“District nursing has been like a silent service that people often forget about,” Waitākere district nurse Rosanne Maber told Kaitiaki. “They have their big meetings at hospitals and reporting on staffing [there] but I think we often get forgotten about.”
The Waitematā nurses — who help hundreds of homebound patients every day across west Auckland’s Waitākere, North Shore, Wellsford and Hibiscus Coast — have been complaining for more than a year that understaffing was forcing them to cancel and postpone patient visits daily.
On just one single day this week — Tuesday — Maber said they were 29.5 hours short across the four district nursing areas, which meant 38 patients would have been affected by delayed or cancelled appointments.
‘So, for us it’s not acceptable for the patients, but it’s not acceptable for our profession, either.’
Maber said it wasn’t about pay — which was part of the wider bargaining still dragging on after 18 months — but safety.
“Patients are not receiving the care they need — they are being deferred on a daily basis,” said Maber, an NZNO delegate. “So, for us, it’s not acceptable for the patients, but it’s not acceptable for our profession, either.”
Loss of professional development
Crucial professional supports had also been cut, including portfolio days to meet ongoing Nursing Council practising requirements and a monthly “resource group” where nurses kept up-to-date with latest practice and policy, she said.
“Professional supervision, which to me is really vital for our nurses, also isn’t happening. That’s quite protected time for nurses to debrief, put out any concerns they’ve got with patients.”
Te Whatu Ora – Health New Zealand (HNZ) promised a review of the service after the situation worsened a year ago — but has since told district nurses they had to work “better, faster and more efficiently”, Maber said.
“It’s not nice making those phone calls every morning, to tell patients we’re not coming,” she said. “And when do you defer them to? Because tomorrow’s likely to be the same, the next day’s likely to be the same. So we’re feel like we’re constantly trying to catch up.”
‘At the end of the day, we’re doing this for our patients. I just hope that we’re listened to.’
District nurses dealt everything from chronic leg ulcers to changing catheters or feeding tubes. Many of their patients, were seriously unwell, with high needs, and included the terminally-ill, Maber said.
“We work alongside hospice quite closely, as well as with post-op patients, mastectomy patients — anyone who requires any kind of nursing in their home, who can’t get out or get to a GP.”
Due to pressure on hospitals, patients were often discharged early. Yet district nursing numbers had not risen to meet the higher, more acute, need, she said. And nurses were often not replaced after leaving — or not for several weeks or even months.
“We feel like our staffing levels aren’t meeting the demand of the community.”
Maber said striking was an absolute last resort, but the nurses were desperate.
“Nurses definitely don’t like striking. But at the end of the day, we’re doing this for our patients. I just hope that we’re listened to.”
The picketing comes off the back of two weeks of uniform strikes by the Waitematā district nurses to try and highlight staffing woes.
Nurses were infuriated when managers confiscated their safe staffing pamphlets, demanding they stop handing them out to patients.
However, the move only “fired up” members, who have carried on giving out the pamphlets.
NZNO chief executive Paul Goulter has said NZNO would support any member being bullied for taking part in strike action during collective bargaining, which was a legal right.
The district nurses are picketing today, Wednesday, at the Auckland electorate offices of Minister of Health Simeon Brown, and those of his Cabinet colleagues Mark Mitchell and Chris Penk.
HNZ responds
HNZ national chief nurse Nadine Gray said HNZ was “always looking at ways to improve our system, quality, and safety”. The district nursing service was being reviewed, as part of a new national programme of work to assure safe staffing across the organisation.
A survey had recently been completed and was being analysed, with a working group being set up to consider “next steps”, she told Kaitiaki.
“We value the significant contribution of our nursing and healthcare assistant workforce and remain dedicated to ensuring we have the right people and skill mix to deliver quality and safe patient care.”
