Nursing reports

New Zealand Nurses Organisation media release, 6 July 2020

More than 3400 primary health care nurses and medical receptionists/administrators across more than 500 practices and accident and medical centres will stop work for two hours nationwide on Thursday 23 July after mediation to settle their multi-employer collective agreement (MECA) negotiations failed.

New Zealand Nurses Organisation (NZNO) Industrial Advisor Chris Wilson says this has not happened before in these primary health care workplaces and is a clear indication of the frustration workers feel after eight months of fruitless negotiations.

“It’s not surprising employers have not increased their offer to one that our members could accept because their funding from Government is completely inadequate. Employers have been very clear that they also want pay parity with DHBs so they can keep their staff and continue delivery of a quality primary health care service.”

Ms Wilson said an experienced nurse covered by the Primary Health Care MECA is currently paid 10.6 percent less than their DHB colleague with the same qualifications, skills and experience.

"This is completely unjust and undervalues the amazing work these nurses do in providing expert care in the community – demonstrated so clearly in the COVID-19 response."

She said this was not your usual union versus employer dispute.

“Owners, doctors and managers are also disappointed that Government funding for pay parity has not been forthcoming. This is despite approaches to ex-Health Minister David Clark, the Ministry of Health and DHB officials by both NZNO and employer advocates the NZ Medical Association and Green Cross Health.”

Ms Wilson said the recently released Health and Disability System Review Report was clear that primary health care nurses should expect pay parity, and that ex-Health Minister David Clark acknowledged there was a disparity as recently as a month ago.

“Resolving this really comes down to political will, and our members’ patience has just about run out. Budget 2020 put an extra $3.92 billion into DHBs over the next four years, whereas pay parity for PHC nurses would cost a mere $15 million.

“Last week $15 million was promised to assist completing the Christchurch Coastal Pathway. Our members are wondering what has to happen for Government to appropriately value them and the Primary Health sector as the frontline of our health service.

“Without additional funding, recruitment and retention issues will only be solved by passing additional costs on to the consumers. This is not a responsible solution and clearly not in the interests of communities."

Ms Wilson said NZNO will be contacting the Chief Nursing Officer, Director General of Health, relevant Ministers and the Prime Minister this week to make the case again for improved Government funding.

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

New Zealand Nurses Organisation media release, 12 June 2020

Pay talks stalled yesterday and Mediation is the next step for primary health care nurses, says the New Zealand Nurses Organisation (NZNO). NZNO has been negotiating the Primary Health Care Multi-Employer Collective Agreement (PHC MECA) since November last year for 3400 nurses, receptionists and administrators across more than 500 practices and accident or medical centres.

NZNO Industrial Advisor Chris Wilson said the employers were not able to increase their offer rejected last month by NZNO members, and that additional funding is clearly needed before they could. However they were also clear that pay parity with DHB nursing staff is necessary to continue delivery of quality primary health care.

“It is very disappointing for all parties that we have not yet gained the Government funding needed despite approaches to the Health Minister, the Ministry of Health and DHB officials by NZNO and organisations such as the New Zealand Medical Association, Green Cross Limited and General Practice NZ.”

NZNO released a petition two weeks ago asking the Government to intervene and that DHBs urgently provide the funding needed to fix pay parityy and properly value primary health care workers. Almost 8000 people signed and Ms Wilson says the messages are very clear.

"People want these staff to be properly valued and they want enough of them available to provide the primary health care services we all need. General practices and emergency centres are the front door of the health system."

An experienced nurse covered by the PHC MECA is currently paid 10.6 percent less than their DHB colleague with the same qualifications and experience.

“This is completely unjust and undervalues the amazing work these nurses do in providing expert care in the community – demonstrated so clearly in the COVID-19 response,” Ms Wilson said.

The next stage in the negotiation process is Mediation, which will take place on 29 June.

“That leaves two weeks to fix the disparity and it really comes down to political will. Budget 2020 put an extra $3.92 billion into DHBs over the next four years whereas pay parity for PHC nurses would cost a mere $15 million.

“Without additional funding, recruitment and retention issues will only be solved by passing additional costs on to the consumers. This is not a responsible solution and clearly not in the interests of communities."

On Friday 19 June primary health care workers will be highlighting the pay parity issue by holding a “Seeing Red Day” to demonstrate that they are in fact “Seeing Red”. General practices and emergency centres across the country will be decked out in red and staff will wear items of red clothing.

Primary health care funding comes through the Vote Health Budget and is allocated to general practices and other services via the DHBs and primary health organisations (PHOs).

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

More information

People signing the petition for pay parity with DHB nurses were able to include comments. Here are just a few select examples.

Nurses

“I absolutely support my primary health colleagues in their fight for pay parity. It is outrageous that any pay increases do not apply to all professional nurses.”

“After 45 years working in primary and secondary care, I am fully aware of the different skills required and demands on nurses in each sector. Neither group is more important, or more essential, to the health of the patient, the community or the nation – so why does our pay not reflect that? General practice a private concern, so not your problem??? Get real!!”

“After 50 years of Nursing I feel undervalued and underpaid.  We are worth so much more.”

Doctors

“Our primary care nurses are one of the key foundations of our health system in New Zealand. I've seen first-hand that many amazing practice nurses are considering leaving to go to hospital nursing because of the pay inequality.”

"As a GP and practice owner we are now in the position of being so restricted in what we can charge patients that it makes it near impossible to recover business expenses (such as a fair wage for practice nurses) by passing those costs onto our  users (patients). I support the NZNO in their position of requesting additional funding from MOH/DHB's to cover the cost of a nurse wage increase. "

“As a GP, we could not do our jobs and promote the health of Kiwis without our amazing primary care nurses. General practice is the backbone of healthcare in Aotearoa and the nurses who work tirelessly educating and supporting patients are priceless. Please help us support our nurses and show them we value them!”

Patients

“A chat with your practice nurse is always helpful. They provide an amazing service for ALL age groups. They should never be undervalued!”

“Please value the hard work these nurses do. They save the DHBs money and resources by preventing hospitalisations and by supporting people with chronic/complex health needs… to self-manage in the community. The least the DHBs can do is pay them the same as their nursing colleagues in the hospitals.”

“I have struggled significantly with health issues for years, leading me to spend time at my GP clinic frequently and being in hospital. I spend more time with the nurses than I

New Zealand Nurses Organisation media release, 13 May 2020

The New Zealand Nurses Organisation (NZNO) says it welcomes the incident review report released today by Waitematā District Health Board (DHB) into COVID-19 Staff infections at Waitakere Hospital during April.

Seven nurses contracted the virus at the hospital during April, one of whom was admitted to hospital.

NZNO Associate Professional Services Manager Kate Weston thanked the DHB for acknowledging the exemplary care provided by the nurses and for their apology to those nurses and their whānau.

“This will go some way to rebuilding their relationship with their employer,” she said.

However, Ms Weston said the report’s recommendations highlight a number of serious concerns and some valuable lessons about practice going forward.

“Health and safety concerns continue with a real lack of clarity around patient flow and rostering to properly eliminate exposure risk, case definitions and ongoing PPE access issues.

“The DHB has put these nurses and their whānau at an unacceptable risk and we’re concerned lessons weren’t learned from the larger clusters in Waitemata and Rosewood/Burwood.”

Ms Weston also said a major concern arising from the report is that workplace exposure to COVID-19 is not recognised as a reportable event to Worksafe.

“NZNO and other unions are very concerned that health workers aren’t afforded that level of investigation from this external body and regulator when things related to safety go wrong in workplace and someone is hospitalised.”

She said, however, that NZNO is pleased the DHB has been in contact with affected staff to check on their wellbeing.  NZNO has also supporting the nurses who had been in contact.

“Our thoughts are with the nurse who was hospitalised with hopes for a full recovery. They are also with those other staff unwell and at home, especially where other members of their household were exposed.”

An NZNO delegate was part of the review panel that produced the report and Ms Weston said NZNO is keen to provide part of the oversight as the report’s recommendations are implemented.

“There is an urgent need to implement the recommendations immediately to provide clarity, and build confidence for staff and the public as we move from Level 3 to Level 2, which involves a real ‘unknown’ in terms of another COVID-19 spike.”

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

New Zealand Nurses Organisation media release, 20 March 2020

The New Zealand Nurses Organisation (NZNO) is calling for measures to improve support for nurses in the Government’s next round of pandemic initiatives after still more infections were reported today.

NZNO President Grant Brookes says the Government is doing a remarkable job but that, while more funding has already been promised for the health system, some resources could now be specifically for nurses who bear the brunt of working on the frontline across all sectors.

“Things we could do include paid special leave to look after an isolated dependant or a child unable to go to school; or free child care so nurses can carry on working.

“The competing demands on nurses are incredible and unprecedented right now. We are already hearing of their fatigue and anxiety about getting sick themselves, or that they will take infection home to their families and communities.

“But nurses also know they are expected to be there, because they always have been in the frontline for any medical emergency. They’re actually the glue that holds our COVID-19 response together, and will be working long hours under extremely stressful conditions.

“The potential for overwork and burnout is enormous, especially in cases where nurses are the sole breadwinners.”

It’s still to be confirmed that all of the total 39 cases reported to date have all come from overseas, but Mr Brookes said community spread was probably inevitable.

“If and when that occurs, health employers are expecting 25-30 percent of staff to be on sick leave from becoming symptomatic or from the need to care for dependants who are ill or off school. Anything we can do to acknowledge and relieve the pressure nurses are under would be welcome.

“We will get through this, because we know we can rely on our nurses. Let’s give them what they need to do their jobs and keep themselves safe and well.” 

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

New Zealand Nurses Organisation media release, 7 February 2020

The New Zealand Nurses Organisation (NZNO) is reminding both employers and employees that they have rights and obligations regarding their own safety and the wellbeing of others during a pandemic situation.

NZNO Associate Professional Services Manager Hilary Graham-Smith said that much of the information coming from authorities such as the Ministry of Health was comprehensive and helpful, but that the rights of nurses and others working in health to be fully informed and fully protected must also be very clear.

“Good infection control practices by clinicians will be essential in reducing the likelihood of disease spread should we find ourselves in a pandemic situation and coronavirus cases start turning up in Aotearoa New Zealand.

"Nurses and health care assistants will be central in this work and employers must ensure these employees are given guidance around best practice in a pandemic and about how to remain safe while providing clinical care.”

NZNO recommends all health facilities have up-to-date disaster and pandemic guidelines for employee health and safety and Ms Graham-Smith said employees should notify management via their health and safety representative if they are not satisfied their wellbeing is being sufficiently cared for.

“Under the Health and Safety Act employees have the right to refuse to perform work likely to cause them harm if steps to mitigate risks to wellbeing are not taken in conjunction with employers to resolve the situation.

“We recommend nursing staff contact NZNO and that other employees contact their unions immediately if they have remaining doubts about their safety at work.

“It is often nurses, midwives and health care assistants who play an important and leading role in ensuring readiness for an emergency such as a pandemic, and they should be supported in this task by management – and their leadership, expertise and mana acknowledged.”

The World Health Organization has declared a public health emergency of international concern over the coronavirus and Ms Graham-Smith said that should send a clear signal to both employers and employees around preparedness and full disclosure of information, including information about employee rights to safety and how staff will be protected at work.

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

New Zealand Nurses Organisation media release, 26 November 2019

The New Zealand Nurses Organisation (NZNO) welcomes Learning from adverse events: Te ako I ngā pāpono kōaro, released by the Health & Safety Commission last week.

However, NZNO Professional Nursing Adviser Kate Weston says the yearly report is once again evidence of an under-resourced health system that is putting the wellbeing of New Zealanders at risk.

“More than 50 percent of the 916 reported adverse events relate to clinical care and indicate under-staffing. Failure to rescue, for example, which has risen by an alarming 28 percent, happens when staff are busy and stretched. The high number of pressure injuries reported are also evidence of not having enough time to deliver proper care.”

Ms Weston says factors mentioned in the report reflect what NZNO members say across the country about too few nursing staff to meet ever-increasing patient needs.

“The report confirms the incredible stress nurses, midwives and health care assistants are under every day. How many times do we need to be reminded that the health system is not sufficiently resourced for employers to meet their obligations around safe staffing? How many adverse events will it take?”

The report suggests the increase in recorded serious events could be the result of better reporting, while acknowledging this should not be assumed. Ms Weston says, however, that the notion of better reporting has been around for too long to continue as an acceptable explanation and that the increases are more likely to relate to workloads, insufficient staffing and poor skills mix – which the report also acknowledges.

“Many of those affected by adverse events are our most vulnerable, such as the elderly. Apart from the pain and suffering caused, many will no longer be able to live independently, which is a huge cost to them on a personal and financial level, and to the health system funded by tax payers.”

Ms Weston said the report was a valuable tool and indicator of the need for increased spending on health. But she questioned the lack of security and staff safety reports.

“We are well aware there has been a significant increase in violence and aggression towards staff, and we also know this is being underreported because internal systems and policies around staff safety also tend to fail when staffing resources are stretched.”

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

The New Zealand Nurses Organisation (NZNO) says changes proposed to staffing for the CREST service proposed by Canterbury District Health Board (DHB) will reduce the quality of care available to older persons in Christchurch and surrounding areas.

The Community Rehabilitation Enablement Support Team (CREST) cares for the health of older persons when they are first discharged from hospital so they spend less time on return hospital visits and remain in their own homes longer – instead of in residential care.

NZNO Professional Nursing Adviser Marg Bigsby said NZNO members are very concerned the changes would disestablish 17FTE of experienced nurses (including two leadership roles), replacing them with just five ‘liaison staff’ and one clinical nurse specialist (CNS). Case management work would then be contracted to private community providers.

“Depending on who is appointed to  the liaison and CNS positions, this represents a loss of 11-16 experienced nurses to CREST, which would have serious impacts on the care available to older persons in the region, especially when they are leaving hospital. This is something Canterbury older persons’ health services can ill-afford,” Ms Bigsby said.

“Our members are also concerned about people being employed who were unfamiliar with the CREST service and the possible lack of case management expertise when work is given out to community providers.

“Many of these providers are already quite underfunded and short-staffed so they will struggle to provide care to the standard they would like and which currently exists. It will be a systemic problem.”

NZNO is also concerned about the failure of the DHB to collaborate with or consult CREST staff.

“Case managers learned about the proposed changes from nurses in community providers before they had heard anything about them directly, which is a completely unacceptable violation of professional confidentiality,” Ms Bigsby said.

NZNO made a submission today to Canterbury DHB opposing the changes, suggesting alternatives and calling for nursing expertise to remain in-house. Ms Bigsby said CREST nurses are invested in the service and that she hopes the DHB will listen to their voices.

At NZNO’s encouragement more than 160 health professionals around the region including doctors, nurses and allied health professionals, have sent letters to Canterbury DHB CEO David Meates opposing the changes and in support of the nurses’ call for a rethink.

Ms Bigsby said the CREST service supports elderly to regain independence and quality of life following a stay in hospital.  Without its support the focus will inevitably fall on just the basics – and there is so much more to life than merely being able to wash and dress yourself or go to the toilet.

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

More information:

The spokesperson for this media release is Professional Nursing Advisor (Canterbury) Marg Bigsby, who would be happy to be interviewed. However, NZNO can also provide media access to an NZNO delegate working in the CREST team. Please contact Rob Zorn (as above). 

New Zealand Nurses Organisation media release, 6 September 2019

The New Zealand Nurses Organisation (NZNO) is challenging proposed staffing changes at two facilities run by Presbyterian Support Southland (PSS), saying they will reduce standards of patient care and put extra strain on nursing and care staff, and that they are being justified on out-of-date guidelines.

NZNO Organiser Simone Montgomery said that across its hospital services and two rest homes (Vickery Court in Invercargill and Rest Haven in Gore), the PSS proposals would cut net staff care by around 157 hours per week – and, she said, this comes after net care hours were cut by 114 per week last year.

“The staff reductions are being justified by the claim that PSS services are currently over-staffed according to the 2005 Aged Care Staffing Guidelines, but we have been saying for some time that these standards are hopelessly out-of-date and do not account for the increased number of people in aged care, or for their increasingly complex needs.

“The clear message in all of this to current staff, who are already overstretched, is that somehow they aren’t working well or hard enough, and that’s ridiculous.”

In March this year NZNO and E tū released their joint report: In safe hands? How poor staffing levels and rationed care are harming aged care residents and staff. The research surveyed 1194 people working in aged care facilities and found that three quarters (73.45 percent) of those surveyed either disagreed or strongly disagreed that staffing levels were sufficient to provide quality care for residents.

The report called for a review of the existing standards and that new resulting standards be made compulsory. The 2005 standards currently in place are voluntary.

The rationale for the staffing reductions is that DHB funding for aged care does not cover staff that would be considered ‘extra’ when staffing levels are compared to the 2005 Guidelines, but Ms Montgomery said the proper solution should be to seek increased funding and not reduce standards of care to save money.

“We think New Zealanders care very much about the health, wellbeing and dignity of our seniors and would agree that the way we care for them reflects back on all of us,” she said.

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

New Zealand Nurses Organisation media release, 26 July 2019

The New Zealand Nurses Organisation (NZNO) says an emerging crisis at Middlemore Hospital demonstrates the serious problems district health boards (DHBs) are facing in recruiting and retaining nurses.

On Tuesday ambulances to Middlemore were diverted to Auckland and Northshore Hospitals due to a lack of capacity, including lack of beds, understaffing and the emergency department being under pressure. Counties Manukau DHB has requested nurses from Auckland DHB to provide emergency relief.

However, it has been confirmed to NZNO that Auckland Hospital is also at full capacity and has suggested that Counties Manukau DHB request emergency assistance from the New Zealand Defence Force instead.

NZNO Organiser Justine Sachs said this sort of thing happening outside of a civil emergency situation should send alarm bells to those holding the purse strings and responsible for resource and workforce planning. 

“Nurses are at breaking point; many telling us they are leaving the profession or going to work overseas because of intolerable workloads.

“Delays caused by diverting ambulances to other hospitals puts patients at serious risk and puts pressure on other hospitals also struggling to cope because they are under-staffed and under-resourced.”

Ms Sachs said increased demand on the public health system should be expected during the winter season and that contingency plans that include having options for patients to being admitted in other hospitals and sufficient nurses on staff should be in place to cope with increased demand.

“Given the enormous stress on our under-resourced health system it’s frightening to contemplate how hospitals in the Auckland region would cope should there be a significant catastrophic event.”

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

New Zealand Nurses Organisation media release, 7 June 2019

The New Zealand Nurses Organisation (NZNO) has written an urgent letter to the Hawke’s Bay District Health Board (HBDHB) saying difficult working conditions faced by nurses are seriously compromising both staff and patient safety.

NZNO Professional Nursing Adviser Anne Brinkman said that what the union and professional association is hearing from HBDHB members is alarming but that no response from management has been received to alleviate nurses’ expressions of concern.

“Nursing staff have been expressing and documenting their health and safety concerns with management repeatedly and at every shift because they pose a significant danger to both patients and staff. Despite this, no response has been received from management and nothing has happened to mitigate these systemic weaknesses.”

Ms Brinkman said there has been increasing disquiet about risks arising from high bed occupancy, inadequate staff numbers and skills mix and increasing incidents of violence and aggression by patients.

“Staff are fearful and say their ability to care for patients has been seriously diminished. Managers at HBDHB must recognise their responsibility to staff under the Health and Safety at Work Act and promptly produce an action plan to resolve these concerns.”

She says nurses are leaving their shifts in tears and many are actively seeking alternative employment.

“This is a really serious concern as recruiting to nursing vacancies and retention of nursing staff has already been identified as an ongoing problem at the DHB.”

She also says the impact of the resident doctors’ strikes has been significantly underestimated and that the strikes could not have gone ahead without the tangible support of nurses at an already difficult time.

NZNO has asked HBDHB to account for how it will address the health and safety concerns raised by nurses in the short- and medium-term, and has requested a response within one week.

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