ICU & NICU Roster Review
As part of the settlement of the 2024 NZRDA & Te Whatu Ora Collective Agreement, the parties agreed to review RMO ICU and NICU rosters, with a view to make improvements.
Current RMO concerns about ICU & NICU Rosters
Information collected in 2024 by NZRDA from RMOs in ICUs and NICUs suggests:
- 1 in 3 RMOs have experienced adverse fatigue consequences on their current roster including; motor vehicle accidents, prescribing, charting or dosage errors, or burnout & exhaustion.
- 1 in 5 RMOs describe their roster as ‘very fatiguing’.
- 1 in 4 RMOs find their workload as manageable and sustainable only ‘some of the time’.
- Variable satisfaction with unit rostering across New Zealand, and some rosters operating under previous collective agreement rules or non-compliant with the NZRDA CA.
- Concerns about rosters having little continuity, heavy night, or weekend frequencies, mix of shift and non-shift elements, shift length, lack of days off, number of consecutive 12 hr shifts.
- Clinical workload and rosters are not structured to be conducive to the training and education of trainees.
- More should be done to ensure the needs of both rotational ICU and NICU doctors and ICU and NICU specialty trainees are being met within the department and through the roster.
- Lack of teaching and training issues including; dedicated study days, access to teaching, airway training, exam specific teaching, teaching being cancelled, lack of SMO teaching on rounds, and availability of simulations.
- Lack of a proactive approach in some units to the emotional or psychological impacts of the work, including through mentors, debriefing and EAP.
- Lack of a coordinated approach to ICU & NICU RMO workforce planning.
In 2025, NZRDA will be meeting with RMOs and ICU and NICU leadership to implement a plan to impact improvements in the:
- Current RMO roster, & RMO workload.
- Teaching/training opportunities.
- RMO welfare provisions and support.
