28 August 2013:

Recent media reports highlighting ‘care rationing’ in two New Zealand hospitals are a cause for concern but not a surprise for the New Zealand Nurses Organisation (NZNO). NZNO believes the practice is widespread as DHBs and the nursing team are forced to do more with fewer staff and less money. Fiscal constraints are creating a ‘head in the sand approach’ to staffing issues in our hospitals.

NZNO associate professional services manager, Hilary Graham-Smith says, “Care rationing is both a service quality and patient safety issue; it is much more than patients not having their hair combed or being assisted with personal hygiene. There is no such thing as “optional” care or “comfort” care – care rationing is when the right care is not being provided to the patient at the right time.”

“International research shows a strong association between inadequate staffing levels, care rationing and poor patient outcomes.”

“We need to listen when nurses say they don’t have time to deliver the cared required to achieve a satisfactory outcome for patients. Our members are concerned about staffing levels; they are stressed, distressed and anxious about their ability to deliver safe and effective care in an environment that is not appropriately resourced. Care rationing is the ethical dilemma nurses face every day. The conscious decision of prioritising care provision and dropping off the nursing tasks that are deemed less of a risk is draining, demoralising and exposes nurses professionally. Urgent action is required.”

“We already have the tools and systems to make sure care rationing doesn’t happen. The care capacity demand management (CCDM) programme ensures staffing levels are safe – safe for patients and safe for staff. CarePoint is the NZNO strategy which shows how the elements of the CCDM programme; patients, staff and resources, work together to improve care.

“We need to make sure that the right number of staff with the right skills are in the right place at the right time to deliver all of the care a patient requires. DHBs need to be supported and resourced to implement this programme sooner rather than later,” Hilary Graham Smith says.