Better staffing ratios called for

More than half the shifts at a Dunedin acute mental health ward were understaffed last year, a damning report by the nurses’ union shows.

Wakari Hospital ward 9a was among nearly one fifth of mental health wards nationally found to be short-staffed more often than not.

"Mental health wards report the most acute levels of understaffing in the health system," the New Zealand Nurses Organisation (NZNO) report said.

It also highlighted the lack of nurses or midwives in other areas, including children’s wards, women’s health wards, and inpatient cancer wards.

Nurses rallied in Dunedin and throughout the country in a push by NZNO for safer staffing ratios yesterday following the release of the report.

Members of the New Zealand Nurses Organisation rally outside Dunedin Hospital yesterday in a push...
Members of the New Zealand Nurses Organisation rally outside Dunedin Hospital yesterday in a push for better staffing ratios. PHOTO: GREGOR RICHARDSON
A total 51.1% of shifts in Wakari Hospital ward 9a were understaffed in 2023, up from 43.6% of shifts in 2022.

Lack of staff has been an ongoing issue for the 15-bed unit.

Last May it had 11.1 FTE registered nurses, just under half the number needed to operate at full capacity, as reported by the Otago Daily Times.

Because of the shortage it had reduced the number of operational beds to just 10.

Health New Zealand Te Whatu Ora (HNZ) did not provide the current number of staff and beds when asked to do so yesterday.

Southland Hospital also struggled with nursing shortages, the report found.

The number of understaffed shifts at the inpatient mental health ward had almost doubled from 23% in 2022, to 43.5% in 2023.

The report surveyed mental health staffing in 91 locations throughout New Zealand.

Of these, 52 had less than the target number of staff in more than 20% of shifts last year, and nearly one fifth had understaffed shifts more than half the time.

"This is particularly pronounced for forensic psychiatric services, but includes services for patients with acute mental health, intellectual disabilities, and older persons’ mental health needs."

On average, one in four HNZ shifts were understaffed last year, the report said.

Negative consequences this could cause ranged from falls or medication errors to care work left undone and an increase in patient deaths.

"Shifts below target indicate a heightened level of risk for patient safety, patient outcomes and nursing workforce safety and morale."

Children’s healthcare was another issue raised the report, which considered data from 63 children’s wards.

Dunedin’s NICU ward was understaffed 48.8% of the time last year, it showed.

However the figure was an improvement on 2022, when the figure was 60.6% .

Women’s health wards were also struggling with staffing, as shown by data from 79 wards.

Last year, 24 of these were short-staffed for more than one third of shifts, including two in Dunedin’s Queen Mary Maternity Unit.

The antenatal ward was understaffed for 44.8% of shifts, while for the postnatal ward the figure was 33.2% — both similar figures to 2022.

Data on eight adult inpatient cancer wards showed it to be another area of concern.

Last year Dunedin’s inpatient cancer ward 8c was understaffed 21.4% of the time.

The figure had jumped from 11.1% in 2022.

Surgical ward staffing was another problem area, but no Southern hospital was on the list of places where this was a especially common.

The data on inpatient cancer wards and surgical wards showed HNZ did not have enough nurses to meet health targets set by the government, the report warned.

HNZ acting director of hospital and specialist services Christine Lowry said the NZNO figures reflected wider health workforce shortages.

"Our Health Workforce Plan 2023 — 2024 estimated New Zealand was short around 4,800 nurses as at July 2023.

"We are extremely conscious of the impact of these shortages."

HNZ had increased the number of nurses, including through an international recruitment drive, and had expanded bachelor of nursing clinical placements and increased pay, she said.

"The latest data [in] December 2023 from the NZ Nursing Council shows there are now 77,634 nurses with current Annual Practising Certificates, up from 68,277 just two years ago."

"However, the demand for nurses is not static.

"It continues to grow due to a growing and ageing population, so we will remain focused on this area."