Handover | Issue 35 – July 2016 – Chief nurses office update by Jane Bodkin

The theme for International Nurses Day 2016 was ‘Nurses: a force for change: Improving health systems’ resilience’.Jane Bodkin, senior advisor nursing, Office of the Chief Nurse, Ministry of Health

The International Council of Nurses (ICN) has published an informative and thoughtful toolkit with ideas to encourage nurses and nursing organisations to think about how they influence organisational effectiveness, www.icn.ch/publications/2016-nurses-a-force-for-change-improving-health-systems-resilience.

Nurses are a force for change. As the biggest health workforce, nurses make an enormous contribution by working with people, their families and whānau and their communities. Nurses also work towards service development, in supervising and developing other members of the health team, and in collecting data to inform the development of evidence to improve health systems.

Every decision nurses make in practice can make a difference to the efficiency, effectiveness and resilience of the whole system. Resilience is the ability to cope with life’s challenges and adapt to adversity. Both individuals and organisations can be resilient. A resilient health system is flexible, adaptable and willing and able to learn. A focus on wellbeing and resilience, health promotion and prevention of illness is at the heart of the New Zealand Health Strategy.

Resilience is an important topic in mental health. In the last few years the Ministries of Health, Education and Social Development have established a number of initiatives designed to build resilience in communities. For example Te Rau Matatini and Le Va have developed community led resilience building programmes in Māori and Pacific communities and the Ministry of Education’s Positive Behaviour for Learning programme has been taken up in more than 600 schools.

Mental health and addiction nurses work in challenging situations with people and families who are under stress. Mental health and addiction nurses have the opportunity to support people to develop personal resilience and support resilience in the wider community. For example some nurses use dialectical behaviour therapy in their practice where part of the approach is to empower people to look after themselves better using self-soothing, self-care and mindfulness.

A good understanding of the relationship between our own mental health and its relationship with our ability to provide care to others is important. There is some evidence of links between staff health and wellbeing and patient safety, patient experience and effectiveness of care.

Nurses can reduce their vulnerability to adversity in the workplace by strengthening their own personal resilience. By taking care of ourselves we increase our capacity to be effective in our work with others. Nurses are familiar with the foundations of maintaining wellbeing. However, sometimes nurses are more focussed on caring for others than taking care of themselves. Taking time to eat healthily and exercise, being kind to ourselves, as well as good mentoring and clinical supervision processes in the workplace, all help to increase our personal resilience.

Increasing personal resilience is one component of increasing health systems’ effectiveness. Other systems and processes also need to be in place including safe staffing, supportive team processes and opportunities for supervision. Employers have an important role in promoting resilience by providing a good working environment.

People living in Canterbury are well aware of the impact of adversity on their ability to care for others. Canterbury District Health Board has been resourcing workforce wellbeing for some time. It has introduced a range of wellbeing activities including yoga, free counselling and wellbeing workshops for employees. A Staff Wellbeing Action Group oversees these workshops and provides guidance and advice to People and Capability (formerly human resources) on workforce wellbeing.

As well as the programmes to enhance personal wellbeing of staff they have run a number of workshops targeted at people that are in supervisory/management roles across the organisation. ‘All right?’ is a project led by the Canterbury DHB and the Mental Health Foundation to support Cantabrians to think about and improve their mental health and wellbeing as the region recovers from the earthquakes. There are lots of good ideas on the website that have broader application.

It is in everybody’s best interests to increase personal resilience. Take a look at the all right? website and the Mental Health Foundation’s five ways to wellbeing website for further information.