Newshub can reveal 40 percent of all nurses currently registered in New Zealand are from overseas - the highest rate it's ever been.
But New Zealand Nurses Organisation (NZNO) president Anne Daniels wants to see better support for nursing students in Aotearoa - especially as one in three are dropping out, mainly due to the financial struggle of unpaid placements.
"Finance is the biggest problem for nurses. The dropout rate is about one in three, and that's totally unacceptable," Daniels revealed in the latest episode of Paddy Gower Has Issues.
The high dropout rate means New Zealand is highly reliant on internationally qualified nurses, also known as IQNs, and it has her worried.
"We have a real concern that the reliance on IQNs from overseas is going to continue and is going to reduce the impetus of the government and Te Whatu Ora to do something" she said.
To combat that, Daniels, who's been nursing in NZ for decades, is calling for nursing students to be paid while on placement so that more Kiwis actually graduate.
"It is very much a gender discrimination issue that a female-dominated health workforce is actually discriminated against. It would be only fair to give them a living wage just like all the other apprenticeships are receiving."
Paddy Gower Has Issues latest investigation looks at why we're importing so many nurses when we already have keen students here who struggle to graduate.
'It causes a lot of stress and makes it very difficult'
To become a registered nurse you have to complete at least 1100 hours of clinical placements, which are unpaid. We talked to several Bachelor of Nursing students about the course, and all said the same thing - it is a financial struggle.
"We don't get anything during placement and it's hard. It causes a lot of stress and makes it very difficult", second-year student Amaya Leslie said.
Second-year student Ella Macgillivray agrees. She's juggling a part-time job at Speights Ale House and her 40 hours a week of unpaid placements just to get by.
"It's exhausting. I mean, having a lot of things on your plate you can burn out very quickly. The other day I had my watch on and it told me I was standing for 17 hours," said Macgillivray.
When Daniels studied to be a nurse it was through a nursing school where she lived on-site and her accommodation, meals and uniform were all supplied for free.
"As an undergraduate nurse, I was paid as well because it was recognised that the work I did, even though I was a student, was work. So we were paid and that was the way it should have been," she said.
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However, in the 1970s, nursing education was moved to universities and polytechnics.
"When it moved... housing, accommodation, food uniforms and pay stopped, nurses' homes closed and that was a big mistake I think."
Leslie and Macgillivray agree. They also want to see better financial support for students because when they're working 40 hours a week on placement it's almost impossible to fit a part-time paying job, let alone study for exams.
"It would make all the difference," said Macgillivray.
She said the placements are hands-on work.
"We are working hard. We're not just watching, we are involved and we are looking after these people essentially by ourselves," she said.
"There's a bunch of super keen, motivated nurses out there, but I definitely think that financial support is needed. If you want to keep us in New Zealand and keep us getting through to the finish," added Leslie.
Figures from the nursing union show that 33 percent of nursing students aren't finishing their degrees, a problem that a recent report from Te Whatu Ora recognises, but makes no promises to act on.
The figure is even higher for Māori and Pasifika.
"The number one barrier for many Māori and Pacific students completing placements and graduating as health professionals is financial hardship," the report states.
"This can include having to absorb costs associated with pre-placement requirements, decreased earning capacity during placements, parking, transport and accommodation costs for out-of-town placements."
And many students who might make it to graduation, are considering moving to Australia.
"My goal is to end up in Australia. I've got eight friends who are already planning on moving over there", said Leslie.
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Daniels said if nursing students aren't paid on placements, then she fears the health workforce crisis will deteriorate further.
"The nursing shortages are getting a whole lot worse. I'm very, very concerned for our future. We have to retain and recruit nurses to New Zealand and they have to be New Zealand nurses as opposed to relying on internationally qualified nurses," she said.
International nursing numbers soar
Figures obtained by Newshub show the number of international nurses registered in New Zealand has grown to what's believed to be the highest number ever seen. As of September 30, 2023, 40.7 percent of nurses registered in NZ and holding an 'Annual Practicing Certificate" are from overseas.
This number could rise even higher, as the National Party plans to increase the number of international nurses by establishing a relocation support scheme with grants worth up to $10,000 each to support their move to NZ.
That's money Kiwi students could really use to keep them studying and get them into the workforce.
"We need to increase the number of nurses they are actually supported to learn in New Zealand within the New Zealand culture, and we need a hell of a lot more Māori and Pacific nurses," Daniels said.
Something Te Whatu Ora's Chief People Officer, Andrew Slater, promises he's working on.
"It's about how do we do that with what we've got allocated at the moment and how do we maximize that.
"The challenge for us... is that, we've got a 4000 nurses shortage today ... So we have to bring in an internationally trained, experienced health workforce and grow as much of our own," said Slater.
'Their purpose is not to be part of the workforce'
Although the nurses' union and its 55,000 members want to see paid placements for nurses to encourage them to complete the degree, the Nurses Society is against it.
Its director, David Wills said students should not be treated as employees while on placement.
"Well, they're doing things under supervision and they're important tasks and skills that they're learning. But their purpose is to get experience. Their purpose is not to be part of the workforce," Wills said.
Instead, he would like to see grants for students to help with accommodation costs. He said under the historic nursing school system, when students were paid, the nurses suffered.
"You start paying them and they are de facto employees and there is a risk that the service and operational needs of facilities will begin to dictate where they're placed and how they're placed and the length of those placements," said Wills.
It's a stance that frustrates Anne Daniels.
"We need to focus on the health and wellbeing of our country and we have to be able to deliver that care. And to do that, we need our student nurses. It's pretty simple."
'There is an affordability factor for us'
But Te Whatu Ora said instead of paying students on placement, it's focused on improving the experience.
"We'll continue to make sure we've got as many nurses coming through the education pipeline as possible. There is an affordability factor for us and for the education sector about whether we could afford to do that right across the health education curriculum," said Slater.
But can they really afford to lose any more nursing students?
"The worst-case scenario is that the health and well-being of our nation is going to continue to go down the tubes," said Daniels.
But Slater said his key focus is pulling "every possible lever" to retain and train nurses in New Zealand.
Patrick Gower is the host of Paddy Gower Has Issues on Three and ThreeNow.
