Case study: ‘I am savouring not being in the Irish health system’

Sally Casey had been working as a renal nurse specialist for three years at St Vincent’s Hospital in Dublin when the pharmaceutical company sponsoring her post withdrew funding in 2011. “I was offered a staff post in general nursing but I saw this as a regression in my career. It was difficult to adjust after spending 11 years in renal nursing,” she says. “The wards were so short of staff.”

Despite working extra agency shifts on her days off, Casey struggled to pay the mortgage on her house in Naas, which was in negative equity. When she was offered a well-paid position in peritoneal dialysis as a nurse coordinator in Saudi Arabia in 2012, she "jumped at the opportunity".

The culture shock was difficult. “I had to wear an abaya [loose-fitting full-length robe] outside the hospital, and cover my head in shopping malls. Women are forbidden to drive. There are no cinemas or bars. And women and men cannot be together unless they are blood relatives or spouses. Somehow though, it makes the expat society more supportive of each other.”

At the hospital in Riyadh, Ms Casey led a team of five staff nurses with the help of an interpreter, working 44 hours a week. “We worked with modern technology. All documentation was computerised. Medications and take home supplies for patients were dispensed in an efficient manner.

“Patient satisfaction surveys and quality indicators were tools used to access our standards and we benchmarked against the top hospitals in US,” she says.

Most nurses working in the region are on one- or two-year contracts, which meant there was a high turnover.

“Recruitment to the Middle East could be hindered by media exposure of nearby troubles. I was surprised to find staff shortages, but not on any scale like my colleagues were facing back home,” she says.

After three years, she moved to Abu Dhabi to take up a staff nurse position in haemodialysis at the new American-run Cleveland Clinic.

“I am provided with accommodation, transport to and from the hospital, uniforms, free private healthcare and a rewarding (tax-free) salary,” she says.

“The conditions are very centred on staff well-being. There is plenty of opportunity to do further study too, often sponsored by the hospital.

“I don’t think I would find this back home. Staff retention is not a priority in Ireland. Additional courses for nurses are expensive and quite often it is expected that nurses will continue with their professional development in their own time with no funding offered.”

Ms Casey intends to stay in Abu Dhabi for a few more years before moving home.“I am savouring not being in the Irish health system.”