Nursing reports

Te Whatu Ora’s attempt to cut costs by requiring health care assistants to carry out cohort patient watches is harming vulnerable patients and staff, NZNO says. 

Patient watches involve trained and experienced health care assistants monitoring patients deemed a threat to themselves or others. They often have confusion, delirium or dementia. 

Tōpūtanga Tapuhi Kaitiaki o Aotearoa NZNO delegate and Christchurch health care assistant Al Dietschin says cohort patient watches are occurring throughout the country. 

“In Christchurch, health care assistants have written to local Te Whatu Ora leadership to raise our concerns that short-staffing and cohort patient watches are inherently unsafe and places both patients and staff at considerable risk. 

“There have already been documented incidents of patient harm directly resulting from the use of these cohort watches. With winter approaching, the situation is now at a critical point. The letter warns: ‘the NZNO members are extremely concerned that without immediate and substantive change, further patient harm is not just possible, but inevitable’. 

“The patients we watch are often highly agitated, have dementia or deliriums and can have mental health issues. They often have intravenous lines, drains, nasogastric tubes and catheters in which they can pull out, causing them further distress and trauma. They can hurt themselves in falls if they are not constantly watched.  

“There has already been a warning from the Coroner about the link between short staffing and falls. Despite 18 months of raising concerns with Te Whatu Ora in bargaining about understaffing, the situation is getting worse,” Al Dietschin says. 

NZNO delegate and Auckland health care assistant Anamei Graham says understaffing means health care assistants are constantly forced to prioritise their tasks. 

“It is very difficult to watch several such patients at once if they are put into a cohort, especially if they are in different rooms. It is not safe for them, and it is not safe for the kaiāwhina watching them,” she says. 

“A lot of us are feeling unsafe. Whānau are asked to help but they are not trained to provide patient supervision and monitor changes in behaviour. Often it is a spouse caregiver who really needs some respite from 24/7 care themselves. 

“We are pulled in all sorts of directions at once and we are stressed out and burnt out. There’s not enough HCAs on the wards and patients and whānau can feel it,” Anamei Graham says. 

Te Whatu Ora must explain why its rolling out new uniforms for nurses and health care assistants nationwide at a time when patients are struggling to get the care they need because of short-staffing and under-resourcing, NZNO says.

In an internal email seen by NZNO, Te Whatu Ora has told staff: "The uniform changes are part of a wider effort to create nationally consistent systems and standards across Health NZ and build a more unified, modern health system where patients and staff experience the same high standards wherever they are in the country".

Tōpūtanga Tapuhi Kaitiaki o Aotearoa NZNO delegate and Waikato Hospital nurse Tracy Chisholm says members are questioning the timing and cost of the new uniforms.

"Everyday nurses and health care assistants arrive at work to face short-staffed wards and old under-resourced systems in rundown and no longer fit-for-purpose buildings.

"Staff vacancies aren’t being filled and IT failures at Te Whatu Ora facilities are occurring weekly, if not daily.

"We have been fighting for safe staffing, and a cost-of-living wage increase through our collective agreement bargaining for the past 18 months.

"The timing of now - four years after the DHBs were merged - is questionable," Tracy Chisholm says.

"Te Whatu Ora should reveal how much the new uniforms are costing and explain why they are being prioritised over employing more nurses and health care assistants and fixing our crumbling hospitals.

"More health workers will ensure patients can get the heath care they need which should be a priority, not shiny new uniforms," Tracy Chisholm says.  

Reading the Sunday Star Times (22.3.2026) caused me to observe the devolution of much of what is meaningful to our collective society. The health and wellbeing of our nation is, indeed, under continuous attack through deliberate dismantling of legislation, infrastructure, policy and procedure that should lift us up equitably. Instead, George Orwell’s “1984” reminds us of the mechanisms of power that compromise our right to live healthy lives in a society that is being systematically dismantled by a Coalition Government without us, ignoring the checks and balances of due process.

Imagine if we as nurses ignored due process during medication administration or any procedure that we conduct. Doing so would increase the likelihood of avoidable harm to our patients and their families. Yet this is exactly what the Coalition Government is doing. Some examples are outline below from the Sunday Star Times.

Media articles covered the Government’s decision to partner with a vape firm that has taken it to court five times in a bid to keep nicotine limits high in vaping products. The company has been awarded a “vape to quit smoking programme” by Te Whatu Ora. How does that work when 50,000 of us have died since 2010 with smoking related causes? This is the same government that stopped the increasingly successful Smoke Free campaign under urgency without any public consultation.

A “Five days of fuel” article looked at pressure at the pump that highlighted the stressors a large majority of people are trying to cope with. As one person said – its one thing after another – food, fuel, roadworks, (housing, jobs, education) whatever Trump is doing that drags everyone else in the world into. The impact on those who are unemployed, or in low wage jobs such as community support workers who rely on their cars for work is reaching breaking point. To add insult to injury Foodstuffs CEO said that the fuel costs will impact on supermarket prices. Little is being done by the government to reduce the financial and health impact on workers, their families and those in the community they care for. The ripples of suffering from the lack of decisive and meaningful government leadership to help rather than hinder the people of this nation, continue.

The shadow of Trump is getting longer. Another Sunday Star Times article explores “Demonising Migrants”. Proposed amendments to the 2009 Immigration Act by Erica Stanford are being challenged as they will give immigration officers more powers to stop, question and detain people suspected of overstaying if they are not carrying identification. The changes may lead to fear in targeted communities. Whatever this Is, it will exacerbate fear, racism and division. The Coalition Government has been called out on being ‘The most overtly racist government in decades’ | E-Tangata as the changes to legislation, policy and funding negatively impacts on the rights and outcomes of Māori. This includes overt opposition to the United Nations Declaration on the Rights of Indigenous Peoples.

The psychosocial stressors of our current context, on those with little power, control or choice is escalating in parallel with all the constant attacks on legislation that is supposed to support us, protect us, and uplift us. Proposed changes to the Health and Safety in Employments Act which will see psychosocial stressors removed from identified critical risks. Nurses and many other women workers face under recognised risks in the workplace such as psychosocial harm, gendered violence and harassment, and musculoskeletal risks. The Bill’s “critical risk” framework, including regressive critical risk definition, and fails to recognise the impact of these risks. The proposed prioritisation framework is built around the traditional, male-dominated industrial hazard profile that has long dominated health and safety practice, as though women don’t warrant the same protections given to men. It is short-sighted, unethical and discriminatory to reduce the system's capacity to address these risks. Moreover, the short submission period has compounded the (deliberately) inadequate and narrowly targeted consultation processes. All of which impacts on workers rights to safe and decent work.

Yet I know that we the people can stand up and fight back. One such individual is Enrolled Nurse Leonie Metcalfe. Her life and works were celebrated at her well attended funeral on Saturday. Her life is an example of what nurses have done and continue to do to reverse and improve legislation that impacts on us as a profession and as human beings. Her relentless commitment to doing what was right was recognised in 2021 when she received the NZNO Award of Honour as an invaluable Enrolled Nurse leader. I know that there are many more of our NZNO members, just like her. No matter what is in front of us, we will stand up and fight back. And we WILL WIN.

Tōpūtanga Tapuhi Kaitiaki o Aotearoa NZNO apologises sincerely and unreservedly for the involvement of nurses in historic abuses in state care.

The apology was made in a video by NZNO Kaiwhakahaere Kerri Nuku and published today on the organisation’s website. It has already been shared with survivors and their whānau. 

NZNO has also apologised unreservedly for any role nurses may have had in ignoring and not standing up to abuse in state care.

Kerri Nuku says for decades from the 1950s, children in psychiatric hospitals and other state and faith-based care suffered horrific abuse. 

"And among those responsible were nurses-our own profession. Nurses who were entrusted to care, to protect, to heal. Instead, some inflicted harm. Others turned away. This is a double betrayal, because care and compassion are the very essence of nursing. 

"The experiences of survivors, told to the Royal Commission of Inquiry into Abuse in Care, were horrific, she says.

"These children were subjected to electric shocks, painful injections and degrading treatment. Nurses stood by while sexual abuse occurred. Some actively participated."

Kerri Nuku says most of the children involved were Māori, placed in institutions because they were Māori. 

"Colonisation’s destructive intent was at work, and nurses became instruments of that harm. The scars left behind are not just physical. They are pervasive, lifelong, and intergenerational. Survivors and their whānau still carry the weight of trauma. Many do not trust nurses today - and that mistrust is justified.

"That this abuse occurred and for so long is a national disgrace. It is not only an issue of historical significance, but with abuse recognised up to 2019, it is also a contemporary issue. For this reason, NZNO joins calls for the swift implementation of all Royal Commissions’ recommendations."

An apology without action is hollow, Kerri Nuku says. "Words alone cannot heal. We commit to ensuring this never happens again." NZNO's response is guided by the findings of the Abuse in Care inquiries and the Lake Alice Hospital investigation and is a pledge to:

• Embed trauma-informed and culturally safe practice in nursing education and professional development.

• Advocate for a robust redress scheme that meets survivors’ needs and honours international standards.

• Protect whistleblowers and enforce transparency, ensuring no member can hide from accountability.

• Collaborate with the Nursing Council of New Zealand to strengthen Codes of Conduct and Ethics, making care synonymous with safety and dignity.

These actions reflect NZNO's commitment to tika and pono - or justice and truth - and to restoring the trust that was broken, Kerri Nuku says. 

The ACT Party should leave nursing to the professionals and medical evidence, NZNO says.

Tōpūtanga Tapuhi Kaitiaki o Aotearoa NZNO Kaiwhakahaere Kerri Nuku says ACT MP Todd Stephenson has dismissed the Nursing Council’s draft code of conduct - which proposes strengthening cultural safety, whānau-centred care and te Tiriti o Waitangi obligations - as political ideology.

"This is not political ideology. It is evidence-based health care which has been proven to be the key to lifting health outcomes for Māori.

"ACT should leave nursing to professionals and medical evidence," Kerri Nuku says.

"Culturally safe care reduces health inequities, keeps more Māori out of hospital by helping identify the risk of preventable illnesses and enabling early intervention, and saves the health system money - something dear to the ACT Party," she says.

"Todd Stephenson wants health care based on need not race. There can only be equal health care if there are equal health outcomes. Māori life expectancy is seven years lower than non-Māori and Māori are more likely to suffer heart disease, cancers, diabetes and mental health issues.

"Many Māori fear hospitals and the health system, which has been found to be systemically racist. Without culturally safe health care, Māori will continue to suffer poorer health outcomes and lead sicker and shorter lives than other New Zealanders.

"As well as the devastation to lives and whānau health and wellbeing, it costs Aotearoa more in the long run," Kerri Nuku says.  

The Government’s announcement today of 378 extra staff to help hospitals cope with winter demand is a drop in the ocean of what patients need, NZNO says. 

Tōpūtanga Tapuhi Kaitiaki o Aotearoa NZNO Chief Executive Paul Goulter says every extra staff member is helpful. 

“However, our hospitals are in crisis and barely keeping up with demand before the winter respiratory illnesses hit.  

“The capacity for hospitals to meet patient need has been severely depleted after two years of Government cost-cutting and funding to an arbitrary budget.  

“We constantly hear from our members that Te Whatu Ora regional health directors are deliberately delaying recruitment and still not giving local managers approval to fill vacancies,” Paul Goulter says. 

“These additional staff are a drop in the ocean of what patients need. The 378 full-time equivalent (FTE) staff include medical, nursing, health care assistants, allied health, support and non-clinical roles, but it is unclear how many of those are nurses.  

“These additional nurses aren’t going to go far considering an Infometrics report released last year found our hospitals were short on average 587 nurses every shift,” he says. 

“The same report (page 22) found that nursing staff shortages are three times as bad in winter. It found between 2022-2024 nursing staffing were about 50,000 FTE hours short in April compared to 150,000 FTE hours short in July. 

Paul Goulter says additional short stay beds in the hospitals and for aged residential care are desperately needed. 

“NZNO acknowledges the acute need at Middlemore, Waikato, Wellington and Christchurch hospitals. But unfortunately, other hospitals are at capacity even before the winter illness peak,” he says.  

The knock-on effects of the latest wars started by the United States is a reminder that when they act Aotearoa is not immune.

Just last night, the Government met to urgently consider the return of carless days and fuel rationing. Flights have been reduced to some of our most vulnerable regions to conserve fuel and families are bracing for drastic rises in electricity bills this coming winter.

While Christopher Luxon and the current Government is urging the New Zealand public to not be nosy, to not get involved with the world, what they are really telling us is “don’t make us accountable for our actions these last two and half years”. Because they’ve cut the earning potential of women and wāhine for generations – money that is proven to go to heating homes and feeding children. Because they’ve exchanged renewable energy solutions for tax breaks in the landlord’s pocket. They’re selling multimillion-dollar citizenship to the billionaires who are burning the world to the ground.

And now this Government are facing the consequences of their actions – because their time is up. At the College and Section Forum earlier this week I gave a call to action: that we can still care whilst we amplify our voices through action. That we can continue to promote our profession as one of strength and dignity, and we can do that through resistance – by reclaiming our sovereignty in the workplace.

While this Government has its own priorities, we will continue to maintain ours. To hold the line for our patients, their families; whānau and communities.   

The Health Minister must explain why after years of concerns from nurses about Christchurch Hospital’s barely functioning dialysis unit, he only stepped in late yesterday when life-saving treatment had to be rationed, NZNO says.

Tōpūtanga Tapuhi Kaitiaki o Aotearoa New Zealand Nurses Organisation (NZNO) Chief Executive Paul Goulter says NZNO members have been raising concerns about the dilapidated and cramped dialysis unit for "a number of years".

"These issues have been well-known by hospital leadership. In their most recent letter, (attached) NZNO members warned ‘the current conditions pose a serious risk to both patient safety and staff wellbeing’.

"The mouldy and leaking unit has never been refurbished and increasing demand last month forced the Clinical Director to write to patients saying life-saving dialysis would have to be rationed," Paul Goulter says.

"However, it was only yesterday when 1 News started asking looking into the issue that Simeon Brown stepped in and ordered more staff for the unit.

"Questions remain unaddressed about how the new staff will fit in the unit which is so tiny there is no room for existing staff to even leave their bags in their workspace.

"The Minister’s announcement was so rushed it seemed to catch Te Whatu Ora Waitaha Canterbury off guard.

"Simeon Brown claims to put patients first and values nurses. If this is true, he should listen to health workers rather than manage the public health sector based on the 6pm television news bulletin," Paul Goulter says. 

Nurses, midwives and health care assistants throughout Aotearoa New Zealand will wear purple on Friday to show their support for Pay Equity - and urge all New Zealanders to join them.

The Go Purple day is in recognition of International Women’s Day on Sunday. The NZNO members will be joined by members from other frontline public service unions.

NZNO delegate and Hospice nurse Anna Garton says she’ll be wearing purple after her and her colleagues’ Pay Equity claim was dumped overnight last May when the Coalition Government gutted the previous scheme.

"It was devastating for the workforces that had already put claims forward.

"The work Hospice nurses do is an important part of a caring society and we deserve to have it valued and paid fairly.

"NZNO Hospice workers have now lodged a new claim under the new system, but conditions have already deteriorated since the law change last year. Donations already fund 33% of Hospice nurses wages. Hospices can’t afford to close the gender pay gap without a Pay Equity settlement.

"I urge all New Zealanders to wear something purple to work on Friday to show their support for Pay Equity," Anna Garton says.

NZNO delegate and Waikato-based hospital nurse Tracy Chisholm will also be wearing purple on Friday, within her local hospital uniform rules.

"Hospital members received their Pay Equity claim in 2023 and under the previous scheme, were entitled to a review last year to ensure our wages keep up with similarly skilled male dominated sectors.

"Under the new scheme, we are not entitled to a review for 10 years. Over this time our wages will once again fall behind.

"So women health workers and their whānau continue to lose out and pay the price for historical gender discrimination," Tracy Chisholm says.

Editor notes:

• Pay equity in New Zealand requires that women and men receive the same pay for doing different work that is of equal value.

• Local photo opportunities can be organised on request.  

The right of health care workers to provide care during international conflicts must be protected, Tōpūtanga Tapuhi Kaitiaki o Aotearoa NZNO says.

NZNO Kaiwhakahaere Kerri Nuku says hospitals and health care workers are increasingly being targeted in war torn nations.

"Hospitals and health workers should never be targets. Health care workers must have the right and freedom to provide care in conflict zones," she says.

International media have reported an Israeli air strike hit a hospital in Tehran’s north, badly damaging the facilities and forcing patients to be evacuated. The air strikes were part of the ongoing US-Israel military campaign against Iran.

"Sadly, attacks on hospitals and health care workers are not a new development," Kerri Nuku says.

"The World Health Organization last week said attacks on Ukraine’s health care facilities had increased by 20% last year and hit a staggering total of 2881 since the war with Russia began four years ago.

"In Myanmar, at least 34 people were killed and dozens more injured late last year after air strikes from Myanmar's military hit a hospital in the country's west.

" NZNO is supporting Myanmar health care workers providing care on the Thai border. We have heard firsthand the struggles of providing health care in a conflict," Kerri Nuku says.