Auckland nurses and midwives are being offered a $500 bonus for every night shift they work to help hospitals combat severe staffing shortages amid Omicron.
One nurse told the Herald there was concern among staff that the extra shifts they were picking up was leaving them exhausted and potentially jeopardising patient care.
A record 24 Covid-related deaths were reported yesterday - 16 of which were historical - with 971 people fighting the virus in hospital, including 21 in intensive care.
With hundreds of hospital staff off sick, executive leadership teams had been forced to work in emergency departments, making beds, answering call-bells and clearing empty linen ships.
A Waitematā District Health Board document, seen by the Herald, showed a Covid-19 remuneration arrangement became effective on March 4 and remained in place until March 18.
All nurses, midwives and other hospital support staff employed by Auckland, Waitematā or Counties Manukau DHB, who worked a full eight-hour night shift had been given an extra $500 allowance on top of the amount they would usually get under the multi-employer collective agreement.
If they worked overtime - which equated to more than an eight-hour shift or 80 hours a fortnight - staff received an additional $250, the Waitematā DHB document showed.
Ordinarily, a nurse would earn between $220 to $320 a shift, depending on length of service and skills. A charge nurse or a specialist nurse could earn $320 to $520 a shift. They all receive an additional 25 per cent after 6pm and 50 per cent more for weekends.
Nurses Society of New Zealand director David Wills said the added $500 was a significant bonus which showed how desperate they were for staff. He said he couldn't recall that amount being offered before.
He understood doctors had also been offered additional payments for working night shifts and overtime during this period.
Earlier this month, a strike that would have seen 10,000 healthcare workers walk off the job was called off after the Employment Court granted a last-minute injunction.
While Wills said the extra payments had been generally well received, one nurse who didn't want to be identified said there had been some frustration over the lack of fairness.
"It was not equitable to all as it was just night shift and overtime day shifts that qualified. People are falling over each other to pick up extra shifts now. We all work hard, we are all exhausted, but only some get the payment," the nurse who worked at Waitematā DHB said.
She said that initially Auckland DHB started making payments but then Waitematā and Counties Manukau were forced to follow suit out of fear staff would jump ship.
"We are so short staffed in every department that management are working on the floor. All departments are struggling," the nurse from Waitematā DHB said.
In her ward, she said seven to 10 staff were sick with Covid every day.
"We are doing extra lists every weekend at North Shore to try and keep up, while other DHBs have stopped or heavily reduced lists, it seems we are doing more."
Yesterday, the Ministry of Health also announced that critical workers could return to work six days after testing positive for Covid if they have two negative rapid antigen test. Alternatively, infected staff could work on the ward where all other patients already had the virus, the ministry said.
However, two unions representing healthcare workers hit back, saying it was another desperate attempt to address the nursing crisis.
"The DHBs must recognise their obligations to protect staff and the community and should be looking for extra ways to support and recognise nurses who agree to take on this additional burden," Nurses Organisation kaiwhakahaere Kerri Nuku told RNZ.
Midwives' union Meras co-leader Jill Ovens said they supported the bonuses as it had been very difficult to get midwives to do nights and was proving to be a real problem during Covid.
Last year they tried to claim additional rates for night shifts, especially for those working weekends, but DHBs rejected this, Ovens said.
In a press conference on Friday, Northern Region Health Coordination Centre clinical lead Dr Andrew Old described the "incredible lengths staff at hospitals across Auckland were taking to allow clinicians to deliver the "highest possible care".
The entire legal team at Waitematā District Health had been redeployed to support security guards, and the chief financial officer has been seen working the wards, delivering patient meals, Old said.
At Auckland City Hospital, anaesthetists have been taking blood, and the executive leadership team has been working in the emergency department, making beds, answering call-bells and clearing empty linen skips.
And at Counties Manukau District Health Board, which had seen the country's highest number of Covid-19 cases, elective surgical staff had been redeployed from satellite services into acute services, public health nurses had been shuffled into hospital roles and on-call staff had picked up shifts outside normal hours to fill roster gaps, Old said.
While the majority of people battling Covid-19 in hospital were in Auckland, with Middlemore seeing the most patients with the virus (243), other parts of the country were also starting to feel the impact.
Porirua's Kenepuru Community Hospital had temporarily closed to all visitors after a number of patients tested positive for Covid-19.
Hutt Valley DHB and Capital & Coast DHB chief medical officer John Tait told the Herald the Covid-19 positive people had been transferred to Wellington Hospital but Kenepuru would be closed for three days as a precaution.
"Whanau members or loved ones nominated by patients as kaitiaki are able to visit on a case by case basis with prior arrangement with ward staff," Tait said.