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What we want for health

Pre-budget2

The Government’s 2016 Budget will be announced in a couple of weeks so we thought we’d set out now what NZNO wants for health. Here’s hoping that is what the Government delivers.

What we want is a health system where everybody can access the health care they need, where and when they need it.

It’s not an outrageous ask, and we’ve never met anyone who disagrees. So, let’s unpick it and see what lies beneath the words.

  • We want a health system that is funded to provide equitable and universal health care.
  • We need the right people to make it happen; nurses, doctors, kaimahi hauora, kaiāwhina, administrators, cooks, cleaners and clinical leaders.
  • Those people must be trained and paid appropriately and be provided with safe work environments.

Last years’ Budget does not provide enough funding to meet the health needs of New Zealanders. Nor did the Budget the year before, or the year before that… In fact economist Bill Rosenberg estimated last year that the funding allocated for health was at least $260 million short. This year will be worse. Rosenberg says that in the eight months to February 2016, District Health Boards were already $27.9 million in deficit.

Funding for the primary health services we so desperately need are being squeezed and cut and services are closing. It just doesn’t make sense – primary care is the way to make our vision for a healthy New Zealand happen. Attacking small services as they begin to make headway into our communities is completely counter-intuitive.

Pre-budget

The Minister of Health is famous for saying “We must live within our means” – implying that health funding is a finite pool. It’s not. This Government could prioritise health if it wanted to.

The Government could say, for example, it’s worth spending more on health for the next 10 years until the massive benefits of focusing on primary care start showing in the system. It could say, more spending now means spending less in future.

If there was a plan, we would know how many nurses to train and we’d be able to support and mentor them after graduation appropriately.

It would be recognised that short term “savings” often don’t yield long term rewards, for people or for budgets.

Nurses, midwives, caregivers and other health care workers tell us they are stretched to the limit. Some are having to sacrifice tea and lunch breaks and working unpaid overtime just to keep up with the care they need to give to ensure needs of patients are met. Support for training and development is decreasing. Stress levels are rising and morale is low.

Pre-budget3

A healthy health system would train and employ the right number and skill mix of staff so that people aren’t burning out and/or making mistakes and/or rationing care.

So, that’s what we want in the Budget. New Zealanders deserve it and, as the largest health workforce, we expect to be heard. We are putting it out there that we will fight for it, for all New Zealanders.

A healthy health system should be a top priority for any Government. We want a health system where everybody can access the health care they need, where and when they need it.


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Its tough out there for new grads

NETPNZNO associate professional services manager Hilary Graham-Smith talks about the realities of too few Nurse Entry to Practice (NEtP)places and too many new grad nurses not getting the support they should have.

It’s a busy time of year for everyone, especially for the hundreds of newly graduated nurses out there who have just got the results of their state finals and are now looking for jobs.

It’s tough out there. We know it. And that’s why we’re feeling pretty disappointed that the Minister of Health is putting out press statements painting a rosy picture of the nursing landscape.

NZNO, and the other national nursing organisations have a goal of 100% Nurse Entry to Practice places for all new grad nurses by 2018. We’re pushing hard to make it happen and pursuing every avenue for change.

The issues are complex:

  • There just aren’t enough NEtP places
  • The Government has not allocated enough funding to the NEtP programme
  • Employers want ‘experienced’ registered nurses
  • No NEtP programme for new graduate enrolled nurses
  • New graduates in their first year of practice working outside of the NEtP programme have inadequate support

The results of the latest Advanced Choice of Employment (ACE) round for graduating nurses makes for depressing reading. Of the 1451 applicants including first time and repeat applicants, 51% (735) gained employment in a Nurse Entry to Practice programme. November 2015 graduate numbers were 1245 and of those 568 did not gain employment through the ACE round. We can endlessly slice and dice the numbers every which way but the point is that we still have large numbers of graduating nurses who do not gain employment on a NEtP programme. Just hold that thought in your head as you read on.

The Minister’s press release celebrating this will have been of no comfort to unsuccessful applicants and makes those of us who know the real story shake our heads in dismay. For the Minister to say “This result is in line with the pattern seen in the first four years of ACE” suggests that the status quo is OK? Really?

In November 2013 the National Nursing Organisations convened a workshop with Health Workforce New Zealand (HWNZ). The purpose of that meeting was to inform HWNZ’s and the Office of the Chief Nurse’s direction for education, workforce development programmes and innovations. It was agreed that one of the key action points from that meeting should be “a balanced approach to the nursing pipeline, including full utilisation of Nurse Entry to Practice funding to support a goal of 100 per cent employment of new graduates”*. The timeframe for achieving this was 2018 at the latest.

One could reasonably expect that two years on we would see some improvement in the numbers of new registered nurses being employed through the ACE programme.

In the same press release the Minister goes on to say “The data also shows from past ACE rounds that the vast majority of graduate nurses find employment over the next year”.  The salient truth about this statement is that the new graduates may well find employment outside the NEtP programme but this is likely to be in environments where they will be given too much responsibility and will not have the support and oversight of more experienced nurses. Our experience is that  these new graduates end up in competency reviews, disciplinary proceedings, in front of the coroner’s court or being reported to the Health and Disability Commission. NZNO lawyer, Margaret Barnett-Davidson had this to say, “In rest home/hospitals where nurses faced allegations relating to their practice, there were a number of common issues that increased the nurse’s vulnerability….. unsupportive managers and caregivers, time pressures too challenging for the skill set, busy environments and accepting responsibilities beyond manageability or competence level.” (Kai Tiaki Nursing New Zealand, November 2013)

Remove the gloss and spin from the rhetoric and the fact is that the registered nurse workforce is being disadvantaged by systemic unfair funding models that do not recognise it as the largest health workforce in New Zealand and one that is pivotal to providing safe and effective care for our populations and communities.

Yes the issues are multi layered as are the solutions, yes there needs to be collaboration between the education providers and employers and yes we need a strategic plan that takes account of the nursing workforce shortage predicted for 2035. But first of all we need an equity lens passed over the funding that is made available to nursing, in particular our new graduate nurses.

* (Summary of selected themes and some agreed actions that emerged from discussions at the Health Workforce New Zealand (HWNZ) Nursing workshop held on 29th November 2013).

 

 

 

 


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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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The Budget and the MECA

scalpel12This past week has been a busy one. Thursday 21 May was Budget Day. It’s a day we are always on the edge of our seats, hoping for a plan for health that delivers for our members and all New Zealanders.

And the day after that we held our final meetings about the offer from DHBs for our multi-employer collective agreement. The results of those meetings did not surprise us but what we didn’t expect was the extent to which NZNO members working in DHBs rejected the DHBs’ offer. Over 82 per cent voted no.

This years’ Budget does not provide enough funding to meet the health needs of New Zealanders. In order to meet the costs of rising prices, an increasing population, an ageing population, an ageing health workforce, long overdue decent wage increases, new services etc etc, we estimate the funding allocated is at least $260 million short.

District Health Boards (DHBs) are short-changed by at least $121 million. And we know almost all of them are already struggling to manage massive deficits, meaningless health targets and the continuing push from government to “centralise” services at any cost.

How are DHBs going to deal with the likely flow-on impacts on safe staffing, workplaces that are healthy for staff and patients and quality care?

Nurses, midwives, caregivers and other health care workers are telling us they are already stretched to the limit. Some are having to sacrifice tea and lunch breaks and are working unpaid overtime just to keep up with the care they need to give to ensure needs of patients are met. Support for training and development is decreasing. Stress levels are rising and morale is low.

And it’s not only DHBs that are bearing the brunt of reduced spending. Efforts to reduce poverty related illness are not being tackled in a “joined-up” way.

Health workforce planning is proceeding at a snail’s pace. New graduate nurses are still looking for jobs that aren’t there. Older nurses are still being pressured to work night shifts.

Health workers need a fair deal to cope with the increasing demands that are being placed on them.

And this means we need to stand together to make progress in our bargaining with the DHBs for our multi-employer collective agreement.

NZNO members working in DHBs don’t feel valued. They instructed the negotiating team to retain what’s already in the MECA, secure a decent pay increase, improve access and support for professional development and advance safe staffing and healthy workplaces.

The DHBs’ offer clearly didn’t cut it. They need to do better for their largest group of workers.

We’re heading back into bargaining on Thursday with a clear mandate: the offer must be improved. Nurses can no longer continue to take up the slack for a sick health system.

We can’t do all the work here! DHBs need to take some responsibility for advocating for the funding that provides appropriately for every member of staff and every patient. New Zealanders won’t settle for anything less.


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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!

 

 


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Our health, our taonga

233_Hui_a_Tau233

Inspired attendees at the Indigenous Nurses Aotearoa conference 2014

Kerri Nuku is NZNO’s kaiwhakahaere and is of Ngāti Kahungunu descent. As a leader for Māori within NZNO she sees it as her responsibility to ensure that equity is achieved for all Te Rūnanga members.

The other day someone asked me what the highlight of my year has been so far. Usually that kind of question causes me to ponder for a while, but not this year. The absolute highlight of my year is the very first Indigenous Nurses Aotearoa conference, held in Tāmaki Makaurau in August.

The theme for the conference was “Our health, our taonga”, which really resonated with me – as I sense it did with every other attendee. We were stimulated and challenged in our collective responsibility to protect our fundamental right to good health and wellbeing.

It was so energising to be with over 250 indigenous nursing leaders, including nurses, midwives, nursing students, kaimahi hauora and health care assistants. Our combined enthusiasm and commitment to make sure health is a taonga was infectious. It is a privilege of our te ao Māori (Māori worldview) that we see health/hauora as a part of our whakapapa, our whanau, our environment and our culture.

As indigenous nursing professionals, we are committed to reaffirming our rights under the United Nations Declaration of Indigenous people’s article 3, to self determine, and this must underpin any future Māori nursing strategy. We must have faith in ourselves and be courageous in our aspirations for the health of our whānau, hapū and iwi. We must look towards the imagination place to see what could be.

We honour our early Māori nursing pioneers, like Te Akenehi Hei, who halted the death of Māori from introduced diseases. We have nothing to fear as we move into the future – our tipuna made sacrifices and we will too, so that our mokopuna, whānau, hapū and iwi receive the best health care available in Aotearoa.

As indigenous health professionals, we must have the freedom to determine what is best for us.

We will continue to advocate for Māori nursing and workforce issues. We will lobby for change and challenge the barriers that are placed in the way of Māori nursing and workforce success.

Kaimahi hauora:  be brave, take action when you can! Ko te kai ā te rangatira he kōrero!

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

 

Click here for more information about Te Rūnanga o Aotearoa, NZNO.