Wellington neonatal unit gets big staffing top-up

June 1, 2021

Wellington’s neonatal intensive care unit (NICU) has hired an extra 26 full-time equivalent (FTE) nurses, after safe staffing acuity tool TrendCare helped identify a large shortfall.

Rosemary Escott
Rosemary Escott

Capital & Coast District Health Board (C&CDHB) neonatal nurse manager Rosemary Escott said after two years of data collection, in 2020 the tool produced “robust data” identifying a 26-FTE nursing shortfall in the busy 36-bed unit. That included 3.24 FTE senior nurses such as educators and clinical nurse managers.

The external care capacity demand management (CCDM) safe staffing team checked the results, confirming a large increase in nursing hours was needed to safely staff the unit.

C&CDHB initially planned to recruit new staff gradually, to allow them to be supported into the role, Escott said. However, after delivery suite bookings predicted “the busiest year ever” in 2021, they sped up the recruitment process.

All 26 positions had now been filled, by a combination of new graduates, overseas nurses and nurses from other areas, she said. “It’s been really positive, going through this robust process of data collection, which has resulted in a really effective team.”

“The speed of the recruitment has put a strain on the unit and educators, but staff have been magnificent,” she said. “It’s been exciting to see the calibre of new nurses joining the NICU team.”

Poverty, violence, mental health issues and addiction had all contributed to increased pressure on the neonatal unit in recent years, she said. “Neonatal care has become more complex in the current social environment, meaning that nurses are under pressure.”

A national review of neonatal care by the Ministry of Health in 2019 found NICUs consistently exceeded the desired occupancy levels of 85 per cent, for which they were resourced. This put pressure on staff and more staff, cots and equipment were needed, it said.1

TrendCare measures staff – skill mix and numbers – and patients, to inform the safe staffing programme, CCDM. Under the NZNO-DHB 2018 safe staffing accord, CCDM was to be implemented at every district health board (DHB) by June 2021.

Escott said implementing safe staffing at the NICU had been a “real partnership” between the DHB and NZNO.


  1. Ministry of Health. (2019). Review of neonatal care in New Zealand.