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School clinics need direct funding.

I read my Kai Tiaki Nursing New Zealand from cover to cover fast month, as usual It always contains something relevant to my nursing practice, even now I am a school nurse. A large section of the March 2008 issue covered nurse practitioners (NPs) and the visions and outcomes of the report of the Ministerial Taskforce on Nursing published in 1998. (1) It saddens me to read that none of our primary hearth organisations have yet employed an NP.

I can think of many examples of nurses who may not be putting themselves forward as NP candidates, knowing the current primary health care situation regarding NP employment. Why would nurses even consider starting the process? I note that one NP commented it was a long process. This needs review. Many in the private sector are overworked in their current positions and do not have the support of a larger organisation to help them prepare their NP application.

Nurses need to know the process for NP registration, have good, accessible mentoring, which seems to be in place, and a dear framework that is achievable in a realistic timeframe. (NZNO's NP mentoring programme is co-ordinated by professional nursing adviser, Charlotte Thompson, who can be contacted at Ed.) I am surprised there are not more NPs, given when NP endorsement began.

I feel strongly primary health care is not only losing new graduates but also nurses in the 45-55-year age bracket, owing to stress in the workplace, tack of professional pathways and tong processes to upgrade qualifications and skills etc. A group that comes to mind is school nurses. School nurses are unable to be part of a collective agreement, leaving them in a hard position to bargain for wage improvements. We are too few to count, according to the powers that be.

If the government is serious about improving the hearth of the nation, it needs to acknowledge and be smarter about using nurses already at the coalface and to support them to fulfill their professional career aspirations.

In 2005, I moved from practice nursing to school nursing because, at the time, there was talk of nurse-led clinics as primary hearth care initiatives. My younger son thought I was "nuts" at the time, but now admits the word is out that Kelston Boys' Health Centre in Auckland is a youth clinic to be envied. It has been hard work and there have been frustrations, but from nothing, we now have myself as a full-time nurse, GP clinics, public hearth nurse visits, outside agencies eg the Asthma and Respiratory and the Heart Foundations, offering their services, a physiotherapist attends daily and there is now a receptionist.

Last year I initiated the senior hearth day, with the theme "Health doesn't have to be boring", during which 250 pupils spent a day focusing on health. Serious presentations included police representatives on drugs/driving, the Family Planning Association and the Heart Foundation, but there were also fun activities including rock climbing and juggling. By educating the young people at our school the messages reached the wider community, as they went home via newsletters and talk around the dinner table. This year we are trying to increase our messages to the wider community.

The Ministry of Hearth should directly fund school clinics where education for change can be directed to those who need it most. We need to think smarter and use what is in front of us now and not wait for yet another report. Health officials need to get on the ground and visit youth clinics to see first hand the work being done and the problems of care delivery.

Lastly, congratulations to all our "tall poppies"--our current NPs and all our senior nurses. To our new graduates, we need you to stay, but don't forget TLC (tender loving care)--that's our generation's TXT. I took forward to being cared for in my old age by professional knowledgeable, capable nurses. I'm proud to be a nurse.

Elizabeth Perales, RN

School nurse, Kelston Boys' High School



(1) The Ministerial Taskforce on Nursing (1998) Releasing the Potential of Nursing: the report of the Ministerial Taskforce on Nursing. Wellington: author.
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Author:Perales, Elizabeth
Publication:Kai Tiaki: Nursing New Zealand
Article Type:Letter to the editor
Date:Apr 1, 2008
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