Author: grantbrookes

In my first speech to the membership as your newly-elected President, at the NZNO AGM all the way back in 2015, I outlined three key priorities which would guide my leadership of our organisation: 

• heeding the voice of the membership, 
• tackling health inequities through an unrelenting focus on their social determinants, and
• strengthening NZNO’s bicultural partnership.

Over the four and a half years that followed – the longest continuous term in office for any NZNO President – together we as members have achieved many things. In particular, we’ve gotten a lot louder in raising the voice of the membership. NZNO today is a much more membership-driven organisation, because of us. 

The changes began in earnest when we stood together on the picket lines in 2018. They came to a head in 2019, when the previous Board launched a last-ditch attempt to prevent change and remove me from office. 

Collectively you organised and together we overcame the resistance to member-led change. The Board failed to stem the tide of change at their Special General Meeting in September. But their actions did take a heavy toll on our organisation. 

During 2018 and 2019, the Board ran up a quarter of a million dollars in legal bills, failed members over the DHB MECA, triggered the loss of key staff, presided over the first annual fall in membership in half a century and opened up deep divisions in the organisation. As the co-editors of Kai Tiaki Nursing New Zealand said last October:

“In our combined 50-plus years of reporting and observing the activities of NZNO and the wider profession, we have witnessed some turbulent times. But never before have we witnessed the division now, sadly, so evident within the organisation.”

Pointedly, they added this: 

“Sadly, the results of the SGM seem to have been framed, by some, as a “Mâori vs Pâkehâ“ contest. And is this, perhaps, another source of disconnection? Or, perhaps, has the race card been played as a distraction? Are different parts of the organisation operating under differing understandings of what partnership means in a membership-driven organisation?”

When a new Board was elected in September 2019, I had high hopes that the times of division could come to an end. 

But as 2020 got under way, those hopes were starting to fade. In the February 2020 issue of Kai Tiaki, I was moved to write: 

“There’s no easy way to say this – unity in NZNO has lately been in short supply.

“To advance the health and wellbeing of our professions, we must heal our internal divisions. Each of us – especially those in positions of leadership – must take our share of responsibility for the years of division, and commit to rebuilding NZNO unity and power. The way to do so, I think, has already been written.

“Whatever people’s personal or political understandings”, said the co-editors, “the constitution offers a clear definition of partnership: Partnership is defined as including an acknowledgement by NZNO, based upon the te Tiriti o Waitangi partnership, of the ideals of reciprocity and of mutual benefit, including an obligation to act reasonably, honourably, and in good faith. In so recognising, NZNO further acknowledges the need for, and emphasis on, recognition, respect, accountability, compromise, and a balancing of interests.

“With ideas of reciprocity, respect, recognition and mutual benefit, this partnership concept is about working collectively to advance the interest of all, not just your own immediate interests. Indeed, our definition of partnership is a well-written way of describing the fundamental union principle of looking out for everyone. In 2020, this must be our way of working.”

I wrote this unity plea because shadowy forces behind the failed bid to remove me from office were continuing to pursue their own immediate interests, above the interests of our organisation.

Sadly, my call to work collectively in the interests of all wasn’t heeded. 

Two weeks ago, despite no new allegations being raised, I learnt that a lawyer would again be hired to advise on further actions which could be taken against me. The prospect of still more legal battles paid for by members, and still more division, didn’t seem to matter to them.

At the same time, it is has become very clear that different parts of the organisation are operating under differing understandings of what partnership means in a membership-driven organisation. And those differences are growing wider and wider. 

Having put my heart and soul into strengthening NZNO’s bicultural partnership for four and a half years, I am devastated that I can now see no way of achieving the type of genuine partnership that our Constitution envisages and our membership deserve.

Over the last two weeks, I have considered how to respond. I thought of all the people who have supported me, and in particular the thousands of NZNO members and supporters who stood up for me against the previous Board. My family and I owe you a debt of gratitude that we can never repay. 

But today, as we’re all struggling on the front lines as essential workers and at home in our bubbles, I could not ask for you to do that again. I couldn’t put my family through those battles again, either. 

For these reasons, I have submitted my letter of resignation to the Board. 

My letter proposed a joint communication announcing my departure, to avoid more public disunity – just as I did repeatedly before the Board’s SGM last year. But I couldn’t agree to the added condition of staying silent and hiding the truth from my fellow members for ever more.

From my perspective, the last four and a half years of my Presidency were never about me. They were about us.

By defending me from an unfair and unjust attack in 2019, you ensured that fairness and justice remained at the heart of NZNO. You showed how members can and will take back their union when it loses its way. That lesson was noticed by trade unionists around Aotearoa and beyond. And it will guide us, long into the future.

The struggle to take back our union will continue. As US Presidential hopeful Bernie Sanders said a fortnight ago, after suspending his campaign, “Real change never comes from the top on down, but always from the bottom up. 

“I ran for the Presidency”, he said, “because I believed that as a President, I could accelerate and institutionalise the progressive changes that we are all building together. And if we keep organising and fighting, I have no doubt that that is exactly what will happen.”

As for me, my heart has always been with members at the coal face – the place where real nursing happens and where camaraderie and common purpose exist. I am happy and proud that at last, I can follow my heart and return. 

Ngā mihi aroha

Grant

Many nurses find Nightingale’s statements on colonisation and the fate of indigenous people a dangerous legacy. For this reason, NZNO’s board of directors will celebrate other nurses and models of health on International Nurses Day 2020.

by NZNO president Grant Brookes & kaiwhakahaere Kerri Nuku

It’s surely testament to the huge significance of Florence Nightingale in the development of our profession that 200 years after her birth, she continues to stimulate debate.

On the one hand, her contributions to raising the status of nursing, establishing formal training and applying statistical methods in sanitary reform are celebrated to this day. 

But the historical figures we choose to venerate say a lot about who we are. And the legacy Florence Nightingale left for us is a mixed one – especially here in the South Pacific. It’s right that her legacy should be open to scrutiny. 

For decades, feminist nurses in New Zealand have been uneasy about Nightingale’s insistence that “to be a good Nurse one must be a good woman” (1). Her instructions to nurses (dutifully reprinted in Kai Tiaki, 63 years later) told us to always display the “higher or holier” womanly virtues of forbearance and endurance, and that we must “above all” obey the male doctors. 

Nurse leaders in Aotearoa have long understood how Nightingale’s opposition to registration and higher education for nurses undermined our professional autonomy and fostered the eventual dominance of the medical model of health (2). 

In the end, however, it was Nightingale’s troubling role in colonisation which led the NZNO Board of Directors to decide that on International Nurses Day 2020, we’ll be celebrating our indigenous and home-grown nurses instead. 

It’s a little-known fact about Florence Nightingale that she was a close advisor to the Governor of New Zealand, Sir George Grey, during his second term in office from 1861-68. She also advised colonial authorities in Australia and elsewhere. 

The collected letters and reports she sent to Grey and others, published in 2004, reveal a long-hidden side of her legacy. 

It is now known that Nightingale supported the alienation of Māori land, in order to force migration to European settlements and to bring contact with what she termed, “the inestimable blessings of Christian civilisation”.

“The object should be to draw them gradually into better habits and gradually to civilise them”, she said, in her Note on the New Zealand Depopulation Question. (3)

To those who objected, and said that “provision of land should be made for the exclusive use of the existing tribes” in the colonies, she replied: “this by itself would be simply preserving their barbarism for the sake of preserving their lives” (4). 

Perhaps her most disturbing advice, in the present circumstances, was her dismissal of reports about outbreaks of infectious diseases among indigenous communities following contact with Europeans. 

“People assert that they always have influenza after a boat comes to them from the mainland”, she wrote, in a letter to the Colonial Office in London. “But, after all, is it a fact? 

“Diseases and eclipses used to stand as effects to causes, in semi-scientific observations of the Middle Ages. It is the usual error of quarantine reasoning”, she concluded (5).

Nightingale advised that efforts to support the heath of indigenous people should focus elsewhere. 

Her 1863 report on Sanitary Statistics of Native Colonial Schools and Hospitals (6), produced at the suggestion of Governor Grey, explained the high rates of child mortality using the then-discredited “miasma theory”.

“Within or near the tropics the miasmatic class of diseases occasions most of the mortality at the earlier periods of life.”

In her Note on the New Zealand Depopulation Question, Nightingale attributed the prevalence of “chest diseases” among Māori to “the introduction of pigs, as an article of food.”

Running through all of her colonial writings is the idea that population decline was due to inherent defects of indigenous people themselves, when compared to superior Europeans. 

Excessive consumption of pork was responsible for the “bad habits, filth, laziness, skin diseases and a tendency to worms and scrofula” which she believed were characteristic of the Māori people (and also of the Irish). (3)

“Incivilisation, with its inherent diseases, when brought into contact with civilisation, without adopting specific precautions for preserving health, will always carry with it a large increase in mortality”, she said.

“The decaying races are chiefly in Australia, New Zealand, Canada and perhaps in certain parts of South Africa. They appear to consist chiefly of tribes which have never been civilised enough or had force of character enough to form fixed settlements or to build towns.”

“These aboriginal populations… appear to be far more susceptible to the operations of causes of disease arising out of imperfect civilisation than are civilised men (meaning by “civilised” men who can live in a city or village without cutting each other’s throat).” (6)

“As for the Australians, in their present state, very few of the human race are lower in the scale of civilisation than these poor people.” (7)

Faced with such frank expressions of racism, Nightingale’s defenders argue that she was a product of her time and that whatever her faults, her priority was the health of indigenous people. 

Yet other public figures of the time were able to see more clearly. A select committee report from the Legislative Council of Victoria in 1858-59 found that, “The great and almost unprecedented reduction in the number of the aborigines is to be attributed to the general occupation of the country by the white population.”

Nightingale rejected this conclusion, arguing that decline is “not a universal law when savages come into contact with civilisation.”

Her criticism of the report suggests where her priorities really lay: “I hope the time is not far off when such a stigma as it affixes to the empire might be wiped away.” (6)

Or as she put it elsewhere, “This question of the fate of aboriginal populations is one closely concerning our national honour.” (7)

Here in Aotearoa, Nightingale’s upper class paternalism and her White Supremacist views were inculcated in many (though not all) of our early nurses. 

These attitudes were then carried across the South Pacific, as the New Zealand Department of Health assumed responsibility for nursing services firstly in the Cook Islands in 1903, then in Western Samoa and Niue in 1920 and later in Fiji and Tonga. 

Nightingale’s colonial legacy in the region re-surfaced in 2018, in a debate at the South Pacific Nurses Forum (SPNF) in Rarotonga. Indigenous nurses expressed their pain that the global Nursing Now campaign planned to celebrate the bicentenary of her birth. 

A resolution, moved by NZNO and seconded by the Fiji Nursing Association, was passed unanimously, “To recommend and request that two representatives from SPNF representing indigenous nurses be appointed on to the Board of Nursing Now Global Campaign.”

On behalf of the SPNF Steering Committee, we wrote to the Board of Nursing Now in early 2019. We explained that, “Florence Nightingale wrote about our Indigenous peoples in the South Pacific in a racist, paternalistic and patronising way. 

“The continued veneration of Florence Nightingale in the Nursing Now campaign is therefore disrespectful and painful. It continues to highlight for our Indigenous nurses that their traditional knowledge and ways of being and doing are not being respected. Raising her as the beacon for nursing globally causes trauma and re-ignites the history and pain of colonisation. 

“It was in order to address these issues of Eurocentrism that we had lobbied to gain two seats on the Nursing Now Board.”

Our request was declined – coincidentally, around the same time as the Waitangi Tribunal released its landmark report on the WAI 2575 claim. 

“The severity and persistence of health inequity Māori continue to experience indicates the health system is institutionally racist,” said the Tribunal, “and that this, including the personal racism and stereotyping that occurs in the primary care sector, particularly impacts on Māori.” (8)

As nursing leaders in 2020, we see Aotearoa’s most pressing health issue to be health equity. The persistent and systemic health inequities have been two hundred years in the making. Our health inequities will continue if we insist on being wilfully blind to their existence, or fail to acknowledge their origins.

For these reasons, the decision for us and for the NZNO Board was obvious. Celebrating Florence doesn’t fit with our vision. Instead, in the Year of the Nurse and the Midwife, we are choosing to celebrate those who move us forward to a bicultural future of equity for all. •

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References

1. ‘A Letter From Florence Nightingale’. (1924, 1 July). Kai Tiaki: The Journal of the Nurses of New Zealand, Vol 17(3), p123. https://paperspast.natlib.govt.nz/periodicals/KT19240701.2.35

2. Rodgers, J A. (1985). Nursing Education in New Zealand, 1883 to 1930: The Persistence of the Nightingale Ethos. MA thesis, Massey University, Palmerston North. https://mro.massey.ac.nz/handle/10179/6274

3. McDonald, L. (Ed.). (2004). Florence Nightingale on Public Health Care – Collected Works of Florence Nightingale, Volume 6. Waterloo, Canada: Wilfrid Laurier University Press, pp 183-5.

4. Ibid., p 180.

5. Ibid., p 196.

6. Ibid., p 168-183.

7. Nightingale, F., & National Association for the Promotion of Social Science. (1865). Note on the aboriginal races of Australia: a paper read at the annual meeting of the National Association for the Promotion of Social Science, held at York, September, 1864. Retrieved from http://hdl.handle.net/2027/uc2.ark:/13960/t07w6pn5d 

8. Waitangi Tribunal. (2019). Hauora – Report on Stage One of the Health Services and Outcomes Kaupapa Inquiry. Lower Hutt: Legislation Direct. Retrieved from https://forms.justice.govt.nz/search/Documents/WT/wt_DOC_152801817/Hauora%20W.pdf

First published in Kai Tiaki Nursing New Zealand, April 2020.

OUR LIVES have changed, utterly. 

I write this column in the early days of the historic COVID-19 lockdown. Given the daily rate of change, I can hardly imagine what our professional and personal lives will look like when the April issue of Kai Tiaki Nursing New Zealand is completed. 

But I know this. We have the potential to create lasting, transformational change beyond this crisis – a different future for our profession and our society is possible. 

Health Minister David Clark said he’s been given a blank cheque to maintain New Zealanders’ wellbeing. “As a Health Minister, it’s not often you get that mandate”, he observed, “that actually resource should not be your constraint.”

The top priority for the country right now is to unite against COVID-19. Collectively and individually we’re stepping up. And as we step up, the Government is mobilising the country’s resources behind us. 

For as long as any of us can remember, NZNO has been fighting for a fully-funded health system. Now, at last, the focus is on the value of our work, not the cost. We are being recognised for what we are – “essential”. 

These first days of lockdown have seen seismic shifts in practical support for our essential work. 

Some cities made public transport free for us. Our need to get to work became the focus for hastily re-designed timetables. Staff parking became free for most, too. 

Provision of free childcare began. Discretionary sick leave was suddenly available when we needed it. Constrained budgets for clinical supplies, like those which regularly forced the indignity of rationed continence pads, were gone over night. 640,000 PPE masks were shipped to district health boards in a day. 

None of this made the health system perfect. Parts of the sector were completely overlooked. Many inequities remained. But such resourcing was almost unthinkable just weeks earlier.

This transformation extends far beyond health. As a society, we are now embracing new values and ideas. From the Prime Minister down, the message is, “Be kind”. We’re working together so the needs of the community are prioritised above individualism. New “caremongering” groups are springing up in communities, to help more vulnerable members.

We have returned to more socialist ways of thinking – “from each according to their ability, to each according to their needs”.

The same thing’s happening internationally, too. Countries less affected by, or recovering from the pandemic are helping those suffering more – because until there’s a vaccine, the only way any of us will be safe from future outbreaks is through global control.

As World Health Organisation Director-General Tedros Adhanom Ghebreyesus says: “The bottom line is solidarity, solidarity, solidarity”.

We’re all in this together. He waka eke noa. As the weeks go on, we must intensify this focus on community, solidarity and kotahitanga. This is the way to keep us united against COVID-19, support essential health workers and fix the inequities still in our health system.

But let’s not shelve this approach once the virus is under control.

All around the world, countries are comparing the fight against COVID-19 to a war. And like in a war, when the battle against COVID-19 is over, we will have to rebuild.

There may be hard times ahead. But with our new priorities and values, the world we rebuild can be better than before. 

As World War Two was drawing to a close, the British Government contemplated a radical vision of post-war reconstruction. It knew the people who’d sacrificed so much for the country – especially the troops on the front line – wouldn’t settle for going back to how things were before.

So, despite the war rationing and scarcity, they drew up plans to massively expand workers’ rights, social housing and the welfare safety net. Out of this came what was then the world’s best health system, the National Health Service.

I believe Prime Minister Jacinda Ardern when she says, “we will get through this”. And when we do, today’s frontline will be insisting on a better future. •

First published in Kai Tiaki Nursing New Zealand, April 2020.

We write to express our heartfelt thanks to you all on behalf of the NZNO Board of Directors.

On Sunday we received news of the country’s first death from Covid-19. And last night we learned that a nurse in Queenstown has tested positive for the virus. Our hearts and aroha go out to the family and support persons for Anne Guenole and for the nurse in Queenstown.

But we are also thinking of the growing numbers of nurses, midwives, students, kaimahi hauora and health care workers now in self-isolation. We understand many of you are worried, not only for your patients but for yourselves and your families and whānau.

We believe in you. You have the skills and knowledge to safely care for people through this crisis and we are working to ensure you have the resources and support you need.

As nurses on the frontline ourselves, the members of the Board are alongside you. We hear your concerns at our workplace, and in reports from around the country. We are continuing to meet virtually so we can focus NZNO’s priorities and oversee the organisation’s internal COVID-19 response, and contribution to the national response.

Deferred fee increase

As part of the Board’s work, we have deferred the membership fee adjustment for six months. We understand that the health system and its staff are under immense strain and this is one small burden we can help relieve you from at this time.

The advertised increases which were due to come into effect tomorrow on 1 April now won’t happen until 1 September. We realise a small number may already have paid in advance and NZNO will be holding those payments in credit for you where that is the case.

We appreciate the work you do and as an organisation will advocate to ensure health and safety standards and resources to enable you to do what you do best. Thank you again.

We are in this together. He waka eke noa.

And together we will get through this.

Kerri Nuku (Kaiwhakahaere) and Grant Brookes (President)

New Zealand Nurses Organisation | Tōpūtanga Tapuhi Kaitiaki o Aotearoa

E ngā iwi, tēnā koutou!

A New Year and a new Board of Directors brings this new regular column to Nursing Pulse in which we will highlight some of the work we do. 

One of our tasks as governors is to set the organisation’s guiding values. To the existing values of Whakawhirinaki/Trust, Pono/Integrity, Tika/Fairness, Waharua/Commitment and Whanaungatanga/Relationships, the Board has now added Kindness/atawhai:

“To be kind to each other, without any specific reason; doing good for others; speaking with love/truth; listening with patience; and acting with compassion”. 

Thanks to Board member Anamaria Watene for consulting with Kaumātua, to give us this addition.

The Board has also been developing NZNO’s new five-year Strategic Plan 2021-25. We aim to present the final version for approval at the NZNO AGM in September, but a first draft should be out for member consultation before the regional conventions in April.

Feedback last year was that our new plan should demonstrate above all that NZNO is a membership-driven organisation. It should also be about strengthening NZNO’s response to equity and bicultural issues; prioritising; following through; and championing the public image of nursing.

A full review of the NZNO Constitution will follow, once the Strategic Plan is in place later this year. Meanwhile, the Board will be asking members to vote on Constitutional Remits to protect Te Rūnanga’s right to self-determination and to increase flexibility around our employment of the Chief Executive. Online voting on these remits will take place in July and August.

The Board has also agreed to consult members, through the same “one person, one vote” process, about NZNO’s Safe Staffing strategies, including CCDM. Should additional mechanisms to achieve Safe Staffing across all health sectors be considered? More information about this Policy Remit will follow.

In response to the recommendations in Ross Wilson’s report on the 2017/18 DHB MECA bargaining and campaign, the Board has established a MECA committee. Proposed by Board member Anne Daniels, it includes equal representation from Te Rūnanga. This committee will enable closer oversight and support of industrial processes.

Finally the new Board is committed to greater engagement with members, who are now invited to observe our meetings, by arrangement. We will also hold meetings in other regions, away from the NZNO National Office. The first of these regional meetings will be in Ōtautahi/Christchurch on 7-8 April.

For more information about these engagement opportunities, or any other aspect of this Board Briefing, please feel free to email us at kerri.nuku@nzno.org.nz or grant.brookes@nzno.org.nz. •

First published in Nursing Pulse, March 2020. Reposted with permission of the authors.

THE YEAR of the Nurse and Midwife is now just over a month old. This international celebration is long-overdue recognition of our professions’ contribution and our worth.

But we all know our professions need and deserve more than a year of acknowledgement. Behind the celebrations is our health system under strain and our professions under pressure. Distressing health inequities persist and nurse and midwife shortages are predicted to grow.

So how can we, as NZNO members in Aotearoa, make this a year to celebrate? 2020 affords real opportunities, but success is not a certainty unless we unite.

Our work has been historically undervalued because we’re a female-dominated profession. A pathway to resolution may be close, with our first pay equity settlement due this year. Will we be able to drive this settlement to all sectors and members?

A solution to entrenched pay disparities for those in Māori-led health-care providers could also be close at last, thanks to years of campaigning and a landmark claim lodged with the Waitangi Tribunal by Te Rūnanga. But with their first deadline of 2020 already missed, can we hold the Crown to account?

The district health board multi-employer collective agreement (MECA) is up for renegotiation. Can we make the gains our professions need in our benchmark collective?

Together, we can make 2020 our year. But that will rely on us using our best source of power: unity in action. And there’s no easy way to say this – unity in NZNO has lately been in short supply.

“In our combined 50-plus years of reporting and observing the activities of NZNO and the wider profession, we have witnessed some turbulent times”, wrote two co-editors in this journal last October. “But never before have we witnessed the division now, sadly, so evident within the organisation.”

To advance the health and wellbeing of our professions, we must heal our internal divisions. Each of us – especially those in positions of leadership – must take our share of responsibility for the years of division, and commit to rebuilding NZNO unity and power. The way to do so, I think, has already been written.

Acting in good faith

“Whatever people’s personal or political understandings”, said the co-editors, “the constitution offers a clear definition of partnership: Partnership is defined as including an acknowledgement by NZNO, based upon the te Tiriti o Waitangi partnership, of the ideals of reciprocity and of mutual benefit, including an obligation to act reasonably, honourably, and in good faith. In so recognising, NZNO further acknowledges the need for, and emphasis on, recognition, respect, accountability, compromise, and a balancing of interests.”

With ideas of reciprocity, respect, recognition and mutual benefit, this partnership concept is about working collectively to advance the interest of all, not just your own immediate interests. Indeed, our definition of partnership is a well-written way of describing the fundamental union principle of looking out for everyone. In 2020, this must be our way of working.

When together we remove historic pay injustices for women, the men in NZNO will benefit too. When together we end discriminatory funding for Māori and iwi providers, gains will also be made for the many non-Māori working in that sector.

But mutual benefit is not always automatic. It takes work, and commitment from us all.

By May this year, as things stand, NZNO members covered by the primary health care MECA will be paid up to 10.6 per cent less than those in DHBs. All those benefiting from extra steps in their latest MECA should now lend their support to those who don’t yet have them.

2020 is the year of the nurse and the midwife. Let it also be our year of coming back together. Our professions and our patients are relying on it. •

The World Health Organization has designated 2020 as the Year of the Nurse and the Midwife. NZNO will be joining in to celebrate the contributions nurses and midwives make and to envision the even greater contributions we can make in the future.

As we reflect on the mahi of nurses and midwives, we take inspiration from the whakataukī: “Titiro whakamuri kōkiri whakamua – Look back and reflect so you can move forward.” In so doing we honour our ancestors and learn from past mistakes.

2020 also marks the 200th anniversary of the birth of Florence Nightingale. Florence is a hugely important figure in the development of our profession, but she left behind a mixed legacy.

Nurses, midwives and tohunga have been serving their communities and practising healing in Aotearoa for centuries; from long before when Florence was advising Colonial authorities in Aotearoa New Zealand about how to prevent the “inherent diseases” of the “savages” from leading to their extinction, as they were brought out of “barbarism” through “the inestimable blessings of Christian civilisation”.

In fact much of our nursing history has been marred by these sorts of conservative and racist views, some of which persist today.

Returning to the whakataukī with which we opened, here are just some of the notable figures and events in our history we can look back on:

• In 1901, thanks to the pioneering efforts of Grace Neill, Aotearoa New Zealand became the first country in the world to pass legislation recognising the qualifications and status of registered nurses. Recognition of registered midwives came three years later.
• In 1902 Ellen Dougherty of Palmerston North became the world’s first registered nurse.
• Akenehi Hei became the first Māori nurse and midwife to register under her own [Māori] name six years later in 1908. However, Māori trained nurses were providing care even before official registration began, following in the footsteps of Mereana Tangata (Mary Ann Leonard) who qualified in 1896.
• Founded in 1908, Kai Tiaki Nursing New Zealand is one of the world’s longest running nursing publications. Last year, Kai Tiaki became one of just 20 publications so far inducted into the Nursing Journal Hall of Fame at a ceremony in Reno, USA.
• Turning 111 years old this year, the New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa is proud to be one of the world’s first professional nursing associations.

Our indigenous and home-grown nurses and midwives have made an immeasurable contribution throughout the 20^th and 21^st centuries towards raising the health of all peoples in Aotearoa New Zealand. They’re now being joined by our internationally qualified nurses, too.

However, our health system today is under strain. Distressing health inequities persist and nurse and midwife shortages are predicted to grow. Historically our work has been undervalued because we are a female dominated profession. Thankfully an end is finally in sight, with the first Pay Equity settlements due this year. Entrenched pay disparities for those in Māori-led health care providers could also be closed at last, thanks to years of campaigning and a landmark claim lodged with the Waitangi Tribunal by Te Rūnanga o Aotearoa NZNO.

Nurses and midwives need to be properly deployed, valued and included in policy and decision-making. By the end of 2020, we hope to achieve greater investment in improving education, professional development, standards, regulation and employment conditions for nurses and midwives. Our goal is greater influence for nurses and midwives on health policy, more nurses and midwives in leadership positions, and more opportunities for development at all levels.

The needs of the 21st century also require innovative services that make better use of new technology. We need more community and marae-based services that are holistic and people-centred, as well as an increased focus on prevention and on undoing the harm caused by colonisation. These are all areas where we can play a leading role.

Finally, it is our hope that by the end of 2020, NZNO’s Strategy for Nursing 2018-2023 will be accepted across the health sector. This would signal a stronger commitment to a safer and more equitable future for all nurses and midwives in Aotearoa New Zealand.

“Me haere tahi tātou mō te hauora me te oranga o ngā iwi katoa o Aotearoa”, “Let us journey together for the health and wellbeing of the people of Aotearoa” (Rev Leo Te Kira 15 December 2005).

First published at NZNO’s blog. Reposted with permission of the authors.