‘I feel like I’m just drowning’: Nurses say Nelson Hospital workload forces them to ration care

Saturday, 18 July 2026

More than a year after senior clinicians described Nelson Hospital as “dangerous at times”, nurses say chronic staffing shortages are only increasing, despite a series of changes aimed at improving care.

In a letter obtained by the Nelson Mail, nearly 200 nurses, healthcare assistants and midwives across Nelson and Wairau hospitals and the districts say their workloads only continue to grow.

Frontline staff say they have been largely excluded from decisions about the hospital’s future, while one nurse has described the feeling of “drowning” under her workload, and being forced into “care rationing” every day.

The concerns were outlined by New Zealand Nurses Organisation (NZNO) delegates in a letter recently sent to Health New Zealand Te Whatu Ora Nelson Marlborough’s chief nurse.

The letter followed Health NZ asking union members in early June for feedback on reporting line changes introduced in January.

The latest consultation follows a major independent review commissioned in 2025 after senior doctors and nurses publicly warned chronic staffing shortages had left Nelson Hospital at “rock bottom”, contributing to waiting lists of more than 37,000 patients.

That review found the traditional model of care had led to underinvestment in junior staff, excessive pressure on senior doctors and delays to acute and planned care because workforce numbers and infrastructure had failed to keep pace with demand.

It also recommended stronger clinical leadership and greater involvement of clinicians in decision-making.

In April, the $10.6 million emergency department expansion was completed, with Health Minister Simeon Brown saying then 28 permanent full-time roles had been filled, including senior doctors, nurses, allied health professionals, and support staff.

However, NZNO delegates said that for the majority of respondents, their workload had only grown since January.

The letter said the increase in medical staff had resulted in a surge in workload for many members, with no additional resources to accommodate this. A significant number of responders raised concerns that there were now additional resources going towards middle management and not towards more hands on the front line.

“Members cannot see how this will help with the lack of staffing, burnout and stress they are feeling,” they wrote of the reporting line changes.

While emergency department staff had reported positive changes following the opening of the new ED, respondents elsewhere said they had seen little or no improvement.

Nurses hoped last year’s review would have provided an opportunity to address concerns they had been raising for years. Instead, frontline nurses had “largely been excluded” from the committee and working groups established to implement its recommendations.

The delegates said the latest request for feedback was a “token gesture”, saying it did not seek meaningful input from members.

“It is concerning to us that going to the media continues to be the only way positive change can be initiated,” they wrote.

“Furthermore it is of concern to us that the issues being raised by our members are either not reaching you, or are being disregarded.”

One nurse, who asked not to be named, said staffing pressures had reached the point where nurses were forced to ration care every day.

“Definitely my workload feels like it's increased. Sometimes I feel like I’m just drowning,” she said.

Nurses in her specialist department routinely started early and finished late because there was simply too much work to complete in one shift.

“We do a lot of care rationing, which means that it's almost like triaging,” the nurse said. “So there is a lot of patients who, sadly, I don't contact because, or I haven't had time to spend with them, because I've had to triage and put out and deal with what is the most important pressing thing, or the safe thing.

“It’s a constant juggle of what is the most important care to be giving, which means someone else's care is rationed.”

The nurse said it was infuriating they had been raising concerns about safe staffing for years, including during industrial action in 2014, but meaningful change only seemed to follow after senior doctors spoke publicly.

She wanted Health NZ to genuinely involve frontline nurses in decisions affecting patient care.

“It's like shouting into the abyss and no one's listening. Anyone out there?”

Health NZ was approached for comment but did not respond before publication.