At this election, rise like lions!

First published in Kai Tiaki Nursing New Zealand, August 2017. Re-posted with permission.

There are now just a few weeks to go. The country is counting down to the general election, to be held on 23 September.

Health is political, and never more so than in 2017, when the impact of underfunding became intolerable for healthcare workers and the public we serve.

Every day we speak out about being short-staffed, about the sheer volume of admissions, referrals and presentations, about the lack of resources or risks to patient safety.

More often than not, it seems, our voices are ignored. We’re even told that there is no underfunding or resource shortages, so we’re either imagining things or it’s our fault our workload is unmanageable.

But at election time, at least, the politicians have to listen to us.

For the last couple of years, people around the world have been using the ballot box to express their rejection of ruling elites and establishment politicians. This populist wave has brought down the mighty, catapulted political outsiders to centre stage.

NZNO does not advise members who to vote for. But since kaiwhakahaere Kerri Nuku and I launched NZNO’s Open letter to New Zealand voters in April, we have been encouraging every member to “shout out for health”, to help make health funding the top priority this election.

NZNO is publishing a manifesto containing other policies, too, because health outcomes are fundamentally determined by access to social and economic opportunities: a liveable income, safe and decent work, affordable housing, education, adequate and nutritious food, and clean, healthy and sustainable environments.

Regardless of who wins the election, we’ll be urging the next government to prioritise:

• A sustainable, fully utilised nursing workforce

• Investment in public health

• A primary health care approach to improving population health

• Oranga Tamariki – the health and well-being of children and young persons

• Safe clinical environments

• Fair employment

• Social and health equity, within Aotearoa, the Asia-Pacific Region and globally

Voting once every three years will not be enough, on its own, to achieve our ultimate goal — a health system where every patient knows that when they need care, they will see the right health professional, with the right skill, in the right place, at the right time.

Other kinds of activity are needed, too, like writing letters, making submissions, getting to meetings and joining protests. But as the populist wave overseas has shown, for better or worse voting does make a difference.

One of the most unlikely scenes it has produced was this year at Glastonbury, the United Kingdom’s famous annual rock music festival. A youthful crowd of around 120,000 cheered as a 68 year-old, grey-haired politician read from a 200 year-old poem.

The poem Jeremy Corbyn chose to read is also my all-time favourite. So my message to NZNO members, from now until the election, is the same:

Rise, like lions after slumber

In unvanquishable number!

Shake your chains to earth like dew

Which in sleep had fallen on you:

Ye are many—they are few!”

Facing up to global challenges

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NZNO’s official congress delegation, from left, chief executive Memo Musa, kaiwhakahaere Kerri Nuku and president Grant Brookes.

Globalisation, patient safety, nursing leadership and climate change were among the myriad topics debated at the congress.

By NZNO president Grant Brookes

“I just want to say up front, we absolutely have deliberately put this topic on the agenda. For some, it’s a very controversial subject. There are people who may have extreme and differing views.

“It’s an issue which has become political over recent months as well, but there’s no doubt it is impacting on nurses, nursing practice and the work of our associations.”

With these words, ICN nursing and health policy director Howard Catton introduced the panel debate, Globalisation: Its impact on nurses and their associations, at the congress.

When I met Catton before speaking on the panel, he explained that under the leadership of president Judith Shamian and new chief executive Frances Hughes, ICN had been pushing for greater relevance by engaging with the major global challenges of today.

Alongside presentations on nursing leadership, nursing education and specific areas of practice, the congress elevated climate change, gender equality and sustainable development to headline this year’s agenda.

‘Care, compassion and advocacy’

The congress was opened by the former United States (US) deputy secretary of health in the Obama administration, Mary Wakefield, a nurse.

She called on nurses to lead the implementation of the United Nations’ sustainable development goals. Quoting former World Health Organization director-general Margaret Chan, she said we must tackle the root cause of ill health – inequality – and respond to the refugee crisis. “The core of our profession is care, compassion and advocacy for strangers,” Wakefield said.

World-leading researcher into clinical outcomes and nursing workloads Linda Aiken presented the latest evidence that safe staffing saves lives. Welsh chief nursing officer Jean White followed with a presentation on the Nurse Staffing Levels (Wales) Act 2016.

Last year, Wales became the first country in Europe to pass legislation requiring the use of safe staffing tools in hospital inpatient wards.

The tools, now under development, have similarities to the care capacity demand management methodology, currently stalled in the implementation phase in many New Zealand district health boards. From 2018, the Welsh law says staffing levels must reflect patient acuity and the professional judgement of the nurse in charge.

Professor Barbara Sattler of the University of San Francisco began her presentation on climate by quoting from The Lancet: “Climate change is the biggest global health threat of the 21st century. The impacts will be felt all around the world – and not just in some distant future but in our lifetimes and those of our children.”

“We cannot have healthy people on a sick planet”, Sattler said. As well as encouraging activism for transition to low-carbon economies, she gave examples of nurse leadership in creating “climate-smart health care”.

These included ending the use of coal-fired hospital boilers in South Africa, solar-powered cold chains, “meatless Monday” food services and procurement policies for medicines and clinical supplies which favour low-carbon production.

In addition to my presentation on the impact of globalisation, the other NZNO speakers were kaiwhakahaere Kerri Nuku and professional nursing adviser Anne Brinkman.

Nuku spoke on NZNO’s role in the recent gains for advanced nursing practice in this country, including medicines management and nurse prescribing, while Brinkman’s presentation was titled Nurses leading in tomorrow’s globalised world.

Also from New Zealand, Otago University senior lecturer Daryle Deering and Heather Casey of the College of Mental Health Nurses Te Ao Mâramatanga spoke in a plenary session, on mental health and primary care.

Past president of the World Medical Association Michael Marmot, who is a global expert on the social determinants of health and author of The Health Gap, closed the congress.

He quoted Martin Luther King, that “unarmed truth and unconditional love will have the final word”, in support of his two key messages for a world of “post-truth politics”– evidence-based policy, in a spirit of social justice.

With 8200 registrations, 88 sessions in a range of languages, 1900 posters and an unknown number of side meetings, any congress participant would have seen just a subjective snapshot. This was mine. •

Related coverage:

‘Boosting Pacific representation at ICN’

‘In the footsteps of nursing heroines’

First published in Kai Tiaki Nursing New Zealand, July 2017. Reposted with permission.

 

In the footsteps of nursing heroines

SMAC nurses - Spain 1937
The three nurses shortly after their arrival in Spain, from left: René Shadbolt, Isobel Dodds and Millicent Sharples.
EIGHTY YEARS ago this month, another group of New Zealand nurses was arriving in Barcelona – part of New Zealand’s Spanish Medical Aid Committee.

The group was led by René Shadbolt, head sister of Auckland Hospital’s casualty ward (and the aunt of Invercargill Mayor Tim Shadbolt and author Maurice Shadbolt, and later the Matron of Rawene Hospital), accompanied by Isobel Dodds, a staff nurse from Wellington Hospital and Millicent Sharples a nurse aide from Levin (see photo above).

Shadbolt, Dodds and Sharples were among 40,000 international volunteers who travelled to Spain between 1936 and 1939. They were responding to a humanitarian crisis and a threat to democracy. In mid-1936, a Fascist army backed by Adolf Hitler had risen up to overthrow Spain’s elected socialist government.

Joining others in Spain The trio joined other New Zealanders already working there. There was surgeon Doug Jolly, who had worked as a resident doctor in Dunedin and Wellington Hospital, and Auckland nurse Una Wilson. Dorothy Morris, a Christchurch nurse, had deployed to Spain with the British Universities Ambulance Unit at the start of 1937 and was based in a Quaker-run children’s hospital south of Barcelona.

Their stories are told in two recent books, Kiwi Compañeros – New Zealand and the Spanish Civil War and Petals and Bullets – Dorothy Morris, New Zealand Nurse in the Spanish Civil War, which was reviewed in the August 2015 issue of Kai Tiaki Nursing New Zealand.

I spent the afternoon before the opening of the ICN’s CNR contemplating these nurses’ time in Catalonia, the semi-autonomous province around Barcelona.

At the Museum of Catalan History, I met an historian and we talked over Kiwi Compañeros. He knew of some of the people mentioned in the book, but could shed no more light on our nurses.

In the museum’s exhibition hall, I watched the newsreel footage of Hitler’s air force perfecting its aerial bombardment of civilian areas – the same techniques which, three years later, would be used on London during the Blitz. I thought of the injured and traumatised children who were evacuated from Barcelona and into Dorothy Morris’ care.

History tells us that in 1939 Hitler triumphed, as other countries (apart from Mexico and the Soviet Union) refused the appeals for help from the Spanish government.

As the danger of far-right extremism grows once more, our Kiwi nurses deserve to be remembered.

While walking the same Barcelona streets they described in their letters home, I reflected on their courage and commitment. If allied governments had shown the same spirit during 1936-39 as our nursing heroines, they might have checked the rise of fascism in Europe, and its incomparable horror could have been prevented. •

Report by NZNO president Grant Brookes

Related coverage:

‘Facing up to global challenges’

‘Boosting Pacific representation at ICN’

First published in Kai Tiaki Nursing New Zealand, July 2017. Reposted with permission. 

Boosting Pacific representation at ICN

KT photo July 2017
Some of the New Zealand nurses who attended the ICN congress in Barcelona flank ICN chief executive Frances Hughes (centre right, in white) and NZ’s chief nursing officer Jane O’Malley (centre left). NZNO president Grant Brookes is on the far left and chief executive Memo Musa is third from left.

NZNO successfully promoted better representation for Pacific nations at ICN.

By NZNO president Grant Brookes

Last month, NZNO chief executive Memo Musa, kaiwhakahaere Kerri Nuku and I travelled to Barcelona for a series of meetings held under the auspices of the International Council of Nurses (ICN).

From May 27–June 1 we took part in the 2017 ICN Congress, along with close to 20 other New Zealand nurses. For the three days prior, we represented New Zealand nursing at the ICN Council of National Representatives (CNR).

Founded in 1899, ICN articulates the voice of nursing to the World Health Organization and other global institutions. NZNO has been a member since 1912.

CNR is ICN’s biennial decision-making forum. There, the 135 member organisations from 133 countries are able to debate and vote on the way forward.

Unlike previous meetings, there were no other national nursing associations (NNAs) from the South Pacific attending. So it was up to NZNO, along with the Australian College of Nursing and the Australian Nursing and Midwifery Federation, to bring a Pacific nursing voice to the world stage.

Among the votes at CNR was an election to fill four vacancies on ICN’s 14-member governing board.

ICN elections are conducted regionally. New Zealand is part of area seven, which covers the Asia-Pacific region. Nuku was standing for election to the single vacant seat on the board for this area.

But the smaller countries of the Pacific have long struggled to get our nursing voice heard at the top table. Area seven board members are usually elected from the large NNAs of North Asia. In Barcelona, the seat was won by Wu Ying, the candidate from China.

So, when a separate vote on redrawing the boundaries of the voting areas to match those of the World Health Organization, placing New Zealand in a new Western Pacific Region, NZNO moved an amendment to create a South Pacific sub-region within that.

“There is a large group of NNAs from the South Pacific who share commonalities of language, culture, nursing education, regulatory and legal frameworks and health system organisation. And yet this large group of NNAs has been largely excluded from representation,” I said, when introducing the motion. It was seconded by the Australian College of Nursing.

In 2016, the ICN board and president had considered the possibility of establishing sub-regions, but decided against. With support from Australia, CNR voted by a margin of three to one to overturn that decision and support NZNO’s amendment.

CNR also heard an update from ICN chief executive Frances Hughes about her transformation agenda, aimed at modernising the 118 -year-old organisation.

Plans include decentralising ICN away from its Geneva headquarters to provide a greater regional presence, revamping ICN’s communications and digital services (including a new international platform for online professional development) and stronger governance and financial management.

NZNO has expressed concerns over recent years about ICN governance and financial sustainability. In Barcelona, Musa was unexpectedly invited to present a training session on good governance to the incoming ICN board, under newly-elected president Annette Kennedy.

As part of its push to decentralise, ICN wants expressions of interest in hosting a series of regional forums from 2018. At last year’s NZNO annual general meeting, delegates, by a show of hands, expressed support for hosting such a forum in New Zealand. NZNO is now in the early stages of planning a possible ICN forum. •

Related coverage:

‘Facing up to global challenges’

‘In the footsteps of nursing heroines’

First published in Kai Tiaki Nursing New Zealand, July 2017. Reposted with permission.

 

Speaking for NZ nursing at a time of global change

 

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First published in Kai Tiaki Nursing New Zealand, June 2017. Reposted with permission.

I’M WRITING these words during a break from packing. Tomorrow, I board a plane for Barcelona, Spain, where I will join kaiwhakahaere Kerri Nuku and chief executive Memo Musa, as part of NZNO’s delegation to the International Council of Nurses’ (ICN) biennial conference.

For the next 10 days, our job is to speak up for New Zealand nursing at a time of global change. ICN represents millions of nurses in 130 countries and brings the nursing voice to the world stage.

The first three days in Barcelona are taken up with the Council of National Representatives (CNR), where National Nursing Associations (NNAs) including NZNO will vote on proposals to reshape ICN.

ICN is governed by a board of representatives elected from seven areas. In our area, the Asia-Pacific region, the smaller countries of the Pacific have struggled to get our Pacific nursing voice heard at the top table.

In Barcelona, we’re voting on a proposal to redraw the boundaries so ICN areas match those of the World Health Organization. This would place New Zealand in a new Western Pacific region and strengthen the Pacific nursing voice.

We are also proud to support our kaiwhakahaere’s bid to bring a Pacific voice to the table. At CNR, Kerri is standing for election to the ICN board.

After CNR comes the ICN Congress – the largest international event for nurses. There we’ll be joined by other NZNO members and staff, as we take New Zealand perspectives on nursing to the world.

Kerri is presenting examples of how we have contributed to policy and legislative change to improve advanced nursing practice, eg medicines management and nurse prescribing.

I am taking part in a panel discussion on how globalisation is impacting on nursing internationally, and how NNAs and ICN should respond.

Globalisation’s impact is being felt in seven main areas: workforce mobility, immigration and recruitment practices, technology and telehealth, population displacement and climate change, workforce development and regulation, trade and investment agreements and in the influence of ICN and member NNAs.

Grow local workforce

New Zealand has the highest dependence on migrant health professionals of any OECD country. NZNO supports the right to freedom of movement, and supports IQNs having secure work visas and supportive work environments. At the same time, we must reduce our dependence on migrant nurses by growing our locally educated nursing workforce, with a supported entry-to-practice place for every new graduate.

Technology and telehealth transcend borders and are increasingly impacting on nurses and models of care. Our position statement contains pointers on how NNAs might respond.

NZNO recognises that climate change and population displacement due to conflict and natural disasters are putting pressure on health systems in many parts of the world, including the South Pacific. Nurses should lead the global transition away from carbon-based economies and contribute to plans to mitigate the impact of climate change on health.

The influence of NNAs and other health sector organisations has been key to halting harmful trade and investment agreements like the Trans-Pacific Partnership Agreement (TPPA). Recent attempts to revive the TPPA and other challenges of globalisation show why international collaboration by nurses at forums like ICN is so important. •

 


References
1) New Zealand Nurses Organisation (NZNO). (2017). Internationally Qualified Nurses: immigration and other issues (discussion document). Wellington: Author.
2) NZNO. (2016). Position Statement: Nursing, technology and telehealth. Wellington: Author.
3) NZNO. (2016) Position Statement: Climate Change. Wellington: Author.

VIDEO: Globalisation – Its Impact on Nurses and our Associations. Panel debate at the 2017 Congress of the International Council of Nurses, Barcelona

Yesterday I represented NZNO​ at the ICN Congress​ in Barcelona, in a panel debate on “Globalisation: Its Impact on Nurses and our Associations”. I spoke alongside nurses from Malawi, Denmark, Rwanda and Canada.

Dealing with the impact of globalisation requires international coordination, as it’s too big for any one country to tackle on its own. Opening remarks by Howard Catton, Director of Nursing & Health Policy at ICN​, take up the first seven minutes and are also well worth a watch.

Unfortunately, the video did not capture the Canadian speaker, or the wide-ranging questions and discussion from the conference floor. My speech notes are posted below.

Globalisation: Its Impact on Nurses and our Associations

ICN Congress Panel Debate,  29 May 2017

2017-05-16 ICN Panel on Globalisation-GB changes.pptx copyKia ora, greetings. I am Grant Brookes, Co-president of the New Zealand Nurses Organisation.

I would like to thank Howard Catton and ICN for inviting to participate in this panel discussion on Globalisation. I would also like to greet my fellow panelists: Dorothy, Vibeke, Barbara and Andre.

Our organisation is a professional association and union which represents 48,000 nurses, midwives, students, kaimahi hauora and health workers on professional and employment related matters. NZNO is affiliated to ICN, the South Pacific Nurses Forum, Global Nurses United and the New Zealand Council of Trade Unions. NZNO embraces biculturalism, the partnership between the indigenous Māori peoples and the more recent settlers of European and other ancestries who have arriv2017-05-16 ICN Panel on Globalisation-GB changes2.pptx copyed in the last two centuries.
In the words of the whakataukī, or ancient Māori proverb, we all in the canoe together.

 

 

Our association believes that globalisation will be felt by nurses and NNAs in seven main areas.

  1. 2017-05-16 ICN Panel on Globalisation-GB changes3.pptx copyWorkforce mobility
  2. Immigration/migration/ recruitment practices
  3. Technology/telehealth
  4. Population displacement and climate change
  5. Workforce development and regulation
  6. Trade and investment agreements such as the Trans-Pacific Partnership Agreement
  7. Influence of ICN and member NNAs

 

2017-05-16 ICN Panel on Globalisation-GB changes4.pptx copyRegarding workforce mobility:

  • Health workforce shortages globally are predicted to continue
  • Workforce mobility is set to continue
  • Reliance in some countries on internationally qualified nurses (or IQNs) is likely to continue

 

If allowed to persist, health workforce shortages will increase inequities in access to healthcare, causing preventable illness, disability and death, and threatening public health, economic growth and development. These key points were highlighted by the High-Level Commission on Health Employment and Economic Growth in 2016.

For our association, our publication on Internationally Qualified Nurses and Immigration released this year notes that: “New Zealand has the highest dependence on migrant health professionals of any OECD country (Zurn & Dumont, 2008), and… very low retention of health professionals (Hawthorne, 2012; Ministry of Health, 2016a). [There is a] high percentage of churn among IQNs, both leaving the country and leaving the sector they were recruited for (Walker & Clendon, 2015).”

The next slide illustrates our association’s response.
2017-05-16 ICN Panel on Globalisation-GB changes5.pptx copyLong-term planning for a sustainable nursing workforce should include a commitment to employment of new nurse graduates. In 2016, only 57 per cent of new graduates from New Zealand education institutes found work through the Advanced Choice of Employment scheme, according to the Ministry of Health.

Meaningful IQN retention strategies could include:

  • Accessible and affordable competence assessment programmes
  • Security of working visas (for example, freedom from revolving renewals)
  • Supportive work environments (including safe clinical environments, equitable remuneration and freedom from xenophobia and racism)

2017-05-16 ICN Panel on Globalisation-GB changes6.pptx copyTechnology is the fastest growing enabler of health care delivery. Technology transcends borders and thus its impact on nurses, on nursing practice, and on associations is inevitable.

Technology allows for remote care (telehealth) and interdisciplinary clinical support, as well as knowledge transfer. It has been shown to enhance people’s access to health services.

The way in which consumers/patients use technology as an enabler for their own self care will also impact on nursing and influence future models of care.

Technology and telehealth will change the notion of place and presence. Consequently, nursing care may not be provided in the traditional way (face-to-face). It may be provided across national boundaries, which raises regulatory concerns.

To influence direction in New Zealand we have developed a Position statement: Nursing, Technology and Telehealth, published in 2016.

2017-05-16 ICN Panel on Globalisation-GB changes7.pptx copyAccording to the High Level Commission on Health Employment and Economic Growth, the number of political conflicts globally has doubled over the last decade. The number of people displaced due to conflict has increased from 37 million to 60 million, mainly in middle income countries. Between 2008 and 2014, natural disasters displaced 184 million people.

Within conflict zones, healthcare workers and nurses might become deliberate targets.

Nurses and our associations will need to be more prepared, educated and trained to work with displaced populations and refugees, including providing nursing care in conflicts.

2017-05-16 ICN Panel on Globalisation-GB changes8.pptx copyRegarding climate change, our association published a position statement in 2016. We have since divested our funds from fossil fuel companies. The communiqué of the 2016 South Pacific Nurses Forum, which we attended, identified population displacement as a result of climate change – along with migration, education and regulation – as key areas for attention. Our members frequently respond to disasters in the Pacific caused by extreme weather events.

The health crises caused by SARs, Ebola virus, MERS, Zika virus and yellow fever demonstrate the interconnectedness of global health and the inescapable impact on nurses and our associations.

2017-05-16 ICN Panel on Globalisation-GB changes9.pptx copyTo succeed in implementing the agenda for sustainable development through SDGs in poverty reduction, quality education, decent work inclusive economic growth and gender equality, we potentially will see a shift in workforce development away from narrow specialisation to broader and lifelong building of competencies.

Nursing workforce development, education and training will likely have a strong emphasis on early intervention, community based care, primary care, population health, public health promotion. This will be complemented by improvements in advanced nursing practice to improve access to health services.

Likewise, our associations are likely to change their focus to support a broader approach to workforce development but will continue to ensure that this results in decent jobs, working conditions and pay for health workers.

2017-05-16 ICN Panel on Globalisation-GB changes10.pptx copyGlobalisation requires NNAs to engage more in political commentary.

Some governments respond to globalisation by entering into trade and investment agreements like the Trans-Pacific Partnership Agreement (TPPA). These have a potential negative impact on economic inequality and other determinants of health and illness, on health policy, health funding and access to medicines. Nurses and our NNAs will need to promote inter-sectoral collaboration at local, regional, national, and international levels.

We have an election in New Zealand this year. Our political commentary will be based on our Election year manifesto (2017), which identifies 7 priorities for nursing and public health:

  • Sustainable nursing workforce used to its full extent
  • Investment in public health
  • Primary care approach to improving population health
  • Best start for children
  • Safe clinical environments
  • Fair employment
  • Social & health equity in Aotearoa/NZ, Asia-Pacific region & globally

2017-05-16 ICN Panel on Globalisation-GB changes11.pptx copyI will conclude by saying globalisation will require multi-level engagement to address the seven areas highlighted in this talk:

  1. Workforce mobility
  2. Immigration/migration/ recruitment practices
  3. Technology/telehealth
  4. Population displacement and climate changes
  5. Workforce development and regulation
  6. Trade and investment agreements such as the Trans-Pacific Partnership Agreement

Nurses and our associations will need to be adept at managing the impact of globalisation.

As the High-Level Commission on Health Employment and Economic Growth stated: “No single agency and no single sector can implement the changes required to achieve a fit for purpose health workforce in the context of persistently high unemployment and underemployment in many countries, and amid the major demographic, technological and socioeconomic changes occurring across all countries. Political will, leadership, inter-sectoral action and international partnerships will be critical to success”

Thank you

2017-05-16 ICN Panel on Globalisation-GB changes12.pptx copy

International Nurses Day 2017 – Launch of ‘Listening with my heart: Poems by Aotearoa New Zealand nurses’

NZNO celebrated International Nurses Day in Wellington today with the launch of Listening with my heart: Poems by Aotearoa New Zealand nurses. Edited by Professional Nurse Advisor Lorraine Ritchie, this fabulous new book features the work of 35 nurses, three of whom – Clare Mills, Gayle King-Tamehana and Ali Morris – read their poems aloud to us. Reverend Don Rangi blessed the books, which were then snapped up by the invited guests. Production of this poetry book is part of NZNO’s Visibility of Nursing Project. It can be ordered online here. Some photos of the launch, and my few words of welcome, are below.

collage-2017-05-12-2
The cover of ‘Listening with my heart: Poems of Aotearoa New Zealand nurses’ features panels from the Nurses Chapel at Wellington Hospital. It was my privilege to welcome guests the launch.
collage-2017-05-12-4
Lorraine Ritchie received flowers to express NZNO’s gratitude for her work in editing the book. Oncology nurse Clare Mills read us her poem, ‘Calibration’.
collage-2017-05-12-3
Gayle King-Tamehana, a nurse from the Waikato, read her poem ‘Internal assonance’. Stroke Rehab Nurse Ali Morris, from Christchurch, read ‘Nurse’.
collage-2017-05-12
Reverend Don Rangi blessed the books, which were then snapped up by the invited guests, who included (l-r) Andrea McCance (DONM, Capital & Coast DHB), Pam Doole (Manager, Strategic Policy, Nursing Council of NZ) and Kathy Holloway (Director, Graduate School of Nursing, Midwifery & Health, Victoria University).

My welcome:

“E ngā reo, e ngā mana, e ngā karangarangataha maha, tēnā koutou katoa.

To the voices, the authorities – too numerous to mention – and the many affiliations, greetings to you all. A special welcome to those who have travelled from afar, and the nurse poets who will read to us shortly.

We are gathered today to celebrate nursing, past and present. International Nurses Day is marked every year on May the 12th, the birthday of our great foremother, Florence Nightingale.

I have been re-reading the poems of William Wordsworth, which I enjoyed so much when I was younger, and recently came across his description of “the best portion of a good man’s life: the little, nameless, unremembered acts of kindness and love”.

So I think that today is about not only the nursing greats, who are rightly celebrated and who give their names to our scholarships, our buildings, and our ceremonial events. It’s also about the unremembered and unsung nurses – the Mary Seacoles as well as the Florence Nightingales; Heni Whangapirita, the second Māori Trained Nurse, as well as Grace Neill; the famed Hester MacLean of the Army Nursing Service, but also Miss Ethel Jennings of Wellington, one of the nurses who joined Ettie Rout’s Volunteer Sisterhood during World War One.

We are gathered not only to celebrate nursing, however, but literature. And it occurs to me that so many of the great literary works I’ve had the privilege of discovering over the years have been by, or about nurses. Vera Brittain’s Testament of Youth, is familiar to many, I’m sure. The main character in Nor The Years Condemn, by my favourite New Zealand author Robin Hyde, is the beautifully drawn Nurse Bede Collins. Last year, I was introduced to another nurse author at the Hui-a-Tau of Te Rūnanga o Aotearoa – Helen Waaka, who read from her short story collection, Waitapu.

And soon, we will launch another fabulous literary work by nurses, edited by Lorraine Ritchie, Listening with my heart: Poems of Aotearoa New Zealand nurses.

Without further ado, then, thank you for coming and welcome, welcome, welcome to you all.”