Patients recovering from strokes at one of New Zealand’s biggest wards are languishing in wet beds and being put at risk of falls because of “chronic understaffing”, according to nurses who spoke to the Herald.
Forty staff who work at Waitākere Hospital’s Muriwai ward, including nurses and healthcare assistants (HCAs), signed a letter warning Health New Zealand (HNZ) of “urgent” safety concerns on the ward.
The letter, sent to HNZ chief executive Dr Dale Bramley and northern region deputy chief executive Mark Shepherd, and obtained by the Herald, says staff are struggling with burnout, patient safety is being compromised, and they need more staff.
Kate Gilmour, HNZ chief nurse for Waitematā, responded in writing, acknowledging challenging circumstances, but said current staffing levels at the ward were “appropriate”.
Two nurses, who spoke to the Herald in their capacity as delegates for the New Zealand Nurses’ Organisation (NZNO), said they felt HNZ’s response was “dismissive” and swept serious concerns of frontline workers “under the carpet”.
A meeting had since been arranged between senior leaders and nursing teams, but the pair believed that was only because the Herald contacted HNZ to ask why there had been no in-person meeting.
Neil Warrington, who has worked at Muriwai ward for 23 years and is an NZNO delegate, claimed patients were suffering needlessly because staff were overrun.
The ward provides care for patients aged over 65, including those recovering from strokes. Warrington said many were completely dependent and needed help with eating, washing and toileting.
“They can have issues around incontinence. With patients we don’t get to in time, they will try and get up on their own. They will sometimes fall,” he told the Herald.
He said such incidents led to a loss of dignity for patients.
Staff were often blamed for the poor service by patients or their family members, he said.
“[We’re told] that we’re all useless, that we’re terrible nurses. We bear the brunt of that because we’re standing in front of that visitor or that patient.”
Gemma Bethell, who started work at Muriwai ward 13 years ago, said such criticism was “heartbreaking” for staff, who strove to do the best for patients and their families.
“We’re nurses because we care for people. We chose this career because we want to do the best we can for the people we’re looking after, and I feel that, because of short staffing, we are not able to deliver care to a high standard,” she told the Herald.
Bethell, who is also an NZNO delegate, said delayed care could lead to increased risks of complications, such as skin breakdown for patients left in wet beds.
“How would you feel if it was your mum or your grandmother left sitting in incontinence because she rang the bell for the nurse, but the nurse was busy with other patients, or delivering medications or dealing with an emergency at that time.”
Those who signed the letter wanted improved staff-to-patient ratios.
Bethell said that, at present, it was not unusual for one nurse to be responsible for 11 patients during a night shift.
“I want what’s best for my patients and their families, and we’ve asked [for more staff], and it just feels like we’re not being heard.”
In an emailed response to the letter from nurses, HNZ would not commit to boosting staff numbers.
Gilmour said Muriwai ward was “fully recruited” for nurses, but acknowledged there were vacancies for “watch” staff – those who provide continuous, close observation of patients to make sure they’re safe.
Recruitment for those vacancies was underway with “requests awaiting approval”, her email said.
The gaps identified were mainly because of unplanned leave, such as for sickness, and while bureau staff were usually brought in to help, “unfortunately, demand exceeds available resource”.
Bureau staff are casual nursing staff used by HNZ to cover shortages across various wards around the country.
In response to questions from the Herald, the group director of operations for Waitematā, Brad Healey, said the safety of staff and patients was an “absolute priority” and feedback from the frontline was taken seriously.
He said workload and resources on the ward were being investigated.
However, inquiries to date showed staffing last month was “generally at expected levels”.
During April, 84 requests were made to help cover shifts, and bureau staff were available on 75 of those occasions.
“We are meeting with staff this week to further understand their experiences and ensure their voices are heard,” Healey told the Herald.
Warrington believed a meeting was only now being arranged because leaders were in “a bit of panic” after concerns were shared with the Herald.
“I don’t think they had any intention of meeting with us.”
He didn’t have much hope that the meeting would result in improved staff-to-patient ratios.
“We used to have one nurse to four patients [during a morning shift]. That was good, you could help the patient rehab during your shift.”
The current situation meant one nurse was often responsible for six patients on the morning shift, which made it “impossible” to get everything done.
Bethell said that, because of staffing gaps, she and others were frequently called on to pick up extra shifts, which was not fair.
“You can’t be a Band-Aid for a failing healthcare system, because we all have families and lives of our own. Everyone is tired of picking up [shifts] and extending just to try and bridge the gaps that exist.”
She said she had felt compelled to speak publicly because she did not feel staff were listened to, or that management acted on their concerns.
“I’m tired of feeling ignored.”
Michael Morrah is a senior investigative reporter/team leader at the Herald. He won News Journalist of the Year at the 2025 Voyager Media Awards and has twice been named reporter of the year at the NZ Television Awards. He has been a broadcast journalist for 20 years and joined the Herald’s video team in July 2024.