“Nursing has always been my passion – I love clinical stuff, I love everything about nursing. It’s just that I can’t with a family anymore,” Suzette (last name witheld on request) told Kaitiaki Nursing New Zealand.
She was among several nurses who shared their experiences in person recently with Te Whatu Ora chief people officer Andrew Slater and national director of hospital services Fionnagh Dougan, while handing over a survey of 925 NZNO members who work at Te Whatu Ora.
After media leaks, Te Whatu Ora revealed it had been ordered to cut back on spending in a bid to save $105 million by July 1, the start of its new financial year.
Measures include banning double shifts, limiting sick leave cover and wiping vacancies that are not part of a new structure. Staff are also being pressured to take leave on public holidays like Matariki and ANZAC day.
Shifts ‘unsafe’
Despite her passion for nursing, Suzette ended up quitting for a non-clinical role after a particularly tough night shift on her ward.
‘I felt guilty because I couldn’t nurse the way I want my patients to be nursed. I’m all for patient safety – and that shift was not safe.’
Instead of four registered nurses (RNs) there were just three, including a new graduate, when they were fully occupied with acutely unwell patients.
“We all ended up having six patients — I had seven — and I was coordinator on top of that,” she said. “The three of us never had breaks, we just went through our whole shift.”
It took Suzette two days to recover, emotionally and physically, and she decided to leave soon after.
“I felt guilty because I couldn’t nurse the way I want my patients to be nursed. I’m all for patient safety – and that shift was not safe.”
When she shared this with Slater and Dougan, she broke down — but was told everyone had to work within the new limits.
Another senior nurse at the meeting, Dawn Barrett, said the budget cuts created an “impossible situation” for nurses, already run off their feet.
‘It’s not all about numbers and ticking boxes and CCDMs and shifts below targets. It’s actually a really different picture on the floor.’
Afterwards, Barrett told Kaitiaki it was one of the busiest shifts she’d ever experienced.
“We had the biggest number of acutes we’ve ever had since I’ve been here. Me and the other staff literally ran for the whole shift.”
Nursing ‘compromised’
Barrett said nursing was just getting back on its feet over summer, following COVID, loss of nurses to Australia and difficulty recruiting. But she feared the latest move would “undo all the good work”.
“They’ve just compromised the whole nursing crisis by this move. All the measures that have done great work are going to be undone by putting incredible pressure on staff, especially when sick leave is off the chart.”
Senior theatre nurse, Deena Cardon, told the leaders that not replacing sick staff could have a big “overflow” impact on other staff and patients.
“If one person’s sick and they don’t get replaced in preop . . . you might find the overflow effect is a patient’s late to theatre. Theatre runs late, an anaesthetist, a tech, three nurses & a PACU [post-anaesthesia care unit] nurse all have to work overtime or a patient gets the operation cancelled,” she said.
‘We don’t blame our charge nurses — we’re angry at Te Whatu Ora and the New Zealand Government.’
“We’re in this decision every single day as to who’s going to get their operation and who’s not.”
Cardon said what happened in reality was not always matched by the hospitals’ acuity tools.
“It’s not all about numbers and ticking boxes and CCDMs and shifts below targets. It’s actually a really different picture on the floor.”
And while she was glad the Te Whatu Ora leaders listened, their meeting seemed “hurried” lasting only 10 minutes or so, Cardon said.
Te Whatu Ora ‘hands tied’
The leaders simply said their hands were tied and they were not allowed to start their financial year in deficit.
‘But we need our leaders to make those decisions locally because they know their own situation best and each hospital and ward will be different.’
Cardon said she wanted to acknowledge that charge nurses were doing a “bloody amazing job” despite being stuck between their nursing staff and management “who just want to squeeze every dollar out of the department”.
“We don’t blame our charge nurses — we’re angry at Te Whatu Ora and the New Zealand Government.”
Of those surveyed by NZNO, the overwhelming majority said the moves would impact their health and wellbeing.
The main concerns were:
- Understaffing – leading to stress, burnout and nurses leaving
- An unsafe work environment
- Feeling undervalued
- Being unable to upskill or train new staff
- Financial impacts on staff
‘Local decisions’ — Te Whatu Ora
Slater said while hospital leaders had been asked to be “mindful” about overtime and backfill, he expected they would make the right calls based on the circumstances at the time.
“But we need our leaders to make those decisions locally because they know their own situation best and each hospital and ward will be different,” he told Kaitiaki via email.
“They may not always need to use backfill if staff are away, for example when patient numbers on a ward are lower.”
Slater said taking leave was important for nurses’ wellbeing.
“For too long, nurses haven’t been able to take the leave they need. Now we have more nurses, we’re encouraging them to do that.”
Te Whatu Ora had increased its nurses with another 2500 last year but Slater said he knew their experiences on the ground would vary. Te Whatu Ora was also working on nurse shortages in mental health, intensive care and emergency departments.
“Patient safety and outcomes, coupled with staff wellbeing, remain fundamental alongside the need for financial sustainability.”