A focus on nursing: a former organiser and professional nursing adviser reflects on her time with NZNO and some of the changes the profession has faced.

When I left NZNO last month, after being farewelled by my national office colleagues, it was with mixed feelings. The prospects ahead are many and varied. At the end of June I leave for New York with my husband Michael who is taking up a United Nations appointment there. Yes, it is exciting and challenging, but, as with any new venture, there are aspects of my life here I will miss. The collegial support, advice, knowledge, friendship and continuing devotion of my professional colleagues to nursing, will be one of the many things I will miss. One of the aspects I have found admirable about NZNO, is that whatever the work or whoever is doing it, there is always a real commitment to that work.

Like many before me, I first joined NZNO out of a desire to be part of New Zealand's professional nursing association and from a realisation that I needed indemnity insurance. My initial involvement was passive--reading Kai Tiaki and attending education sessions. As I slowly progressed towards a BA (Social Science), selecting nursing and health orientated papers, I became aware that the assignments, which were initially a chore and a burden, were increasingly an avenue for me to form and express my beliefs. If that were so, then maybe I should look at other areas of my practice in which I could express my beliefs and participate more fully in the career I had chosen.

Passion for nursing

Unlike many nurses today, my career has not been planned but has followed a pattern of seeking employment wherever my husband's career has taken us. And that has been to a variety of rural and urban localities. More often than not, my employment was only sorted out after I had attended to all the other things involved in shifting: settling two sons into schools, establishing a new home, making new connections--a situation which will no doubt be familiar to many of you. Over all this time, my passion for nursing and the ability to have a positive impact on people and their health, has grown.

After predominantly surgical nursing experience in intensive care, perioperative care, general and gynaecological surgical care and nursing education, I worked in primary health care as a practice nurse for ten years before joining NZNO. I was an organiser in the mid '90s when, under a National Government and the Employment Contracts Act, I was responsible for negotiating and maintaining 21 collective contracts.

After two years as an organiser, I was appointed a professional nursing adviser (PNA), a position I held for the last five years. The role of a PNA is varied, with advisory, policy, educational and support responsibilities to members, staff, and external agencies, both regionally and nationally.

I have appreciated the opportunity to be involved at a strategic level, both organisationally and professionally, within nursing and health. My contribution to primary health care in my role in helping establish and then convening NZNO's Primary Health Care Nurses' Council, seeing the completion and publication of the PHC professional development recognition programme; involvement in the senior nurses" scoping and titles working parties, established under the inaugural district health board multiemployer collective agreement; my role as secretary to the Nursing Education and Research Foundation and the smear taker training grant scheme, and presenting at numerous professional forums and seminars have all been both challenging and satisfying.

Much has changed over the five years. The introduction of the Health Practitioners' Competence Assurance Act 2003 has led to a growing awareness, among nurses and other health professionals, of the need for current clinical knowledge and professional accountability. The regulatory requirements implemented by the Nursing Council to ensure nurses comply with the HPCA Act, have left nurses feeling burdened. Many have commented on the treadmill of constantly up-grading academic and clinical qualifications, only to find they are viewed as obsolete almost before they are completed.

Debate and discussion

In an environment where technology is a predominant force, influencing all aspects of our lives, nurses need to be aware, focused and informed.

The photographic essay in the May issue of Kai Tiaki Nursing New Zealand has led to considerable debate. While I have no intention of entering this debate, it can be viewed as a healthy contribution to the way in which society generally and our profession in particular develop their beliefs and values. It is also worth noting that for nurses and nursing, debate and discussion are things we are very proficient at and love doing, but we tend to leave the solutions to others. If we, as nurses, want change and want to see health care and nursing become more effective, then we have to be involved in that change.

Focus on the person

It is also important that we remain focused on why we are nursing. The one component that must be present for nursing to exist, is the patient or, as some would prefer, the person. Nursing cannot afford to lose focus on the person, who may be before us as an individual, but who is also part of the greater whole of family, society and the environment.