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In 1909 New Zealand nurses formed the first national voice for nursing. For much of its first 100 years this voice recoiled at becoming a union but eventually evolved into the dual professional and industrial roles of today’s New Zealand Nurses Organisation. Fiona Cassie in 2009 looked back at NZNO's history.

The hats are probably the giveaway.

Resplendent Edwardian headgear dominates the photo of the first New Zealand Trained Nurses’ Association gathering in November 1909.

Whilst beneath those milliner’s masterpieces were probably some of the country’s most able women leaders it was clear they also regarded themselves as gentlewomen.

And a gentlewoman put caring before commerce. Nurses were ministering angels not militant unionists.

The one-woman powerhouse who recommended the “fellowship” of forming such an association – Hester Maclean – also warned against it lapsing into unionism.

“We must, however, guard against any element of trades unionism creeping in among us. A nurse must be a woman, working not in the first place for the sake of money-making but for the good of her fellow creatures to alleviate suffering when she can and help towards health those who need her care,” she wrote in an editorial in 1909

Maclean, the formidable Australian nurse, arrived in 1906 to take over the reins as Assistant Inspector of Hospitals from Grace Neill, the nurse behind the world’s first national Nurses’ Registration Act passed in 1901. She records in her memoir that she found no national organisation “and the nurses of the North Island knew nothing of the nurses of the South Island”.

But regional associations had popped up with the first of these the Wellington Trained Nurses Association set up in 1905 that grew out of a private nursing bureau and nurses “residential club”. The first president was a “retiring” woman with “quiet wisdom” a Mrs Kendall, who had been awarded a Royal Red Cross from Queen Victoria for her nursing services under fire during the “frontier troubles” in India.

She was also a surgeon’s wife and the association had the mayor’s wife amongst its lay members so it was an association with some social status. (A 1908 Kai Tiaki report of a Wellington Association social event sounds more like Tatler with a member being described as “picturesque in black velvet and lace…her fair hair thrown into relief against the carved screen and tall white lilies”.)

Similar associations of nurses popped up in Canterbury, Dunedin and Auckland and Maclean persuaded the four associations to join forces under one common New Zealand Trained Nurses’ association with “uniform aims, objects and similar rules”.

The first council meeting was held in Wellington in November 1909 with Mclean, as elected president in the chair. Interspersed with business was a series of formal afternoon teas and a dinner party. Maclean reminiscing two decades later found the first council photo – with those startling hats – “really amusing”. “How much more sensible are our present fashions.”

That first delegate photo includes a male doctor but as the infant association was keen to join the International Council of Nurses (itself only a decade old) he had to go as ICN required strict self-government by nurses alone.

From the start the association was strong on nursing representing nursing and setting professional standards but the focus was mostly on private nurses with registered nurses in hospitals still in its infancy.

One of the first acts by the association was to protest against enforcing the eight-hour day (or 56 hour week) on all nurses with the association more in favour of longer shifts and days off instead. A further push – eventually successful - was for superannuation for nurses amusing one nursing historian that the association was more concerned with financial considerations for retired nurses than those actually working.

The association understandably had close links with the department of health with its founding president, Hester Maclean, being a senior employee and from 1920 the country’s first official “chief nurse” not forgetting she was also the registrar and the founder and editor of Kai Tiaki for its first 20 plus years. This close relationship with the chief nurse of the day continued for decades and the association had automatic nominees on the registration board (forerunner of Nursing Council) right up until the 1980s.

It was the Great Depression that prompted the association to first consider an industrial role.

By 1931 there was 50 per cent unemployment amidst private nurses though the association still frowned upon nurses joining unemployed marches on the grounds it would “lower the prestige of the profession” and put the uniform to “ridicule”.

But it did call for hospital boards to keep on trainees for an additional year on qualifying and in 1932 had a representative on the Unemployed Women’s Committee. Also, in response to a union pursuing student nurses, altered its constitution in 1937 to set up the Student Nurses’ Association with its members being associate members of the parent association, now called the Registered Nurses’ Association.

The depression, and the 1938 Social Security Act bringing in free public hospital care, saw the decline and then demise of the “private nurse” movement with the Wellington branch finding itself bankrupt in 1943 and forced to sell its 14 bedroom nurses residential club.

The focus on public hospital nursing grew and further union moves and looming nursing shortages saw the national association in 1939 vote “in the hour of need when outside control was imminent and our self-government threatened to courageously step forward” and seek to become a trade union

It formally applied in 1940 but the war intervened, the mood changed (the president in 1941 saying unions with their “possible strikes” have “no place in nursing”) and in 1947 the conference resolved unanimously to remain a professional organisation only.

But the association did feel in 1947 it had made some headway industrially as for the first time a mechanism, the “salaries advisory committee” had been set up to “advise” hospital boards and the association had been recognised by government as the “organ to represent and negotiate for nurses on salaries and conditions”.

The first code for hospital nursing salaries was suggested in 1938 amidst major shortages and a revised salary scale was negotiated in 1944 (see sidebar) and adopted by most hospital boards. (The association was also successful amidst wartime rationing for negotiating a government supply of suitable shoes at a suitable price with 4000 pairs distributed between 1943-46.)

But after the build-up of wartime momentum, the female-dominated profession lost industrial traction with little salary movement for nearly the next two decades – nurses’ work was once again considered beyond moneymaking.

There was much discussion in the 1950s about the philosophy of membership and the role of married nurses in the workforce with in 1959 there about as many practicing as non-practicing members of the association.

Financially the association was also always under strain with in 1956 the director still having to seek council permission to buy a carpet sweeper and mop. Headquarters weren’t exactly luxurious either with only chairs of the dining or kitchen variety – several of which were ‘”very rickety”.

The ethos of the association remained much unchanged from Maclean’s day with the association in 1957 withdrawing from the Council for Equal Pay and Opportunity in the fear the association might become political.

But the 1960s saw the mood begin to move with a PR firm boosting membership by a thousand and more career nurses seeing nursing as more than filling the gap between school and marriage. In 1962 an ICN economic advisor was brought in to lead the association to a “more effective way of negotiating conditions of employment” than the failed salaried advisory committee”

For while the association regarded itself as having more professional respect than the Public Service Association, which represented nurses in the state psychiatric hospitals, the PSA’s greater industrial clout equaled greater pay packets.

The momentum began to get an arbitration mechanism for the association to negotiate with public hospitals which was finally won in 1969 – along the way in 1965 there was the first real pay rise since 1950 and the introduction of over-time and weekend penal rates.

The early 70s were a heady time for industrial and education matters. On the industrial front the association was recognised as the negotiating body for the state sector hospitals but as a non-union it could not represent nurses in the private and NGO sectors and competition was again looming with the Clerical Workers Union in 1970 seeking out practice nurses.

So in 1971 it agreed to form a union and in 1973 the New Zealand Nurses’ Industrial Union of Workers (later NZNU) was opened as the association’s industrial arm for non-state sector nurses and it set forth to negotiate awards for groups like private hospital nurses and Plunket nurses. The association also changed its stand on not-allowing special interest groups inside the association and the first of what are now the NZNO sections and colleges started to form.

But there was also dissatisfaction with the association brewing in Auckland in the early 70s, which lead to a student splinter group and eventually the Nurses’ Society that in 1984 had a membership of 9000.

Meanwhile on the education front the high attrition from hospital-based courses in the early 70s had the association mobilizing behind the Carpenter Report and lobbying hard in the early 70s for the shift to technical institute (polytechnic) training along with university postgraduate education.

In the 1980s high inflation and a wage freeze had built up nurse anger at their eroded pay lead to the “Nurses are worth more” campaign in 1985 – the first time that nurses really tried to use industrial clout and public opinion to sway government.

The restructuring of the late 80s coincided with the building of the delegate movement and in 1988 the NZNA, a member of the Council of Trade Unions, agreed for the first time that nurses could take strike action, which nurses did along with other health unions in 1989.

But the restructuring and industrial reform did not stop and the 1991 Employment Contracts Act saw the end of national awards and compulsory unionism. Soon after the NZNA and NZNU merged to form NZNO, along with Te Runanga o Aotearoa NZNO, to help buffer themselves from the impact.

With the millennium came the Employment Relations Act and having weathered the 90s reforms the NZNO regrouped and started to negotiate first regional and then national multi-employer collective agreements with the district health boards. It has also since the late 1990s brought under its wing a wider health professional membership than nurses alone, including unregulated health workers, who have helped the rapid growth in membership in recent years.

Its major coup of the decade has been the 2005 DHB MECA, which brought in a “pay jolt” at least partially linked to resurging interest in nursing as a profession. Along with a Safe Staffing Healthy Workplace unit, and a negotiation style that appears much more “gentlewomanly” than their heath professional colleagues seeking their own pay jolt.

It appears that more than fashion has changed in the past 100 years of nursing for the organisation that now wears two hats as a union and professional association. One is unsure whether Hester Maclean would eat her hat or throw it in the air in celebration if she could see her association 100 years on. Just maybe she’d do both.

Sources:

Nursing in New Zealand: History and Reminiscences by Hester Maclean, 1932 (full text on-line at www.nzetc.org)

Objects and outcomes: NZ Nurses’ Association, 1909-1983: commemorative essays edited by Margaret Gibson Smith and Yvonne T Shadbolt, 1984

Things Accomplished: a history of the Wgtn branch of NZNA 1905-1989 by Anne McDonald, 1993

Nursing in NZ Society by Marie E. Burgess, 1984

Recording nursing highlights through the pages of Kai Tiaki by Anne Manchester, Kai Tiaki, Jan 2008