Not enough nurses, too many or an 'artificial glut'?

Hundreds of nurses called on to fill critical workforce shortages are without jobs, with one in four recent graduates unemployed and international nurses warning others to stay away.

More than 7000 people are training to be nurses, with 535 completing their final exams last month, but 160 had not yet found work through the centralised staffing portal.

Student nurse Shannyn Bristowe will graduate in January from her three-year degree and said the nurse shortage was real - but so was the fear among students about whether there would be work for them.

"I think you're going to go through nursing with the understanding that, and because there is the nursing shortage especially, that so long as you pass everything, you pass your state exam, that you'll have a job to go into. And now that isn't certain, and that future of your job prospects is kind of up in the air.

"You know that there's a nursing shortage, but you're not sure if you can even get a job in nursing. So you've got a huge student loan, that's sitting there but are you going to be able to work as a nurse or not? Are you competing with nurses that have a whole lot of experience as well?"

A recent incident in Waikato, where students were mistakenly sent emails offering them jobs, had added to the disquiet.

Bristowe, the co-chairperson of the National Student Unit for the Nurses Organisation (NZNO), said some students were thinking about moving to Australia, though that was not an option for everyone.

NZNO chief executive Paul Goulter said recent figures from the government suggested the country was 1000 nurses short, but he believed it was worse than that.

"It doesn't count the number of nurses [who] have left, and also doesn't address acute shortages in areas like mental health, women's health, children's health and oncology, and also for the shortage of nurses in primary health. And so this shortage has not got any better, and to have budget cuts then come in and affect the employment of nurses more generally, it just doesn't make sense.

"There's a shortage of nurses, and there's definitely a shortage of New Zealand domestic nurses, and to think that the current crop of graduates haven't all been employed is a matter of great worry. What we're worried about, it's not just for the current nurses or the nurses in training right now, it's the perception for people who are thinking about entering into nursing, what the impact on them will be if they know they don't have a job at the end of that quite expensive and elongated training."

There may need to be a pause, or a 'turning down of the tap' of international nurses until there was capacity to support them, he said.

International nurses

Nursing was put on the immigration green list 18 months ago amid the workforce gaps and long waiting lists, and answered the call.

Nursing Council figures show internationally qualified nurses make up 45 percent of the New Zealand nursing workforce, but in the last year accounted for 85 percent of all new registrations. In the last quarter, they made up 98 percent of all new nurses, albeit in a period when neither of the annual two domestic graduations took place.

New Zealand graduate nurses are matched through the ACE portal for jobs, whereas international nurses apply directly to healthcare facilities or agencies.

Registered nurse Khushboo Sabherwal, from India, estimates she has spent about $40,000 to $50,000 to get her CAP [competence assessment programme], nursing registration, visa, flight and living costs since May. She said she applied for 300 jobs, and is now heading to Australia to find work.

"There are 200-plus CAP students, and none of them got a job, not even one," she said. "I have applied for so many jobs, in rest homes, hospitals, villages, even school nurses, in clinics. And I got rejections only."

She had this plea for the government and health authorities: "Please stop taking more candidates if you can't provide jobs".

"I came here with a lot of ambition. Now, nearly five months later, I sit in a room jobless and next month my visa's going to be expired and I am still looking for visa sponsorship - we all left stable jobs and made significant financial sacrifices to pursue nursing positions in New Zealand. If these nurses are accepted and their registrations processed, why are they continually deemed unwanted by employers?"

Other countries, such as the UK and Ireland conducted interviews prior to job offers, followed by tests as part of the registration process, she said. "We urge the governments of New Zealand, as well as their respective nursing and healthcare councils, to review their hiring practices."

Recruitment agencies told her that vacancies existed but the government had frozen recruitment, she said.

'Artificial nursing glut'

The former president of the Filipino Nurses Association, Monina Hernandez, said New Zealand still needed more nurses to reach safe patient ratios, and it was cost-cutting that created an 'artificial nursing glut' making it appear that there were too many.

"The government will have to employ the nurses that are in the country first before, before they reach out to other countries or nurses," she said. "This is essential in keeping New Zealand nurses and in attending to the health needs of Kiwis.

"There is a shortage of nurses if health officials are using the patient safety lens when looking at workforce planning. On the other hand, there would not be any nurse shortage if they are using a different lens when looking at the current health situation, ie, cost-cutting or their political priority. If the nurse patient ratio is followed, New Zealand would need several thousand nurses more."

Hernandez, a nursing lecturer and infection control specialist, said the CAP competency assessment costs $9200 and even if nurses got their licence quickly and found a job in a fortnight, their overall costs averaged almost $24,000 - more than two years' salary as a nurse in the Philippines.

Some fortunate overseas nurses were sponsored, but even that could go wrong, she said. One nurse was told that the job she was offered was no longer available, and had instead been offered a job as a health care assistant.

"She was sponsored by an aged care facility, but that same aged care facility cannot even give her a job. If they ask these nurses to come over and sign a contract they are obliged to provide them with jobs, because these people are uprooted from their families, from their countries, and they're in an uncertain state."

Health Minister Shane Reti said in a written statement that as workforce needs changed, so would New Zealand's international recruitment requirements.

Nursing shortages remained in areas such as mental health, critical care and midwifery.

"Training our own home-grown health workforce - including nurses - remains a priority for Health NZ," said Health NZ head of communications Catherine Delore. "At any given time, there are more than 7000 trainee nurses going through our system.

"While our progress in nursing recruitment over the past year or so has exceeded expectations - with more nurses now employed by our hospitals than ever before - we recognise this success has significantly changed the nursing workforce landscape and resulted in far fewer vacancies than in 2023.

"We understand graduate nurses began training with the reasonable expectation there would be a role at Health NZ when they finished. While this has been the case for the majority of them, with 334 matched to roles at Health NZ and 35 to roles elsewhere, we know those yet to be placed will remain concerned."

It was not unusual for graduate nurses to not be employed immediately following registration, she said, and they would be supported to find roles.

"We are confident placement of graduate nurses will continue over the coming weeks and months, as district and regional leaders consider recruitment within their budget parameters."