Poland's nurses warn of crisis in profession

Abstract

Low wages and poor working conditions caused hundreds of Poland's nurses to go on strike last month and warn the government of looming staff shortages in the profession. Ed Holt reports. Polish nurses have warned that their profession could soon be “extinct” amid claims that the government is doing nothing to encourage younger people to become nurses. Last month, hundreds of nurses at four hospitals in southern Poland went on strike for weeks after rows with the health ministry over working conditions and low wages—both of which they claim are also putting young people off joining the profession. And nursing union leaders have warned that with the average age of nurses in Poland now at 45 years, the government must act to make sure young people start taking up the profession. “There are no norms, no effective control over funds and no wage increases. Nurses are becoming an extinct profession with the average age of a Polish nurse at around 45 years old. The health ministry creates no incentives for young people to undertake education in this profession”, said Dorota Gardias, head of the All-Poland Trade Union of Nurses and Midwives (OZZPiP). Discontent with wage levels has been running high among nurses for years in Poland. In 2007, nurses went on a nationwide strike and held mass public demonstrations in cities across the country demanding better wages and working conditions. Sporadic industrial action has followed since. The average monthly wage in Poland is €825. But for nurses it varies, depending on qualifications and experience, from just over €350–775, according to the OZZPiP. The nurses who went on strike in southern Poland last month said some with 20 years experience were paid €470 per month and that authorities had reneged on a deal in 2007 to raise their salaries to €740. Nurses also argue that they are forced to work long shifts in under-funded and poorly equipped hospitals which have changed little from communist times. Nursing in Poland has also been under pressure following an exodus of medical staff to western countries since the country joined the European Union (EU) in 2004. Attracted by higher salaries, thousands of nurses have left Poland to work abroad over the past 6 years, according to data from local nursing organisations. Nurses who have left to work abroad say that they can earn up to four times their Polish salary doing the same jobs at hospitals and clinics in countries such as the UK, Ireland, and Italy. This has led to a shortfall in nursing staff back home which nurses have warned is affecting provision of patient care and, they say, will be hard to make up with such little incentive for people to start a career in a profession in which wages are poor and conditions are bad. Longina Kaczmarska, vice president of the OZZPiP, told The Lancet: “The government needs to offer incentives to get people to work as nurses and, above all, they need to raise salaries. The work of a nurse is very difficult, requires a special personality, and knowledge and compassion. The current low wages do not attract the right kind of people to be good nurses.” She added that low wages were also almost certainly stopping men from taking up nursing positions. “To get more men interested in such a job, salaries would have to be raised, definitely. In Poland, men are still regarded as the head of a family, someone who supports the family”, she said. The Polish health ministry refused to answer The Lancet's questions about the current situation in nursing. But it has told local media that decisions on nurses' wages are down to individual hospital directors. But hospital bosses blame local authorities and the health ministry for not providing hospitals with adequate funding. Some nursing groups say that disputes over who is responsible for raising wages is ignoring a serious fundamental problem in nursing which only governments can solve. Paul de Raeve, general secretary of the European Federation of Nurses (EFN), said that all EU Governments must act to head off serious future problems in nursing recruitment. “The nursing workforce is ageing and EFN members' data indicate that in the coming 15 years the nursing workforce [in Europe] will decline on average by 15%.” “Attracting students and workers to study and work in the health and social sector will be a major policy challenge. We need action now.”