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Some questions and answers about our campaign for new grad nurses

NZNO Colour-31 Alex smNZNO acting professional services manager, Hilary Graham-Smith answers a few of the questions people have been asking about our campaign to get a ‘nurse entry to practice’ position for every new grad nurse.

Q:    Aren’t the tertiary institutions just churning out too many nurses? It’s just “bums on seats” with no thought for the workforce needed.

A:     The NZNO petition calling for 100% of new graduates to be employed in a NEtP programme has drawn comment about the role of the education providers in creating what is seen as a glut of new graduates i.e. the problem of lack of employment for new graduates is seen as a consequence of large intakes of students to boost enrolment numbers and keep the tertiary institutes fiscally upright.

NZNO has been working with other national nursing organisations (known as the NNO group) in developing a report on the New Zealand nursing workforce for Health Workforce New Zealand (HWNZ).

The report describes the demographic and fiscal challenges facing the health system and plots these against the challenges facing the New Zealand nursing workforce. The challenges to the system are the growing and aging population with the incumbent increase in demand for health services. The challenges for nursing are similar with 50% of the nursing workforce predicted to retire over the next 21 years.

Filling the gap requires forethought and planning, not in 21 years time but now, including knowing the numbers of student intakes in tertiary institutions and whether these are appropriate for future nursing workforce requirements.

Q:    How can there be a shortage of nurses if the ones we’re training can’t get a job? Doesn’t that suggest the opposite?

A:    The NNO report states that if everything remains the same (student recruitment, retention, numbers active in the workforce) then we will have sufficient nurses in the workforce until about 2020 but maintaining the existing status quo will result in a shortage of 15,000 nurses by 2035. The supply issues need to be addressed now both in terms of recruitment and retention and the NNO group has signalled the need for those workforce planning conversations to occur across the sector so that we have enough nurses and so that the nursing workforce reflects the needs of our population.

Q:    What’s the big deal about NEtP anyway? Shouldn’t nurses just get a job like any other new graduate coming out of a tertiary institution?

A:    The aim of the NEtP programme is to ensure that new graduate nurses commence their careers in a safe, supported clinical environment where they can grow their skills and confidence as RNs. It provides a framework for further learning and development and contributes to the development of a sustainable nursing workforce. The education providers and their curricula are subject to monitoring and approval by the Nursing Council in order to ensure a high quality of delivery and achievement.

Q:    Why do we need a plan? Isn’t “supply and demand” enough?

A:    Our campaign for 100% employment of new graduate nurses is as much about the need for a nursing workforce plan, something which is woefully absent at present. Given the predictions in regard to the shortage of nurses NZ will experience in the not too distant future we want Health Workforce New Zealand (HWNZ) to realise its commitment to work with the NNO group and sector to put a plan in place to avoid this shortage. Our new graduates are an important part of that plan in terms of managing the supply side pressures.

Q:    Nice idea, but where’s the money going to come from?

A:    Medicine (ie doctors) currently receives 60% of HWNZ funding for workforce development. Nursing shares the other 40% with other allied health professions. We believe it is time that nursing as the largest health workforce are given an equitable share of the funding so that we can recruit to and retain our New Zealand prepared nursing workforce.

We’re asking the Minister of Health, Tony Ryall to commit to 100% NetP for new graduate nurses and to come up with the funding to achieve this.

And we’re asking you to sign and share the petition with your family and friends.

Ma whero ma pango ka oti ai te mahi
With red and black the work will be complete
(If we all do our part our goal will be achieved)

You can find out more about the New Zealand Nurses Organisation campaign to support our new grads here: http://www.nzno.org.nz/newgrads

 


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The long road to justice at Capital and Coast DHB

leave entitlementCapital and Coast DHB (CCDHB) delegate Erin Kennedy talks about a workplace situation where holding the DHB to account has taken years. The hard work and perseverance of delegates and organisers has finally paid off.

After several years of work by NZNO organisers and delegates at CCDHB, members whose shift leave was not calculated correctly look set to finally get the leave they are due. Staff affected worked alternative rosters (10 and 12 hour shifts). CCDHB has reviewed records of affected staff from 1 January 2007 to 1 January 2013 to determine which staff are owed leave, with ICU used as a pilot group.

Previously, all shift leave was credited based on shift count under clause 13.2 of the MECA. However, clause 6.19 of the MECA, which covers alternative rosters, states that on completion of one year on alternative rosters, employees should receive one week of shift leave in place of the provisions set out in clause 13.2.

While delegates and organisers are pleased that, at least in one directorate, the end is in sight for this project, we still have some concerns. The first is that a number of staff who have left CCDHB have not been able to be contacted.

If you worked alternative shifts at CCDHB during the time covered, please contact CCDHB to ensure you receive any leave due (gary.waghorn@ccdhb.org.nz). If you know someone who has left CCDHB and who may be covered, send this on to them. Although NZNO does not normally support cashing in of leave, on this occasion the cashing in of leave is supported, as staffing in some areas prevents any extra leave being taken.

Our second concern relates to members who may have had leave over-calculated.  Letters set to go out from the DHB ask those staff to sign a form agreeing to pay back any overpayment, either in a lump sum or as salary deductions.  Our view is that the Wages Protection Act kicks in here, and our advice to those staff is not to agree to any repayments without union advice. That advice regarding alleged overpayments also applies to other staff who have recently been asked to repay money which CCDHB claims to have overpaid, including senior nurses on the PDRP. If this applies to you, contact a delegate immediately.

NB: The ICU project which involves correcting miscalculated “adjust to normal” pays is a separate one, which will hopefully soon be concluded and staff paid out.  Again, if you worked at Wellington Hospital’s ICU and think you may have been affected by this, please contact CCDHB.

You can read the multi-employer collective agreement that covers NZNO members and DHBs here (it’s a pdf).


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Teuila deserves more

Aged careTeuila (not her real name) arrives at work early for every shift. The tasks she performs during her shift are as varied as the residents she works with. She assists our elders in all their everyday routines as well as going the extra mile – sometimes dispensing medications, sometimes catheterising a resident, sometimes bearing the brunt of violence and aggression from a resident with dementia.

Not everyone can do a job like Teuila’s. It is a highly skilled and demanding role, with barely any recognition in the form of pay but much in the way of love and appreciation from the residents themselves.

When Teuila talks about the work she does, she talks about the pleasure she gains from helping an elderly person regain dignity and well-being, how great it is to build a relationship and see self esteem and quality of life maintained for a resident, how satisfying it is to be part of someone’s transition from anger and sadness to happiness and acceptance.

As a caregiver Teuila is amongst the lowest paid in the country and from April 1 this year, her job became a minimum wage job when the three largest aged care collective agreements in the country had their bottom step wiped out by an increase of the minimum wage to $14.25 an hour.

It is no accident that the most significant test of the equal pay legislation for many years has originated in aged care. You do not need to be a lawyer to see that the amazing people doing this work are being underpaid and exploited. You can work as a check out operator at a supermarket and be paid more.

What is really interesting is that after many years of crying poverty as a reason for not paying aged care workers more, but doing little about the situation, the Aged Care Association (ACA) and its members are standing up to a Government that has continued to significantly underfund the care of our elderly.

This week they refused to sign contracts with DHBs citing among other things, underfunding, and saying that the current funding levels were unrealistic to provide increases to hard working caregivers and maintain and improve the quality of life for those in care.

Such public action by members of the Aged Care Association is rare and if their figures are to be believed is a sign of the negative impact of continued Government underfunding.

What is disappointing is that the Aged Care Association has not asked the Government for funding increases to fairly pay aged care workers, but solely focussed on their own immediate costs and expect aged care to remain a minimum wage job.

The problem is that the ACA wants an increase in funding of 7.6 percent – but there is no way they are going to pass that 7.6 percent onto our members. They made it very clear that there would be no pay increases offered this year. Perhaps we would feel the love more if they asked for more funding, and for it to be earmarked for staff pay rises, retention and development.

Teuila deserves more – and so do the thousands of caregivers who do the important work of looking after our grandparents and mums and dads.

(The photograph is of caregivers from Aranui Home during Caregivers Week 2014)


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Nelson ED nurses get together to create change

successNZNO members at Nelson Hospital have had their voices heard. They have successfully advocated for quality patient care and a safe environment for staff.

ED staff have been concerned for some time that their work is being compromised by a lack of staff, and all the flow on effects of that situation.

Reportable events about staffing levels had been logged but no action taken. NZNO College of Emergency Nurses guidelines for nurse/ patient ratios were not being met and nursing staff were concerned about the potential for breaches of the Health and Disability Commission code of patient rights.

The ED was experiencing an increased number of high acuity patients and Government targets were not being met. Staff vacancies were not being filled in a timely way and staff were worried that more vacancies were coming up. Annual leave requests were being turned down and staff were becoming more and more stressed and fatigued. They were overworked and overwhelmed.

It’s pretty hard on morale if you work in an emergency department and you don’t have the resources to deal with an emergency!

It’s often difficult to see the wood for the trees when you’re feeling like that, so it is a testament to the courage and wisdom of NZNO members that they made a decision to do something about it, and then followed through.

A meeting with the Director of Nursing and Midwifery and the Nelson Associate Director of Nursing was called and members told their stories one by one. It was a powerful and moving meeting. Staff were honest, passionate and resolute that the situation needed to change. That was 2 weeks ago.

Within 2 days the numbers had been crunched and ED staff were notified that an extra 2.14FTE had been approved and were being advertised. In the interim, casual staff are being used to ease the workload.

It’s a great outcome, and one that only happened because NZNO members worked collectively to address their concerns. When we stand together we are heard.

Ehara taku toa i te toa takitahi. Engari, he toa takitini.

Success is not the work of one, but the work of many.

 


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Growing our advocacy out of the ward

advocacyGuest blogger Erin Kennedy is a senior CCDHB delegate. She has a long history as a union advocate and is passionate about empowering members to work together towards a better working life.

Last week, Radio New Zealand asked to speak to a nurse about what it’s really like working at Auckland DHB in an environment that is understaffed, under resourced and, at times, unsafe.

Not surprisingly, there were no volunteers from Auckland’s current staff.  Most nurses are swift to advocate for patients on immediate clinical matters, but not so forward in publicly speaking out for patients and the health system, fearful that they risk their jobs if they do so.

This is a real worry.  How often have you shuddered at a horror story told in the tearoom, or heard a colleague declare that “I wouldn’t let anyone from my family stay on that ward…it’s just not safe”.  Surely the public has a right to know what is happening in our hospitals.

Dunedin nurses acted together this month to speak out about safety issues in the south. Sadly, nurses all over the country face the same problems – unsafe staffing levels, difficulty taking minimum breaks, problems getting study leave to maintain their PDRP and rosters which do not meet the MECA.  No wonder they feel burnt out and unsupported.

There are many ways nurses can make their voices heard. Speak to your local MP – most are readily contactable, particularly in an election year. Explain to relatives why bells cannot always be answered promptly, or why there is nobody to watch their demented relative and keep them safe. Take five minutes to fill out a reportable event documenting problems. Yes, reportable event forms disappear into a black hole at most hospitals but they still provide essential data when safe staffing and other issues are under the spotlight.

But the most effective voice nurses have is through NZNO – go to meetings, have a voice and keep your delegates and organisers informed about what is happening in your area.


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Progress at Dunedin hospital

ImageWe often say that NZNO is its members. Staff at Dunedin hospital are showing the truth of that statement. Unless members are working together to solve a problem, all the NZNO staff resource in the world won’t be able to fix it. Our power to affect change comes from the leverage we gain when individual members come together and work collectively.

Progress is being made at Dunedin hospital. NZNO delegates, with support from NZNO staff have been meeting with DHB representatives to work on solutions that are practical, real and will make a difference to NZNO members on the floor.

We have negotiated solutions that the DHB are putting in place, with 15 new registered nurses starting on NETP programmes on 28 March, ENs starting at the end of April and four casual HCAs to help with patient watches being recruited now.

A roster audit was completed this week and some changes will be seen in the rosters starting 24 March and we have been informed that 13 new staff have been recruited since January.

In the Emergency Department, benchmarking against other EDs around the country has been completed and ED staff are to be asked to complete a survey.

Longer term solutions include resourcing and properly implementing care capacity demand management right across the hospital, better clerical cover, organising breaks so staff can actually take them and providing safer resources like electric beds.

It remains to be seen how much pressure members need to keep on to make sure the right things happen at the right time.

One thing we are sure of is that members at Dunedin hospital are now actively engaged and have some control over what’s happening in their workplace. 


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Why 300 nursing staff stepped up for safe staffing at Dunedin hospital

Organise!We hear from NZNO members every single day how grim the situation is in hospitals around the country.

DHBs are being forced to make massive cuts in their budgets and for some, the way they’re doing it is by squeezing nursing budgets. You can see why they do it, the nursing budget is large, but it is a false economy.

Cutting nursing budgets to the bone means that staff are burning out and leaving, patient care is being compromised, vacancies aren’t being filled, staff are burning out… you get the picture.

NZNO members at Dunedin hospital have finally had enough. A meeting for NZNO members and DHB management was called for the 24 February and to everyone’s surprise 300 nursing staff showed up to have their say and they were not there to nod and smile and accept the same old “but we have no money” story.

The numbers at the meeting are an indication of the scale of the problems at the hospital and how seriously nurses are taking it.

Members and delegates spoke passionately about what’s happening in their wards and units; they talked about feeling desperately worried about not being able to provide the right care at the right time to their patients. They spoke about low morale, fatigue and burnout. They talked about an over 12 percent increase in patient admissions over the last year and the climbing levels of acuity of patients presenting at the emergency department.

Hospital management responded by assuring staff that their concerns were being heard and suggested working groups to look at issues. They also suggested that NZNO was over reacting and pulling an election year stunt. 

Members respectfully suggested that working groups are not the only answer. They said what is needed is urgent action, in the form of more staff, and they were clear that they are not in a position to “find efficiencies”. NZNO members know there are no more efficiencies to be found.

And they are right to be offended that their concerns are considered nothing more than a stunt. Election year or not, when patients are no longer at the centre of DHB decision-making and dollars are, something is sadly awry. NZNO members have an obligation to act.

This is a serious matter. The ability for nurses to provide the right care at the right time should never be used as a political football.

We expect an immediate response from the DHB and a long term solution, including improved funding for safe staffing, to be developed in consultation with NZNO staff and every single affected member.

Dunedin hospital members have reason to be proud of their actions. The journey towards a solution will take commitment and perseverance. We thank each and every one of them for their collective stance and we will continue to support their fight for quality care, a safe working environment and proper staffing levels.