October 2017 December 2013 | Page 6

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actually do differently. Believe me this is a
question I ask myself on a daily basis. In my
mind nursing leadership is about being highly
focused on patient and community health
outcomes and addressing what nursing can
do differently to meet those goals. As a
discipline we have carefully identified and
articulated those changes required to “release
the potential of nursing” (Ministerial Task
Force on Nursing, 1998). Our own internal
professional goals have been fulfilled. They
include (but are not limited to) radical changes
to postgraduate nursing education from a
social science focus to a clinical focus,
development of the Nurse Practitioner scope
of practice, a much more enabling and flexible
scope of RN practice to increase consumer
access to care, acceptance of registered
nurse prescribing, and well developed
collaborative processes across all nursing
groups and their leadership.

The same cannot be said for the identified
barriers which are external and thus beyond
our control. As noted ad nauseum in many
workshops, publications and meetings with
Ministers and others, in primary health care
and beyond, nursing development remains
constantly stymied by a range of barriers and
legislative obstructions. It is indeed brilliant

© Te Puawai

that the Medicine’s Amendment Act is done
and dusted as of last week. But how tedious it
is to keep asking; Why is the Health
Practitioners Statutory Reference Bill still
sitting in Health Legal in the MoH? And why
has the Ministry never made it clear to all and
sundry that capitated payments for patients
are not an exclusive funding source for GPs?
Much more could be said and many more
subtle barriers identified. The point however is
that to me it is hard not to see the suggestion
that PHC nursing leadership should step up
as a strategy to distract. It aims to distract
from a complete failure to truly enable and
resource the very workforce that really could
and really wants to deliver on the goals the
Ministry constantly articulates. This is namely
a flexible responsive workforce that is able to
work differently, innovatively and responsively
to major areas of need, increasing disparities,
and what General Practice leaders have
themselves referred to as the ‘burning
platform”.

I am well versed in the mantra that as a leader
I should look for solutions rather than
articulate problems. Despite the best will in
the world I just cannot think of any more
solutions right now. Are there any ideas out
there?

College of Nurses Aotearoa (NZ) Inc
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