Nurses in tears every day

Tears and prayers are helping Wellington nurses get through understaffed shifts that have left almost half of them feeling unsafe or unsupported at work.

‘‘Every day, we hear of nurses in tears on wards, and patients left waiting for basic cares such as pain relief and help mobilising,’’ New Zealand Nursing Organisation (NZNO) delegate and Wellington nurse Erin Kennedy said.

Another, unidentified, Wellington nurse has spoken of praying "nothing bad happened’’ on a night shift when left as the only one able to administer morphine while in charge of 37 patients.

Eight per cent of all nursing positions are vacant across Capital and Coast District Health Board (CCDHB), its executive director of nursing and midwifery has confirmed.

Andrea McCance said an international shortage of midwives had also left 9 per cent of midwifery positions vacant. ‘‘Part-time nurses and midwives often work additional shifts to assist when there are vacancies or to cover for those on sick leave, and we also use casual nursing staff.

‘‘We make every effort to assist and support our staff, and strive to ensure they are not overworked and get the breaks they need and are entitled to.’’

But Kennedy said consistent shortstaffing and insufficient resources meant the system was stretched beyond capacity.

‘‘When there are not enough nurses and midwives, patient care has to be rationed, and mistakes such as medication errors increase.’’

Her concerns come shortly after a staff engagement survey, commissioned by CCDHB chief executive Debbie Chin, found that 48 per cent of nursing staff and midwives did not feel safe or supported at work.

Earlier this year, a Wellington nurse claimed to have been in the role for only 18 months when put in charge on a night shift, as the the most experienced staff member rostered on at the time.

‘‘I ... was the only nurse able to give IV morphine, and deal with epidurals, for 37 patients,’’ the unnamed nurse said, in response to an NZNO campaign that asked nurses about their experiences working in the health system.

‘‘I just prayed that nothing bad happened; it was so unsafe.’’

NZNO chief executive Memo Musa condemned the conditions, saying that a stretched workforce led to ‘‘rationing’’ of care.

‘‘Working in conditions where you are not able to do the best for your patients is demoralising, demotivating, and it lowers morale.’’

Musa said nurses were having to miss their breaks, meals and, in some cases, sick leave was increasing as a result of the pressure.

‘‘Every day, we hear of nurses in tears on wards, and patients left waiting for basic cares such as pain relief and help mobilising.’’ Erin Kennedy, New Zealand Nursing Organisation delegate and Wellington nurse

Nurses were so focused on getting the job done that speaking up about issues was difficult, and many feared blow-back from their peers, he said.

‘‘In situations when people are under pressure and are concerned about the health of their patients, they should have the ability to voice their concerns without fear of retribution from their peers or managers.’’

A nurse at Canterbury DHB said this week: ‘‘Hardly a day goes by when we don’t need extra staff to help with shifts hospital-wide. This mostly is to cover sick calls or an increase in patient loads.

‘‘The funding for the DHB has not kept up with demand. We have more patients and higher need than 10 years ago and, if this continues, there will be a shortage of skilled nurses for this level of care.’’

In Wellington, McCance said a ‘‘range of activities’’ had been put into motion to address the survey findings.

‘‘This includes enhanced training for managers and leaders, raising awareness of our values and code of conduct, and nominating people throughout our organisation for staff to talk to confidentially about these issues and how to resolve them.’’

A total of 47 new graduate nurses and 10 mental health graduate nurses started work in August, and a number of new nursing staff were coming on board in the coming weeks.

An extra 22 fulltime equivalent nursing positions had been added to meet winter demand, she said.

Ministry of Health chief nursing officer Jane O’Malley said: ‘‘We are aware that DHBs and the NZNO are working closely together to predict and manage the relationship between patient demand and staffing. The Ministry of Health strongly supports this work.’’