“We must … guard against any element of trades unionism creeping in among us,” she wrote in an editorial in 1909. “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.”
The ‘womanly’ nature of nursing saw talk of fair pay sidelined for much of the 20th century. The Registered Nurse Association (the forerunner of today’s New Zealand Nurses Organisation) even withdrew from the Council for Equal Pay and Opportunity in 1957, fearing that the association “might become political”.
Fast forward 60 years and pay equity for the still-female-dominated profession remains an issue. No nurse begrudges the long-underpaid and undervalued care and support workers receiving their historic settlement. But from
1 July the closing – and in some cases closed – pay gap between unregulated healthcare assistants and regulated and accountable degree- and diploma-qualified nurses has opened up a Pandora’s box of questions about a nurse’s true worth.
The proposed new pay equity framework states that a claim has merit if there are reasonable grounds to believe the work has been historically undervalued because it uses “skills or qualities” generally associated with women. With the tabling of a pay equity claim for district health board nurses, Hester MacLean’s historic words may help to prove just that.
Fiona Cassie, Editor
[email protected]
www.nursingreview.co.nz
NB: This edition’s 60-minute PD learning activity (p.13) looks at the impact of skin tears on patients – particularly the elderly – and how skin tears reflect the quality of care provided.
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Within minutes, clinicians can have blood test results to help them assess whether or not a patient’s chest pain is a heart attack, manage a diabetic patient with ketoacidosis, or decide whether a blood transfusion is required.
Patients can also have peace of mind that they can be treated close to home in Hokianga and a decision made whether the two-hour trip to Whangarei or four-hour trip to Auckland by road is warranted.
Point-of-care testing (POCT) devices allow blood tests to be carried out at the bedside or in a clinician’s room; tests that were once only available at a central laboratory.
Using POCT for acutely unwell patients is now well-established at Hokianga Hospital in Rawene. The community-owned, trust-run hospital includes 10 acute beds (along with long-stay and maternity beds) serving the predominantly Māori, socio-economically deprived communities located around the beautiful but isolated Hokianga Harbour.
Residents of these remote communities have high rates of long-term conditions such as heart disease, diabetes and renal disease. Being cut off by flooding is part of life in this region and, with no on-site laboratory, even in the best of conditions blood test results could take from eight hours to as long as 72 hours over a weekend, so pioneering the use of POCT analysers, which return results in two to 10 minutes, has had a particular appeal.
Nurse practitioner Catherine Beazley is one of two ‘super-users’ of POCT at Rawene – the other is fellow nurse and hospital services manager Christine Dorsey.
In the 16 years since Beazley began working at Rawene, she has gone from using a simple glucometer for measuring blood sugar to being the quality control guru for ‘half a shelf’ of increasingly sophisticated POCT technology, ranging in size from the handheld to a haematology analyser roughly the size of an Auckland telephone book.
Beazley says the big game-changer in being able to keep and treat patients locally was the trust’s purchase of the iSTAT analyser in 2008. The handheld device supported clinicians to assess suspected heart attacks to heart failure, and diabetic ketoacidosis to acute renal failure, by being able to carry out urgent blood tests for levels of blood gases, chemistries, troponin and BNP. Also on the shelf is an on-the-spot coagulation checker (Coaguchek), an HbA1C analyser (DCA Vantage) and a more recent addition is the haematology analyser (Emerald 22).
A 2010 study, led by Dr Kati Blattner of Hokianga Health, found that with having prompt access to POCT results patient transfers to Whangarei Base Hospital reduced by 62 per cent and patient discharges increased. Clinicians reported substantial (75 per cent) changes in the treatments that were offered.
Beazley reported another spinoff for the nursing staff, apart from the comfort of test results to support their clinical judgement and care plan, was fewer call backs to escort ambulance transfers. Before iSTAT, patients with undiagnosed chest pain were often transferred by ambulance to Whangarei, with urgent escorts adding a minimum of five hours to a nurse’s working day.
At the outset nurses and doctors received comprehensive ‘herd’ training in using POCT with these clinicians keen to get on board, even offering their own blood.
However, as the novelty wore off, using the devices increasingly became part of the nurses’ role and now the majority of the 23 active users on the main POCT analysers are nurses. Adding amateur lab technician to a nurse’s job description could be viewed as stretching multi-tasking a little too far.
“When working rurally you have to have a generalist attitude,” says Beazley. Being trained to use POCT devices is now perceived as business as usual for nurses at this hospital.
Routinely, when a diagnostic test is ordered, a nurse not only takes the blood sample from the patient’s vein but usually carries out the test. For iSTAT the testing procedure involves inserting two or three drops of blood into the appropriate test cartridge, entering the required information (including the nurse’s council number as a user ID) and inserting the cartridge into the handheld analyser. Within two to 10 minutes (depending on the test) the results are ready.
Initially, nurses would stand anxiously waiting for the test results but now carry on with normal duties, returning to take a quick look at the results as they deliver them to the requesting doctor or NP (post-haste if they show elevated troponin results). While registered nurses don’t order or usually interpret POCT – senior nurses may take the initiative while inserting an IV line into an acutely unwell person to also take a blood sample in anticipation that POCT tests may be wanted.
Point-of-care testing may be fast but it is not cheap so the preferred approach remains waiting for a traditional lab test result. Last year clinicians ordered between 80–130 iSTAT tests a month and 35–60 haematology tests a month. As Beazley emphasises, POCT tests don’t replace good quality clinical assessment and care but do support clinicians to decide on the best management plan for an acutely unwell patient and can give increased peace of mind to both patients and clinicians.
“Sometimes it might be used to help adjust medication for someone such as renal or heart failure,” says Beazley. “Or you might be trying to determine whether a person has a chest infection/pneumonia-related shortness of breath/cough or whether it is heart-related.”
The New Zealand Society of Pathologists in a letter to the Ministry of Health last year acknowledged that modern medicine was impossible without POCT, but said that alongside the advantages of speedier access to diagnostic testing came challenges – including that POCT can appear to be “deceptively simple to use” but was not without risk and needed consistent quality control and risk management processes.
When the Hokianga team presented to the Rural Health Conference in March, Blattner spoke of the positives of POCT but also watching the nursing staff “working harder and harder” at making it work and to meet the ongoing treadmill of quality standards. She believes that funding and policy work is needed to make the benefits of POCT sustainable for settings like Hokianga.
Beazley acknowledges that carrying out quality control (working in tandem with Northland District Health Board’s point of testing coordinator Geoff Herd and the DHB’s medical laboratory), looking after the shelf of POCT devices plus the training and annual testing of users has become a routine part of her role. The organisation is reviewing this workload as part of a current research project and recommendations may be made in the near future about formal FTE hours being allocated to manage POCT devices at Hokianga.
Meanwhile, working at 9pm on a Monday night wearing her POCT ‘hat’ is not unknown for Beazley. The rural NP says what motivates her is the benefits that POCT testing brings to the hospital’s staff, patients and wider community by being able to provide a modern acute care service to an isolated population.
Should other nurses be ready to follow or wary of following the POCT path?
“I think it [POCT] is something to be embraced as a way forward in rural practice but it has to be done with the right supports in place and the right funding,” says Beazley. She suggests that nurses seek answers about who is going to do the ongoing training, fund the test supplies, coordinate quality control and be responsible for the day-to-day maintenance of devices.
While the diagnostic comfort that the shelf of devices in Rawene’s drug room can provide doesn’t come without costs, Beazley adds that along with the increased peace of mind also comes a great sense of community pride in what the hospital can deliver to the people of Hokianga.
A project to roll out point-of-care testing to rural practices from Great Barrier Island to Warkworth is also underway. The Rural Point of Care Testing (R-POCT) project aims to provide general practices in the Auckland Waitemata Rural Alliance with POCT analysers.
So far the Waitemata DHB has committed $1.02 million for the project over the next two and a half years. The alliance’s practices serve a rural population of nearly 60,000 people – mostly in rural north and west Auckland, including Great Barrier Island, Waiheke Island, West Rodney, Wellsford and Warkworth.
The project will make rapid on-the-spot blood test results available to help diagnose and decide whether acutely unwell rural patients can be cared for at their general practice or need hospital referral. It is being led by Waitemata DHB, whose POCT team will provide quality assurance and training for practice ‘champions’ in using the selected analysers.
The R-POCT project has identified that more than one analyser will be needed to carry out the required tests for troponin, D-dimer, INR (international normalised ratio) and a full blood count with a three-part differential.
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PROS include: Fun and entertaining. Written by doctors and reviewed by doctors, specialists and nurses. Uses languages relevant to many
New Zealanders.
CONS include: The text is lengthy and comic-style speech bubbles may not appeal to everybody.
See more information on this and other reviewed apps at
www.healthnavigator.org.nz/app-library.
The NZ App Project: Health Navigator, a health website run by a non-profit trust, is using technical and clinical reviewers to develop a New Zealand-based library of useful and relevant health apps. Nurses are invited to support the project by either recommending consumer-targeted health apps for review and/or offering to be app reviewers. Email
[email protected] to find out more.
The experienced aged care nurse is the general manager of the Selwyn Institute for Ageing and Spirituality, which initiated a pilot into using tablet-based telehealth technology to help older people living at home to manage their long-term conditions.
The case study Johnson-Bogaerts shared was of George, a man with heart failure (leading to multiple hospital admissions, COPD (chronic obstructive pulmonary disease) and hypertension.
As part of the pilot, George had access to a blood pressure monitor, pulse oximeter, thermometer and scales, which were connected by Bluetooth to a touchscreen tablet. He used the devices to take his ‘vitals’ daily, with the information digitally delivered to his telehealth nurse Sandi Milner.
During follow-up teleconferences on the tablet – to discuss missed out or out-of-range readings – Sandi found out that George had a problem with constipation, had little energy and had stopped gardening. She also found out that George – who had been advised to go on a low-salt diet – wasn’t sharing meals with his family and was trying to resolve his constipation by eating cornflakes.
Johnson-Bogaerts said the telehealth nurse guided George on how to check the salt content on the packaging of food, like his cornflakes, and shared advice on how to better manage his fluid and salt intakes. Sandi also suggested he try kiwifruit and he slowly started to introduce fruit and vegetables back into his diet and to eat with his family again.
Over six weeks he improved and over the four months he learnt to better control his symptoms. At the post-discharge check, George reported he was out in the garden planting vegetables, feeling better than he had felt in years and had had no hospital admissions.
Following the pilot, the telehealth-based chronic disease management programme is now being delivered by a joint venture between the Selwyn Foundation and Australian provider Feros Care, called Inviga. A second telehealth care pilot also got underway late last year, which involved retirement village residents having home-based video consultations with the on-site doctor.
]]>Your initial personal statement – what drew you to the profession of nursing and what you can offer and contribute.
(Rachel Phillips and Lorelle Bobsien, graduate programme coordinators at Auckland DHB.)
(Sandra McLean-Cooper, nurse consultant education and development at Nelson-Marlborough DHB.)
(Steph White, NETP coordinator for Capital & Coast DHB.)
( Sally Houliston, nurse consultant workforce for Hawke’s Bay DHB.)
(Rachel Phillips and Lorelle Bobsien, graduate programme coordinators at Auckland DHB.)
(Sandra McLean-Cooper, nurse consultant education and development at Nelson-Marlborough DHB.)
(Steph White, NETP coordinator for Capital & Coast DHB.)
( Sally Houliston, nurse consultant workforce for Hawke’s Bay DHB.)
The CV template on the ACE Nursing website is recommended as a good guideline for what a CV should include.
If you are applying for a Nurse Entry to Practice (NETP) or New Entry to Specialist Practice (NESP) graduate training programme through the ACE process, the documents to be submitted as part of the online application include:
Full details of the ACE application process and the CV template and other resources are available at https://nursing.acenz.net.nz.
]]>The National Nursing Organisation group (NNOg) decided in late 2016 that it would be useful to host a strategic planning day to look at the rapidly changing future and address the goals of the New Zealand Health Strategy. The Office of the Chief Nursing Officer provided significant support in arranging the 20 April forum in Wellington that was generously facilitated by a Ministry of Health staff member.
Those invited included all members of the NNOg, all members of Health Workforce New Zealand’s (HWNZ) Nursing Governance Taskforce for Nursing and a range of nurse leaders from different practice and service locations around the country. Medical colleagues and consumers were also present. We were limited by space so regretfully could not invite all of the possible candidates. But the strategy day was regarded as just a beginning conversation that will now be developed more extensively and in an inclusive manner.
The strategy day began by reviewing the significant achievements of the last decade including the developments in postgraduate education, the move to nurse prescribing, the passage of the Health Practitioners (Replacement of Statutory References to Medical Practitioners) Bill, establishment of the nurse practitioner role and much more. (I also personally acknowledge here the many nurses currently working under intolerable pressure who may not be in any way affected by these achievements.)
The 2016 Health Strategy has a strong emphasis on primary prevention and early intervention to ensure New Zealanders live well, stay well, get well. Key drivers of this strategy are persisting inequalities, a growing and ageing population, and the need to support people to be active participants in their own health care.
The purpose of the day was to consider what the 2030 world would look like to a healthcare customer and how policy direction and the Health Strategy could influence this.
The discussion was stimulated by a number of the presentations, particularly those focusing on the exponential rise in technology. It is clear that there will be significant changes in who provides services and how they will be provided.
The day was separated into two parts:
The extensive deliberations of the day are still being analysed and a fuller report will follow after the NNOg has considered the analysis on 7 June.
However, in brief, nurses present recognised the:
Nurses present noted that:
A tentative conversation was started about what we need to do differently. This is a conversation that will be continued with urgency.
Professor Jenny Carryer is executive director of the College of Nurses Aotearoa and chair of the NNOg.
]]>I am aware that many of my Filipino registered nurse colleagues working in the aged care sector here have enjoyed and done remarkably well with their nursing roles – which absolutely contradicts the idea of them being deskilled. I believe that the statements made around deskilling my fellow Filipino nurses, appear – though maybe not intentionally – to be short-sighted and don’t reflect the New Zealand healthcare system and areas of nursing practice here, particularly gerontology nursing.
Aged care nursing is specialty practice, but it is not a common career pathway for Filipino nurses nursing in the Philippines. Although gerontology is integrated into the Philippines’ nursing curriculum, post-registration nursing experience in the Philippines focuses on acute care provision in hospital settings.
Gerontology nursing is uncommon in the Philippines for cultural and economic reasons. Filipino families primarily look after their elders in their homes and, apart from that, there are more acute and pressing health issues on the country’s healthcare agenda resulting in a different healthcare delivery focus.
There is huge nursing autonomy in aged care and that professional responsibility is underpinned by good nursing knowledge, skills and attitude.
My responses to the ‘deskilling’ comments are based both on my actual nursing experience and accounts from fellow Filipino nurses working in the aged care sector. I did not feel deskilled when I first started working in aged care back in 2011; instead I felt challenged by the complexity of this care environment that taught me to regularly carry out comprehensive nursing assessments so I could make the sound nursing care decisions that were critical to the care I provided. I indeed got to apply the skills I had gained from my acute care and emergency nursing background.
There is huge nursing autonomy in aged care and that professional responsibility is underpinned by good nursing knowledge, skills and attitude. My Filipino nursing colleagues working in aged care have progressed to senior nursing positions, and some hold managerial roles in aged care at a national level, a clear skill progression from novice to expert status. And they have a professional status that is far from being deskilled.
While I acknowledge that every Filipino RN has different experiences of working here in New Zealand, that is not a reason to devalue skills applied in one nursing practice setting or specialty when compared with another.
I am also aware that some Filipino registered nurses work as healthcare assistants (HCA) here in New Zealand; this is not an issue of being deskilled but is a separate, socio-political circumstance brought about by factors such as awaiting nursing registration or complying with state registration requirements.
Also, based on conversations I’ve had with Filipino RNs working as HCAs in aged care, working as an HCA is not viewed as a deskilling process at all. I’ve asked them where they want to work after registration and they all want to come back as RNs in aged care.
Perhaps it is a matter of career choice, rather than one of being deskilled. Yes, there are issues in aged care, such as low pay and difficult working conditions, but these are not new or unknown to other nursing work environments around the world. I believe that nursing skills and education are best judged not by where a nurse practises, but by how they apply their previous nursing knowledge and background to their current practice setting and their ability to provide professional and safe nursing care.
Author: Dr Jed Montayre is a nursing lecturer at AUT University who came to New Zealand from the Philippines in 2011 and began his New Zealand nursing career in the residential aged care sector.
]]>As a third-year nursing student, I had the pleasure of completing my elective placement in the Hokianga, working on the ward alongside a supportive group of health professionals. This placement is unique as the ward nurses are also responsible for running the emergency room if a status one or two patient arrives.
On my second day of placement, a lady in diabetic ketoacidosis (DKA), presented to the emergency room. She was brought in by her family and was unconscious. The nurses and doctors arranging her treatment plan asked me to assist in her care and I took up the opportunity.
At first I thought to myself, “This is extremely different from reading it in a case study or book.” I also felt quite out of my depth. But after speaking with the charge nurse, I felt very confident that I could carry out the designated assessments. My role included taking 15-minute observations and blood sugar level readings and transcribing these onto the board, preparing saline flushes, gathering equipment for catheter insertion and IV fluids and, most importantly, speaking with the patient’s family.
I think this patient had been in DKA for a long time before she was brought to the hospital. I also think the family didn’t understand what was happening to the patient or how serious this condition can be.
The patient was not responding to the treatment provided and needed to be transferred to a bigger hospital – a two-hour ambulance ride away. I felt a helicopter transfer might have been more beneficial because of the risks a long ambulance journey might pose to the patient, but fortunately she arrived safely.
On reflection, the positive learning experiences from this emergency were that the DKA protocol was being followed, everyone worked as a team, and decisions were made as a team. There was a designated leader right from the beginning, which helped to facilitate the patient’s care and everyone had a specific role.
If a similar situation arose, I would again take the opportunity to participate. What I might do differently is ensure that the family understood what was occurring right from the beginning, and explain to them more about the seriousness of DKA.
I believe that as students we should embrace such opportunities during clinical placements, as these can provide perfect learning situations and environments to enhance our teamwork skills, even though they take us out of our comfort zones. Remember, we are supported throughout our clinical placements so we can practise safely within our scope and can begin to build a professional foundation for when we too are registered nurses.
]]>This is not an uncommon scenario for a postoperative patient on a surgical ward. However, for me this was a new experience. No longer was I the eager third-year student trying to lend a helping hand wherever possible. This time, I was the patient.
When I reflect on all I have learnt so far about being a nurse and providing care, I think my experience as a patient taught me one of my most invaluable lessons. As I lay there on the floor that day, I could truly understand how vulnerable it can feel to be a patient.
My experience reminded me of the time I was involved in the care of Rachel* a healthcare assistant of 20 years. Rachel really struggled with the concept of being the patient. She cried as she explained to me that she had always been the one to provide care, and was struggling to accept help. She hated the fact that she could no longer go to the toilet without some assistance. She felt extremely vulnerable.
From day one of our nursing education we are taught that patient-centredness forms the foundation of care. We are taught that in order to provide the best care possible we need to form partnerships with our patients – partnerships based on empowerment and active participation.
When I was a patient, it was important to me that I was informed of my own treatment plan. So when my nurse promptly explained why I had fainted and what they were going to do about it, I felt understood and empowered.
To Rachel, being an active participant meant doing as much of the care as possible for herself. It was therefore our responsibility, as providers of care, to enable and support her independence. It was important that we recognised what mattered to Rachel.
I now better understand the significance of the nurse-patient partnership and how empowering it is to be an active participant in your own care. I consider learning this lesson to be the silver lining of my patient experience, and I hope it will enable me to provide more empathetic, individualised care.
*Not her real name
]]>Comfort and practicality saw dresses give way to tunics and trousers, then loose-fitting scrubs or scrubs-style uniforms became increasingly popular. And not only for nurses.
Patient confusion was one of the reasons why the nursing leaders of Waikato and Auckland District Health Boards decided a few years ago to shift away from a generic scrubs look and single colour uniform.
“You couldn’t tell who was the registered nurse, the charge nurse or who may have been an administrator or even a cleaner,” recalls Sue Hayward, chief nursing and midwifery officer at Waikato DHB.
Margaret Dotchin, chief nursing officer at Auckland DHB had similar concerns.
“We heard from our patients that they didn’t always know who was who.”
Along with being able to better identify at a glance who was a healthcare assistant and who was the senior nurse on the ward, Dotchin and Hayward say they were also seeking a more professional look for their nurses.
“A new uniform is a small, but important part of raising professional standards not just for nursing but for Auckland DHB as a whole,” Dotchin wrote in a DHB blog in October 2014.
Selecting a new uniform that is comfortable, practical, affordable, professional, and acceptable to most staff, was not a simple or speedy process for either board. What you get to wear to work each day is naturally a topic nurses have strong and diverse views on.
Some of these views have grabbed media attention over the years, including a “Please don’t take away our scrubs” petition started at Auckland District Health Board, a “Mickey Mouse outfit scrubbed” headline in the Waikato Times and “Some nurses unwilling to wash uniforms” in the Otago Daily Times (after ED nurses had to swap DHB-laundered scrubs for take-home uniforms).
Reaching a consensus on a uniform that suits everyone is always going to be difficult, says Dotchin. But the Auckland DHB was keen for its nursing and midwifery workforce to have a say on uniform styles.
Dotchin and a group of nurses and midwife representatives worked with their chosen uniform supplier and came up with three options regarded as breathable, hard-wearing and easy-care.
The next step was having about 30 nurses, midwives and health care assistants trial the uniform so staff could see the options in action and also test how practical the uniforms were for carrying out the duties required of them.
Staff got to see the styles on the ‘runway’ in a series of roadshows, plus a special Grand Round fashion show, before voting on their preferred option. Dotchin says it received more than 2,300 responses on the proposed uniforms and 1,500 votes on the colour choices. The feedback led to the uniforms being restyled and a second trial taking place.
“Taking the time to involve nurses and midwives in our design, listening to feedback, making adjustments and then allowing some choice in design was an important part of the process,” says Dotchin.
Board feedback included the 420-signature “Please don’t take away our scrubs” online petition that argued scrubs did look professional if fitted and were closely linked to the nursing identity. “A good looking uniform which is practical, comfortable and able to be kept clean makes a huge difference in promoting team cohesion, pride in who we are, personal discipline and staff morale,” said the petition.
Dotchin said when the board heard that some people were very attached to the scrubs-style uniform they currently wore, it went back to the uniform suppliers and came up with a new option that is more like a fitted scrubs-style tunic top.
The new uniform decided on has three tunic top options for female nurses (cross-front, collared or zip front) and, based on feedback, just one option for males (a fitted-scrub style tunic). There are also two trouser options for males and three trouser options for females. Auckland opted for three colours to help patients distinguish who was who: light blue for health care assistants, dark blue for nurses/midwives and dark grey for senior nurses/midwives.
Dotchin says the board took its time with its decisions, and she is really pleased with the process and the resulting options that she looks forward to seeing staff wear later this year.
Updating Waikato’s nursing uniform was initiated by Hayward about four years ago.
One of the most important lessons she says she learnt along the way was that the relationship developed with your uniform company is “incredibly important”.“We couldn’t have been able to be as flexible and as responsive to nurses needs if we didn’t have that relationship.”
Feedback from nurses wearing the first version of the new tunic and trousers uniform saw them change the fabric, add extra colours, change the cut of trousers and add more trouser options.
Hayward says nurses didn’t like the feel of the first fabric used or think it was fit for purpose. “We’ve finally got a fabric that actually washes well and irons well. We’ve got a fabric that is beginning not to fade and we’ve now got a uniform that doesn’t fall to pieces after a few washes.”
Hayward was very keen for the uniform to identify the role of the person wearing it. Waikato opted for one style of tunic in initially just three colours: green for enrolled nurses and different shades of blue for registered nurses and charge nurse managers.
But Hayward says it then began to see needs for other groups of nurses to stand out – this time not for patients but other health professionals on the ward. So it added trim in another colour to the uniform of the Patient At Risk (PAR) team nurses so people on the ward could quickly identify a PAR nurse arriving in response to an emergency.
It also created the ‘red coats’ – a red tunic for associate charge nurse managers in large units like ED, intensive care or the neonatal ward – so a doctor, nurse or other health professional arriving through the door of a large unit like ED, intensive care or the neonatal ward can quickly spot and find what are now known as the ‘red coats’. (Theatre staff still wear standard scrubs but now have different-coloured disposable hats to distinguish the different roles.)
Hayward says the collared tunic option chosen (one option for women and one option for men) allows movement and includes side pockets. The three trouser options now include elasticated versions but with a cut she says that is both comfortable and smart.
The biggest tension at Waikato was over the uniform options for the paediatric ward. The Waikato Times back in 2014 reported paediatric nurses’ disappointment at being expected to wear the new blue tunic and no longer being allowed to buy and wear their own cartoon-patterned scrubs to work.
Hayward says there were “many, many discussions” on the topic including whether the new tunic could be in a cartoon style fabric for paediatric nurses. “What was difficult was to source fabric that was going to be cost-effective and was able to be washed at the temperature required.” Eventually the board decided to go with the standard blue tunic for all registered nurses.
From start to finish the uniform selection and ward-by-ward rollout took about two and a half years. The DHB is now rolling out a new and different style uniform for healthcare assistants – a tailored scrub-style top in burgundy.
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