Safe Nurse Staffing Accord Signed at New Zealand Parliament

Safe staffing was one of the key issues in the recent 24-hour nurses’ strike by in New Zealand. On July 30, an accord was signed between the Ministry of Health, the District Health Boards (DHBs) and the New Zealand Nurses Organization (NZNO) to ensure that a sophisticated tool for determining staffing needs would be implemented by DHBs across the board by 2021. Nurses on the ground, however, do not appear to support this tool.

The Care Capacity Management Tool (CCDM) uses a variety of standards and predictors to calculate required care hours and the expertise needed in terms of patient mix. The tool was introduced over a decade ago but its implementation by DHBs has been slow and patchy. Staffing levels were still determined mainly by available budgets.

The accord acknowledges that the issues around safe staffing and workload have developed over an extended time period. The purpose of the signed accord was to put to paper all three parties’ commitment to ensuring and monitoring safe nurse and midwife staffing by DHBs – and to spell out the actions that would be taken to achieve this. All the DHBs have to fully implement CCDM by 2021 but in the meantime were being held accountable through quarterly reports to the Ministry of Health. By early 2019 they also have to present a strategy on how they plan to retain and re-employ nurses.

“It is clear we’ve been asking too much of our nurses and their workloads are not sustainable”

“The Government is committed to making sure we have enough nurses in our public hospitals to ensure both their own safety and their patients’ safety. It is clear we’ve been asking too much of our nurses and their workloads are not sustainable,” said David Clark, Minister of Health. “I accept that nurses don’t feel that DHBs have always delivered on previous commitments. As Minister of Health, I will be requiring DHBs to make good on all staffing commitments.”

The safe nurse staffing accord was in addition to the government’s offer to fund an additional 500 nursing positions as part of the ongoing pay negotiations.

From comments on the “New Zealand, please hear our voice” Facebook group, it appears that nurses on the ground are unimpressed by the CCDM tool and are calling instead for a legislated nurse to patient ratios – a system that is proving effective in many parts of the world.

“Many if not most nurses have expressed their total dissatisfaction with the CCDM model of staffing management – corruptible, mismanaged and has taken 14 years so far to try and implement it unsuccessfully” commented Dale Anderson. “Time to demand legislated ratios as they have in Australia – it actually works and improves nurses’ working conditions and patient outcomes.”

Frieda Paton is a registered nurse with a Master’s degree in nursing education. Her passion for nursing education, nursing issues and advocacy for the profession were ignited while she worked as an education officer, and later editor, at a national nurses’ association. This passion, together with interest in health and wellness education since her student days, stayed with her throughout her further career as a nurse educator and occupational health nurse. Having reached retirement age, she continues to contribute to the profession as a full-time freelance writer. In the news and feature articles she writes for Nurseslabs, she hopes to inspire nursing students and nurses on the job to reflect on the trends and issues that affect their profession and communities - and play their part in advocacy wherever they find themselves.

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