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Following is a speech by the Secretary for Health and Welfare, Dr E K Yeoh, at the 2000 Graduation Ceremony of the University of Western Sydney, Hawkesbury:

Sir Turbott, Professor Carey, distinguished guests, graduates, ladies and gentlemen,

It is a great pleasure to officiate at this Graduation Ceremony for the Bachelor of Health Science (Nursing) programme. I would like to extend my warmest congratulations to the graduates.

To many, the role of a nurse is that of a carer and a service manager. The most widely known definition of nursing originates from Virginia Henderson (1966):

The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to a peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge and to do this in such a way as to help him regain independence as soon as possible.

In the new millenium, the focus of health care system is on the wellness of individuals : a state of complete physical, mental and social well being, as defined by the World Health Organisation. Our mission is to have a health care system which provides life-long holistic care, promotes health, enhances quality of life and enables human development. While Henderson's definition remains valid in a wide range of circumstances, it does not explicitly cover the important roles of nurses in working with families and communities, in education, public health and health promotion activities.

The role of nurses is evolving as our mode of delivery of health care services undergoes major transformation. In line with international trend, we are shifting our focus in the provision of health care services from the traditional hospital setting to ambulatory and community care. For instance, the Hospital Authority has set up nurse led clinics for treatment of diabetes, renal, continence, pulmonary and midwifery in various public hospitals. In the long run, a network of community-focussed integrated health care services on preventive care will complement the hospital system. More health care will be delivered in the home environment to help maximise the quality of life of patients. Patients staying in hospitals will be acutely ill, requiring intensive attention and complex care; while patients with less complex conditions can be cared for at home.

Looking into the crystal ball, what will be the future roles of nurses?

Nurse practitioners will play a role in the care of the chronically ill, the mentally disabled and the elderly. They will assess, guide, counsel and provide agreed treatment to patients in ambulatory clinics of hospitals. They will do follow up checks, assess drug compliance, review self-care abilities, monitor onset of complications, explain investigative and therapeutic procedures, conduct health education, foster self-determination and make referrals to physicians as appropriate.

On the hospital nursing front, nurses will participate in functions that require clinical reasoning skills as well as specific skills in the use of high-tech equipment and protocols. They will need to equip themselves not only with knowledge of the pathophysiology of their areas of specialisation, but also the basic biological and physical sciences, instrumentation and computer technology.

With regard to community care, nurses will be at the forefront of providing home healthcare and care in community nursing homes. The visiting nurses could provide direct care such as oxygen therapy and intravenous infusion at patients' home, teach patients and their families self-care techniques, manage the anxiety of patients and their families, identify early signs of inability to cope with the diseases, detect and prevent complications, as well as monitor and manage risks of the home environment.

Primary health care professionals are the gate-keepers of our health care system. Nurses working in primary care will be health promoters and educators, promoting the concept of wellness in schools, the workplace and the community. They will also act as public health workers, focussing on whole communities as well as individuals, fulfilling the public health functions of community profiling, health needs assessment, communicable disease control and community development.

The road ahead for nurses is full of challenges. In order to discharge their evolving roles in the delivery of primary, secondary and tertiary care, nurses need to have a firm grounding on biological sciences as well as social and behavioral sciences. And lifelong learning by way of continuing professional education and development is a must.

The Government supports the upgrading of basic nursing education to degree level for enhancement of quality health care services. We are grateful for the support of tertiary institutions like the University of Western Sydney in furthering our goal by running degree conversion courses to upgrade the competence of our nursing profession. To the graduates, I would like to extend my appreciation to all of you for your pursuit of professional excellence through continuing education which will be instrumental to our success in providing quality health care to the community. Finally, I wish all every success in your career in the nursing profession. Thank you.

END/Saturday, August 19, 2000 NNNN