Use of Temporary Nurse Mechanisms by New Zealand's District Health Board

Abstract

Nursing shortages is a concern globally, and in this context has emerged a research focus on reasons and costs of turnover and retention. A national study on the costs of nursing turnover in New Zealand public hospitals was conducted between 2005-2006, with 12 month’s data collected per randomly selected unit. Annual turnover rates were found to be high at average 39.16%, with a range between 13.83% and 73.17%. Budgeted nurse staffing per unit in is expected to be sufficient to deliver nursing work for the patient population (occupancy, acuity and complexity) and provide for leave (annual, sick, study, family, bereavement etc). In the context of study it was assumed that temporary cover mechanisms were mainly to cover vacancies and occasional unplanned contingencies such as influenza affecting staff, and higher than normal demands for nursing work. The cost of temporary cover would therefore be a cost of turnover. An unexpected finding of the study was that temporary cover mechanisms were widely used, including when actual staff numbers were equal to or exceeded budget, and no consistent relationship within vacancies was evident. It was concluded that management of nursing resource was driven by cost, no strategic, considerations. Published research on use of temporary cover and the effect of such practices on turnover of nurses provided a perspective to critique the funding.