Striking nurses rallying on Queen St in Auckland (Photo: Radio NZ/Dan Cook)

Nurses’ fight should be your fight too

We’re fighting a losing battle for patient safety, says this Auckland nurse – and it’s everyone’s problem.

There’s been a lot of chin scratching by the political-pundit class in New Zealand about the nurses strike lately. Why, do they wonder, have nurses waited to take industrial action until a more labour-friendly government is in power? Why weren’t they striking under National?

This sentiment has been mirrored at times by the public at large, and various rationales have been presented, ranging from a calculated ploy to discredit the current government to a lack of understanding from nurses about who our friends are.

Here’s a novel idea. If pundits or politicians want to get to the bottom of why nurses are striking now, why don’t you ask us?

I can’t claim to speak on behalf of all nurses, but I will attempt to satisfy some of the curiosity around our ongoing negotiations.

Nurses within the hospital system have been sounding the alarm with growing urgency about how unsafe our working conditions are becoming. There are many reasons for this, ranging from increasingly complex patients, to a growing mountain of documentation we’re expected to complete every shift, to the rapid expansion of both our nursing skillset and specialisation of patient care.

But underlying every issue is the lack of adequate staff. This is the absolute crux of our current struggle and one that frighteningly no one, from the media to the DHBs to the government, seems to be taking seriously.

So I will reiterate what nurses have been saying for years. OUR HOSPITALS ARE NOT SAFELY STAFFED. Yes, some individual areas or wards are fine, and I count myself lucky to have mostly worked within these areas. But on the whole, nurses are fighting a losing struggle for patient safety. And if something is not done now, this is only going to get worse.

We have been promised fix after fix for this issue. We’ve been promised more staff. We’ve been promised a computerised acuity tool to help us make smart staffing decisions. We’ve been promised more pay to help attract and retain people into our workforce. We were promised safe staffing and pay equity back in 2004. As a nursing colleague of mine pointed out, she was in primary school in 2004. We are still waiting. We have watched these promises evaporate as successive governments have chosen to continue to kick the can down the road, and the DHBs prioritise tidy budgets and executive salaries over patient care.

Nurses are fundamentally hard workers and good team players. When we have been told to trust those with power over our workplaces that really, this time, help is coming, we have believed them. While we’ve waited for that help to arrive, we have absolutely run ourselves into the ground as a workforce, trying to stretch and stretch to ensure our patients remain safe every shift. We miss breaks. We work unpaid overtime. We do extra shifts. We work while we’re sick or injured. During many shifts, we don’t even have time to go to the bathroom. And the promised help never materialises.

And while we’re running ourselves ragged, our ability to care for our patients is degraded. We must ration our care so that often we are able to do only the bare minimum. It’s not only the human side of nursing that gets lost – we are often unable to complete critical tasks such as ensuring resuscitation trolleys are stocked or that falls precautions are in place.

Meanwhile, the DHBs won’t even agree that we need a consecutive two days off each week to prevent burnout and exhaustion. Would members of the New Zealand public want to fly in a plane with an overtired pilot and an aircraft that hadn’t had basic safety checks performed? No, yet we are essentially asking our nurses and patients to exist in this environment day after day.

And so at last, we’ve had enough. Galvanised in large part by social media, nurses were able to connect and compare stories and see that yes, it really is that bad everywhere. No, we are not imagining it. No, it is not limited to one workplace or ward. No, we do not need to work on our time management. Yes, the time has come to do something before it’s too late.

Nurses do not strike lightly. And we certainly do not make strike decisions based on cynical political calculations about who’s in government at the moment. We are striking because we are desperate. We are afraid of losing our jobs, of harm coming to the people in our care, and that if we don’t make a stand now, things will only continue to get worse.

And so we collectively withdrew our labour to protect ourselves and our patients, and to sound the alarm as loudly as we possibly could. After this show of how absolutely desperate we’ve become for someone, anyone, to take our concerns seriously, we were met with chiding from acting PM Winston Peters, as though we were recalcitrant children. An absent Minister of Health insisted we were stretched rather than unsafe, as though by simply playing rhetorical games he could change the reality in our hospitals. The leader of the opposition seemed to lack the ability to take any responsibility for how his party had run the health system into the ground under the last nine years of austerity, and thought the problem was that the current government wasn’t browbeating us more thoroughly.

And we’re told over and over again that there is no more money to be had for nurses. Health was the number one issue for New Zealanders in the last election. Why is it not the number one issue in the Budget?

Nurses will not be browbeaten into accepting substandard pay and working conditions any longer. And DHB nurses are only the tip of the iceberg. Midwives are facing the same issues of pay and lack of staff, as are our nursing colleagues in aged care. Mental health and public health services are critically underfunded. Much of our infrastructure needs repair or replacing. We are running an antiquated model of health that deprioritises primary care and takes an ambulance at the bottom of the cliff approach. This is only the beginning of the issues that need urgent action in order to make our health system truly fit for purpose.

I had a conversation with my sister-in-law back in the States, who is also a nurse and who has been experiencing some of the same issues. She lamented that it seems impossible to communicate to the public at large that this is not a nursing problem, this is an everyone problem. She is absolutely right.

I’m calling on the people of New Zealand to join us in this “everyone problem”. I am calling in particular on those in government, on every MP from every party, to have the moral courage to do what’s right and save our ailing health system. Nurses are the backbone and the beating heart of health services. We are not a cost to be contained, we are an investment that pays rich dividends to our communities. And our communities deserve a first-class public health system.

We need investment in nursing workforce development. We need to be remunerated equivalently to our education and responsibilities. We need funding for further positions for nurses so that we are safely staffed and future-proofed against the tsunami of retirements heading our way (the average age of a nurse in New Zealand is 45), and to stop the haemorrhage of nurses leaving New Zealand to work for countries that recognise our value. We need the expansion and support of advanced practice roles for expert nurse clinicians. We need salaries to attract and retain talented people into our ranks to help care for all New Zealanders.

We need politicians to stop using our cause to score political points off each other. Make our fight your fight. Work with us to save our health system. Ignore us at your, and everyone’s, peril.

Siobhan Lehnhard is a registered nurse who works in Auckland. She holds a Masters in Public Health, and is interested in how patients and health professionals organise themselves online.

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