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Positive outcome from nurse assistant forum.

Clarification of the role and scope of practice of nurse assistants (NA) was one of the most significant outcomes of the Nursing Council forum on NAs held Last week.

Speaking after the forum, NZNO chief executive Geoff Annals said a joint letter from the Nursing Council and the Ministry of Health, written in 2003, had had a significant impact on the employment of enrolled nurses (ENs) and NAs, with many ENs being moved out of acute care. Chair of the national EN section, Robyn Hewlett, the only second-level nurse to attend the forum, said that letter had, and continued to have, major ramifications on the employment of ENs. Annals said the most concrete outcome of the forum had been recognition of the impact of the 2003 letter. The letter had been signed by Council chief executive Marion Clark and the Deputy Director-General of the Ministry's clinical services directorate, Colin Fee.

Chair of the Nursing Council and chair of the forum, Annette Huntington, said that letter "appears to have caused ambiguity and we need to address that". She also said that some had interpreted the letter as giving flexibility, while others had interpreted it as constraining.

The Council and the Ministry will work together to "re-iterate clearly the scope of practice of the regulated NA", Huntington said. The Ministry's chief nursing adviser Mark Jones, who attended the forum, said once the Nursing Council's statement had been prepared, he would write to district health boards and private providers on "operationalising" the statement. Jones said he had encountered instances, mainly in acute care facilities, where health care assistants were deployed with a wider scope of practice than regulated NAs, because they were cheaper. "That can't be right--it doesn't seem to be the correct situation. The rationale for it has been reference to the 2003 letter," he said. Jones said things had moved on since that letter was written and "my desire is to have a second-level nursing workforce fit for purpose". Huntington said the forum had been "extremely worthwhile" from the Council's perspective. The second-level nurse was an "extremely valuable" member of the overall nursing workforce but decisions about appropriate skill mix were over to directors of nursing and managers, she said.

'Non-nursing solutions'

Annals said, from an NZNO point of view, the forum had been valuable because all the stakeholders--the Council the Ministry, NZNO, district health boards, private employers and educators--had discussed issues around the best use of the second-level workforce. "Everybody says we need these nurses. If nursing fails to respond to this need, there will be non-nursing solutions--somebody else will do the work." He said a more cohesive approach to developing second-level education programmes was needed.

Head of Christchurch Polytechnic Institute of Technology's (CPIT) School of Nursing, Cathy Andrew, said the forum had been positive, with good dialogue about the issues and ways to move forward.
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Publication:Kai Tiaki: Nursing New Zealand
Geographic Code:8NEWZ
Date:Jul 1, 2006
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