Up to 8000 people will have procedures rescheduled ahead of Thursday's nurses strike and hospitals are ramping up preparations to make sure they can treat those who are in urgent need.
Thousands of nurses, midwives and healthcare assistants voted to walk off the job on Thursday for the first time in 30 years after rejecting the latest pay offer from the district health boards (DHBs).
Capital and Coast chief medical officer John Tait, speaking on behalf of health boards around the country, said between 6000 and 8000 elective procedures would be deferred.
"Nurses are the cornerstone of hospital services. We cannot underestimate the impact of this strike," he said.
"DHBs have been planning for a considerable length of time to reduce patients and patient demand, leading up to this strike.
"We will be, and are, working extremely hard to get people the care they need in acute emergency care. But in situations that are not life-threatening, care will take longer."
The DHB, as with others throughout the country, was taking steps to lessen the load for the staff left working during the strike which would run for 24 hours from 7am on Thursday.
Essential and acute services would be prioritised, outpatient appointments and elective surgeries would be reschedule and inpatients would be assessed to see if it was clinically appropriate to discharge them.
Speaking on behalf of the DHBs, Helen Mason said they were still hopeful the strike could be avoided and had asked the Employment Relations Authority to facilitate further discussions.
She said hospitals around the country were very busy at this time of year and had already experienced significant disruption in the lead up to the strike.
Mason said emergency and essential services would still be provided through the strike and people should not delay seeking medical and hospital treatment if the matter was urgent.
The Life Preserving Services agreement between DHBs and the union meant enough staff would be rostered on at each hospital to make sure patients were protected from permanent harm or a threat to life.
Starship medical director Dr Mike Shepherd said they had been working on contingency plans for Auckland City Hospital and Starship for a couple of weeks and had already started postponing elective procedures and non-urgent outpatient clinics.
Affected patients would be contacted in the next 24 hours if they had not been already. If people had not heard from the hospital they should attend their appointment as was planned, he said.
Shepherd said the hospital was at 95 per cent occupancy, with many patients suffering from serious winter illnesses. He reassured patients they would still have enough nurses on to make sure they were well looked after but people might have to wait longer.
The intensive care unit would be fully staffed but the emergency department and other wards would have less staff than usual. He could not say how many fewer staff would be working during the strike.
Association of Salaried Medical Specialists executive Ian Powell earlier said DHBs were working to make sure the wards were rescheduling elective procedures to ensure the wards were as empty as possible and should be treated like Christmas Day.
The New Zealand Nurses' Organisation this morning announced its members had voted to reject the fourth pay offer and go ahead with a strike on Thursday.
Industrial services manager Cee Payne said the organisation had been ordered to take part in further talks facilitated by the Employment Relations Authority this afternoon and tomorrow morning in a final effort to avert strikes.
Payne said it was unlikely any agreement would be reached if there was no more money made available to the union.
Acting Prime Minister Winston Peters was clear this morning that the current offer was "the best we can do" and that there was no more money available.
The latest offer was worth $500 million and would see all nurses receive a pay rise of at least 9.5 per cent in the next year with more senior staff promised even more.
DHBs had also been given an extra $38m to hire 500 extra staff so nurses did not have to work long hours and pick up extra shifts to plug the gaps.
Nurses thinking of the future
Danni Wilkinson, who has been a registered nurse for 15 years, voted for the strike and said nurses were thinking about the future of the healthcare industry.
The 40-year-old, who works in Auckland, said part of the problem was nurses were training and gaining experience here then moving to Australia and other countries where there is higher pay.
"We cannot afford to keep losing nurses – we are already a projected 1300 or more short, country wide."
She said higher pay was important to influence people to enter nursing and midwifery training which helps with the need for more staff.
"If we are 1300 short and the DHBs are only offering 500, they really aren't paying attention to the problem."
Safe staffing saves money, due to the fact staff burnout and turnover costs DHB's $100 million a year, she said. Along with this, unsafe staffing increases the risk of death by 7 per cent.
Wilkinson voted to strike and said it was empowering for nurses to take this stance, "to not lay down and accept the same old empty promises of the past."
She said by walking off the job, nurses are looking after future patients as while their job is to heal patients, they were being provided with inadequate resources.
"We are doing this because if we did not, the healthcare system would continue to lose nurses, not attract nurses, endanger patients, endanger nurses.
"Right now, our patients are being let down by the very system that is expected to care for them when they need it most."
CEOs were getting large bonuses for saving money, despite patient care outcomes, nurses working unpaid overtime and through breaks said Wilkinson.
"By 2035, projected nursing shortages will be at 15,000.
"By that point it will be too late."
Wilkinson hopes for more money and more staff with an 18 per cent pay increase and 1500 new nurses, plus pay equity by 2020.