Evaluating the impact of a new pay agreement on New Zealand nursing

Exploring the challenges of taiwanese nurses in the COVID-19 post-pandemic era

In the wake of the COVID-19 pandemic, the fluctuating nurse resignation rates highlighted an understudied area in healthcare: post-pandemic challenges in clinical settings. This study, conducted from May to November 2023, employed a qualitative inquiry using focus groups to delve into these challenges. Six focus group sessions, involving 33 nurse participants recruited through snowball sampling from various hospital settings were conducted to explore their clinical experiences during and after the pandemic. Thematic analysis revealed two primary themes: the 'Invisibility of Nurses' within the healthcare system and the 'Moral Duty of Nursing Practice'. These findings illuminate a tension between the overlooked role of nurses and their ethical obligations, underscoring a critical need for policy reassessment. The study advocates for systemic changes, particularly in the undervaluation of the nursing profession and the National Health Insurance system, to address the poor working environment and mitigate long-term nursing shortages. This research deepens understanding of post-pandemic nursing workforce challenges in Taiwan, highlighting the need for policy evolution to enhance recognition and support for the nursing industry. It is suggested to provide tangible compensation to acknowledge nurses' daily care and health education for patients. A healthier working environment can be enhanced by collaborative efforts between healthcare institutions and nurses.

New graduate separations from New Zealand's nursing workforce in the first 5 years after registration: a retrospective cohort analysis of a national administrative data set 2005-2010

AIM

To describe workforce separation rates and its relationship with demographic and work characteristics in the 2005 new graduate cohort's first 5 years as practising RNs in NZ.

BACKGROUND

Retaining new graduate RNs is critical to nursing workforce sustainability; one study showed that if an RN is still employed in a hospital setting 5 years after graduation, he/she tends to remain active in the health industry.

DESIGN

Retrospective analysis using the Nursing Council of New Zealand's registration data set for years 2005-2010.

METHODS

All newly registered NZ graduates practising in NZ in 2005 (n = 1236) were tracked for 5 years.

RESULTS

Within 5 years of graduation, 26% of the cohort had separated from the NZ nursing workforce, 18% in the first year. The under-25s (n = 517), 42% of the cohort, had the highest loss, 32%, in 5 years. Separations were significantly lower for graduates in their 30s vs. their 20s and for those who gained postgraduate tertiary qualifications post-registration (10%) vs. those who did not (29%). Hospitals were the most frequent employment setting over 5 years, the largest increase being community settings. Five-year retention rates in the four largest practice areas were surgical 26%, medical 16%, mental health 60% and continuing care 10%. After 5 years, 24% of those still practising (n = 920) worked in a different health board region.

CONCLUSIONS

New graduate RN losses were higher than in previous research, with younger RNs at most risk, threatening future sustainability of the nursing workforce and highlighting the need for evidence-based targeted strategies to retain them.

A systems perspective on nursing productivity

PURPOSE

Recent New Zealand reports have identified the nursing workforce for its potential to make a significant contribution to increased productivity in health services. The purpose of this paper is to review critically the recent and current labour approaches to improve nursing productivity in New Zealand, in a context of international research and experience.

DESIGN/METHODOLOGY/APPROACH

An examination of government documents regarding productivity, and a review of New Zealand and international literature and research on nursing productivity and its measurement form the basis of the paper.

FINDINGS

It is found that productivity improvement strategies are influenced by theories of labour economics and scientific management that conceptualise a nurse as a labour unit and a cost to the organisation. Nursing productivity rose significantly with the health reforms of the 1990s that reduced nursing input costs but impacts on patient safety and nurses were negative. Current approaches to increasing nursing productivity, including the "productive ward" and reconfiguration of nursing teams, also draw on manufacturing innovations. Emerging thinking considers productivity in the context of the work environment and changing professional roles, and proposes reconceptualising the nurse as an intellectual asset to knowledge-intensive health organisations.

PRACTICAL IMPLICATIONS

Strategies that take a systems approach to nursing productivity, that view nursing as a capital asset, that focus on the interface between nurse and working environment and measure patient and nurse outcomes are advocated.

ORIGINALITY/VALUE

The paper shows that reframing nursing productivity brings into focus management strategies to raise productivity while protecting nursing and patient outcomes.

Winners and losers: organizational impacts of a nurses pay agreement

This article considers the impacts on organizations of a new national employment agreement for nurses in New Zealand. In the 1980s, local employer bargaining replaced national awards. As nurses' employment conditions deteriorated, in 2004 that trend was reversed with a new national agreement between the nurses' union and the public sector health boards. Qualitative information was collected and analyzed from two employers covered by the agreement and from five nongovernment organizations not party to the agreement. In the organizations studied, there was evidence of winners and losers within and between organizations, flow-on effects on other groups of nurses not represented by the union and on other employee groups. Although impacts on public sector nursing workforces were generally positive, some imbalances and unintended consequences arose from the agreement. Differing experiences and perspectives of a national pay agreement largely reflected local nurse market conditions.