Student nurses and midwives on workload, financial pressure
Photo:
123RF
Student nurses and midwives say they are taking on the same workload as qualified staff in order to fill gaps in the sector, and they are doing it all for free.
It comes as nurses, midwives and other healthcare staff around the country prepare to take
strike action
over what they say is a failure by Health NZ to address their staffing concerns.
Australia has just introduced a payment for eligible students doing unpaid placements, including nursing, midwifery, teaching and social work.
The latest New Zealand Nurses Organisation student survey found finances were a significant issue for over 80 percent of respondents, along with 60 percent who said they had to significantly reduce their paid work hours during placement.
Many students said a similar system should be introduced here to support them through their studies.
Maisy Holzer is in the second year of her midwifery degree at Ara Institute of Canterbury.
She said the three year degree has four years worth of content squeezed into it, making for a busy load of hands-on work placements, assignments and tests.
By this point, over 20 percent of her cohort has either taken a break from the course or dropped out.
"It's quite tricky, we have assignments that go through the entire year, for example I'm working a 42 hour week on placement next week and I've got a 2000 word assignment due the monday after. So it's tricky to find that balance, for sure."
Over the three years midwifery students must complete 2400 hours of practical placements, or 54 weeks full time.
In her first year of study Holzer managed to occasionally work a casual job to bring in a little extra cash on top of her student allowance.
But she said between the workload, mental load and placements she had to quit, something that had made her already stretched budget even tighter.
"Things like petrol, you're driving home after a night shift and going I don't get paid for a couple of days but my gas light's on am I gonna make it home in time?
"Things like food, trying to make sure you're still eating well but it becomes trickier. If you've had a really busy week and you've had to pay for parking heaps. It becomes a real strain and you have to budget really really meticulously."
Holzer said part of the degree requirement was a rural placement, most often completed out of the region, meaning the majority of students would have to relocate and self-fund their travel and accommodation fees, adding to the financial strain.
Sana Ahmed is in her final year of a three year nursing degree at the University of Waikato.
In six months, at just 20 years old, she would be a qualified nurse.
But she said carrying the strain of full-time clinical placements, patient care, strict assignment deadlines and a weekend part-time job often made her feel like she was missing out on her twenties, rarely finding a moment for herself.
"When I do like eight-hour shifts, that's expected from me each day, I come home, I'm so exhausted but I still have to open my laptop and finish on those assignments or prepare for assessments."
As she reached the end of her degree, Ahmed was preparing for the final 10 week stretch of clinical placement.
Unlike the previous 28 weeks, she had already completed, this time she'll be rostered anytime between Monday and Sunday, including late nights, leaving no time for her part-time job.
"I knew nursing would be intense, I knew it required a lot, but I didn't expect it to be this difficult... people say it's a tough degree but I didn't realise how much we were expected to carry without proper support.
"I thought there would be more financial support, or at least some form of compensation during the placement."
Ahmed said by the time she reached her second year of study she already felt like she was taking on the same workload and pressures as a fully trained nurse.
"We're expected to arrive on time, we're expected to attend those meetings early in the morning in each ward, we're expected to do handovers, we're expected to take over the patient load, so pretty much we're doing what is expected of the nurses."
Organiser of Paid Placements Aoteroa Bex Howells
delivered a petition to parliament
in May last year calling for a stipend for all students undertaking unpaid placements.
And despite the petition gathering more than 16,000 signatures, she said they were no closer to a solution.
"[The government] acknowledges that we have a workforce shortage and we need to do something about it, they need to support people into these professions and that Australia has recently introduced paid training, and that the European Union has voted to ban unpaid placements on the grounds that they're exploitative.
"But [the government] is not going to do anything about this because it's not an immediate solution to staffing crisis that have been decades in the making."
NZ Nurses Organisation Kaiwhakahaere Kerri Nuku said there were still significant deficits in the nursing workforce numbers which contributed to the demand on students.
"It's a bigger systemic problem, many schools of nursing are trying to ensure clinical placements for students don't encounter those types of pressures, but it's really difficult to achieve that when the system itself is clogged up, under pressure and overloaded."
Checkpoint
has approached Health NZ Te Whatu Ora for comment.
Sign up for Ngā Pitopito Kōrero
,
a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
RNZ News
3 hours ago
- RNZ News
Taupō struggling to attract doctors as residents rally to improve working conditions at town hospital
File photo. Photo: 123rf Taupō residents have vowed to fight to improve the town's hospital, which has faced dire workforce shortages. Those shortages have been so bad that contingency plans were drawn up last year to move patients to Rotorua Hospital if Taupō's clinic had to close . That would have left the area's 40,000 without easy access to emergency care - a situation those at a packed public meeting on Wednesday night say cannot happen. Long-time Taupō resident John Davis said locals should be prepared for a rumble in the battle to adequately staff the hospital. "I'm quite happy to organise, if people are interested. We'll get a committee together and we'll focus on one thing ... that Taupō Hospital doesn't go downhill, it actually goes uphill. "We'll get people who are prepared to stand up and be counted. I'm happy to stand up and be counted." Davis said the hospital proved its value to his family when his grandson was rushed there when he was younger and was revived several times before flying to Starship Children's Hospital in Auckland. The idea for a committee seemed to gain support from the more than 100 people who turned out to Taupō's Hilltop School at a meeting organised by Patient Voice Aotearoa. Others in the crowd suggested ideas to help find new doctors a place to live and settle in to the area. Among those attending was local nurse Iretana, who said shortages among healthcare workers in the region were having an effect on people. "They're getting put back. We can't get into appointments. People are swamping ED [the emergency department] and it's just not viable, so people are getting misdiagnosed or late diagnoses." RNZ has revealed the existence of the contingency plans should Taupō not be able to get enough doctors to keep the hospital running, although Health NZ says the plan isn't active. There are just 3.3 full-time equivalent senior doctors employed there out of nine funded positions, meaning expensive locums fill the gaps and permanent staff face burn out . One agency list seen by RNZ shows Taupō Hospital requires locums on seven days between 3 and 18 August, paying $300 an hour for weekday work and $350 an hour for night work. Robin Chan is a senior doctor at the hospital, and she said roster problems had persisted for some time. "What I don't see and what I haven't seen is any targeted funding to improve the most pressing issue, which is the medical workforce for rural communities. "It's not good enough to fund 100 new clinical placements or waive registrar training fees and expect those benefits to end up in rural communities." Too many health decisions were made through an urban lens that didn't work for smaller areas, Chan said. In her seven years in Taupō she's seen many colleagues come and go, and she said if doctors were to stay in smaller centres they needed to be valued. "The greatest predictor of rural practice, of doctors staying rural, is actually being from a rural town. This is where you guys come in," she told the meeting. "If you have children, and I don't care if they're a toddler or a teenager, or nieces or nephews or grandkids, for god's sake, buy them a stethoscope." Taupō Hospital's clinical lead Dr Ralston D'Souza said partly because of public pressure health officials were now working with hospital staff to make change. That includes creating eight more junior doctor positions, of which five were filled from later this year, to help ease the burden. "It's not uncommon on a shift to see about 15 to 20 patients. Nationally, the average is probably seeing about eight to 10 patients per shift. "That's the reason why we've struggled to attract doctors as well because they can work in Rotorua ED or other EDs around the country and it's much better working conditions." Overnight at Taupō just one doctor was rostered on for the whole hospital, which could put off clinicians. "The other thing that scares the locum doctors to come and work here is we've got a birthing unit right next door and birthing emergencies can happen. "If a birthing emergency happens in Taupō Hospital, it [could be] just the one doctor and midwife assisting the patient." Association of Salaried Medical specialists executive director Sarah Dalton said spending money on workforce conditions would help recruitment. "The single most important issue for our members, senior doctors and dentists, and for all those nurses taking strike action and their colleagues, is they don't have enough colleagues. There aren't enough of them." Patient Voice Aotearoa's Malcolm Mulholland said staffing was a real issue at Taupō Hospital, and the community had a right to know about the contingency plans and to act "as you see fit". Health NZ wasn't represented on Wednesday night, but in a statement said its executive regional director Cath Cronin had discussed the meeting with Dr D'Souza. "They agree that while there have been many challenges with recruiting and retaining permanent senior medical officers (SMOs) and filling vacant shifts, the SMO group feel supported to progress improvements at Taupō Hospital. "A change being made to the emergency department staffing model is an example of a partnership approach between clinicians and hospital management to support our people, while maintaining access to safe services for the public." Senior doctors had regular meetings with officials to present their ideas and plans, Cronin said.
RNZ News
6 hours ago
- RNZ News
Russian-born man who was adopted as child loses ACC appeal as injury occurred before immigrating
Photo: Supplied A child who was assaulted in Russia before his adoption into New Zealand has been declined cover for mental injury by ACC in the Court of Appeal. The child, referred to as D in the recent decision by Justice Susan Thomas, was born in Russia in August 2001 and was a Russian citizen when he was physically assaulted as a young child. In August 2004, D was adopted by New Zealanders and emigrated to New Zealand. In November 2019, D was diagnosed with severe post-traumatic stress disorder (PTSD) attributed to the physical injuries he suffered in Russia. He applied for ACC cover, and was declined - a decision that was confirmed on review in February 2020 - because the personal injury had not been suffered locally. The decision to decline cover was appealed in the district court, which ruled ACC should have approved D's cover, because the mental injury resulting from those physical injuries was suffered in New Zealand. That decision was then appealed in the High Court, and upheld, before escalating to the Court of Appeal. Now, the Court of Appeal has set aside that decision, ruling D is not covered by ACC, as "the causative physical injury did not occur in New Zealand and D was not ordinarily resident in New Zealand at the time he was physically injured". Thomas wrote in her decision that causation was the "primary consideration" as "it is the physical injury which is the root of the mental injury". "When D suffered the physical injuries which caused his mental injury, he was neither in New Zealand nor ordinarily resident in New Zealand. It follows that D does not have cover under the Act." She said that interpretation was "consistent with the overarching purpose of the Act, focused as it is on enhancing the public good and reinforcing the personal injury social contract between New Zealanders". "The Act cannot be interpreted as intending to provide cover for injuries caused overseas to people who are not ordinarily resident in New Zealand. Such an approach would mean the scheme was required to fund the consequences of events outside its jurisdiction and over which it could have no influence." The decision made no orders as to costs. ACC's deputy chief executive corporate and finance, Stewart McRobie, said in a statement: "ACC was seeking clarification of the law and acknowledges the Court of Appeal's decision." "ACC acknowledges the impact of the decision on the claimant, and empathises with them and their family." Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
RNZ News
6 hours ago
- RNZ News
Pharmacy owners call on Government to take 'urgent' action after baby's death
CAPTION: Bellamere Duncan's parents are calling for a law change that would make it mandatory for medication to be checked by two people before it is dispensed. Photo: 123RF CAPTION: Bellamere Duncan died at Starship Hospital on July 19. Photo: Supplied Pharmacy owners have written to the Government calling for "urgent" action, warning "lives are at stake" following the death of a two-month-old baby after she was allegedly given medication at an adult dosage by a pharmacy. "We owe it to this child - and to every New Zealander - to fix a system that is failing," one pharmacy owner said. It comes after RNZ revealed Bellamere Arwyn Duncan died at Starship Hospital on 19 July . The two-month-old was allegedly given an adult dosage of phosphate by a Manawatū pharmacy. A coroner's preliminary opinion is she died from phosphate toxicity. The revelations have prompted the Ministry of Health and Health New Zealand to "urgently" undertake a joint review into the incident with Medsafe visiting the pharmacy to ensure it was safe to continue operating. The Pharmacy Council, which is also investigating, said it's "clear that an awful error has occurred". Bellamere's parents are calling for a law change that would make it mandatory for medication to be checked by two people before it is dispensed. Pharmacist Annabel Turley, owner of in Christchurch, earlier told RNZ the pharmacy workforce was under "immense pressure" , adding both the current government and the last had "been dishing out pharmacy licences like lollies". Turley wrote to several ministers including former Health Minister Dr Shane Reti and Prime Minister Christopher Luxon in October last year. "I write to bring to your urgent attention the critical workforce shortages that are endangering the sustainability of pharmacy services across the country," she said. Turley warned the profession was "at a tipping point". "Pharmacists have been front-line healthcare providers for years, offering critical services such as medication management, vaccinations, and health advice, particularly during the COVID-19 pandemic. However, many pharmacies are under immense pressure without sufficient staffing, and our ability to maintain these essential services is seriously jeopardised." She called for an "immediate moratorium" on issuing new licences for greenfield pharmacy sites until the workforce situation was addressed. "Opening new pharmacy sites in the current climate only exacerbates the strain on an already overstretched workforce. Without adequate staff, these new pharmacies will struggle to function, and existing pharmacies will be further depleted of resources, spreading our already thin workforce even more thinly." CAPTION: Bellamere Duncan's parents were allegedly given an adult dosage of phosphate by the pharmacy. Photo: Supplied On Thursday, Turley sent another letter to the Prime Minister, Health Minister Simeon Brown and other politicians. In the letter, seen by RNZ, Turley said since her letter the profession had seen "no significant improvement in workforce stability". She said Bellamere Duncan's death was "not an isolated incident". "It is a symptom of a workforce under immense pressure-burned out, short-staffed, and stretched to breaking point. "Pharmacists are no longer able to guarantee safe, consistent care in all circumstances. As one of the few remaining accessible front-line health services in many communities, this is not just a pharmacy problem-it is a public safety issue." Turley said, unless "bold steps are taken", including an immediate halt on new greenfield pharmacy licences, there would be "more preventable tragedies like this one". "We owe it to this child - and to every New Zealander - to fix a system that is failing," she said. "Lives are at stake. Let's not allow another preventable tragedy to occur." Turley welcomed the opportunity to meet with the ministers to discuss solutions "to this crisis". "We all want a pharmacy sector that is safe, sustainable, and resilient-and we need your leadership now more than ever to make that happen." Bellamere Duncan's parents were allegedly given an adult dosage of phosphate by the pharmacy. Photo: Supplied Another pharmacy owner and pharmacist, Anna Hewitt, wrote to Brown, Luxon and other ministers on Wednesday. "Last week, our worst fear took place. A baby lost its life as a direct result of this Crisis. The critical workforce shortage has endangered the sustainability of Pharmacy in NZ and now it is having direct consequences on our Patients." Hewitt said the workforce was "stretched, it is overworked, and close to burnout". "This is not just a workforce issue, it is a Public Health Crisis. Pharmacists and Pharmacies are highly specialized, and the first point of call for many patients who cannot access timely health services. "We dispense and catch prescribing errors, we advise both other health professionals and the public on medication use, we vaccinate, we treat, we prescribe in many cases. But we are not superhuman, we cannot continue like this with no support." Hewitt referenced Turley's letter from last year. "I know firsthand that other Pharmacists from around the country have also written letters to call for action within the sector. These calls have fallen on deaf ears as it seems." She said the Government had added Pharmacists to the immigration green list and opened a new pharmacy school at the University of Waikato, which while they were steps in the right direction, they were "medium- and long-term solutions to a problem which is in immediate crisis". "This isn't just numbers, this isn't just words on a page, this is real lives, real patients, real pharmacists who are desperately trying to hold it together, and care for their patients. The human face of this crisis is Bellamere Arwyn Duncan." Hewitt called for the Government to stop issuing new pharmacy site licences and to look closely at how pharmacies were funded. "We owe it to this beloved child that was lost, we owe it to all New Zealanders, we need to fix a system that is failing." Pharmacists have written to health minister Simeon Brown to voice their concerns. Photo: RNZ / REECE BAKER On Wednesday, a Ministry of Health spokesperson told RNZ there were a number of investigations underway. "Medsafe has completed an urgent assessment and is comfortable there is no immediate patient safety issue at the pharmacy. Medsafe will continue to work with Health New Zealand and these findings which will inform the information provided to the Coroner. Medsafe is also sharing information with the Pharmacy Council. "Once these reviews are completed, we will be able to look at next steps." Health Minister Simeon Brown told RNZ on Monday he raised the incident with the Director-General of Health as soon as he was made aware. "She assured me that there would be an investigation undertaken by both the Ministry of Health and Health New Zealand. That investigation is underway. "I am advised that this incident has led to Medsafe undertaking an urgent assessment of the pharmacy. A further investigation is being undertaken by the Pharmacy Council, and the death is also the subject of a Coroner's inquest." Health agencies would provide information to the coroner as needed to support the inquest. "It is important that the reviews are undertaken, and that the circumstances that led to this incident are understood. I expect that these investigations may propose recommendations, and that these will be reviewed once reports are complete." The Pharmacy Council said it was unable to comment further when asked by RNZ on Monday whether it supported calls for a law change. "Our enquiry and investigation processes are currently underway and, until these are complete, we cannot provide any further details. At the end of the process, we will make any recommended changes to ensure as best as possible an event like this does not happen again." The owner of the Manawatū pharmacy that dispensed the medication said in a statement to RNZ the baby's death was "a tragedy". "Our sympathy is with the family and whānau. This is a very difficult time. "We are looking into what has happened to try to understand how this took place. There will also be external reviews which we will work with." RNZ asked the owner how the medication was given at the wrong dosage, whether they disputed the allegations, when the pharmacy became aware the wrong dosage had been given, and what confidence people could have about other medication received from the pharmacy. The owner said the pharmacy was "devastated about what has happened and are investigating to find out how this occurred". "It is not appropriate to comment further at this stage." Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
