Nursing reports

New Zealand Nurses Organisation media release, 29 August 2022

Members of the New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) will be holding public rallies today in five main centres to call on the Government to ensure Te Whatu Ora Health New Zealand (formerly the DHBs) urgently provides the funding needed to properly value Aotearoa’s Primary Health Care nurses.

The main centres are Auckland, Tauranga, Hamilton, Wellington and Christchurch and the rallies will run from 12.30 until 1.30pm.

Primary Health Care nurses work in areas of the health system such as General Practice, after-hours emergency centres, Plunket, Māori and iwi health providers, Urgent Care and Family Planning. They have the same qualifications, training and responsibilities as Te Whatu Ora nurses, but are paid significantly less.

A nurse at a medical centre typically earns 10-20 percent less, and nurses working for Māori and iwi providers can earn up to 25 percent less.

Many employers say they want to pay their staff the same rates as Te Whatu Ora nurses, but they can’t do so without increased capitation funding from the Government.

Christchurch-based Primary Health Care nurse Denise Moore says many nurses are leaving Primary Health Care for hospital-based jobs with Te Whatu Ora where they can earn more, and that this is causing real problems for members of the community.

“I don’t blame nurses for leaving Primary Health Care for better pay because it is hard to make ends meet on our wages, but it does make things worse for those who remain because staff numbers are so low and the hours are already long and arduous.

“When employers can’t find new nurses to replace the ones who have left, it means they have to cut services or delay appointments and that affects everyone in the community.”

Registered nurse Gina Chaffey works at a Māori Health provider in Tairawhiti. She says she would never leave her Primary Health Care role because it is about the people.

“He aha te mea nui o te ao? He Tāngata, he tāngata, he tāngata. Meeting the needs of my people is always paramount and they depend on me. But why is the pay gap for nurses who work in Primary Health Care or for Iwi so big? The Government needs to step up and meet its obligations under te Tiriti.

“Injustice has been a lifetime battle for Māori and pay parity with Te Whatu Ora nurses would be a step towards equality. Like them we studied for our nursing degrees, and we go way beyond the call of duty every day. It just isn’t right that the Government funds one group of nurses more than another.”

At today’s rallies members of the public will be invited to rate the Government’s performance on fairly paying Primary Health Care nurses by placing a sticker on their chosen location on a large Plunket chart. They can also cast a ballot to vote on how well they think the Government is doing at valuing Primary Health Care Nurses.

The rallies will be at the following locations, starting at 12.30pm.

• Auckland: Corner of Memorial Drive and Gt North Road, New Lynn
• Tauranga: Red Square (bottom of Devonport Road)
• Hamilton: Garden Place, Victoria Street
• Wellington: Midland Park, Lambton Quay
• Christchurch: Riverside Market

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Media inquiries: Rob Zorn, NZNO Media and Communications Advisor: 027 431 2617.

New Zealand Nurses Organisation media release, 26 July 2022

The New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) says nursing shortages have become so dire that Dunedin Hospital has called on nursing students to do tasks normally done by qualified nurses, placing the students at unacceptable risk. It wants to know what the Government’s plan is to keep nursing staff safe and to address the chronic shortage.

The students were asked to do patient-watch work, in exchange for a $200 Countdown voucher, because the hospital said it was ‘desperate’ for help as chronic understaffing was putting patient safety at significant risk. The students did not receive orientation training to the promised level, and one of the students was hit while working at the hospital.

NZNO student representative Manu Reiri said the students had little idea what the watch work involved, and most were unlikely to have been in a hospital ward before.

“They were supposed to be under the direction and delegation of registered nurses, which also placed employed staff at increased risk as they would be responsible for whatever mistakes were made under extremely busy and trying work conditions.

“A hospital resorting to this, against its own better judgement out of desperation, indicates just how critical the situation is.

“Dunedin Hospital is the employer responsible under the Health and Safety Act to anticipate and mitigate the risks arising from chronic staffing shortages, and the buck for that stops with the Government.

“We’ve been asking the Government what its plan is around safe staffing for more than a year, and there has been nothing of substance offered to date.”

Manu Reiri said the staffing crisis is worsening every day and that it was clear another approach is needed.

“We need to do things differently, and to manage that we need to be consulting and working together to ensure we are working on a plan to address understaffing in both the short- and long-term. This is what the Health and Safety Act requires and it is clearly not happening.

“Incidents like this are likely to happen again as desperation in the health system is everywhere. Dunedin Hospital did this under the radar and without working in accordance with the Health and Safety Act because it just didn’t see any other option, and that is deeply troubling.”

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Media inquiries: Rob Zorn, NZNO Media and Communications Advisor: 027 431 2617.

Embargoed until 12.30pm, 20 July 2022

New Zealand Nurses Organisation media release, 20 July 2022

The New Zealand Nurses Organisation, Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) says it received more than 2700 responses (in just two days) after inviting members to send a message to the Minister of Health about the nursing/health crisis.

NZNO gave its members the opportunity in response to Health Minister Andrew Little’s persistent assertions that there is no health crisis and that the system as a whole is coping.

NZNO Kaiwhakahaere Kerri Nuku said one only has to read the news to see that the system is actually on the brink of collapse, just as many health professionals are saying.

“Ninety-nine percent of responding members said the system was either in crisis (70 percent) or already beyond crisis (29 percent).

“What word we use to describe this situation is probably not important, but the Government’s insistence that this is just a temporary situation caused by covid and a cold winter has made nurses feel unheard and completely undervalued, and that is evident in the messages to the Minister. Many are furious, and many are in tears as they write.”

Some of the messages are lengthy, and NZNO President Anne Daniels said the fact that so many went to such lengths to share their thoughts is significant.

“Decades of poor planning, inadequate funding and outright neglect have led us to a time of absolute crisis in terms of pay, staffing resources and morale across the nursing sector.

“This isn’t a temporary glitch; many are seeing it as the end of the road, with 72 percent of respondents saying they are either seriously thinking of leaving nursing or New Zealand, or that they had already made plans to do so.

“This is not union officials opining in Wellington. These messages are the heartfelt pleas of nurses and other health workers right across the country working in a wide variety of nursing sectors. We hope for their sakes that the Health Minister and the Government will be willing to listen.” 

Interestingly, 95 percent of respondents (not all of whom work in the DHB sector) said honouring the promised back pay to DHB nurses and extending DHB Pay Equity rates to all nurses in New Zealand, regardless of where they practice, was one of the most important things Government could do to help address the nursing/health crisis.

The book of messages, amounting to 330 pages of print, will be anonymised and delivered to the Health Minister today at 12 Noon by a small team of Wellington region NZNO delegates.  Journalists would be welcome to photograph and speak with these members at Parliament at around 12.30pm.

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Media inquiries: Rob Zorn, NZNO Media and Communications Advisor: 027 431 2617.

Further information: survey stats

Regions

Nurses completing the survey were from all sectors: DHB; Primary Health Care; Aged Care; Private Hospital and Hospice; and Māori and iwi. Responses were received from all 20 DHB regions.

Is there a crisis?

2735 answered the question about whether there was a nursing crisis. No and Maybe were answer choices. 1910 (70 percent) said there was a crisis. A further 29 percent said the situation was already beyond crisis. 

How does the Government denial of a health crisis make you feel? 

Indifferent was an available choice. However, 39 percent said they were angry; 19 percent said they were disillusioned; 41 percent said they felt undervalued. Total = 99 percent.

Are you thinking of leaving nursing?

• Seriously thinking about leaving: 33 percent
• Seriously thinking about taking a nursing job overseas: 27 percent
• Already made plans to leave for good: 5 percent
• Already made plans to nurse overseas: 6 percent
• Determined to battle on: 28 percent. 

In other words, less than a third indicated they wanted to stay in their jobs.

What are the most important things Government could do to help address the nursing/health crisis?

• Honour the promised Pay Equity back pay for DHB nursing staff, and extend those Pay Equity rates to all nursing sectors: 96 percent.
• Provide more nurses: 80 percent
• Prioritise health and safety in workplaces: 70 percent
• Put internationally qualified nurses on the fast track to residency: 64 percent
• Remove financial barriers for nursing students: 60 percent
• Make it cheaper and easier for IQNs already here to gain registration: 53 percent
• Implement te Tiriti across the health system: 34 percent.

New Zealand Nurses Organisation media release, 22 June 2022. 

The New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) says the Aged Care sector is in dire straits without mandated minimum safe staffing levels.

In 2020, between 200 and 300 Section 31 notices were submitted to the Ministry of Health notifying of the health and safety risks to patients caused by understaffing. 

841 were submitted in 2021. Now 841 have been submitted between January and April of 2022 alone.

Chair of the NZNO College of Gerontology Natalie Seymour says the Aged Care sector is in crisis.

“Nurses are doing 12-16 hour shifts without a proper stand down period. I recently worked a 93 ½ hour week and this is getting more and more common.

“We have a huge shortfall of qualified registered and enrolled nurses, which is having a massively negative impact. I manage a facility with four nurses on the floor for 75 patients who require specialist care.

“The voluntary standards for our aged care facilities say each patient needs only need half an hour of one nurse’s care. But our ageing population are sicker, older, and more acute. The patients we have need much more care than half an hour a day.”

Ms Seymour says Aged Care facilities are responding to understaffing by refusing to fill beds.

“790 beds were closed this past year. When this happens it backs up hospitals, which are already over capacity, or leads to people being discharged when they shouldn’t be, burdening their whānau and communities.

“In order to make up the wages we have to increase room charges, and these are already $1500-2500 per week. We have people selling the family home to pay for care.”  

Ms Seymour told the Health Select Committee this morning that a standardised acuity tool is needed that would help set staff/patient ratios that ensure clinically and culturally safe care for our patients.

“But we must also address the disparity between DHB and Aged Care worker pay, which can be up to $20,000, and this makes it incredibly difficult to recruit and retain staff.

“We do our best to pick up the pieces and support families through their grieving, to give them the care, support, and touch they deserve in their dying days. But the reality is no longer possible for our burned out Aged Care nurses and health workers.”  

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Media inquiries: Rob Zorn, NZNO Media and Communications Advisor: 027 431 2617.

New Zealand Nurses Organisation media release, 16 June 2022.

Health and Safety Representatives (HSRs), with support from the New Zealand Nurses Organisation, Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO), have issued three provisional improvement notices (PINs) to Palmerston North Hospital’s Emergency Department.

The PINs were issued late on Wednesday afternoon 15 June, and are based around three core issues: an overcrowded noisy work environment; lack of staffing resources resulting in untenable workloads; and staff wellbeing and stress, resulting in increased sick leave, burnout and resignations.

A PIN legally requires an employer or service provider to address a health and safety issue before a certain time in this case within eight days) and is a powerful step employees can take through their health and safety representative (HSR).

Safety concerns have been raised repeatedly with MidCentral District Health Board (DHB) over the last few months, but the HSRs say concerns have not been adequately addressed. Staff were surveyed about their support for the PINs, with 100 percent of those completing the poll (n=62) voting yes.

Staff say they are experiencing critical and unprecedented staffing shortages at the emergency department making it unsafe for both patients and staff.

The PINs’ recommended improvements include, among other things: closure of outpatient clinics; cancellation of elective surgeries; review of overflow bed practices, decreased visitor numbers, roster reviews and additional medical cover overnight.

HSR Kirsten Caves says it is extremely unsafe for both patients and staff if staff continue working under these circumstances.

“We’re stretched physically, mentally, and emotionally with a high level of sick leave leading to high resignations. This now means we are significantly understaffed.

“To make matters worse, we are lacking in resources and our department space just isn’t sufficient for the number of patients coming into ED.”

She said staff were absolutely exhausted, and that the health system needs desperately to be recruiting more nurses.

“These PINs highlight exactly why so many experienced nurses are decamping overseas to safer environments, and we just don’t have the nurses to replace them.”

MidCentral DHB management have until 23 June to comply with the PINs' recommendations.

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Media inquiries: Rob Zorn, NZNO Media and Communications Advisor: 027 431 2617.

New Zealand Nurses Organisation media release, 7 June 2022 

The New Zealand Nurses Organisation | Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) will today be supporting staff at Wellington Regional Hospital to issue a provisional improvement notice (PIN) regarding unsafe staffing affecting eight inpatient wards.

A PIN legally requires an employer or service provider to address a health and safety issue before a certain time in this case within eight days) and is a powerful step employees can take through their health and safety representative.

Staff say they are experiencing critical and unprecedented staffing shortages within these wards.

Sarah Ward, an NZNO delegate and registered nurse working in the 6 South/Cardiology Ward, says nurses are feeling burnt-out, fatigued and are experiencing high levels of sickness and COVID-related special leave, which has also taken its toll.

“On some shifts the ward is working four nurses down, but we are still expecting a high number of elective and acute patients coming in from the Emergency Department. We cannot continue to provide adequate nursing care with so few nurses.” 

NZNO members and organisers have met with the charge nurse managers who escalated the safety concerns to the hospital management team. Staff at the eight wards were also polled to gauge support for the PIN, with 100 percent of those completing the poll (n=256) supporting it.

In issuing the PIN, staff want elective surgeries to be put on hold, including cancer surgery, for two weeks to give staff some breathing space.  The PIN does not include acute surgery, paediatric and neonatal areas, and day surgery cases.  

Staff also want no new admissions when wards are in critical ‘Red VIS status’ unless extra staffing and resources are provided to meet the extra need.

Lastly, they want operations managers more visible on the ward floor to support public awareness about critically unsafe staffing days – and to assist with patient triage/discharge. 

Charge nurse managers say issuing a PIN has become necessary as a last resort. 

“With extremely high vacancy rates across the inpatient areas, and a lack of nursing applicants, we cannot continue to provide safe care.  We have tried all other avenues to resolve this and have worked closely with our colleagues. 

“We acknowledge the excessive hours and huge discretionary effort of our nursing teams to prevent patient harm. As the global issue of nursing shortages is now severely affecting patients and staff at Wellington Regional Hospital.

“We have significant concerns for the safety and wellbeing of the nursing staff and the patients in our care.”

The eight wards affected are: 4 North Gynaecology; Medical Assessment and Planning Unit; 5,6 & 7 South; and 5, 6 & 7 North).

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Media inquiries: Rob Zorn, NZNO Media and Communications Advisor: 027 431 2617.

New Zealand Nurses Organisation media release, 18 May 2022

The New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) is profoundly disappointed with the Budget announced this afternoon in which nurses barely get a mention.

NZNO Chief Executive Paul Goulter said NZNO has been very clear and expressed to Government on many occasions that the health front line made up of nurses, health care assistants and kaimahi hauora across all sectors is in crisis, and that significant funds were needed in this Budget to address staffing and pay issues.

"The Government seems oblivious to the fact that it cannot have a robust and workable health system when there are chronic staffing issues that are worsening every day, but it seems the best it can do is 76 million for workforce development over four years.

"We’re not even sure what that means, but $19m a year is really just loose change.

"There is nothing mentioned about nursing wages or conditions, or about how the Government intends to address the widening pay gap between nurses who work for DHBs and those in other sectors - and that is just going to perpetuate health inequities and staffing problems for non DHB providers.

NZNO Kaiwhakahaere Kerri Nuku said the Budget was disheartening.

"There is nothing here that invests to build a sustained public health response. The allocated funding seems just pennies in the scheme of things, so we’re just seeing a perpetuation of underfunding for some of the people and services in communities that we desperately need to be there for us.

"Without yet understanding the details, we can see there is funding for workforce development across the Māori health workforce, but the amounts are too small to address the wage parity issue, and Māori and iwi health will continue as the poorest cousin in the health system. That’s a tragedy, really."

Paul Goulter said NZNO would do more analysis of the Budget over the next few days.

"We’re looking forward to getting some of the detail from Government that we hope will show concrete support for the health workers, but it’s pretty clear at this point that the urgent need at the frontline has gone unacknowledged.

"This is a real opportunity that has been missed, and that will be a sad outcome for many needing quality health care for themselves and their loved ones.

"I don’t think we can call it a wellbeing budget at all."

ENDS

For more information contact:

Rob Zorn | Communications and Media Advisor, New Zealand Nurses Organisation

Email: rob.zorn@nzno.org.nz, Tel: +64 (0)4 494 8242, Mobile: +64 (0)27 431 2617

New Zealand Nurses Organisation media release, 11 May 2022

The New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) says it will be launching a new campaign tomorrow through which it intends to win the political and resourcing commitments needed to address the nursing shortage crisis permanently – and across the whole health sector.

12 May is International Nurses Day, and NZNO Chief Executive Paul Goulter says that’s the perfect time to launch Maranga Mai! (meaning ‘Rise up!’), an ambitious campaign that calls on every nurses everywhere in New Zealand to rise up together and demand that they be resourced and enabled to do their jobs safely and well.

“So much has been asked of nurses, midwives, health care assistants and kaimahi hauora, and they have delivered like the courageous and professional workforce they are, right across Health. I am not just talking about our DHB-run hospitals.

“But decades of poor planning, inadequate funding and outright neglect have led us to a time of absolute crisis in terms of pay, staffing resources and morale across the nursing sector.

“NZNO intends to go hard. We will be relentless in pursuit of our goals and we will not stop until they are achieved.”

Central to the Maranga Mai! campaign will be the ‘Five Fixes’ which form the charter of demands for the campaign:

1. te Tiriti actualised within and across the health system
2. more nurses across the health sector
3. pay and conditions that meet nurses’ value and expectations
4. more people training to be nurses
5. more Māori and Pasifika nurses.

Paul Goulter says these are what is needed to solve the crisis and that NZNO must be at the table when decisions are made affecting nursing.

“We are more than 55,000 strong and growing. We have a portfolio of solutions and it’s time for Government to listen and involve us so we can work together on fixing this.”

He said a start would be addressing Pay Equity issues for DHB nursing staff without delay and honouring back pay obligations, which would reassure nurses they are valued and go some way towards restoring trust.

“And then those improved rates have to be rolled out across other sectors so people will want to become nurses and want to work where they are needed instead of where the better money is. I’m talking about Aged Care, Primary Care, and especially Māori and iwi providers where nurses earn 30 percent less than their colleagues in other sectors.”

He said a second solution is to implement mandatory staff to patient ratios in every area of health, supported by staff allocation systems and programmes that match nursing resources to patient needs.

“These are the sorts of things it is going to take to guarantee quality of care and that nurses have the time to see that patient needs are met in a compassionate and holistic way.

“Make no mistake about it, people are sicker than they need to be and some are dying because of the nursing crisis and it is time to get serious about addressing this.

“We are deadly serious. Maranga Mai! is not just a campaign for every nurse everywhere. It’s a campaign that will benefit all people in Aotearoa New Zealand because nurses who are well-resourced to do their work without the constant stress of being short-staffed will improve access to good health care and services for all of us.”

Maranga Mai! will be launched at an online forum for members at 11am on Thursday 12 May 2022.

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Media inquiries: Rob Zorn, NZNO Media and Communications Advisor: 027 431 2617.

New Zealand Nurses Organisation media release, 10 May 2022

The New Zealand Nurses Organisation, Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) says its members and others affected by the recently proposed DHB Nursing Pay Equity settlement have indicated they want the proposed settlement referred to the Employment Relations Authority (ERA) for a determination.

This follows widespread concern from members and other affected DHB employees that the DHB employers were not honouring an agreement in the 2020 DHB/NZNO MECA (signed last year) that each employee would receive back pay on the basis of the new rates to 31 December 2019.

Instead, a series of lump sum payments in recognition of past work has been proposed, amounting to much lower remuneration for many nurses than they would have received had they been back-paid as originally agreed.

Around 40,000 nursing staff covered by the DHB Nursing Pay Equity claim were invited to participate in a poll which closed at 5pm on Monday 9 May. Poll participants chose, by a significant majority, to refer the proposed agreement to the ERA over the second option which was to proceed with a ratification vote, once a final proposed settlement had been agreed.

In April NZNO commissioned a legal review of the proposed settlement which found it was contrary to the Equal Pay Act with regards to the backpay issue.

NZNO has now instructed its lawyers to file an application with the ERA to seek a determination that the DHBs are required to individually backdate the pay equity rates to 31 December 2019 as was formally agreed in collective bargaining last year.

Determinations will also be sought on the rates themselves, including concerns from some senior nurses about the effect of the new pay equity rates, and on a review mechanism to ensure pay equity with male-dominated professions is maintained into the future.

NZNO Chief Executive Paul Goulter said the timing of the review would be entirely up to the ERA but that NZNO would ask for urgency.

“It may well be that when the ERA receives our application, it directs all parties into a mediation or facilitation process as a first step.

“We have informed the DHBs that we will be filing with the ERA, but that we are willing to do all we can to narrow the differences between us in the meantime.”

He said NZNO would keep members and other affected DHB nursing employees informed about when the application would be filed and other matters relevant to the filing of the application as steps unfold.

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Media inquiries: Rob Zorn, NZNO Media and Communications Advisor: 027 431 2617.

MORE INFORMATION

Please refer to the attached media FAQ that explains some of the complex issues behind the proposed DHB Nursing Pay Equity settlement: 2022-05-10 NZNO Post poll media FAQ.pdf

New Zealand Nurses Organisation media release, 14 April 2022.  

The New Zealand Nurses Organisation, Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) says a legal review of the recently proposed Nursing Pay Equity settlement has concluded the proposed settlement is contrary to the Equal Pay Act 1972.

On 17 September 2021, NZNO and the twenty district health boards signed a settlement which provided that the pay equity pay rates once settled would be back paid to 31 December 2019. This back pay entitlement is an existing contractual term for each member.

The Equal Pay Act provides that a pay equity settlement that contains a term that reduces an employee’s employment agreement entitlements has no effect. The proposed settlement agreement conflicts with this rule as it removes a large part of the contractual back pay entitlement previously agreed.

The purpose of the rule is to prevent settlements under which pay equity increases are offset against existing entitlements.

"On the basis of this advice I have informed the Government, the DHB employers and our fellow union the Public Services Association (PSA) that NZNO does not accept the proposed settlement and that the ratification vote scheduled to commence 20 April has been cancelled."

"We have informed members of this advice and will be consulting with them on next steps, specifically whether they endorse an approach to the Employment Relation Authority to review the legality of the proposed lump sum payment, or whether their preference is to vote on the deal offered, despite it breaching earlier agreements."

He said that he nevertheless fully supports the work of the Pay Equity negotiation team.

"These negotiators, who include NZNO members, were operating under intense pressure in complicated circumstances. They brought to members what they believed was the best possible proposed settlement under those circumstances, and they should be congratulated for their hard work and determination to get the very best result for members after years of delay."

Paul Goulter said these developments would delay implementation of the new pay rates to DHB employees but he reiterated that NZNO will go hard to see that any eventual DHB base rates are extended to all sectors of nursing, including primary health care (e.g. medical centres), aged care, and particularly Māori and iwi providers.

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Media inquiries: Rob Zorn, NZNO Media and Communications Advisor: 027 431 2617.