Continuing staff shortages in the Wairarapa.
Subject: Hospitals (New Zealand)
Hospitals (Human resource management)
Hospitals (Services)
Nurses (Supply and demand)
Nurses (Practice)
Author: Thomas, Laura
Pub Date: 02/01/2009
Publication: Name: Kai Tiaki: Nursing New Zealand Publisher: New Zealand Nurses' Organisation Audience: Trade Format: Magazine/Journal Subject: Health; Health care industry Copyright: COPYRIGHT 2009 New Zealand Nurses' Organisation ISSN: 1173-2032
Issue: Date: Feb, 2009 Source Volume: 15 Source Issue: 1
Topic: Event Code: 600 Market information - general; 280 Personnel administration; 360 Services information; 200 Management dynamics Computer Subject: Company personnel management
Product: Product Code: 8060000 Hospitals; 8043100 Nurses NAICS Code: 622 Hospitals; 621399 Offices of All Other Miscellaneous Health Practitioners SIC Code: 8060 Hospitals; 8049 Offices of health practitioners, not elsewhere classified
Geographic: Geographic Scope: New Zealand Geographic Code: 8NEWZ New Zealand
Accession Number: 194904210
Full Text: In the last year, members working at Wairarapa District Health Board (DHB) have regularly reported shortages of nurses to cover I the basic roster in most areas of the hospital I The particular current "hotspots" are the medical/surgical ward, maternity services and district nursing (DN) services. Members are highlighting these issues through incident forms when there are not enough nurses to meet clinical need.

Midwifery: Late last year midwives called a meeting with management because there was insufficient staff to work the roster. They recommended the hospital reduce the service to Monday-Friday only. There was, at that time, only nine full-time equivalent (FTE) midwives when a minimum of 14 FTEs is required to cover the roster. The DHB stated it was only a 2.8 percent FTE shortfall however, as the service operates with registered nurses (RNs) covering many shifts. Thus it is also an issue of skill mix and obstetric cover. DHB managers declined the midwives' preferred option of reducing the service. At the special meeting in November, midwives expressed concern that the DHB response did not address the core problem of not enough people to cover the roster. The DHB's response did not consider what would happen in the event of staff sickness, or the different scopes of practice of RNs and midwives, or the long travel times of some on-call staff.

Wairarapa midwives want to be supported to provide a safe midwifery service. Other DHB midwifery services in the lower North Island have advised their communities of a reduced service because of a lack of staff and appropriate skill mix. Midwives' concerns will continue to be raised with DHB management.

District nursing services: The service was restructured early in 2008 and has expanded its service and hours. Te Omanga Hospice has dosed its operation in the Wairarapa and the DHB has funding to manage hospice services in the region, which has added to DNs' responsibilities. Also, staff illness has led to DNs acting in management positions without backfilling of DN positions. NZNO has raised this issue and the need for the DHB to have a casual pool of DNs.

Medical/surgical ward: The DHB is introducing a "model of care" nursing structure early this year. NZNO members provided a submission to management in response to the proposed structure. The issues Faised were around skill mix, education and the need for a team leader role on each shift. While NZNO members are cautious over the actual effect of the new "model" due to low registered and enrolled nurse numbers in the last 12 months, NZNO delegates were able to make the retention of an RN to take the role of team leader on weekend shifts a condition of accepting to trial the proposed model.

Report by NZNO organiser Laura Thomas
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