NZ’s nursing squeeze is an election issue. Is it time for compulsory patient ratios?

Getty Images Nurses are often described as the glue that holds hospital care together.

They monitor patients for changes, administer medications and coordinate a wide range of services, keeping everything on track.

But what happens when that glue is spread too thin to hold? Nursing numbers are now an election issue and public attention is turning to the impact of understaffing on hospital wards.

With fewer nurses caring for more patients comes the risk of “ missed nursing care ” – essential work being delayed, only partly completed or not done at all.

This can lead to poorer patient care, longer hospital stays, higher readmission rates and a greater risk of harm.

And the problem is widespread.

In a 2022 independent review , 83% of 3,366 frontline nurses said patients did not receive complete care on understaffed shifts.

More than half (53%) also rated their mental health as poor or very poor on understaffed shifts.

Recent research by my University of Auckland colleagues has meanwhile found lower nurse staffing on surgical wards was associated with higher rates of post-operative death and complications.

Modelling in the study estimated correcting the observed staffing shortfall could result in around 182 fewer postoperative deaths each year.

This all raises pressing questions about whether current staffing settings are adequate – or whether New Zealand should consider legislated minimum nurse-to-patient ratios.

How short staffing affects patients To measure how much nursing time patients need on each ward and shift, New Zealand uses a system called Care Capacity Demand Management .

Introduced nationally in 2021 after more than 15 years of work, it assesses patients according to the complexity of their needs and calculates the nursing hours required to look after them.

That is then compared with the staff actually available.