But it had been a “frustrating” and drawn-out process due to hospital management reluctance to pay higher rates for the demanding new role, they say.
“I felt disappointed, frustrated and also quite naive because I just assumed they would act in good faith, being that the nursing workforce is such an integral part of how we function as a health system,” said ED nurse Helen Armstrong. “I’m a little bit more sceptical now.”
Armstrong was the first and only patient flow coordinator (PFC) at Wellington’s ED department when the role was first created in 2010, in response to the then-National-led Government’s six-hour ED waiting time targets.
‘You can’t just invent jobs and decide to pay them on the lowest rung. That’s the whole point of the MECA , fairness and equity.’
It was paid at low senior nurse rates yet was a complex, high pressure job. “It’s very high level decision-making. You’re trying to advocate for the patient, advocate for the department and advocate for the hospital all at the same time,” she told Kaitiaki Nursing New Zealand. “It’s really exhausting – and I don’t think anyone appreciates that unless they’ve actually done the role.”
‘Fairness and equity’
Former PFC Jess Buckley said the nurses only realised in early 2020, when another department was creating a new nursing role, that the PFC role had never been scoped as required by the NZNO multi-employer collective agreement (MECA) with then-district health boards.
“You can’t just invent jobs and decide to pay them on the lowest rung. That’s the whole point of the MECA , fairness and equity,” Buckley told Kaitiaki.
Under the collective (p76), new senior nursing roles must be evaluated and graded by JERC (the job evaluation review committee), a joint NZNO–Te Whatu Ora body.
‘We were asking for the money we were owed already if they had followed the proper process they agreed to as part of the MECA.’
With the support of Tōpūtanga Tapuhi Kaitiaki o Aotearoa — NZNO, Buckley sprang into action and asked JERC to investigate. COVID delays meant that didn’t happen for another year, but in March 2021 JERC agreed the hospital had failed to scope what the role was worth.
But the hospital continued to resist — taking another year to appeal, doing so it the day before the JERC hearing in March 2022. The night before, a nine-month-pregnant Buckley stayed up late to rebut the hospital’s argument (that it was not a complex role, that it did not deserve a higher pay scale) point-by-point. “We disagreed,” said Buckley.
The employer lost. JERC ruled the 18 former and current PFCs should be paid — and back paid up to six years — at grade 3 on the senior nurse pay scale, which was $7000 to $11,000 more per annum for a full-time-equivalent.
While the PFC role had been underpaid for 13 years, under the Wages Protection Act claims can only go back six years from when they were lodged. In the PFCs’ case that was back to 2014.
‘For the district health board to turn around and act in the way they had, it felt disrespectful for the amount of work that goes into that job and the amount of stress that those nurses have to work with each shift.’
“They didn’t have a case,” said Buckley. “We weren’t asking for more money – we were asking for the money we were owed already if they had followed the proper process they agreed to as part of the MECA. We just wanted to be paid what we deserved.”
Wait ‘too long’
It took another year-and-a-half to kick in (and a fight to include those who had left the hospital), but all 18 former and current PFCs had this month received their lump sum, Buckley said. While happy about the win, the process had been frustrating and felt “disrespectful”.
“Three-and-a-half years — it shouldn’t have taken that long,” Buckley said. “For the [then] district health board to turn around and act in the way they had, it felt disrespectful for the amount of work that goes into that job and the amount of stress that those nurses have to work with each shift. So it’s pretty frustrating.”
‘We recognise the frustration that the delays have caused and we apologise for this.’
Patient flow coordinating role ‘huge’
The job was “huge”, she said. Not only did PFCs have to explain and apologise to patients and their families for the delays, they also wrote safety reports about those who had experienced harm due to the delays.
“There’s a real complexity and a huge autonomous decision-making part to it. It’s very complex clinically, it’s very stressful, you’re trying to manage multiple admissions per hour in a busy ED.”
Armstrong says the role had a lot of “kudos” for its support of an understaffed, often overwhelmed, ED. “We did it so diligently — our team were just performing at such a high level.”
She was “really pleased” everybody was getting the pay they were owed. “I know as well as everyone else how hard you have to work, mentally, in that role.”
‘We’re sorry’ — hospital
Te Whatu Ora Capital, Coast & Hutt Valley acting chief nursing officer Claire Jennings acknowledged its failure to scope the role and the delay in rectifying the error. The hospital highly valued its nurses’ work and “was committed to learning from this experience”, she told Kaitiaki in a statement.
“While we are pleased to have been able to resolve this matter, and pay our staff appropriately, we recognise the frustration that the delays have caused and we apologise for this.”
Jennings said the hospital would work closely with NZNO to meet its obligations when new roles were established and provide training for managers and HR staff to ensure they understood. “. . . we expect all of this will help to ensure that such a situation does not happen again”.
While Armstrong is back in ED, Buckley has left the hospital for a regulatory role. “I really love emergency nursing and the team — but I didn’t love the system and the position it put patients in,” she said.
The experience showed the value of the union beyond negotiating collective agreements, Buckley said. “For Jo (Coffey, NZNO organiser) to work beside me for this hard for this long — shows how dedicated NZNO is to nurses being valued.”
Next up, the “flow bros” are planning a celebratory dinner after their hard-fought win.