Te Whatu Ora Must Fully Staff Vital Starship Children’s Hospital Wards

Te Whatu Ora must fully staff all wards at Starship
Children’s Hospital including four vital wards which are
short of a total of 18 full-time nurses, NZNO
says.

Tōpūtanga Tapuhi Kaitiaki o Aotearoa NZNO
Kaiwhakahaere Kerri Nuku says the Shift Below Target data,
obtained under the Official Information Act shows Starship’s
intensive care unit, its medical specialties ward and two
general wards are short-staffed.

“The data (see graph
attached) covering January to the end of August shows these
wards were short staffed during the peak of winter.
Including the six
nurses needed in oncology which led to cancer treatments
being postponed, Starship was at least 24 FTE nurses short
during Aotearoa New Zealand’s worst influenza outbreak in a
decade.

“This includes nine FTE nurses short in
Paediatric ICU, two short in Ward 24B for general surgery,
ENT, plastics and trauma services, three short in Ward 26B
for medical specialties and four short in Ward 25 which is a
general paediatric ward,” Kerri Nuku says.

“ICU was
short staffed 73% of all shifts in July and 56% in August.
The children in ICU are among the sickest in the country.
Staffing this ward should have been the utmost priority for
Te Whatu Ora.

“Te Whatu has today said: ‘Experienced
senior nurses from other parts of the service and the
hospital are being redeployed to support staff’. This is
robbing Peter to pay Paul and meet the Government’s
arbitrary budget cuts, it has to stop for the sake of sick
children,” Kerri Nuku says.

Meanwhile, two NZNO
members working in Ward 27B haematology/oncology at Starship
have spoken out anonymously, for fear of reprisal from
management.

Nurse A

Management keeps saying
there’s no hiring freeze, and while we have had some new
nurses start, a lot of them are either newly qualified or
have come from completely different clinical areas. The
problem isn’t just the number of nurses we have, it’s
the level of experience on the floor.

When I first
started working in this area, you had to have a lot of
experience before you could work with transplant patients.
Even after years of working in the specialty, there was a
period where you weren’t expected to work independently
with those patients. Now we’re seeing nurses with only
months of experience looking after incredibly vulnerable
transplant patients.

These are really complex
patients. When they become unwell, they can deteriorate very
quickly. They often need multiple medications, antibiotics
and other interventions. You need to know what you’re
doing, and you need experienced people around
you.

It’s the skill mix that’s the biggest issue.
You might have enough nurses on paper, but that doesn’t
mean you have enough people with the right experience to
safely care for these patients.

I’ve never seen it
this bad. I’ve never felt so unsafe at work, and I’ve
never cried so much. It’s honestly broken me.

I feel
terrible because I can’t support the newer nurses in the
way I want to. I can see that they need help, but I’ve got
so much going on with my own patients that I just don’t
have the time.

I love my job. I really do. One of the
things I’ve always loved about working here is that we
have long-term patients. We get to know them and their
families, and we get to be there with them throughout their
journey. You build these relationships, and you become part
of what they’re going through.

But we can’t do
that anymore.

We’re so stretched that we barely have
time to do what absolutely needs to be done, let alone spend
time with patients and their families. And that’s such an
important part of what we do.

It’s heartbreaking
because we know what good care looks like. We know what
these patients need, and we want to be able to give them
that. But right now, we’re just trying to get through each
shift.

Nurse B

We’re really short of
experienced nurses, especially those who are qualified to
give chemotherapy. Some of the newer nurses have been told
they won’t be able to do their chemotherapy training until
next year. They’ve put on extra training days, but it
feels like people are being rushed through before they’ve
had the chance to build up their skills and
confidence.

Chemotherapy is absolutely being delayed
because we don’t have enough nurses qualified to
administer it, particularly on night shifts. Sometimes
treatment gets pushed to the next day, or even a couple of
days later, depending on who’s available.

We’re
also not getting our breaks. We’re constantly trying to
keep up, and there isn’t enough time to give patients the
care and attention they need.

There’s so much
happening, and it feels like there’s no time or support
for any of us to process it.

It’s not that we
don’t care. We care so much, and I think that’s why
it’s affecting us so badly. We’re going home knowing we
haven’t been able to give our patients the care they
deserve, and that’s an awful feeling.

Notes:

Shift Below Target refers to
whether the staffing levels for a shift are safe for both
staff and patients. Shifts below target is the number of
shifts where the difference in staffing hours supplied and
the care hours needed by patient acuity is greater than
negative 8.5% (or 40 minutes per FTE). Shifts below target
indicate a heightened level of risk for patient safety,
patient outcomes and nursing workforce safety and morale.
Shifts below target mean there is inadequate staffing in
either the numbers of staff on the floor or the skill mix
and competencies of staff available to provide patient care.
This can increase the incidence of adverse events or near
misses such as falls or medication errors, care rationing
where care is missed, delayed or suboptimally delivered or
in some cases work left undone due to lack of time, resource
or communication. Patient mortality increases with exposure
to increased number of shifts below
target.

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