Urgent Government action is needed as the feared exit of aged care nurses to better paid DHB jobs following the recent pay and safe staffing settlement becomes a reality, says the Aged Care Association.
“Every day members are ringing and emailing me saying they’ve lost another nurse to a DHB because of the pay gap, and the vast majority are not able to pay their nurses more than they are funded for,” says New Zealand Aged Care Association Chief Executive Simon Wallace. He questioned why the government was ready to recruit up to 900 more teachers for schools but wasn’t responding in the same way to the desperate nursing shortages in residential aged care.
He said it had not re-surveyed members since its survey in late July which found about 500 nursing vacancies across the country – about 10 per cent of the around 5000 registered nurses working in the residential aged care sector – but the phone calls indicated what was a ‘trickle” to DHBs’ was now a “torrent” with nurse turnover reaching nearly 38% in August.
David Wait, NZNO’s industrial advisor for aged care, said comparisons with the difficulties facing recruiting teachers was well made as both shortages reflected significant under-investment over the past decade. He argues that addressing pay and staffing concerns are the most important part of a sustainable solution for the aged care nursing workforce. Because facility nurses, even when technically fully staffed, were under emotional and physical pressure and facing situations that were “professionally unsafe”.
Wallace said it had had several meeting with the DHBs and Ministry of Health over the pay gap but was yet to have a resolution. “Obviously we want a boost in pay for our nurses – as that is the primary reason we are losing our nurses to DHBs.” He said it was aware of one facility that had to close its hospital wing because of lack of nurses. Meanwhile RNs at other facilities were working double shifts, retired nurses being pulled back to work and clinical managers were working night shifts.
“My nurses deserve better”
One of these managers, who requested not to be named to protect his staff, has just lost one of his eight registered nurses to a higher paid job at the local DHB and says his experienced and loyal staff are asking when will they see more money too.
“My nurses deserve better – and something needs to be done.” The general manager is a registered nurse and clinical lead of the small 50 bed facility which has nearly 20 hospital level beds as well as a dementia unit.
He says he struggles to maintain the required 24 hour RN roster and even if he gives three week notice of a roster gap to the local nursing bureau they are usually unable to help, let alone if somebody calls in sick. And it is not unknown for him to have to step in and do night shifts himself after working a ten hour day. “If I’m just hopping into bed at night and I get a phonecall that a nurse can’t come in and then I get up and go. It’s not pressure from the owners – it just had to be – I’ve got to have a registered nurse on site. But that all comes at a toll.”
The manager believes the long-term answer is for the current review to address the underfunding of residential aged care. “In the short-term I can’t see how a Government that campaigns on equity and equal pay can allow two nurses with the same qualification – and both ultimately being paid out of the public purse – to be paid at vastly different rates.”
“It is not just aged care facilities that are suffering as businesses and entities – it is the residents who are ultimately going to pay for this. Do we think that old people don’t deserve the same quality of care? Or nurses aren’t important in aged care?”
“I think the Government immediately needs to put some funding in. I don’t really care how they do it frankly – even if they want to mandate staffing levels and pay accordingly – I don’t think they will do anything quite that radical but there needs to be funding going in so nurses can be paid more.”
He said at the moment it was not worth it financially being a registered nurse, particularly a recently qualified one, as following last year’s pay equity settlement the pay gap between a new graduate RN and a level four health care assistant is virtually non-existent but the HCA did not face the same professional responsibilities. He said aged care nursing was definitely not unrewarding but was underpaid for the clinical skills and challenges required.
Migration the answer? No says NZNO
Wallace asked if the Government was ready to respond to the teacher shortage by recruiting more teachers from overseas why wasn’t it bringing in hundreds of registered nurses from overseas to ease shortages in facilities.
The Association is lobbying the Government and Immigration New Zealand to return aged care registered nurses to the Long-Term Shortage Skills List in recognition that there is a national systemic shortage.
Wallace says counter-arguments that nursing shortages in the aged care sector were due to pay and conditions not lack of nurses showed “a lack of understanding by Immigration and the Government more generally”. Particularly that that the sector was largely Government funded and therefore the pay increases it could pass on to staff were limited by what increase facilities received in their annual contract increase. “And this year it was two per cent.”
He said some of the large operators that run big retirement villages that can and are paying nurses more as they can cross-subsidise the costs but the vast majority did not have the “wriggle room” to pay their nurses more than the two per cent increase.
Wallace said easing immigration rules were a partial, short-term solution allowing facilities to recruit nurses overseas to fill the current gaps while the sector dealt with the pay issue.
Wait said the Aged Care Association’s proposed solution to shortages of bringing in hundreds of registered nurses form overseas would do nothing to stop the exodus to DHBs. “And would be like turning on the tap without putting the plug in the basin”.
The manager says his facility has some very good migrant nurses on its staff and agrees more migrant nurses is a partial solution. “But any good migrant nurse, like any good Kiwi nurse, if they can see just over the fence in the DHB they can get huge more pay … of course that is going to attract them.”
“My fear is that (the pay gap) it’s just going to bleed aged care dry…particularly young nurses – who are already not attracted to aged care…this isn’t Shortland Street… the glamour is with the DHBs who can pay them more as well.”
Wallace says the association was conscious that few providers had enough senior nurses to support taking on new graduate nurses. “We have to look at creating the environment to support nurses coming into aged care and for those already working in aged care. Pay is part of it – that’s a big part of it – but so is providing the support that they need.”