Nurses march from Christchurch Public Hospital to Cathedral Square to hear speeches during the 2002 nurses' strike. (Photo by Paddy Dillon/Getty Images)

What nurses are fighting for

Having voted down a 2% pay offer from district health boards, nurses will soon decide whether to instigate a strike. In a post first published on Facebook that has since gone viral, nurse Elizabeth Alice explains why they’re not backing down.

Update, July 12: Following the breakdown of talks with the DHBs, nurses are on strike for 24 hours today

Here’s the thing, New Zealand. This nurses’ strike proposal isn’t about money and it isn’t about nurses using emotional blackmail to get our demands met by jeopardising patient safety.

You need to understand that we are fighting for the future of our public health system. And that affects every one of us – in particular, our children.

Nurses in our public hospitals have believed for some years now that patient safety is being compromised by chronic understaffing of nurses at the bedside. The shift happened around 12 years ago and the resulting loss of experienced nurses has deepened the crisis ever since.

The suggestion by Prime Minister Ardern yesterday afternoon that an independent panel be established is just the latest slap in the face for nurses. We don’t need yet another group of non-nurses telling us what we need.

Here’s what the government and senior management across the country think we do: make beds and cups of tea, take people to the toilet and give out the pills that the doctor prescribes.

What we actually do is gather assessment information and repeatedly assess patients, in order to aid in the making of a diagnosis. We are there to notice when you or your family member are getting sicker, so that we can notify the doctor who is responsible for up to 100 patients and can’t possibly know what is going on with every single one. We are the ones who have the time to listen to the whole story, to advocate when things have been missed or forgotten or mistakes have been made. When we give out medications we’re checking that the medication and dose are appropriate; if we are worried we challenge the doctor to review the prescription. I have avoided killing someone on no less than three occasions in 13 years through not blindly following instructions to “help the doctor”.

When I wipe a bottom, I make sure that it’s done in such a way that the person who needs my help feels the full dignity of their humanity in that moment of vulnerability. While I do that I am assessing mobility, muscle tone, skin integrity. I am noticing if the individual is unusually distressed by this process and if so, I am asking the tough questions to find out if they are vulnerable to abuse. I am the one who sits with families to make sure that they understand what the surgery really means, after the doctor has finished their overly technical speech. I am the one who takes the time to help you and your family feel brave enough to talk about death when it is coming, so that you don’t miss the chance before it’s too late. I am the one who takes the time to give you the information you need to accept the pain relief, when you’re putting up with your severe cancer pain to avoid becoming a drug addict like your friend.

We, the nurses of New Zealand, want two things:

Firstly, we want safe staffing levels to ensure the safety of you and your loved one when you are sick and need hospitalisation. We want a ratio of one nurse to four patients, instead of 1-6, or 1-8, or 1-14. We want this so that we can provide the care that is needed to reduce rehospitalisation, to eliminate mistakes, to ensure that people aren’t lying in soiled beds or being discharged too early.

Secondly, the money thing. We want a monetary recognition of our worth, comparative to our qualification. It feeds back into the perception of what we do. We are government employees on par in qualification and responsibility with teachers and police. If you don’t believe this then you don’t know what our jobs are. We also cope with verbal, physical and sexual abuse as part of our week to week encounters on our job – sometimes from patients, sometimes due to their state of health (lack of oxygen, delirium, psychosis), sometimes from their families. People come to us in a state of panic and often express this as anger. We are trained to de-escalate these situations. It’s not always possible. Recently I restrained a raging, intoxicated person who was physically fighting me and the security guard. By the time the police arrived, another nurse and I had the situation under control.

I translate difficult medical speak into information you can understand, and act as a go-between to improve understanding between you and you doctor. Don’t you dare tell me that I’m worth just $4 an hour more than someone who walked off the street and into a health care assistant position. These people do amazing jobs and I value them every day, but they cannot do my job. We are not replaceable with health care assistants. Our ability to critically assess, evaluate, monitor and act are the result of our bachelor’s degree. Our skills are honed through years of exposure and experience. It is not true to say that a nurse is a nurse is a nurse. I could not do the job of my colleagues in theatre any more than they could do my job in the emergency department. And if you want to give me a panic attack then send me to work in the neonatal specialty unit.

Our public health system is broken, and the most broken aspect of it is nursing. Nurses are the backbone of our hospitals. It’s a team effort; none of us (doctors, nurses, HCAs, cleaners, receptionists, orderlies and managers) could do our jobs without the others. But nurses are the glue and without us it all falls apart. We have been holding it together for over a decade now, and we are at breaking point. Our communities deserve investment in public health. If we don’t fight for it now then it will be gone, and we will have a situation like the USA where the rich get premium care and the poor die on the streets from curable diseases. Or Britain, where chronic underfunding has been going on for much longer and the NHS is so broken that no one will apply for a job within it.

This is our chance. Let’s actually do this.


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