Chief Nurse backs a strong role for nurses and midwives

The Lamp talks with Professor Debra Thoms, NSW Chief Nursing Officer, about her plans for the role and vision for the nursing profession.

The new Chief Nursing Officer, Professor Debra Thoms, is keen to ensure that nurses and midwives have a strong nursing voice and role in the NSW health system.

In a role that provides linkages between the NSW Health Minister, NSW Health and the nursing profession, Debra will be promoting the importance of nursing   roles at senior levels in the AHS and the need for good leadership and management by nurses and midwives – ‘for the profession and for high quality care’.

Debra was appointed to the position of Chief Nursing Officer in NSW in May 2006. She was previously Chief Nursing Officer in South Australia.

Her role serves as the professional link between the NSW Minister for Health, the Director-General of NSW Health and the public, private and education sectors of the nursing and midwifery professions in NSW. As Chief Nursing Officer, she provides advice to the Health Minister on professional nursing and midwifery issues and on policy issues, monitors policy implementation, allocates relevant funding and manages nursing and midwifery initiatives in NSW and represents the health department on various committees.

Six months into the job, Debra said she is enjoying the role.

‘While the profession is facing significant challenges such as a nursing and midwifery shortage and the increasingly complex care needs of an ageing population, it’s an interesting time for nursing and midwifery,’ she said.

‘I am looking forward to working with the nursing and midwifery profession to ensure we continue to make valuable contributions to the health system. It’s important we work to articulate how we make our contributions to healthcare and demonstrate how nurses and midwives are valuable to the system.’

Varied background provides a broad picture of health

Debra comes to the position of Chief Nursing Officer with a varied nursing background. Her experience has been in cardiothoracic, remote area nursing, midwifery, and nursing education.

By her own admission, the direction of Debra’s career has been unplanned.

‘After finishing school I didn’t know what I wanted to do. Prince of Wales and Prince Henry Hospital, with the University of NSW, was running a combined nursing degree. It sounded interesting and I was able to combine a Bachelor of Arts –majoring in psychology and economics – and a nursing degree.’

On completing her degree, Debra worked at Prince Henry Hospital in the cardiothoracic unit, then went to the Northern Territory where she worked in remote area nursing and in education and management roles.

‘I achieved midwifery qualifications while I was working in the Northern Territory – the varied experiences made it an interesting place to do midwifery,’ she said.

Debra’s career then steered to nursing management when she moved on to a position as Assistant DoN at Royal Darwin Hospital.

Back in NSW, Debra undertook a Masters in Nursing Administration.

‘From there my career moved in an upwards direction in nursing management.’

There was a stint as Deputy DoN at Manning Base Hospital in Taree, before Debra moved to the Royal Hospital for Women – first as DoN, then Executive Director of the hospital.

‘I was then appointed CEO of Macquarie AHS – as it then was.’

In 2004, Debra moved to South Australia to take up the position of Chief Nursing Officer in South Australia, leading to her current appointment as Chief Nursing Officer in NSW.

‘My varied background has given me a broad-based picture of health,’ she said.

‘I believe I have an understanding of and empathy with the different situations in which people find themselves delivering healthcare.

‘With a good basic grounding in nursing, those principles can be applied across a range of settings. For example, when I was working in remote areas, I drew on my basic training even though I was inexperienced at nursing in this setting,’ she said.

Since her early days in nursing, Debra has been a member of the ANF and NSW Nurses’ Association.

Role and training of ENs

Debra welcomes the national review of EN education and the move to a national standard for EN education being undertaken by the Community Health Industry Skills Council.

‘The entry qualification for ENs currently differs between the States and Territories. Once signed off, there will be national standards in place. The changes in the Health Training package will provide ENs with greater opportunity to study in specialised areas,’ she said.

‘The role of ENs has shifted significantly in past 10 years. Their theoretical knowledge has expanded and their clinical practice has changed along with the theoretical changes.

‘The expansion of the EN role parallels developments in the RN workforce. ENs are now educated and it’s a role that has a broader scope of practice.

‘We need to consider how to best utilise their enhanced skills and capabilities.’

Maintaining a strong nursing voice in AHS restructure

Mindful that her role does not get directly involved in industrial relations issues, the Chief Nursing Officer is cautious on the subject of the AHS restructure but supports the need for senior nurse managers in the new structures.

‘Nurses and midwives have an important role to play in health services. Their role is 24/7, they understand the needs of patients and clinical matters. Nurses and midwives are well placed to provide a valuable contribution to management in general,’ said Debra.

‘Good leadership and management by nurses and midwives is important for the nursing and midwifery profession and patient care.’

Valuable role of nurse practitioners

The Nursing and Midwifery Office within NSW Health aims to increase the number of nurse practitioners, according to Debra.

The Office is working to identify situations where nurse practitioners can play a role and is working with nurse and midwife practitioners in developing their guidelines.  It also has a role providing advice on legislative changes that may be required to facilitate the role.

‘Nurse and midwife practitioners are meeting a real need in the health system – such as the needs of patients requiring chronic and complex care – and ensure patients receive continuity of care,’ she said.

‘It’s an important role for the nursing and midwifery profession. The role of nurse/midwife practitioners provides another clinical career path and enables senior nurses and midwives to maintain their clinical focus. ‘It is a mark of recognition of the capacity of experienced nurses and midwives,’ she said.