|
|
|
|
|
EXECUTIVE DIRECTOR'S REPORT 2006 |
||||||||||||||||||||||||
Presented at the 15 th AGM, Wellington : 17 October 2006General Comment
This fifteenth report from the College comes at a time when the health sector is deeply concerned with having sufficient resource, especially workforce, to meet increasing demand. Nursing as the largest single health workforce will be increasingly central to the delivery of sustainable services both primary and secondary. As such the activities of professional organisations in consulting, advising, leading and managing the internal issues of the profession become even more important. The goals of the College's 2006-2009 Strategic plan are chosen to direct the College towards ensuring that nursing is as well positioned as possible to maximise the delivery of services. At the Annual General Meeting this year, with immense regret, we farewell two longstanding and deeply valued Board members: Dr Denise Wilson and Dr Stephen Neville. Both completed PhDs whilst holding office as co-chairs of the College and this is a tribute to their singular energy and commitment. Neither is lost to the College however as Stephen will continue his excellent work in consumer alliance with Age Concern and Grey Power and Denise will continue to mentor the Maori caucus. Nominations have been requested for the vacant position for a non Maori Board member. This report is presented, for the first time, in a new format, aligned with the strategic goals of the College as outlined in our Strategic Plan. It represents our intention to improve strategic and business planning and to make reporting processes more transparent.
Financial StatusThe full financial report is included with this report. Overall the financial statement represents the directions taken at previous AGMs. All available money is used to invest in professional activities and through careful use of resources we are able to steadily increase this investment. It remains however very small. Additional expenses were incurred this year in investigating the possibility of a full time Executive Director role located in Wellington and in holding a special meeting to address these issues.
Strategic Goals
1) FOSTER NURSING WORKFORCE DEVELOPMENT1.1 Ongoing implementation of the Nurse Practitioner Role
1.1.1 NPAC-NZ Report provided to the College by Deborah Harris, NP MHSc, FCNA(NZ) and Chair of NPAC-NZ.
The specific objectives of the NPAC-NZ committee this year were agreed to at the last face- to -face meeting in 2005.
These objectives were too:
Recently, we have also agreed to review terms of reference and the Memorandum of Understanding held with the Nursing Council of New Zealand ( the Council ). The purpose of this review is twofold - firstly, to review the role of NPAC-NZ over the past five years and secondly, to analyse where NPAC-NZ needs to strengthen for our next annual plan. In the next few weeks we will be forwarding an audit of the work by NPAC-NZ under the current terms of reference. We will be asking each professional organisation represented on NPAC-NZ to contribute to the review. We will also be inviting the Council , the Chief Nurse, NETS and Nurse Executives of New Zealand to contribute to the feedback. After we have received feedback, we will circulate a report to the professional organisations. NPAC-NZ, as a committee, has worked to the above objectives over this past year. We have also performed the annual DHB stocktake of the Nurse Practitioner implementation which is circulated to all the professional organisations, DHBs, the Ministry and the Minister of Health. We maintain a database of all the Nurse Practitioner research that is being performed in New Zealand , this is available via the professional organisations' website and further details can be obtained from the Chair of NPAC-NZ. Finally, a large role of NPAC-NZ is to be a vehicle to assist with and maintain open dialogue with the professional organisations, the Council , the Ministry and the importantly the sector on matters regarding the implementation and development and sustainability of the Nurse Practitioner within New Zealand .
1.1.2 Nurse Practitioner Network. Report provided by Helen Snell, NP, MN, MPhil MCNA(NZ) The role of the Nurse Practitioner Network is: 1. Leadership
2. Research
3. Support
Proposed plan of initiatives and/or activities for the future
1.1.3 Nurse Practitioner Employment and Development Working Party College members Jenny Carryer, Susan Jacobs, Cathy Cooney and Jan Bulteel-Adams are currently serving on this working party although not all are of course in a representative capacity. The working party is making steady progress towards work which analyses the funding streams into primary health care settings and how they could be utilised to support NP employment. In addition work is nearing completion on a proposal for funded NP training. The Minister has currently recommended that the working party become an advisory group to ongoing efforts towards increasing NP employment.
1.2 Primary Health Care Nursing Workforce Development There is still a great deal to be done to fulfil the goal of aligning the development of primary health care nursing with community need. The maintenance of the private business model of general practice acts as an impediment to full implementation of the strategy especially from the perspective of the development of nursing services. Our energies now must focus really hard on the need for direct funding of nursing services in PHOs and the full and appropriate integration of all nursing services in the community. In addition the rapid implementation of NPs in primary health care remains a pressing need. I would like to see the College further develop its leadership in demonstrating that the current model of delivery of primary health care is not meeting the needs of significant numbers of our communities and that even more radical change is required towards implementing a nursing model of care delivery through nurse led services.
1.2.1 Membership of National Groups The Executive Director of the College is deputy chair of the Ministry of Health Taskforce on Implementation of the Primary Health Strategy and PHO implementation, which provides a critical link to primary health care policy activity. Currently the MoH PHC expert nursing group is in abeyance. 1.2.2 Primary Health Care Network Leader Deborah Parry has signalled that her term as network leader is up. We are delighted that Mary-Jane Gilmer (Nurse Practitioner from Hawkes Bay ) will take over this role. 1.2.3 Jenny Carryer, Taima Campbell and Mary-Jane Gilmer have just returned from attending the American Consortium of Nurse Led Clinics conference in Florida . Whilst their attendance was not sponsored by the College their experience at the workshop provides excellent guidance to the College on the potential value of nurse led clinics which are run in partnership with communities and which especially focus on under-served populations. Tine Hansen-Turton, the CEO of the Consortium, will be in NZ next year conducting some workshops. The College will provide help and sponsorship towards this initiative.
1.24 Management of Lifelong Conditions (Care Plus) Workshop The College hosted this one-day workshop attended by more than 80 nurses on 27 October 2006 in Palmerston North. This is being done in partnership with the College of Practice Nurses (NZNO). Facilitation will be provided by Joanna Harper of Harper Devine in Hawkes Bay and presenters include Dr Michal Boyd, Jayne Hill, Christine Nicholas and representatives from the Ministry of Health who present their findings of the review commissioned by the Ministry. Care Plus is a potentially important aspect of primary health care nursing services and an area where nursing needs to increase its leadership of how those services are shaped.
1.3 Nursing Leadership and Professional Development
1.3.1 Policy, Politics & Practice Workshop In July this year the College hosted a second workshop in Palmerston North with health policy, political development and nursing's recent history as the subject of exploration. Thirty plus nurses from all corners of New Zealand attended and those present comprised a cross section of areas of practice and leadership interest. The workshop was facilitated by Professor Donna Diers from Yale University , USA , Professor Jenny Carryer, Dr Barbara McCloskey (USA), Dr Stephen Neville and Dr Susan Jacobs. The workshop was an extremely useful experience and many participants suggested we repeat the experience in other parts of the country and with additional case study material. Clearly nursing and the health sector generally, offers rich material for case study as a means of increasing the political and policy development of nursing. The College is planning repeat workshops at a later date and is considering the suggestion of a partnership with Universities in which attendance at the course will comprise a segment of course learning for policy and leadership papers.
1.32 Scholarships There are five College scholarships (valued at $750 each) available for the 2006 academic year. Four applications were received and awarded. Thanks to the generosity of a benefactor, three Trailblazer Travel Awards (one valued at $1,500 and two valued at $750) were also approved to College members. All scholarships are advertised in Te Puawai and on the website, as well as reminders being forwarded to members with whom we have e-mail contact. The low number of applications received is surprising, particularly considering the current cost of study.
1.3.3 Portfolios College led portfolio development workshops have been assessed as hugely valuable by the nearly 180 nurses who have undertaken them. Our thanks to Jane Brosnahan for keeping the portfolios up to date, to Joanna Harper for skilled initial development and to Stephen Neville for donating precious time to facilitate additional workshops in diverse locations. The College believes there are still a great many nurses in many non-DHB locations who need vital assistance to establish a portfolio and also a programme of professional development to sustain their portfolios.
1.3.4 Mentorship Application forms and all information are available on the website and we remain hopeful that members will embrace this process as a way of supporting the development of young leaders in the profession.
1.4 Foster and Support Aspirations of Maori Nurses
2) INFLUENCE POLICY AND HEALTH LEADERSHIP
2.1 Use of Evidence and Research to Inform Policy
2.11 Submissions A number of submissions have been presented this year drawing on evidence and expertise to influence national policy direction. Submissions made this year on behalf of the College included:
2.1.2 ACC report In 2005 we commissioned an analysis of the ACC – Requirements and Barriers for Registered Nurses and Nurse Practitioners under ACC's Current Legislation, Regulations, Policy and Procedures. This report provided most instructive information and was given to ACC leadership, the relevant Ministers and is now on the College website. A response received from David Rankin as the ACC General Manager at the time was not entirely helpful. A follow up letter to Dr Jan White the new Chief Executive has been sent requesting an ongoing review of the recommendations.
2.2 Development of Strategic Relationships 2.11 Within Nursing It is my view that nursing has currently lost some ground in working effectively together to maximise our input to strategic goals and shared projects. The National Nurse Leaders group in partnership with the Chief Nurse could function much more effectively than it currently does to ensure shared information, transparency of current projects and a no surprises policy for national developments. As DHBNZ plays an increased role in nursing policy and workforce development then nursing must develop consistent and strong processes for working with them. The College will work with the Chief Nurse and organisation leaders to develop a way forward. 2.2.2 Development of Consumer Alliances Following the publication of a position paper on the importance of consumer alliances, consumer alliances have been forged with Grey Power and Age Concern. Over the last 18 months regular meetings with both of these organisations has materialised into a commitment to regular meetings and updates on the key issues influencing the health and well-being of older adults. Meetings with Grey Power have seen this organisation recognising the value of nurse practitioners in the aged care sector at their recent AGM. Age Concern utilised the College's expertise and developed a pamphlet titled “Men's health – Ignoring it won't make it better”. In addition, Dr Stephen Neville was asked to be the spokesperson for Age Concern on men's health issues during International Men's Health Week. This resulted in several media interviews. Work has recently begun in the development of a consumer alliance with the NZ Women's Rural Network led by Judy Yarwood and Jean Ross. Goals for the following year are to strengthen the existing relationships with Grey Power and Age Concern, and formalise the NZ Women's Rural Network alliance. In addition Dr Karen McBride-Henry has signalled her interest in having the child health network focus on an appropriate consumer alliance.
2.3 College's Political and Media Profile The College has a well-established political profile and is regularly consulted for comment and representation. The media profile remains an ongoing challenge, which can only be resolved by consistent effort by an increased number of senior College members. As Executive Director I am reliably contacted by major newspapers and occasionally by television. Whether or not such media actually publish such interviews is of course at their discretion and most major media still have trouble in understanding a nurse perspective as vital to health stories. 2.3.1 College Members on Key Decision Making Forums Below is a list of Members and Fellows of the College who are on various committees
Health Practitioners Disciplinary Tribunal
Expert Advisors to Health & Disability Commissioner
3) PROMOTE INNOVATION
3.1 Development of Effective Nursing Initiatives No specific College initiatives have been made but significant support is provided to individuals nationally who are developing and pursuing initiatives. In addition the relationship with the American Consortium of Nurse led clinics recognises that nurse managed primary health services especially for those who are poorly served is a critical objective. 3.2 Implementation of the Magnet Programme Magnet update provided by Jane Brosnahan, RN, MN, MCNA(NZ) who represents the College on Magnet NZ. Current membership of Magnet NZ includes the following organisations:
Additional organisations have recently been invited to join Magnet NZ including:
Magnet New Zealand has reappointed Christine Payne as chair and Frances Hughes has joined the executive; currently the positions of deputy chair and the other executive positions are still to be filled (from the membership). Magnet NZ's most major priority at present is to facilitate a workshop in December 2006 to discuss across health professional groups the multidisciplinary approach it is envisaged New Zealand will take regarding the implementation of the Magnet concept in New Zealand. Clinicians, allied health professionals and nurses have been invited to participate in this workshop. This workshop had been planned to be held in October but had to be delayed. Other current activities by Magnet NZ include:
It is the view of the College that progress towards Magnet hospitals in NZ remains a critically important goal for strongly evidence-based reasons. We believe progress could be improved and that work is needed urgently to reduce DHBNZ resistance to the notion of magnetism despite acceptance in principle of magnet principles. The College has written to all key stakeholders outlining our concerns.
3.3 Maori-centred Approaches to Health Care Delivery Support in principle was provided for the proposal by National Council of Maori Nurses to establish an undergraduate programme based on Maori values and tikanga. Dr Denise Wilson was part of the group who worked on the curriculum and Margareth Broodkoorn was on the assessment/evaluation team for Nursing Council.
4) DEVELOP A SUSTAINABLE FUTURE 4.1 Involvement of Fellows and Members in Implementation of Strategic Activities As noted in many other areas of this report Members and Fellows of the College are actively involved in a wide range of strategic activities spanning policy practice and education concerns. 4.2 Communication and Engagement with College Membership 4.21 Regional Groups Limited and sporadic regional activity occurs depending on the energy and goodwill of professional co-ordinators. Many members still do not participate in local activities, leaving a small number of people who feel let down when excellent professional development activities are so poorly attended. This does not make sense as the need to acquire professional development hours should now be an additional encouragement to members to attend. There are of course exceptions - the Nelson region reports well attended activities (up to 70 at a time) and other centres do hold regular meetings. 4.22 Networks within the College The Board continues to consider and review the notion of networks and ways in which they could be made most effective. Despite the fact that networks exist at member request, current challenges include some frustrations, notably that network leaders find that they need to do all the work and that network members are rather passive. There is a clear need for networks in terms of ensuring that appropriate expertise is brought to bear in specific areas or a forum is created whereby people can comment and act through the College rather than from within the umbrella of their employment setting. This is a critical and unappreciated aspect of political maturity. The College represents the ideal venue from which nurses can comment freely without concern to their employment situation, and when members actively brief the Board and network leaders about local situations, it enhances the validity of College representation. The website upgrade has had, for the past year, an improved network structure.
This means all members can engage without officially belonging to a network and ensures that all members have access to what is going on. At the same time it does not preclude those with a special or shared interest taking a particular interest in a chosen area of expertise. The success of the networks is entirely contingent on membership utilisation. 4.2.3 Report from Child Health Network Co-ordinator The Child Health Network consists of approximately 78 Registered Nurses, who are employed in a variety of specialty areas across the health and illness continuum. There has been some debate over the past few months about the merits of melding with another network, such as the Primary Care Network, due to competing member interests across various networks; however, no firm decisions have been made about this issue to date. As a Network we are also looking to strengthen links with consumer groups, with the aim of further advocating for children within New Zealand . In addition to this, we enjoy the support of the Chief Executive, and the various Networks Co-ordinators. The members of the Child Health Network are aware that there are a number of significant issues impacting upon the health of children within New Zealand . These include the high rates of certain illnesses, such as rheumatic fever, pertussis, and meningococcal disease, all of which contribute to the morbidity and mortality rates in this country. There are also significant disparities in the health status of New Zealand children, with certain groups in our society being systematically disadvantaged. This is directly attributable to the fact that children are often unable to access affordable and appropriate health care, especially in certain geographic areas. In addition, exposure to domestic violence and child abuse continues to be a source of grave concern for all Child Health Nurses. This said, the members of the Child Health Network are active within their individual areas addressing these issues on a daily basis. We also strive to participate at a national level, with current activities including our membership in the Well Child Framework Review Reference Group. This group convened for the first time in September 2006, with representatives from the Ministry of Education and Social Development, a variety of well-child providers, Maori and Pacific providers as well as the College of Nurses Aotearoa . The aim of the reference group is to bring a broad sector-wide perspective to the review, as well as guide and advise the Ministry of Health on how to improve the Well Child Framework. The group will also ensure linkages between service providers and agencies, whilst providing advice about appropriate consultation processes. This framework review will take approximately 18 months to complete.
4.2.4 Report from Elder Person Nursing Network Co-ordinator Previous Initiatives / Activities: This network is small and is possibly not as active as it could be. This is due to increasing workload as well as the more frequent use of the discussion site. The network members are actively involved in their work settings and use the network as a link to gain information about conferences and discuss issues. Network members are involved in national workgroups and organisations (e.g. local DHB workgroups, Nursing Council, auditing agencies, aged care education workgroups). The network gained 2 new members, both working in aged care. The Network is increasingly receiving enquiries from overseas - mostly regarding working conditions and education for nurses working with older people in the wider health care setting. There has been one request to provide specific aged care education, this was discussed with head office and referred to education providers. Submissions to the “Care and Support in the Community” draft paper were sent to the Ministry. The July 2006 edition of Te Puawai focused on aged care and received many positive comments through the network. Status of previous activities:
Issues for the Network for 2006/2007
The network appreciates the ongoing support of the Board, the College office and fellow College members and is looking forward to suggestions. 4.2.5 Website We remain proud of our vital and very active website which receives increasing utilisation. In 2002 monthly hits averaged 1,000. In 2006 the average monthly hit rate is 2,800. All members who are electronically connected are now e-mailed whenever an update occurs on the website. The number of members (about 180) who do not provide (or update) an e-mail address is a concern as they really do miss out on the opportunity to be in touch with many activities and possibilities. The electronic discussion group has waxed and waned. Some lively discussions have been held and many members e-mail privately to say that although they don't contribute to the discussion they read it avidly. We are fortunate to have the services of an excellent webmaster, Udo von Mulert, who works tirelessly to provide a high level of service.
4.3 Work towards Full-time Executive Director Role In April this year all members received a full report outlining the investigative process, which was undertaken to consider the possibility of the College hiring a full-time Executive Director and/or moving the College office to Wellington . Legal and accounting consultations strongly advised us against such a move. However after eight years of being based in a private dwelling, the College moved the office to commercial premises in Palmerston North in August this year. The office is shared with Nursing Praxis and is staffed each afternoon from 2pm to 5pm. Facilities have also been upgraded. In addition the College increased its investment in its current leadership as a commitment towards eventually achieving the role of full-time Executive Director.
4.4 Market and Promote the College 4.41 Membership Last year membership declined very slightly, largely as the result of the NZNO, MECA activities. People resigning from the College almost universally express regret, noting that they have felt hugely supported as a member and have felt very in touch through the various publication and communication forums. Resignations are due almost entirely to retirement, leaving the country or needing to pay the NZNO bargaining fee. Increased marketing has been discussed at length, aimed at targeting what might be considered our core membership. It is clear that most nurses will not entertain the notion of dual membership although a number of more senior people do. Essentially most nurses retain the notion that a professional organisation fills two roles. One is the provision of indemnity insurance and the other is industrial bargaining. There seems to be little widespread recognition of each individual nurse's potential contribution, even if only financial through membership, to the numerous professional and political activities, which sustain nursing's ability to deliver high quality care. It has also been our experience that personal contact is the single most effective way of attracting membership and the most effective membership strategy as suggested at least ten years ago would be for individual members to each attract one new member a year!! Dual memberships have been discussed at length. This involves one organisation markedly reducing its fee by not providing indemnity insurance to those who hold it from somewhere else. From the indemnity view this is futile as the premium is based on membership numbers and will rise steeply if the number utilising the service declines. In addition organisations such as ASTE are adamant that they would expect the full fee as a bargaining agent. The Board is currently finalising a marketing strategy.
4.5 Function according to the College's Bi-cultural Structure The College currently benefits from the experienced leadership of Maori Co-chairperson, Taima Campbell, who leads an active Maori caucus. Longstanding Maori Board member and former co-chair Dr Denise Wilson remains as mentor and support to the caucus, which has also been joined by ex officio member Margareth Broodkoorn.
CONCLUDING COMMENT As Executive Director of the College I want to offer my heartfelt thanks to members of the Board who have worked so hard and so constructively through a challenging year. Taima Campbell and Debbie Penlington, as Co-chairs, have brought enormous wisdom and grace to the role and I thank them personally and on behalf of the College. Sincere thanks are also due to Philippa Cole who works tirelessly on behalf of members and on behalf of the Board. Her meticulous attention to detail and her personal commitment to the organisation are deeply appreciated. There are many challenges inherent in running a small but vibrant organisation and there is a great deal of work which occurs behind the scenes but which ultimately makes a difference to nursing's ability to deliver service to its fullest potential. Professor Jenny Carryer RN PhD FCNA(NZ) MNZM
|
Back to Top All rights reserved © College of Nurses Aotearoa (NZ) Inc. |