Madam, - Recent discussion about the shortage of nurses in Ireland does not explain its causes or the implications for future health care. There is a shortage of nurses internationally; even wealthy countries such as Sweden, whose health system is optimally resourced, cannot recruit enough nurses to fill vacancies.
A Swedish colleague who is a paediatric intensive care nurse earns the equivalent of his weekly salary for working one night shift in a children's hospital which is desperate to employ qualified specialists.
Hardly any countries can find enough nurses to staff their health services. Why? In most countries, there is no shortage of nursing students. However, the drop-out rate is high as students come to understand what working as a nurse means - shift work, night duty, and heavy legal responsibility.
If a student graduates and become a registered nurse, hierarchical power structures means little autonomous practice. There are increasingly litigious societal expectations, and pay scales may not adequately reflect the years of education and level of responsibility. Often nurses find other professions with better recognition and fewer problems.
The implications for patient care are manifold. A cycle exists - nurses leave the profession, and those who stay are faced with increasingly heavy workloads. Bringing nurses from developing countries is not the answer. In fact, the International Council of Nurses advised strongly against this as it is unethical to deprive poorer countries of their ever-decreasing nursing workforce.
There is no easy solution. Nursing organisations and health services around the world must meet to come up with international plans to ensure nurses are valued and retained in their workforces. The Irish Government could become a world leader in this, by working in collaboration with the International Council of Nurses to set up meetings of health and nursing ministries, and by starting an examination of nursing policies for Ireland and the world.- Yours, etc.,
Prof LINDA SHIELDS, PhD, FRCNA, Department of Nursing and
Midwifery, University of Limerick, Limerick.