Push-pull factors of nursing crisis
Published:Tuesday | December 7, 2010 | 12:00 AM
The Editor, Sir:
Migration of nurses is not a new phenomenon to Jamaica and the rest of the Caribbean. Reports indicate that between 2002 and 2006, more than 1,800 nurses left the region to work overseas.
In 2007, according to Dr Hermi Hewitt, the then director of the University of the West Indies School of Nursing stated that the Caribbean was in the midst of a crisis of a shortage of nurses with an average vacancy rate of 42 per cent. The Ministry of Health in Barbados confirmed that between 1999 and 2004, 229 nurses resigned with the majority taking up positions in the USA and the UK. In Trinidad and Tobago, it has been estimated that each year about one-third of the nursing graduates had actually resigned from their duties in the public health sector to take up a position abroad.
Jamaica's Ministry of Health Jamaica has reported that 58 per cent of nursing positions were vacant in 2003. This critical shortage may have a crippling effect on the region's ability to meet its health-care services, especially in the areas of disease prevention and care (Hotcallaloo.com, 2010).
According to Dr Hewitt et al, low pay, poor career prospects, and lack of education opportunities are among the reasons nurses resign. Other reasons for migration include violence and stressful working conditions, inequality in the distribution of professional status and non-recognition of nurses as equal partners in patient care. These are categorised as 'push factors'. Compounding the impetus of the mass exodus of nurses are 'pull factors' that attract nurses to 'greener pastures'. These include better salary and fringe benefit packages, better working conditions, opportunities for training and professional development and recognition of nurses as key stakeholders in the delivery of quality patient care, to name a few.
Jamaicans are now able to get treatment on a more regular basis and at an affordable cost (free). However, while it is good that more persons are accessing health care, the number of nursing staff remains the same to cater to the influx of individuals seeking health care. Jamaica continues to operate on an archaic (30+ year-old) nursing cadre to meet the health-care needs of the growing population as well as providing supervision and expertise to nursing students and medical students alike. In many hospitals across the island, it is common to see one registered nurse being assigned to a ward built to accommodate 24 or fewer patients but has 40-60 patients while expecting admissions, or three nurses caring for 75 critically ill newborns on a neonatal unit. This has resulted in many nurses being infected with the 'burn-out syndrome'. Poor remuneration and increase cost of living also put a strain on nurses' ability to function at a maximum.
They continue to suffer
While nurses patiently await the implementation of the ruling of the industrial tribunal for the Government to set a date for the reclassification of the health sector, they continue to suffer indignation at the hands of other health-care workers who are regarded as the crème de la crème of the health team. This has contributed to the low morale of nurses and an increased inclination to seek a more favourable working environment.
It is evident that the Government of Jamaica has fallen short in any attempts to negate the mass migration of nurses and prevent the impending collapse of an already struggling health sector. They need to pay close attention to the push and pull factors for the migration of nurses, and put strategies in place to revamp the 'managed migration' programme.
I am, etc.,
ANDREA CHRISTIE