Health Minister Tony Ryall

Speech Notes - NZNO National Enrolled Nurse Section Conference

Opening

Thanks Robyn.

I'd like to acknowledge the Australian enrolled nurses with us this morning.

I'd also like to acknowledge the Nursing Council, members, staff and Nano Tunnicliff, New Zealand Nurses Organisation president.

And thank you Enrolled nurses and Nurse Assistants for asking me to join you here this morning.

It is a pleasure to be with you – particularly today on National Enrolled Nurse Day.

One of the greatest achievements in nursing this year has been the elevation of enrolled nursing.

This seems like a good day and a good place to expand on that.

Priority to Government

Restoring enrolled nursing has been a priority for this Government.

One of the first actions the National government took when it came to office was to ask the Nursing Council to work with the sector to expand the role and training of enrolled nurses in New Zealand.

This was an election commitment.

For more than 30 years, Enrolled Nurses have played a crucial role in the public health service.

Enrolled Nurses role marginalised

But your numbers were allowed to dwindle.

Today, there are just over 3,000 practising nationwide.

The title got changed to Nurse Assistant but that role has not been popular enough to fill this void: there are somewhere in the region of just 200 Nurse Assistants.

And you became unjustifiably marginalised in the public health service.

Just how so struck me when I was reading a recent article in Kai Tiaki.

It was an example of how marginalised Enrolled Nurses had became in the eyes of some – how little some have appreciated your very good skills and experience.

Sara Keen, Enrolled Nurse of Oamaru wrote it.

Sara has very kindly allowed me to quote her story.

Now Sara is justifiably proud of her job – she's a certified childbirth educator at the Oamaru Maternity Centre.

But she was devastated when she picked her young son up from school one day recently – wearing her enrolled nurses uniform.

Her boy's teacher was astonished that Sara was 'only' an enrolled nurse when she'd thought Sara was 'a real one' – a nurse with a degree.

Sara was – understandably – hurt and insulted.

Sara says she brooded about it for weeks. She lost self confidence. She let it get to her.

And this is quite possibly what many enrolled nurses have experienced - to one degree or another – and I should add – unjustifiably.

But Sara rallied. She came to a conclusion. That she should dwell on the good things she has done as an enrolled nurse over the years.

And this is what she wrote:

I am an Enrolled Nurse and I am good at what I do.

I am able to speak to an elderly person or infirm person without a single hint of condescension or embarrassment as I assist them in the toilet or shower.

I have been punched, kicked, spat at and sworn at.

I have been given flowers, chocolates, cakes, thank-you cards and hugs.

I have held the hand of and spoken softly to a person as they died alone in a rest-home - their family not interested.

I have suctioned a two-day old infant who could not breathe because of the mucous in his throat. His parents remain grateful to this day.

I've fed and changed babies.

I've fed and changed elderly people.

So when I tell someone I am a nurse, I am stating a fact. When they want to know what kind of nurse I am, it is their ego that is the problem, not mine.

My self esteem and confidence are intact and I'm singing it loud and proud. I am an enrolled nurse!

Good on you Sara.

Your work is deeply valued. And it will continue to be valued.

You and all other enrolled nurses are why the National Government has strongly supported the expansion of the Enrolled Nurse scope of practice.

We want to recognise your skills and experience.

We want to give you the opportunity to expand on that – and be allowed to be the fully contributing and valuable health professionals that you always have been.

We have put considerable effort into encouraging change in this area.

And we are very pleased with the progress that has been made so far.

A lot of work has been done to re-establish the role of Enrolled Nurse.

The scope of practice for Enrolled Nurses and Nurse Assistants has now changed.

There'll be one generic scope of practice: one set of competencies, and one title — ‘Enrolled Nurse’ — for all second level nurses.

The new scope is broader and requires higher skills, the new qualification for Enrolled Nurses is an 18 month diploma, at level 5 on the NZQA framework.

A new national curriculum will be in effect next year.

This will involve ensuring that nurses can refresh their skills, particularly in areas where they haven’t been able to practice.

And this transition to restore what you had on the past should not be burdensome in my view.

Once you have made the transition – you have an important role to play in the future of a strong and enduring health service.

And there is no doubt we need you.

We face increasing costs with newer and newer health technology – and the public are wanting more and better services.

If demand for health services is to double over the next 10 years, then we are not in a position to double the size of Auckland Hospital or double the number of doctors or nurses.

We want to deliver a fit for purpose and enduring health service into the future - we can't rely on the traditional roles to see us through. We will be needing a much greater flexibility among health professionals.

We will need you – our Enrolled Nurses - to step up and do more.

Enrolled nursing has a place in the health service – yours is a valuable contribution itself – not as a substitute nor as a response to nursing shortages - but as a legitimate profession in its own right.

We live in difficult economic times – and we will continue to do so for quite some time yet.

There are encouraging signs that we're coming out of the recession.

My colleague Bill English has announced the fourth consecutive quarter of economic growth.

But there is a long way to go before the Government can relax its quite tight control on spending.

We had the worst global financial crisis in 70 years.

New Zealand used to have large Government surpluses.

But this week we borrowed $240 million and next week we will borrow another $240 million and we'll do the same every week after that for the next four years – just to keep public services like Health ticking over.

But this is not unique to New Zealand.

Overseas Situation

Governments around the world – including New Zealand - are suffering massive reductions in revenue.

And public services, including health services, are only now starting to feel the pinch.

A new austerity drive is sweeping across Europe.

In Ireland, the Government has cut public service salaries - including doctors, nurses and teachers - by up to 15%.

Spain has announced a 5% pay cut in public sector pay, including Health, and a wage freeze for 2011.

Italy has established a 3 year wage freeze for all public servants and will not replace one in five staff who leave.

Canada has frozen wages in the public service for the next two to three years.

The new Coalition Government in Britain has just announced – among other measures - that it will freeze public service pay for two years.

The NHS has to save 20 billion pounds over the next four years.

New Zealand is part of the same world, and the same international economy.

We face the same challenges and uncertainty. They are real and with us

Living within our means is not some right-wing agenda...it is what every country is confronting.

I can not emphasise enough just how serious the economic climate has been and still is – or how it will impact on the way we are able to deliver health services to New Zealanders.

But here in New Zealand this Government is protecting and growing the public health service.

We have increased Vote Health by an additional $2.1 billion over the next four years.

And we are putting a lot of work into changing the face of our health workforce – to give our health professionals the opportunity to contribute and diversify and work in greater collaboration with each other.

We are fortunate to have Professor Des Gorman leading this work.

As Enrolled Nurses you will be the cornerstone of aged-care – they need you.

Health of older people is a priority. In particular the increasing prevalence of dementia will be a major challenge for Health Ministers in the future.

We're doing a lot of work in this area and would welcome the input of the enrolled nursing section of the NZNO.

Acknowledgements

Finally I'd like to acknowledge some of the people who've played such an important role in restoring the place of enrolled nursing.

Robyn Hewlett, who is Chair of the National Enrolled Nurse Section of NZNO, has worked for this for a long time.

The NZNO supported the Nursing Council right through this process, contributed their knowledge and insight into this work.

Carolyn Reed and Pam Doole of the Nursing Council have done excellent work implementing the new scope of practice.

Most importantly, I’d like to acknowledge all the Enrolled Nurses and Nurse Assistants here today.

You’ve campaigned well for this over the last ten years, even in the face of pressure from other nursing groups to forget about Enrolled Nursing.

I’m told this conference is your first real chance to celebrate the new scope of practice.

It is a real achievement and you are all to be congratulated.

It’s about letting you do what you became nurses to do: caring for patients.

Nursing is a very challenging career – and a rewarding one – as Sara Keen so eloquently put it.

It is my hope that the expanded scope of practice for Enrolled Nurses will make your careers more rewarding as you work in a broader range of situations, with greater responsibilities, and with a greater range of health professionals.

Patients will be the big winners from this change, this expansion of the scope of practice for Enrolled Nurses.

Thank you for your support of this important change.

Happy Enrolled Nurses Day – enjoy your conference.

ENDS

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