NZNO'S work in 2004 under review: it's been a busy year for NZNO'S staff, including the professional nursing advisers. Safe staffing, fair pay, professional recognition and the nurse practitioner role are just some of the issues dealt with.

For me, 2004 has been an extremely eventful year as I have slowly established my niche within NZNO. It has been a pleasure to join NZNO at a time when the organisation's professional and industrial voices have come together so effectively. How can one argue for fair pay without portraying the realities of short staffing and their effects on nurses, organisations and the public's access to health care? The publication of NZNO's booklet Nursing the system back to health: nurse to patient ratios outlines the NZNO safe staffing model and the four components to achieve this. These are: nurse to patient ratios; the establishment of associate charge nurse positions; dedicated time for professional education and development; and the evaluation of patient outcomes. This is not the only model for safe staffing that NZNO is prepared to investigate but this is the model that has attracted more than 5000 nurses back into the health system in Victoria, Australia. (1) What is required are appropriate workloads, so patients receive quality care in an environment that is safe for patients, health professionals and the organisations in which these people work. The outcome from the extra staffing in Victoria has meant it is now possible to admit 200,000 additional patients to hospitals each year and provide them with a higher level of care. (1) Fair pay, plus the ability to provide better quality of care to more patients, is exactly what nurses in New Zealand have been asking for.

Safe staffing principles have been expanded to the aged-care sector where NZNO has input, along with providers, into the development of a Standards New Zealand handbook recommending staffing and benchmarking across the sector. All parties recognise that none of the recommendations can be implemented without additional funding from Government. With this in mind, NZNO is working with providers to lobby for increased funding for the sector. Caregiving training has received attention over the year, with nearly 3000 signatures collected in support of a petition calling for more funding from Government in order to pay caregivers for the qualifications they gain. NZNO developed this petition into a detailed submission to the parliamentary Health Select Committee and a new campaign is underway to achieve the funding urgently required.

The Magnet hospital concept is being studied by many district health boards (DHBs) in an attempt to understand the principles that attract and retain nurses--from administration issues through to clinical practice and professional development. Hutt Valley DHB is seeking Magnet recognition and is well on its way to meeting the necessary criteria. A number of other DHBs are focussing on the culture of their organisations and how to change them. Magnet recognition will not necessarily be the outcome of this work, although many of the magnet principles will be adopted.

The continuing development of professional development recognition programmes (PDRPs) within DHBs has been a major learning curve to add to my primary health care background. I have been working with a superb team of nurses as the five DHBs involved in a joint programme (Lakes, Tairawhiti, Waikato, Bay of Plenty and Northland) have amalgamated/integrated/culled/expanded and reinvented a process for all. This has been both an exhilarating and exhausting experience, which has made me appreciate the work being done by the nurses and midwives presently negotiating a much larger document--the multi-employer collective agreement involving all 21 DHBs.

The Nurse Practitioner Advisory Committee-NZ has met with the Minister of Health and the Ministry to discuss the key barriers nurse practitioners (NPs) face. They are legislative, contractural/funding, access to diagnostics and payments. A ministry policy analyst is putting together a report on these legislative barriers and ways to overcome them. To date, Nursing Council has endorsed 11 NPs. Applicants are welcome to become involved in a mentoring system and can source this through NZNO.

This support for those applying for NP status is typical of the kind of support NZNO offers across the nursing spectrum. This year, 113 NZNO-administered scholarships have been awarded to nurses and student nurses this year, with a further 37 applications being processed. In addition, accreditation and recognition of advanced practice levels have been awarded to 45 practice nurses and 26 diabetes nurses. Nurses continue to advance their specialties, with a district nurse and primary health care nursing accreditation and career framework being developed.

The importance of caring for ourselves

In the midst of all these advances and pressures, I wonder whether nurses are caring for themselves. It has been interesting to see the recent expansion of green prescriptions and the "push-play" concept that I was familiar with in primary health care. Some DHBs are now using these concepts too. The 10,000 Steps at Work programme was launched at MidCentral DHB in August, using pedometers to motivate people to increase their physical activity. The recommended number of steps to maintain a healthy lifestyle is 10,000 or eight kilometres a day. Teams of staff were formed and the team that undertook the most exercise over the initial 12-week period won. For many of the participants the exercise did not stop at the end of the competition. One participant reported that she got to know her work colleagues much better while she walked with them at lunch time. Her concentration improved (particularly after lunch) and she was more productive at work. At a time when nurses and caregivers are facing difficulties associated with short-staffing and higher acuity workloads, it's great to hear that nurses are caring for themselves. On this positive note, I wish all readers a happy festive season and a healthy new year. I look forward to working with members on a range of activities next year, continuing NZNO's professional and industrial aim of improving the health care environment for all.

Reference

1) Pike, B. (2004) Media release from the Minister for Health, Victoria, Australia. October 6. www.dpc.vic.gov.au.