Hospitals around the country are swamped with a mix of Covid-19 patients and others with winter illnesses, while there are fears some nurses are leaving New Zealand for higher pay in Australia.
The grim situation comes amid reports that a 50-year-old woman died with a brain bleed after allegedly being told by staff at Middlemore Hospital's emergency department there would be an eight-hour wait before she was examined.
The New Zealand Nurses Organisation (NZNO) said the nursing sector was more than 4000 nurses short and the Government needed to admit there was a crisis.
The Ministry of Health said health workforce shortages were a global issue and addressing New Zealand's nursing shortages and providing a safe work environment was a priority.
NZNO president Anne Daniels said nurse shortages in New Zealand were "pretty horrendous".
"The fewer nurses there are, the more likely [it is] that the workloads increase.
"Right now, we have an extremely exhausted, burnt-out, morally injured workforce of nurses that who, when they go to work, know they are not going to have the number of staff they need to work with in a team to keep themselves and their patients safe and the likelihood of them making mistakes in that context increases as well."
Waikato DHB – with an emergency department that has been operating near capacity for the past fortnight – has around 215 nursing vacancies, which is 5 per cent of its workforce. Canterbury DHB, with 180 empty positions, also has a 5 per cent vacancy rate.
Of the country's five biggest DHBs, Counties Manukau has the largest vacancy rate at 17 per cent or 347 vacant positions. Waitematā and Auckland DHBs have vacancy rates of 3 per cent and 6.5 per cent.
Daniels said the situation worsened every day.
"Just two days ago, I got texted by one of the ED nurses I know and they started the shift with seven registered nurses down, which means they've got seven gaps in their rosters; nearly half the working team."
Daniels said she was "extremely upset" to hear a woman had died from a brain bleed after allegedly being told at Middlemore Hospital's emergency department there would be an eight-hour wait.
"I believe it's just the beginning of many issues that are going to be identified but to know that it's actually happening, to know that this woman has lost her life, her family has lost a member of their family, it's just mind-boggling."
A doctor - who asked not to be named out of fear of putting his job at risk for speaking to the media - told the Herald the woman presented to ED with a severe headache [on Wednesday] at 1am.
"She was frustrated so left. She returned at 0400 [4am] that same day and was intubated. CT showed a massive subarachnoid haemorrhage, she died," the doctor said.
Meanwhile, the Herald reported last week that hospitals had hit "a level of panic", with 71 patients waiting for beds at Middlemore's ED in one night.
Daniels said the whole world was in the same position and trying to recruit nurses – but other countries were "prepared to pay for it".
An advertisement by a recruitment company in Australia calling urgently for experienced emergency nurses in regional New South Wales offers new recruits a A$7500 ($8280) "sign-on bonus".
"[That's] just to sign on the bottom line. Add to that free accommodation, free flights, support to get education and increase your skill and knowledge and experience. New Zealand at the moment cannot compete with that."
A doctor who has worked in the sector for more than 10 years said he knew of around 10 nurses – a mix of colleagues and friends - who had left New Zealand for jobs in Australia over the past three months.
One nurse, who the Herald agreed not to name, said his pay increased 30 per cent when he moved to Australia earlier in the year. Better pay was one of several reasons why he moved.
Pay slips seen by the Herald showed the nurse was paid $39.80 per hour in New Zealand per hour and A$47.37 in Australia. He said another bonus was that a small part of his salary was exempt from tax.
The nurse said working during the pandemic in New Zealand was stressful, with increased workloads while wearing a face mask all day.
"To think that the Government is ... telling the public they've handled Covid really well and New Zealand is the leading [country] in the pandemic, it's because of the nurses and the doctors and the health staff that are working tireless and taking extra loads and not taking breaks.
"That's why it was successful, because of the health staff and the frontline workers and they're not even giving us the right amount [of pay]."
In a statement, a Ministry of Health spokesperson listed a wide number of initiatives and investments aimed at increasing nursing numbers, including overseas recruitment and attracting nurses who have left the profession to return.
These initiatives included campaign investments to promote nursing as a rewarding career and boost the domestic supply of nurses; a Voluntary Bonding Scheme to improve retention in several hard-to-staff specialties and communities; and measures to increase numbers of funded Nurse Entry to Practice programme places for graduate nurses.
"Nurses provide a valuable contribution to New Zealand's health and disability system.
"The Ministry of Health appreciates that New Zealand nurses perform a variety of important frontline tasks that are crucial to the success of our health system."
Nursing union: "We've got to get real"
NZNO co-president Kerri Nuku told the Herald said the sector was at breaking point and many nurses had reported being broken themselves. The first step in addressing the problem was to admit it was a problem in the first place.
"The Government has to admit that we have a crisis at the moment that needs to be dealt with actively.
"Then we've got long-term things we need to look [at] around the workforce, education, immigration, how we support nurses to come in, how we support them in the training, but to deal with the here and now we have to be real."
Nuku said the crisis was not isolated to DHBs but had overflowed into primary healthcare and the aged-care sector.
"The whole system is under enormous pressure."
Anne Daniels, NZNO's president, said the situation could not continue.
"We really need to turn this around but doing that is like shifting the Titanic, and we all know that, but it has to be done."
