If I had advice for anyone right now, it would be to not become elderly or seriously ill.
Waiting times at emergency departments are frightening, ambulances are queued down hospital streets, very unwell people are being treated in tents and that rest-home your children have their eye on for you is probably on the brink of closure.
Covid-19 has turned existing cracks in the system into yawning chasms and the sad fact is people are dying unnecessarily.
At the heart of this crisis is the lack of nurses and everyone acknowledges this. NZNO estimates at least 4000 nursing vacancies across the health system (including jobs such as healthcare assistants and midwives) and in a recent survey, about 72% of our members said they are thinking of leaving nursing. They’re burnt out and exhausted and feeling like they just have nothing more to give.
All governments over the last two decades are to blame for this. We have warned of the looming nursing shortage repeatedly, and the problem has never been seriously addressed.
So how do we fix it?
In the short term, the Government has announced plans that are right out of NZNO’s Maranga Mai! campaign. They’ve removed financial and administrative barriers to overseas nurses having their qualifications recognised and they’ve put financial incentives in place to attract ex-New Zealand nurses back into the profession.
That will help, but it is not a long-term solution. We need to grow our own robust nursing workforce and, equally important, we must address why they are so intent on leaving.
Growing our own workforce will take time, but how to do it is not rocket science. Why not make the training free like we do for trade apprenticeships? Starting a low-paid job with a massive student debt is not a great incentive.
Another barrier is the hundreds of unpaid work placement hours student nurses must do. Sometimes they are working 40-hour weeks for nothing, which is costly to them and simply unfair. It’s also why more than a quarter drop out during their first years of training.
Lastly, we need to guarantee that every student nurse will be given a good job when they graduate. If we remove training barriers and guarantee meaningful employment, more young people will want to become nurses and hopefully fewer will want to leave.
Employed nurses are pretty clear on why they want out. They’re repeatedly asked to work long hours even when extremely fatigued, yet their workplace health and safety concerns often seem trivialised by their employers. They feel desperately unfulfilled at the end of a working day because they have not been able to complete basic cares.
They fear coming into work because a mistake under pressure could cost them their careers and they worry about the wellbeing of their patients when they go home after a shift. Lastly, they are disillusioned with a Government that doesn’t seem to hear them or understand why they feel so devalued.
It would help enormously if the Government would work with us to get the pay equity back-pay dispute settled so nurses can start receiving the new agreed pay rates. To its credit the Government has been ungrudging in its commitment to paying nurses these new rates so let’s get on with it.
The next issue the Government must address is pay parity, in which every nurse, everywhere in New Zealand, is paid the new rates regardless of where they work.
A nurse working in primary healthcare (e.g. medical centres) earns 10-20% less than a nurse working for Te Whatu Ora Health NZ (previously the DHBs) for work of equal worth. A nurse working for a Maori health provider earns about 25% less. You can imagine the pressure this places on primary healthcare employers to recruit and retain staff — and the pressure it puts on the diminishing number of workers who remain.
Again, to its credit, the Government has said it sees the sense in pay parity and how it will help stop smaller and more marginalised providers such as Maori and iwi losing staff to public hospitals where wages are better. So let’s get on with it.
Lastly, there’s the problem of aged residential care facilities closing like falling dominoes because they cannot find enough nurses and caregivers. The Government has introduced some immigration policy adjustments to help get overseas staff but, again, why aren’t we focusing on growing our own caregivers, who require less training than nurses, instead of taking them from other countries where they are also needed?
The solutions aren’t difficult, but they will cost time and money. Nurses are the backbone of good health. Literally, we cannot live without them.
Paul Goulter is chief executive of the New Zealand Nurses Organisation
