Step it up, #ShoutOutForHealth – Speech to NZNO Greater Wellington Regional Convention

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Ko Ranginui kei runga, ko Papatūānuku kei raro, ko ngā tāngata kei waenganui – tīhei mauri ora!

Kei te tū ahau ki te tautoko i ngā mihi ki te Kaihanga. Kei te mihi anō ki ngā maunga, ngā awa me ngā wāhi tapu o tēnei rohe.

E ngā mate, haere, haere, haere. Rātou te hunga mate ki a rātou. Tātou te hunga ora e huihui mai nei, tēnā tātou.

E te tiamana, ko Jane, me ngā mangai-ā-rohe o Te Rūnanga o Aotearoa NZNO, ko Lizzy, tēnā kōrua. Ngā whakawhetai ki a kōrua mō tā kōrua pōwhiri.

E ngā rangatira – Memo, Titihui – tēnā kōrua. E ngā kaimahi, me ngā kaiārahi nēhi e huihui nei, tēnā koutou.

Ko wai ahau?

Ko Kapukataumahaka te maunga, ko Ōwheo te awa, ko Cornwall te waka

Nō Ōtepoti ahau, engari kei te noho ināianei ki Pōneke

Ko Don rāua ko Helen ōku mātua, ko Tangata Tiriti tōku iwi. Ko Grant Brookes tōku ingoa.

Ka maumahara ahau ki tēnei whakatauāki: “Ko te toki tē tangatanga i te rā”. Nā konei, tēnei te kaupapa o te rā nei: ka huihui tātou kia whakapakaritia ake te mahi tahi. Ka kōkiri ngā nēhi, ka whitiwhitia te tautiaki.

Nō reira, tēnā koutou, tēnā koutou, tēnā koutou katoa.

It’s Ranginui above, Papatūānuku below, and the people in between.

I stand to support the greetings to the Creator. I also acknowledge the mountains, rivers and sacred areas of this district.

I greet those who have passed on, and the living gathered here.

To the Chair for today, Jane, and the Rūnanga rep, Lizzy, thank you for your invitation.

To the chiefs – Memo and Titihuia – greetings. To the staff and all the nursing leaders gathered here (which is all of you), greetings.

Who am I?

Although I now live in Wellington, I hail originally from Dunedin. I grew up at the foot of Mt Cargill and by the Water of Leith.

My ancestors arrived in Dunedin on board the ship Cornwall in 1849, although I now live in Wellington. The son of Don and Helen, my name is Grant Brookes.

I recall this proverb: “We are the adze whose bindings cannot be loosened by the sun” – we will work as one, in unity. In sharing it, I acknowledge the mana whenua of Taranaki Whānui ki Te Ūpoko o Te Ika, to whom this whakatauki belongs. It also gives rise to the purpose of today: we are all gathered for the building of productive workplaces. When nurses are at the forefront, care is transformed.

So greetings, greetings, greetings to you all.

It’s good to be back in front of a home crowd. So many familiar faces.

This is the fifth Regional Convention for me in the last month. They have all shared the theme: “Nurses at the forefront, transforming care – Building Productive Workplaces”.

At the Southern Regional Convention and Canterbury/West Coast Regional Convention, I also shared a whakataukī of Kai Tahu, the iwi with mana whenua in those areas.

“He mahi kai takata, he mahi kai hōaka”. “It is work that devours people, as greenstone wears down sandstone”.

Is this true? I think many here would acknowledge that it has some validity.

The latest issue of Kai Tiaki contains the testimonies of many nurses, midwives and other healthworkers on this subject. It makes for sobering reading.

I’d like to share one, from Duty Nurse Manager Kathy Knowles. Kathy is also the National Delegates Committee rep for Cap Coast. She says:

“The constant pressure of striving to care for patients in an underfunded environment results in nurse disillusionment, fatigue and low morale. In my duty nurse manager practice, I hear these stories every day. 

“Very rarely can duty managers fill the staffing requests from our pool of bureau nurses. It’s not uncommon for some areas to request multiple nurses on a daily basis, to fill both sickness and existing roster gaps. 

“Recently, I received 13 staffing requests but only three nurses were available. How can we divide these nurses up? We are very rarely able to staff the hospital to the satisfaction of nurses or the organisation.

“Continual restructuring, too few beds, and multiple demands on nurses exacerbate the problem and can lead to nurses feeling overwhelmed. 

“Nurses have told me that sometimes patients are not showered for days because of staffing pressures. When there are so many demands on nurses, showering goes to the bottom of the priority list. Nurses go home very dissatisfied after days of constantly chasing their tails.

“Nurses shouldn’t be afraid to speak up and to campaign for ourselves and our patients. Nurses who are politically aware and who speak out tend to be heard. One ward where nurses worked together to challenge constant understaffing had their needs prioritised. 

“A simple ‘thank you’ to staff at the end of a frantic shift, while a small gesture, can have a big impact.

“We need to grow our nurse leaders and nurse managers through ongoing postgraduate education. On the whole, most managers listen but we have to learn to speak up and with more confidence.”

The testimonies in Kai Tiaki are in line with research findings contained in the NZNO Employment Survey 2017, published in February.

It was NZNO’s fifth biennial employment survey of our nurse membership, and it revealed a steady decline of overall morale with specific concern about safe staffing levels, workload and pay. In addition there is an increasing loss of confidence in health sector leadership.

The survey revealed that nurses are showing resilience and commitment to their profession in the face of continuing restructuring and resource constraints.

But workload, increasing patient acuity, stress and lack of job satisfaction are contributing to staff turnover and to lower morale. Over a third surveyed experienced significant restructuring in the past two years. Some restructures were leading to loss of clinical nursing leadership in the health workforce.

A perception of poor pay relative to other professions such as for teachers and the police, is a growing source of dissatisfaction for many.

Evidently the Care Capacity and Demand Management programme is not gaining the traction, or resulting actions, it should have in DHBs and this means safe staffing improvements and progress is stalling.

All these issues are a symptom of an underfunded health system that is under pressure.

While in Dunedin and Christchurch for their Regional Conventions, I visited our members in Dunedin Hospital, Hillmorton, Princess Margaret Hospital and Burwood Hospital. There, I heard them express these concerns in person.

“He mahi kai takata, he mahi kai hōaka”. “It is work that devours people, as greenstone wears down sandstone”.

And yet our vision for nursing is something different. We aspire, as NZNO together, to be “Freed to care, proud to nurse” – in productive workplaces.

How do we get there, from here?

Building productive workplaces requires a multi-faceted approach. This is reflected in today’s programme.

Shortly we will hear about the importance of a positive workplace culture from NZNO Professional Nurse Advisors Suzanne Rolls and Anne Brinkman.

I think that many of us will want to know more about “Dealing with bullying and harassment in the workplace”, the focus for NZNO Educator Angelique Walker.

And we will learn from each other, as NZNO members together, when Lead Organiser Lyn Olsthoorn and local delegates present on “How we are transforming the workplace”.

I will use the short time left to me now to highlight one more facet of the multi-faceted approach that’s needed.

Lifting productivity requires investment. This truth has been repeated for decades by politicians, business leaders and by unions.

And yet, it has not been heeded, at least in our workplaces. Annual increases in government health funding have failed to keep up with population growth and other cost pressures. Council of Trade Unions economist Bill Rosenberg has calculated that the cumulative shortfall means that health is now underfunded by $1.85 billion, compared with 2009 funding levels.

Kaiwhakahaere Kerri Nuku, Chief Executive Memo Musa and I meet twice a year with the Minister of Health. We have presented him with evidence of the need for greater investment. On its own, this has not been enough.

Recognition of the impact of underinvestment on workplace productivity – on our own stress and burnout, and on the people we care for – led the Board of Directors to decide last year that health funding would be a major campaign focus for NZNO in 2016/17.

Just over a month ago, the YesWeCare roadshow arrived in the capital. YesWeCare is a coalition of health unions and consumer groups.

Outside of the Wellington and Hutt Hospitals, the team assembled 200 life-sized cut-outs, representing the missing health workers who are needed to ensure safe staffing, safe care, 24 hours a day, 7 days a week.

Some of you were there. Erin Kennedy, the legendary lead delegate from Cap Coast who is unfortunately unable to be here today, spoke to the Dom Post about why she was supporting the action. NZNO supports YesWeCare because it’s in tune with our own campaign for a fully-funded health system, Shout Out For Health.

In the build-up to DHB MECA bargaining and the general election in September, we are taking our Shout Out message to all decision-makers and all political parties.

Last month, the two main opposition parties announced “Budget Responsibility Rules” which would tightly restrict government spending in any future Labour/Green government. These rules are not good enough. We support CTU president Richard Wagstaff’s call for “higher levels of government activity and investment than these rules permit.”

“There is”, said Richard, “an urgent need”.

At the same time, we’re calling on the current government to restore the $1.85 billion missing from health in this month’s Budget.

Last week Finance Minister Steven Joyce made a significant pre-Budget announcement. He signalled an $11 billion increase in government spending over the next four years, including some increased investment in health. This came after years of government Ministers insisting that health spending was adequate. Why the sudden change of heart?

We should take some credit for bumping health up the government’s priority list, through our collective action as unionists, in partnership with health consumers and the wider community.

I know that many of us today can feel powerless to effect real change. But remember what Prime Minister Bill English told Newshub, when he was asked what he thought about the YesWeCare campaign. He said, “Discussions are under way right now about the next Budget. So yeah, we do pay attention to the views of people on the front line because they’re a pretty good measure of what’s happening.” We have already made a difference.

So we know what works. Now we need to step it up.

Last month, Kerri Nuku and I launched the latest phase in the Shout Out For Health campaign – an open letter to New Zealand voters. It asks everyone to make health funding their first priority this election. The letter is in your registration pack, and online at NZNO Blog.

The main goal between now and the election is to get as many signatories to the open letter as possible, both online and on hard copy. Signed letters are now starting to arrive in Wellington from all over the country. They are being gathered up for use in a pre-election event. We will hear more about the letter this afternoon.

NZNO staff and member leaders are also starting to distribute Shout Out For Health leaflets and bumper stickers. Wrist bracelets are coming soon. We ask you to use these resources to start conversations in your community about health funding being an election issue. Primary Health Sector members in particular are being asked to investigate hosting community meetings on health funding through the next few months, as the DHB members start to be involved in their own MECA negotiations and campaigns.

Have conversations about enrolling to vote and taking positive action for health funding – spreading the word through stalls, meetings, leafleting, writing letters to the editor and meeting MPs from all parties. We will have a great opportunity this afternoon, to address MPs from Labour, the Green Party, the Māori Party and NZ First.

Members wanting to take action can ask their local staff and member leaders for support.

Shout Out for Health is about empowering you, the NZNO members, to carry out your own campaign ideas.

But something else I have heard clearly while meeting with members at work over the last month is that nurses are tired. It’s hard to find the energy to participate in campaigning activities.

So Kerri and I are leading another piece of work, along with the Board, to improve volunteer sustainability, member engagement and leadership development within NZNO. To begin with, we have decided to reinstate the training day for new chairs and treasurers of Regional Councils, Colleges and Sections.

In April and May, a small number of focus groups are being held, to find out from members what else would enable you to get more involved in NZNO’s many and diverse areas of activity. Once the results are analysed, then resourcing will be allocated in the NZNO budget, to support our volunteers. Next steps will be discussed at a meeting for all chairs at the NZNO AGM in September.

Sustainability and leadership development may also extend to greater support for Board members. At present only two of NZNO’s Board members – the President and Kaiwhakahaere – receive remuneration from NZNO. AGM this year will be asked whether the other Board members should also be remunerated. So that’s something to think about between now and then, and something to talk about with your AGM delegates, in the Regional Councils, Colleges and Sections, Student Unit and Te Rūnanga.

Together – NZNO board, members and staff – we can achieve our vision. The challenge is large. But with nurses at the forefront, we will transform care.

Nō reira, tēnā koutou, tēnā koutou, tēnā koutou katoa.

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