There was also a lack of “effective or meaningful” consultation with stake holders such as NZNO or the Nursing Council. Other nursing leaders had also expressed concern at this “devaluing of the nursing role in this critical phase of COVID-19 management”, Weston said.
Concerns related to how regulated vaccinator nurses would be responsible for supervising up to six unregulated vaccinators, as well as the devaluing of nurses by substituting them with unregulated practitioners.
NZNO – a key stakeholder – had not been directly consulted on embedding unregulated vaccinators, which would require legal and regulatory changes, she said. Only in mid-May was there a chance to feed back on the proposal, with only a few days given by the Ministry of Health (MoH) – a process she described as “lip service”.
NZNO was highly supportive of the COVID-19 vaccination programme, but would prefer unregulated staff to support whānau, facilitate education, manage patient flow and other supporting roles rather than the vaccinating itself, Weston said.
Describing the vaccination programme as a way of providing “entry-level” health roles to Māori and Pacific people, “exemplifies the abject failures to ensure the Māori and Pacific communities are properly supported with quality health services”, she said.
NZNO remained committed to a safe and effective roll-out of the COVID-19 vaccination programme and working with the MoH to achieve this.
Unregulated staff risks
No consultation, no idea of the training regime, but lots of responsibility – an unregulated COVID-19 vaccination workforce has set off alarm bells for NZNO kaiwhakahaere Kerri Nuku.
“You’ve got an unregulated workforce that is being trained to do a specific task – and the task isn’t just taking a blood pressure, the task has significant ramifications if somebody has an anaphylactic shock,” she said.
Registered nurses (RNs) would have to take responsibility for any unregulated staff working underneath them. “Unregulated staff don’t have indemnity. So ultimately who becomes responsible… is the RN – so their practising certificate is on the line.”
There was always a need for unregulated kaimahi in health services – linking with communities, providing support and education, she said. However, NZNO was concerned COVID-19 was an excuse to roll out an unregulated workforce, and devolve nursing responsibilities to this workforce.
It would place the burden of a nursing task on kaimahi in Māori health providers – already at the bottom of the pay scale.
Some Māori providers might have welcomed the move – but that viewpoint came from a management position, not from the nurses, Nuku said. “And when somebody’s had an anaphylaxis, they’re [the manager] not going to be there to hold the nurse’s hand – the manager’s going to be trying to free themselves of any blame or responsibility.”
It appeared there were no details yet on what the training programme would look like, she said. “And given that they haven’t consulted with us, as the largest group of health-care workers’ representation, that’s a real concern.”