Printer Friendly

NZNO writes to DHBs in support of enrolled nurses.

NZNO CHIEF executive Geoff Annals has written to all district health board (DHB) chief executives outlining a process to ensure enrolled nurses (ENs) practise safely within their scope of practice.

His letter is in response to the letter to DHBs from Director-General of Health Karen Poutasi and Nursing Council chief executive Marion Clark on DHBs' employment responsibilities in relation to ENs. (See Kai Tiaki Nursing New Zealand, September 2003, p9.) The letter stated ENs' scope of practice "significantly restricts the number of acute settings in which ENs are competent to practise". The ministry letter arose from the Health and Disability Commissioner Ron Paterson's inquiry into Southland DHB's mental health services. The inquiry looked at the quality of care Mark Burton received.

Annals' letter challenges the ministry views and states the issue of safety can only be determined in relation to specific situations and nurses, not through "bureacratic, blanket categorisation of workplace setting and nursing class". The process to determine what is safe and lawful practice for ENs was a matter of considered professional assessment, "not crude application of a formula", Annals said.

Considered professional assessment must assess four conditions: the knowledge, skill and experience of the EN; the knowledge, skill and experience of the registered nurse (RN) providing direction and supervision; the nursing care needs of the patients/clients, ie they have relatively stable and predictable health outcomes; and the setting in which care is delivered.

Only such professional assessment could determine whether EN practice was appropriate in any particular specialty, work type or setting. "So long as all the conditions of practice are met, EN practice may be safe and lawful in any specialty, work type or location," Annals' letter said.

Employers could expect nurses to act professionally and should not replace that professional autonomy with general guidelines, as suggested by the ministry. "Any attempt to apply guidelines for EN practice without a thorough consideration of the relevant factors by the nurses charged with the responsibility to make the professional assessment required, is likely to restrict patient access to appropriate care." It was also likely to create dissatisfaction among nurses who were prevented from exercising their professional responsibilities.

Professional evaluation

The "bureaucratic guidelines approach" suggested employers could obtain a list of activities ENs could undertake and suggested ENs could not work in acute settings. This was not so. "The activities ENs may undertake must be evaluated professionally and will vary according to relevant conditions. And the settings of EN practice will vary according to the relevant conditions and many ENs practise safely and appropriately in a range of acute settings, including operating theatres and acute medical wards," Annals said.

There were no generally applicable specific limits to the practice of ENs acting under appropriate direction and supervision.

Annals suggested DHBs review their nursing practice policies to ensure those policies were not imposing unnecessary restrictions on EN practice.

NZNO has received backing from Mark Burton's father Trevor in its support of ENs. In a letter to NZNO, he said while the report on his son's care in Southland was extremely critical of many health professionals, it did not criticise ENs. "The Burton tragedy was the result of individuals failing to perform to even minimum standards and it seems to me that the 'profession of enrolled nursing' emerged from the inquiry with reputation unblemished.

"There will doubtless be some ENs who should not be working with seriously ill psychiatric patients, the same as there will be some RNs and even doctors in that same category. However, a wholesale ban is ... an overeaction," Burton's letter said.

It was more a matter of needing clear job descriptions, each staff member fully understanding their responsibility and staff responsibilities being consistent with each individual's training. That had to be reinforced by adequate supervision, as well as providing checks and balances to ensure work was being performed properly.

Annals said Burton's support meant a great deal, as nurses judged their own worth on their value in patients' and families' eyes.

Meanwhile, a letter to ENs from national EN committee chair Robyn Hewlett and professional nursing adviser Faith Roberts encourages them to join their local EN section as now was a "tough time" for ENs. The letter includes a card with a list of issues and asks ENs to tick those they support. One issue is Nursing Council's policy that RNs sign off ENs' competencies, rather than ENs submitting portfolios for competence-based annual practising certificates. NZNO opposes this policy. These cards will be presented to Nursing Council.
COPYRIGHT 2003 New Zealand Nurses' Organisation
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2003, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

Article Details
Printer friendly Cite/link Email Feedback
Title Annotation:news and events
Publication:Kai Tiaki: Nursing New Zealand
Date:Oct 1, 2003
Previous Article:London Hospital orders public health nurse's booklet.
Next Article:Nurse adviser looks at primary care in England and Holland.

Related Articles
NZNO lobbies Government to resolve enrolled nursing issues.
The next round in the pay campaign begins: district health board negotiations are underway in the South Island. NZNO hopes the outcomes will close...
Palmerston North.
NZNO makes the case for higher pay for nurses and midwives: NZNO has released its background paper on why nurses and midwives should be paid more and...
NZNO to get more 'aggressive' in its support of ENs.
Bargaining for a national MECA: half or more NZNO members must have voted 'yes' in this month's national ballot if national bargaining is to take...
ENs buoyed by success of inaugural day.
Non members must pay to get benefits of pay deal: NZNO has negotiated a bargaining fee which means non-NZNO members must pay for the benefits arising...
Poll in favour of bargaining fee.
Policies on ENs to be collated.

Terms of use | Privacy policy | Copyright © 2020 Farlex, Inc. | Feedback | For webmasters