Source: New Zealand Nurses Organisation
Te Whatu Ora must fully staff all wards at Starship Children's Hospital including four vital wards which are short of a total of 18 full-time nurses, NZNO says.
Tōpūtanga Tapuhi Kaitiaki o Aotearoa NZNO Kaiwhakahaere Kerri Nuku says the Shift Below Target data, obtained under the Official Information Act shows Starship's intensive care unit, its medical specialties ward and two general wards are short-staffed.
“The data (see graph attached) covering January to the end of August shows these wards were short staffed during the peak of winter. Including the six nurses needed in oncology which led to cancer treatments being postponed, Starship was at least 24 FTE nurses short during Aotearoa New Zealand's worst influenza outbreak in a decade.
“This includes nine FTE nurses short in Paediatric ICU, two short in Ward 24B for general surgery, ENT, plastics and trauma services, three short in Ward 26B for medical specialties and four short in Ward 25 which is a general paediatric ward,” Kerri Nuku says.
“ICU was short staffed 73% of all shifts in July and 56% in August. The children in ICU are among the sickest in the country. Staffing this ward should have been the utmost priority for Te Whatu Ora.
“Te Whatu has today said: 'Experienced senior nurses from other parts of the service and the hospital are being redeployed to support staff'. This is robbing Peter to pay Paul and meet the Government's arbitrary budget cuts, it has to stop for the sake of sick children,” Kerri Nuku says.
Meanwhile, two NZNO members working in Ward 27B haematology/oncology at Starship have spoken out anonymously, for fear of reprisal from management.
Nurse A
Management keeps saying there’s no hiring freeze, and while we have had some new nurses start, a lot of them are either newly qualified or have come from completely different clinical areas. The problem isn’t just the number of nurses we have, it’s the level of experience on the floor.
When I first started working in this area, you had to have a lot of experience before you could work with transplant patients. Even after years of working in the specialty, there was a period where you weren’t expected to work independently with those patients. Now we’re seeing nurses with only months of experience looking after incredibly vulnerable transplant patients.
These are really complex patients. When they become unwell, they can deteriorate very quickly. They often need multiple medications, antibiotics and other interventions. You need to know what you’re doing, and you need experienced people around you.
It’s the skill mix that’s the biggest issue. You might have enough nurses on paper, but that doesn’t mean you have enough people with the right experience to safely care for these patients.
I’ve never seen it this bad. I’ve never felt so unsafe at work, and I’ve never cried so much. It’s honestly broken me.
I feel terrible because I can’t support the newer nurses in the way I want to. I can see that they need help, but I’ve got so much going on with my own patients that I just don’t have the time.
I love my job. I really do. One of the things I’ve always loved about working here is that we have long-term patients. We get to know them and their families, and we get to be there with them throughout their journey. You build these relationships, and you become part of what they’re going through.
But we can’t do that anymore.
We’re so stretched that we barely have time to do what absolutely needs to be done, let alone spend time with patients and their families. And that’s such an important part of what we do.
It’s heartbreaking because we know what good care looks like. We know what these patients need, and we want to be able to give them that. But right now, we’re just trying to get through each shift.
Nurse B
We’re really short of experienced nurses, especially those who are qualified to give chemotherapy. Some of the newer nurses have been told they won’t be able to do their chemotherapy training until next year. They’ve put on extra training days, but it feels like people are being rushed through before they’ve had the chance to build up their skills and confidence.
Chemotherapy is absolutely being delayed because we don’t have enough nurses qualified to administer it, particularly on night shifts. Sometimes treatment gets pushed to the next day, or even a couple of days later, depending on who’s available.
We’re also not getting our breaks. We’re constantly trying to keep up, and there isn’t enough time to give patients the care and attention they need.
There’s so much happening, and it feels like there’s no time or support for any of us to process it.
It’s not that we don’t care. We care so much, and I think that’s why it’s affecting us so badly. We’re going home knowing we haven’t been able to give our patients the care they deserve, and that’s an awful feeling.
Editor notes:
Shift Below Target refers to whether the staffing levels for a shift are safe for both staff and patients. Shifts below target is the number of shifts where the difference in staffing hours supplied and the care hours needed by patient acuity is greater than negative 8.5% (or 40 minutes per FTE). Shifts below target indicate a heightened level of risk for patient safety, patient outcomes and nursing workforce safety and morale. Shifts below target mean there is inadequate staffing in either the numbers of staff on the floor or the skill mix and competencies of staff available to provide patient care. This can increase the incidence of adverse events or near misses such as falls or medication errors, care rationing where care is missed, delayed or suboptimally delivered or in some cases work left undone due to lack of time, resource or communication. Patient mortality increases with exposure to increased number of shifts below target.