More than 200 healthcare professionals at Auckland's Middlemore Hospital have signed a letter warning they are in a crisis, calling on Health New Zealand to prioritise patient and staff safety.
Health New Zealand told RNZ it was reviewing the concerns raised by staff, noting that patient safety and staff wellbeing were the organisation's highest priorities.
The letter from Middlemore Hospital staff backs a state of emergency recently declared by workers at North Shore Hospital's emergency department and raises concerns about chronic understaffing, overcrowding and staff being asked to work while sick.
"We are in a crisis," the letter says.
It comes after nurses in Middlemore Hospital's emergency department told RNZ they had been asked to come to work despite calling in sick.
The healthcare workers say the requests are putting both staff and patients at risk and are a consequence of chronic understaffing.
"When we call to advise we are unfit to work, we do not expect to be coerced, bullied or emotionally blackmailed into working," the letter says.
"Recently, staff working in the Middlemore emergency department are being asked to come into work sick.
"This endangers the safety and wellbeing of both staff and the patients we see and is a disturbing consequence of the chronic short staffing we have been expected to work through. This increase in risk was predictable and completely avoidable."
The workers say the emergency department regularly operates over capacity, at times reaching about 400 patient representations when its capacity is 150.
"This winter, Middlemore emergency department has routinely operated at 200 percent over capacity, peaking closer to 250 percent over capacity at times," the letter says.
They claim the situation is being driven by a recruitment freeze and chronic understaffing.
The letter also says the conditions breach workers' rights under their employment agreements, as well as the rights of workers and patients in the Emergency Department under the Health and Safety at Work Act 2015.
"We are exhausted, burnt out and we and our families are carrying the burden that should sit with Te Whatu Ora. Our immune systems are compromised, and we are more likely to be unwell," the letter says.
"We cannot continue to simply accept this when the consequences are patients being exposed to preventable harm. Or accept continued breaches of our rights to safe work."
The healthcare workers are calling on Health New Zealand to act immediately.
One of their demands is the recruitment of 40 additional nursing full-time equivalent positions they claim have already been identified through the Care Capacity Demand Management process without further delay.
They also want Health New Zealand to commit to culturally appropriate nurse-to-patient ratios that reflect patient acuity and demand.
Another demand is for Health New Zealand to stop asking staff to work while sick.
Anne Daniels, president of New Zealand Nurses Organisation Supplied
New Zealand Nurses Organisation president Anne Daniels said the collective letter suggested that healthcare workers had exhausted other options.
"This public letter is a very, very clear declaration that none of the things that are supposed to work in terms of going through the system have worked and they've been left with no choice," Daniels said.
She said it was "extremely heartbreaking" to see the situation at Middlemore Hospital, describing it as being the direct result of "deliberate underfunding" of the health system.
Daniels said the government and nursing employers needed to focus on filling nursing gaps, and that the workforce could do little about staffing levels other than demand that vacancies be filled.
"The accountability is with the government and employers," she said.
Daniels said no nurse should be coerced into working if they were sick.
Earlier this month, nurses at Middlemore Hospital told RNZ they had been asked to work despite calling in sick.
"When I called the [hospital] sick line, they told me to take paracetamol and come to work," one nurse told RNZ.
Another nurse said they had been asked to wear an N95 mask and come to work.
Daniels said such practices were unacceptable.
"The nurses are choosing to do the right thing and stay away from work," she said.
"If they are being threatened or if they feel that they're being coerced, they must come to the union, and we will stand up with them and beside them and push back on this because it is totally unacceptable."
Vanessa Thornton, group director of operations for Counties Manukau, told RNZ that patient safety and staff wellbeing were Health New Zealand's highest priorities.
"We are reviewing the concerns raised by staff, including those relating to workload, capacity and workforce pressures, and are engaging with clinical, operational and nursing leaders, alongside staff representatives, to better understand the issues and identify any actions required," Thornton said.
"We remain focused on maintaining safe care for patients while supporting the wellbeing of our staff."
Thornton said Health New Zealand did not expect staff who were unwell to attend work, and managers were expected to support staff to stay home when sick.
She said Middlemore Hospital's emergency department continued to experience high demand and that staffing requirements, workforce needs and service capacity were regularly reviewed to ensure the hospital could provide safe, high-quality care.
RNZ asked Health New Zealand whether Middlemore Hospital's emergency department was currently understaffed, how many nursing FTE vacancies remained and whether it would recruit the 40 nursing FTEs requested by staff.
"We remain committed to recruiting into vacant roles and supporting our frontline teams," Thornton said.
She said Health New Zealand took its obligations under employment and health and safety legislation seriously and would continue working closely with staff and their representatives to address the concerns raised.
"We recognise the significant pressure our emergency department teams have faced over winter, and we thank staff for their ongoing commitment to caring for patients and whānau," Thornton said.
A spokesperson for Health Minister Simeon Brown said the minister expected the NZ Nurses Organisation to engage directly and in good faith with Health NZ, rather than through the media.
-RNZ