National | Health

Can Aotearoa be 'the most attractive place in the world' for nurses?

The announcement that came out of the Beehive last week was an important one for Internationally Qualified Nurses seeking to practice in New Zealand- along with midwives and doctors, they have been placed on the Straight to Residency pathway on Immigration New Zealand’s Green List. Under the old rules, they would have been required to work for two years in the country before being eligible to apply for a resident visa. From Thursday the 15th, they can apply for a residency on day 1.

It was something the opposition and the sector had been asking for for quite a while. Both the Prime Minister and Minister for Immigration Michael Wood were insistent that the government had listened to these demands and acted on them. The objective? “To make New Zealand the most attractive place in the world to live,” said Prime Minister Jacinda Ardern.

A workforce deficit

“What we are seeing is a globally competitive environment,” she said. “There is a global shortage. Let’s get in front of things.”

“We believe that it (the shortage of nurses) is somewhere between three and four thousand,” says Kerri Nuku, Kaiwhakahaerae  at Tōputanga Tapuhi Kaitiaki o Aotearoa (NZNO). “Every day we are hearing of nurses leaving to go to Australia because there’s better working conditions. Six months ago we were at a 3500 nurse deficit, so we’d only assume that that number has increased slightly.”

National’s Spokesperson for Health Dr. Shane Reti believes “the damage has already been done.”

“Other countries have taken nurses who might have looked at NZ,” he says.

“Now were competing with Australia, now we are competing with Canada. We are not a welcoming environment,” says Dr. Reti. “This is too little too late.”

Increased interest

“The interest has peaked” since the changes, says Licensed Immigration Advisor Mary Joseph. New Zealand has been attractive for nurses because of the relatively easier processes to gain registration as a nurse when compared to the other OECD nations and subsequently gain residence, she says.

The country is in demand, according to the Prime Minister. “Since March, over 4500 IQNs have applied for registration with the Nursing Council.”

“Quarter on quarter, the number of Internationally Qualified Nurses seeking registration has continued to grow,” said Minister Wood. “So it’s not just that it’s a large number overall, we have been seeing an increase through the year.”

“The numbers speak for themselves,” said the PM with a “record number of nurses applying to come to New Zealand.”

But the deficit isn’t going away overnight. “It is a long drawn process for overseas nurses to gain registration with the Nursing Council of New Zealand,” says Joseph. This can take a minimum of 8 months."

And not all of the 4500 nurses are waiting offshore for an opportunity to come in to Aotearoa. This number also includes IQNs that are already here, working in other areas while waiting to get on the register. Lenny Tubilleja is one of them. With over a decade of nursing experience in the Phillippines, she has been working as a Health Care Assistant for three years. She applied for her registration in October this year. “It takes while for them to process,” she says.

The wait isn’t only for the registration process. “The unpredictable & unreliable visa processing timeliness add to further delays,” says Mary Joseph.

Increased pay

Changes to Immigration’s Green List was not the only news for nurses last week. An interim order from the Employer Relations Authority last week to go through with a pay rise for Te Whatu Ora nurses will mean about 30,000 nurses working with the organisation will see their pay increase by over 14%. The pay rise had been agreed to last year but was put on hold since the issue of back pay currently sits in the Employment Court.

Kerri Nuku says it’s a step in the right direction but also points out that it doesn’t, unfortunately, cover all nurses. “It’s specific to those within Te Whatu Ora,” she says, and those in the community and in hospices “are still looking for pay parity.”

More is required to grow and sustain the workforce, she says.

“Pay has always been part of the picture,” says Nuku “But actually, it’s the health and safety aspect we are still concerned about.” And that includes things like nurse-patient ratio, the quality of care providers are able to provide etc.

Something Prisma S* wholly agrees to. She left Aotearoa in October and is starting a new role in a private hospital in Australia in January.

“If the pay rise had come a few months ago, I would have thought of it (staying back),” she says. But it was the working conditions more than the pay that made her decide to leave. “It was a war zone,” she says, remembering her shifts at the Emergency Department where she worked as a senior nurse. The nurse to patient ratio was low, there was no flow (of patients through the Emergency room) and taking a break was tough because that meant the few colleagues in the same shift would have to take over her patients while also watching over the ones they were already attending to.

Even with the recent pay rise, she’ll be much better off in Australia, she says. She started seeing recruitment ads targeting nurses from New Zealand earlier this year, with many employers throwing in a relocation package along with a higher salary. And while “New Zealand was home, having lived there for 12 years, going to another shift knowing we would be short-staffed and overworked made it very difficult not to be tempted.”

A domestic workforce

But attracting international nurses "is not the silver bullet that we have been waiting for,” says Nuku. "What we have got to ensure is that there is a long-term strategy to sustain and build workforce domestically as well as leaning into some Internationally Qualified Nurses.”

And New Zealand is working on both fronts, say Ailsa Claire, Interim Workforce Lead at Te Whatu Taskforce and Anna-Marie Ruhe, Interim Workforce Commissioning Lead at Te Aka Whai Ora in a joint statement.

“There is a global shortage of health workers and New Zealand is recruiting in a very competitive market. The ability to fast track residency for nurses is very welcome.”

It’s about making the message a lot simpler, says the Prime Minister. “Our message to nurses everywhere- we are the best place to live work and play.”

And whether not this messaging works, the months to come will tell.

* not the interviewee's real name