The “Reset and Review” paper obtained by RNZ lays out Health NZ’s plan to boost graduate employment by creating more part-time jobs, and encouraging other employers to take them on.
Photo: RNZ
A leaked document reveals Health NZ is planning to employ more graduate nurses on part-time hours and cut the amount of on-the-job training they receive.
Health NZ says it is about creating more “flexible” job options – but the country’s biggest nurses’ union accuses it of cost-cutting and “gaming the numbers”, and warns more graduates will go overseas.
The “Reset and Review” paper obtained by RNZ lays out Health NZ’s plan to boost graduate employment by creating more part-time jobs, and encouraging other employers to take them on.
It is reducing minimum hours from four days a week to three, or 0.6 of a full-time equivalent position (FTE).
The paper said its focus was on solutions that would help deal with the problem of nursing graduates without work and “long-term reduction of cost”.
Changes include:
Reducing the minimum FTE from 0.8 FTE to 0.6 FTE
Reducing “clinical load sharing” (previously called “supernumerary” hours, because the new graduates were not counted on the shift roster) from 240 hours to 80 hours.
Reducing study hours from 96 to 80, including all mandatory training, to “reduce the time out of the clinical learning environment”.
Nurses Organisation student spokesperson, Bianca Grimmer, who lives in Auckland, said it would be hard to make ends meet on a 0.6 job.
“We’re on placement at the moment and hearing from nurses who are on 0.8 already and they’re working two or three other jobs because that doesn’t cut it.
“Depending where you live in New Zealand, it’s looking pretty rough on 0.6, to be honest.”
Health NZ figures showed just 45 percent of mid-year graduates secured hospital jobs in July.
The Reset document says the changes would “clarify” that Health NZ employed “to vacancy”, not to entry-to-practice programmes.
Grimmer expected more graduates would head directly to Australia, where they could earn more and pay off student debt faster.
“The trend just keeps getting worse for student nurses at the moment, particularly for those set to graduate at the end of the year, which is where I’m at.
“It’s already looking pretty scarce for job opportunities, and now they’re cutting FTE back to 0.6, which is barely anything.”
Health NZ “gaming” the numbers, says union
Nurses Organisation president Anne Daniels said it appeared Health NZ was trying to “make its numbers look good” by hiring more nurses – but giving them fewer hours.
“If you have budgeted FTE for 10 nurses, and you hire them all at 0.6, you can get lots more nurses for the same money.
“But that doesn’t do anything for the understaffing or under-resourcing or the overworking or the huge workloads, nor the appropriate standard of care that we should be providing to our patients.
“It’s gaming.”
New Zealand Nurses Organisation president Anne Daniels speaking at the conference this morning
Photo: RNZ / Pretoria Gordon
Health NZ was also reducing study hours for grad nurses, and so-called “clinical load sharing”, where they work alongside senior nurses before taking on a full patient load.
Those hours were to be slashed by two-thirds: from 240 to just 80.
The paper noted this would “enable graduate nurses to be counted on the roster earlier”.
However, Daniels did not expect those nurses to stay.
“They will leave. The research is very clear about that: unless you have new graduates that are supported to become competent and confident in practice, they will leave in the first and second year.”
She was also critical of Health NZ’s intention to scrap the designation “new grads” (which it said was “reductionist”) replace it with “graduate RNs” to immediately identify them as qualified, registered nurses.
“They are going to be expected to work as experienced nurses and the change of the name is absolutely behind that,” Daniels said.
“That’s problematic, because as a new graduate, you’ve got a lot to learn.
“I have real concerns about the safety of our graduate nurses.”
Bianca Grimmer agreed graduates needed more support, not less.
“It’s just going to end up creating tired nurses who aren’t as settled as they should be in their speciality areas, and especially if they’re going to really niche areas, they’re going to need that support.”
Health NZ responds
Health NZ National Chief Nurse Nadine Gray said the goal of the Supported First Year of Practice programme was to provide a safe transition into clinical practice.
“The specifications for the first year of supported practice are flexible to the learning and support needs of each individual graduate.
“After consultation across the sector, we have reduced the minimum FTE for graduate nursing roles to 0.6 to allow for greater flexibility as we know everyone’s life circumstances are different and to unlock more job opportunities.”
It was important to note that 0.6 FTE was a minimum standard and most graduates who had been matched to roles were filling 0.8 FTE roles and above, she said.
“Health New Zealand is committed to assisting graduates into jobs across the health system and once they are in roles supporting them as they transition into the workforce.”
The specifications in the Nurse Entry to Practice framework had not been reviewed in 20 years, having been originally developed in 2005, Gray said.
“Our first year of supported practice is flexible to the needs of the graduate. While the minimum supervision / clinical load sharing and study hours is now 80 it can increase up to 120 as necessary.
“As part of the update, we benchmarked against Australia and the new minimum of 80 hours workload sharing is comparable with most Australian states.”
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