EULALEE THOMPSON
NURSES ARE UNHAPPY ... again. Maybe soon there will be protest action and journalists will be interviewing hospital heads ... again, to find out how patient services are affected. Then the Ministry of Health will make some overtures and then the nurses will resume duties. And what difference will all this make? The core issue will remain, that is, there is a severe shortage of nurses and it's not just a Jamaican problem, it's a global problem.
The sour truth is that nursing has moved a long way from the mystique of Mary Seacole, Victorian England and the Crimean War. It is now a very unattractive profession for youngsters - low pay, long hours and unglamorous working conditions have seen to that.
US SHORTAGE
The nurse shortage in the U.S. has been going on for about 15 years. The ripple effect is the constant poaching on trained personnel in the Caribbean. According to the New England Journal of Medicine (April 2006, Vol. 354 #15), increasing wages alone is unlikely to resolve (U.S.) nursing shortage, but probably exacerbate the global nursing shortage. More important to nurse satisfaction are inadequate staffing, heavy workloads, lack of respect and recognition, and a perceived lack of authority.
The U.S. Department of Health and Human Services study (Projected Supply, Demand and Shortages of Registered Nurses: 2000-2020; July 2002) of the nursing situation in that country unearthed some interesting findings.
FACTORS AFFECTING SUPPLY
Examining the factors on the supply side affecting the current shortage of registered nurses (RN), the study pointed to the declining number of nursing school graduates, the ageing of the RN workforce, declines in relative earnings and the emergence of alternative job opportunities.
Just taking the issue of declines in relative earnings, the study stated that actual earnings for RNs increased steadily between 1983 and 2000 but that real earnings (that after adjusted for inflation) have been relatively flat since 1991. Elementary school teachers have been doing much better than nurses in the U.S. In 1983, the average elementary teacher earned US$4,400 more than the average RN, but by 2000 elementary teachers earn about US$13,600 more than the RN.
The study noted that most of the growth in earnings occurs in the early years of the RN's career but tapers off and flattens in later years. The purchasing power of the American nurse has really not changed in the last nine years or so.
FACTORS AFFECTING DEMAND
Edith Allwood-Anderson, president of the Nurses Association, arrives for a general meeting at the nurses headquarters at 72 Arnold Road on Wednesday, April 19. - RUDOLPH BROWN/CHIEF PHOTOGRAPHER
Examining the factors on the demand side which are affecting the current nurse shortage, the same U.S. study finds that population growth, an ageing population, increased per capita demand for health care and trends in health care financing have all increased the demand for nurses.
Some of these supply/demand factors may be relevant to the Jamaican situation, but we won't know until an agency, such as the Ministry of Health, does a comprehensive study that will steer that health sub-sector in the solution mode. New Health Minister, Horace Dalley, was overheard telling Parliament's Standing Finance Committee last week (when quizzed by Opposition Health Spokesman, Dr. Ken Baugh) that a study on the areas of shortage in nursing should be done soon. A study just now after all these years of shortages. Oh, well.
REDUCED VACATION LEAVE
I did ask Edith Allwood-Anderson, the current president of the Nurses Association of Jamaica, why she thought nursing was such an unattractive profession in Jamaica. She pointed out that because of the nurse shortage, most nurses now can get only 50 per cent of their annual vacation leave (that is, 15 days); that bonding to the government is onerous as when nurses go on a six-month training course they are bonded for five years; nurses can't afford to buy a house as they are paid an average rate of $1,500 to $1,700 per day; and nurses can't afford car loans and are at risk for abuse when they have to travel on public transportation after leaving the late shift.
Mrs. Allwood-Anderson said that there are about 2,000 nurses in the public sector system and that it would begin to cope when there are between 4,000 and 5,000 nurses employed.
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