Lack of senior staff sees hundreds of foreign nurses waiting to get work

A lack of senior staff is a key reason why several nursing jobs in Canterbury were listed, explicitly saying applications from some foreign nurses would not be accepted.

1News reported in February that Health NZ / Te Whatu Ora - Waitaha Canterbury's adverts for roles within its maternity, oncology and acute general surgery wards had a note that the services were "NOT currently accepting applications from Internationally Qualified Nurses who have completed CAP".

CAP, which stands for Competency Assessment Programme, is an additional training requirement for nurses coming from countries like India and the Philippines, who are deemed to have a non-comparable health system.

At the time, Health New Zealand Te Whatu Ora management said the wording was "a bit of a mistake".

What led to the mistake was the fact that the areas did not have adequate resources to be able to support new staff, correspondence obtained via the Official Information Act (OIA) has revealed.

In an email, Canterbury's executive director of nursing, Becky Hickmott, said it was suggested by an HR consultant, and the clinical nurse managers had agreed to it - but it wasn't what the senior nursing leadership team would have supported.

".Noting the areas involved, they are areas of huge attrition who already have a high volume of IQNs [internationally qualified nurses] and new graduates, so the availability of support is severely stretched."

Figures provided to 1News in the same OIA show overall nursing vacancies have dropped from the approximately 4,000 first quoted by officials in 2022.

The latest data from December 2023 shows they are probably closer to 2,000. The available nationwide numbers, which exclude Canterbury and the West Coast, show a shortage of 1816 full-time positions.

Data wasn't available from Canterbury and the West Coast because its systems were going through an upgrade.

The region with the largest number of vacancies is Central, which encompasses Whanganui, Hawke's Bay, the Capital Region and Wairarapa, with 778 roles needing to be filled - the areas of the greatest need were across mental health and critical care.

Te Whatu Ora Health New Zealand chief people officer Andrew Slater said the numbers of newly registered nurses coming from overseas and recent graduates have helped bring the vacancy rate right down.

"As we look forward, though, what we do see are some quite critical nursing areas that we are still targeting recruitment for, so mental health, emergency departments and experienced nurses, for example. Globally, those are some of the areas that continue to have shortages," he said.

The department has recently expanded its recruitment campaign, with a new one specifically targeting mental health nurses from the UK, Canada, the USA and South Africa.

"We've seen some really good early interest coming in, and our international recruitment teams, in partnership with our hospitals and our NGO partners, will be focusing on starting to process those expressions of interest in the coming weeks."

And it's also doing work to encourage more New Zealanders to consider nursing as a career.

New Zealand has long been a popular choice for nurses. American nurses Kate and Grant Wright have often thought of moving their family to New Zealand - something they finally made happen in January this year.

Kate Wright is a nurse practitioner, and her husband, Grant Wright, works in Wellington's Intensive Care Unit. Coming from the United States, which is deemed to have a comparable health system to ours, and with senior experience working in areas that are hard to staff - finding a job was easy.

They had the choice of jobs in Nelson and Wellington and were able to make the choice of moving to the capital.

"We intend to be here as long as possible," Grant said. "We definitely wanted to have a feel of permanence here, to put down roots and make it feel like home, especially for our kids.

"I felt like that bedside experience, not to mention just the last few years in a pandemic environment in the United States, set me up in a pretty good spot for my resume."

Both have enjoyed their short time working within New Zealand, even as they acknowledge an ongoing shortage of staff.

Kate said New Zealand's natural beauty is a drawcard for their friends and colleagues back home.

"We definitely foresee some of our fellow nurses coming over and joining us in Aotearoa."

But for many of those whom officials deem come from non-comparable health systems, the process of finding a job here hasn't been as easy. Many have to do the additional CAP training.

That's a six-week long programme that must be done here and can cost up to $10,000 to complete - and is a requirement for nurses who are unable to be registered based on their qualifications and experience alone.

Nursing Council figures show that between October last year and March that 2665 of the newly registered nurses had done so after completing CAP.

That's a number which, in theory, could fill the current nursing vacancy, but many foreign nurses have reported struggling to find work. Some have found part-time work, while others are still searching, and others are thinking of leaving the country altogether.

Accent Health recruiter Prudence Thompson says she still gets messages daily from foreign nurses who've completed their CAP and are eligible to work here but can't find work.

She said the challenge is so many have arrived in recent months, and that can create a different kind of pressure in the system when there isn't the right skill mix or experience on the floor.

"It's difficult for any employer in New Zealand to take on a new graduate or a CAP nurse because they do need senior induction and orientation for three to six months to be able to work well.

"We just don't have the senior nurses here to support and orientate the nurses that are new to New Zealand."

The president of the NZNO nursing union, Kerri Nuku, says safe staffing isn't just about the numbers but the right mix of staff.

She says that every nurse who leaves the system hasn't always been replaced by someone with the same level of skill or experience.

"If we don't have that skill level, then it can mean services may not be able to be delivered because the staff don't possess those skills, so it is not just about number counting, but suitably competent staff."

The union says the pressure on senior staff is still a concern.

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