The global nurse shortage

Nursing has become a valued international commodity as countries around the world experience crippling shortages of qualified nurses.

How serious are the shortages, and what are governments doing about them?
The Lamp looks at diverse examples from Australia, Britain and the Philippines to illustrate the global nature of the nursing crisis.

Much talk, little action from Australian governments

Australia’s severe shortage of nurses is likely to get much worse when 40% of the nursing workforce who are 45 or older, retire in the next 10-15 years. So you would expect governments to be taking firm action now to prevent a dangerous scenario unfolding.
But federal and state governments so far have been all talk and little action.

This year Australian universities again turned away thousands of qualified applicants for nursing degrees. For example, in NSW, Charles Sturt University distance education nursing course attracted 500 applicants for 100 places.
Much of the blame lies with the federal government which provided only an additional 400 university nursing places for 2005 in last year’s budget.

The government chose to ignore an expert study by Professor Warren Hogan, which recommended an extra 2,700 nursing places over the next three years, starting with 1,000 places in 2005.

The government’s drive to shift higher education costs to consumers is also to blame.

Universities must raise an increasing proportion of their funds from student fees. But they are not permitted to increase fees for nursing and teaching which are regar-ded as ‘National Priority Student’ places.

This barrier to putting up fees largely explains last year’s decision by the University of Sydney to opt out of undergraduate nurse education and transfer places to other institutions.

Nursing students already enrolled at Sydney University have been permitted to remain until they complete their courses. But as one student, Karoline Morwitzer, told The Lamp: ‘We are feeling disillusioned because we feel the course has been devalued.’

Karoline said it was deplorable that students had to fight to get guarantees from university authorities that essential services such as the nursing faculty library would remain open.

In a series of actions late last year, students occupied administration offices and picketed a meeting of the University Senate. Karoline said posters advertising student meetings were torn down by university authorities who also brought in the police tactical response group to confront a peaceful student picket.

Faced with insufficient graduate nurses, Premier Bob Carr has promised to recruit 300 interstate and overseas nurses this year.
NSW Nurses’ Association General Secretary, Brett Holmes, said the union welcomed every effort by the government to get more nurses. ‘But it’s also important to retain the people we already have in the system and ensure that the working conditions of nurses improve. Then maybe the people who have left nursing will say it is worthwhile coming back,’ Brett said.

There are some 90,000 registered nurses in NSW, but only about 33,000 working in the NSW public health system. There is a mass exodus of nurses, trained and experienced, from our hospitals and that’s the problem the government has to address.

That’s precisely why the NSW Nurses’ Association is campaigning for higher salaries.

A decent pay rise will make nursing a more attractive career, drawing more staff back into the public health system. As staff numbers increase, the workload will ease, giving nurses more encouragement to stay on. Our campaign gives the NSW government a chance to put its money where its mouth is.

In the Territory: Hospitals cut agency nurse pay

Northern Territory hospitals are paying short-term agency nurses two-thirds more than resident nurses in order to lure staff from southern states.

The pay gap is causing ‘huge resentment’, the Territory’s Health Department admits.

The department has now decided to progressively reduce agency nurse pay to the same hourly rate as resident nurses, while it runs a campaign to recruit more resident nurses.

The department’s principal nursing advisor, Greg Rickard, cited the town of Katherine as an example of the pay gap, where resident nurses earn $30 an hour and agency nurses $50.

He said agency nurses recruited on short-term contracts through private agents were sometimes working on $50 an hour, plus free accommodation, return airfares and free STD calls.

In the Philippines: Doctors want to be nurses

The Philippines is exporting more nurses than it is producing, leading to a severe drop in the quality of hospital care and even forcing some hospitals to close.

Almost 90,000 nurses left the Philippines in the last 10 years, according to the National Institute of Health.

So great is the lure of a foreign nursing salary that experienced Filipino doctors are studying nursing with the aim of working abroad.
In the last four years, 3,500 Filipino doctors left the country to take on nursing jobs overseas, the institute reported.

The Philippines supplies an estimated 25% of all overseas nurses worldwide.

More than half are in Saudi Arabia, 14% in the USA and 12% in the UK.

About 10% of the country’s 2,500 hospitals have shut down in the past three years, mainly because of the loss of doctors and nurses to jobs overseas, according to a study by the Philippine Centre for Investigative Journalism.

In 2002, 11,911 nurses chose to work abroad compared to the 4,228 students who graduated as nurses.

In the UK: Registration test follows influx of foreign nurses

The number of overseas nurses registering to work in Britain has risen fourfold in the past five years, prompting UK authorities to announce a more rigorous registration program.

The number of annual overseas registrations in the UK rose from 3,621 in 1998-99 to 14,122 in 2003-2004.

There is ‘widespread concern that many overseas-trained nurses are thrown straight into practice without proper preparation and little or no understanding of the cultural differences and expec-tations of patients,’ according to the Nursing and Midwifery Council which regulates nurses in the UK.

The council announced a new Over-seas Nurses Program, which must be successfully completed before the council will register applicants.

The program, to be introduced from September 2005, includes:

  • Common entry standards regardless of where the nurse was trained.
  • A compulsory 20-day period of ‘protected learning’ for all nurses trained outside the European Economic Area.
  • A period of supervised practice of between three and nine months for applicants assessed as needing more training or education to bring them up to UK standards.
  • A compulsory English-language test before applicants can be admitted to the program.