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Thread: Nurses fear US-style staffing scheme

  1. #1
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    Default Nurses fear US-style staffing scheme

    Nurses fear US-style staffing scheme
    By SUSAN PEPPERELL - Sunday Star Times
    Last updated 05:00 09/05/2010

    Nurses sat a pilot programme using American health workers to act as "physicians' assistants" in New Zealand is depriving them of an opportunity to expand their own roles as "super-nurses".

    The assistants, being recruited in the US where the programme has been established for more than 40 years, are not doctors but will have had at least two years' medical training. The trial starts with the Counties-Manukau District Health Board in July and is likely to be extended to fill gaps around New Zealand.

    The pilot programme, expected to cost up to $500,000 over at least two years, is being funded by Health Workforce New Zealand, a government agency set up to address health workforce needs.

    Initially there will be just two assistants taking part in the pilot, who will help surgeons by taking over the organisation of testing and other administrative requirements for patients needing an operation. Eventually it is likely a training programme will be established to train New Zealanders for the role.

    But New Zealand Nurses Organisation professional nursing adviser Chris Millar told the Sunday Star-Times the pilot was a hasty, premature solution that had not considered how to expand the role of nurses to fill the gaps.

    The organisation believed it would be better to first undertake a national study on health workforce capacity and the needs of New Zealanders.

    "This is a missed opportunity," Millar said. "Nurses in expanded roles could fill some of the gaps but without a strategic study no one can say what the need really is. The pilot is a short-term fix with no long-term solution or strategy."

    Millar says nurse practitioners registered nurses with advanced education and experience who are able to prescribe medicine and order diagnostic tests could easily fit into the role of physicians' assistant.

    The Nurses Organisation was also concerned that the assistants would have no understanding of New Zealand culture or its health system and would not be required to be registered under the Health Practitioners Competence Assurance Act.

    The junior doctors' union has also called for the trial to be halted.

    However, Health Workforce chair Professor Des Gorman says the physicians' assistants trial was geared to help nurses nurse, and he sees no need for a national study of health workforce needs. "We know where some of the most important shortages are. We have an unsustainable reliance on recruiting doctors from overseas and a desperate shortage of nurses. We are very keen to protect the ones we have."

    He says the point of the pilot was to see if the position would work in this country.

    Employing US physicians' assistants was just phase one. Phase two would involve sending New Zealanders to training programmes in Australia ahead of the third phase setting up a Kiwi-based training programme. That was likely to take a couple of years.

    Gorman said there was no need for registration, as the assistants will work under the licence of a doctor, who will take full responsibility.

    "These people will not be behaving autonomously, they will not be making decisions, they will be following procedures."

    Results from the trial will be ongoing with most available by the end of the year. If, for instance, the presence of physicians' assistants meant junior doctors were missing out on hands-on experience, that could be addressed immediately.

    Gorman also said much of the work done by Health Workforce centred on extending the roles of nurses and cutting excessive paperwork. "Nurses need to nurse. We are not trying to do away with their roles, it's about trying to free them up."

    He said nurses will be invited to participate in the pilot programme's assessment process.

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  2. #2
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    I can see now this program won't fly - for two reasons. First, "that's not the way WE do things in New Zealand", and second, it's American. Sad to say, but from the tone of the article, people aren't even willing to see if it will work. If there is a glut of doctors or nurse practitioners in New Zealand, someone needs to point out where this is. I really think a "study" to see if physicians assistants are needed, or if nurses could fill this in an expanded role, is a huge waste of time and money. With 40 years of training and utilizing physician's assistants in the US, it's hardly a new concept. If nurses in New Zealand could fill this role, why hasn't this already been done?
    I see so many things in the health care system here that waste time and money.....it could be the best system in the world, but heaven forbid anything would change. (As an example, I "borrowed" a form (from another DHB) for trending blood sugars results as a graph, which the physician liked, but was quickly shot down when I showed it to a nursing operations manager. Can't change because we have been using the same form for years.) I know people don't like change, but have never come across a place as resistant as New Zealand. Don't expect to see any physician's assistants here soon. Instead, the registrars and house surgeons will just be overworked, since that's the way it's done.
    Arrived in Auckland on August 6, 2008.Now live in Kawakawa with my kiwi partner.
    I just started working at Bay of Islands Hospital at the beginning of December 2009.
    Work permit renewed and good until June 2010
    EOI submitted and selected, case manager assigned and ITA received. PR application submitted 28/08/09
    approved in principle 26/01/10, PR granted and received 19/03/10

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