It’s not something that’s publicised, and it’s not something the health professions are comfortable discussing but, just like the rest of the population, we have the potential for mental illness and substance abuse – given the casual familiarity with medications (which reduces the taboo nature of narcotics and tranquilisers), the rate of musculoskeletal injury associated with manual handling (which often necessitates taking prescribed narcotics and/or muscle relaxants like Valium), easier access to prescription medications than the general public, and a culture that normalises post-work drinks as a way of reducing stress and facilitating team bonding, the incidence of substance abuse is possibly higher among nurses and midwives than the general public
And, just like the rest of the population, this can result in an impairment of job function, as well as having a significant impact of our relationships and the rest of our lives. Of course, in our jobs this can mean doing serious harm to those vulnerable people entrusted to our care.
Bear with me – the next couple of paragraphs are a little dull, but necessary. The Nursing and Midwifery Board is tasked with protecting the public from nurses and midwives, by ensuring that those of us registered to provide care are appropriately qualified, have adequate communication skills, maintain education and knowledge to keep up with changing technology and requirements, are not criminals, and by addressing complaints and concerns from the public. A requirement of registration is the completion of an annual questionnaire that requires a declaration (with statutory weight) that applicants have adequate recency of practice, sufficient on-going education to meet the minimum requirement of 20 hours per year, have no criminal charges pending or convictions filed, and have professional indemnity insurance. Every year ten percent of nurses and midwives will be audited, to ensure compliance with these requirements. Their role is not to look after nurses and midwives, or the profession – it is to police the profession and safeguard you.
Two years ago the individual state and territory nursing and midwifery boards were combined into a national board, as part of the development of the Australian Health Practitioner Regulation Agency. AHPRA oversees the registration of fourteen health professions, allowing easier communication across state lines and national standards.
Prior to the move to AHPRA each state board had leeway over how it handled potential issues. In consultation with experts, in 2006 the Victorian Nursing and Midwifery Board introduced the Victorian Nurses Health Program. Designed to support and assist impaired nurses and midwives, VHNP (now NMHPV) was funded through registration fees and focused on returning impaired nurses and midwives to safe practice. Most importantly, it gave impaired nurses and midwives somewhere to seek help without worrying about penalties, and allowed concerned colleagues to report staff they thought might be impaired without worrying about risking their registration.
This last part is crucial – it means our profession is better regulated from within, allows faster intervention (often before any harm is done), and ensures a focus on rehabilitation instead of punishment. It is a program that is extraordinarily cost-effective, proven, supported by the people whose registration pays for it, that encourages nurses and midwives to come forward and seek assistance. The alternative risks the lives and wellbeing of nurses, midwives and their patients.
This week the Board announced plans to cease the program, which costs $6 a year for each registered Victorian nurse and midwife. We don’t penalise our patients for being human, yet the NMB is prepared to end the careers of nurses and midwives, instead of helping them.
We cannot afford, as a profession or as a community, to lose valuable, qualified, skilled nurses and midwives who have a temporary, resolvable substance and/or mental health issue.
Our registration fees have jumped by almost three and a half times in under a decade – considerably higher an increase than our pay. Nurses and midwives support the program that cares for our profession, our colleagues and (potentially) any of us. We don’t stigmatise these issues in our populations – we ought, as a profession, but at least as kind, understanding, and supportive of ourselves. At a time when unprecedented, global nursing and midwife shortages are forecast by 2020, maintaining this program makes not only human and professional sense but economic sense.
Please sign the petition (link) to save NMHPV funding. We need not to cut or limit it but expand it, and extend it federally – every dollar spent is hundreds saved in training, orientation and experience costs, and allows us to retain some of the best of our profession.