Whangārei Hospital theatre nurses and healthcare assistants striking in June. Photo / Denise Piper
By Ruth Hill, RNZ
Nurses across the country are refusing to work extra shifts or fill roster gaps, forcing hospital managers to cancel planned care and reduce ward beds in some places.
More than 37,500 members of the New Zealand Nurses Organisation (NZNO), including nurses, midwives, healthcare assistants and kaimahi hauora, are in the second of two weeks of “work-to-rule” action to highlight what they call unsafe staffing levels.
Health NZ says it has plans in place to ensure patient safety, but it has raised concerns with the union about the “unusually high number of sick days” in some areas and accuses some union members of refusing to provide life-preserving services as agreed.
Whangārei Hospital delegate Rachel Thorn said that, by refusing to do extra shifts or back-fill for other departments, nurses were simply exposing the chronic gaps that already existed.
“Nurses are sick of being used as chess pieces by Health NZ, just slotted in wherever.
“It’s not acceptable to have specialist nurses taken away from their own patients to fill gaps in other departments.”
Thorn, a clinical nurse co-ordinator in the emergency department, said it was a relief in some ways not to be constantly sending messages and phoning staff on their days off to find cover.
“You really feel like you’re harassing the staff all the time to do more. It’s a horrible feeling.
“This has given people a bit of a breather and a reset to give them permission to say ‘no’ and push the responsibility for patient safety back uphill to management, where it should be.”
However, while hospital managers had the option of cancelling some elective procedures and “closing” beds to fit the available staffing, ED had no control over who walked through the door, she said.
Whangārei’s ED was in Code Red for most of Tuesday, meaning it was over 135% capacity.
It was only at the end of the day that Thorn had a chance to enter the data for patients treated during the day and work out exactly how many staff they were short.
“We were missing 12 whole nurses [over the day], and we only have 13 nurses on the morning shift altogether, so we were half-staffed. It was absolutely nuts.”
Earlier this month, a coroner’s inquiry into the 2020 death of Taranaki man Len Collett found he died as a result of a preventable fall in the overloaded ED.
In his report, Coroner Ian Telford said that, in May this year, the ED at Taranaki Base Hospital had 15 fewer fulltime nurses than when Collett died, and warned Health NZ that under-resourcing meant there was a high risk of another catastrophic event.
Thorn said that, after 14 months of contract negotiations, including 40 days of face-to-face bargaining, Health NZ continued to “deliberately use short-staffing to save money”.
“People are suffering and probably dying because of understaffing. I could name numerous instances of close calls.”
A poll of 1020 people commissioned by the NZNO found 83% of New Zealanders believed patient safety was at risk because there were not enough nurses.
Ninety-five per cent agreed that addressing staff shortages in health was important.
Rotorua ED nurse Lyn Logan, another union delegate, said many nurses in the department had been doing 12-hour shifts this week because there was no one to replace them.
“We have had patients waiting over 12 hours in ED to be transferred to beds on the ward.”
Staff had been able to shift some patients to a “bridging” ward, she said. “Otherwise, all those patients would still be waiting in ED at this rate.”
The public health system had become reliant on the goodwill of nurses, healthcare assistants and other staff to be moved around the hospital to plug the gaps in other areas.
“You don’t want to let your team down, and you don’t want to leave patients without care either.”
Nurses were still waiting for agreement on a new calculation for nurse staffing levels, which had been repeatedly delayed, she said.
“There was the ‘pause’ and then the ‘not pause’, but then the delay. So we haven’t had an increase in the FTE for 18 months, probably coming up two years.”
Robyn Shearer, Health NZ’s national director of people and culture, health and safety, said staffing levels and “care capacity demand” calculations were part of the ongoing bargaining process with the union.
“To be clear, there is no hiring freeze for frontline clinical roles, and we are committed to strengthening our workforce and continue to actively recruit to vacancies.”
Plans were in place to ensure the continued delivery of hospital services during the partial strike, using staff not covered by the work-to-rule where necessary, and life-preserving services (LPS) in line with the adjudicated decisions.
“Patient safety remains our priority throughout the strike.
“During the strike action, we have additional procedures in place for the intensive monitoring of patient flow, acute demand, capability and capacity to ensure we have the right resources in the right place.
“This also ensures, as per normal business, that we meet acute needs before undertaking elective or deferrable procedures.”
She expected that the union action would result in “only a small number of cancellations for planned care treatments and appointments”.
“We have raised some concerns with NZNO about some striking members refusing to undertake LPS as adjudicated, and also instances of an unusually high number of staff taking sick leave in some districts.”
As well as negotiating with nurses, Health NZ is in a deadlock with the Association of Salaried Medical Specialists, which represents 6600 senior doctors and dentists, who have gone on strike twice this year.
It is waiting to hear whether the Employment Relations Authority will agree to its unprecedented request to override the bargaining process and decide the terms of a settlement.
Physiotherapists and lab workers settled for 2% pay rises on Wednesday.
- RNZ