Act:

The 30 day rule is repealed

This means that new employees who are not union members will not be covered by the collective agreement even if their job comes within the coverage clause. Until last week, new employees were covered by the collective agreement in their workplace for the first 30 days. This protection is now stripped away so a new employee can be they can be paid less than the collective agreement right from the start. Over time this will reduce everyone’s pay and conditions.

Employers opting out of MECA bargaining

Employers will be able to opt out of multi-employer collective agreement (MECA) bargaining. An employer who seeks to opt out of MECA bargaining must give written notice to all intended parties to the bargaining within ten days of receiving the initiation notice. This could dismantle MECAs that have brought steady improvements in pay and conditions for NZNO members over the years.

Removing the duty to conclude bargaining

It is no longer a breach of the duty of good faith to fail to enter into a collective agreement.

Employers are now able to apply to the Employment Relations Authority to declare bargaining is over. Once that happens:

  • employers will be able to put pressure on individuals to agree to lesser pay and conditions
  • industrial action will be unlawful for two months

Here are a few examples of what we have been doing and will continue to do to address these attacks on workers fundamental employment rights.

We have been implementing our strategy to address both the 30 days and the conclusion of bargaining issues with new clauses in our collective agreement bargaining over the last 12 months and this work is ongoing as collective agreements reach the end of their terms.

We have been including in bargaining clauses to address the issues around conclusion of bargaining.

We will be back around the computer making sure initiation of bargaining for collective agreements is undertaken at the soonest opportunity and that conversations happen with employers around this matter to ensure coverage of collective agreements remains as it is currently.

Our sector groups (DHB, Aged care, Primary health and Private hospitals and hospices) have been identifying strategies for each particular sector.

We have developed resources for organisers to discuss with delegate the process for new employees.

We have been able to initiate all our MECA bargaining prior to the Act coming into force and maintaining collaborative relationships with as many employers as possible to secure our future MECAs and national collective agreements.

We have been participating in conversations with the CTU around the Code of Good Faith.

We have been educating our delegates and members through the Bad Medicine Campaign, delegate training and other processes.

We are strong, growing and ready for the future. We need to maintain the upmost vigilance with our employers who we have collective agreements with – we have learnt from the 1990s that our aged care employers pose the greatest risk in this type of industrial relations environment. We have been here before and thrived.

Kia kaha. We will build power through our unity.

Talk to your NZNO delegate or organiser if you’d like to become more involved.

 


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A demand to be taken seriously

dilbert-ceo-payNZNO delegate Ady Piesse is an activist for fairness at work and an advocate for collective action. This blog post has previously been published as a comment on Facebook. 

I’m a thinker….I think a lot. Sometimes I’m accused of over thinking, but generally my thinking usually provides me with ideas or helps me problem solve.

So, a couple of weeks ago, I got to thinking – what do I do in my job that is so different from my CEO’s that justifies our salaries?

At the start of every shift I check my equipment so if that cardiac arrest, acute SOB, trauma or the blue floppy baby arrives unannounced, I have the confidence that myself and my colleagues will be able to use that equipment to potentially save a life.

My CEO makes sure his lap top ‘on’ button works.

I monitor numerous pieces of equipment attached to my patients, checking for those spiralling trends so I can intervene early if I need to.

My CEO monitors computer screens that check to make sure my patients are meeting the six hour targets.

I do ‘end-of-bed-o-grammes’ all day every day, with new patients, existing patients, other nurses’ patients, to monitor change, deterioration or improvement.

My CEO looks at spread sheets to see how hard I’m working or how much harder I can be made to work.

I hold in my hand medication that has the potential to kill or to cure.

My CEO holds a pen, an iPhone.

I sit holding a patient’s hand while a doctor tells her and her family her condition is terminal. I hold a child’s hand. I hold the hand of a terrified patient who can’t breathe. I hug people I only met today and know won’t be here tomorrow.

I don’t know if my CEO has ever held a hand or given a stranger a hug.

Every day I take home people’s stories; for some it will be the worst day of their lives. These people have faces and I know some will never leave my memory.

My CEO takes home statistics.

Some days I leave wondering if I have it in me to keep doing what I’m doing – less is not more in my job – but my CEO seems to think so.

I know it’s all more complex than that.

I use my knowledge and observation skills to think ahead and intervene early to avoid a failure to rescue situation, my CEO uses their knowledge and observations to think strategically, for example.

What I’m thinking doesn’t take away from the important role my CEO plays in the day to day running of my organisation, but thinking simply – that’s about the bones of it.

Then some more thinking. I play a damned important role in this organisation too, so how is it I only get paid maybe a quarter of what my CEO earns?

And why should I feel guilty or scared of standing up and asking for more? So I’ve decided I owe nobody an apology for feeling the way I do.

More thought. Stand up and be counted, get as many colleagues on board as I can to speak out and say enough is enough!

I’ve become quite vocal in the past couple of weeks –I’ve decided to stand up for myself. I’ve realised that complaining to colleagues is not going anywhere. We need to be the very visual faces behind our MECA.

I’m guilty like many of having not gone to meetings in the past, been so apathetic to expect Government and the Boards to realise my worth and support me accordingly – I’ve been ridiculously naive! I know there are many colleagues feeling the same way and I’m hoping my ranting will given colleagues the confidence to stand up too and speak out for change!

MECA representatives at these current negotiations can only push the “we’re serious about this…” boat so far – we need to make ourselves visible to Government and our Boards and not just ask, but demand to be taken seriously,  otherwise we have another long three years of the same and more than likely, a lot worse to come.

So, be at those MECA meetings that are coming up and come with ideas! It’s time we got tough!