Infant mortality rate ‘unlikely to improve’

Press, 25 September 1987, Page 4

Infant mortality rate ‘unlikely to improve’

By

SARAH SANDS,

, in Wellington

New Zealand’s poor infant mortality rate is unlikely to improve because overworked Plunket nurses say they cannot provide a minimum standard of care.

The New Zealand Nurses’ Association’s annual conference was told yesterday that Plunket nurses in Hamilton were so overworked they were struggling to meet their standards of practice and were “only just making it.”

In a remit to the conference, the Hamilton branch recommended that the Nurses’ Association ask the Minister of Health, Mr Caygill, for more Plunket nurses so that a nurse's caseload did not exceed 150 new babies a year. Ms Carol Jarvis, a Hamilton delegate, said that New Zealand’s infant mortality rate was very poor. In a 1985 review of infant mortality, New Zealand had dropped from seventh place to twentysecond. she said.

In the same year, New Zealand’s 216 full-time equivalent Plunket nurses had an average caseload of 172 babies, 277 toddlers, and 182 preschoolers.

In some cases, nurses actually had a caseload of 240 to 250 babies a year, she said. "It is unrealistic for nurses to continue with these caseloads — taking into consideration the multiple needs of the infant and maternal health sectors of our society, these caseloads are unrealistic.”

The number of "at risk” cases in the community had increased and although the Plunket Society was able to employ 15 extra Plunket nurses in 1986 to cope with priority areas, there was still a heavy responsibility felt by district Plunket nurses supervising at-risk cases, said Ms Jarvis.

“Stress levels for nurses Increase when working with at-risk cases, yet there is no recognition for this — a proportion of these cases involve domestic violence, therefore the nurses are in turn at risk themselves.”

In an associated remit, the Hamilton branch asked that the association request the Plunket Society to increase its staffing level so that relief nurses were available when regular Plunket nurses were away sick or on annual leave.

The remit also urged the society to ask the Minister of Health to increase the Plunket nurse salary funding subsidy to cover the increase in staff.

Ms Jarvis said that at present there was no provision for extra nurses to cover annual leave or sick leave even though the Plunket nurses were classified as an essential service.

"Nursing care ceases during this time except for first visits — Plunket nurses ‘catch up’ on the backlog when they return to work.”

With the existing workload already high, nurses knew they could not afford time off and often went out when they were sick to look after babies,