Nursing Council decision on ENs creates difficulties for Pacific nations.

The recent Nursing Council of New Zealand decision to change the title of graduates of the new enrolled nurse (EN) programmes to nurse assistant has sparked concern, not only in New Zealand, but also in a number of Pacific nations. The decision was the cause of significant concern among delegates attending the SPNF in Rarotonga Last month.

It was clear from a number of country reports that moves by the Nursing Council to phase out ENs is in stark contrast to nursing developments in many neighboring countries, including Australia. In this country, EN workforces are being developed by broadening the EN scope of practice and raising the level of educational preparation to better respond to population need.

Many of the attending countries were already aware of the changes made in New Zealand and questioned New ZeaLand delegates about the prospect of the decision being reversed. ALong with NZNO, their essential concern was that the new title would be interpreted generally as meaning unregulated health workers. Not only was this misleading to employers and the public, but it also created difficulties for their own nurses, delegates said.

Australian delegates pointed out that, as Australia has a mutual recognition agreement with New Zealand, the decision by New Zealand to introduce a new title for ENs that has a quite different meaning in Australia, had implications for the movement of nurses between the two countries. Other delegates spoke of the close association between New Zealand and other Pacific countries on matters of nursing education and practice.

They were concerned that New Zealand did not understand the importance of this dose association to South Pacific nurses and insufficient consideration had been given to the effect of the title change on the ability of South Pacific nurses to gain further education in New Zealand and AustraLia.

One delegate questioned the right of one country to comment on a decision made by the regulator in another country. In response, other delegates said that the whole purpose of the SPNF was to identify matters that obstructed the development of nursing quality and nurses' practice throughout the South Pacific. It was agreed that the meeting should take whatever steps it could to address what was seen as a significant regional problem.

NZNO delegates did not take an active role in the discussion advocating our position but responded to questions. NZNO invited Nursing Council member Noeline Warmington to take one of New ZeaLand's seats so that she could present the Council's position. Warmington took up this offer respectfully and gave a clear presentation of the rationale for the Nursing Council decision. The meeting was not convinced. Discussion moved to consideration of actions the forum could take. The foLLowing recommendation was proposed by Australia, seconded by Fiji and unanimously endorsed by the forum:

"That in order to facilitate mutual recognition across the South Pacific the Nursing Council of New Zealand reconsider its decision to title enrolled nurses as nurse assistants and that this be done in consultation with other nurse regulatory authorities across the South Pacific."

As a first step toward enacting this recommendation, it was decided to raise the issue with the CNOs at their joint meeting with the forum. It was clear the CNOs also saw the change of title in New Zealand as a problem for the region. It was decided that each country should raise the matter with its own regulatory body and relevant Minister or Ministers of Health, with a view to having them raise the matter with the Nursing Council.