Nursing reports

The New Zealand Nurses Organisation Tōputanga Tapuhi Kaitiaki o Aotearoa (NZNO) joins te ao Māori to mourn the loss of Dame Tariana Turia - a former Associate Minister of Health and Whānau Ora Minister.

NZNO Kaiwhakahaere Kerri Nuku says like nurses throughout Aotearoa, Dame Turia was passionate about achieving better health outcomes for Māori.

"Dame Turia was the most influential Māori politician so far this century to shift thinking on government health policy.

"She introduced the concept of whānau ora into the health system, and while that hasn’t been fully implemented yet, the seed has been planted.

"Dame Turia introduced policies aimed to achieve a smokefree Aotearoa. And she advocated for better support to improve the Māori nurse workforce and achieve pay parity for nurses everywhere, especially with especially Māori and iwi health providers."

Kerri Nuku said the sacrifices Dame Turia made to advance Māori health, and Māori rights, would not be forgotten by the Māori nursing community.

"She bled for our people! Her achievements didn’t just happen, she had to fight for them.

"We can only imagine the outcast treatment she would have got by exiting one political party to build another political party."

Kerri Nuku said much of what Dame Turia stood for was now under attack by the current Coalition Government but many Māori working in health are "drawing strength from her work".

"Our aroha goes to the whānau pani of Dame Turia - thank you to her children and mokopuna for giving us the taonga they did."

Te Whatu Ora’s Health Workforce Plan released today shows our health system is focused is on capping costs not meeting patients’ needs, New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) says.

NZNO Kaiwhakahaere Kerri Nuku says the plan normalises ongoing understaffing across all settings in the health system.

"It is entirely drawn from operating within a constrained funding environment and repeatedly cites workforce planning around ‘living within our means’ and ‘ensuring more sustainable workforce translates to a more financially sustainable system’."

One of the priorities is getting ‘workforce basics right’ by improving national workforce planning including by reviewing current and future supply models.

"NZNO calls on Te Whatu Ora to utilise safe staffing ratio tools for this work to ensure patient needs are met with sufficient nurse-to-patient numbers. This will also require the current pause in the FTE calculations for the Critical Care Demand Management programme - which Te Whatu Ora nurses are currently striking over - to be lifted," Kerri Nuku says.

Another priority in the plan is to "training more health workers locally" so they "reflect the diversity of our own communities".

"Unfortunately, this rings hollow given Te Whatu Ora’s failure to support new graduate nurses into employment and a lack of support for training more Māori and Pacific nurses to achieve population parity.

"Māori nurses are 7.5% of the nursing workforce but Māori are 20% of the population. Te Whatu Ora needs to properly invest in Māori-focused programmes, continue to fund effective initiatives to increase recruitment and retention of the Māori workforce and grow mātauranga Māori specialists," Kerri Nuku says.

The Coalition Government should mark Human Rights Day by agreeing to end all gender and ethnicity pay discrimination in the health sector, says the New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO).

NZNO Kaiwhakahaere Kerri Nuku says today is Human Rights Day and it’s is a good time for the Government to do the right thing.

"Evidence before the Wai 2575 from our Māori workforce highlighted structural discriminatory practices in the health sector.

"Our members who work for Māori and Iwi health care providers face a double whammy - both gender and ethnicity discrimination.

"It’s time for the Government to be the change.

"For too long nurses, midwives, health care assistants and kaimahi hauora have been the victims of gender-based wage discrimination. It is almost 2025 and undervaluing women-dominated workforces should be relegated to the history books.

"They deserve to be paid the same as their colleagues in other parts of the health sector and at least the same as men in occupations the require the same or similar skills, knowledge, effort and responsibilities

"It’s time for the Government to show its respect and gratitude for the work done by the female dominated nursing workforce - including kaimahi hauora," Kerri Nuku says.

NZNO has pay equity claims being investigated for our nurses, caregivers and support members in aged care, laboratory members and nurses who work for Plunket, hospices, primary practices and urgent care centres, and district nursing services outside of Te Whatu Ora. 

About 36,000 Te Whatu Ora nurses, midwives, health care assistants and kaimahi hauora will down tools tomorrow (Tuesday 3 December) in a nationwide strike over patient safety concerns following proposals raised in recent collective bargaining with Health NZ.

The New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) members fear Te Whatu Ora’s plans to pause a key component of its safe staffing programme put patient and whānau safety and wellbeing at risk, NZNO Chief Executive Paul Goulter says.

Te Whatu Ora proposed pausing FTE calculations for the Care Capacity Demand Management (CCDM) programme during recent collective bargaining. CCDM calculates the number and the range of skills nurses, midwives, health care assistants and kaimahi hauora need based on how sick patients are and how much nursing care they require.

Paul Goulter says NZNO members are concerned this pause leaves few safeguards on staffing levels and will result in fewer health care workers on duty.

"Ultimately, patients will pay the price for hospitals that are continuously understaffed and under-resourced."

Members are also disappointed Te Whatu Ora indicated their bargaining parameters are restricted to 1% of total employee costs, he says. This would be just ½% in the first year because it won’t come into effect until April 2025, and up to 1% in the second year.

"This means nurses, midwives, health care assistants and kaimahi hauora will be offered a wage increase well below the rate of inflation - and effectively a pay cut. Nurses should not have to prop up the health system by taking cuts in pay.

"This could lead to a further exodus of New Zealand nurses to Australia. Nurses need a pay rise that reflects at least the cost of living and recognises their skills and knowledge. With Australia looking like an attractive option, we need pay and conditions that value them and help keep them in New Zealand," Paul Goulter says.

Strike day actions at centres throughout the country can be found here. There will be interview, photograph and video opportunities at every location.

Editor notes:

- The nationwide strike will be a complete withdrawal of labour at every place in New Zealand where Te Whatu Ora provides health care or hospital care services.

- It will be held from 11am to 7pm on Tuesday 3 December.

- Life preserving services will continue to be provided.

- The nationwide strike will be followed by rolling district strikes. Details of these will be released in due course.

Nurses explain in their own words why they are striking...

Waikato nurse Tracy Chisholm, says:

We are striking because we know that nurses play an integral part to the NZ Health System. The lack of respect for the health of New Zealanders and the nursing community by this government needs to be called out.

For me it’s about safety - the safety of our patients. How do we provide culturally safe care without the nurses to do it; how do we educate, prevent deterioration and further harm without the nurses to provide; how do we meet the governments health Kaupapa without the nurses?

Rotorua nurse Lyn Logan, says:

We are striking because Te Whatu Ora's constant financial constraints impact the care we provide our patients. When we are under-resourced and understaffed, we do not have enough healthcare workers to give the best care, and our patient's care will suffer as a result. NZNO members are standing up for a better health system for our patients, whanau, and our country.

For me, it’s about informing the public who use health services, and my community, that if I do not strike then I am not committed to improving health services in my region. I want to give our community the best care I can when they come into the hospital, at present I cannot do this.

The Government and Te Whatu Ora are not listening to healthcare workers who are on the frontline, so striking is the only way I can raise awareness of the issues I face with unsafe staffing and inequity. If we rise up together, we can make a difference and try and change how things are at present.

Hutt Valley nurse Nathan Clark, says:

We are striking because it's about patient safety, ensuring we have enough skilled healthcare workers at the patient’s bedside, in the community, in people’s homes and where they are needed.

We have been fighting and advocating for years for safety for our patients. As health professionals we know that nurses at bedsides and safe staffing provides for a better outcome, better patient care and patient experiences when receiving health care services.

We are striking because putting our patient needs at the forefront by seeking increased staffing levels, commitment to the identified Care Capacity staffing increases and a wage that reflects our skills and knowledge and to retain our workforce.

Christchurch nurse Debbie Handisides, says:

For me this strike is for our future nurses and health care; to not lose the gains we’ve made for nurses and patients in Aotearoa.

We have fought for years for nurses to be paid equally to a male comparator, but with the parameters that Te Whatu Ora are proposing up to 1% total cost of a nurse won’t even meet the household cost of living, so why would anyone pick nursing as a career if they can’t pay their household bills.

The future of health care sits on nurses’ shoulders because we care with our hearts, yet the Government just talks about budget targets saving lives, yet it’s actually doctors and nurses that save lives, and are the ones that care so much we’re fighting by striking for a better funded health care system to save people’s lives.

Tauranga nurse Helena Joyce, says:

I am striking because as a nurse I see how dangerous it is when we are short-staffed, nurses get overworked and then make mistakes like medication errors. Years of effort have gone into CCDM and now they are throwing it away. What happens next year when they start a new ward or do some changes to a ward how then, are management going to decide how many nurses are needed. There seems to be no point in throwing this out except to make us understaffed.

Waitemata nurse Troy Stewart, says:

We are fed-up with the constant undervaluing of our complex and comprehensive work as nurses, and the disrespect being shown towards our understanding of what we need to do our job properly.

We feel that Te Whatu Ora's suggestion that we are only worth a net pay cut and that we don't know how to represent how understaffed we are is insulting and irresponsible. Why would anyone be willing to roll over and accept a precedent that would undermine the wellbeing of our health system founded on telling the workers that hold the system up that they are worth less than nothing?

Whakatāne nurse Tracy Black, says:

For me, it’s about the safety of my people, culturally safe staffing saves lives.

Te Whatu Ora has utterly failed graduate nurses by employing just over a half of this year’s cohort, says NZNO National Student Unit co-chair Bianca Anderson.

New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) has more than 5000 nursing student members throughout Aotearoa.

"It is devastating for nurse graduates to learn today that only half of their cohort have got jobs after three years of hard study and clinical placements," Bianca Anderson says.

"Te Whatu Ora has failed in its most basic duty - to plan the future nursing workforce. The first year of employment is critical for nurses entering the health workforce.

"Te Whatu Ora’s decision to hire just 844 of 1619 applicants (52%) will mean some graduates are forced to find other work and will never go on to nurse. Others will be packing their bags for Australia."

Bianca Anderson says two years ago, Te Whatu Ora was hiring 100% of graduate nurses.

"These graduates studied nursing because New Zealand was crying out for nurses during the pandemic.

"For decades New Zealand has failed to train enough local nurses and relied on having to import internationally qualified nurses.

"There are only fewer vacancies for graduates this year because of Government cost cutting, not because there is less need for nurses in our hospitals.

"Nursing students train to work in the health sector because they care about people and it is patients who will be affected by these cutbacks on graduates," Bianca Anderson says.

Today’s announcement of $10 million for specialist nurses and allied health professionals shows the Government has no vision to fix the broken health sector, NZNO says.

New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) Kaiwhakahaere Kerri Nuku says the $10 million is not new investment in health.

"This is a money-go-round. It is reallocated money from within existing budgets and has come from making cuts elsewhere in the health system.

"More specialist and regional nurses are good news for patient and whānau safety and wellbeing, but $10 million represents a 0.2% increase in investment on nurses - which is even less once allied health professionals are hired out of the same fund.

"It is a drop in the bucket of what is needed to fix critical nurse shortages in areas such as mental health, maternity care and emergency departments.

"Aotearoa desperately needs more Māori nurses to ensure there are culturally safe nurse to patient ratios and improve Māori health outcomes.

"There is no recognition of this in today’s announcement which comes on the day it is revealed that Te Whatu Ora plans to cut staff in its Hauora Māori unit.

"The Government has no vision for the health sector beyond slogans and continues to tinker around the edges of a chronically under-funded health sector," Kerri Nuku says. 

The Government will today be urged to ensure the new Dunedin hospital provides crucial tertiary level health services for the Southern region in a petition being handed over at Parliament today.

Tertiary level health services are specialised and lifesaving care such as surgery and lifesaving and cancer treatments. The current Dunedin Hospital which provides a range of these specialist services to patients throughout Otago and the South Island is in a state of disrepair.

The 34,406-signature petition from the New Zealand Nurses Organisation (NZNO) Tōpūtanga Tapuhi Kaitiaki O Aotearoa calls for the new hospital to be fully funded as planned after the Coalition Government in September said it would be scaled back to reduce costs.

The proposed downgrades are a false economy, says NZNO delegate Linda Smillie.

"A scaled back hospital will increase costs over the long term because it will reduce the clinical capacity to care for an increasingly aging population.

"Nurses will not be able to provide the appropriate level of care their patients need. This will lead to patient harm and loss of life."

The Coalition Government must fund the full new hospital as was promised, Linda Smillie says.

"Southerners deserve more than half a hospital or a slow rebuild of the old hospital."

• NZNO representatives will be at Parliament at 12:30 with the Dunedin City Council delegation led by Mayor Jules Radich.

New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) members employed by Te Whatu Ora are alarmed by Health New Zealand’s plans to pause a key component of its safe staffing programme.

Te Whatu Ora indicated they would pause calculations for the Care Capacity Demand Management (CCDM) programme during collective bargaining late last month.

CCDM calculates the number of nurses needed based on how sick patients are and how much nursing care they need.

Te Whatu Ora also indicated their bargaining parameters are restricted to 1% of total employee costs*.

Both issues will be discussed at 62 urgent paid union meetings across the country this week.

NZNO chief executive Paul Goulter says the meeting will allow nurses, midwives, and health care assistants to determine their next steps in the ongoing bargaining process.

“Our members are fiercely committed to caring for their patients. They don’t want to see patients’ safety at risk because there are not enough nurses on duty to give them the care they need.

“Putting a pause on CCDM calculations is putting a pause on patient safety.”

Nurses are also insulted by Te Whatu Ora’s indication they would only be offered a ½% wage increase in the first year and up to a 1% wage increase in the second year, he said.

"Nurses need a pay rise that reflects at least the cost of living. Our members deserve fair pay and conditions that recognise the value of nurses and healthcare workers. With nurses flocking to Australia, we need pay and conditions that help keep them here.”

-Ends-

* Total employee costs include salaries, penal rates, allowances, leave entitlements, work related expenses and other expenses including leave revaluations, ACC and Superannuation.

Mental Health Nurses have serious concerns about the safety of their patients, the public, their colleagues and themselves when police changes to emergency 111 calls come into effect on Monday, New Zealand Nurses Organisation (NZNO) Tōpūtanga Tapuhi Kaitiaki o Aotearoa says.

On Monday 4 November police will begin a phased withdrawal from most mental health emergency call-related work including attending callouts, waiting with patients in Emergency Departments and transporting patients to mental health facilities.

NZNO Mental Health Nurses Section chair Helen Garrick says mental health nurses often need to go into people’s homes and in the past have had the back-up of police.

"It will now be up to nurses to prove someone is a serious danger to themselves or others before they get police support. This will delay urgent assessments and creates the potential to endanger the patient, the mental health workers, and possibly, the public.

"Nurses don’t have the legislative power to restrain people in the community or the tools to keep themselves or others safe when dealing with a psychotic or drug induced illness. We fear these changes will lead to more threats and assaults on nurses," Helen Garrick says.

The already stretched mental health workforce doesn’t have the capacity - or the skills and tools - to pick up this extra work safely, she says.

"We are very short staffed across acute mental health services, crisis services and forensic (criminal justice-related) services. Te Whatu Ora assumes there is the workforce to pick up this work but mental health workers are struggling to maintain their current services.

"There has been no discussion with frontline staff about the potential resourcing and changes required. NZNO has called for these changes to be stopped until Te Whatu Ora can reassure patients and nurses there are processes in place to make them safe.

"Changes like this require years of planning and workforce development. But Te Whatu Ora has only just begun putting plans in place for the health sector to deal with these changes despite police indicating since August 2023 they are coming," Helen Garrick says.

The United Kingdom model - which the change from a police to a mental health response is based on - was phased in gradually throughout the country with significant investment in purpose-built crisis hubs and hospital-based suites, but there had been no additional investment here, she says. 

On Saturday (19 October), New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) nursing students take their struggle to the streets calling on the Government to invest in their futures with paid training.

Students need assistance while they study but are being ignored and exploited by those in charge, NZNO spokesperson and former National Student Unit co-chair Shannyn Bristowe says.

They are given no additional financial help during clinical placements which sees them working full time without pay for up to 12 weeks - and often away from their hometown, she says.

"Existing student allowances aren’t enough to cover even the most basic necessities.

"Tauira (students) are stressed both financially and mentally. They are living in sheds, in cars, or in cramped, temporary spaces, just to get by. Some can’t afford to keep the lights on or put kai on the table for their whānau. The financial burden of studying weighs heavily on us all, forcing some of us to make impossible choices between paying bills, buying food, or continuing our education.

"This burden is even heavier for Tauira Māori, as existing inequities create additional barriers, leading to the continued under-representation of Māori in the nursing workforce.

"This is the reality we face every day. And we endure it because we want to serve, we want to help, we want to be the faces of care for our communities."

Ms Bristowe says with a high student drop-out rate of 33 percent, paid training is essential to keep students focused on studying and professional development instead of perpetually struggling.

"Aotearoa cannot wait. Our people need nurses who are well-prepared, culturally safe, and emotionally resilient. Nurses who have not been broken by the journey to get there but have been supported along the way.

"We ask the Government: Is this not a worthy investment? Because this isn’t just about us-it’s about the health and future of Aotearoa. We’ll be calling on the public to support us by signing our petition to the Government calling for paid training," Ms Bristowe says.

Rallies take place at nine centres across the country.

Find the locations here