NZNO's Blog

Anne Daniels, NZNO President
NZNO Tōpūtanga Tapuhi Kaitiaki o Aotearoa

Our action to stand united in making our point to Te Whatu Ora and refuse additional shifts from 3 to 9 October has left me proud of my colleagues and of being a nurse.

One nurse, Rachel Thorn is one of 1695 delegates who support members on the ground. Rachel led the way to challenge the decision made by Te Whatu Ora regarding winter payment inconsistencies and inequities. Last week’s unprecedented action was generated from her leadership (Whangārei nursing staff demand better winter incentives) in July. Since then, 80 percent of her colleagues in the Whangarei Emergency Department withdrew their goodwill and declined any extra hours of work.

Rachel has not only worked locally and but also nationally becoming the voice of last week’s action while demonstrating the principles of Maranga Mai!

As a result of her letter, an information gathering survey was sent out on 29 July to all members. We received more than 4000 responses in just over two days. Those responses made it clear that we needed to push back to Te Whatu Ora on the lack of consultation and the pitiful, gender-discriminating winter payment (when compared to our doctor colleagues) offered to nurses.

A survey, has just gone out to NZNO members asking for your experience of this action. Te Whatu Ora has also sent out communications on 30 September.

We expect to see the need for additional hours reducing as a result of COVID-19 and flu infections dropping. There will always be a need for some additional hours, although these are likely to be reduced over time and in line with our normal work now that we are past the peak of COVID and winter.

So, where to from here? The results of the survey sent out, will tell us. But there is one thing I do know, ‘winter is coming’ again. In a context where negotiations are about to start for the tertiary sector, when pay equity and backpay, pay parity, and no movement being made towards financial relief for student nurses or a reduction in immigration barriers for IQNs, I believe there is a growing NZNO member appetite to all stand up and act collectively. Maranga Mai!

Kaiwhaka Kerri Nuku
Tōpūtanga Tapuhi Kaitiaki o Aotearoa NZNO

Tōpūtanga Tapuhi Kaitiaki o Aotearoa NZNO
Tu tonu mai
Te iwi e
Maranga mai
Hikitia te wero
Kia mau
Tatou katoa

Stand tall, stand proud
The people
Let us rise up to together
Let us take hold of the challenge
Let’s stand together and face to the
future together

“Maranga Mai! – Let’s rise up together”. We must work collectively to bring members together and address the workforce issues in the nursing, midwifery, kaimahi hauora, health care assistance and tauira arenas. 

Growing inequalities have been perpetuated and this could be attributed to apathetic politics that does not address the issues or the need for urgent change. This has led to many lagging behind in Aotearoa New Zealand’s health care system. 

This is not acceptable, fair, or just. Nurses, midwives, kaimahi hauora, health care assistants and tauira must be courageous. To be unsung heroes we need to be prepared to lead change. 
What we need is inspired collective action to ensure we as a union and a professional organisation leave no one behind. We must rise up!

Ki te kotahi te kākaho, ka whati; ki te kāpuia, e kore e whati.
If a reed stands alone, it can be broken; if it is in a group, it cannot.

Anne Daniels, President
NZNO, Tōpūtanga Tapuhi Kaitiaki o Aotearoa

Many words were spoken, sung, whispered, shouted and written over three days at Te Papa, Wellington from 13-15 September. Our conference theme: “Nurses. Fronting the Battle for Health Nga Tapuhi – Te aroa kapa toa mo te hauora”, had many meanings for the 175 plus nurses, midwives, health care assistant and nurse practitioner participants.

Our words are powerful. They carry our thoughts and our intentions. Words have a deep connection to our way of being. Their effect can affect the “cardiac-orientating reflux”. This is when two or more hearts resonate together by listening to each other. Paying attention with an outward focus has a calming influence on the heart rate. Research suggests that a single word has the power to influence the expression of genes that regulate physical and emotional stress (Newberg & Walkman), positively or negatively. More importantly, the way words are expressed gives them power.

Māhirahira mai or staying curious, being interested in others and listening is good for our health as well as our effective leadership.

NZNO members and conference participants chose to “look up and look out” through our growing understanding of the Maranga Mai! campaign and what it meant for them as individuals, as whanau within their workplace, and the power we have in working collectively and in solidarity. This was tested, when conference participants learned that there was a change in the programme. It was a call for all to walk to parliament to honour the 50-year anniversary of 50^th anniversary of the Māori language petition.

Some could not understand the connections with nursing but words spoken by NZNO leadership, particularly those from Kaiwhakahaere Kerri Nuku, were heard.

Kerri told us the march to Parliament was a sign of solidarity to show those champions and pioneers who organised the march that we were there to support them.

“We have an obligation and an opportunity to deconstruct the walls that have been built and oppressed us. Whatever goes forward we are there, we are part of that, and we support them.”

The words resonated with those of us who listened and we acted.

The walk to Parliament gave respect to the 50-year-old fight to bring te reo Māori back into our schools, was a powerful reminder of what collective action can do for our hearts and minds. It was an action for the right to use words in a language that is the lifeblood for Māori. It brought us together.

The march gave us hope. It prepared us for a plea for help from Rachel Thorn, Whangarei ED CNM, to support her team’s action to Rise up through Maranga Mai! nationally. It turned into a call for action by NZNO CEO Paul Goulter, myself, Kerri and the NZNO board for all members to work their contracted FTE only in the week of October 3-9, 2022.

This was a fitting use of words that gave power to NZNO delegates to Maranga Mai! to go forth and act. We are stepping up and out to become the future we want to be.

Maranga Mai!

Paul Goulter, Chief Executive
NZNO Tōpūtanga Tapuhi Kaitiaki o Aotearoa

Kia ora tātou,

Ngā mihi nui kia koutou katua
Ko Paul Goulter taku ingoa
Ko au te tamuaki o te
Tapo tanga Tapui kaitiaki o Aotearoa

It is a privilege to stand here and address you. It’s our first chance to get together kanohi ki te kanohi.

This is our first chance as a group to confront our situation and address what needs to be done – nurses, midwives, HCAs, care and support workers, Māori and Iwi – we all have this in front of us

But firstly, a tribute to you all. You are the living face of the frontline. You stood firm against Covid, you took on risks and you met your professional obligations.

And the New Zealand public love you for it.

But what my speech will be about is the future – what we need to do together, in our union to take on the biggest nursing crisis we have faced.

Because we find ourselves in the middle of that nursing crisis, with a govt that is struggling to fix it.

So we NZNO will drive the fixing it and we will be relentless in doing so.

So what is our situation?

Simply put:

• we don’t recruit and train enough nurses
• we don’t retain enough nurses in the service; and
• the jobs are increasingly not good jobs.

We are more than 4000 nurses short. Our workforce is aging, our nurses are leaving – not just overseas but leaving the profession – nurses have simply had enough!

Our nursing numbers are propped up by immigration – we have the highest number of immigrant nurses in the OECD 26 percent in 2019 (and more now). Switzerland is just behind us then a significant drop to Australia at 18% then basically everyone else is in single figures.

Of course, we welcome our nurse colleagues from overseas but fundamentally this country has to take responsibility for recruiting and training its own.

And it has failed and continues to fail to do this – instead relying on immigration to prop up failed workforce strategies. 

Do you know what they call their nursing workforce strategies? The nursing pipeline – there is even a Nursing Pipeline work group – well you can guess what I think when I think of a pipeline – it’s an insult to the profession and its contribution.

We simply do not have enough students going into training, they struggle to stay in training and come out of training with huge debts. For Māori nurses – the numbers are way worse and attrition of Māori nursing students is much higher.

Fundamentally there are not enough nurses and the ones who remain here are being flogged to death. A fact that the public seem to know but our political leaders seem unable to respond to.

Instead in the last Budget, the Government committed billions for the change from DHBs to Te Whatu Ora and Te Aka Whai Ora but hardly a cent more for the frontline work force – nurses, doctors and allied health.

So what do we struggle with? We struggle:

• to get paid properly
• to have safe and health workplaces
• with getting nursing students into education and training
• with a system that relies on immigration but won’t put nurses on the green list (as doctors are)
• with a system that does not recognise and respond to the needs of Māori health and Māori nurses.

This is a crisis – the Minister can call it whatever he likes but it is and remains a crisis. You know it’s a crisis because daily you live it in your workplaces

And if we standby and let it run without fighting for the changes we need then we all – as NZNO, as member leaders – we all stand condemned.

We came to this conference to learn, to recharge, meet old friends but you also came here to do something about that crisis

And you came here to lead your part of NZNO – in whatever roles you have – to make those changes.

This nursing workforce crisis is not new – it predates Covid, it worsened during Covid and it will continue post Covid.

And it has a face, a human face, your face and the faces of the nurses you represent.

And they are all saying – ‘enough’.

And they are challenging their union and its leadership to get out there and advocate their cause and organise.

That is why we have Maranga Mai! Every nurse, everywhere – out there and active

It’s simply not good enough be a bunch of dispersed voices complaining about their situation.

As a union we need to join up those voices, directing and focusing them around the key Maranga Mai! messages and fixes; and then

And then we need to get out there, on the streets organising and fighting for our fixes.

I congratulate those of you who have been active in the workplace, in your sectors and in the public.

• Our delegates
• Our HSRs
• Our regional councillors and college and sections leaders
• Our aged and retirement care nurses and care workers who rallied back in May around the country for just funding
• Our primary healthcare colleagues who rallied two weeks ago for pay parity
• Our Māori colleagues who daily confront the injustices of our existing health system
• And if I have forgotten anyone – sorry about that and let’s give them a big clap as well!

Before I go any further I want to talk about a couple of areas that effect everyone in this conference – pay equity and pay parity.

It is now well known that our hospital nurses made it quite clear that despite around six years of waiting, the pay equity proposals emerging from the pay equity process were not good enough.

So you spoke up and it was stopped. It was stopped because:

• it didn’t provide full back pay to 2019 despite this being promised
• it didn’t address gender discrepancies across the board
• it didn’t provide for a mechanism of review that ensured the gender discrimination did not re-emerge later down the road.

And then our members said – quite correctly – take it to the Employment Relations Authority and the Employment Court and get it sorted – get the rates arbitrated by an independent ERA member and the back pay by the Employment Court.

So we are in the Employment Court arguing that the government was obliged to pay full back pay to 2019; and

We are in the ERA saying that all the proposed rates need to be reviewed and reset higher due to flawed bargaining processes forced by the Crown.

And by the way – on the backpay lets here what our Minister said and what the DHB employers said about back pay

AL – There would be back pay to the agreed starting point of December 31 2019. The government had not considered any further back pay.

DHB – Settling the pay equity claim comes with a commitment to backdate any increase to 31 December 2019 and the DHBs are asking that’s taken into consideration in this pay round

And what has been the response from the Minister when we lodged with the ERA –

Nurses in hospitals, right now, would be on base incomes between $10,000 and $12,000 a year more had the Nurses Organisation not blocked a pay equity deal they signed up to in December last year. You can understand that I find the Nurses Organisation talking with a forked tongue on many issues,

And if that is not good enough the Crown goes further and lodges a claim for a $20,000 penalty for a breach of good faith because we stopped the process.

Minister – we say there was no deal. An agreement in principle is not a contract. Here is the final draft document they were asking you to vote on – you cannot see it from this distance but:

• it has ‘draft’ all over it
• changes were still being tracked in and
• none of the various government authorities expected to have signed it before you voted on it had done so.

And the Minister still says we had welched on the deal.

No, there was no deal and yes we are using your governments Equal Pay Act to resolve it

Our nurses need that money.  And we must recognise our midwives are lining up behind this process as their pay equity process has also stalled awaiting resolution of the nurses’ issues.

Its scandalous that on one hand the government acknowledges the long-standing gender discrimination and on the other refuses to pay out.

In saying ‘no’ you have shown the public and the government, NZNO will no longer be pushed around.

It signals that time is over, that things have changed

That’s Maranga Mai! – Rise Up!

And of course, any discussion of pay equity leads directly to pay parity

And that is the struggle our nurses outside of the hospitals are having to even receive the current DHB rates – in ARC, primary and community health, Māori and Iwi providers, Pasifika, Plunket and all our other frontline areas, let alone any pay equity enhanced rates.

And the very time when the public and NZNO and nurses and doctors everywhere are crying out for funding at the frontline – in the last Budget our govt delivered basically nothing for that frontline

What were they thinking?

Now the future

Firstly – in hospitals –

We must fix this winter payments debacle. The decision by TWO to unilaterally introduce a series of payments with no negotiation with NZNO is:

• unacceptable
• disrespectful
• a danger to health and safety as it encourages already fatigued nurses to work on
• It discriminates between doctors and nurses on the payments, and in our view
• It breaches good faith and the Act.

We have already heard from members who are taking a stand on this winter payments programme and have been calling on NZNO to support those members.

And so today we are calling on Te Whatu Ora to immediately enter into negotiations to change the current programme that ends on 30 September and any new replacement programme.

And if they don’t satisfactorily conclude those negotiations then we call on our members in the week of Monday 3 October till Sunday, 9 October to work only contracted hours.

It is a health and safety issue and it’s a respect issue.

TWO needs face up to their obligations:

• under the ERA,
• under the H&S Act and
• in good faith.

And negotiate safe arrangements with NZNO that are nationally consistent and are consistent with what doctors get.

Can we do that?

Should we do that?

Secondly, right around the corner is the bargaining for new Te Whatu Ora CA to replace the DHB MECA which expires on 31 October

We have been planning this campaign for some time and are ready to launch.

Apart from other claims to be raised by members, we will focus on –

• An acceptable pay increase in line with the rise in cost of living – to be either delivered through the current negotiations between the govt and the public sector unions – called a Public Sector Pay Adjustment; or
• Through direct bargaining across the table
• We want to give teeth to what is called Safe Staffing. As the Ministerial review showed (but strangely did not conclude) CCDM is not working for nurses atb. Just like the Aussie nursing unions we want ratios – mandated staffing levels along with a CCDM generated overlay on top of those levels as well as a cultural overlay for Māori nurses working with Māori. We want the ratios regulated but we cannot wait for legislation so we are going after them in our CA negotiations; and
• We want expanded health and safety rights and protections. Our nursing crisis is a health and safety crisis for staff and patients alike. We need to use and expand on the existing rights and protections to give force to correcting unsafe workplaces – and for those of you already doing that – congratulations
• We have established escalation pathways to escalate these health and safety issues including violence in the workplace. We need to be prepared to take advantage of our rights under the Act – issuing PINS, standing up against unacceptable management behaviour, moving to cease work orders and fundamentally be prepared to use the legal protections of the Act to refuse unsafe work if not satisfactorily addressed.
• The situation is so bad there is nothing left to do than take this ramped up stance and support our HSRs and delegates who lead this. What is called a staffing crisis is in fact a health and safety crisis.
• And this means putting intense pressure on Te Whatu Ora through exercising our H&S Rights and protections in this bargaining campaign to demonstrate why we need extended those extended rights in our new CA. H&S is our number one risk, and we cannot sit back and wave it through

For Aged and Residential Care

Your challenges are now very public – attracting and retaining staff.  We have two pieces in play-

For those covered by the Care and Support legislation – we are now in a full blown pay equity process

For those covered by CAs in the 5 big ARC employers (Oceania, BUPA, Radius, Summerset and Rymans) we are taking on a whole new campaign using what is called pattern bargaining – bargaining the same MM based claims across those 5 employers – pay equity/pay parity, ratios, health and safety, protections for immigrant nurses and so on.

Why those five employers?

Because they dominate the ARC market – they set rates for residents and rates for nurses and caregivers.

They make enormous profits and yet cry poor when it comes to paying their staff more.

In primary health care, we continue to be stuck as we cannot yet achieve either pay parity or a pathway to pay parity. The Minister continually said he is committed to pay parity for this sector but nothing emerges- and all the time this frontline suffers as nurses leave for better wages and new nurses are not attracted.

Te Whatu Ora says that the two recent capitation payments to GPs have enough to pay parity. But that’s not true – and so we campaign onwards and move to action.

Our Plunket nurses are in the same spot. Losing nurses everywhere and failing to attract and retain nurses due to the pay rates.

This situation for primary health must be fixed and fixed once and for all.

Lastly but not least – let’s turn to those working for Māori and iwi providers.

Where the worst pay discrepancies are found?

This situation is a scandal successive govts have been responsible for years for –

• Inadequate funding
• Failure to recognise the additional cultural responsibilities on Māori nurses
• Poor funding models ensuring a lack of confidence in ongoing funding;
• And a lack of concern for Te Tino Rangatiratanga.

This has to stop!

On NZNO’s part we are launching a separate campaign to address this and achieve pay parity plus (the plus being the additional recognition for the cultural knowledge, skills and responsibilities expected of our Māori nurses.

We will build Māori models of organising and will take a different form from normal organising campaigns – but it will be an organising campaign – members working together to win.

And of course, there is a whole lot more to win that I have run out of time to cover.

We need to build a sustainable education and training system that meets NZ workforce needs now and into the future.

And while we fix that – we need to get nursing onto the immigrant Green List – like doctors – to expedite the immigration of nurses to New Zealand.

We need to build career pathways (or staircasing) so health sector workers can see a way ahead if they so choose.

And is there any urgency about all of this – you bet – in twelve months plus time there is a general election and if the govt changes it all becomes so much harder.

Conclusion

In conclusion – I want to talk about respect.

Since my time in NZNO I have felt keenly this issue of respect – or rather lack of respect that is shown to nurses, our HCAs, our midwives, our care and support workers and other NZNO members and their union NZNO.

I know you feel this. You have told me.

Well – that is going to change.

NZNO is not going to sit back any longer –

• and just accept what’s dished out to us
• waiting at the end of the queue
• letting the system and employers trample all over us
• having others set the agenda for our profession. Telling you what is good for you
• And ultimately – being disrespected

That’s finished!

That’s finished as of now

NZNO will from now on be respected

We will be respected as –

• the biggest health union
• as the professional and industrial voice of the profession
• but most importantly as the powerful force of 55,000 and growing members

And if your union is respected, then you as members of that union are respected.

And I am sure that is what you want and it is what the people you represent want

But you know it simply doesn’t happen because we want it

It happens because we are prepared to go out and do what needs to be done to win it

That is Maranga Mai

But do you know what the big win will be?

It will be respect – respect for –

• you
• your colleagues
• your profession
• and your ambitions

And in my last question to you – are we going to take this on?

Do we have the strength, the endurance and ultimately the belief?

We believe  what we stand for is right and we should be respected for that.

Are we up for winning this?

Are we up for respect?

Because if we are –

We will win it

Maranga Mai!

Rise up!

Maranga Mai!

Rise!

Kerri Nuku, Kaiwhakahaere
Tōpūtanga Tapuhi Kaitiaki o Aotearoa NZNO

I want to use this blog to highlight the devastating flooding in Pakistan, which has led to hundreds of lives lost and millions displaced. I send my deepest aroha and solidarity to those communities being ravaged by this climate catastrophe. It was created through greed and the powerful believing in endless expansion on a finite planet.

I think it’s important to point out that these communities are bearing the brunt of something that they are not responsible for. Just like with islands being swallowed in the Pacific, or the droughts and forest fires in Australia, climate change is wreaking havoc on indigenous people, on workers, and on te taiao. Meanwhile the billionaires who are actually responsible for the massive extraction, consumption, waste and pollution are taking nine-minute private jet rides and planning to live on Mars.

As nurses we can understand the injustice of being saddled with the outcomes of a system that’s not of our own doing. We’re at the coalface dealing with terrible working conditions and seeing first-hand how inequality is ruining people’s health. And even though we weren’t responsible for the system we work in, we fight to change it, both for ourselves and for our patients. That’s why we rallied for Primary Health Care earlier this week and why we will continue to fight for change.

In the same vein, we have a responsibility to fight in solidarity with communities across the globe struggling through climate change. Part of the aim of Maranga Mai! is to build a more emboldened, political voice that pushes on all issues that affect health and workers. As nurses and unionists we have a role and responsibility to speak up on climate change because we know how intimately linked health and the climate are. And, much like trying to improve the health system, we know decision makers won’t be bold enough unless we stand up and take action.

Anne Daniels, President
NZNO Tōpūtanga Tapuhi Kaitiaki o Aotearoa

As I write the turmoil and peril of the New Zealand health system is evident. Desperate multiple txts going out to nurses every day offering overtime are now the norm. Inequity is rife as evidenced by the very different additional workforce payments offered to doctors that perpetuates the gender discrimination and undervaluing of our profession.

Nursing students are being asked to do patient watches for grocery vouchers with little training to conduct a role requiring skill and experience (putting them at risk) – and often carried out by our amazing health care assistants.

The pressure on NZNO members, no matter where they work in the system, to do more with less (and less and less) is unrelenting. What does this mean for our wellbeing when working in a failing system, our mental health when we feel guilty for giving ourselves a few hours to sleep, eat, and be with our families, instead of going back to help our overwhelmed colleagues? How do we get off this downward spiral?

We are struggling to survive but NOW is the right time to take the appropriate action to correct the situation. Those who accomplish change are willing to engage in the struggle. To survive we must collectively find ways to work together to create the change that needs to happen.

Now is the time to Rise Up! Every member, everywhere must become actively engaged in the Maranga Mai! campaign for change and stand strong until the changes we need are embedded in our workplaces, our work, our contracts and in legislation. We must establish cohesive communication networks so we can work across the public/private/tertiary/primary care divides.

We must also be cognisant of the opportunities Māori models of organising and campaigning offer us all. Maranga Mai! is a national campaign conducted through local events led locally by leaders who are inclusive of NZNO members across all sectors within their local region. Every member needs to step up and act.

One example is occurring in Whangarei Hospital Emergency Department. The nurses decided to work to their contracted FTE only. The expectation that nurses will always step up to fill the roster gaps is now being challenged. These nurses understand that if you continue to do what you always have done nothing will change. They are now supporting each other to put their wellbeing first and nursing shortage issues are being made visible by their action. And their action is being supported by nurses across New Zealand.

Another example is what nurses and health care assistants in Canterbury did. They were not being paid properly or on time as legally required and a local protest was arranged after the employer refused to engage. They organised locally through their networks, social media, radio and tv, to bring the issue to the publics’ attention nationally. The DHB representatives met the NZNO members on the picket line and agreed to work together to resolve the issues.

Where there is anger born of injustice, discrimination and racism; agitation and action by each one of us working together will bring hope. The realisation of beneficial change will only come if we harness our anger and make it work for us. Maranga Mai!

Kerri Nuku, Kaiwhakahaere
Tōpūtanga Tapuhi Kaitiaki o Aotearoa NZNO

Health is the ultimate political football in Aotearoa. Every party in power tries to use it to their advantage, to impose their short-term ideals onto health and – even worse – to only focus on the surface issues so they look like they’ve done something. We can’t let politicians keep doing this at the expense of people’s health and lives.

Opposition parties are willing to tear each other down over failures, even though they’ve all helped gut the system we have today. Yet when in power, rather than be accountable and effective, they tinker around the edges, failing to address the systemic issues.

Politicians go on three yearly cycles, during which time they’re mostly better at destroying than creating. But unlike them, our voice and our work is constant. We must urge for a common public health approach based on the idea that all people deserve the best health care, and all workers deserve the best conditions. If we don’t take control of the political narrative, governments will continue trying to distract people from the real health issues.

To do this we must fight the anti-Māori and anti-union rhetoric on the right. We need to stake our claim as experts of our own field and fiercely protect our profession. The current workforce crisis is going to require some immediate fixes and a long-term strategy which will require nursing to be part of the planning.

COVID has brutally exposed the nursing shortage. While the obvious course should have been to build the nursing workforce, this has not been the case. Instead, changes to the Health Act further undermined and eroded nursing by extending the scope of an unregulated workforce to bridge the shortfall.

We have a 4000+ nursing workforce shortage and the international Council of Nurses reports a 4.6 million nursing shortfall worldwide, so I repeat: if nursing is going to be the political football we need to control the narrative!

Political parties need to consider how we are going to make nursing attractive again, how are we going to make nursing a career choice for school leavers, support them through their training and graduate them into good jobs. How are we going to support and retain the nurses currently in the workforce by valuing their work, protecting their health and safety, including deconstructing the pay disparities that continue?

I have been inundated with calls of immense distress from nurses, health care assistants and kaimahi hauora upset and powerless to speak out against what they are witness to: care choices and negative outcomes driven as a direct result of nursing shortage.

If only our nursing crisis was as simple as a hospital drama tv show  – but  when a nursing shift finishes the emotional debrief plays out in your head hours after leaving the workplace, or wakes you from your sleep as you try to remember whether or not you signed that form, or what you need to do today, or whether there will be enough staff on the next shift.

Nursing is not a drama – nursing is real and it’s up to us to ensure that Government responds to the needs of the people, not us having to bend to their whims.

Anne Daniels, President
NZNO, Tōpūtanga Tapuhi Kaitiaki o Aotearoa

Is every nurse, everywhere sufficiently resourced to safely do their job?

What can we make of the Minister of Health saying the hospitals are coping when a raft of professionals within the health sector are saying exactly the opposite? Let’s unpack the statement: Hospitals are coping……

Health care is delivered by nurses everywhere in New Zealand, not just in hospitals. Are Primary Care, Aged Care, Māori and Pasifika nurses coping? I don’t think so. In many cases they are even less resourced. They are at the front-line providing prevention, health education, and wrap around services that include whānau and iwi, but this appears invisible in the Minister’s statement. If it was not for them, the pressures on hospitals would be so much greater.

But the situation is so dire that doctors themselves have written to the Minister demanding that change happen for nurses so they (the doctors) can do their work.

And Aged Care is definitely not coping. Facilities are closing due to nursing shortages, making for unsafe work environments. At a recent Select Committee hearing, NZNO College of Gerontology Nursing Chair Natalie Seymour clearly outlined the major challenges Aged Care nurses and facility managers are facing. The toll being taken on those who provide the care, nurses and health care assistants, in the current nursing shortage context, is beyond belief. Yet our members keep going to work, keep caring, and keep voicing their concerns about unsafe work environments ever more loudly.

Maranga Mai! – The Health and Safety umbrella.

Health and Safety is a main area of focus within our Maranga Mai! campaign. Under this umbrella we are organising opportunities to build member power to hold our employers and their masters to account.

NZNO now has a Health and Safety Representative (HSR) WhatsApp group run by NZNO educator John Howell. This is bringing HSRs together to build understanding and support to engage all members to actively participate in resolving nursing shortage issues. We are building infrastructure, capacity and action by and with our NZNO HSRs, delegates and members.

Those NZNO HSRs and delegates – in combination with members – are a power to be reckoned with, particularly when the HSRs utilise the Health and Safety at Work Act (HSWA) 2015. The HWSA’s main principle is that workers are given the highest level of protection from workplace health and safety risks as possible.

All NZNO members are expected to participate and, as a result, increasing numbers of Provisional Improvement Notices (PINs) are being submitted by NZNO HSRs in regions such as Palmerston North, Auckland, Hawke’s Bay, Southern, Wellington, and I believe more will come.

A PIN is written notice legally requiring an employer or service provider to address a health and safety issue before a certain time.

Nurses are rising up to make sure that every nurse, no matter where they work in the health sector, has the power and resources to safely do their job. Maranga Mai!

This is just the beginning.

Kerri Nuku, Kaiwhakahaere
Tōpūtanga Tapuhi Kaitiaki o Aotearoa, NZNO

Finally, our organisation is becoming more progressive, politically active, and responsive to our member voice. This can be seen in Maranga Mai!, our overarching health and safety campaign that recognises workers across all sectors—aged care, primary and private health, community and Māori health—are all now being prioritised alongside DHB. Maranga Mai! advances Tino Rangatiratanga and Mana Motuhake as real drivers for change; achieving the best outcome for all without Māori losing mana.

With NZNO’s elections coming up (nominations have just opened) I wanted to reflect on what’s moving us in this direction and what I believe will strengthen us moving forward. For me, it comes down to values. What I see making the difference is that the leadership are taking a more values-based approach. That means we’re working in unity, making decisions based on what we’re trying to achieve together. It also means coming back to our shared values to navigate differences.

Members expect a lot of NZNO’s Board, just as we expect a lot of all leaders. We’re rightly held to account to do the best for our members, and to be guided by our shared values when making decisions. We’re all well familiar with seeing politicians and leaders start off saying one thing and then doing the opposite. And instead of owning up to their failings, or addressing them, they put the blame elsewhere. At their worst, they champion false news and repetitively articulate off the wall messages that aren’t grounded in fact, until the uninformed become believers. We have all been a witness to this over recent years from politicians and the like.

To keep building on the momentum we have right now, we need to ensure our leaders have integrity and commitment to their values and to our organisation. We need to be able to trust that those elected will stick together to do the best for all our members. Our organisation will continue to flourish if we continue to make decisions based on values.

The flipside is that we can’t buy into division amongst ourselves. Our members deserve better than that and I believe we know such rhetoric won’t serve us. My hope for these elections is that we instead shift our focus to what we’re building together, our shared vision of justice. I hope those who put their hats in the ring will model the values that have helped NZNO turn the corner in the last year.  I look forward to the outcomes of these elections and continuing to build our collective voice and action. We have so much more to do, and we can only do it together.

Anne Daniels, President
NZNO Tōpūtanga Tapuhi Kaitiaki o Aotearoa

On 12May 2022 NZNO launched the Maranga Mai! campaign. Central to Maranga Mai! are the “Five Fixes” which form the charter of demands for the campaign:

1. Te Tiriti o Waitangi actualised within NZNO and across the health system
2. More nurses across the health sector
3. Pay and conditions that meet nurses’ value and expectations
4. More people training to be nurses (in New Zealand)
5. More Māori and Pasifika nurses

These fixes have a number of areas of focus.

In her recent blog,, NZNO Kaiwhakahaere Kerri Nuku said our work and lives are political. She encouraged members to “get political”, and indeed, it is our professional responsibility to do so.

The third fix, more specifically the conditions needed to meet nurses’ values and work conditions, demands political critical thinking, collective power and action to meet our responsibilities to ourselves, our future selves and those we care for.

So what is the” WHY” in our Maranga Mai! campaign?

Our why is to win the necessary political and resourcing commitments needed to address the nursing, midwifery, HCA, support worker and kaimahi hauora shortage crisis permanently, across the whole health sector.

“WHAT” are we aiming to achieve?

1. Mandated minimum nurse-to-patient ratios supported by a fit for purpose tool that can increase appropriate skilled and experienced nurse resourcing when and where it is needed.

Mandated means legislation, which means political and collective power and action is needed. This is an outcome of the remit passed by the membership at the 2020 AGM.

Going forward, nurses must have appropriate levels of experienced and skilled resource available, built on data driven information to ensure patients and nurses are not put at risk. Nurses must not have to struggle to do the best they can, fearful of what may meet them when they go to work. This must be worked through across all sectors of the health system, not just the DHBs – and the Māori and iwi sector is the most urgently in need of attention.

2. All nurses, regardless of their sector must receive pay equity/parity and work conditions that: reflect the true value of nurses everywhere; attract people to the profession; and support nurses’ work choices.

While the Minister of Health has already signalled this will happen, the questions are when and which sector first? Māori and Pasifika nurses in primary care have, for a long time, been marginalised, more so than many other nurses in different sectors.

Making our commitment to te Tiriti o Waitangi a reality is a real opportunity for us all. Raising up our Māori and Pasifika colleagues will drive parity of pay and conditions for all.

“HOW” are we going to do this?

Our national Maranga Mai! campaign strategy is being developed by our great team and it will be up to us, the nurses at the coal face, to make it real for ourselves locally. Our expectation that the recent Budget would deliver on some of our goals has not been realised. Therefore, we have to to take the lead.

The Care & Support Worker rallies we held across the country (together with the PSA and E tū) on 23 May were our first ‘on the ground’ and publicly visible Maranga Mai! action, and I was proud to lead and speak at the one held in Dunedin. We will do many more of these sorts of activities.

The power to create change is in our hands. Every nurse everywhere must Maranga Mai! – Rise up and act together.