Nursing Graduation Ceremony, Nelson Polytechnic

Graduands and partners, mums and dads, sisters and brothers, sons and daughters, teachers and, to make sure no-one gets left out, ladies and gentlemen.

It's a risky business, asking for a keynote address at a graduation ceremony. After all, this sort of speech is expected to be packed with advice. As some cynic once noted, advice is merely the ideas we prescribe for other people, to see if they really work.

Yet as well as the risk to the audience, there's also the risk to the speaker.

A few decades ago, there was an American university president who used to make a keynote speech at the beginning of each academic year. One year - perhaps because he was still gearing up for the year, rather than looking forward to the Christmas break - he was feeling grumpy.

He broke off after the first few sentences of his prepared notes - "I intended to give you some advice," he said, looking around the hall. However, "now I remember how much is left over from last year - [still] unused."

So instead of trying to provide answers which may not be relevant to you, it might be more useful if I asked you a few last questions before you graduate - a very low-key final exam.

Not to worry though - your answers aren't required immediately. Any time during your working life will do for most of them. Besides, your answers probably couldn't be marked properly anyway, because what they are worth depends completely on you, the person doing the answering.

Question number one is, what do the terms, "health professional," or "professional caregiver," really mean? Or what do they imply. Both terms are industrial-strength administrative jargon, but they hint at least, that there are two halves to your chosen career.

One half is practical, but the other always strikes me as code for the ethics and ideals of the work.

The "professional" half is easier and more comfortable to think and talk about. It's emotionally neutral: the rational business of earning a living, while sharing standards with other people in the same field. As members of a profession, you are at present hearing quite a bit about this side of your work. For instance, with the re-structuring of health services in New Zealand, you'll probably have to make career choices that are novel by traditional standards, as a matter of course. One example might be: at some time in the future, do you want to go into business for yourself?

But only a short distance from such "professional" issues, you get back to the real world - and the people you will be serving. Even the definition of health has been under review during the last few years. "Health" now formally includes the prevention of illness as well as its cure. But in spite of this broadening of focus, in your career you will still spend a lot of your time with people who've turned into patients.

As "caregivers," you will be working with people under stress, in need, or in pain, or who are grieving - and who may want you to come along on their emotional roller-coaster rides.

So your next question is, how are you planning to keep a balance between the emotional support of the people in your care, and your own needs? Who cares for the care-givers? in other words. How are you, personally, going to prevent yourself from burning out and turning into a time-server instead of a people-server?

Keep in mind that it can be very easy for the routine of any job to eventually smother your pride in what you do. For example, I'm sure that all of you, at some time, will come off-shift after a perfectly bloody day. Right then is when it will be most difficult to remember the reasons why you got into nursing, or homecare, or being on-staff in a rest home, in the first place. For most of you, I hope that being of service to others was at least part of your motivation. But living up to an ideal often gets harder and harder, the longer you work. Things like working conditions, administrative detail and medical protocols can easily sidetrack you from your original goals and detract from the joy you once felt in your job. So just how are you going to keep alive some of the idealism - enough of a spark to keep you warm, anyway - that prompted you to become a "health professional" in the first place?

Personally, I find this thought ironic. Nurses have for decades struggled to free themselves from the suffocating legacy of the Florence Nightingale mythology, and to be recognised as equal, independent, technically qualified health professionals, so don't think for a moment that I'm trying to turn the clock back. But my feeling is that in a world where medical technology can provide so many miracles, there is a tendency to expect a technical or scientific solution to every need or condition.

It's easy to become dedazzled by the "gee-whiz" excitement of technology - and understandably so, in many cases. But those dealing with the sick and damaged should, I believe, never forget that the greatest "miracle drugs" come from the human spirit and the natural tendency of the human organism to heal itself. The care and stimulation of the person can allow that old healer, "nature," to do its work effectively. This is no less applicable to those of you who are graduating in the Family Care and Home Management Course.

On to another question in this final exam: this year's comprehensive nursing-course graduands include many male students - a high proportion by the standards of just a few years ago, anyway. This is refreshing - it's not healthy (there's that word again) for the caring professions to exist as a female job-ghetto. But the majority are still women. And the majority of you could be out of the workforce for years at some stage, while you have children. Yet with the pace of the advances in medical science and technology, how are you going to stay abreast of developments, while your babies are staying abreast of you? It's worth some advance planning, if only because having career interests will usually make you a better parent.

The next question: at the moment, the qualification that you are about to receive could be part of an OE kit. After graduation, you might be planning to travel and work for a while, then come home. But what if you settle overseas? What do you need to do to prepare yourself for having your family at the wrong end of a trans-Tasman or trans-Pacific commute? And are you ready for a life of being a permanent overseas ambassador, with only occasional visits to where you grew up? I'm not sure that buying shares in an airline with your first few paycheques is the complete answer to this one.

Now for the last question. Have you consciously set some career and life goals for yourselves? It seems to me that a graduation ceremony is a time when you owe yourself a resolution or two, every bit as much as on New Year's Eve.

I suggest that you keep them small, but that when you reach them, that you make it a point to replace them or add to your list as time goes by.

Of course, this isn't a question, it's a piece of advice - I figured that by now, I'd lulled you all into a false sense of security. And it just so happens that I do have something I would like you to try out, to see if it works. It is that out there in the workplace, at least once every day, you pay someone a compliment. (By the way, I should explain that as Governor-General, I'm also Chief Scout and President of the Girl Guides. Encouraging a "good turn" every day goes with the territory.) It's my theory that an increase of the number of kind words in New Zealand daily life could cure the Tall Poppy Syndrome. Such a cure would of course be a significant contribution to New Zealand's social health - definitely something worth achieving.

Family members, I hope all of you are proud of your graduate, today - as, I assure you, the rest of us are. Along with you, I warmly congratulate all 1992 graduands of Nelson Polytechnic's Faculty of Nursing and Health Education.