Nursing shortage: Starship Hospital workers 'commonly end up in tears', 'make mistakes' as understaffing takes its toll

A nurse at Auckland's Starship Hospital says the shortage of workers is so dire that staff are quitting in their droves due to stress and "commonly end up in tears" during shifts.

The nurse, who Newshub has agreed to keep anonymous, has worked in the Intensive Care Unit (ICU) for several years and has seen about 30 of their 160 coworkers in the unit leave since the beginning of 2021.

The high turnover is partially attributable to the COVID-19 pandemic since job openings were scarce last year and few people wanted to leave due to a hiring freeze, they say. But now nurses who wanted to leave last year are leaving this year, leaving those still in the job feeling "undervalued", "underappreciated", and highly stressed because of understaffing.

"It makes us feel like we haven't achieved what we needed to for our patient. It means we skip breaks, leave work late, go home stressed and disappointed," the nurse tells Newshub.

"We commonly end up in tears. We make mistakes because we have time pressures and we are tired."

Nurses also face the dissatisfaction of patients and families who are upset their child isn't receiving care on time.

"When working with understaffing, it feels like you are not safe and this is something I hear all the time from nurses, that they feel unsafe," they say.

"This means that they are scared they are not able to take care of a patient in a way that is actually safe for the patient, and if something goes wrong, they feel they are not going to be able to deal with it and then keep all their other patients safe too."

In Starship's ICU, there is usually a 1:1 nurse to patient ratio for those needing any form of life support and a 1:2 nurse to patient ratio for those who are less sick but still need close monitoring, they say. On top of that, there are two floating nurses and an additional nurse who transports unwell patients to Starship Hospital from elsewhere in New Zealand.

Float nurses help out the rest of the unit, assist nurses who need extra help, and relieve nurses for breaks, among other things.

The Starship nurse says it's been common in the last few months for their ICU to have one, or sometimes no, float nurses because they're needed to take care of other patients. There have also been occasions where the transport nurse has been allocated a patient or has been the only free nurse to float, meaning if there's a transport call from another hospital, they haven't been able to retrieve the patient.

"In the time I have worked in the paediatric ICU, I have not experienced these shortages [before]. We have a lot more nurses taking an unsafe workload, or many nurses caring for two patients that should be cared for one to one," they say.

"It is now common to look back and wonder how we managed to get through the day without a major incident. Sometimes we are grateful because all our patients remained stable knowing that if they hadn't, we would have struggled to provide safe care for them."

Nursing shortage: Starship Hospital workers 'commonly end up in tears', 'make mistakes' as understaffing takes its toll
Photo credit: Getty Images

The nurse shortage is especially concerning given winter and spring are coming up - the time of year where there's a "significant rise" in patient numbers. People spend more time indoors in close proximity to each other since it's too cold and wet to be outside or have the windows open.

"Cold and damp housing and overcrowding in houses impacts this a lot and we see a high proportion of patients coming from areas of low socioeconomic housing," they say.

For the paediatric ICU, this means the unit is full of babies with bronchiolitis and children with pneumonia, they add.

"Our busiest times in the ICU and in the medical wards of Starship is always late winter and early spring when the flu and respiratory viruses have been increasingly spreading all winter and they reach a peak occurrence."

The current pay negotiations for nurses will also go a long way if they are successful, they say. Currently, graduate enrolled nurses - those with a diploma - at a DHB start on $49,000 a year. After one to four years of experience, they usually earn $51,000 to $57,000.

Registered nurses - those with a degree - start on $54,000. Those with three to seven years of experience usually earn $62,000 to $77,000, and senior registered nurses with more experience and responsibility usually earn $79,000 to $130,000.

Nurses have been pushing for 17 percent pay increases and held a strike earlier this month.

Without the increase, the Starship nurse says many will head to Australia where pay is thousands of dollars more.

"We used to earn the same as Australian nurses, now they earn at least $10 more an hour than us with better working conditions and more manageable nurse-to-patient ratios. They also get pay recognition for postgraduate study they have done," they say.

"It is near impossible to buy a house on a nurse's wage now. Nurses are so fed up with empty promises for pay parity that many don't want to be in the nursing profession anymore."

There are even talks among some nurses who are thinking about a career change due to their working conditions.

"If our pay negotiations are successful, it would definitely help with retention of nurses within New Zealand and it would make us feel more appreciated and valued," the nurse says.

"It would encourage more young people to enter the profession because right now I don't think there is much to encourage graduates to become nurses when they can do a trade and get paid for training, start a career with no student loan and earn more money than a nurse."

The Starship nurse says many are upset the Government has decided to spend nearly $700 million on a bridge for cyclists across Auckland's Waitematā Harbour and $250 million in Parliament building upgrades.

"The Government says they don't have any money for us and then they make these announcements," they say.

"My unit is trying to get funding for an upgrade that will cost $25 million. The Government gave us $10 million and the rest is being fundraised for.

"These are the most unwell children in New Zealand and we have to fundraise to be able to accommodate them and then cyclists get handed a sum of $700 million. It makes everyone in my unit angry with the Government that they don't have the children of New Zealand as a priority."

Dr Mike Shepherd.
Dr Mike Shepherd. Photo credit: The AM Show

On Thursday, Starship fronted The AM Show to address the nursing shortage and capacity issues. Starship director of provider services Dr Mike Shepherd says there are at least 600 nursing vacancies in the Auckland region - and he's appealing to former nurses to return to the workforce.

"I think, most importantly, we know there's a lot of people who have previously worked as nurses throughout the workforce, throughout healthcare, and we're really keen to hear from them to help them return to what is an incredibly fulfilling role," he says.

But he adds although there is a shortage, families can be assured their children will get seen if they're brought into Starship.

"It's not a problem if your child's sick - we still want you to bring them into your local emergency department, including Starship," he says.

"But also, I think we want to reassure people that there's a lot of fever and cough around. We think that's not necessarily a reason to come to the emergency department. Call Healthline, have a look online, look at information like KidsHealth, and really see if you can manage that at home."

If families are still concerned after sifting through information, Dr Shepherd encourages people to see their GP before visiting an emergency department.

"We're good at doing busy and I think we can cope with that, but we do think there are some other ways that sometimes people can help their own children."