Nursing reports

New Zealand Nurses Organisation media release, 8 September 2023

The New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) wants more detail from campaigning political parties about how they will urgently fund 4000 more nurses, especially those who are Māori and Pasifika.

NZNO Kaiwhakahaere Kerri Nuku said at least 4000 nurses were needed tomorrow, but that any recruitment initiatives must be focused on having more Māori and Pasifika nurses, midwives and health care assistants in place.

“We have a health system based on western models from which many Māori and Pasifika people feel culturally alienated. This means they are much more likely to seek health care late, or not at all.

“That’s a tragedy, but denying Māori and Pasifika culturally appropriate care also puts a greater strain on the health system’s resources through longer than necessary treatment and longer hospital stays. Those are resources that could be used to fund more beds or pay wages for more nurses.”

The most recent Nursing Council statistics indicate that Māori (17.4 percent of the population) make up just 7 percent of the nursing workforce. Pasifika (8 percent of the population) make up just 4 percent.

Ms Nuku says increasing these numbers significantly will result in care across the health system that is culturally appropriate and that will lead to increased (and earlier) Māori and Pasifika engagement with services. And this will significantly reduce the economic health burden.

“We need also to remember that upholding te Tiriti o Waitangi firmly across the health system is part of the obligation for Māori to have self-determination over their own health and wellbeing and to achieve equitable health outcomes. Pasifika are also entitled to culturally appropriate care.

“We cannot achieve these things without more Māori and Pasifika nurses.”

She said to grow nursing numbers we will also need to address the nursing student problem.

“By the third year of study 25 percent of nursing students drop out overall – mostly due to financial hardship. That figure is 33 percent for Māori and 37 percent for Pasifika.  

“One way of attracting nursing students would be funded free training for them, and to have their work placements paid. Dropout figures would fall and the number of new nurses would rise more quickly over time.

“We do this for much-needed trade apprentices, so why not for nurses? Surely that’s a policy gap any political party with a modicum of courage could grab!”

Ms Nuku says she wonders how many political parties really grasp how bad things will get in the next few years if these problems aren’t addressed.

“I would love to hear more from political parties about just how they will find the courage to fund more nurses more quickly, particularly Māori and Pasifika.

“These are real problems and I want to know just what each party intends to do about them.”

-Ends-

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

New Zealand Nurses Organisation media release, 5 September 2023

The New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) supports the senior doctors and dentists on strike today for wage increases that reflect real rises in the cost of living.

NZNO President Anne Daniels said asking senior doctors and dentists to take a pay cut by not offering increases that match the CPI is both unfair and short-sighted.

“We are at a time when health professionals are leaving their jobs at unprecedented rates.

“The work is endless, the pressures are high and the prospect of burnout is very real. Refusing fair pay lifts is just going to exacerbate the problem, causing more doctors to leave or retire early.

“It’s hard enough right now to get an appointment with a doctor and this has already resulted in massive pressures on emergency departments, which affects us all. Te Whatu Ora’s penny-pinching on wages will just end up costing the health system more in terms of pressure on other workers and remaining resources.”

Ms Daniels said that, like nurses, senior doctors and dentists care about their patients and they are going on strike for the good of their profession’s future. Wages that properly recognise the qualifications and contributions of senior doctors in the public system – by at least matching the inflation rate – will help reduce the number leaving for overseas or private sector positions.

“NZNO calls on Te Whatu Ora to show more foresight. Asking senior doctors and dentists to take a pay cut will just further reduce the availability of health services to everyone in Aotearoa New Zealand.

“Our whānau, our loved ones and our communities need their doctors and dentists. Give them at least the cost of living so more will stay.”

-Ends-

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

NZNO Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) and PSA members, employed at Whakarongorau Aotearoa New Zealand Telehealth Services, will embark on an hour-long rally on Friday morning following a breakdown of talks with their employer.

The rallies take place in Auckland, Wellington and Christchurch.

NZNO delegate Bruce Tomlinson said more than 300 NZNO and PSA members have been in protracted bargaining with Whakarongorau for months without many inroads.

Tomlinson said after more than a year since the previous collective agreement expired, Whakarongorau management had offered a paltry 2.5 percent increase for most workers, which falls far below the claim for a cost-of-living increase.

"This is a pay cut in real terms. Union members working at Whakarongorau have had enough. Our battle is over having decent wage increases, and we are committed to achieving an increase that reflects what we are worth and mitigates the cost-of-living crisis all our members face.

"Whakarongorau has offered well below this. They have refused to move and have not meaningfully engaged in many of our claims."

Tomlinson said the enterprise allegedly paid out $11 million to each of its shareholders - Pegasus and Procare - in the last financial year.

Whakarongorau employees provide immediate support to everyday people all across the country through services like: Healthline, 1737 Need to Talk?, Ambulance Secondary Triage, National Poisons Centre, GP After Hours, Earlier Mental Health Response, Shine Domestic Abuse Helpline, Diver Emergency Service Hotline, NZ Defence Force Mental Health Line among many others.

"We are literally the first line in many of the services we provide. We are the voice on the other side of your calls 24 hours a day, and seven days a week.

"It could be said that without us the inhouse health sector would fall over because much of the job is to either keep people out of EDs or away from GPs and refer them in a timely manner if needed."

The rallies take place at 8.30am and 4.30pm on Friday 1 September near the Whakarongorau offices in Auckland (25 College Hill, Freeman’s Bay), Wellington (36 Customshouse Quay) and Christchurch (36 Madras Street).

"Show your support for NZNO and PSA members who are standing up for fairness at work," Tomlinson said.

"You can also share your message of support with #thenurseweneed"

The annual Indigenous Nurses Aotearoa Conference will be going back to its roots by "Reclaiming our Whakapapa - Mana o te wai" its theme for this year.

The conference takes place at the Holiday Inn in Tamaki Makaurau, Auckland on Friday and Saturday.

New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) Kaiwhakahaere Kerri Nuku said: "Korero, waiata, moteatea haka or whakatuaki shared by whanau, hapu, and Iwi katoa each have their rhythmic expression to describe the timeliness of whakapapa or a celebration of the beauty of their whenua, acknowledgement of their tipuna or other majestic beauties.

"Our whakapapa connects us and grounds us to our turangawaewae our whenua and our culture, and our rights to protect this taonga is imperative."

Ms Nuku said indigenous nurses have been historically disenfranchised by a system designed to keep them on the sidelines.

"Lower wages, fewer opportunities, lack of respect, passed over for promotions by virtue of being Māori are just some of the acts of prejudice indigenous nurses experienced in the past.

"As a consequence, at just over 4000, only about 7.5 percent of nurses in Aotearoa are Māori. Our nurse numbers continue to lag behind."

She said making the system more culturally sensitive and more responsive to the needs of Māori communities offered an obvious solution to problems faced by indigenous people in Aotearoa.

"We need to turn this frustration into action and continue the fight of our whakapapa to push for recognition in a system that makes it difficult for us to even remain relevant."

Also, on the evening of Friday, 18 August, for the sixth year running the Pharmac Tapuhi Kaitiaki Awards - the Māori nurse awards - will be hosted in tandem with the conference.

Ms Nuku said some truly exceptional nurses and tauira have been recognised over the years through these awards, and she was confident this year would be no different.

"Māori nurses are not only dedicated professionals but great innovators. The Kaitiaki Awards provide a wonderful opportunity to showcase their day-to-day mahi for the betterment of their people."

The New Zealand Nurses Organisation, Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) says it has supported the issuing of a provisional improvement notice (PIN) to Waikato Hospital’s Emergency Department (ED) in response to health and safety concerns arising from unsafe staffing levels.

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

The PIN was issued today (Wednesday 2 August) at 10am by Janferie Dewar, a registered nurse who is also HSR for the ED, because severe staff shortages and unreasonable and unmanageable workloads have made the ED critically unsafe, and led to increased sick leave, burn out and resignations.

Ms Dewar says she issued the PIN representing workers in the ED, but that more than 150 staff across the hospital have signed a document in support of the notice - ranging from nurses to health care assistants, students, cleaners, paramedics and doctors.

"The PIN was also endorsed by a health and safety working group of 35 NZNO delegates and external health and safety advisors because, even after three letters of recommendation to Te Whatu Ora Waikato management since April this year, the health and safety risks in the ED have not been addressed to anywhere near an acceptable level.

"Despite ongoing meetings with management nothing significant has changed even though the ED is almost in code red by default.

"We’re at the point now where staff have had enough."

Other issues addressed by the PIN include Waikato Hospital not training health and safety representatives to the required NZQA standard (so they are not qualified to issue PINs); staffing levels significantly below requirements on a regular basis; and the hospital not following its own policies around escalation when safety risks become critical.

"There’s been a fundamental non-compliance with the employer’s primary duty of care to keep staff safe and provide reasonable workloads," Ms Dewar said.

"Other big employers in New Zealand have to comply with the Health and Safety Act by managing risk and ensuring workloads are reasonable for workers. Te Whatu Ora is an employer and should not be exempt from the law.

"It’s just not physically possible for one person to do the work of two or three nurses, but that is what is regularly required of staff, and the result has been chronic fatigue and anxiety. Their only relief from work stress is a quick and quiet cry in the toilets.

"Staff turnover is unprecedented, and a number are on stress leave as we speak so the situation just continues to worsen. The ED is in critical care deficit by the organisation's own risk scoring and this PIN is because the hospital is failing to meet its obligations under the Health and Safety Act.

Te Whatu Ora Waikato management have until 11 August to comply with the PIN’s recommendations.

New Zealand Nurses Organisation media release, 31 July 2023

In an historic ballot, which closed at noon today, nurses, health care assistants and kaimahi hauora covered by the Nursing Pay Equity claim voted overwhelmingly to accept a proposed settlement.

Those voting included members of the New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO); the Public Service Association (PSA) and other part and present employees of Te Whatu Ora who do not belong to a union.

The proposed settlement arose from mediation between Te Whatu Ora, NZNO and the PSA who have been in litigation over the claim in the Employment Relations Authority (ERA) and Employment Court since early 2022. The three parties have agreed that this litigation will now cease.

NZNO Chief Executive Paul Goulter said the robust outcome is a significant milestone in the history of nursing in Aotearoa New Zealand.

“This is a long overdue step towards addressing the significant gender-based inequality nurses, midwives, health care assistants and kaimahi hauora face in their work every day. But it is also just a beginning, and we look forward to working with Te Whatu Ora to address other forms of gender-based discriminations nurses face.”

However, he said NZNO will not rest until these new rates addressing gender inequality were extended to every nurse, everywhere in Aotearoa New Zealand.

“The need for Pay Parity across all nursing sectors is well-established and not in dispute. That all nurses are paid the same according to their qualifications and experience is a matter of wage justice.

“It will mean nurses can work where they believe they can best contribute, rather than where they can earn enough to pay the bills. It will also help end the discriminatory wages and conditions faced by Māori and iwi, Pasifika, rural and other disadvantaged health service providers.”  

-Ends-

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

New Zealand Nurses Organisation media release, 18 July 2023

Members of the New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO), who are employed by Te Whatu Ora, have received a new collective agreement offer from their employer. The offer was received in the latest round of negotiations on 17 July.

NZNO Chief Executive Paul Goulter says the offer is an improvement over the last one, but there are still significant gaps between the offer and what members have claimed around issues of pay, safe staffing and health and safety.

“Our processes are democratic, and it will be up to the 35,000 or so of our members who work for Te Whatu Ora to decide collectively whether it is good enough.”

The offer comes a day before a ballot for 24 hour strike action on 9-10 August by Te Whatu Ora members is due to close (at midday on 19 July). Paul Goulter said that if members vote in favour of the strike, it will go ahead unless members vote to ratify the recently received offer. A ratification vote on the offer will take place during the first week of August.

“Members had become fed up at the lack of bargaining progress. The current agreement expired in October and Te Whatu Ora didn’t even produce a first offer on anything until March. Since then progress has remained excruciatingly slow, and that is why members demanded a strike ballot.”

Meanwhile, NZNO Te Whatu Ora members are also set to vote on a Pay Equity offer from the Government and Te Whatu Ora, which, Paul Goulter says, is meant to address long-standing gender discrimination.

“Pay Equity is actually an entirely separate process from collective agreement negotiations.”

The Pay Equity ratification ballot will open on 24 July and close on 31 July. The collective agreement ratification ballot will open on 1 August and close on 7 August.

-Ends-

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

New Zealand Nurses Organisation media release, 5 July 2023

The New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) welcomes the Health workforce plan, released yesterday by the Ministry of Health’s Workforce Taskforce.

NZNO Manager of Nursing and Professional Services Mairi Lucas says there has never been a specific strategy addressing the health workforce and that is part of the problem.

“Had such a plan been produced 20 years ago, when this current crisis was first predicted, we wouldn’t be in this mess.”

Ms Lucas said it was great to see both Health Minister Hon Ayesha Verrall and the plan itself, acknowledge there has been a failure in long-term workforce planning resulting in our current staffing shortage.

“Significant mahi has been done by NZNO delegates, members and officials to highlight the dire situation nurses have struggled with for too long, so the plan – which includes many of the focus areas of NZNO’s Maranga Mai! strategy – is certainly welcome.

“Growing pathways for Māori and Pasifika into health are the first and second of six defined action areas in the Taskforce’s plan, and we agree that we cannot fix staffing shortages or reduce the health burden without more Māori and Pasifika nurses providing culturally appropriate care.

“It’s also good to see that settling outstanding pay issues, collaborative pay negotiations and helping staff stay safe at work are key tenets in the fifth action area: Supporting and retaining our valued workforce.”

She said the important thing now is to ensure that the new pay gap between Te Whatu Ora and other areas of nursing, such as: Community; Primary Health Care; Māori and Iwi; and Aged Care does not exacerbate the problem of these nurses leaving their current roles for ones where they are better able to provide for their whānau.

“The plan estimates New Zealand is currently short 4800 nurses across the whole health system (not including midwives) and predicts that number will have risen to 8000 by 2032. We’d like to see the evidence and core data behind those numbers.

“NZNO currently has a bargaining claim with Te Whatu Ora for staffing ratios that would guarantee enough nursing staff to meet patient numbers at all times. For health and safety reasons we need to be confident that the plan takes those future ratios into account.

“We have a massive problem, and we need all hands on deck and a workable strategy to get ourselves back on course. If we don’t the nurses, midwives, health care assistants and kaimahi hauora of the future will be working in even more horrendous conditions.

“The people of Aotearoa deserve a health system that can provide safe, quality care to ensure the wellbeing of us all.  To still be facing an understaffed, inaccessible and frankly dangerous health system in 2032 is the last thing anybody wants to see.”

-Ends-

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

New Zealand Nurses Organisation media release, 20 June 2023

The New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) says it supports ethnicity being part of the logarithmically derived Equity Adjustor Score currently applied to decisions over surgical wait times in Auckland.

NZNO Kaiwhakahaere Kerri Nuku says the approach should be adopted nationally as a way of upholding te Tiriti o Waitangi across the health system and addressing historic institutional racism in health, which has disadvantaged Māori and Pasifika people in particular for decades.

“Of course clinical urgency has to be the first priority, nobody should have life-saving or critically important health care delayed on the basis of race. But we do think ethnicity and where someone lives should be part of the overall score that determines how you are prioritised for your surgery.

“We need to remember that Māori and Pasifika people are already years behind when it comes to interacting with the health system, especially those who live remotely or who are the most disenfranchised from a traditionally colonial health system.

“That means they are sicker with more acute health needs requiring more health resources in their treatment.”

Ms Nuku says inequitable health outcomes for Māori and Pasifika peoples are already a significant contributor to the intense workloads currently faced by understaffed nurses, health care assistants, midwives and kaimahi hauora across the health system.

“Upholding te Tiriti in health is the number one item on NZNO’s Maranga Mai! health campaign agenda because we know that what is good for Māori is good for everyone in Aotearoa New Zealand.

“Inequality is a massive drain on resources because it shuts people out of the health system and then costs are multiplied when they finally present for treatment in an advanced state of unwellness that could have been avoided.

“Tax payers foot the bill for that. It’s a waste of resources. It’s a waste of people’s lives and it is fundamentally unjust.”

She said it is incumbent on the Government and Ministry of Health to find ways to combat the unfairness Māori and Pasifika face in accessing health care.

“This is one small thing we could do that could lift the statistics, improve health outcomes for Māori and help us get closer to the equitable health system we all want.

“It’s one small thing we could do to help address the pressure on our health workers over time because reducing the health needs for Māori, the poor and the remote will lead to better health over all and reduced demands on the time of the people who care for them.”

-Ends-

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

Nurses are saying some areas of mental health are beyond crisis point and many mental health nurses are close to quitting from the relentless pressure of staff shortages and daily assaults by patients.

New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) Mental Health Section chairperson Helen Garrick says while mental health nurses are committed to protecting the public by ensuring that standards of service are of the highest order, the current system makes this impossible.

"It is with regret that we have to express this dissatisfaction and frustration with the current standards as we’re concerned for the patients who receive our care."

Ms Garrick, herself a mental health nurse, said the situation reported recently in the media at Wakari Hospital in Dunedin was becoming the norm rather than an exception.

"Bed numbers are being cut at Wakari Hospital’s mental health ward 9A. It has only 50 percent of the staff it needs to operate at full capacity, and this is unacceptable.

"Another absolute crisis is taking place at Southland Hospital where working double shifts is common and community nurses have come in to fill the gaps. This means they cannot see to those in immediate need in their communities."

Other regions were also struggling with a large number of vacancies which in turn leads to staff having to cover more shifts and this leads to burn out.

"We would welcome zero fees by the Government for nursing students as one of the solutions."

Ms Garrick said another area of concern among mental health nurses was the number of assaults that they experienced.

"People need to realise that working in mental health takes advanced communication skills such as de-escalation and assessment of the cues that are occurring at the time."

She said mental health nurses are being assaulted by patients every day across Aotearoa. These range from having water or milk thrown at them to more serious infractions where nurses have been hit so badly, they’ve lost consciousness or being badly scalded with hot liquids.

Some of these assaults result in nurses being retired on medical grounds while others resign in fear.

"I know of a nurse in Auckland who was punched in the head until she passed out. All she did was to ask the patient not to vape which was in line with the no vaping policy.

"This happened five months ago, and the nurse has not been back to work since due to her injuries."

Dozens of these cases have been reported to police but nothing has been done, she said.