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Nurses front and centre delivering equity in health care

Wednesday, May 12, 2021

Feature

By Jackie Edmond

Chief Executive, Family Planning

2021 is a notable year for those with an interest in sexual and reproductive health. It’s 60 years this year since the contraceptive pill became available in New Zealand. It’s hard to imagine now – with the contraceptive options we have available – just what a change the contraceptive pill precipitated in women’s lives. It was truly revolutionary. Just 25 years earlier, Family Planning was founded in response to a dearth of sexual and reproductive health information and services.

For 85 years we have been providing sexual and reproductive health services which have evolved and expanded over that time. Since 1936, we’ve been innovative in delivering services, increasing access to care, and reducing inequity. And in large part, we’ve done this by recognising the value of nurses and supporting them to undertake advanced education and training to be able to work at the top of their scopes of practice in this area of health care.

Chances are, if you’ve had an appointment at one of our clinics, you were seen by a nurse. More than 80 per cent of the consultations at our clinics are undertaken by a nurse. These nurses work at the top of their scope – inserting IUDs and implants, taking cervical screens, and providing abortion services at our Whangarei and Tauranga Clinics. Many are prescribing in their own right as registered nurse prescribers and some are nurse practitioners. Our clinic in Blenheim, for instance, is entirely nurse-run with two nurses providing services to their community.

Let me be clear, this is in no way undermining the phenomenal work our doctors do every day. But, on this International Nurses Day, I want to speak specifically to the work of our nurses and to fully acknowledge their contribution to improving access to services in an area of the health system that is often marginalised.  

Significant change began in 2006, when in response to increasing demand for long acting reversible contraceptives, we made the decision to train a small group of nurses to insert copper intrauterine devices. Every week, our clinicians are inserting some 1500 long acting reversible contraceptives and around half of these insertions are done by our nurses.

In addition to IUD and implant insertions and removals, nurse-led consultations at Family Planning can include: contraception options; contraceptive pill starts and repeats (repeats are often now completed via phone consultation); Depo Provera injection starts and repeats; emergency contraception, including insertion of post-coital IUDs. Cervical screening and STI screening are a large part of our nurses’ daily work, which can also include colposcopy referral and treatment of infections. Family Planning nurses are skilled at pre-natal discussion, pregnancy testing and discussion about pregnancy options. Our nurses are also trained in routine enquiry about intimate partner violence, and manage referrals to specialist sexual violence and domestic violence services.

This is a long list. But in short, the competencies our nurses have today reflect not only what nurses are capable of, but also their value as front-line health care providers.

International Nurse’s Day – celebrated each year on the anniversary of Florence Nightingale’s birth – has a theme this year which positions nurses and nursing as a vision for future healthcare.  There has been quite a bit of media coverage lately about the dire state of women’s health care in New Zealand. Sadly, we agree that we need to do a whole lot more to meet the needs of women in this country. This needs to start in primary care, with health services essential to people with a uterus – like contraception and cervical screening. We cannot overlook the role of nurses in delivering this preventative health care.

Equity in healthcare doesn’t mean providing the same service in every location and hoping that people will find their way to accessing it. Equity in healthcare means providing services in a responsive way – listening to and acting on the voices of these seldom heard communities. I am certain that we will go further and faster towards ensuring equity in health care by better utilising and harnessing the skill of our nursing workforce. Happy International Nurses Day 2021.

Family Planning has clinics located throughout New Zealand. Use the clinic finder to find your nearest clinic.

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