Wellington, New Zealand – In Lisa*’s 25 years as a health care assistant, the understaffed situation will only get worse.

Her typical day includes changing the patients’ dirty sheets, cleaning their trash, escorting them in and out of the bathroom, helping them exercise, feeding, walking, and washing them.

“You can’t complete patient care because you don’t have enough staff,” Lisa told Al Jazeera. “It means you feel that you have failed people, which is not fair to them or us.”

For years trying to arrange 10-hour work in 8-hour shifts, Lisa is tired of it. She is one of more than 30,000 nurses, midwives and medical assistants working at the New Zealand District Health Board (DHB). The final year of negotiating with the government to improve salaries and working conditions.

“This is a workload that we are not satisfied with and must be changed,” she said. “The number of patients is so high that it is impossible to plan or keep up with demand.”

The last collective agreement-covering nurses, midwives and medical assistants working for DHB-expired on July 31 last year. Twenty DHBs in New Zealand fund and provide medical services in the country.

In June, employment negotiations between the New Zealand Nurses Organization (NZNO) and DHB broke down, and medical staff began to strike.

The union hopes to increase the total wages paid by 17%, as well as nurses to take sick leave when needed, and to consider what they call an unsafe working environment.

Subsequent proposals were made and rejected in July, leading to a vote on strike action on July 29 and August and September. The government subsequently revised the proposal, the union suspended the strike plan, and the nurses are considering the new proposal.

Health Minister Andrew Little said the union’s decision was a positive move.

“[The offer] A team of 120 nurse representatives has been approved for circulation for approval, and has resulted in [union] Withdraw their notice of strike. This is encouraging, but in the end, the decision is in the hands of the nurse members. “

Overwhelmed by work

Jessica* is a registered nurse living in Hawke’s Bay.

She likes nursing-she said she would even do this work “for free”-but every day she was overwhelmed by heavy physical, emotional, and mental work.

“When you start a shift, you have to go all out,” she told Al Jazeera. “You will feel stressed. You often don’t have time to complete tasks. In some cases, this means that medication distribution may be delayed. You will miss the ringing of the call for help. Sometimes you may not be able to go to the bathroom all day while you Only when I got in the car did I realize that I was going to the toilet.

“I know that the budget is tight, but health care is important to a country. Taking care of our employees is important. I don’t understand why health care is not a priority. COVID-19 is especially difficult for us because we actually have to Risking their lives to go to work while everyone else stays at home. Now we are rolling out the vaccine-where to consider?”

Judith*, a midwife and registered nurse in Oakland, has been involved in discussions about nursing staff retention and staffing for 20 years, and she said it was frustrating to see little change.

“It’s sad because I really like my job,” she said. “I like the fact that women work with them when they are happiest in their lives. It is an honor to be able to participate in this process.”

When her daughter told her that she had to cook her own birthday dinner for the third year in a row, Judith’s own calculation came out.

“It’s really shocking,” she said, noting that now she makes sure to avoid being overwhelmed by work.

“I am now very active in defending myself so that I can rest and rest. Getting the vacation I need is not necessarily easy, but it is necessary to keep myself safe.”

Industrial services manager Glenda Alexander said that most of the problems stem from gender discrimination.

“This is a female-led job, like most nursing professions-women should provide care for free. Traditionally, roles such as teaching or nursing have been underestimated because soft skills are not considered’work’,” she said .

Little said the response to the latest salary proposal was “encouraging” but admitted that the nurses themselves have the final say [File: Nick Perry/AP Photo]

In addition to salary negotiations, Alexander has been cooperating with DHB and labor unions to put forward pay fairness requirements to the government in accordance with the Equal Pay for Equal Work Law. The claim is expected to end at the end of this year.

As part of the pay equity claim, NZNO interviewed more than 200 nurses to determine if there are male-dominated equivalent roles in other jobs.

“This is a very interesting exercise,” Alexander said. “For example, compare male-dominated and more paid police jobs. They may have to participate in terrible events and see terrible things, but there is a certain degree of distance, and this happens more frequently than nurses every day. Less has to be dealt with directly.”

If the issue of discrimination is established, compensation will follow.

“We hope to see results in pay equity by the end of the year, but the strike is a means to correct the current problems facing the health industry and the public.”

The government has not disclosed the details of its latest proposal for medical staff, saying that NZNO members have the right to view and evaluate it first. It includes two components-cost of living adjustments and pay equity requirements. Health Minister Little admitted that these two requirements have not made enough progress.

He said: “What I can say is that this is a higher salary for nurses.”

He acknowledged that the government has also promised to conduct ministerial review of agreements on personnel safety and intensive care needs, which are sometimes “incomplete”.

‘Need to strike’

DHB spokesperson Dale Oliff stated that DHB “failed to reach an agreement on salary negotiations and prevent [June] strike. “

Oliff insists that DHB understands the pressures facing health professionals and has resumed formal negotiations to better understand the needs of nurses.

Currently, the annual salary of medical assistants starts at NZD 40,382 (USD 28,071), the annual salary of registered nurses starts at NZD 48,632 (USD 33,819), and the annual salary of registered nurses starts at NZD 54,034, and is fully responsible for patient care (USD 37,575).

Oliv said that narrowing the gap between the lowest-income earners and the highest earners is a key part of the discussion, and pay equity requirements will go back nearly two years.

DHB declined to discuss the details of the fourth offer, but Oliff said it was a major improvement, including a series of benefits and staffing measures.

A spokesperson for the Ministry of Health said that the government has also been working hard to recruit more nurses. The number of people holding annual practising certificates has increased by about 10% since 2017, reaching 61,039 last year. According to current figures, the number of nurses is expected to increase to more than 63,400 this year and to more than 64,600 by 2022.

On the front line, Lisa said that the number of staff cannot adequately meet the needs of patients, especially as New Zealand’s population is aging.

Although nurses and medical staff say that they love their jobs, they are under increasing pressure, working long hours and low wages [Courtesy of NZNO]

“Our population is getting older; they live longer and the needs are greater,” she said.

As she worked hard to do her best for the people she cared about, her work pressure became more and more stressful.

“Sometimes I think,’Gosh, why am I here?’ Then I go home and I absolutely have enough,” she said. “I have a family to take care of, and the workload makes everything else impossible.”

Lisa has always been angry at the management she described as “completely out of touch”, but is optimistic that the negotiations may now be over. The decision to strike is the last resort, but she thinks it has achieved the goal.

“Unfortunately, I think they need to go on strike to listen. They need to come down and see for themselves instead of sitting behind a table and making a decision.”

*Names have been changed to protect the identity of nursing professionals who are talking to Al Jazeera.