The New Zealand Anaesthetic Technicians’ Society (NZATS) would like to thank our nursing colleagues for their views in relation to the review being conducted by the Medical Sciences Council (MSC) into the anaesthetic technician (AT) scope of practice. While the message portrayed by the perioperative nurses is nothing new and was not unexpected, it does allow us the opportunity to share our views, relay some context and correct some misinformation.
It is true the review is looking at expanding the areas in which ATs can provide patient care. However, two of these are already considered part of the expanded scope of practice — PICC (peripherally inserted central catheter) and PACU (post-anaesthesia care unit) practice. These pathways have been supported with comprehensive additional training. Yet, despite having these pathways available, a review of the current AT workforce shows the number of registered ATs who have taken up this opportunity is low and has largely not replaced the nursing workforce in those areas.
All health-care professionals are under stress, but by working together, sharing ideas and skills, we can achieve better outcomes for the people of Aotearoa.
There is a huge discrepancy in the number of staff registered in our respective professions. The Government recently stated that about 8000 nurses registered for the first time in New Zealand last year. Compare this to the less than 150 newly registered ATs in the same timeframe.
It is staggering that there is still the belief that our workforce would ever replace nurses — be that in an operating room or elsewhere. With nearly 70,000 nurses in the national workforce, compared with 1200 ATs, the nursing profession is not at risk of losing its foothold in any area of the hospital.
Over this timeframe there has also been a small group of RNs who have completed RNAA (RN assistant to the anaesthetist) training across the country, having had appropriate support, often from their AT peers.
Both Te Whatu Ora and the Ministry of Health are promoting the need for a flexible workforce to help overcome the staffing crisis that all health-care professions are facing. Being able to share workloads in areas of stress may eventually help reduce waiting list times and ease the level of burnout felt by all members of the operating theatre team.
ATs have been trained for more than 40 years with an increasing level of higher education pathways, to now stand on par with nursing educational pathways.
All health-care professionals are under stress, but by working together, sharing ideas and skills, we can achieve better outcomes for the people of Aotearoa.
There is no suggestion in the review that graduates of the health science degree in perioperative practice will be placed in roles that are outside our current prescribed AT scope of practice as soon as they graduate. Their course work still has a heavy focus on anaesthetic assistance and any scope expansion will likely require additional support and training during a supervision period after graduation. This would be no different to the current process for new graduate nurses entering the perioperative field. They undertake new-to-operating-room programmes, as nursing students are given limited time in perioperative care during their undergraduate training.
It is disappointing that the perioperative nurses define themselves as the “trusted, safe and educated workforce”. ATs have been trained for more than 40 years with an increasing level of higher education pathways, to now stand on par with nursing educational pathways.
The fact that we are a lesser-known health-care workforce due to our lack of numbers does not make us less safe or educated. A three-year degree with clinical placements provides our future workforce not only with the clinical knowledge to provide safe patient care in the perioperative environment, but also allows them to learn the reflective and critical skills that are expected of all health-care professionals today.
NZATS is saddened and disappointed that this siloed mindset of nurses-versus-techs still exists, when we should be working together in our multidisciplinary teams to best service the needs of our patients.
Much mahi has been done to achieve a flexible and resilient workforce, for now and into the future — a goal stated by Te Whatu Ora in its health workforce plan 2023/24.
The potential changes to our name and scope reflect this mahi and signal a start to addressing the health workforce crisis. This is not about taking the jobs of another health-care profession, but rather sharing a goal of patient care through teamwork and the efficient use of available and suitably skilled resources.
Matthew Lawrence,
President, NZ Anaesthetic Technicians’ Society