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Nursing in New Zealand

Chief Nurse Newsletter, December 2008

The week before Christmas was pretty ‘full-on’ at the Ministry, so I now find myself writing this note looking out across the wintery scene through the lounge window of my parents’ home. It still amazes me that it is possible to travel to the other side of the world and end up in a totally different season so readily. Well, 29 hours in a plane, resembling a twisted pretzel at the end is not so much fun, but it is good to be able to travel 20 000km in that time anyhow!

During my journey I met three nurses and a medical doctor. Nurse 1 was on my first plane, a Brit, like me returning home for Christmas with her family. Nurse 2 was Scottish, similarly returning to her roots for the break, she joined us on the second plane. Hopping on in Hong Kong to join the third plane was a Chinese nurse going to start work in London and they wanted her there for the holiday period! The doctor I met in the transit lounge at Heathrow – A kiwi working in Houston Texas on his way to Scotland to join his partner who works there in the oil industry.

Of course this got me to thinking about our ongoing workforce issues. With almost a quarter of our nurses coming from outside of NZ, we can truly appreciate that our profession is certainly a global commodity with all the issues that entails. As with the other employment groups reflected within our immigration authority’s ‘skilled migrant’ list, it would be most difficult to meet our needs for nurses entirely from a domestic market, further I am not convinced this is an essential or optimum goal. Just as we have the great ‘OE’ tradition, so nurses from other countries have a desire to travel, practice in different countries, and learn something to take back home. Our quest of course is one of stability in the workforce.

It is useful to have some Kiwi nurses travel abroad and learn skills, but we need them to come back! Likewise it is useful to be able to offer nurses from around the world an experience in our health care system, but, as with our indigenous populations, we need to keep them in the workforce for a sustained period of time, so giving some reassurance of stability to managers.

The issue of migration can be quite complex. A regional example would be the prescient debate regarding the International English Language Testing System (IELTS). On the one hand we have nurses from the Pacific islands articulating their right to migrate and urging our Nursing Council to make it easy for them to register here, yet on the other I have my Chief Nurse colleagues giving a strong signal that we should not be accessing their labour market and that we need to make it a whole lot more difficult for Pacific nurses to work here!

The IELTS issue is but one part of this, but it has been seen as a significant block to registration in NZ by Pacific nurses in particular. I am pleased to say though, at a recent meeting our Ministry and Pacific Health teams, our Nursing Council, the NZNO, and representatives of Pacific nurses, all agreed that we needed a robust test of English competence, but that probably IELTS was not it. We are now keen to investigate the possibility of developing our own testing system, incorporating elements relevant to being a culturally competent nurse in NZ, and extending knowledge of language to encompass understanding of the real Aotearoa New Zealand. This will not be easy, but it is a noble aim, and I look forward to working with the Council and others to make it happen.

As for the wider issues of workforce, the Ministry is just establishing a new strategic unit under the leadership of Debbie Taylor. In parallel we are working with DHBNZ to utilise and bolster the capacity of the HWIP unit in mapping our workforce as it is today, as it should be today, and scoping out future needs. This latter partnership will initially focus on providing our CTA team with the information they need to make effective investment in future educational needs of nurses, but will expand as resources become available to tackle the need for workforce development in a range of specialty areas where we already know shortages exist.

I don’t wish to end the year on a low note re workforce, and it is reassuring to note that other countries respect and admire NZ educated nurses and are keen to have them providing care to their people. However, we need to work to a point where we can guarantee stability in our own country, and be sure that all areas of care, be they acute hospital based or out in the rural communities, have adequate numbers of nurses forming well rooted and established teams. We can achieve this and the improved data collection and analysis capacity we will acquire in the New Year will be of great assistance.

So, wherever you work, thanks so much for doing so, enjoy a break when you next get one – hopefully over the holiday season – and stick at it in 2009! A very special thanks though to all those colleagues who will be working 24 / 7 as many of us enjoy time with families and loved ones. We are indebted to you.

Merry Christmas and a great New Year ahead!

Mark Jones
Chief Nurse

Page last updated: 24 December 2008