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Supporting Health Professionals through a Career Crisis

Supporting Health Professionals through a Career Crisis. Opportunities or Threats ?. Pauline Cook RN, BN. ADN Competency Review Advisor New Zealand Nurses Organisation. Outline for this session. Information about NZ legislative framework Competence issues or concerns A practise crisis

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Supporting Health Professionals through a Career Crisis

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  1. Supporting Health Professionals through a Career Crisis

    Opportunities or Threats ? Pauline Cook RN, BN. ADN Competency Review Advisor New Zealand Nurses Organisation
  2. Outline for this session Information about NZ legislative framework Competence issues or concerns A practise crisis Pathways to recovery Tools to help nurses maintain their competence

  3. Legislative framework for safety in health services in NZ

    Applies to all health services
  4. Legislation Accident Compensation Act 2001 Health and Disability Commissioner Act 1994 Health Practitioners Competence Assurance Act 2003
  5. Accident Compensation Act 2001 Comprehensive, no-fault personal injury cover for all New Zealand residents and visitors to New Zealand This can include a wide range of services, from: payment towards treatment help around the home during recovery income support to cover the period off work because of injury Develop and Promote injury prevention programmes and strategies
  6. Health and Disability Commissioner Act 1994 Code of Consumer Rights when receiving a health or disability service Provides an independent advocacy service Investigates complaints and possible breaches of the Code Refers to other agencies i.e. Human Rights Commission Ministry of Health Regulatory Bodies such as Medical Council/ Nursing Council
  7. Health Practitioners Competence Assurance Act 2003 (HPCA) To protect the health and safety of members of the public by providing for mechanisms to ensure that health practitioners are competent and fit to practise their professions Registration and practising certificates for health practitioners Competence, fitness to practise and quality assurance Complaints and discipline

  8. Competence issues and concerns

  9. Section 36: When authority may review health practitioners competence Authority to undertake a Competence Review (4) The responsible authority may at any time review the competency of a practitioner who holds a current practising certificate, whether or not – there is reason to believe that the practitioner’s competence may be deficient, or the authority receives a notice of the kind described in subsection (2).
  10. Section 34 Notification that practice below required standard of competence If a health practitioner has reason to believe that another heath practitioner may pose a risk of harm to the public by practising below the required standard of competence, the health practitioner may give the Registrar of the authority that the health practitioner is registered with written notice of the reasons on which that belief is based.
  11. Nursing Council’s responsibility The Council is not wanting to establish who was right or wrong related to the concerns raised, but: They need to determine whether the nurse is safe to practise and/or whether they pose a risk of harm to the public under Section 39 (HPCA)

  12. A career crisis

  13. Competence review This is the nurses’ opportunity to prove to Nursing Council that they are safe to practice.
  14. The career crisis To have your practise examined To have to answer about the reported practise concerns or issues Possible loss of position or employment Feeling Embarrassed Threatened Confused Anxious Hyper vigilant
  15. Competence review of nurses Full day of: Questioning Scenarios Role plays Testing Can be asked anything that is in the nurse’s scope of practice.
  16. Outcome of a competence review The nurse may: No further action Be required to undertake a course of education Be required to meet with a mentor/supervisor for a period of time Be required to undertake a competence assessment in the workplace, once other requirements are met.
  17. Have conditions placed on the practising certificate Such as: May not be the sole registered nurse on duty Must have a Nursing Council approved employer Must practise under the supervision of a Council approved registered nurse May propose to suspend the practising certificate

  18. Information about NZNO members

    Who went through competence review
  19. Nurses/midwives supported by NZNO for competency Year NZNO Members 2004/05 17 2006 14 2007 13 2008 53 2009 61 2010 57 NZNO members 215 Nursing Council reported 346 cases for the same period
  20. Qualifications
  21. Age groups
  22. Length of career
  23. Specialty breakdown
  24. Outcomes Of the 36 reviews attended in 2010 No further action 5 Suspended 2 Requirements 29

  25. Pathways to recovery

  26. Pathways to recovery Remediation of practice issues Following the Nursing Council requirements Seeking supervision/mentorship – even if it is not a requirement Finding ways to reward yourself for your achievements
  27. Once all the requirements are met The nurse returns to normal practice The conditions are removed from the practising certificate There has been lots of learning from the studies The nurse regains confidence The nurse knows that they are competent to practice.
  28. With crisis comes opportunity and new beginnings Decision making time A fresh start to their career Resolve the issues and advance nursing career to a higher level New nursing pathways Career versus developing other interests New career pathways Retirement from nursing

  29. Tools for the maintenance of your competenceand... avoid a career crisis

  30. If you make mistakes Accept responsibility Reflect on ways you would avoid this situation recurring and what you would do differently Immediately seek training or education on the issue Engage in performance management process if you are offered it Get peer support Seek professional support
  31. Show that you are competent by: Maintaining your own self respect Building alliances Learning to negotiate well Support respectful behaviour Reduce negativity over past events Don’t let any lack of confidence be perceived as incompetence
  32. Focus on the basics of trust respect and common sense Be responsible for your contribution in the team Manage stress with humour Support your peers Share your knowledge with others Be helpful and responsive to each other Praise success stories Encourage your colleagues to try new things, to be autonomous and innovative in their practice
  33. Ways to maintain your competency Take responsibility for your career by: Keeping up to date with changes in practice Using evidenced based practice Actively seeking professional development opportunities beyond what employers provide Find a supervisor/mentor to help you reflect on your practice and keep you on track Keep on learning
  34. References Accident Compensation Act 2001 Cook, P. (2009) Facing a Competence Review, Kai Tiaki: Nursing New Zealand, (Vol. 15, Issue 8, Page 26 (1)) Keenan, R. (2010) Health Care and the Law (4th Ed), Wellington, Brookers. Health and Disability Commissioner Act 1994 Health Practitioners Competence Assurance Act 2003 The competence review process, (2008) Nursing Council of New Zealand
  35. It’s an opportunity to improve practice but can be a threat to the health professional’s career Pauline Cook Competency Review Advisor Paulinec@nzno.org.nz 04 494 6393
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