(or: how the nursing team is propping up DHB budgets)
As I’m sure each one of you knows, we are coming up to a General Election, and while there are many issues to consider as we head for the polling booth (both policy-wise and ‘other’), for most NZNO members, the health system will be on our minds.
DHBs are underfunded and being forced to cut every budget line to the bone. We know this affects the nursing team – in your day to work and in other ways too.
What we don’t often think about is how the way we work financially benefits our employers. Here’s what I mean:
Carol works in a unit that is chronically understaffed, where there’s no cover for sick leave and annual leave and, because the DHB is “making savings”, overtime must be signed off by the CEO in advance.
What that means for the nursing team is that Carol and her colleagues work at least half to an hour of overtime every day without claiming. If they get a morning tea break, they’re lucky, if they get an afternoon tea break it’s like Christmas has come early, and as for lunch breaks, well that’s another story.
Carol knows the DHB MECA clause 7.1 says you are able to have meal break of a minimum of half an hour within the first five hours of work (except in urgent and emergency work). The MECA clause 7.3 says if you are not able to take a meal break after 5 hours you are to be paid at time and a half until you get that meal break.
The reality is that lunch breaks are almost seen as luxury, even though every nurse knows the quality of our practice is improved with getting good breaks.
So, let’s add it up. At a very conservative estimate let’s say that Carol “gifts” her employer one 30 minute lunch break every week.
For an RN or midwife on step 3 of the pay scale that’s $2044 every year. Enough for a decent holiday!
But let’s take those numbers a bit further. With around 50,000 members of the nursing team working in DHBs around the country, and using that very conservative estimate of $2044 per year – that’s over $100 million we’re not claiming!
And that means we are propping up DHBs finances to the tune of $100 million plus every year!
There are a couple of issues here.
Firstly, you are entitled to take breaks, breaks help ensure the quality of your work and you should never feel obliged to just keep on trucking. If you keep on keeping on, you can be sure that your employer will be happy to keep on not paying out staff entitlements. NZNO says to each and every one of you:
“Please claim your entitlements! We have worked hard over the years to negotiate fair collective employment agreements that include breaks and entitlements. If you do not claim you are undermining your collective agreement, and that’s the start of a slippery slope!”
And secondly, why is the government underfunding the DHBs to the extent that DHBs must now rely on the goodwill of the nursing team to try and balance their books?
Both those issues are worth taking into consideration as we head to the polling booth in the next couple of weeks. And they are both issues that you can take collective action about, at work and in your community.
NZNO's Blog 
September 1, 2014 at 1:45 pm
Absolutely! Underfunding is a major issue. As the CTU’s unchallenged analysis of the 2014 health budget (http://union.org.nz/news/2014/232-million-effectively-cut-health-budget) showed, health funding was effectively cut by $232 m and DHBs, faced with increasing patient numbers and acuity, are underfunded by ~ $100m. Guess who is making up that shortfall?
Meanwhile a projected $90m over three years is wasted on free GP visits for kids under 13yrs when we know that there are significant sections of the population, including the most disadvantaged who have the most to gain from primary health care, who do not, cannot, and probably will never enrol or go to a GP. If we really want to reduce hospital admissions, we need nurse-led primary health care.
September 1, 2014 at 5:58 pm
It’s high time nurses stopped subsidising district health boards in this way. While the MECA provisions are quite clear, at CCDHB, for example, staff in some areas have to jump through hoops to get their entitlements – and many just give up. Unpaid overtime and missed meal breaks are a regular topic at meetings with the DON, but this issue will not be sorted until all members claim what they are due – and let a delegate know if they are having problems being paid correctly.
September 10, 2014 at 1:46 pm
First off let me say that all Nurses should be paid fairly for the work that they do and the time that they spend working. There is also no justification for being expected to work “extra” due to understaffing and then being made to jump through impossible hoops to get paid. But, and this is a big but. As a profession we need to look at why staffing is so uneven between our DHBs, and if the fact that the nurse at DHB “A” not getting a break is the same reason that the nurse at DHB “B” is not getting a break. Do we sometimes blame our poor working practice on staffing? Do we need to take some professional ownership as well as industrial action? Does the system that has remained mosly unchallenged for the last 100 years still work?
This is a mulitfaceted problem that every health system in the world is facing to some degree, and I haven’t heard a solution yet from a government.
September 10, 2014 at 1:52 pm
This will not change , unless we as nurses stop doing this. We need to get tough, and take our breaks, and leave on time. I have been through this in a different country some 10 years ago, and it worked really quick. I am a team leader in a very busy, sressfull and fast paced department, and I support my team, I make sure they get their breaks and that they do not do overtime unless an emergency requires this. It took only 5 days of hospital management trying to intimidate me, but when I politely reminded them of the MECA, the pressure the managers put on me, disappeared within a matter of days. None of that was easy, but watching a team of excellent nurses gradually brake down under pressure is much harder then any battle in support of them. We as nurses need to come to the realization that we are not push overs, and that we do indeed have power, and yes, that does require some courage… If we only complain and do not ACT, nothing will ever change. It really was and is up to us.
September 10, 2014 at 4:53 pm
We need more team leaders like Cas!
September 10, 2014 at 2:44 pm
In response to Herschel who stated “$90 m…is wasted on free GP visits for kids under 13 years…” I find this statement extremely offensive, arrogant and short sighted. You further insult us with the statement ” …..we all know…blab bla bla.” You chose to use a nom de plume so I am guessing you knew your statements were inflammatory.
I maybe new to the profession of nursing but “defeatist” attitudes such as yours before the proposed programme has had a sufficient chance to roll out is disappointing. I applaud the push for nurse-led primary health care and beleive you are onto a winner but in relation to your previous statement, please put your optimistic goggles on and chuck the pessimistic ones out.
September 12, 2014 at 8:47 pm
Just stop doing it, refuse and so NO. Hand over to the nurse in charge and take a break or lunch. Stop work at the rostered time. Any nurse who voluntarily works unpaid is doing all nurses a disservice and are not helping anybody except the Government. You are not helping the patients by working long hours or working tired or working hungry. STOP doing it, stand up for yourselves, other nurses and your patients. Stop being victims.