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Not holding my breath for Budget

HamishHi, my name is Hamish Hutchinson. I’m a registered nurse, an NZNO delegate and I work at Waitakere Hospital in Auckland.

We’re coming up to the Budget, which is when the Government prioritises its spending for the next year. Will they prioritise health? I’m not holding my breath.

The Council of Trade Unions calculated we are well over a billion dollars short for the health system just to stand still. I can’t really comprehend what a billion dollars looks like, but I can tell you what underfunding looks like to me, every day.

I’ve been working as a nurse for 5 years. I chose nursing because it’s the sort of profession where you can use your own humanity to help others. This is still why I want to be a nurse.

I work in an Emergency Department (ED), so we are used to it being busy. We have a great team that responds well in a crisis. But it’s not always trauma and lights and sirens – another part of the ED is about doing screening for family violence and asking about how things are for people in the home. When it’s busy – and it’s getting more and more busy all the time – this stuff – the social stuff, the time spent listening to people gets pushed aside. That worries me.

ED nursesWe always say that the Emergency Department is for emergencies only. I’ve lost count of the times I have heard people saying that they couldn’t get into their GP for 3-4 days or couldn’t pay for after-hours clinics or couldn’t get into a GP because they work two jobs and have kids. Inevitably they come to ED – where else will they go?

Just as an example, I saw one man who had an infected wound. He had put off seeing the GP because of cost and because he couldn’t take a sick day from work. When he finally arrived in the ED his wound had gotten really bad. Something that probably could have been managed by a GP a few days ago ended up needing surgery and a hospital stay. It was worse for the patient and it cost so much more than it needed to as well, in equipment, bed space, and staff time. This doesn’t need to happen.

Some days the Emergency Department feels like a game of musical beds. When the hospital is full it’s just one big balancing act. I’m amazed it works and I think that’s down to the tireless work of nurses and other hospital staff.  But the reality is this is not a game, this is people’s lives.

Good health is vital for a good society and if I got to make the big decisions, I would make health and wellbeing a bigger priority than it is now. Everyone needs to be able to get health care in their own communities. We need more hospital staff for sure – but keeping people out of hospital is cheaper in the long run.

ED nurse talking with patientWhat this would look like for me?  It would mean having enough time to talk to people to find out what brought them to ED and how we can stop it happening again. You can’t do that when it’s too busy, when there’s people in corridors, and it’s the really important stuff like this that falls away with underfunding and understaffing.

Other things that would make a big difference, in my opinion are:

Free GP visits for everyone and clinic hours extended to suit working families. People should be able to see a GP on the same day and have flexibility if they are workers.

Improving the ‘social determinants of health’- the things that should keep people well in the first place, like housing, welfare, education and employment. We would have more time available for the unavoidably sick if preventable causes of disease were reduced or removed.

In particular, outside of the hospital, there has to be more emergency housing, and this is an issue that’s needs to have been resolved yesterday! There’s nowhere in West Auckland to go if you are homeless, only sleeping rough or paying for a motel which might not be an option for lots of people.  Addressing the human right to safe shelter is an absolute must and would ultimately improve the health of people in hardship. If nothing is done on this issue, I will be worried for the future, because it’s bad enough now. On Thursday, I hope the Government prioritises health and the people in our communities. And that means housing, welfare, education and employment as well. They could do it if they had the will. They could fix this all if they wanted. That’s something we are all holding our breath for.

Hamish footer

 

 


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Volunteering in Laos

By NZNO members and nursing students Dana Baillie and Laura Knox

In January of this year, we were lucky enough volunteer for two weeks in Laos, South East Asia. Laos is a communist country that only opened its borders to the rest of the world in 1990.

As a developing country, a third of its population are living well below the poverty line. In our short time spent there it was evident that although they may be poor, they were rich with happiness and love. We found Laotians to be deeply family orientated and the most generous and hospitable people.

Our volunteering consisted of construction in a small village primary school, and at an elephant conservation centre both situated in the heavy military based province of Sayaboury.

In our studies to become registered nurses, cultural safety is a key aspect of providing competent care to patients.

Our time spent with people from a totally new and different culture and religion (Buddhist) was eye opening, teaching us so much that we did not know about ourselves. We have realised the importance of culture in people’s lives and furthermore have the utmost respect for their beliefs.

In Laos everyone, from the children in kindergarten to the elderly who remain in family homes until they pass on, shows so much friendship towards anyone who may cross their path. They are always willing to teach, we don’t think they realised just how much they actually taught us.

Our time in Laos showed us that there is so much beyond what meets the eye and that culture is not only the basis of a persons’ life. For us, the experience was a lesson on how to live our lives.

 

Thanks to http://www.elephantconservationcenter.com/ for the use of the photos above

 

 


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Nurses, a force for change

We offer a warm thank you to talented NZNO member, Judy Hitchcock, for sending us this International Nurses Day poem.

Nurses: a force for change, improving health systems’ resilience

Poem

With Mother’s day remembered and now “Nurses week” ahead

There’s material citing ‘resilience’ that really should be read.

The ICN has nailed it, no more elephant in the room,

We need to look at what we do, how and why and we must do it soon.

Changing trends demands resilience but now here comes the spin:

Embracing less as being more, it’s the accountants who really win

With wages and employment frozen and hours cut to six

The expectation is still to find that perfect skill based mix

Dollars saved on paper, it’s easy to count the cost

Harder to quantify as ‘savings’ the quality that’s been lost.

Resilient in facing change with less; of course we will do more,

We give the best we can with what we have; only the minimum is poor,

There’s making it the ‘buzz-word’ endorsing our ability to cope,

But nurses are more than just resilient, for nurses provide the hope,

Whilst in the darkest hours, filled with misery and despair,

It’s nurses who provide the light, using evidence based care,

As Florence did in days gone by, “The lady with the lamp” as she was known,

Nurses care for those in desperate need and where that Red Cross is flown,

Targeted for their commitment, it’s not just resilient they must be.

But commended for their unwavering courage and acts of bravery,

Florence showed indomitable resilience, tending those injured in the war.

And still the founder of our profession inspires us to do much more:

“Unless we are making progress in our nursing every year, every month, every week,
Take my word for it, we are going back”

You can almost hear her speak.

Thoughts become our actions and speak louder than the spoken word.

Resilience and determination will ensure our voices will be heard.

Nurses are a force for change, of that there is no doubt,

Resilient and yet still caring: it’s what nursing is all about.

 


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International Nurses Day 2016

IND resources

An International Nurses Day message from NZNO chief executive, Memo Musa.

On Thursday we celebrate International Nurses Day, Florence Nightingale’s birthday, a very special day for our profession. It seems to come around quickly, which I think is an indication of the busy lives and careers nurses’ juggle. Nice that it does, too – because nurses are worth celebrating often!

After listening to presentations about some of you work at regional conventions around the country recently, I concluded that every day we should celebrate international nurses day, as nurses are involved every hour of the day in caring for someone in our health system.

Nurses are the largest profession in the health system, and without you the health outcomes for people receiving care and treatment in the health system would not be improving as they are.

Nurses, we couldn’t do what we do, without you. Thank you.

I often reflect that nurses hold the world together. We are in every community, culture and society the world over. Nurses are the woman and men who see health holistically and are able to innovate and advocate for whole person, whole whānau and whole population health.

The theme for this year’s International Nurses Day is Nurses: A Force for Change: Improving health systems’ resilience and here at NZNO we are certainly taking that challenge on board.

NZNO members are at every level advocating for a resilient New Zealand health system where everyone can access the healthcare they need, where and when they need it.

Our policy advisers and researchers are providing government and other decision makers with the evidence needed to make good and sustainable decisions.

NZNO members like you are making the difference to healthcare in your workplaces and communities and beyond.

Along with the World Health Organisation and the International Council of Nurses, NZNO believes that action on the social determinants of health should be a core part of nurses’ business. Not only does it improve clinical outcomes, and saves money but taking action to reduce health inequalities is a matter of equity and social justice.

“Every health professional has the potential to act as a powerful advocate for individuals, communities, the health workforce and the general population, since many of the factors that affect health lie outside the health sector, in early years’ experience, education, working life, income and living and environmental conditions health professional may need to use their positions both as experts in health and as trusted respected professional to encourage or instigate change in other areas.” Institute of Health Equity (2013), p.5

Nurses, people in the health system can’t reach their goals without you, and we can’t reach our goals without you too.

Tēnā koutou, tēnā koutou, tēnā koutou katoa.

Yours in nursing solidarity
Memo Musa
Chief executive
New Zealand Nurses Organisation

 

 

 

 


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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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A midwife’s story

Hi, my name is Lyndal Honeyman and I’ve been a midwife for 5 years now. I started studying midwifery because I was fascinated with the physical process of pregnancy and birth. It seemed mysterious and I wanted to know more.

What sustains me now is more than the processes of pregnancy and birth, it’s the whole journey of meeting women and families, walking with them as they grow and develop, give birth and begin their new life with a new baby.

There is one woman’s story that has stayed with me for years. It’s not a complicated story or a bad or sad story. For me, it’s a story that reminds me why I became a midwife.

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They were a young couple and the woman was pregnant with their first baby. When I first met them, early in her pregnancy, she was feeling really unsure about the pregnancy and becoming a parent.

Sadly, she had been told by a medical professional that because her body mass index (BMI) was relatively high she would have a difficult pregnancy and definitely need a caesarean section birth. What better way to make a woman feel like she’s not good enough!

The poor woman was feeling ashamed, like she wasn’t good enough to be pregnant, let alone be a mother. She felt like she would fail at everything – birthing, feeding, mothering.

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Fortunately we had plenty of time to build a relationship and I was able to reassure her and help her begin to delight in her pregnancy.

She went into labour pretty much right on her due date, which was great, and she had quite a long early labour. I saw her at home several times before we made the decision together to go to the birthing unit at the hospital.

Because the early stage of her labour was so long she was tired and began to get anxious and self-doubting again.

We discussed the next steps. She decided to have an epidural to assist her body to rest, as she had tried other physiological and pharmacological methods and found that they were not working for her at the time. We were able to help her create a calm and relaxing environment, which was very important to her to have, and she progressed very quickly and gave birth – on her hands and knees – to a handsome baby! She ended up having the birth she never thought she could have and I have never seen anyone so over the moon.

I could see on her face the sudden awareness that she was a strong and awesome woman, capable of anything! Suddenly it all came together for her – she knew she’d be able to feed her baby, she knew she’d be a great mother.

Film-Colour-10They went home the next morning feeling really, really confident.

And I went home that day feeling excited and humbled. I was honoured to have helped this woman to realise confidence in herself and her body, and was privileged to be part of her journey into motherhood.

I still feel relatively new in my career as a midwife. I am inspired by my colleagues who are so skilled, insightful and confident, whose years of practice have made them so wise. One day I will be like them.