Health NZ Plans Part-Time Roles for Graduate Nurses Amid Criticism

A leaked document has revealed that Health NZ is planning to implement a strategy that involves hiring more graduate nurses on part-time contracts, significantly reducing their on-the-job training. The proposal, which aims to create more flexible job opportunities, has drawn sharp criticism from the country’s largest nursing union, which accuses Health NZ of prioritizing cost-cutting measures over adequate staffing and training.

The document, referred to as the “Reset and Review” paper, outlines Health NZ’s intentions to increase graduate employment by offering more part-time positions. Specifically, the minimum hours for these roles are set to decrease from four days a week to three, effectively creating positions of 0.6 Full-Time Equivalent (FTE). According to the plan, this shift is designed to address the growing issue of unemployed nursing graduates while simultaneously achieving a “long-term reduction of cost.”

Bianca Grimmer, a student spokesperson for the Nurses Organisation, voiced concerns about the feasibility of living on a reduced 0.6 FTE salary. “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,” she noted. “Depending on where you live in New Zealand, it’s looking pretty rough on 0.6, to be honest.” Health NZ data indicates that only 45% of mid-year graduates found hospital jobs as of July 2023.

Concerns Over Reduced Training and Support

The Reset document further states that the changes are meant to clarify Health NZ’s hiring practices. It emphasizes the shift towards employing nurses “to vacancy” rather than through entry-to-practice programmes. Grimmer anticipates that many graduates will seek opportunities abroad, particularly in Australia, where they can earn more money and pay off student loans quicker. “The trend just keeps getting worse for student nurses at the moment,” she said, highlighting the scarcity of job opportunities for those graduating at the end of the year.

Union representatives have accused Health NZ of “gaming the numbers.” Anne Daniels, president of the Nurses Organisation, explained that by hiring more nurses at 0.6 FTE, Health NZ can present a facade of increased staffing without addressing the underlying issues of understaffing and high workloads. “If you have budgeted FTE for 10 nurses and hire them all at 0.6, you can get lots more nurses for the same money,” Daniels stated. “But that doesn’t do anything for the understaffing or the appropriate standard of care that we should be providing to our patients.”

Additionally, Health NZ plans to slash training hours for graduate nurses from 240 to just 80, a reduction of two-thirds. While the paper asserts that this change will allow graduate nurses to be counted on the roster sooner, Daniels expressed doubt about the long-term retention of these nurses. “Research shows that unless new graduates are supported to become competent and confident in practice, they will leave within their first and second year,” she said.

Health NZ’s Response to the Criticism

In response to the backlash, Nadine Gray, National Chief Nurse at Health NZ, emphasized that the Supported First Year of Practice programme is designed to facilitate a safe and flexible 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,” she explained. Gray clarified that the minimum FTE of 0.6 is a standard, and many graduates who have secured positions are filling roles at 0.8 FTE or higher.

Furthermore, she noted that the specifications for the Nurse Entry to Practice framework had not undergone a review in two decades and that the new minimum clinical load-sharing hours are aligned with standards in Australia. “Our first year of supported practice is flexible to the needs of the graduate,” Gray added, indicating that while the minimum hours are now set at 80, they can be increased to 120 if necessary.

The ongoing debate underscores the critical need for a balance between flexible job creation and adequate support for new nursing graduates, as the healthcare system grapples with staffing challenges and the retention of skilled professionals.