Nursing reports

Nursing student survey report shows training system costing us nurses

New Zealand Nurses Organisation media release, 16 February 2024

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

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

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

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

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

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

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

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

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

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

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

The survey report is available on the NZNO website.

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


Nurses furious at Te Whatu Ora Holidays Act remediation pay delays

New Zealand Nurses Organisation media release 15 February 2024

New Zealand Nurses Organisation Toputanga Tapuhi Kaitiaki o Aotearoa (NZNO) members employed by Te Whatu Ora are furious after almost eight years of delay in their employer’s failure to fix $1.95b worth of unpaid holiday pay and other leave they are owed.

Every Te Whatu Ora district failed to meet the requirements of the Holidays Act, but to differing degrees, so while some members will receive very little, others will be getting payouts of tens of thousands of dollars, dating back to 2010.

NZNO Chief Executive Paul Goulter said NZNO’s Te Whatu Ora members have been dangled promise after promise about when the payments will be made, only to have their hopes dashed by one delay and excuse after another, year after year.

“Last year Te Whatu Ora said dates for payment by the various Te Whatu Ora regions would be confirmed in January which was revised yet again. We were then promised definitive payout dates would be provided on 9 February this year, but heard nothing on the day.  

“At a meeting with Te Whatu Ora yesterday (14 February) we were informed that final dates would be provided in the next fortnight, but not for all regions.

“They’ve had eight years to put this right while monetary amounts devalue and while our members struggle with the cost of living as much as anybody else. No wonder our hospital nurses feel devalued and want to go work overseas.”

He said NZNO would be lodging a complaint with Minister of Health Hon Dr Shane Reti.

“Justice delayed is justice denied, and this is at a time when we face unprecedented safe staffing issues because we can’t find enough nurses. How can Te Whatu Ora think this is even remotely acceptable.

“Unfortunately the people of Aotearoa New Zealand suffer because of this as nursing staff leave the profession in New Zealandand and our communities are faced with the consequences.”

More information

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

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

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


Student nursing survey reveals significant training barriers

New Zealand Nurses Organisation media release, 27 December 2023

The New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) bi-annual National Nursing Student Survey closed late in 2023.

Further details and commentary will be released in 2024 once analysis is complete. However, a preliminary analysis reveals student nurses face a number of significant barriers to completing their studies that must be removed if we are to attract and retain students and grow our own nursing workforce.

The 2023 survey was completed by more than 1400 student NZNO members up from 685 in 2021 and Co-chair of the NZNO National Student Unit Shannyn Bristowe said issues of hardship are particularly intense for Māori tauira (students) who typically enter nursing at a later stage in life, often having families and increased responsibilities.

“There is a particularly important need for appropriate cultural support and pastoral care which was cited as integral to students feeling safe and understood in both their study and clinical placements.

“Māori and Pasifika tauira often face unique practical and cultural barriers, including travel, whānau obligations and language difficulties. 

“But these nurses are essential to the people of Aotearoa New Zealand receiving the culturally appropriate care that will improve health outcomes for Māori and Pasifika and save health system resources. We need to find ways to support Māori and Pasifika students in particular.”

She said the survey is one way nursing students can express their concerns and let the Government know what changes it could make to attract and retain more of them.

“We’re hoping the New Government will listen and adjust the way it plans to support nursing students.”

“Fewer students would drop out if they received financial assistance while they completed their courses. Helping pay off graduates’ student loans is a nice gesture from Government, but it doesn’t address the real hardship they face while they study,” Ms Bristowe said.

“Many just can’t carry on because of financial pressure added to other stresses.

“We face an alarming nursing crisis long into the future. If we’re serious about addressing that crisis, why can’t we find a way to give nurses free training as we do with many other essential trades and professions? Most students would have no problem with some form of bonding in return.”

Another predominant theme was how hardship impacts on physical and mental wellbeing. The cost of clinical placements during training (petrol, parking, travel and accommodation were identified as a particular pressure point and 84 percent of respondents said students should receive some form of financial compensation during clinical experience.  

“Supporting nursing students financially now, instead of helping pay off their loans after they’ve graduated, could see us producing up to a third more students and if the Government really has the wellbeing of the health system to heart it needs to reduce every single barrier it can. This is vital for the future wellbeing of us all.”

Interestingly, 33 percent of respondents had been impacted by extreme weather events, with flooding, road closures, and the cancelling of clinical placement days cited.

However, Ms Bristowe said the most significant concern from the survey was that more than 30 percent of respondents said the barriers made them question whether nursing was right for them.

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


Two nurses celebrate 100 years of Wellington service

New Zealand Nurses Organisation media release, 7 December 2023

Two nurses at Wellington Hospital will be celebrating 100 years of full-time nursing between them at a gathering at the Hospital at 10am on Friday 8 December.

Theatre enrolled nurse Jenny Kendall has been in the profession since 1968 and has worked in Wellington Hospital for the last 48+ years. Theatre enrolled nurse Silaina Sione, originally a registered nurse from Samoa, has spent the last 52 years of her 59-year nursing career there as well.

“It’s been eight-hour days the whole time and we’ve been rotating through the shifts (mornings afternoons, evenings and weekends) like any other nurse,” says Jenny,  

The pair say they always wanted to be nurses and never really considered anything else as a career. For both it was the caring and looking after people that attracted them.

“It’s been really rewarding, but things have quite deteriorated over the last decade. We have had real problems with short staffing and a tightening fiscal purse around health – and that has made things really hard.”

She says that, as a theatre nurse, progress in technology that can help patients has been a highlight.

Silaina says surgery is now often much less invasive , which makes a real difference.

A lot of surgery is now performed as day cases and patients can go home after a few hours rather than a few days. Patients can be up and about much quicker, which is better for their recovery.

“We’ve also seen the role of the nurse increase in inter-disciplinary teams, and this has been wonderful acknowledgement of the skills we bring.”

Jenny says one of the biggest challenges has come through her 40-year role as a delegate for the New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO).

“Management often don’t want to hear what you have to say as a delegate, and they can be quite resistant. That makes the job of liaising between the union and members around health and safety or workplace conditions issues really difficult, but you carry on because the work is really important.”

“Being elected as a lead delegate has made a big difference through being visible around the hospital and able to help solve issues with both management and colleagues.

The women say that, despite the 100 years they have clocked up between them, they are not thinking of retiring soon.

I’ve got less than 18 months until I hit 50 years, and I certainly want to achieve that before I’m done,” Jenny says. “Perhaps we’ll have an even bigger celebration then!”

The celebration on Friday will be attended by health staff from across Wellington Hospital and will include ex-employees who have been there at various stages thought the two women’s careers.

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Note: journalists wishing to attend the 10am celebration will need to call the hospital and clear their visit with the communications team.

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


NZNO member meetings put Te Whatu Ora on notice

New Zealand Nurses Organisation media release, 24 November 2023

The collective agreement ratified in August by members of the New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) who work for Te Whatu Ora will expire in less than a year and the union says these members have unfinished business with their employer.

NZNO Chief Executive Paul Goulter said NZNO Te Whatu Ora members are committed to continuing pressure for the nursing workforce to be valued, specifically around such issues as nurse-to-patient ratios, safe staffing levels, health and safety at work and meaningful pay and pay rises.

“Our Te Whatu Ora members will be attending around 40 paid union meetings (originally known as ‘stop works’) from 27 November to 1 December. The purpose of the meetings is to put the new Government and Te Whatu Ora on notice that they must increase funding to the health sector and fix the nursing shortage.”

The new Government is planning to release a mini-Budget in December that will shape public spending for the next three years, and Paul Goulter says Health needs to top the list of Government spending priorities in that mini-Budget.

“NZNO needs to be part of that conversation to help ensure everything is being done to secure 4000+ extra nurses and health care workers. Ultimately our patients will pay the price for hospitals that are continuously understaffed and under-resourced.”

Paul Goulter says the meetings will also mark the start of the campaign around the 2024 collective agreement and members will discuss how they will continue the fight for safe staffing in 2024.

“Te Whatu and the new Government must meet our demands in order to ensure the wellbeing of our staff, patients and health system.

“Te Whatu Ora has an obligation to provide a safe and properly staffed workplace and we intend to hold them to that obligation.”

He said that according to the Employment Relations Act, arrangements will be made with Te Whatu Ora to have enough staff on hand to keep health workplaces functioning during meeting times.

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Note to journalists:

  • A copy of the meetings schedule is attached to this release.
  • Journalists will not be able to attend meetings but may wish to interview NZNO members before or after meetings that have been arranged off-site. Members will be carrying placards and, in some cases, arriving at meetings by bus.
  • Local member spokespeople are available for many of the regions where meetings are being held.

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


NZNO President urges Kiwi to vote health

New Zealand Nurses Organisation media release, 12 October 2023

The President of the New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) wants people living in Aotearoa New Zealand to vote with health in mind on Saturday.

Anne Daniels, herself an emergency department nurse at Dunedin Hospital, said health should be just as important a consideration for voters this election as the cost of living and crime.

“Health has become somewhat of a “wicked problem” in Aotearoa New Zealand because the harms are rife and there is no short-term solution.

“We need to be voting people into power now who will set the groundwork for finding 4000 more nurses in a hurry, who will reduce costs and restore health justice by finding and employing more Māori and Pasifika nurses and who have the foresight to see that funding health properly now will save the system money and resources in the long run.”

Ms Daniels said she sees the results of underfunding and the under-prioritisation of health every day in her work and in her interactions around the country with nurse and other health worker members.

“People need to realise that the long wait times and the care rationing that are currently happening will just get worse and worse. This has serious implications for everyone needing health care.”

She said nurses know what’s needed to fix the problem: more nurses; pay and conditions that attract and retain nursing staff; nurse-to-patient ratios; and culturally appropriate care for Māori and Pasifika.

“Unfortunately some political parties don’t have a real grasp of these things and do not have policies that will address them.

“Parties proposing tax cuts or the dismantling of Te Aka Whai Ora (the Māori Health Authority), for example, don’t get it at all.

“These things would only create further barriers to people already struggling to access health care in their communities or who have to suffer long unhealthy waits in the emergency department.

“Health is a massive issue this election and I hope people will have that in mind when they choose which party and candidate to back on 14 October.”

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


Auckland nurses to picket for safe staffing

New Zealand Nurses Organisation media release, 5 October 2023

Nurses, midwives, health care assistants and kaimahi hauora will come to Manurewa from all over to Auckland to picket in support of safe staffing on Thursday 5 October.

The New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) members will congregate holding signs at 131 Hill Rd, Manurewa at 1.30pm and will also approach members of the public to talk about the importance of the health workforce this election.

Auckland NZNO delegate Ben Basevi said the point of the picket was to call on the public to vote for Health at the ballot box on 14 October.

“We are calling on the public to support those political parties that will commit to resolving the staffing crisis in health care, in particular the urgent need for 4000 more nurses.

“People, including our politicians, may not yet fully realise the impact the nursing shortage has on our health system and how this will affect their care, and the care of their loved ones and whānau when they need it.

“The incoming Government, no matter what its composition, must take urgent action to reduce the nursing shortage. That means making the profession attractive to new students, and addressing frontline needs to ensure we keep the nurses we already have.”

He said parties needed to develop policies around issues such as more Māori and Pasifika nurses so people get culturally appropriate care and need the health system less; funded free training for nursing students so they don’t start work with a massive debt; decent wages and Pay Parity across the health system so every nurse everywhere is equally valued; and legally mandated staff-to-patient ratios to help ensure the safety of nurses and the people they care for.

NZNO’s scorecard of political parties’ health policies* will be distributed from a stall at the picket and will also be handed to members of the public in one-on-one conversations.

“We’ll be encouraging people to enrol and vote with health foremost in their minds because we simply cannot carry on as we are,” Ben Basevi said.

“People need to enrol and vote for the good of their whānau and communities.”

The picket is expected to conclude at around 3.30pm.

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* NZNO’s political scorecard is available at: https://maranga-mai.nzno.org.nz/scorecard.

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


National’s health policies hollow without workforce

New Zealand Nurses Organisation media release, 3 October 2023

The New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) says the National Party’s new health policies announced today ring hollow because they don’t address the missing workforce needed to deliver them.

NZNO Kaiwhakahaere Kerri Nuku said there was nothing new in what National announced and that the policies, while laudable in themselves, presupposed there were sufficient health staff available to deliver them.

“Increasing maternity services is a great idea, but how are you going to do that without the nurses and midwives to support new and expecting mothers?

“Increasing clinical training placements is also great, but what will National do to make nursing and other health worker training more attractive – other than student loan payoffs that come too late to really help struggling nursing students?”

Ms Nuku said recruiting and retaining nurses, midwives, health care assistants and kaimahi hauora is the ‘make or break’ behind any health policy and that National is conspicuously quiet on how it will urgently recruit 4000 nurses or respond to the needs of frontline staff so they will stay in their jobs.

“Christopher Luxon has said National ‘will be doing everything [they] can to boost the health workforce,’ but very little beyond that.

“What about funded free training for nursing students so they don’t start work with a massive debt in the first place? What about more Māori and Pasifika nurses so people receive culturally appropriate care and need health services less?

“What about decent wages and Pay Parity across the health system so every nurse everywhere is equally valued and earns the same according to their experience and qualifications? What about mandated staff-to-patient ratios to help ensure the safety of nurses and the people they care for?”

She said health should be at the top of discussion this election because the system is hanging by a thread and will fall apart unless more nurses are found and/or kept.

“That has serious implications for the health care we and our loved ones receive, and we need to be putting concrete solutions in place now. The best health policy in the world will fail miserably without the workforce in place to support it.”

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


NZNO welcomes plan to grow health workforce

New Zealand Nurses Organisation media release, 13 September 2023

The New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO) welcomes the plan to grow the health workforce announced by Health Minister Ayesha Verrall and Prime Minister Chris Hipkins today, but says even bolder action is required to fix the health crisis in Aotearoa New Zealand.

NZNO President Anne Daniels said there is much in the announced policy that resonates with what nurses have been campaigning for.

“The plan to grow the workforce for both doctors and nurses is laudable, as is the recognition that paying nurses and midwives well, and improving their working conditions, is crucial to retaining them.

“However, we need at least 4000 more nurses right now, as many are still leaving the profession or are due to retire. 700 per year starting next year is just not going to fix the problem quickly enough and nurses’ ability to provide adequate care will just continue to decline.

On the need for free training to attract more nursing students, Ms Daniels said she noted the plan includes opportunities at least for nurses to earn as they learn.

“That’s not free training but we look forward to clarification on exactly what it might mean.”

Ms Daniels said the plan to grow the Māori and Pasifika nursing workforce was also welcome and important.

“It is unjust and contrary to te Tiriti that we are unable to provide culturally appropriate care to Māori and Pasifika. This has left them disenfranchised from the health system, which costs us all more in the long run.

“More Māori nurses are essential to Māori having self-determination in health, and the skills and the cultural knowledge and experience Māori (and Pasifika) nurses bring with them is beyond value.

“But we want to see te Tiriti upheld in every area of the health system so those nurses are free to act in a culturally appropriate way across the entire context of their work.”

She said NZNO did not support increasing overseas recruitment of health professionals.

“Our focus should be on growing our own health workforce instead of poaching nurses from poorer countries where they are sorely needed. And if we remain overly dependent on internationally qualified nurses, we run the risk of having our supply cut off again should there be another global pandemic.”

However, Ms Daniels said she wanted to acknowledge the mahi of Health Minister Ayesha Verrall.

“I would like to thank the Minister for admitting there are serious problems in health and for her commitment to continue working with the sector to address those issues. NZNO is also keen for that dialogue to continue.”

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


NZNO wants more Māori and Pasifika nurses; calls for free training

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.”

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


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