Nurses-to-patient ratios will ease health crisis

The legal mandating of nurse-to-patient ratios needs to
be done immediately to help turn around a crisis that puts
staff and patients at risk, New Zealand Nurses Organisation
Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO).

NZNO
President Anne Daniels said feedback from across the health
sector showed the Care Capacity Demand Management (CCDM)
based system used by Te Whatu Ora was clearly not working
for patients or staff as there aren’t enough nurses to
make it work.

Ms Daniels said decades ago during
weekends and holiday periods such as Christmas, hospitals
would reduce staff to allow more people to take a break over
the Christmas period, but that was no longer the
case.

“We are as busy if not busier than ever. And the
culture of reducing staff over this period has continued
which puts more pressure on the nurses who remain at work
because they’ve got even less staff than they should have
and it’s already unsafe.”

Nurse-to-patient ratio
legislation has markedly improved recruitment and retention
in Australia, Ireland, Canada and parts of the United
States, Ms Daniels said.

“It will keep nurses in the
profession and will attract more students by showing they
are valued for the work they do and the incredible pressures
they face every day.

“Our patients have the right to
safe care and our nurses/midwives have the legislated right
to a safe working environment. Legislated nurse-to-patient
ratios will deliver both.”

The health sector has been
plagued by chronic understaffing and that’s why NZNO is
seeking to have nurse-to-patient ratios established not just
within hospitals but across all sectors including primary
care and aged residential care.

“We are actually
regressing because some of our members say that 97 percent
of shifts at Te Whatu Ora are understaffed. It was 83
percent in 2022 and lower before that.

“Getting
legislation on nurse-to-patient ratios is a top priority for
the organisation because safe and healthy work environments
need to be reestablished.”

A nurse-to-patient ratio is
the number of nurses or midwives working on a particular
ward, unit or department, in relation to the number of
patients. CCDM is intended to be used to adjust the minimum
number of nurses to meet patient acuity (how sick the
patient is and how much nursing care they need).

“Full
implementation of CCDM has never occurred or been funded
appropriately. The system needs to be reviewed and made fit
for purpose to support culturally safe
care.

“Legislation is the forcing factor that will
deliver the right number of nurses and midwives with the
skills, knowledge and experience needed to deliver safe and
timely care, where and when it is needed.”

Ms Daniels
said the major challenge for Te Whatu Ora and other health
sector employers lay in their inability to retain staff and
this was reflected in the turnover numbers.

“Nurse
turnover has increased from 9.1 percent in 2013 to 15.3
percent in 2022 for registered nurses and more than doubled
for nurse practitioners, emergency nurses and health care
assistants.

“The costs of registered nurse turnover
alone is about $1.5 billion a year and this reflects poor
staff retention. The time has arrived to turn this
around.”

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