Safe staffing tools could help ameliorate unsafe workload concerns raised recently in the second union survey of Auckland health workers to link unsafe staffing with underfunding.
The Public Service Association released a survey last month of 627 members (171 of those nurses) across the three district health boards in Auckland, with the majority of nurses and other staff ranking the workload manageability at very high or unsafe levels, causing them to feel exhausted and stressed.
That survey follows a New Zealand Nurses Organisation member survey at Auckland District Health Board, released in early June, which showed the DHB was short of 120 nurses and linked this to cost cutting pressure to stop a $4 million budget blowout.
Richard Wagstaff, national secretary of the PSA, says DHBs are working under tight financial constraints as they try to deliver services on “significantly reduced” budgets. Many DHBs were responding by holding open staff vacancies for extended periods of time, which was taking its toll on staff and services, Wagstaff said.
“The government is forcing DHBs into a very difficult position, and decisions are being made that compromise frontline services. The result is that cuts are being made by stealth.”
The survey asked members to rank from one to 10 how manageable they felt their workload was, from acceptable (1) to unsafe (10), and whether they left work to head home feeling ‘up-to-date’ (1) or ‘exhausted/stress’ (10). In both questions, the vast majority of nurses scored between 5-10, including high numbers scoring 7-10 for the workload question (PSA membership includes nurses working in mental health and public health).
Ngaire Buchanan, joint interim chief executive of Auckland DHB, said the DHB understood staff were concerned, but while it did hold recruitment for a time in March, as part of successful efforts to come in under budget on June 30, it was not accurate to say it held open vacancies for an extended period of time. She said it actually had more, not less, nurses employed in hospitals, but “it may not feel like it” for nurses dealing with the pressure of complex cases and very ill people.
Buchanan said the DHB had recruited 892 extra staff across all professional groups since March, and Margaret Dotchin, Auckland DHB director of nursing, added that it actually had 14 less vacancies in mental health nursing than it did at the same time last year. Dotchin also said a business case for purchasing acuity tool TrendCare, a necessary first step towards introducing safe staffing tools at ADHB, was close to being signed off in a collaborative initiative with NZNO.
First off the block with investing in TrendCare and starting to roll out safe staffing tools is Waitemata DHB. Its director of nursing, Jocelyn Peach, said the programme would help the DHB understand its demand and capacity issues. She said that Waitemata, which had 87 nurses respond to the PSA survey, was not underfunded, but like all DHBs, was living within its means, so questioned overtime and additional shifts.
Beth Bundy, Waitemata’s human resources manager, said while it was always of concern if some people felt stressed and overworked, an independent organisational wide survey last year found 79 per cent of the 2500 respondents liked their job and would recommend the board as a place to work.
Denise Kivell, director of nursing at Counties Manukau DHB, noted that the number of nurses responding to the survey at CMDHB was low (25), but it was still important to keep an eye on all workload surveys, particularly involving frontline staff. Counties Manukau would also be holding its own two-yearly organisational survey in October.
“I’m aware that this winter has been extremely demanding with increased patient complexity and numbers requiring hospitalisation,” said Kivell. “So I’m not surprised that there are staff members who feel exhausted and who have worked extremely hard.”
She said Counties was proactively recruiting to maintain full staffing levels and had recently taken on permanent contract 37 of the 42 nurses who had just completed their new graduate programme. by FIONA CASSIE
