Dunedin nurses and nurse leaders disagree whether staffing crisis exists

4 March 2014

More work is on the cards after a meeting last night to address Dunedin nurses staffing concerns ended inconclusively.

The meeting between about 30 nursing union delegates and Southern District Health Board nursing directors followed a rare stopwork gathering last week involving about 300 nurses from the city’s two hospitals – Dunedin and Wakari. The New Zealand Nurses Organisation members stopped work to raise concerns about what NZNO has described as a staffing crisis leading to nurses working double-shifts, missing meal-breaks and rationing care.

Hilary Graham-Smith, the NZNO’s associate professional services manager, said last night’s follow-up meeting was “largely inconclusive” and more work needed to be done before meeting with the board again probably in a week. She said from staff’s perspective the core nursing staffing was currently too low.

Leanne Samuel, executive director of nursing for SDHB, said last nights meeting went well. It was now waiting on NZNO to set a further date but “expected to meet again with urgency soon”.

She said the DHB did not have a nursing shortage and though it had frozen nursing vacancies when it cut bed numbers over the summer - to prevent nursing redundancies - no vacancies had been frozen since January.

Samuel said there was a shortage in some support staff areas like health care assistants and clerical support i.e. ward reception staff.

She said the DHB provided feedback to the union at the meeting as to what it believed were the key themes including clerical support in wards, addressing skill mix, care capacity demand management (CCDM), meal break cover on night shift, resource/duties team cover and having surge capacity for winter.

“A significant number of these matters have been already addressed in some wards over the last six months, others are awaiting the improvements to occur like night shift meal break cover, and this was acknowledged by some NZNO delegates at last night’s meeting,” said Samuel.

Graham-Smith said the DHB had suggested forming a working party but staff didn’t want a talk fest and union staff would be meeting with delegates and members this week to prepare for the next meeting.

Samuel said Dunedin Hospital is using TrendCare and had been methodically introducing the Care Capacity Demand Management (CCDM) tools over the past two years into relevant clinical areas. “We are confident when the CCDM process in complete in a clinical area that the core staffing is appropriate.”

She said part one of the CCDM process had been carried out in draft in several medical and orthopaedic wards at Dunedin Hospital and were now working towards part two.

Samuel said rather than CCDM data revealing staff shortages they had shown roster pattern discrepancies between staffing levels and patient acuity needs.

“Often this has proven to be simply a matter of rediverting some staff (from) shifts that are too well staffing for the acuity to shifts that need more coverage,’” said Samuel. As well as looking at skill mix. “This is a very transparent and thorough evidence-based process (that is) agreed with the ward staff and NZNO as they can see the issues, the staffing and acuity; and make good decisions about good resource allocation.”