A critical threshold has been reached: the shortage of these doctors is already there, a specialist has to work for three

Why do nurses emigrate abroad instead of working in Lithuania, to what extent this problem really exists and if it is solved, we spoke with Jolanta Keburiene, president of the Solidarumas Medical Union, and with the Department of Primary Health of the Ministry of Health. Artūras Šimkus, Advisor to the Department of Care and Nursing.

According to J. Keburienė, who works as a nurse in Ukmergė, there is a great shortage of nurses in the regions, because the job offer is lower there and young people prefer to move to the big cities or emigrate.

According to her, a state control study was recently conducted that looked at how many nurses are missing for elderly patients in the infirmary. It was estimated that there were 3 times more patients per nurse than there would have been according to the recommendations.

“The recommendations include the maximum number of patients that nurses may need. That is, imagine even 72 percent. there were 3 times as many nurses. And the quality of the patient deteriorates because he receives 3 times less attention and 3 times the nurse receives more workload. These recommendations are tailored to our country, it is certainly not a Scandinavian model where one patient has the entire team, there are both nurses and their assistants. The shortage is really huge, there are also few young nurses, most of them in their 40s and 50s, so they don’t lift as much weight, ”said J. Keburienė.

According to SAM representative Artūras Šimkus, the ministry does not have very precise information on how many nurses are currently missing. However, an estimated 2,000 more nurses would be needed.

Unbearable workload and inadequate pay

But why is there such a shortage of specialists in this field? J. Keburienė says the reasons are complex and certainly none of them. In particular, a bad environment in the workplace and low wages.

“In fact, the environment in the workplace, the unbearable workload and the remuneration for such responsibilities are simply inadequate. Working as a nurse during the day, she receives € 700 full-time. This is very close to the minimum wage. For Therefore, that person still has to do additional work, even if the workload is too high even for one job. This does not motivate and starts a vicious cycle: the work becomes unbearably difficult, the patient cannot give himself even more, then the nurse leaves work and finds a better paying job. Nobody comes in her place, because there is a shortage, and the rest have an even greater burden again, “said J. Keburienė in the program.

The interviewee observes that SAM’s recommendations have not been realized. According to her, it is currently recommended that the medical institution, given the staff shortage, stop accepting new patients and consider closing. In reality, however, this does not work and the medical institution, without reducing the flow of patients, tries to “stretch” with the same number of staff.

Many nurses point to the attitude of employers and colleagues towards this profession as a big problem. Younger teams, according to J. Keburienė, see the nurse as part of the team, and older doctors, unfortunately, often see the nurse as the service personnel.

“And public opinion, made up of journalists, certainly does not contribute to the prestige of the nursing profession. So headlines echoed when the man arrived at the hospital, tied up, and then brought back with bedsores, wounded, and the like. Believe me, no one makes it worse, everyone strives to improve. Afterwards, receiving those headlines and reading them is really very unpleasant and morally painful, in the long run it becomes a burnout syndrome when you no longer want to go to work and change something, ”said the nurse.

J. Keburienė said that there are also cases where the nurse is left alone not only in the entire floor, but also in various buildings of the nursing hospital.

Suggest adding more nursing assistants

The nursing shortage directly affects not only the nurse herself but also the patients. Jurgita Sejonienė, a member of the Seimas who was in the program a few weeks ago, said that the possibility that due to the lack of nurses in Lithuania there is a higher mortality from coronavirus than in the rest of Europe should not be ruled out.

“A doctor is the specialist who diagnoses the disease, prescribes the treatment and examines it. All other responsibilities rest with the nurses. As much as it has time and opportunities, it is both turning and communicating and interpreting. The nurse is the specialist closest to the specialist, ”said J. Keburienė.

According to A. Šimkus, SAM is aware of the problem of the shortage of nurses and the current Government’s program foresees several measures to solve it.

“One of the measures is a competent and adequately paid healthcare professional, and nurses would also be included in this list. To implement this objective, certain actions are planned and the creation of a state formation for the planning and training of specialists is envisaged. There is also a package of working conditions, workload and salary of specialists. At present, a steady increase in wages is taking place, a decision is being taken to modify the tripartite employment contract, and negotiations are under way with the Ministry and the unions. A plan of legal, financial and communication measures will be developed to attract new staff. These measures are established during the mandate of the Government.

We are also thinking of using more nursing assistants, they should be much more involved in clinical work, there should be a nurse’s right hand. They could take away the routine work of the nurse. We encourage institutions to have more nursing assistants. Now we have a situation where 3 nurses have a nursing assistant based on how many of them are in practice. […] At the moment, we are talking with medical institutions, in another format we are a bit, but we constantly ask for the inclusion of many more nursing assistants ”, A. Šimkus spoke at the fair, adding that people who study obstetrics and nursing could also become nursing assistants.

You are already preparing to go to Norway or Sweden while you study.

At the time, J. Keburienė replied that he did not see much goodwill when he participated in the meetings with the Government, and he also spoke very attentively about the salary increase.

“With the prospect of raising them, it will certainly not disappoint the nurses to stay or get a job in Lithuania. Agreements have been signed with the unions and are not being implemented yet, or instead of the recommended 5%. Salary increases in some institutions give as a result a reduction in wages due to the elimination of bonuses.

Whatever promises we receive from the Government, we treat them with great care, because those made by previous governments must also be kept. If we are not even able to control how institutions meet those obligations now, why should we believe in future plans? A young man who comes to such a hive, where more and more responsibilities and jobs are loaded, looks at him very quickly and shakes his head that he is not here for him, ”said J. Keburienė.

According to her, it is easier for young nurses to go abroad and work there than to expect a better salary here.

“It is no secret that there are universities where Scandinavian is taught in parallel. The nurse is studying and learning Swedish or Norwegian. They are already preparing to leave. Either salaries should double this year or we will have to replace nurses with nursing assistants. Or retrain existing migrants, refugees. I don’t see any other way out, “said J. Keburienė sternly.