Nursing reports

Embargoed until 12.30pm, 20 July 2022

New Zealand Nurses Organisation media release, 20 July 2022

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

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

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

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

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

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

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

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

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

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

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

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

Further information: survey stats

Regions

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

Is there a crisis?

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

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

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

Are you thinking of leaving nursing?

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

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

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

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

New Zealand Nurses Organisation media release, 13 July 2022

The New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) is calling on the Minister of Health to acknowledge there is a nursing and health crisis, and for an immediate Conference of health sector spokespeople to focus on the crisis and potential solutions.

The call comes after what NZNO says is a series of inaccurate and disparaging remarks made in the media by Heath Minister Andrew Little about NZNO and other organisations speaking out about the crisis.

NZNO Chief Executive Paul Goulter said the continued comments are unhelpful.

“Just one example is the matter of the DHB Pay Equity back pay, which is before the Employment Relations Authority – exactly where the Government’s legislation says such disputes should go.

“To say NZNO reneged on the deal is inaccurate because no deal can be accepted until it is voted on by members, and to accuse the organisation of lying (speaking with a forked tongue) is misleading and inflammatory. It is unhelpful and ignores the wishes of the 35,000 DHB NZNO members who voted overwhelmingly not to proceed with the proposed settlement’s ratification.”

He said the Minister’s continued comments have upset and angered members, only adding to the disillusionment they feel over his denial that there is a crisis and because their desperate pleas for help have been ignored for years.

“Member feedback on the Minister’s comments today has been swift and angry, and they want to speak out.

“We are asking our members to use an online tool to let the Minister know directly what they face every day in their workplace to help him form a further view on whether or not there is a crisis.

“We’ll compile member responses and present them to the Minister and this will be a useful basis for a whole of sector Conference on the crisis and the urgent need to work together to find real solutions.”

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

New Zealand Nurses Organisation media release, 11 May 2022

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

New Zealand Nurses Organisation media release, 1 April 2022

The New Zealand Nurses Organisation, Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) welcomes today’s announced Living Wage increase to $23.65. It says all health employers, from DHBs through to primary care and Māori and iwi providers, must step up and set the Living Wage as the minimum for themselves and their contractors.

NZNO Kaiwhakahaere Kerri Nuku said the health sector, like any other, cannot prosper on the back of poor pay rates that often perpetuate poverty. 

“Governments have ignored the wage crisis for far too long and driven many whānau into hardship.

“A lot of nurses, midwives, health care assistants and kaimahi hauora, some currently earning below the Living Wage, are taking second jobs or leaving their profession because the pressures of working within the health system are not worth the mental and physical distress. This is only exacerbated when it’s hard to put food on the table.”

Ms Nuku said that to survive on low wages both parents or caregivers often need to work yet still barely keep their head above water.

“The slightest change to income or expenses takes months to recover from and the mental impact on everyone in the family is significant. It’s so much harder for children to have a decent start in life with both parents having to work for the minimum wage.   

“There is no wellbeing in these types of wages and that is why an accurate Living Wage that reflects the minimum required to meet basic wellbeing needs is so important.

“If smaller health providers say they cannot afford to pay what is needed to live with dignity, then funding models must be urgently reassessed.”

NZNO has long been a Living Wage employer and extends that requirement to its contractors.

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

New Zealand Nurses Organisation media release, 8 December 2021

Nurses and other health workers at Auckland Metro district health boards (DHBs) say they are concerned that the picture of a robust health system painted by Wellington health officials is a far cry from the reality they face each day on the frontline.

“The country is being told over and over that the health system is fine and that we’re well-placed to handle a COVID surge,” says NZNO organiser Sarah Barker.

“That might be what DHB executives are reporting, but Auckland nurses say they’re already dealing with caseloads they can’t handle. They’re stretched to the maximum and people are falling through the cracks right now.

“Because of lockdown and the Auckland outbreak, people aren’t coming to the emergency department until they are gravely ill. There are also huge spikes in people with mental health and social issues and people whose conditions are significantly worse because COVID has delayed their much-needed surgeries.

“There just aren’t enough nurses to deal with these complex needs, and nurses say their colleagues are departing at a rate of knots.”

Ms Barker says nurses are still expected to provide adequate and expert care when working conditions are both intolerable and unsustainable.

“We don’t expect people to work in hazardous workplaces, but nurses are continually being asked to do just that, and virtually nothing is being done to manage the situation by the people with the power to do so.

“Nurses are ignored or side-lined when they raise the alarm. Agreed escalation processes that would reprioritise less urgent care are not being used to reduce pressure on our health system, and staffing shortages are not being proactively addressed.”

She says some of the things nurses suggest could be done include active recruitment campaigns; free nursing education; and making it cheaper and easier for people to visit their general practitioner.

“Nurses don’t want to be just the ambulance at the bottom of the cliff, but right now that’s about all they have capacity to do.

“I am really concerned that the Government is telling the people we can handle a COVID surge when the reality is we have 1000 health care worker vacancies across the Auckland region. This isn’t getting any better, and we’re actually in pretty deep trouble.”

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

New Zealand Nurses Organisation media release, 12 November 2021

The New Zealand Nurses Organisation (NZNO) says it’s concerned staffing levels at hospitals in the Auckland Metro DHBs are putting patient care at risk.

NZNO Lead Organiser Christina Couling says that, while Government and the DHBs report they currently have enough beds, that isn’t a lot of use when there aren’t sufficient staff numbers to look after the people in those beds. 

“The strain on Auckland health care workers right now is enormous. Each of the three Auckland DHBs has 300-400 nursing vacancies at present and, on top of this, members say a lot of staff are taking sick leave which puts even more pressure on those remaining at work.

“Auckland hospitals may be at less than 100 percent bed capacity, but in many cases there are not enough staff to provide the care required for patients who are seriously unwell with quite complex needs.

Ms Couling said nurses in the community are also feeling the pressure as the number of patients being monitored and cared for in their homes increases.

“There are now several hundred such referrals every day and demand for service is growing at a rapid rate. It is a real concern that the system simply does not have the capacity to handle this and that this could result in more deaths among Covid patients isolating at home.”

She said the health workforce is under considerable stress right now across the country but is especially dire in the Auckland region with current increased demands.

“We have contacted the DHBs seeking an opportunity to meet and discuss how we might assist, particularly with finding ways to support our members, whose resilience is waning.

“We are seeing nurses not coming into work because they are overwhelmed and stressed. Stand downs relating to COVID exposures events also create additional pressure. This is only going to get worse if they continue to be unsupported.

“Nurses are caring professionals, but who is there and what is being done to care for them?”

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

New Zealand Nurses Organisation media release, 21 October 2021

The New Zealand Nurses Organisation (NZNO) says Aotearoa New Zealand is dangerously underprepared for what seems an inevitable tsunami of community COVID cases that could completely break our health system, and that nurses must be part all proposed solutions.

NZNO Kaiwhakahaere Kerri Nuku says nurses are a highly skilled workforce and have risen to ever-increasing demands, but they are already burnt out and seriously understaffed. Meanwhile our health system is not adequate to meet the demands of Covid, which is only just beginning to have an impact.

“Basically, we’re saying to the Government that, even though you’re acknowledging things are frighteningly bad right now, ‘You ain’t seen nothing yet,’ and we would have been better prepared had you not decided to go it alone around nursing.

“The Government has not acted swiftly enough and, because it has not consulted with nursing experts or the nurses’ union, we have band aid solutions being applied all over the place that only serve to devalue nurses, while the heart of the problem has remained unaddressed.”

Ms Nuku says the announced 300 monthly MIQ spots for health workers is welcome news, but was a surprise that was way too little, way too late.

“Those 300 monthly health workers will be spread across the health sectors, including allied health, aged care, primary care and Māori and iwi providers starting two months from now – and they will need time to adjust to the Aotearoa New Zealand health system.

“Meanwhile we have around 3500 nursing vacancies nationally across the health sector. Even if the nurses took all 300 MIQ places each month, we wouldn’t be breaking even in a year’s time because so many nurses continue to leave.

“So we need a fair say in how those 300 health workers are selected and deployed each month.”    

Ms Nuku also says the Government’s touted solution of training nurses to work in intensive care units (ICU) is also woefully inadequate.

“It takes two or three years after graduating to become a proficient ICU nurse. Nurses are incredible, but it is not a fair or realistic long-term solution to expect them to function professionally in ICU environments on the basis of four hours’ online training. This will put nurses and patients at risk.”

She says the Government must consult with nursing unions and professionals in addressing nursing problems so properly workable solutions can be found.

“How will we incentivise the right kinds of overseas nurses to come here? What are we doing to keep our nursing graduates here and in the profession? These questions should have been addressed months ago, but they still aren’t even a real focus.

“And this is about much more than hospitals and Covid. Evidence from around the world shows people are suffering and/or dying in other parts of health systems because so many resources have been shifted towards the Covid response.

“NZNO needs to be at the table when nursing issues are being decided by Government and the situation we currently find ourselves is just likely to get worse because that has not happened.”  

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

New Zealand Nurses Organisation media release, 15 October 2021

The New Zealand Nurses Organisation (NZNO) says its more than 32,000 members who work in district health boards (DHBS) have accepted their latest employer offer, with 83 percent voting yes. Voting closed at 12 Noon today.

Lead Advocate and Industrial Adviser David Wait said he is really pleased that the DHBs took the advice of the Employment Relations Authority after mediation last month and finally put forward an offer acceptable to NZNO DHB members.

“We have been in negotiations for 15 months, so it is great to receive something that both addresses pay issues and makes important progress towards safe staffing.

“Most of the pay increase comes in the form of down payments on our Pay Equity settlement, a separate process due for completion by the end of November, but the early lump sum payments are substantial.

“We also have a DHB contractual obligation to safe staffing, with a legally enforceable escalation pathway when members’ concerns aren’t addressed. Together with new employment commitments these are steps towards addressing the staffing crisis and making nursing an attractive profession again.”

Wait said he was extremely proud of the way members had engaged with this campaign for better wages and conditions – how they’d stuck it out and managed consistently to come to a consensus over many months.

“There is still a lot to do as we work with the DHBs to implement the changes, and members remain wary of their employers’ promises, so the DHBs have a real opportunity here to begin regaining the trust of their employees.

“How the DHBs respond regarding safe staffing over the next year will play a big role in our next collective agreement negotiations, so I encourage them to take this opportunity to do that.”

Today’s ratified MECA applies to the period 1 August 2020 to 31 October 2022. NZNO will next initiate bargaining late next year.

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

New Zealand Nurses Organisation media release, 23 September 2021

The New Zealand Nurses Organisation (NZNO) has supported staff working at the Hastings Hospital Emergency Department to issue a Provisional Improvement Notice (PIN) to Hawke’s Bay District Health Board (HBDHB) for failing in its primary duty of care under the Health and Safety at Work Act 2015.

PINs legally require an employer or service provider to address a health and safety issue before a certain time.

NZNO organiser Sue Wolland says issuing the PIN became necessary because repeated attempts to escalate concerns about dangerous working conditions that threaten patient safety have been ignored or minimised.

“Staff are working under incredible pressure which is severely impacting their physical and mental health. The department is well beyond capacity every day which means staff are unable to respond to people needing emergency care in the time required to best ensure their wellbeing.”

Ms Wolland said issues included: patients being ‘housed’ in inappropriate or hazardous places such as corridors; dangerous delays in triage and assessment; seriously unsafe and inadequate staffing levels; nurses too overworked to take meal and other breaks; patients missing out on essential care; increased risk of error; and staff feeling unsafe and anxious while at work.

“ED staff, including those in leadership, have repeatedly raised these concerns with the DHB and minor solutions have been proposed that never seem to eventuate. Our members have made these approaches in good faith, but sustained lack of progress has been the tipping point for issuing this PIN.

“What we have here is a serious or sentinel event just waiting to happen, resulting in avoidable patient death and the potential end to nursing careers.

“These concerns need to be urgently addressed, including contingency plans to cover staff sickness and to ensure staffing meets levels required for safe and acceptable standards of patient care.”

She said the PIN was issued on Monday 21 September and that the DHB was required to comply by 5 October. PINs can only be issued by trained health and safety representatives when other avenues to address a serious area of concern have been exhausted.

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

New Zealand Nurses Organisation media release, 15 September 2021

The New Zealand Nurses Organisation (NZNO) welcomes the Nursing Safe Staffing Review, and specifically the effectiveness of the implementation of ‘Care Capacity Demand Management (CCDM)’ at all Aotearoa New Zealand DHBs.

The review was confirmed by Minister of Health Andrew Little in his opening address to the NZNO conference this morning.

Under an Accord agreed between NZNO and the Ministry of Health in 2018, this implementation was promised to be in place by June 2021 but around half of Aotearoa New Zealand’s DHB’s do not yet have CCDM fully in place. This has been a significant issue for members of NZNO.

Hilary Graham-Smith will chair the nursing advisory group, which will also include Dr Rhonda McKelvie, Dr Jill Clendon and Kapua Quinn who each bring a deep understanding of the nursing profession and the staffing concerns it faces.

NZNO looks forward to engaging with the nursing advisory group and to providing its views on the effectiveness and implementation of CCDM.

NZNO is also pleased to hear the Minister acknowledge this morning that the people who work in the health system have been under pressure for a long, long time, and that dealing with the nursing shortage is a high priority for the Government.

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