NZNO's Blog


Leave a comment

Older people deserve a little more of our time

Lyn Shirley is a Registered Nurse who works in aged care. She is also a Shout Out member leader and delegate for NZNO. Lyn’s involvement in Shout Out for Health led her to speak to M.P.s about how health under-funding is affecting the aged care sector. A public meeting in Nelson held by two political parties was the perfect opportunity for her share her nursing experience.

IMG_0811[1]

“I feel very strongly that the issues nurses and other staff face in aged care need to be better understood by politicians and the public. Both staff and residents are impacted by under-funding and short-staffing, as is the whole of the health sector. With an aging population, more families will have to experience these problems soon if we don’t better plan and fund services now.

Elderly people who have just entered an aged care setting are vulnerable. They are more often high needs or even in end of life care. Nurses and other staff need to spend time with them to reassure them about the journey they are going through, moving out of their own homes and away from their communities and the people they know. Sometimes they can be confused about what is happening with their health. This is why it’s really important there are enough staff who can explain to them clearly and calmly what we are doing for them. For this to happen in aged care we need more government funding. All MPs need to be aware of our situation. After all, they may well be in an aged care home one day too!

Way back in 2011 I was involved in the Caring Counts report on the aged care sector, and I didn’t know what had happened to the recommendations of that report. I suspected not a lot, given my experiences working in the sector.

When there was a public meeting in Nelson on aged care earlier this year, I was keen to go. Labour Deputy Leader at the time, Annette King and Green Party Co-leader Metiria Turei were speaking and answering questions from people at the meeting, as well as Rachel Boyack, the new Labour candidate for Nelson. The public comments at the meeting matched my own experiences as a nurse working in aged care – it really validates our clinical expertise on the need for safe staffing for our elderly. There were a couple of student nurses there too who spoke with passion and confidence about the issues facing our sector.

After the meeting I managed to speak directly to an MP about some of these continuing issues; the inadequate staffing levels, the increasing workload due to the residents being more unwell, and problems with the way people entering care are assessed.

I spoke about needing more time to carry out the social and clinical assessments and interventions that we have trained for, and that it was so important in our jobs not to be rushed. This is how to treat the patients with the dignity they deserve. I also described how as nurses we need to not be so overburdened with work that we barely have time to think. The paperwork required of registered nurse has become more demanding. On some days I could be on the computer for hours, taking valuable time away from caring for the residents. I became a nurse to deliver care, not just reports!

We need more nurses to work in aged care. I know a lot of nurses in aged care experience moral distress and burnout when they can’t act in their patient’s best interests because they are short on staff, equipment, and time. We are experts in our own jobs. Part of being the best advocates for our patients is making sure their issues, and ours, get through to decision makers.

I felt really good being able to share just a little of my experiences and hearing others do the same at this meeting. I encourage our other members to make an appointment with their MP too. It’s a simple way you can get your voice heard, and your local NZNO staff will support you.”

To take action on health funding, contact your local NZNO office to be put in touch with a member leader like Lyn, or plan your own MP visit with the help of your local staff. You can also sign the open letter on health funding by leaving a comment at the bottom of this blog post.


4 Comments

Where to next on pay equity/equal pay?

This blog is by Cee Payne, Industrial Services Manager for NZNO. Cee represented NZNO as part of the cross union bargaining team in the hard – won settlement offer for caregivers. Here she outlines some issues with the new proposed law, and what NZNO members can do to make it better.

IMG_5116Excitement at the pay offer settlement announcement for caregivers. Cee is pictured centre in the red skirt in front of Memo Musa, NZNO CE, Grant Brookes NZNO President at left, and NZNO caregiver members.

Pay equity/equal pay has been on a roller coaster ride in the last few weeks in New Zealand. First, we had the historic announcement of the Government’s $2 billion offer of settlement for Kristine Bartlett’s pay equity case for caregivers. The mood from caregivers across the motu was one of total relief and celebration. These women have been waiting so long on the minimum wage or close to it for better recognition of their value. It felt like the confetti had barely settled the very next day when the Government announced they were introducing a new draft Employment (Pay Equity/Equal Pay) law. This law includes a new ‘principle’ –the ‘proximity principle’ – that could have stopped Kristine’s case from ever happening

The mood of celebration turned into a gasp of disbelief from many of our members, who understandably worry about what this means for them. Unions were just as upset at both the message and the timing. The really annoying thing is that apart from this problem and a few other issues we can improve on, the new law sets out a better and easier process for making future pay equity/equal pay claims. It means other groups of women don’t have to go through many expensive rounds of court battles to achieve pay equity/equal pay.

I was one of the negotiators on the pay equity settlement for care and support workers and on the cross union, government and business equal pay principles working group. We had nearly two full – on years of research, meetings, and consultation to get the result we did for care and support workers. And although it was a long process, I believe the principles we used can work, if they are not restricted by this new ‘proximity principle’. In fact, New Zealand will probably have the best pay equity/equal pay law in the world if we can sort this out.

Kristine and the negotiation team signing the terms of settlement of the pay equity offer for caregivers in the Beehive, Monday the 2nd of May 2017. Cee is signing on behalf of NZNO.

Pay equity is being paid fairly for different jobs that are similar, and equal pay is being paid the same as men for the same work. What the Government is proposing for pay equity is that for women in historically female dominated jobs you have to first find a relevant male-dominated job to compare yours to in your own workplace. Then if there is no relevant job available, you can look in your own industry before you can look outside your sector at other jobs done mostly by men with the same or similar skills, training and responsibilities. So for Kristine Bartlett for example, her employer wanted to argue she should be compared to a gardener working at a rest home. But wages are low across the whole aged care sector because it is female dominated, so her union E tū thought she should be compared to a Corrections Officer-a better fit for her skills, responsibility, effort and conditions of work. These male dominated jobs are called ‘comparators’.

Finding the best comparator or even multiple comparators can be a long process but it’s an important one to get right. There will be no perfect male-dominated equivalent, so you might need to take one job for the qualifications, another for the effort, and a third for similar conditions of work to make your case. NZNO believes it’s really important we find the best job, not the physically closest, especially since so much of the health sector is female dominated. Otherwise, equal pay cases could be artificially restricted by the same discrimination we are trying to re-balance.

The good news is it’s not too late. The Government is taking submissions on the new law until the 11th of May before it has to start going through parliament. The more people that write to them, the better chance of removing this new principle to get the fairest comparators. It is imperative the Government passes the best pay equity/equal pay law in Aotearoa/New Zealand.

We don’t know yet which other parts of the membership could be eligible for cases in the future, or if police, engineers, or any other job would be the best ‘comparator’. NZNO is committed to 100% of our members who are performing work historically undertaken by women achieving pay equity/ equal pay. There are existing pay inequalities between different groups of our membership, and we need to carefully go through each group once we have the new law. Any case of course would involve significant consultation with and campaigning from members, just like we did with caregivers.

But right now the most important thing for all future cases is getting a fair and sustainable law that works. For that we need your support. If you feel passionate about women being paid for their worth and ending gender discrimination forever, write to the Government right now and tell them why you don’t support the ‘proximity principle’ before they write it into the law. Send us a copy of what you said too by emailing nurses@nzno.org.nz. It could be the best invested 5 minutes of your life.

 


52 Comments

An open letter to New Zealand voters.

blog banner open letterPictured- NZNO members and Registered Nurses Phoenix and Michael.

 

This year, we are asking for your help.

This isn’t something people working in healthcare would normally do – it’s usually the other way around. We help you in your time of need – in your hospitals, your Plunket office, your home, your marae and in your community. We love our skilled work, and turning your worst day into a better day. When you are sick, injured or in need of support, you can turn to us for healing, comfort and safety. We help no matter who you are, where you come from, how much you earn or where you live. Knowing we can help is what drives us to work in health.

 
Right now it’s getting harder to do the work that we trained for. We want the best for everyone who comes into our care, but health underfunding means that sometimes we’re not able to give you the best. We are often short staffed, rushed, and need a little more time to give you care. We are sad sometimes because of what we couldn’t do for your tamariki, your grandparents or your neighbour. Many of you are feeling frustrated by delays in getting the healthcare you deserve and expect. We are frustrated too.

 
Together, we can fix this. If health was funded sustainably now and into the future we could improve that service for every New Zealander. We can have a health system where every patient knows that when they need care, they will see the right health professional, with the right skill, in the right place, at the right time. This is the proud tradition of our country.

 
It is election year. Who you vote for is your personal choice, but we are asking you to use your vote to help us give you and your loved ones the best care. Make sure you are enrolled to vote now, and that the people you know are enrolled . Check out which political parties are committed to increasing health funding. Pay close attention to what they say about resourcing us to give you quality care.

 
We are asking you to make health funding your first priority this election. Talk to your friends and family about voting for health. Without an increase to health funding we are all in serious trouble. With your vote, we can improve and save lives.

Yours sincerely,

NZNO Kaiwhakahaere Kerri Nuku, NZNO President Grant Brookes, the undersigned nurses, caregivers, midwives, healthcare assistants, kaiāwhina, and the people they care for.

You can add your name, where you’re from and message of support as a comment on the blog. Your nursing team would really appreciate it.

Authorised by Memo Musa, New Zealand Nurses Organisation,
Crowe Horwath House, 57 Willis Street, Wellington
PO Box 2128 Wellington


Leave a comment

Shouting Out because We Care!

A message for politicians and NZNO members from Richard and Annie.

A couple of weeks ago, the Yes We Care tour arrived at Wellington Hospital on the most horrible day of the year. It was cold, it was wet, and the rain was falling sideways. Richard and Annie are two Shout Out member leaders who were determined to deliver a health funding message despite the weather. Here is why they did it.

Richard

Richard McCormick Wellington Nurse 2.jpgRichard in the rain!

Quite honestly, standing outside in the cold and windy Wellington weather was minor compared to the challenges of working in an underfunded health system. Like many nurses, I believe everyone has the ‘right to health’ – that New Zealand has a fundamental duty to provide access to healthcare that people need. That’s what we try to achieve in our work.

But, the work of nurses is being undermined by living and working conditions that don’t enable good health outcomes for an increasing number of people. And when those people get sick and come to us for help, at the moment we are not able to provide every patient with the best quality care every time. Slowly, Kiwis’ ‘right to health’ has been taken away, until we have reached a point where my colleagues are experiencing moral distress in their work. They regularly tell me that they feel despair when they are faced with preventable situations they can’t fix with their clinical skills because of a lack of health resources.

That’s why it’s time to use our political skills as well as our clinical ones. As a nurse and NZNO delegate, what really mattered to me was showing up to this event to demonstrate we can overcome our despair.  We have a strategy to campaign based on hope, courage and collective action: hope for a healthier future and courage to stand up for what we aspire to achieve. We stand up for collective action, no matter how small it may seem at the time, to protect the right to health. Even in the rain!

My message to politicians is that underfunding of the health system is not about money, but is about the right thing to do for New Zealanders. Just like nurses do, each of you make choices about how much money to spend on different priorities. When you were elected, you took on responsibility for the health of the nation. We are telling you as clinicians that it’s time now to increase health funding. In fact it is overdue. When health needs aren’t met, they don’t just vanish, they get much worse, and our population is growing and ageing. Acting now is a moral imperative before the problem is even bigger.

My message to nurses is that I know what you are going through at work, because I experience it too. Sometimes it feels like you couldn’t possibly do anything more – but that’s why we need to shout out for our health now, so we can be the change we want to see.

Annie

Wellington We careWellington NZNO staff, delegates, and NZNO President Grant Brookes at the Yes We Care tour action outside Wellington hospital. Annie is wearing the pink hat to the right of the picture.

My message for politicians is very simple. My colleagues and I just want to be able to do a job that gives the very best care for the people we look after. Part of that is having the right tools, safe staffing levels, and a reasonable workload. I want to be able to take my meal breaks, go home on time and not constantly revise and ration the care I am able to provide. This doesn’t seem like too much to ask, but at the moment this is not happening in our health system. Each and every nurse I know comes to work to give 100% on the job, despite the shortages. If you fund health properly, we can go back to having good work days where we go home satisfied with a job well done, and patients’ needs being met.

To my fellow NZNO nurses: As health professionals, it comes naturally to us to speak up for our patients. Every day we are our patients’ advocates. We want the best outcome for each and every one of them. So I’m not willing to stand by in silence and allow them to be disadvantaged by an underfunded health system. And I don’t think that you are willing to be silent either. If we don’t speak up for our patients, who will? That’s all that we are doing- extending our advocacy outside of the ward. Join me, because this year we have to do it together. We will win this, for us all.

The Yes We Care tour is coming to to Pukekohe tomorrow and moving north up the country until the end of March. For a full list of events that you can go to support, see www.facebook.com/pg/yeswecare.nz/events/ . We’d love to see you there.

 


Leave a comment

A comfy chair

Social media shares2 10 Feb2

A Shout out for health blog by NZNO delegate and member leader Rachelle Smith.

My name is Rachelle and I work in the Bay of Plenty. I am a Health Care Assistant on a ‘high acuity’ medical ward, where we also specialise in looking after the elderly. High acuity means that patients need lots of immediate care, unlike conditions you can manage over a longer term or outside the hospital. So it can be quite full on, but I love my job.

My satisfaction comes from impacting lives in a positive way, and providing quality care that meets my patients’ needs and helps them achieve their goals. We provide a holistic approach to care, where we encourage whānau to give us feedback and input. This supports both us and the well-being and safety of each patient.

I am passionate about engaging others on the effects of chronic underfunding of health care in New Zealand. I see this every day in my own work, but I’m still learning through our Shout out for health campaign how it affects every other part of our health system too. I’m part of this campaign because each of the patients and families we work with are worthy of our time, quality care, and our advocacy.

On reflection, I see our health system as a framework, a framework that supports our families and wider communities. When our framework is built on a foundation of underfunding, like building on sand, it becomes compromised and the whole long-term system that keeps our communities going starts to break down. This shows itself in big ways, like longer waiting lists, but the little ways are just as important too.  Simple things like an appropriate comfortable chair for our older patients now are a ‘luxury’ item. But a comfy chair can make all the difference for someone who is old and in pain. Facilities need to weigh up whether they can afford to purchase these things against all their other growing expenses. It’s not a simple case of providing what patients need straight away anymore. These decisions take more thought and time.

Healthcare staff and other organisations are doing their best to fix these little gaps in the framework. But if the Government dedicated more funds for health than it does at the moment we would have a stronger foundation to build on. We could provide ‘uncompromised’ care and ensure every New Zealander could achieve their own health goals. The Government needs to put a higher priority on the well-being of the whole population, especially when they are in need of a little extra help from healthcare services and staff.

I know that little things like comfy chairs for the elderly end up adding up to make a big difference to the quality of our lives. I want a strong health framework, not just for my patients, but to support the kind of country I want us to be for future generations.


1 Comment

Patients deserve to get back to their homes pain free

By Registered Nurse and delegate Ben Rogers as part of the Shout Out campaign

As a Registered Nurse working in the theatre and recovery environment I frequently see patients who having long ordeals before they have had the opportunity for their surgery. I became a nurse because I get great joy from the process of healing and recovery – getting patients back to their work and their families in as good shape as possible, no matter what has happened. But often, patients will have to fight ACC just to get the need for their surgery recognized. Or, they have surgery delayed as there was simply not enough staff to run all the planned operating theatres that day. Sometimes acutely injured patients wait without food on ‘nil by mouth’ only to have their surgery cancelled and rescheduled for the next day, or are discharged too soon to make space for the next person who will go through exactly the same thing. Rinse and repeat.

One case that stuck with me was a patient who had their surgery late in the day. They had been given local anaesthetic to numb the area and reduce their pain, which normally wears off early in the morning. It was late in the day so there were no pharmacies open nearby open to collect the strong pain relief they would likely need when the local anaesthetic wore off. Ideally they would have stayed in hospital overnight, and then been discharged the next morning, however the hospital was simply too full and there was a lot of pressure to minimize incoming patients. This patient did go home that day. I slept poorly that night, worried that this patient who was in my care would now be in excruciating pain.

For me, health under-funding leads to full wards of people stuck in limbo, frustrated, hungry and suffering; and staff such as myself stressed and losing sleep, from being not able to give the quality of care the people of New Zealand deserve. This is why I feel so strongly that health should be funded to meet the health needs of New Zealand, so we can discharge people in the state that they deserve from our publicly funded health system.


4 Comments

Give nursing grads a fair go

By NZNO member leader and nursing student Phoebe Webster, as part of the Shout Out campaign.

nzno-students-30Pictured- Phoebe Webster, 3rd year nursing student.

“I am a 25 year old nursing student in my 3rd and final year of nursing study, and looking forward to starting my professional career. By the time I finish my Bachelor of Nursing (BN) I will have completed over 1100 hours of approved supervised practice. I will have spent countless more hours attending practice laboratories, clinical preparation sessions, lectures, tutorials, guest speaker sessions and workshops as compulsory components of my BN degree. After completing this I will sit my state final exam and, all going well, will become a Registered Nurse (RN).

My course is designed to make sure I am a safe, competent, innovative, and articulate nurse. It means that I can work in different parts of the health care sector and improve health outcomes for local, national and global communities. But there is still a steep learning curve going from a student nurse to confidently performing all of responsibilities of an RN.

The Nurse Entry to Practice/Specialist Practice (NEtP/NESP) 1 year programme provides new graduate nurses with an invaluable introduction into the healthcare system. It’s really crucial support for us going through this steep learning curve. It provides a safe and supportive environment for graduate nurses to slowly transition into the responsibilities of a competent registered nurse. This crucial support is sadly not available to all graduates however, and I can’t help wondering how I will fare in this competitive race for employment after my state finals. Only around half of graduates manage to get a NETP position in the first year, and the job opportunities for new graduates outside of the programme can be limited- everywhere wants ‘experience’, but how can we safely obtain it?

More funding is needed to provide these NEtP and NESP placements for new graduates. Sure, it is possible to enter the workforce without a NEtP position, but why make this transition less safe and harder for new grads?

More highly trained nurses are exactly what our complex healthcare system needs. Comorbidities, where patients have many related and often serious health problems going on at the same time are common. Nurses now deal with complicated care under widening scopes of practise. Making sure these new scopes are adequately prepared for and supported is vital for future workforce planning.

Other professions in New Zealand are supported to train and transition slowly into their jobs. When entry to training is regulated with supervised progression, people who come out the other end are better recognised as highly skilled professionals. Take the police force for example. In New Zealand new police undertake extensive entry requirements and progress through a (paid) training programme and are then placed in supported roles in different areas of the police force. Builders have apprenticeships which provide many hours of supervised, supported time on the job. Should the same on the job support and continued supervised learning not be available to all nursing graduates, not just the lucky ones?

The NEtP programme is based on many other successful and effective new graduate programmes around the world. Benefits include transferability of skills recruitment and retention of New Zealand nurses. I really, really want to be the best nurse that I possibly can. After sitting my state final exam this year in November it worries me that I may be entering the workforce without the support in place to give me a fighting chance to achieve that quickly. Building the strong, competent nurses of tomorrow is something I see as worth investing in. It’s a profession that I have invested in, in every way, and hope to continue to do so throughout my life. All I’m asking for is that my country supports me a little bit more, to help support them.”

NETP (Nursing Entry to Practice) and NETSP (Nursing Entry to Specialty Practice) key stats

  • There were 1455 applicants in total in the November end of year pool in 2016.  Of these 1303 were NETP applicants and 152 were NESP applicants.
  • There were 151 applicants indicating they were repeat applicants (128 NETP and 23 NESP) and 1304 (1175 NETP and 129 NESP) who indicated they were first time applicants. (Note: 1274 applicants said they completed their degree at the end of 2016.)
  • There were 121 second time applicants, 26 third time applicants and 4 fourth time applicants.
  • Only 52% of NETP applications were employed as at the 25th of November 2016, and 65% of NESP applicants were employed by the same date
  • Of the remaining applicants in the NETP pool, 605 were unmatched, 17 withdrew, were declined, or did not finish their degree. In the NESP pool, 53 were unmatched and 1 either withdrew, was declined or did not finish their degree.

That’s 658 New Zealand qualified nurses who wanted further on the job support but didn’t have NETP/NESP placements to go to at the end of last year. With a nursing workforce shortage hitting us right now, NZNO believes we need a placement for every new grad.