February 2001 Newsletter | ||||||||||||||||||||||
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Minister
Appoints New Council |
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Chairperson's Foreword On 21 October 2000 the Minister of Health announced the appointment of a new Council. Five current members were reappointed and six new members appointed. It is with much pleasure that I introduce the new Council members appointed in October and welcome back current members who have been reappointed for a further term. I would also like to acknowledge the hard work of those Council members who have completed their terms and will not be returning for more hard work this coming year! Thank you to Diana Grant-Mackie, Susan Jacobs, Francie Russell, John Crawshaw and Rahera Ohia.Reappointed Members Judy Kilpatrick (Chairperson) New Members Sandy Grey Council Membership Sandy Grey I am honoured to be appointed as a midwife member to the Nursing Council of New Zealand and look forward to fulfilling my obligations in this capacity. I completed my midwifery training at Christchurch Polytechnic in 1984 and have worked as a midwife since that time. Currently I am self-employed working in a busy West Auckland midwifery practice. I am involved in midwifery politics and the ongoing development of the profession. I hold registration as a midwife and RGON.Annette Huntington I am currently a senior lecturer at Massey University at Wellington and am registered as a General and Obstetric Nurse. I undertook my nursing training at Auckland Hospital and subsequently worked in a variety of clinical areas including theatre, post-natal care and in the community. I have been involved in nursing education for eleven years, and have taught in all years of the Bachelor of Nursing programme, in post-registration and post-graduate courses and in other areas. My area of interest is the development of research in nursing particularly related to the clinical work of nurses and I have undertaken research into nursing practice. I have a particular interest in women’s health and recently gained my PhD in nursing from Victoria University, through exploring the work of nurses in the acute area of gynaecology. Currently I have established a research project involving a team of nurse-researchers exploring the issues for women living with endometriosis, the aim being improvement in services for this large group of New Zealand women.Jean Patterson I feel really excited and challenged about the opportunity to serve on the Nursing Council of New Zealand. It is a role I never imagined I would ever be involved in, so it has taken me some time to get used to the idea. Currently I am teaching in the Otago Polytechnic School of Midwifery. This is a real privilege and a complete change from many years of practice in both midwifery and nursing in rural areas of New Zealand. Although Jack and I now live near Port Chalmers most of our family life has been spent in rural areas of the South Island and I have come to feel passionate about the quality, accessibility and sustainability of primary midwifery services. Thus my ongoing Masters studies are concentrated in this area.Beverley Rayna I am from Christchurch and am registered as a General and Obstetric Nurse and Midwife. I also have a Diploma of Nursing (SANS) and Certificate in ENT nursing. My general qualifications include Masters degrees in both Education and Business Administration. I have had 25 years experience in nursing education both as a teacher and manager and my clinical practice experience has been mainly in the medical/surgical nursing area. I currently work as a Staff Nurse in the Acute Gynaecology Assessment area at Christchurch Women’s Hospital and in a surgical ward at St George’s Hospital, Christchurch.Denise Messiter I am from Ngati Pukenga ki Hauraki, aged 45 and have a daughter who is 27 and a 21 year old son. Over the years I have gained extensive experience in community and indigenous peoples development having worked and trained as a counsellor, tutor, facilitator, policy analyst and corporate manager. I worked for the Hauraki Mäori Trust Board as a Health Portfolio Manager and then went onto establish and manage Te Korowai Hauora O Hauraki. I have worked as a policy analyst for the Ministry of Education, Manatu Mäori and Te Puni Kökiri. In August this year I returned from a VSA assignment in South Africa where I worked in the capacity of Organisational and Strategic Management Advisor to the Executive Management Team of the Eastern Cape Tourism Board. I have also been a self-employed consultant. In my spare time I run the Poutama a personal and professional development programme for indigenous peoples which I developed and designed in consultation with kaumatua from Hauraki. I have held ministerial board appointments and in October this year was appointed by the Minister of Health to the Nursing Council of New Zealand. I am presently working as a Senior Policy Analyst with Te Ohu Whakatupu, the Mäori Women’s Policy Team in Ministry of Women's Affairs.Marie Kiely I am delighted to have been appointed to the Nursing Council of New Zealand and to have been given the opportunity to make a contribution to professions that have an impact on all our lives. Currently I live in Palmerston North, with my husband and two daughters, where I work as a management consultant with Communication Unlimited. I have a background in social work, education and senior management roles. I am looking forward to the challenges of the next three years.
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Notes from the Chief Executive |
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The last few months have been very busy but productive for the Council and the key focus has been the appointment of a new Council, announced on 21 October 2000. We were particularly pleased that the Minister has re-appointed our Chairperson, Judy Kilpatrick, and Deputy-Chairperson, Jan Adams to Council and look forward to working with the new appointees.Strategic focus areas
Developing the strategy for regulation of an advanced level of nurse – the Nurse Practitioner Reviewing the framework for post-registration nursing education, in line with changes to regulating practice Working with groups of nurses in sexual/reproductive health, mental health, occupational health, palliative care, care of patients with diabetes, and respiratory diseases who are looking to expand their practice to prescribe Developing and consulting on a draft programme for a second level worker/nurse Planning and running our annual national forum which attracted 140 nurses from all over the country to debate the key issues Finalising and publishing our analysis of the nursing workforce data The review of pre-registration nursing education is progressing well and I am very pleased with all the debate and ideas which nurses throughout the country are contributing to the review. Please keep an eye on our website www.nursingcouncil.org.nz or contact Nursing Council for up-to-date information.As well as these initiatives, we continue to monitor undergraduate education programmes, assess and register overseas nurses and midwives, issue practising certificates and deal with notifications of disability affecting practice and complaints of professional misconduct. We also meet regularly with the range of stakeholders with whom we work closely.Did you know that on 2 November, 47,360 nurses and midwives hold current annual practising certificates? The increase this year reflects the steady increasing numbers over the past years.Lastly, 848 comprehensive nursing students and 75 midwifery students sat their state finals in November and a cohort of new graduates can be expected in the workplace in December/ January. Please support and encourage these new graduates if they are employed in your workplace. They are very important. They are our future nursing workforce.Marion Clark
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Nursing
Council Forum |
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A Brief Outline of the Forum Topics The Role Of The Second Level Worker In New Zealand Today The Nursing Council discussion document The Second Level Health Worker Of The Future formed the basis of lively discussion and debate around the second level worker. The feedback focused on a variety of issues – title and the protection of the title nurse, regulation of the second level health worker, the programme level, length (generally agreed to be 12-24 months) and content, the current health environment and workforce issues. It was generally felt that the second level worker was more appropriate for areas reflecting chronicity and aging. Workforce issues included clear identification that the introduction of another level of health worker should not be a panacea for the current problems. It was agreed that every health care worker should be regulated; there needed to be clear definition around role and function; and a minimum national standard required. The Forum feedback was conveyed to the Minister of Health, Hon. Annette King, at a meeting on 8 November 2000. Review of Undergraduate Nursing Education The KPMG team responsible for undertaking this strategic Review presented progress to date. Main themes to date include the recognition that face to face contact, caring and compassion must never be neglected; identifying beginning practice as distinct for advanced practice; the importance of integration of theory and practice and improving clinical placements and the need to address recruitment and retention of Maori and Pacific Island nurses. Group discussion centred around competencies, components, programme design, etc and implications. Nurse Practitioner Accreditation of Qualifications and Experience The model will:
We will be consulting widely on the model early in the new year.
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New
Legislation for Nurses and Midwives |
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For some years now nurses have been lobbying for new legislation to replace the Nurses Act 1977and midwives want a separate Act to regulate their practice. While it has been some time in coming, the proposed Health Professionals Competency Bill seeks to accommodate both wishes by creating a single Act covering all regulated health professionals. The Ministry of Health has released a discussion paper on the proposed new legislation, which will replace the Nurses Act 1977. Some of the key concepts of the Bill include
The Act will also empower the Council to define
scopes of practice and set rules/regulations to register nurses to work
within a scope of practice and set appropriate conditions on this
registration. |
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Nurse
Practitioner |
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After a process of national consultation on the draft document majority support was received for the use of "Nurse Practitioner" as a national title. Also agreed was the criterion for application including:
What are Nurse Practitioners? Nurse Practitioners are expert clinicians who incorporate advanced knowledge and skills into practice within a specific scope of practice such as family health, adult health, child health, health of the elderly, women’s health, occupational health and mental health. Nurse Practitioners respond to complex situations in a diversity of contexts demonstrating leadership as a consultant, educator, administrator and researcher. They actively participate in professional and legislative activities to promote professional advancement and health related social policies. Nurse Practitioners emphasize health promotion, maintenance and disease prevention. Scope of Practice for the Nurse Practitioner It is up to the individual practitioner to define their scope of practice on application to the Nursing Council. Educational Preparation for the Nurse Practitioner Educational preparation for the Nurse Practitioner is the satisfactory completion of a Nursing Council approved clinically focused Masters degree programme, or its equivalent. Application Presentation of a portfolio which includes the following:
Assessment of the Application The application will be assessed by a panel of experts including two nursing professionals. Where possible one member will be working with the applicant's defined scope of practice. Panel members will be working at an advanced level in clinical practice. The applicant will be required to meet with the panel where they will be asked to present and demonstrate their skills and knowledge relating to the advanced practice competencies. This may include a clinical viva. The Nurse Practitioner Framework is available from the
Nursing Council website and/or can be requested directly from the office.
The Council look forward to receiving applications from nurses seeking Nursing
Practitioner status. |
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Nurse
Prescribing |
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The passing of the Medicines Amendment Act 1999 enabled the making of regulations to extend prescribing rights to nurses and other health professionals. Cabinet subsequently agreed in April 2000 that regulations be drafted to allow nurse prescribing in aged care and child family health. Six additional scopes of practice have been identified to progress nurse prescribing – occupational health, palliative care, sexual/reproductive health, mental health, respiratory health and diabetes. Nurses from these six groups are currently working on defining scopes of practice, competencies and medications. The groups are working independently of each other with timeframes for consultation being around the New Year. Council staff is supporting the groups to help clarify the requirements prior to wider consultation. The Council will assess the scopes prior to recommending to the Minister that they be included in regulations permitting nursing prescribing. Following the approval of the regulations, Council
will then begin to approve educational programmes for Nurse
Prescribing. |
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Centenary
Celebrations |
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Did you know that the first nurse to be registered in New Zealand in 1902 received a medal that looked very similar to the one you have today? On September 12 1901 The Nurses Registration Act, an Act to provide for the Registration of Trained Nurses in New Zealand was passed and New Zealand became the first country to regulate nurses nationally. The Act provided for a register of nurses, training and state examination, registration fee, penalty for misuse of the title, possible removal from the register for misconduct and court convictions and the making of regulations. To commemorate 100 years of professional nursing through regulation, the Nursing Council is planning national celebrations for 12 September 2001. We will be communicating on specific events closer to that date.
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Workforce
Statistics Report |
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Now Available NEW ZEALAND REGISTERED NURSES, MIDWIVES AND ENROLLED NURSES WORKFORCE STATISTICS REPORT October 2000 This important report will be of value for everyone wanting information on nursing and midwifery numbers and for policy development in nursing and midwifery workforce issues. Information includes:
Copies of this publication are available from the Nursing Council at a cost of $20.
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Publication
Orders |
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Accepting gifts of money from patients The Nursing Council of New Zealand ("the Council"), found a registered general and obstetric nurse guilty of professional misconduct on the grounds that her conduct brings or was likely to bring discredit on the nursing profession. In particular, the nurse accepted four cheques amounting to a total of $25,000 between 1994 and 1996 from an elderly couple, initially patients of a medical practice where she was employed and later, when living in a retirement village. The Council held that it was unacceptable for a nurse to accept gifts of money from an elderly vulnerable couple met in a professional capacity. The Council concluded that the public must have a reasonable expectation that health professionals will act ethically in their relationships with clients and not abuse their position of trust and power. The Council ordered that: the nurse’s name be removed from the Register and that she could apply for reinstatement after a period of twelve months; she pay $6,048 costs and that a Notice stating the effect of the orders be published with the parties' names and specific medical practice permanently suppressed. Administration of drugs In another case the Council found a registered general and obstetric nurse’s conduct amounted to professional misconduct on the grounds of negligence after the nurse admitted the following facts: she failed to act on a GP’s written instructions that Maxalon be administered as the patient was allergic to Stemetil, failed to advise the enrolled nurse under her supervision of this, check if the patient was allergic to any medications, check the practitioner’s order against the intramuscular ampoule, take steps to ensure the patient’s safety after administering Stemetil, including following proper emergency steps. The Council ordered that the nurse practice only under the supervision of an approved registered nurse for a minimum period of 18 months and that she provide three monthly performance reports to the Council relating to drug administration, emergency procedures and documentation. It also ordered she pay costs of $4,517 and that a notice stating the effect of the orders be published with the parties' names and location suppressed. Restraint of a patient The Council recently held that the conduct of a registered general and obstetric nurse in restraining a male patient in bed, amounted to professional misconduct on the grounds that the conduct bought discredit on the nursing profession. The nurse admitted she tightly restrained a patient in a sheet using micropore tape to bind the sheet around the patient’s ankles and arms. The Council did not accept such conduct was acceptable care in any circumstances. It ordered that the nurse practice only under supervision for one year, not be the sole registered nurse on duty, with the Council to approve her workplace and also receive three monthly performance reports. It also ordered that she pay 40% of the costs and that a notice stating the effect of the orders be published with the parties’ names suppressed. Failure to document / visit patients The Council found Maryanne Elizabeth Lagaluga, registered comprehensive nurse, guilty of professional misconduct on the grounds of malpractice, negligence and that her conduct brings or is likely to bring discredit on the nursing profession. Ms Lagaluga failed to make scheduled visits to clients assigned to her as the public health nurse and/or document her visits in the client’s files; failed to refer clients to other members of the multidisciplinary team and/or to other services; and after resigning from her position/job, removed and/or retained 43 files from the Service until requested to return them. In the Council’s opinion Ms Lagaluga’s conduct in failing to visit or document visits on her clients in her care amounted to malpractice. The Council also found the nurse’s conduct amounted to negligence in that her professional role was either to provide or seek immediate assistance for those families in crisis, which she failed to do. The Council further held that her conduct, in removing files from the Service after resigning compromising the follow-up care available to the clients, was totally unacceptable and amounted to malpractice, negligence and brought discredit on the nursing profession. The Council ordered that: Maryanne Elizabeth Lagaluga’s name be removed from the Register and declined to fix a time after which she may apply to have her name reinstated to the Register; she pay $8,300 costs and the effect of the Council’s orders be published with suppression of any identifiable feature. Midwifery care The Council also found a registered midwife and general and obstetric nurse guilty of professional misconduct. In particular, the midwife failed to appropriately monitor a maternity client’s pregnancy under her care and seek specialist advice and/or take proper steps to ensure the well-being of the baby as follows:
The Council was satisfied on the evidence that the patient’s labour was a prolonged labour. Council found that the midwife failed to appreciate the significance of the length of labour, that her management might have compromised the health of the baby and in so failing she then did not seek advice or consult an obstetrician/specialist. In the Council’s opinion, these actions cumulatively amounted to professional misconduct and were negligent because she did not take appropriate and timely action when she recognised the patient’s labour was progressing slowly. The Council was also satisfied the conduct amounted to professional misconduct on the grounds that it brings or was likely to bring discredit upon the midwifery profession because it fell well short of the NZ College of Midwives Standards of Practice. The Council stated that while there was a true obstetric emergency, the delay of eight minutes in summonsing help could have resulted in a more unfortunate outcome and as such was below the standard reasonably expected of a midwife in the circumstances. The Council ordered that the midwife practise for a
period of 12 months only under the direct supervision of a midwife
practitioner, to be approved by the Council, with reports to the Council
quarterly, she pay $24,000 costs and a notice stating the effect of
these orders be published. |
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New
Publications Available |
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Report of the Nursing Council of New Zealand for the Year Ended 31 March 2000 $7.50 Direction and Supervision $5.00 Nurse Prescribing $5.00 Framework for Post-registration Midwifery Education (May 2000) $5.00 Nurse Practitioner (October 2000) $5.00 New Zealand Registered Nurses, Midwives and Enrolled Nurses Workforce Statistics (October 2000) $20.00 Free Publications Strategic Plan 1 April
2000 - 31 March 2003 Some Council publications are also available on the website
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Annual
Practising Certificate Instructions |
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With this newsletter you will find your application form for renewal of your annual practising certificate for the year 1 April 2001 to 31 March 2002. All nurses and midwives living in New Zealand and holding a current APC as of the last week in January 2001 should receive this form. If you require a practising certificate and do not automatically receive a renewal form by the end of February 2001 please telephone the Annual Practising Certificate department on (04) 8020245 or 8020235, to ensure your most recent address is on file. It is important that you complete all sections of your own personalised application form including all the data requested and return it, with a cheque for $32.00, to the Nursing Council by 20 March to ensure that you receive your practising certificate by 31 March 2001. Under section 51 of the Nurses Act 1977 it is illegal to practise as a nurse or midwife without a current practising certificate. As in previous years, payment must accompany the application form. We regret that we can only accept cheques or cash for payment. Payment by credit card is currently not available. Please do not attempt to directly credit payments, as we often cannot track whom these payments are from. The annual practising certificate for the 2001/2002 year utilises a built-in self-lamination feature, the same as last year’s. The laminate layer allows us to personalise the card and prevents any forgery or tampering. Please read and carefully follow the illustrated instructions provided on the back of your certificate.
Your laminated practising certificate will then be ready for use.
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Correct
Abbreviations | ||||||||||||||||||||||
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Correct Abbreviations for Nursing and Midwifery Qualifications Recognised by the Nursing Council Registered Comprehensive Nurse R.Cp.N.
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Registration
- Annual Practising Certificates | ||||||||||||||||||||||
