Policy analyses and reports

Worried Auckland nurses say health system anything but okay

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.


NZNO concerned at hospital staffing level pressures

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.


NZNO warns Government: “You ain’t seen nothing yet!”

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.


Nurses accept DHB offer with firm majority

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.


NZNO issues Provisional Improvement Notice to Hawke’s Bay District Health Board

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.


NZNO welcomes safe staffing review

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.


NZNO satisfied with Auckland DHB visitation policy decision

New Zealand Nurses Organisation media release, 13 September 2021

The New Zealand Nurses Organisation (NZNO) is satisfied now that Auckland District Health Board (ADHB) has agreed to restrict visitation to compassionate grounds only – when it moves Auckland Hospital from Code Yellow to Code Orange at 7am tomorrow.

NZNO Industrial Advisor David Wait said this decision, brings ADHB's visitation practice into line with the other hospitals in the Auckland region and reduces the risk of COVID-19 entering hospitals.

“We absolutely acknowledge that there are many health benefits from family and whānau visits to hospital patients. However, we are at Level 4 in the middle of a pandemic and that is why other Auckland region hospitals have much tighter policies in place.

“This change should have come long ago and we’re just grateful Auckland Hospital has been lucky not to have had a COVID exposure event.”

Wait said the next step was for ADHB to ensure it has a safe visiting policy going into the future.

“We understand Auckland Hospital’s visitation policy will be reviewed and it’s important that we and the hospital’s Health and Safety Representatives are included in that review.

“It is our members who make up Auckland Hospital’s frontline staff and it is therefore imperative they have a say in a policy that will very much affect their own safety and working conditions, along with the health of patients and the public.

“We look forward to ADHB engaging with us on this and to working with them to help ensure the best health and safety decisions are made.”

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


NZNO takes legal action over Auckland Hospital visitor policy

New Zealand Nurses Organisation media release, 11 September 2021

The New Zealand Nurses Organisation (NZNO) has taken legal action through the Employment Relations Authority after Auckland District Health Board (ADHB) refused to meet with it for mediation on Friday over Auckland Hospital’s visiting policy.

NZNO Industrial Adviser David Wait says the policy places staff, patients and communities at risk of COVID-19.

“What we want is for the policy to be brought into line with those of other Auckland DHBs where visitor access is restricted to compassionate grounds and only when absolutely necessary during an outbreak of the delta variant that is by no means fully controlled.

“It makes no sense at all that one of our busiest hospitals in a region that is in Level 4 lockdown continues to allow members of the community to come and go, especially considering the impact COVID transmission would have on the DHB’s ability to safely provide services in this short-staffed environment.”

NZNO and ADHB lawyers met with the Authority by Zoom on Saturday morning and the parties were directed to engage in urgent mediation. Wait says NZNO proposed that the mediation take place on Sunday (12 September), given the urgency and seriousness of the situation, but ADHB has refused to meet before Monday afternoon.   

 “We have a hearing set with the Authority on Thursday afternoon if we cannot reach agreement, but that’s five days away, allowing further time for unnecessary close contacts to occur.

“We urge ADHB to engage with us without delay, and to stop putting the health and safety of our members and the public at risk.”

On Sunday (5 September) a union health and safety representatives issued a Provisional Improvement Notice to ADHB over its “free for all” visitor policy but Wait says the voices of workers have largely been ignored.

Worksafe has also issued an Improvement Notice, directing ADHB to engage with its workers on the policy, but Wait says not even this has made ADHB modify the policy in a way that would resolve the issues in any significant way.

“ADHB needs to look at the evidence, adopt best practice and listen to its staff. It’s staggering that we should have to appeal to a higher authority just to get them to talk to us about what is clearly a sensible and appropriate health and safety measure at a time of serious public danger.”

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


Close contact nurses working underscores DHB staffing issues

New Zealand Nurses Organisation media release, Date 2021

The New Zealand Nurses Organisation (NZNO) says the fact that nurses who live with close contacts are being asked to turn up for work at Auckland’s DHBs, and monitor themselves for symptoms in the meantime, shows how desperate the health system is in terms of short staffing.

On Friday 20 August the Ministry of Health issued an exemption for essential health workers from the need to fully self-isolate as long as certain conditions were met.

Covid-19 Response Minister Chris Hipkins has said hospitals are identifying the lowest-risk people they can have working at the moment so our health system can continue to function.

But NZNO Kaiwhakahaere Kerri Nuku says there is a clear public health order that housemates of close contacts are required to self-isolate and they are still required to do so because they are a health risk.

“The health direction to self-isolate is there for good reason and there should be no exceptions.”

Ms Nuku said nurses, midwives, health care assistants and kaimahi hauora working in DHBs have been speaking out about unsafe staffing for decades.

“Successive governments have not listened, and nurses have just been told over and over to do more with less. The result of this is what you see now, where the Government has changed the Ministry of Health’s public health advice because the DHBs don’t have enough staff.

“It just makes no sense and further underscores the very urgent need to address short staffing by recognising and rewarding nursing so it’s a job people will want to do.”

She said nurses staying away from work because they live with close contacts is also a protection for them, and that nurses were as entitled to that protection as anybody else.

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


NZNO concerned for nurse wellbeing in renewed COVID climate

New Zealand Nurses Organisation media release, 20 August 2021

The New Zealand Nurses Organisation (NZNO) is concerned for the emotional and physical wellbeing of nurses, midwives, health care assistants and kaimahi hauora because of the strain put on them by the community resurgence of COVID-19.

NZNO Kaiwhakahaere Kerri Nuku says the organisation is particularly concerned for primary care nursing staff – who work mainly in medical centres, emergency clinics and testing stations– because they are the first frontline against the virus and are the most exposed and least protected.

“We are already hearing alarming reports that PPE supplies in primary care, such as masks, are running low or being drip-fed; and mask fit-testing, which is essential to proper protection, is not occurring.

“These are among the most essential of essential workers because they help keep people out of hospital. Yet in terms of equipping them, we seem to be in pretty much the same place as this time last year.

“We’re also concerned that the approach to the virus has not been updated, despite the delta variant being airborne and so much more serious and contagious. Current guidelines need an urgent review.”

Ms Nuku said nursing staff in all sectors will be dealing with the emotional toll the renewed risk of contracting the virus will place upon themselves and their family and whānau.

“We know some nurses are struggling to come to terms with what is being asked of them. Even those of us locked safely away in our homes are anxious and we don’t have to go to a workplace where we face the virus every day.

“Nurses in both hospitals and primary care remain chronically understaffed, and nurses leaving, taking roles at MIQ Vaccinations programmes and having the border closed to international nurses, meant many staff are new to their wards or teams which also added strain.”

Ms Nuku also said NZNO would be pursuing matters affecting nurse safety and wellbeing with the Government, DHBs and Ministry of Health – and that it will hold the powers-that-be accountable.

She said nurses are exhausted and don’t have a lot to give right now, and urged the public to get behind them and show their support whenever and however they can.

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


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