District Nurses in West Auckland Are Pushing Through Pain and Fatigue Due to Chronic Understaffing

A nurse in the Waitākere district of West Auckland recently fractured her ankle at work but completed her entire clinic shift because there was no one available to cover for her. This incident highlights the deepening staffing crisis in the region, where nurses are being pushed to their physical and emotional limits.

A group of approximately 16 district nurses has sent a formal letter to the CEO of Health New Zealand (HNZ), urging the agency to address the severe shortage of registered nurses. They argue that the current situation is not only straining staff but also compromising the quality of care for patients.

According to HNZ, there are 20 full-time-equivalent (FTE) staff on the district nursing team in Waitākere. However, the nurses claim they are consistently operating with two to three fewer registered nurses than required. The FTE allocation, they say, has not kept pace with the growing population and the increasing complexity of patient needs in the region.

"The more complex assessments are needing to be put off, they're often scheduled but then come the day, and the lack of staff means we're unable to do them, so that can delay healing time," said Rose Maber, a district nurse and union delegate with the New Zealand Nurses Organisation.

Maber described a typical day as having only six nurses covering over 80 patients. She said this is half the number needed for safe staffing and barely allows time for travel, patient care, and administrative tasks. Nurses are at a breaking point, she said, and the pressure is affecting their ability to provide the quality care they are passionate about delivering.

"People are at breaking point. We're here because we're passionate about what we do in providing quality of care, and we just don't have the time to do it," Maber added.

Another nurse, who chose to remain anonymous, shared a harrowing account of finishing her shift with a fractured ankle. She described using her good leg to "skate" on a chair between patients, struggling to complete her duties due to the pain and limited mobility. "It was a very long duty, because of the pain," she said.

The nurse said she stayed at work because she did not want to let her team down. Maber, too, has delayed essential hip reconstruction surgery due to work demands. "You feel like you can't have six weeks off work, because you just feel like you're gonna make it harder for your colleagues," she said.

Other nurses have also raised concerns about the difficulty of getting time off. One nurse needed two weeks of leave for an elective procedure but was told it would be "difficult" to approve. Annual leave, according to HNZ operations director Brad Healey, is proactively managed to ensure that no more than a certain number of staff are on leave at the same time.

Healey acknowledged that district nursing teams in the area are stretched thin due to recent resignations and the growing complexity of patient care. He said the agency is actively recruiting for vacant roles and has already accepted offers from three nurses who will join the Waitākere team in the next two months.

However, the anonymous nurse expressed skepticism about whether this will solve the problem. "In two months, a lot of us will have burned out, and in two months, there would possibly be more resignations," she said.

She described the current work conditions as "heartbreaking." A recent hospital visit as a patient left her feeling disconnected from the compassionate care she strives to provide. "The people that I was dealt with were just wonderful in caring and compassionate, and I just looked at them and I felt I had none of this left ... and that, as a result of how we are pushed to get as many people through as we can," she said.

HNZ maintains that it has no record of staff being injured at work and then being denied access to appropriate treatment due to workload. "This would certainly not be an approach we would expect of our staff," Healey said.

The nurses' letter calls for an urgent review of staffing levels and service models, noting that the number of district nurse roles in the area has not increased in over a decade, despite a significant rise in patient referrals. Maber emphasized the need for systemic change, not just temporary fixes.

"We need a sustainable solution that takes into account the realities of our growing population and the increasing demands on our services," she said.