Nurses are the largest professional group within the global healthcare system. Worldwide, a total of 19.3 million people work in the nursing and midwifery professions. The current and growing shortage of registered nurses in healthcare systems is therefore a global problem. The European Commission estimated that more than 590,000 nurses will be missing in EU countries. Most countries in the Organization for Economic Co-operation and Development (OECD) report a shortage of nursing personnel, and this trend is getting worse year after year. The shortage of nurses affects healthcare delivery with a negative impact on patients and worsening job satisfaction among nurses working in the system. At the same time, many nurses are considering leaving the profession. According to a survey conducted by the Slovenská komora sestier a pôrodných asistentiek (SK SaPA), among 442 respondents currently contacted, almost 49% want to opt for retirement, almost 12% want to opt for early retirement, and more than 20% of those questioned want to change profession, i.e. leave healthcare. Only 18% of respondents want to stay and continue working in healthcare.
What about the new nurses and nursing students who should replace the retiring generation, which makes up the majority of all nurses and midwives in Slovakia? The average age of nurses in Slovakia is unfavourable and is 47 years. SKSaPA registers more than 5,290 nurses over the age of 60. These are nurses who can already make use of the option of early retirement. In EU countries, while the average number of nurses is 8.4 per 1,000 inhabitants, in Slovakia it is 5.7 nurses per 1,000 inhabitants. If we wanted to reach the EU average, we would need to have 46,000 nurses here; in reality, we have 31,309 nurses in Slovakia. We are short 14,000 nurses. Within the EU, only Bulgaria (4.4), Lithuania (4.4), and Poland (5.1) are worse.
Health Care Institute o.p.s. conducted from September to December 2020 an international survey, “Nurses’ Barometer,” which included students of secondary, higher, and tertiary schools that train nurses (1,080 respondents in total in Slovakia). Most students still during their studies in Slovakia (76%) plan to continue working at home. What changes after graduation: Most of our graduates migrate to the Czech Republic; for Czech students, it is Germany. Students consider job security and stability as the decisive factor in deciding where they will practice professionally in the future. Inadequate financial compensation is the most important factor that was the reason for rejecting a job offer. Students’ expected salary range in Slovakia is 1,150–1,550 € (i.e., a graduate’s gross wage: without overtime, shifts, or allowances), whereas today the salary of the majority of nurses, including those with 30 or more years of experience, is 971 € gross. 32% of students in Slovakia who plan to leave for abroad after graduation cite, as reasons, especially better wage conditions. Besides financial compensation, students also viewed as negative factors when deciding whether to enter nursing practice after graduation poor interpersonal relationships at workplaces, performing work that does not match their training and field of study, lack of opportunities for career and wage progression, and unsuitable working hours. Of the 412 respondents who said they want to continue working in Slovakia, all want to work in hospitals. Not a single student mentioned outpatient care, home nursing care, or social care facilities.
In 2020, according to data from the Center for Scientific and Technical Information SR, 692 students completed nursing studies within higher education and higher professional education. SKSaPA registered just under 56% of graduates (389). Students’ views and decisions during their studies differ significantly from their decisions after graduation, and the percentage of those who do not enter Slovakia’s healthcare system rises sharply. The youngest generation is the most willing and determined to leave the profession. In most European countries, the intention to leave the profession is strongest in the generation of nurses aged 25 to 35. Several factors are associated with young nurses’ intentions to leave the profession, including an imbalance between effort and reward, high mental strain, and increased workload, all of which influence young nurses’ intention to give up their nursing careers.
The state must support nursing education and invest in universities that train nurses. On the other hand, it must do everything possible to retain nurses here. Every departure of a qualified nurse, regardless of whether it is a newly graduated nurse or an experienced nurse with many years of practice, means that the workforce shortage deepens even further. The healthcare system loses the knowledge and experience of experts who have left, and not least the financial investment in the education itself is permanently lost.
Source: Slovenská komora sestier a pôrodných asistentiek www.ksapa.sk
The Slovenská komora sestier a pôrodných asistentiek (SK SaPA) is a self-governing professional chamber organization with nationwide scope, based in Bratislava, representing 40,000 nurses and midwives. SK SaPA’s main task is to defend the professional, economic, and social interests of chamber members in healthcare, social, educational, and other institutions.