Nursing reports

New Zealand Nurses Organisation media release, 2 May 2024

The New Zealand Nurses Organisation NZNO Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) say the Government’s proposal, announced today, to disestablish the Pay Equity Taskforce within Te Kawa Mataaho Public Service Commission is extremely regrettable.

NZNO Chief Executive Paul Goulter says women being paid less than men, even though they do work of equal value, remains widespread across the country.

“To disband the expert group of people tasked with supporting pay equity for women before this work is complete in New Zealand is unwise and speaks again of the Government’s misdirected priorities.

“The demise of the taskforce will come with a huge loss in terms of the knowledge and skills required to ensure women do not remain the victims of sex-based wage discrimination. These skills were of huge benefit to both employers and the unions representing their employees in sorting pay equity issues.”

Paul Goulter says the Government appears to be divesting its pay equity responsibilities under the Equal Pay Act to public sector agencies, making them responsible for meeting pay equity obligations from here on.

“And it’s really ominous that the Government has still not committed to closing the massive pay equity gap around the non-state (funded) sector – for example the huge difference between what nurses are paid in our hospitals as opposed to our general practices, community health and support services, Māori and iwi health providers, Plunket and so on.

“These forms of Primary Care are hugely important for preventing ill health and reducing the burden on our public hospitals and emergency departments. But they are under serious threat because the pay gap makes it hard for them to attract or retain staff. You and I and our loved ones pay the price for that.”

He says there is time for the Government to reverse this decision.

“Instead of dismantling the mechanisms we need to achieve pay equity, we’d like to see the Government actually honouring its pre-election promise to pay all nurses equally, by strongly committing to establishing pay equity across the funded sector (Primary/Community Health).”

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Media enquiries: Rob Zorn, NZNO Media and Communications Advisor: 027 431 2617 | media@nzno.org.nz

Nominations are now open for Te Akenehi Hei Memorial Award for significant contribution to Māori Health. The award is open to all Māori nurses.

This is the highest honour that can be awarded by Te Rūnanga o Aotearoa - a Tiriti o Waitangi partner to the Te Poari o Te Rūnanga o Aotearoa New Zealand Nurses Organisation (NZNO), representing its Māori members. It is awarded every two years to at the NZNO Annual General Meeting and Conference. The recipient of the award is determined using criteria that include Rangatiratanga, Whanaungatanga, Kaitiakitanga, and Kotahitanga.

The Award is named after Akenehi Hei, the first Māori nurse and midwife to register under her own name rather than the name ‘Agnes’ given to her by her Pākehā employers. Like other Māori nurses, she was sent into rural and often isolated areas where there were outbreaks of epidemic diseases and hardship. She challenged cultural competencies and awareness in healthcare and pioneered district nursing. She was a courageous leader and inspired many others to take up nursing during this time.

Te Akenehi Hei Memorial Award recipient for 2022, Mahitahi Hauora Director of Nursing Rhoena Davis said it was an honour to receive the award. As a nurse practitioner, she attributes her work within Māori and rural health. Humbly, she dedicates her award to all that have worked alongside her and states it’s a team effort.

"The award was a recognition of the mahi of my team at Mahitahi and what we are doing to look at things differently and change the system. I encourage to people to provide nominations for the 2024 award and shine a light on the outstanding mahi being done by Māori nurses to improve health outcomes for Māori."

Rhoena has recently been awarded with the Peter Snow Memorial Award for 2023 for her longstanding service and dedication to rural health.

NZNO Kaiwhakahaere Kerri Nuku said some exceptional nurses and tauira have been recognised over the years through this award, and she was confident this year would be no different.

"Māori nurses are not only dedicated professionals but great innovators. This award provides a wonderful opportunity to showcase their day-to-day mahi for the betterment of their people, hei oranga motuhake mo ngā whānau, me ngā hapū, me ngā iwi katoa."

Nominations for Te Akenehi Hei Memorial Award 2024 opened yesterday (1 May 2024) and closes on 30 June 2024.

The award ceremony takes place at the annual Indigenous Nurses Conference in Tamaki, Auckland in August.

New Zealand Nurses Organisation media release, 8 March 2024

On Monday, health workers in Canterbury Waitaha will protest the ongoing, almost eight-year delay in the payment of their holiday pay and other leave owed to them.

At 12 noon, members of New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) will gather opposite Christchurch Hospital’s ED/Waipapa building to voice their frustrations against the delays in the Holidays Act remediation payments.

NZNO Christchurch delegate Allister Dietschin called on Te Whatu Ora to make the payouts as soon as possible and urged the Government to make the employer set a deadline and stick to it.

“Te Whatu Ora had previously been told by the Government that they expected this work to be finished by the middle of 2023, but here we are seven months later and they are still dragging the chain.

“More than 302,000 workers are being owed about $2b, but the length of time this has taken, and fresh delays are unacceptable.

“To make matters worse, last year Te Whatu Ora removed expected remediation dates from their reporting, leaving workers blind as to when they are going to be finally paid.

“This demonstrates a lack of respect from their employer.

“Canterbury Waitaha members are exasperated with the excuses Te Whatu Ora keeps making about payroll dysfunctions, they just want to be paid what they are owed.

“Imagine the frustration of having to wait nearly eight years after being told your employer was non-compliant and paid you incorrectly for your leave, you’re expecting reimbursement but are consistently being told to wait longer. We still have no idea when we will actually be paid.

“This treatment of its staff only reflects how little regard Te Whatu Ora has for their health and wellbeing, especially with the cost of living increasing, placing more financial stress on those trying to make ends meet.”

Canterbury Waitaha has a frustrating record of payment delays which has seen members come out to protest several times in the past.

Last month, NZNO lodged a complaint about the delays in Holidays Act payments with Minister of Health Hon Dr Shane Reti which was acknowledged but a fuller response has not been received.

“Unfortunately, our communities pay the price for Te Whatu Ora’s failures with frustrated health workers leaving the profession in New Zealand,” Dietschin said.

Background information

The Labour Inspectorate of the Ministry of Business, Innovation and Employment identified in 2016 that there were issues with DHB (now Te Whatu Ora) payroll systems and its compliance with the Holidays Act. These meant that some employees weren’t receiving anywhere near their correct leave entitlements.

The NZ Council of Trade Unions wrote to the DHBs in May 2016 proposing a process to review DHBs’ compliance with the Holidays Act and to take a national approach to resolving issues of non-compliance. The then DHBs, now Te Whatu Ora regions, continue to work through the process at varying rates, but at a rate that NZNO considers unjust and harmful to the wellbeing of the people of Aotearoa New Zealand.

Kotahitanga (unity) will be on full display in Manurewa, South Auckland on Saturday when the second Māori health workers netball tournament takes place. And all people have been invited to come along with whānau to enjoy a fun-filled day.

Hosted by Te Rūnanga o Aotearoa New Zealand Nurses Organisation (NZNO) and coordinated by Tāmaki Te Runanga and Te Kaunihera, Saturday’s tournament consists of a competitive section, social section and a fun round section.

Tāmaki Makaurau NZNO representative Rangi "Tiger" Blackmoore-Tufi said the day has been organised to strengthen whanaungatanga (kinship, relationship, sense of family connection) among Māori nurses and other Māori health workers including doctors, allied health, students, social workers and kaiāwhina to promote healthy lifestyles.

Blackmoore-Tufi said with recent events in Aotearoa where the resilience of Māori has been tested kotahitanga had become especially important.

"This is a coming together of hauora providers, iwi providers, marae, health workers, and neighbourhoods who have rallied and continue to rally to ensure we thrive as one despite the ramblings of the coalition Government."

An event such as this will promote Māori cultural identity as it demonstrates, the diversity of Māori in the health workforce, and highlights that every person in this battle for better health outcomes shares the same vision, Blackmoore-Tufi said.

"This is also a unique coming together of Māori that fosters whanaungatanga, and we believe this is essentially important for all Māori health workers.

"The key is we all share a similar vision - to improve the health of our whānau and working well together helps to achieve that. Many of us are on a journey to rediscovering whakapapa, and this fosters those connections further."

Twelve teams from Auckland, Waiariki, Te Matau a Maui and Te Tai Tokerau have already registered to compete in the unofficial "Pa wars". Food stalls, bowel screening team and Māori healers are available for purchase or bookings.

New Zealand Nurses Organisation media release, 16 February 2024

The New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) has released a report on its 2023 Student Survey showing that nursing students face significant barriers to completing their studies, particularly around finances, stress and cultural support – and it’s costing us nearly a third of our new nurses.

The survey was completed by 1406 NZNO student members, and NZNO National Student Unit Co-chair Shannyn Bristowe said the results were really clear.

“At a time of health system crisis, when we desperately need more homegrown nurses, the Government and nursing schools really need to pay attention to what they can do to encourage students to stay in their studies and come out well and ready to nurse.

“Nearly a third (30 percent) of students do not complete their studies and fixing these issues would significantly increase the number of nursing graduates each year.”

Many respondents said they felt moderately or excessively stressed; and they believed students should be given financial help during clinical placements which sees them working full time without pay for up to nine weeks – and often out of town.

Ms Bristowe said paying students the minimum or living wage while on placements would make a massive difference to graduate numbers.

“Nursing students need assistance while they study. Help with paying off student loans after graduation, as the Government proposes, is appreciated but it really misses the point and comes too late to make a difference.”

A second major barrier emerging from the results is institutional racism and a lack of cultural support for Māori and Pacific students.

NZNO National Student Unit Co-chair Stacey Wharewera said Māori and Pacific students are essential and that better cultural support in nurse training would result in a health system that better meets the needs of Māori and Pacific peoples.

“The lack of appropriate cultural support in nursing studies is an issue the Government and training providers need to urgently address.”

The survey is conducted every two years to identify issues student nurses are facing in their studies and to understand how they could be better supported.

The survey report is available on the NZNO website.

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Media enquiries: Rob Zorn, NZNO Media and Communications Advisor: 027 431 2617 | media@nzno.org.nz

New Zealand Nurses Organisation media release, 25 January 2024

The New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) says it is gravely concerned at reports of hospital and health workers being targeted in Gaza. escalating loss of life among health workers and other civilians in the Palestinian Territories.

NZNO Kaiwhakahaere Kerri Nuku says the latest United Nations reports say more than 300 health workers have been killed in the conflict. None of Gaza’s 36 hospitals are fully functional due to bombing, and according to the World Health Organization only 15 of Gaza’s 36 hospitals are partially functional - nine in the south and six in the north.

“We are appalled by reports from health workers in the territories about the constant bombardment, the extreme lack of medical supplies and the tortuous decisions made each day about who can be saved and who will be left to die.

“The health workers say they work under constant fear of being deliberately shot or killed in a bombing. We can only imagine the extent of the suffering experienced by patients, children, families and communities in Gaza and the West Bank.

Ms Nuku said hospitals and their staff are protected under international humanitarian law, and the targeting of hospitals and health workers needs to stop immediately.

“We are calling for an enduring and immediate ceasefire in Gaza and Israel to prevent further civilian deaths and allow health workers unrestricted access to provide lifesaving medical care.”

She said NZNO extends solidarity with health workers everywhere and that the organisation stands with all peoples aspiring for freedom from colonisation.

There will be a health care workers vigil (not organised by NZNO) near Auckland Hospital this evening at 6.30pm on the corner of Domain Drive and Park Rd. The purpose of the vigil is to mourn the health care workers killed in Gaza.

Media enquiries: Rob Zorn, NZNO Media and Communications Advisor: 027 431 2617 | media@nzno.org.nz

New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) says the Ministry of Health is jumping the gun by funding pharmacies to vaccinate infants before investing more in long-established immunisation service providers.

Kaiwhakahaere Ms Kerri Nuku said NZNO fully supported the call for greater investment in primary care to increase childhood immunisation rates instead of transferring responsibility for vaccinations elsewhere.

"We have established, skilled and qualified people in Primary Health Care who have been trained already. They need to be fully supported or supported better.

"We've got a whole sector of nurses including enrolled nurses who have had much trouble becoming vaccinators. It’s not easy even for a registered nurse to become a vaccinator."

Ms Nuku said pharmacies should only be used as a last resort for childhood immunisations after all avenues to enable primary care personnel had been exhausted.

"Let us first utilise the systems that are already available, and let's make sure they are fully supported to be able to deal with the workloads.

"It is primary health care that looks after people from birth to death. Investing in training a whole other sector before exploring all options in the established one makes little sense."

NZNO is also disappointed that key role players such as primary care GPs and nurses were not brought into discussions prior to decisions such as Covid vaccinations and the subsequent transition of unregulated workforce transferring their skills across to childhood immunisation were made.

"Again, we are being told what is being done and not consulted beforehand. The traditional place of vaccinations is with nurses so we should be having some say in these decisions."

Ms Nuku said she also agreed with the General Practice Owners Association (GenPro) that additional funding, especially into the nursing workforce, was a logical option given the issue of pay disparity for primary care nurses and the associated loss of workforce capacity.

The legal mandating of nurse-to-patient ratios needs to be done immediately to help turn around a crisis that puts staff and patients at risk, New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) says.

NZNO President Anne Daniels said feedback from across the health sector showed the Care Capacity Demand Management (CCDM) based system used by Te Whatu Ora was clearly not working for patients or staff as there aren’t enough nurses to make it work.

Ms Daniels said decades ago during weekends and holiday periods such as Christmas, hospitals would reduce staff to allow more people to take a break over the Christmas period, but that was no longer the case.

"We are as busy if not busier than ever. And the culture of reducing staff over this period has continued which puts more pressure on the nurses who remain at work because they've got even less staff than they should have and it's already unsafe."

Nurse-to-patient ratio legislation has markedly improved recruitment and retention in Australia, Ireland, Canada and parts of the United States, Ms Daniels said.

"It will keep nurses in the profession and will attract more students by showing they are valued for the work they do and the incredible pressures they face every day.

"Our patients have the right to safe care and our nurses/midwives have the legislated right to a safe working environment. Legislated nurse-to-patient ratios will deliver both."

The health sector has been plagued by chronic understaffing and that’s why NZNO is seeking to have nurse-to-patient ratios established not just within hospitals but across all sectors including primary care and aged residential care.

"We are actually regressing because some of our members say that 97 percent of shifts at Te Whatu Ora are understaffed. It was 83 percent in 2022 and lower before that.

"Getting legislation on nurse-to-patient ratios is a top priority for the organisation because safe and healthy work environments need to be reestablished."

A nurse-to-patient ratio is the number of nurses or midwives working on a particular ward, unit or department, in relation to the number of patients. CCDM is intended to be used to adjust the minimum number of nurses to meet patient acuity (how sick the patient is and how much nursing care they need).

"Full implementation of CCDM has never occurred or been funded appropriately. The system needs to be reviewed and made fit for purpose to support culturally safe care.

"Legislation is the forcing factor that will deliver the right number of nurses and midwives with the skills, knowledge and experience needed to deliver safe and timely care, where and when it is needed."

Ms Daniels said the major challenge for Te Whatu Ora and other health sector employers lay in their inability to retain staff and this was reflected in the turnover numbers.

"Nurse turnover has increased from 9.1 percent in 2013 to 15.3 percent in 2022 for registered nurses and more than doubled for nurse practitioners, emergency nurses and health care assistants.

"The costs of registered nurse turnover alone is about $1.5 billion a year and this reflects poor staff retention. The time has arrived to turn this around."

New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) is disappointed by the lack of priority given to health in Finance Minister Nicola Willis’ mini-Budget announcement this afternoon.

Kaiwhakahaere Kerri Nuku said the "self-praised" $7.5 billion saving could have gone towards solving the health crisis.

"This Government chose not to fund the frontline. At best, this Government is championing the status quo of an inequitable, underfunded, and understaffed health system.

"At worst, they are driving Aoteoroa’s health system off a fiscal cliff. They seem to be prioritising savings in taxes over the nation’s health."

Ms Nuku said health workers were always asked to do more with less and to support more patients with less funding, to provide high-quality healthcare with less staff and to make do with less pay than they deserve.

"What is desperately needed are funding commitments that help our nurses, our midwives, our health care assistants, and our kaiāwhina do more with more."

Ms Nuku said the finance minister announced $7.47 billion in reduced Government spending to fund tax cuts which will be announced in Budget 2024, and this equated to one-third of this year’s allocated Health budget.

"This Government campaigned on big talk of funding frontline health services, so why is this $7.47 billion failing to make its way to the frontline?"

The total Budget allocation for health services for 2022/23 was $24.638 billion, however, Te Whatu Ora’s recently published Annual Report shows actual spending was $26.703 billion. For the financial year 2022/23, Te Whatu Ora reported a net deficit of $1.013 billion.

"The current Government has only committed its spending in health to match inflation, for context, CPI was 5.6 percent in September 2023.

"This Government’s limited funding commitments for health services does not account for Te Whatu Ora’s existing 4.1 percent deficit due to cost escalation, nor the increasing health costs arising from changing demographics and population needs (for example ageing population or the rise in chronic health conditions), as well as expected cost increases from regular price inflation which is particularly high for clinical resources and medical equipment."

New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) says the cost of ignoring the health crisis will be detrimental to the long-term future of the country if the new government fails to significantly invest in the sector immediately.

NZNO Kaiwhakahaere Kerri Nuku said the "mini-Budget" presented by new Minister of Finance Nicola Willis on Wednesday is a good opportunity to demonstrate whether the new Government is sincere about wanting a healthier New Zealand.

Ms Nuku said it was vital that the mini-Budget increased allocation to health to fund an increase in the number of nurses among other fixes required to address the crisis.

"They should be held accountable for what happens over the next three years.

"We will be continuing to assert pressure for the health workforce to be valued, specifically around issues such as nurse-to-patient ratios, safe staffing levels, health and safety at work and meaningful pay and pay rises."

Last month, thousands of NZNO members stopped work for an hour during paid union meetings to call for increased funding to the health sector from the Government and send a clear message that health workers would not be ignored.

The Government must keep its pre-election pledges around Pay Parity, recruitment and retention of the health workforce, supporting student nurses while they’re actually studying and making New Zealand more attractive to overseas health workers, Ms Nuku said.

"We are concerned about the health and wellbeing of our nation under this Government.

"We need pay and conditions that value nurses right across the health sector and keep them in the job. This includes sustainable funding for Pay Parity and further funds for Pay Equity, which Mr Luxon is on record as saying he would implement."

Ms Nuku said beyond the pre-election promises NZNO insists te Tiriti o Waitangi be upheld in all health settings, so Māori have equal access to a health system that works for them.

"We need training that is affordable and accessible, so more people study and stay on to become nurses and we need more Māori and Pasifika nurses, so people receive health care that fits with their culture."