EDITORIAL
Vol. 20 No. 1 March 2004
A vision whose time has come at last
Nurses have written and spoken for years about the need to improve primary health care services, emphasising the development of nursing itself as central to successful service delivery. The last two years have seen considerable energy directed at primary health care nursing by various nurse leaders. That energy is beginning to bear fruit. A number of Government and Ministry of Health initiatives have been a direct response to advice and direction from the expert nursing advisory group. These have included focused scholarships and
innovation money for the development of local models. We are now seeing the enormous potential unleashed when there is investment in nursing.
Seventeen nurses from across MidCentral District Health Board (MDHB) region cast aside their differences and worked together to develop a successful Ministry of Health proposal to build capacity and to share and build on service innovation. A successful application gained funding to establish a Primary Health Care Nursing Development Team to enable primary health care nurses to deliver on the objectives of the Primary Health Care Strategy (Ministry of Health, 2001).
The Team is led by two Directors of Nursing: Primary Health Care (one Maori) and a Quality/Research Co-ordinator. The team and the Primary Health Care Nursing Clinical Governance Council (elected nurses from the fourteen areas of primary nursing practice within the MDHB) will support primary health care nurses in the region so that they can achieve innovations and make the transition to PHOs from a strong and well prepared position.
The passion which drives this development is the need to see people and their needs at the heart of the service provided. This approach is premised on the health and wellness principles that underpin the concept of healthy communities. Specifically the team will act as a capacity building resource, an advisory centre, a change agent in nursing practice, and will provide information and leaderships for nurses in the region who are moving to, or developing, new models of primary health care nursing delivery. It will also lead and support nurses to develop clinical governance over their practice as primary health care nurses.
The leader’s partnership between Maori and non Maori is ground breaking. The roles are seen as ‘mahinga ngatahi aronga takarua’ - ‘side by side journey’ woven into the fabric of Primary Health Care. The vision is of a partnership model in which nursing practice is shaped by community and individual need rather than employer or contractual constraints.
Our key role will be to influence the strategic direction of our DHB and ensure the sustainability of each PHO by facilitating nursing collaboration and developing a professional practice framework for primary health care nursing workforce development. The 2001 Primary Health Care and Community Nursing Workforce Survey (Ministry of Health, 2003) showed just how fragile that workforce is and how much work is needed to underpin Government’s primary health care strategy with a strong dynamic community based and community focused nursing workforce. We will be guided by an evidence based approach to practice and ‘Te huarahi mo te matauranga i tuaritia nga pukenga ‘ - ‘the pathway to excellence is achieved through sharing knowledge’.
Many in nursing at all levels have a real vision for primary health care which they are working to achieve. We are moving way beyond our tenuous roles in assisting the delivery of primary medical care and looking to a future where health not illness is the focus of our energy.
Leigh Hikawai
Director of Primary Health Care Nursing Maori
MidCentral District Health Board
Chiquita Hansen
Director of Primary Health Care Nursing
MidCentral District Health Board
References
Ministry of Health, (2001). Primary health care strategy. Wellington: Author.
Ministry of Health, (2003). Primary health care and community nursing workforce survey - 2001. Wellington: Author.
