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UHWI struggles after exodus of senior nurses
BY NADINE WILSON Observer staff reporter
Tuesday, January 12, 2010
WITH the resignation of 77 of the hospital's nurses last year, most of whom left for greener pastures overseas, the University Hospital of the West Indies (UHWI) is facing the daunting challenge of finding senior nurses to fill managerial positions at the institution and to mentor younger nurses.
The problem was highlighted by senior director of nursing at the UHWI Beverly Atkinson, who was responding to questions at yesterday's weekly Monday Exchange meeting of editors and reporters at the Observer's Kingston offices.
Beverly Atkinson, senior director of nursing at the University Hospital of the West Indies speaks at the Monday Exchange meeting of reporters and editors at the Observer’s Beechwood Avenue, Kingston offices yesterday. Looking on is Peter Morris, senior director, human resources. (Photo: Lionel Rookwood)
Atkinson said while the hospital has been able to hire 55 recent graduates to fill the vacant positions, there is not much remuneration to encourage more senior and qualified nurses to stay on the island.
"The problem is that the middle level nurses -- and usually those are the more experienced ones, the ones who have done post-basic courses -- they are now the ones who are being invited to go to the United States .... and other Caribbean islands that offer a better package than we do in Jamaica. So we lose our nurses and we lose the persons who are available to mentor the new nurses," said the senior nurse.
Only 45 per cent of the hospital's under 700 nurses are level two nurses, a less than satisfactory figure, since hospitals generally require more level two than basic nurses. These senior nurses are required to work in midwifery, in the accident and emergency unit and in the intensive care unit as well as other critical areas.
To make matters worse, Atkinson said the senior nurses usually leave after being trained at the expense of the institution and without giving sufficient notice.
"We are struggling very much now because you allow people to go through with basic courses, you set up succession planning, with the hope that you are going to get this person, and I don't know of other countries where persons are not open to tell you that they are going to be leaving in two months down the road," she said.
In the case of midwifery, basic nurses are allowed to take a one-year course to upgrade themselves, while a six-month course is required for those in accident and emergency, nephrology and intensive care.
"One of the good things about the university and it may be a bad thing, is that we train a lot of persons in the post-basic courses which allows us to give the care we should be giving as a tertiary centre, but then a lot of our staff, thus having obtained the extra training, are free to go," Atkinson said while pointing out that the students are not bonded.
But even though the migration of the nurses continues to be a major challenge, Atkinson who is earning five times less than the amount she was earning in a similar position in California, said she could understand the reason for some of the nurses leaving.
"For me, to work in Jamaica is for a nurse who has a calling, this is what you want," she stressed.
And Chief Executive Officer of the UHWI, Dr Trevor McCartney, fears that more nurses will be migrating in the coming months, in light of the prime minister's announcement of a two-year freeze in public sector salaries.
"This financial inadequacy when added to an increased shortage of nurses in the United States of America, Canada and the United Kingdom may see even greater migration in the days ahead," he said. "Fortunately with a large number of nurses currently being trained, replacements are available numerically. However, it is a challenge to replace experienced professionals with fresh new graduates."
Atkinson also pointed out that while there are bachelor programmes now being offered for nursing, not many of these programmes focus on the clinical and practical side of the profession, resulting in the hospital having to give these students a six months extended orientation when they are employed.
She said the hospital does not have a problem getting basic nurses as many turn up for positions without them being advertised. However, few stay once they have been trained and upgraded to a senior post.
In an effort to encourage more of them to stay, even with the pull of more money and better working conditions overseas, Atkinson said they have recently implemented a series of programmes at the hospital.
She said the hospital is looking at ways to increase the job satisfaction level for the nurses.
"One thing is to have what they call shared governance," she said. "The nurse from the bedside has an input in what is taking place with the care of the patient, instead of just dictating from the top. That way, we come together as a council that involves everybody and make decisions that involve patient care as a team."
She said they are also looking at fast tracking some of the basic nurses to fill more senior posts.
"Gone are the days when you are several years in a position before you get promoted," she said. "We have to identify persons who have promise and potential and try and fast track those persons in primarily management techniques."
BY NADINE WILSON Observer staff reporter
Tuesday, January 12, 2010
WITH the resignation of 77 of the hospital's nurses last year, most of whom left for greener pastures overseas, the University Hospital of the West Indies (UHWI) is facing the daunting challenge of finding senior nurses to fill managerial positions at the institution and to mentor younger nurses.
The problem was highlighted by senior director of nursing at the UHWI Beverly Atkinson, who was responding to questions at yesterday's weekly Monday Exchange meeting of editors and reporters at the Observer's Kingston offices.
Beverly Atkinson, senior director of nursing at the University Hospital of the West Indies speaks at the Monday Exchange meeting of reporters and editors at the Observer’s Beechwood Avenue, Kingston offices yesterday. Looking on is Peter Morris, senior director, human resources. (Photo: Lionel Rookwood)
Atkinson said while the hospital has been able to hire 55 recent graduates to fill the vacant positions, there is not much remuneration to encourage more senior and qualified nurses to stay on the island.
"The problem is that the middle level nurses -- and usually those are the more experienced ones, the ones who have done post-basic courses -- they are now the ones who are being invited to go to the United States .... and other Caribbean islands that offer a better package than we do in Jamaica. So we lose our nurses and we lose the persons who are available to mentor the new nurses," said the senior nurse.
Only 45 per cent of the hospital's under 700 nurses are level two nurses, a less than satisfactory figure, since hospitals generally require more level two than basic nurses. These senior nurses are required to work in midwifery, in the accident and emergency unit and in the intensive care unit as well as other critical areas.
To make matters worse, Atkinson said the senior nurses usually leave after being trained at the expense of the institution and without giving sufficient notice.
"We are struggling very much now because you allow people to go through with basic courses, you set up succession planning, with the hope that you are going to get this person, and I don't know of other countries where persons are not open to tell you that they are going to be leaving in two months down the road," she said.
In the case of midwifery, basic nurses are allowed to take a one-year course to upgrade themselves, while a six-month course is required for those in accident and emergency, nephrology and intensive care.
"One of the good things about the university and it may be a bad thing, is that we train a lot of persons in the post-basic courses which allows us to give the care we should be giving as a tertiary centre, but then a lot of our staff, thus having obtained the extra training, are free to go," Atkinson said while pointing out that the students are not bonded.
But even though the migration of the nurses continues to be a major challenge, Atkinson who is earning five times less than the amount she was earning in a similar position in California, said she could understand the reason for some of the nurses leaving.
"For me, to work in Jamaica is for a nurse who has a calling, this is what you want," she stressed.
And Chief Executive Officer of the UHWI, Dr Trevor McCartney, fears that more nurses will be migrating in the coming months, in light of the prime minister's announcement of a two-year freeze in public sector salaries.
"This financial inadequacy when added to an increased shortage of nurses in the United States of America, Canada and the United Kingdom may see even greater migration in the days ahead," he said. "Fortunately with a large number of nurses currently being trained, replacements are available numerically. However, it is a challenge to replace experienced professionals with fresh new graduates."
Atkinson also pointed out that while there are bachelor programmes now being offered for nursing, not many of these programmes focus on the clinical and practical side of the profession, resulting in the hospital having to give these students a six months extended orientation when they are employed.
She said the hospital does not have a problem getting basic nurses as many turn up for positions without them being advertised. However, few stay once they have been trained and upgraded to a senior post.
In an effort to encourage more of them to stay, even with the pull of more money and better working conditions overseas, Atkinson said they have recently implemented a series of programmes at the hospital.
She said the hospital is looking at ways to increase the job satisfaction level for the nurses.
"One thing is to have what they call shared governance," she said. "The nurse from the bedside has an input in what is taking place with the care of the patient, instead of just dictating from the top. That way, we come together as a council that involves everybody and make decisions that involve patient care as a team."
She said they are also looking at fast tracking some of the basic nurses to fill more senior posts.
"Gone are the days when you are several years in a position before you get promoted," she said. "We have to identify persons who have promise and potential and try and fast track those persons in primarily management techniques."
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