Over two-thirds of student nurses considering leaving Ireland, survey finds

More than two-thirds of fourth-year nursing and midwifery students are considering leaving Ireland to pursue their careers. This was the main finding of the Irish Nurses and Midwives Organisation (INMO) 2018 Nursing and Midwifery Internship Survey.

The purpose of the survey, which was carried out between February 21st and March 7th last, was to gather statistics and identify trends among the 2018 nursing and midwifery internship students with a focus on their future plans for working in the Irish public health sector. The interns are due to qualify in 2018.

Some 71 per cent of the students said they were considering leaving Ireland while 79 per cent of them said increased pay and improved staffing levels and working conditions would be incentives to remain here.

Access to funded postgraduate education was cited as another incentive that might entice nursing graduates to stay here. On the other hand, more than three-quarters (76 per cent) of respondents say staffing levels are not adequate to support learning and training of student nurses in the clinical setting.

In addition, 60 per cent of the interns said they were considering leaving the public health service to work in the private sector. Fifty-seven per cent of the interns have already been approached by overseas nursing companies while just 18 per cent of them have been offered permanent contracts by the HSE.

Decline in numbers

Recruitment and retention of nursing and midwifery graduates in Ireland is already a serious concern, according to the INMO. The survey highlights the decline in nursing numbers since December 2007 when there were 39,006 nursing and midwifery whole-time equivalents (WTE) employed in the public health system. In December 2017 this had fallen to 36,777, a loss of 2,229 nurses and midwives.

Without real competitive rates of pay the offer of permanent contracts in overcrowded understaffed workplaces is not going to keep nurses and midwives in Ireland, the INMO claims.

According to INMO student and new graduate officer Neal Donohue: “The offer of a permanent contract for an extremely low paid job with poor working conditions is simply not attractive for nursing and midwifery interns. The shortage of skilled and experienced nurses and midwives to support the education of students will also mean there will be further deficits going forward.”

Some of the comments from the students published with the survey underline these points. “The staffing levels and the rate of pay are the biggest obstacles to wanting to work in a HSE hospital . . . I would love to stay and work, but the incentives aren’t there and the responsibility of looking after 14 patients by myself as a fourth-year student is too great. What will it be like when I’m a nurse?” said one.

Angry about pay levels

One intern was very angry about pay levels. “Student nurses are overloaded with work and not supported due to very poor staffing levels. It’s a disgrace. After spending four years in college to become a nurse and get treated like a piece of rubbish and paid so bad for the work we do. This State is a disgrace. There have been weeks I had no money or no diesel to get to my placement.”

Poor working conditions were highlighted by another: “The high workload with insufficient staffing levels to safely and thoroughly carry out duties is what puts me off most as well as not enough rest time between 13-hour days. No increase in pay or promise of job security can make up for that for me. We need rolling rosters with predictable patterns to allow for knowing our days off in advance and regulations that protect us from doing our 39-hour weeks back to back with no break in between. Quality of life and high pressure are the biggest problems in this work environment.”

“The results from this survey are stark and reinforce the point that recruitment and retention is now very urgent,” INMO general secretary Phil Ní Sheaghdha adds. “If we are to develop the services to implement the bed capacity report, the maternity strategy and the recent framework for staffing and skill mix which is to be rolled out nationwide, the Public Service Pay Commission needs to deliver for nurses and midwives. The Government has agreed that there is a deficit in nursing and midwifery and they now need to retain the experienced nurses and midwives we have here and recruit our new graduates who are considering leaving the country. To improve the conditions and staffing levels low pay throughout the nursing career has to be addressed.

Five-point strategy

The INMO has put forward a five-point strategy to address the recruitment and retention issue: pay competitive rates for nurses and midwives; recruit all graduates that have passed the final exams and assignments and have appropriate levels of competency; offer permanent contracts as an incentive to remain within the public health services with opportunities for a career break after one year; provide a structured professional development plan for each new graduate including opportunities for funded post-graduate education; and ensure adequate support and supervision from appropriately qualified and experienced mentors in the workplace.