GUEST BLOG: Ian Powell – Calling out Health New Zealand for intimidation of nurses

Hospitals, whether public or private, are places overendowed in skill, dedication, compassion and kindness.

They are also places that depend on an embedded culture of teamwork both between different health professional occupation groups and between health professionals and hospital management.

Intimidation in whatever form is contrary to everything Aotearoa New Zealand’s public hospitals stand for. The greater its prevalence the more difficult it is for this essential teamwork culture and for achieving consistent quality patient care.

During my lengthy ‘tour of duty’ as the Association of Salaried Medical Specialists executive director I was aware of management intimidation occurring.

But, by a ‘country mile’, it was the rare exception; nowhere close to ‘business as normal’. When it did occur, however, it needed to be called out. But it was not a defining feature of district health boards.

Exposing intimidation

Journalist Denise Piper exposed intimidation of nurses at Whangarei Hospital

This is why the health system, and the wider public, should be grateful for Northern Advocate multimedia journalist Denise Piper exposing unacceptable intimidation by Health New Zealand – Te Whatu Ora management towards nurses at Whangarei Hospital (4 April): Management intimidation.

Piper begins her article as follows:

Whangārei Hospital nurses have been told stickers are a health and safety risk, in the latest move of a bitter industrial dispute between the NZ Nurses Organisation and Health New Zealand.

The two parties had been negotiating for about 18 months on a new national collective agreement. Safe staffing levels was, and remains, a major sticking point in these still unresolved negotiations.

In support of safer staffing, Northland nurses had taken strike action in October along with partial strikes (restricting some duties).

Nurses union delegate Rachel Thorn reveals management intimidation

Piper reports Whangārei Hospital union delegate Rachel Thorn revealing that nurses now felt like they were being scared by management threats to report them to the Nursing Council.

The role of union delegates such as Thorn is vital to our health system. Among many other functions, they enable nurses to collectively speak truth to power without making themselves personally vulnerable.

Management’s threats were in response to Whangarei Hospital nurses highlighting the need for safer staffing and other improved conditions.

They were taking part in a “uniform strike” by wearing bright garments instead of their usual scrubs while still working. Mild perhaps; but certainly novel and eye-catching.

To help explain the change in uniform to patients, the nurses put up posters and wore stickers saying ‘striking for safe staffing’.

Resorting to the ‘fear of God’

Rachel Thorn reported that posters were removed from the wards. More seriously, nurses were told by management that they could not wear stickers and, if they did, they would be reported to the Nursing Council.

In Thorn’s words:

A manager stated basically, ‘if you don’t stop wearing that sticker, I will report you to the Nursing Council and you might lose registration’.

Management trying to use Nursing Council is intimidatory towards nurses

The Nursing Council is a regulatory authority established under the Health Practitioners Competence Assurance Act. It is the largest authority.

It is the statutory authority that governs the practice of nurses, ensuring that they meet standards for public safety. A nurse can’t lawfully practice as a nurse without being registered with the Council.

Along with the authority to register nurses, the Council also has the authority to deregister them (struck them off).

Fear of God used to intimidate Whangarei Hospital nurses

This is a powerful threat that would easily make even the strongest nurse’s knees likely to wobble a little at least. It is an attempt to strike the ‘fear of God’ into someone.

The Nursing Council as a responsible statutory body would reject outright such a spurious referral to it. Regardless, should Health New Zealand proceed with its threat, this would cause unjustified anxiety and stress among those targeted nurses.

Thorn is right when, in her reported comments, she said that these “heavy-handed tactics” were because Health New Zealand “…did not want the public to know safe staffing levels had not been met in the hospital.”

She also noted that the threats did have an effect. Some nurses pulled out of the limited industrial action over fear of losing their job.

A very long bow management defence

Health NZ’s Alex Pimm claims they are only reminding nurses of their responsibility to their regulator. Come on!

Health New Zealand’s Te Tai Tokerau (Northland) Group Director Operations Alex Pimm argued that NZNO notices of industrial action involved:

…NZNO members refusing to comply with Health NZ policies, instructions, rules or requirements relating to public statements or actions relating to collective bargaining or strike action.

This includes requirements prohibiting visual union stickers, badges, clothing, signage, placards or flags.

He argued that:

This means taking reasonable precautions to reduce infection prevention, and health and safety risks, in our hospitals and services.

For example, we have asked staff not to wear stickers on their uniforms or clothes as this can help spread infection or come loose when providing patient care.

This is the basis of Health New Zealand’s threat of reporting nurses to the Nursing Council for wearing the stickers; the purported risk of infection to patients as a result of wearing stickers that were embarrassing for an employer’s failure to address safe staffing! Talk about drawing a long bow!

These are the same nurses for whom protecting patients from infection risk is a key part of their daily duties while working in an unsafe environment. If anyone knows whether wearing a sticker posed an infection risk it is these nurses.

How is it that these nurses can be trusted by management not to put patients at risk of infection when they do their normal duties and responsibilities, but can’t trust these same nurses when wearing stickers in an industrial dispute that just happens to embarrass their employer? Go figure!

Intimidation or weaving?

Intimidation is a word that is sometimes loosely thrown around without regard to its specific meaning. But its meaning clear.

Intimidation is an act or course of conduct directed at a specific person to cause that person to fear or apprehend fear; this might be to force that person to take an action they do not want to take.

The more intimidation becomes part of ‘business as normal’, the more it becomes part of wider leadership culture of bullying.

Te Whatu Ora should be about weaving the strands of our health system, not intimidating some of them

Health New Zealand’s indigenous name is Te Whatu Ora which means “the weaving of wellness”. The intent is to encapsulate the importance of bringing together people, services, and resources to improve health outcomes and equity.

This intent resonates with what the culture of health systems, including for their workforces, should all be all about.

However, intimidation of nurses such as experienced in Whangarei is opposition to and undermining of this noble name.

It is time for Health New Zealand to listen, learn and act by weaving, not intimidating. It is also time to repair its damaged relationships with the nurses it employs and benefits from.

 

 

 

Ian Powell was Executive Director of the Association of Salaried Medical Specialists, the professional union representing senior doctors and dentists in New Zealand, for over 30 years, until December 2019. He is now a health systems, labour market, and political commentator living in the small river estuary community of Otaihanga (the place by the tide). First published at Otaihanga Second Opinion.