The Slovak Chamber of Nurses and Midwives points to a significant difference in the remuneration of nurses in Slovakia and the Czech Republic. The salaries of nurses in our western neighbors, who are already at a higher level today, are to be increased by 6% from 1/1/2022, in our case by 3.75%, which is an increase from €36 to €45 gross. However, the percentage increase does not tell us how wages are set in the Czech Republic, which is the target "destination" of many of our quality nurses and midwives.
A Czech nurse who works for an institutional health care provider will find on her pay slip from 1/1/2022 a salary from €1,135 (exchange rate from 12/31/2021) to €1,678, and we are talking about a nurse with a so-called "basic education", i.e. with professional competence to perform the work activities of a nurse (without higher education, such as a specialization or a second-level university education). Her salary increases at regular intervals according to years of professional experience. Slovak nurse starts after graduation from 1 January 2022 with a salary of €1,008. Unlike the Czech one, her salary does not increase based on years of experience. That is, a nurse who has just finished her studies has the same salary as a nurse with 30 or more years of experience. A nurse with a specialization is remunerated in a different way, as her workload is higher and she performs specialized activities. In the Czech Republic, she starts with a salary of €1,228.46, after 32 years of experience, her salary is up to €1,810, and we are always talking about the basic salary component, without additional payments (night services, services during weekends, holidays, or other non-claimable salary component). The Slovak sister is significantly poorer. A specialist nurse here earns a salary of €1,228, and it doesn't matter if she has experience in a specialized field for a month, a year, or 40 years. The salary is always the same. Our nurses in social service facilities, which are not health care providers, are significantly worse off. In these facilities, nurses are reassigned to the position of caregivers, despite the fact that their work activity has not changed and they also perform nursing services. It is the same in many outpatient clinics. Would it be acceptable to society if we reassigned the doctor to the position of paramedic? Certainly not!
In Slovakia, however, we have one more category of nurse and midwife. She is a nurse and midwife with advanced experience, so in the international sense she is a TOP expert with the highest education. Translated into human speech, this is a specialist nurse with a master's degree with years of professional and specialized experience (more than 3,000 nurses and midwives in our country). In our country, she earns a salary of €1,246. So, a Czech nurse without a higher education will overtake our "TOP" nurse after 6 years of experience. Unfortunately, even today, many of our nurses are not included in the category of nurses with advanced practice, despite the fact that they meet the basic conditions mentioned in the current legislation, even in many state hospitals. For many years, we have been wasting the unused potential of these nurses, who, according to research carried out abroad, as well as in our country, point to the fact that these nurses are ready to take on advanced tasks and in many activities to represent e.g. first contact doctors (care for chronically ill patients, education, prescription of drugs and medical devices, etc.) (Begley, 2010, Casey, 2019, Halász, 2017, Kalabová, 2020). The problem of our healthcare system is the insufficient implementation of research and current scientific discoveries into nursing practice in the Slovak healthcare system, which may have an impact on the safety, quality of nursing care and services provided. According to current research (Kalabová, 2020), the nurses themselves expressed dissatisfaction with the role of the nurse with advanced practice, its implementation and application in the Slovak healthcare system with an alarming rate of almost 90%. Nurses most often mentioned non-recognition of the role, misunderstanding of the legislation by nurses, lack of staff and the related transfer of competences of nurses with advanced practice by substituting work, e.g. sanitation, low financial evaluation. Nurses with advanced practice pointed to the fact that it is necessary to understand the change and want to implement it in practice. Although our system produces high-quality and educated nurses, it cannot really use them for the benefit of the system and the patient.
More detailed comparisons are presented in the graphs.
Slovakia is facing a nursing workforce crisis. Our system fully supports burnout among nurses and midwives. Although we have educated nurses, we force them to perform the activities of cleaners, orderlies, assistants and often doctors. We constantly see efforts to degrade their education and replace them with so-called practical nurses - assistants, even at the cost of reducing the quality of care and patient safety. This is how we publicly degrade and insult them. They have no prospect of a salary increase based on years of experience (a quality health worker has an education, but also clinical experience, so their evaluation should be motivating). Our system, the approach of our managers and politicians, is driving nurses and midwives away, we are not motivating them to stay, but to leave.
In 2021, we lost 965 nurses and midwives, which is more than in 2020 (the beginning of the pandemic). 437 graduates entered the system. With a total shortage of fourteen thousand nurses, we continue the unflattering trend. It is very important to realize the direct correlation between the number of nurses in practice and their education and the number of preventable deaths. So how many people died needlessly in Slovakia due to the insufficient number of nurses? No one else, only the state - the government, is responsible for people's lives and also for stopping the departure of our experienced nurses, e.g. also to the Czech Republic.
Source: Slovak Chamber of Nurses and Midwives Slovak Chamber of Nurses and Midwives (SK SaPA) is a self-governing state organization with nationwide scope, headquartered in Bratislava, bringing together 38,000 nurses and midwives. The main task of SK SaPA is to defend the professional, economic and social interests of the members of the chamber in medical, social, school and other facilities.