EDITORIAL
Vol 18 No 2 - July 2002
Mummy! I got that goal because I believed I could! These were the words that our seven year old son Oliver excitedly said to me a few Saturday mornings ago, after scoring a very impressive goal. He had come from the oppositions half and had managed to stay focused, use his skills to get the soccer ball from one end of the field to the other and then finally kick that ball into the goal. Oliver is extremely talented with his soccer skills and is an asset to his team. But what was important about this goal was the way he believed in himself to achieve his goal. Maybe this is how he will approach many of his aims and aspirations in his life.
These words from Oliver would have given me great joy on any day, but they have stayed with me over the past few weeks because of some challenges that I have been facing as the first Nurse Practitioner™ in New Zealand. That Saturday I was feeling bruised from a conversation which had occurred the previous day with a colleague. Becoming the first Nurse Practitioner™ carries with it many joys, challenges, and responsibilities. It is clear to me that while the majority of the nurses are delighted with the on-going development for advanced nursing practice in New Zealand, there are a number of nurses who are not happy with either the process for application with the Nursing Council, or some of the decisions that have been made. Nursing in New Zealand is responding to the changing needs of our communities and it is this change within nursing that has challenged us all.
Nursing in New Zealand is at the beginning of a unique opportunity to be able to bring the caring back into the delivery of health care. We have an established clinical career pathway which is competency based. The District Health Board (DHB) framework means that the consumer has a greater input into health care. This will assist with the continued establishment of patient centered care measures and ultimately work towards the improvement in health outcomes for the populations in question. Achievement of this will be enhanced by the continued establishment of nursing units/services, working collaboratively with other health care professionals. My vision is that ultimately the paradigms of care and cure will blend together.
There are, and always will be, barriers to change. One the greatest barriers to the development of nursing being able to bring the caring back into health care delivery, and therefore making a greater impact on health and well-being, is the culture of blame. I see this blame culture within our profession as the way you hear nurses humiliate others for incompetence while assuming that their own practice is absolutely exceptional. Also we hear that mistakes are the fault of the external environment, or that the management is out to get us.
Another way to interpret this is to say that our faults are caused by others, and that the faults of others are their own. From this view of the world nurses are the virtuous victims. When in this frame of mind it is impossible to be able to open one’s mind to the possibilities of change, as all the energy is caged in defense and anxiety (Malby, 1998).
We now have the opportunities and frameworks to really make a difference, to bring the caring back into health care delivery. However we must look within the profession. We need to identify our goals and believe that we can make a greater difference. We are skilled at tackling the difficulties, just as Oliver did on the soccer field, and with the many skills that nursing holds and with our knowledge, we can achieve our goals. Then we will improve the health care delivery for the communities we serve and along the way nurture the profession of which we are all privileged to be members.
Deborah Harris
Nurse Practitioner™
Hamilton
Reference
Malby, B. (1998, Spring). Clinical Leadership. Advanced Practice Nursing
Quarterly, Spring, 40-43.
