Operations are being cancelled because Palmerston North Hospital is short of 20 nurses in acute services.
Some theatre sessions have been scrapped because of the shortages, and this week surgery lists have been trimmed because of a lack of staff to cover post-operative beds.
The vacancies are reminiscent of last winter's "red flag" crisis, when elective surgery was often cancelled because nurses were too busy with sick patients.
Nursing director Sue Wood said that despite the phased arrivals of nurses recruited in Britain last year, more nurses were leaving than coming in.
MidCentral Health had recruited 41 nurses from the UK to ease the crisis.
But there were eight more vacancies than two months ago, as a result of what appeared to be a seasonal peak in resignations at the end of summer.
That leaves MidCentral about 55 nurses short - up from 47 at the end of March - at its Palmerston North Hospital, Clevely, Horowhenua and Kimberley sites.
Ms Wood said it was recognised that affordable childcare, flexible shifts and lighter workloads would encourage non-practising nurses in the area back to work.
Two-thirds of MidCentral Health's nurses were already part-timers.
"But they don't get paid enough to pay for childcare," she said.
Ms Wood has stopped short of supporting a nurses fair-pay campaign, but has said she supports pay equity for women.
The nursing shortages were biting at a time when Palmerston North Hospital was still trying to catch up on its backlog of people waiting for elective surgery, Ms Wood said.
"It's a matter of trying to get the mix right."
At the end of March, 964 patients were waiting for treatment, 252 of whom had been waiting more than six months.
Orthopaedics had done the equivalent of 281 operations fewer than the target number for the year, despite a catch-up in March.
Management was trying to "ring-fence" some surgical beds so elective services could continue through winter, despite the expected increase in medical admissions.
Ms Wood said Palmerston North was also struggling to cope with a steady 5 to 7 per cent growth in demand for acute services, both surgical and medical.
She said it would be years before the extra efforts being put into primary healthcare reduced pressure on acute hospital services.
- NZPA
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