'Never felt so unsafe': Starship staff describe cancer ward 'crisis', drug errors, stress

Stretched medical teams at Starship Children’s Hospital say they are working under “intolerable stress” trying to save the lives of children fighting cancer. 

Yesterday, the Herald revealed vital treatments are being delayed up to a week due to staff shortages on ward 27B – the haematology/oncology ward where Kiwi “cancer kids” receive care. 

Health Minister Simeon Brown says no treatments have been suspended and there is no hiring freeze at Health New Zealand. 

Frontline staff have a different view. 

Three workers who spend their days alongside some of the sickest New Zealand kids have spoken out about the pressures they face. 

These are their words: 

From a Starship worker 

The reason we are seeing these problems is because of a hiring freeze that has been in place for more than two years. 

There has also been a policy of only employing junior nurses. 

These are some of the sickest children in the country. Children with cancer diagnoses who are often critically unwell. The chemotherapy treatment regimes are complicated and the children are medically unstable. 

Yet we’re recruiting junior staff to look after them. 

A lot of the senior nurses left because of burnout. Medication errors have increased. You could be given a dangerous dose. 

Those chemo delays are things you can count. But there’s also the intolerable stress on the depleted child cancer team. 

From two NZNO nurses 

Nurse A: Management keeps saying there’s no hiring freeze, and while we have had some new nurses start, a lot of them are either newly qualified or have come from completely different clinical areas. The problem isn’t just the number of nurses we have, it’s the level of experience on the floor. 

Nurse B: We’re really short of experienced nurses, especially those who are qualified to give chemotherapy. Some of the newer nurses have been told they won’t be able to do their chemotherapy training until next year. They’ve put on extra training days, but it feels like people are being rushed through before they’ve had the chance to build up their skills and confidence. 

Nurse A: When I first started working in this area, you had to have a lot of experience before you could work with transplant patients. Even after years of working in the specialty, there was a period where you weren’t expected to work independently with those patients. Now we’re seeing nurses with only months of experience looking after incredibly vulnerable transplant patients. 

These are really complex patients. When they become unwell, they can deteriorate very quickly. They often need multiple medications, antibiotics and other interventions. You need to know what you’re doing, and you need experienced people around you. 

Impact on patient care 

Nurse B: Chemotherapy is absolutely being delayed because we don’t have enough nurses qualified to administer it, particularly on night shifts. Sometimes treatment gets pushed to the next day, or even a couple of days later, depending on who’s available. 

Nurse A: It’s the skill mix that’s the biggest issue. You might have enough nurses on paper, but that doesn’t mean you have enough people with the right experience to safely care for these patients. 

Nurse B: We’re also not getting our breaks. We’re constantly trying to keep up, and there isn’t enough time to give patients the care and attention they need. 

Nurse A: I’ve never seen it this bad. I’ve never felt so unsafe at work, and I’ve never cried so much. It’s honestly broken me. I feel terrible because I can’t support the newer nurses in the way I want to. I can see that they need help, but I’ve got so much going on with my own patients that I just don’t have the time. 

Starship Children's Hospital in Auckland. 

Nurse B: We had a really traumatic emergency situation recently, and it was horrific. But afterwards, nobody from management even checked in to see if we were okay. We were just expected to carry on. There’s so much happening, and it feels like there’s no time or support for any of us to process it. 

Nurse A: I love my job. I really do. One of the things I’ve always loved about working here is that we have long-term patients. We get to know them and their families, and we get to be there with them throughout their journey. You build these relationships, and you become part of what they’re going through. 

But we can’t do that anymore. 

We’re so stretched that we barely have time to do what absolutely needs to be done, let alone spend time with patients and their families. And that’s such an important part of what we do. 

It’s heartbreaking because we know what good care looks like. We know what these patients need, and we want to be able to give them that. But right now, we’re just trying to get through each shift. 

Nurse B: It’s not that we don’t care. We care so much, and I think that’s why it’s affecting us so badly. We’re going home knowing we haven’t been able to give our patients the care they deserve, and that’s an awful feeling. 

Health Minister, Health NZ respond 

Health Minister Simeon Brown says no cancer treatments have been suspended, but "a handful" have been delayed by up to seven days. 

Brown confirmed yesterday that “a handful” of chemotherapy sessions had faced “some minor delays”, which he described as “challenging”. 

Health New Zealand confirmed 20 cycles of chemotherapy were delayed over the last four months by up to a week and two bone marrow transplants were delayed by “a short amount of time”. 

Pressed by media, Brown said: “Any delay is unacceptable for any patient. But I’m the first to acknowledge that our health system has significant pressures and there is always more work do to to make sure patients are getting the care and treatment they need.” 

He said Starship was managing demand and winter pressures as usual, and clinical teams were involved in the decisions. 

Starship nursing vacancies were “natural attrition”. The staffing situation had improved since August and all vacancies were expected to be filled by December-January. 

Brown claimed there was no hiring freeze at Health NZ. 

Dr Mike Shepherd, Health New Zealand’s Auckland group director of operations, said patient safety and high-quality care were always the highest priority. 

“Starship has not suspended any cancer treatments and no children have missed out on cancer care. 

“Treatment schedules are routinely adjusted to match capacity and this has been done more frequently during recent staffing challenges. This is prioritised in a way which ensures the highest risk patients have little to no delay in treatment.” 

Shepherd said finding the right trained and experienced staff took time for a specialist area. 

Workload challenges in the oncology ward had been exacerbated by winter, with staff sickness and high demand. 

Staffing levels had improved in recent months and all vacancies had now been filled or recruited for, he said. 

Lane Nichols is Auckland Desk Editor and a senior journalist for the New Zealand Herald with more than 20 years’ experience in the industry.