Nursing reports

Thursday the 17th of October is International Day for the Eradication of poverty and the New Zealand Nurses Organisation (NZNO) is calling for action locally, nationally and internationally to eradicate poverty. 25 percent of New Zealand children currently live in poverty.

Christchurch nurse and chair of the NZNO Nurses for Children and Young People of Aotearoa section (NCYPA). Becky Conway explains why poverty is a health issue, “Nurses and other health care workers see every day the effects of poverty on children and young people. We see how poverty affects, not only their health, but their self-esteem and future potential and prospects.”
 
“The effects of poverty can be visible through skin conditions, scabies and asthma. Poverty is also internal and invisible – the mental strain caused by living in poverty.”
 
“Here’s one distressingly common example. A teenager with advanced school sores (impetigo) comes into the clinic. He should have come months ago but his family couldn’t afford it. He lives in cramped, cold accommodation. He is ashamed of how he looks, covered in sores and open wounds, and he has stopped going to school. He doesn’t make eye contact with the nurse. The consultation feels like an indignity to the young man and his family, and both the nurse and the family know that even the cost of the prescription may be too much.”
 
“We see cases like this, and worse, every day. Nurses want to make a difference and to improve the health and well-being of their patients and we would love to know that we are making that difference for the long term, not just until next time the same disease afflicts the same impoverished child or young person,” Becky Conway says.
 
“Nurses know what will eradicate poverty. What New Zealand needs is a holistic approach to stopping poverty. The main way for families to move out of poverty is to increase their income, but health, housing, education and social welfare must provide wrap around policy and services too.”
 
“Solutions to child poverty require a multi-pronged approach, good child-focused government policy which is not punitive, and the solutions must address communities.” 
 

11 October 2013:

The New Zealand Nurses Organisation (NZNO) is joining thousands of other organisations and individuals in calling for the text of the Trans Pacific Partnership Agreement (TPPA), currently being negotiated in secret, to be made public.

NZNO believes the Government should not sign any agreement that has the potential to limit its ability to make decisions in the best interests of New Zealanders.

The TPPA will limit the ability of governments to regulate wholesale and retail prices for medicines to ensure that they are affordable, and will also give foreign investors the right to sue governments for making laws which affect those investments, even if the legislation is in the best interests of citizens. 

NZNO policy adviser, Marilyn Head says, "These are matters that affect public health, and must be open to scrutiny. There is a very real risk that multinational corporate interests will override our sovereign interests and that could be disastrous for health."  

TPPA proposals for extended patents on medicines will delay market entry of the cheaper generic medicines that PHARMAC relies on to keep the price of medicines down. Other proposals would delay and interfere with PHARMAC's negotiating and decision making power.  Without PHARMAC New Zealand will find it harder to afford the most effective medicines or medical technologies.”

“The TPPA would also mean our government would lose their right to set policy on issues like tobacco control. Tobacco companies would have the right to sue the New Zealand government for taking steps to reduce the harm tobacco causes.”

“NZNO advocates for effective delivery of public health policy and a Smokefree Aotearoa by 2025. The TPPA will make achieving those important aims much harder,” Head says.

“The health of New Zealanders should not be negotiable. NZNO urges the Government to release the text of the agreement, consult properly with the public and put the health and well-being of its citizens before big business.”

 

28 August 2013:

Recent media reports highlighting ‘care rationing’ in two New Zealand hospitals are a cause for concern but not a surprise for the New Zealand Nurses Organisation (NZNO). NZNO believes the practice is widespread as DHBs and the nursing team are forced to do more with fewer staff and less money. Fiscal constraints are creating a ‘head in the sand approach’ to staffing issues in our hospitals.

NZNO associate professional services manager, Hilary Graham-Smith says, “Care rationing is both a service quality and patient safety issue; it is much more than patients not having their hair combed or being assisted with personal hygiene. There is no such thing as “optional” care or “comfort” care – care rationing is when the right care is not being provided to the patient at the right time.”

“International research shows a strong association between inadequate staffing levels, care rationing and poor patient outcomes.”

“We need to listen when nurses say they don’t have time to deliver the cared required to achieve a satisfactory outcome for patients. Our members are concerned about staffing levels; they are stressed, distressed and anxious about their ability to deliver safe and effective care in an environment that is not appropriately resourced. Care rationing is the ethical dilemma nurses face every day. The conscious decision of prioritising care provision and dropping off the nursing tasks that are deemed less of a risk is draining, demoralising and exposes nurses professionally. Urgent action is required.”

“We already have the tools and systems to make sure care rationing doesn’t happen. The care capacity demand management (CCDM) programme ensures staffing levels are safe – safe for patients and safe for staff. CarePoint is the NZNO strategy which shows how the elements of the CCDM programme; patients, staff and resources, work together to improve care.

“We need to make sure that the right number of staff with the right skills are in the right place at the right time to deliver all of the care a patient requires. DHBs need to be supported and resourced to implement this programme sooner rather than later,” Hilary Graham Smith says.

The New Zealand Nurses Organisation (NZNO) Kaiwhakahaere, Kerri Nuku and President, Marion Guy are pleased to welcome newly elected directors to its board.

Current board member and registered nurse, Karen Naylor has been elected Vice President.
 
Successful candidates for the board are Cheryl Hammond, Debbie O’Donoghue, Eseta Finau, Jacob Panikkamannil, Juliet Manning, Sara Mason and Shane Pleasance.
 
Marion Guy says, “I pass on my thanks to all the candidates who stood for positions on the NZNO board. I look forward to working with the new board members and appreciate the skill and experience they bring with them.”
 
Kerri Nuku says, “It was pleasing to have a good number of candidates standing for election to the board.  NZNO is run by its members and it is good to know that we have so much leadership potential at all levels of the organisation.”
 
Both say they are looking forward to an interesting and challenging three years as the new board works to continue to work to improve and grow the organisation and to bed in the new constitution. 

23 August 2013:

The New Zealand Nurses Organisation (NZNO) congratulates Kristine Bartlett and the Service and Food Workers Union: Ngā Ringa Tota on their historic win in the Employment Court. Aotearoa New Zealand is now one step closer to achieving equal pay for men and women who do similar work.

NZNO industrial adviser for the aged care sector, David Wait says, “NZNO’s membership is 93 percent women and today is a great day for each and every one of them. Equality is now one step closer.”

“Although we have had an equal pay act since 1972 we have never used it, and continue to pay those in female-dominated jobs less than those who work in male-dominated jobs. That’s not fair.”

“It seems bizarre that we have to resort to court action to achieve equality between the sexes in the 21st century. Kristine Bartlett and the SFWU, with support from NZNO and others, have bravely stood up for fairness and won,” Wait says.

“Te pai kē o au mahi, kua whai hua mo ngā wāhine.”

15 August 2013:

Staff at Ranfurly House residential aged care home and hospital have voted to take strike action over the callous actions of their employer. Ranfurly Care Limited are threatening staff with redundancy if they don’t accept the loss of conditions and holidays, and pay cuts of up to $100 per week.

The first picket will take place from 2.30 – 4.30pm on Thursday 15 August outside Ranfurly House, 539 Mt Albert Road, Three Kings, Auckland.

New Zealand Nurses Organisation (NZNO) industrial adviser David Wait says, “Staff at Ranfurly House are barely earning a living wage as it is – they will be forced below the poverty line if these cuts are implemented.”

“Some staff at the aged care facility have worked there for over 30 years. It is shameful that they are being treated like this. These people do an amazing job caring for the mostly war veteran residents. They understand the special care required to care for people who have suffered trauma and loss.”

“The work these carers and nurses do is highly specialised. It is valued by the residents. Any reduction in conditions will undermine and destabilise the nursing profession. NZNO finds it difficult to understand how the owners have such little concern for their greatest asset, their staff.”

Mele Makas is an NZNO delegate who works at Ranfurly House. She is worried that if the cuts go ahead it will affect the families of all the staff at Ranfurly, “We already struggle to pay our bills. If they cut our pay packets by $100 a week we will not be able to keep up with our rent and we won’t be able to put enough food on the table.”

“The work we do is important. It is not right or fair for our bosses to do this. We hope our industrial actions will change their minds.”   

7 August 2013:

Nurses all around the country are taking time out over the next couple of weeks to attend one of over 80 meetings to discuss what they can do about proposed employment law changes.

NZNO industrial adviser, Lesley Harry says, “The stop work meetings will be held at every DHB in the country. We have around 26000 members working in hospitals and they are very concerned about the changes the Government is proposing.”

“The Government wants to make collective bargaining much harder for employers and employees, and they also want to allow employers to opt out of multi-employer collective bargaining. Both those changes will impact the nursing profession greatly.”

“Currently all 20 district health boards (DHBs) negotiate a multi-employer collective agreement with unions. The agreement ensures workers throughout the country receive the same pay and conditions and DHBs receive the benefits and efficiencies of working together.”

“The DHB multi-employer collective agreement makes it possible for the nursing team to provide safe, quality and consistent care throughout the country. New Zealand’s health system relies on a nationwide approach to providing care. Allowing the fragmentation of employees’ terms and conditions will result in a fragmented and stressed health system,” Harry says.

“Nurses will be discussing what the changes will mean for them and their practice. They will also be letting their DHB employers know how much they appreciate working within the partnership of a multi-employer collective agreement.”

 

6 August 2013:

The New Zealand Nurses Organisation (NZNO) welcomes the Government’s announcement that the General Medical Subsidy (GMS) will be extended to nurses and nurse practitioners. Pharmacists will also become eligible for the subsidy.

The General Medical Subsidy is a per capita sum paid by Government to GPs for seeing certain groups of patients. Patients may also be charged a co-payment. Until now only GPs could access the subsidy.

NZNO associate professional services manager, Hilary Graham Smith says, “This is a significant change. Twelve years on from the release of the Primary Health Care Strategy we are finally moving past the rhetoric into a place where nursing can rightfully take its place as a lead provider of primary health care services. For nursing this is about ensuring our communities have timely access to primary health care services.”

“The subsidy also means the General Practices can now work smarter. Until now, even when nurses have provided the health care, doctors would have to “pop their head into the room” in order to apply for the funding. Nurses working in primary health organisations will now be able to be able to access the funding and doctors will be freed up to do their work.”

“NZNO believes the change has the potential to change how New Zealanders receive their health care. The nursing profession has plenty to contribute in delivery of care in primary health care settings. Their involvement in this work is a step in the right direction. We thank the Minister of Health for seeing the big picture and making the right decision,” Ms Graham-Smith says.

1 August 2013:

The New Zealand Nurses Organisation (NZNO) is extremely disappointed and disturbed that Rymans is publically blaming nurses for failure of care in their Malvina Major facility in Wellington.

NZNO industrial advisor for the aged care sector, David Wait says “All NZNO members will be appalled by the treatment of the elderly woman at the centre of this case and we support the family in their call for change and improvements to the sector.”

“However this must not be considered an isolated incident. Residential aged care in New Zealand is in crisis as the Human Rights Commission Caring counts report identified independently last year.”

“The lack of mandatory staffing levels, inadequate registered nursing hours, training requirements and pay rates for carers on, or near the minimum wage, clearly show how undervalued this work is.”

“Nurses and carers simply cannot provide the care which they want to provide if the facility is understaffed and under resourced.  Residents have complex health and personal care needs. Evidence demonstrates that patient outcomes are negatively impacted when there are insufficient regulated nurses. We have heard from a former Ryman’s staffer that on night shifts there is only one registered nurse rostered on for the entire facility – that’s one nurse responsible for over 200 residents and patients, ” says Lorraine Ritchie, NZNO professional nursing adviser.

“There is something seriously wrong with the sector when taxpayers provided $800 million to Rymans last year to provide care for our most vulnerable elderly citizens and at the same time they post profits of $100 million. And that massive profit is up 19 percent on the previous year, and Ryman’s eleventh year of profit increases.”

“NZNO members have been lobbying for Government intervention to address this situation through better transparency in funding (including targeted funding for pay increases), the development of enforceable staffing levels, and the requirement of all workers to be trained. The Government must step up and make the changes needed to improve things for our elderly.”
 

25 June 2013:

The New Zealand Nurses Organisation (NZNO) is pleased to support the case that could change the face of aged care, being taken by the Service and Food Workers Union: Ngā Ringa Tota this week.

Last year caregiver and SFWU member, Kristine Bartlett agreed to be the ‘test case’ for a challenge to the Equal Pay Act. The Equal Pay Act came into law in 1972 but until now it has not been used in a way which addresses the pay gap between male and female dominated professions.

NZNO industrial adviser for the aged care sector, David Wait says, “The case has already attracted strong interest from both the government and employers and as it proceeds will ask two important questions. Firstly, why caregivers working in residential care are paid less than caregivers working in our public hospitals. And secondly, the case will ask why there is a pay gap between jobs largely done by men and jobs largely done by women.”

“A common example that we often see in the aged care sector is the pay rates for ‘handymen’, typically around $20 an hour compared to minimum wage pay rates for carers.”

“NZNO sits within the Council of Trade Unions as an ‘intervener’ in the case, which means we are a primary supporter and provider of evidence. We are hopeful that our evidence and the work of Kristine and many others will pay off, and the court decides in our favour. When that happens, the work of thousands of other low paid women workers in New Zealand Aotearoa will be valued properly.”