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New Zealand: Govt Adamant, Not Considering Laws For nurse-to-patient Ratio - News - Nurses Arena Forum

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New Zealand: Govt Adamant, Not Considering Laws For nurse-to-patient Ratio by katty : July 18, 2018, 11:43:34 AM
Two Australian states have made laws about nurse-to-patient ratios, but Kiwi health leaders aren't keen to follow suit.

New Zealand nurses went on strike in early July, and numbers on the ward floor were cited as one of their key concerns.

Across the ditch, laws in Victoria and Queensland set minimum staffing ratios for nurses, but leaders in New Zealand nursing think we have a better solution.

Ratios are better than nothing but they're too blunt an instrument, the NZ Nurses Organisation's Hilary Graham-Smith said.

"Nurses nurse patients. They don't nurse beds," the associate professional services manager said.

"What you really need to think about is: how sick are the people in those beds?"

Calculating required care hours - and the expertise needed - for patients is part of a project district health boards and the NZ Nurses Organisation have been working on for the past decade.

Care Capacity Demand Management (CCDM) includes using a software tool to determine how many hours of care a patient will need, Graham-Smith said.

It also informs the mix of registered nurses, enrolled nurses, and healthcare assistants needed to give that care.

"In most instances, it tells them that actually they need more staff, that their base staffing is not adequate," she said.

Staffing levels have historically been based on how much was in the budget, she said.

In Australia, the Victorian Government is tweaking the 2015 act which sets out staffing ratios, and says a staffing increase is likely.

In Queensland, ratios were introduced in public hospitals in July 2016 - 1:4 for morning and afternoon shifts, and 1:7 for night shifts in designated wards.

When the change was announced, the state government said about 250 extra nurses were needed, at a cost of about $26m.

While nurses tend to like the ratio idea, New Zealand's solution could be better, College of Nurses Aotearoa executive director Jenny Carryer said.

However, it doesn't matter what mechanism you use for assessing staff need if it isn't filled.

That's echoed by NZ Nurses Organisation national delegate for Waikato DHB Bronwyne Albright.

It's no good having a tool to tell you you're two nurses under if there aren't two nurses available to send in, she said.

Nurses have heard a lot about safe staffing, she said, but are not seeing it happen.

It's a challenge for health boards to respond fast enough when there is increased demand, Waikato DHB chief nursing and midwifery officer Sue Hayward said.

A hospital may help three wards with extra staff, for example, but struggle to find more for a fourth.

Waikato DHB signed up to the CCDM programme about 18 months ago because it is committed to finding a solution, Hayward said, and has already seen some changes.

The programme gives a mechanism and national support "to reduce the frustration that nurses feel at times when they are requesting help and it's not coming".

Health minister Dr David Clark said in a statement that Government was committed to safe staffing levels in hospitals, but saw CCDM as a "more sophisticated approach".

"Ratios are a blunt tool that don't take into account factors such as how acutely ill patients actually are," the statement said.

The NZ Nurses Organisation and DHBs have agreed to use the CCDM programme throughout the country, he said.
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