With much of New Zealand’s healthcare workforce running on empty, one healthcare provider wants to change the way the sector approaches employee wellbeing.
Nursing has had a rough few years in New Zealand. Shortages in the healthcare workforce have created challenging working conditions for many. And as nurses are asked to pick up more hours to make up for the shortfall, rates of burnout and exhaustion in the workforce have risen, ironically chipping away at the hauora of those tasked with the health of the nation.
There are also concerns that a lack of recognition of the contribution nurses make to the sector could increase the number of New Zealand nurses moving overseas or leaving the profession. The impact of Covid on our healthcare systems and rising costs of living have only added to the overall stress of healthcare workers and a system stretched thin. It’s a set of conditions with which Southern Cross Healthcare is familiar and, through a more wellbeing-focused approach, one they’re trying to change.
Permanent employees are offered highly competitive pay, with this being reviewed regularly each year, while premium health checks, subsidised health insurance, referral bonuses and professional development support are also part of the expansion of employee benefits.
Recently, Southern Cross also announced an extra day’s annual leave for Nurses Appreciation Day and unlimited mental health and sick days for their employees, which will be trialled this year.
Lisa Rutherglen is an operating room nurse with Southern Cross Healthcare. She’s been in the field for over seven years, working in New Zealand and overseas, but still believes one of the best places to work as a nurse is right here in New Zealand and says she is incredibly well supported at Southern Cross with initiatives like those mentioned above.
“We do have those days in healthcare that are challenging and difficult, and the leadership is saying it’s OK for you to look after your mental health because you’re important,” says Rutherglen. “For me it’s a show of respect, it’s showing they value the work that we do.”
Clinical duty manager Nuala Carberry agrees. Carberry, who immigrated to New Zealand from Ireland five years ago, says she only intended staying with Southern Cross for a year when she first moved over, but has been there ever since.
“I come from the public system in Ireland which has many of the same issues as in New Zealand. Everyone is trying to support nurses, but it’s not always easy,” explains Carberry.
“After starting to work for Southern Cross, their approach to employee wellbeing was immediately evident to me. The management team is very visible and is always on the floor touching base with staff and making sure that everything’s OK.”
The two acknowledge there are some differences between public and private sector nursing. Public nursing often deals with acute emergencies, however nurses at Southern Cross work on a wide variety of complex conditions and surgical procedures.
A third of Southern Cross patients are referred by Te Whatu Ora and ACC, in a partnership with the public sector. Procedures for ACC mainly comprise orthopaedic surgeries, including hip, wrist/hand, foot/ankle, shoulder, and knee surgery, while Southern Cross supports Te Whatu Ora primarily with hip and knee replacements, eye (cataract) surgery, ear, nose, and throat (ENT) procedures, urology and general surgeries.
Rutherglen believes that the secret to their success at Southern Cross is two-way communication which helps create safe and enjoyable working environments. “Good relationships within the hospital environment equal good patient outcomes, and patient experience,” she says.
The strong relationships that are fostered in their workplace, Rutherglen says, come from the top down – with a leadership team that works on the basis of mutual respect and support.
“They lead through acknowledging challenges; they lead by allowing our education team to offer us an abundance of opportunities.”
As an operating room nurse, Rutherglen notes no two days are the same, and she often sees many different surgeries in a given week, so “you’re never bored” and have the opportunity to continue to develop professionally. At Southern Cross hospitals, the range of surgeries include robotics, orthopaedics and plastics, so Rutherglen’s position “entails a lot of clinical skill, a lot of clinical knowledge, an immense amount of teamwork and ongoing education”.
For Rutherglen, then, it’s crucial she is supported in further education so she can continue to provide the most up-to-date care.
Southern Cross Healthcare programmes like the much-admired Registered Nurse Anaesthetic Assistant (RN-AA) scheme, available internally and to Te Whatu Ora nurses, are helping create a more flexible nursing workforce. RN-AA nurses are able to support care for patients under anaesthetic and post-operatively, making sure operating lists stay on track. Nurses are also offered support to go on and do further Masters or Doctoral studies.
That opportunity for ongoing training is a valuable one in the context of the wider New Zealand nursing workforce, too. Being able to advance a career is a significant attraction of working at Southern Cross for both Carberry and Rutherglen, with senior nursing staff even going on to run hospitals in the network.
But they do acknowledge the wider difficulties of nursing as a career.
As a duty manager, Carberry sees things “change very quickly”. Her job can entail high stress situations and the need to make decisions rapidly. Similarly, Rutherglen has faced a lot of “challenging circumstances” in surgery, where procedures may become more complex than anticipated. But both Carberry and Rutherglen note that these stressful situations are somewhat eased by having tightknit teams. As Rutherglen puts it “you’re not alone; that support, and communication are there to get you through”.
Of course, while they didn’t experience the acute care impacts of the pandemic in the same way as their nursing colleagues in the public sector, the team at Southern Cross wasn’t immune to the strain Covid put on the healthcare system.
For Carberry, ensuring “safe staffing and a safe workload” is still one the biggest challenges a duty manager.
Last year, when it was announced nurses would finally be put in the “green” category for immigration visas, there was widespread relief felt by those in the profession – in the public and private sector. But even with the announcement, nursing is facing critical staffing shortages, with New Zealand Nurses Organisation president Anne Daniels calling the situation “horrendous”.
For Carberry and Rutherglen, the reality of the shortages in the wider nursing landscape of New Zealand is part of why effective management and strong team bonds are so crucial. At the beginning of the pandemic, “there was certainly a heightened amount of stress that people felt because of all the unknown,” says Rutherglen. However, she says this high stress situation was acknowledged with tangible policy changes from their employer.
Despite the ups and downs of working in healthcare over recent years, Rutherglen “couldn’t imagine [herself] in any other career”.
For both nurses, meeting people – both patients and colleagues – is one of the highlights of the job, and “helping people, being there for them in those really trying times,” says Rutherglen.
Both nurses agree at the end of the day, it’s a worthwhile pursuit, and they encourage those who are thinking about the career to go for it.
“You will not regret it,” says Rutherglen. “There are challenging days, but there are far more rewarding days… nursing is exciting, and you will form and build some of the best friendships of your life.”
