Chair Steve Kirby said he estimated fewer than 40 per cent of nurses working in ICUs in New Zealand were fully qualified. This is despite the College of Intensive Care Medicine (CICM) of Australia and New Zealand guidelines which recommend at least 50 per cent of ICU nurses hold a post-registration intensive care qualification.
“It’s been an ongoing issue for 15-20 years, when the first set of guidelines came out that every ICU should have a minimum of 50 per cent qualified nurses, and preferably 75 per cent,” Kirby said. “In New Zealand, most ICUs have, at best, is 40 per cent.”
Gaining a post-graduate qualification was time-consuming – taking a year to complete part-time – expensive and difficult to access, he said. It was offered by three universities in New Zealand – Auckland, Victoria (biennially) and Otago – and by some district health boards (DHBs).
Nor was the content consistent or transferable, which needed to change, Kirby said.
“It’s time-consuming, difficult to access because of the funding and a lack of consistency in the type of courses and hesitancy across ICUs to recognise each other’s training.”
The college wanted an agreed set of knowledge, skills and competencies across all training providers, whether tertiary institutes or DHBs, and “far greater collaboration” to allow nurse qualifications to be recognised across all ICUs.
In-house training was preferable, as it allowed technical skills to be learned at the bedside rather than in a classroom, and was also easier for rural hospitals, Kirby said. But an agreed qualification could be a combination of ICU hands-on, online and/or classroom learning, he said. “We want quality and transferability. If they do it in one part of the country, it should be recognised in another.”
The college had been discussing the plan with the chief nurse, and was keen to build momentum to see an agreed qualification within the next one to two years.
“Our vision is to set up a working group to ensure each of the courses meet the standards required, so it’s completely transparent,” Kirby said.
Recognition of work
“It’s pressing for us because it’s the recognition of the work and time and effort our nurses are putting into ICUs now.” While it would not impact on salary, which was governed through NZNO’s multi-employer collective agreement steps, having recognised qualifications would support ICU nurses’ career progression into more senior roles.
COVID-19 had highlighted the problem, but it was not a new one. “It’s been drive by the current climate but simmering away as an unmet need for a long time and it’s about time we started to sort it out.”
The college was in the process of updating its 2014 critical care nurse staffing standards for “safe, quality, patient-focused care” in line with the CICM and international recommendations.