Dr Katherine Ravenswood
Nurses spent all of last century fighting for recognition of their skills and qualifications – that they have specialised knowledge and considerable responsibility.
Despite huge progress in gaining recognition for nurses, and progress in how we recognise the long tail of gender discrimination (seen in the 2017 settlement for care and support workers), we don’t quite have nurses’ pay and value right.
They have similar qualifications to teachers; the risk of their jobs is perhaps similar to police, yet nurses are more highly qualified.
Nurses’ wages have not kept up with either of those occupations. Why? In part because of several decades of our funding system, but also because we have not yet shed the gender discrimination that results in us expecting nurses to care out of vocation or passion, with a smile, and forgetting the experience, knowledge, and risk that is entailed in their jobs.
A strike by nurses in DHBs will surely have a big impact on New Zealand – it will affect to some extent the healthcare services available on strike days. It could also impact ongoing healthcare services after the strikes as we play catch up on the missed service. However, essential healthcare will continue as is required under law.
Of course, improving nurses’ wages and increasing the numbers of nurses will have a cost. But we need to think about what it is we are paying for. We are paying for expertise, skills, ability to make decisions and communicate with teams across hierarchies, and to be nice to friends, our families and us. We are also paying to have enough nurses that they can provide those services to us in a safe way for both us as customers and for their own workplace health and safety.”
Dr Katherine Ravenswood is a senior lecturer in management at AUT and has been studying work conditions and the socio-political environment within healthcare contexts for 10 years.
Professor Jenny Carryer
The recent nurses’ actions have largely been captured as a concern about salary levels. Undoubtedly there is a real need to value the work nurses do more highly and at a level commensurate with other occupations of similar qualification and responsibility.
Even more importantly there is need for a complete change in the way senior management view the nurses who work in their organisations. Thirty years of international research now proves the critical difference registered nurses make to patient safety, prevention of adverse events, length of stay and the prevention of readmission. Not to mention patients’ comfort and wellbeing.
There is considerable money to be saved by having adequate numbers of registered nurses who have the time to focus their skill and attention on an appropriate number of patients.
Instead there is a constant drive to reduce nurse staffing to levels which mean nurses are under constant stress and making critical decisions in a sea of distraction, whilst trying to prioritise those actions which will ensure people are safe. Nursing must come to be seen as a resource rather than a cost to be pruned.
There is even more at stake as raising the salaries of hospital employed nurses will further widen the gap between those nurses and the nurses who work in primary care and aged care. This is deeply unfortunate when both areas need intensive development if we are to ever reduce the pressures on hospitals.
My sense from listening to nurses is that striking is deeply repellent and goes against everything nurses hold dear.
However it is also true that nurses have never really been taken seriously and this has forced a situation of considering serious action.
Professor Jenny Carryer is based at Massey University’s School of Nursing and is also executive director of the College of Nurses Aotearoa.
Dr Helen Rook
Nurses are uniquely positioned to meet global health needs. It is recognised that developing and supporting nursing will improve global health, gender equality and critically, support economic growth (All‐Party Parliamentary Group APPG on Global Health (2016) The Triple Impact Report).
Recent reports from the International Council of Nurses suggest that an urgent pay rise and improved working conditions for nurses globally will go some way to address that predicted shortage of nine million nurses by 2030. In New Zealand, in a business as usual scenario, it has been predicted that by 2035 there will a shortage of 15,000 nurses (Nursing Council of New Zealand).
There is a profound dissonance between how nurses want to practise nursing and how they actually practise. Findings from my research suggest that nurses want to be present and give time to patients, but they are so busy with paperwork and meeting targets that they can’t, and this causes nurses distress.
Nurses are burnt out, exhausted, anxious and morally distressed. If DHBs and Government are serious about addressing nurses concerns then they must address both pay and conditions, which includes the wider culture of healthcare.
Dr Helen Rook is a Lecturer at Victoria University of Wellington’s Graduate School of Nursing, Midwifery and Health whose research has looked at the dissonance between nurses values and the values that drive healthcare delivery.