Doing a scan of the nursing landscape shows some changes but much still as it has been for the past decade for nurses:

The Health Promotion Forum of NZ put out an interesting read on the Challenges and Opportunities of Primary Care. The paper identifies 8 areas of change:(the italics are mine)

• A reduction in the number of PHOs (by about half)………………………………………………………mostly done

• ‘Better, sooner, more convenient’ primary care (emphasizing the devolution of services from hospitals into the primary care sector)                                                                   …………………………..……………………..in progress

• Increased clinical governance and leadership in decision making…………………………………..not evident yet!

• Changes in funding, generally less dollars but possibly greater local flexibility……………..…..certainly seen the “less dollars”- no sign of the “greater flexibility!”

• Establishment of ‘integrated family health centers’ (IFHCs) ……………………………………………activity visible around the country but variable and not always inclusive of clinical leaders

• The development of ‘Whānau Ora’ services ………………………………………………………………….little effort has been made to intergrate these services with existing provider services; until this is occuring the services may remain fragmented and ineffective

• Changing approaches to service contracting………………………………………………………………..this one may prove problematic for nursing services- without being able to influence planners and funders, nursing services contracts may be put out to tender to funders with little understanding of the PHC environment

• A reduced focus on public health services…………………………………………………………………...this is somewhat alarming considering the PHC Strategy’s focus on population health- how can we have a strong primary health care environment without good public health services?

This week the NZ Government has finally agreed to include delegated prescribing into the legislation.

More changes ahead with Danny Wu’s resignation from his position at the Ministry of Health as the national programme manager for the Primary Health Care implementation. His presence in the Ministry has spanned a decade, so much institutional  knowledge will be lost with his leaving. The part that concerns me is that within the statement from the MoH they said that “A decision is being made over the next month on the future management of the primary health care programme”. Guess we can only watch, wait and sharpen our lobbying tools.

The NZ College of Primary Health Care Nurses, NZNO have started a facebook page- check it out and contribute to the discussion on kiwi nursing.

Can anyone tell me why this is so?

Every smeartaker should be able to complete the second phase of a smear- the bi-manual exam. It is not rocket science. It is a technique like many others nurses do- invasive- yes but you are already down there anyway! But not dangerous.

Makes me wonder who designed the original smeartakers courses in the first place?

Still on the PHC subject- practice nurses overthere have got the marketingthing going on..check out this website for information on Practice Nursing

P.S….Note to self- don’t leave it so long between blogs- you will get out of practice and lose what edge you have….