International Nurses’ Day greetings are just around the corner, as governments and officials prepare once again to recognize the contribution of the largest group in the health workforce to health systems worldwide. Yet, as Public Services International (PSI) warns, nurses across the globe are still waiting to see action on the promises made by ministers and other policymakers.
Despite commitments made during the COVID-19 pandemic, there has been no notable improvement in workers’ rights and working conditions in public health systems. Today, there is a global shortage of six million nurses, with almost 90% of this shortage concentrated in low- and middle-income countries. Paradoxically, in the same countries facing the worst shortages, there are also hundreds of unemployed nurses unable to find decent jobs with decent pay, according to PSI.
Even when it seems that some lessons may have been learned by policymakers, other events come in to disrupt hope. Recently, some European countries endorsed materials reflecting inputs from nurses’ trade unions. This should be good news, but the European Public Services Union (EPSU) points out that at the same time, these countries also passed new fiscal rules. According to these rules, EU members will have to cut their budgets by €100 billion a year starting from 2025.
“These measures mean that many countries will potentially have to cut nurses and other care workers, further contributing to workforce shortages in the sector,” EPSU stated.
Read more: IMF and World Bank: no to austerity, yes to stronger health systems
This does not necessarily mean that all nurses leave because salaries are low. Low income is a prominent reason for dissatisfaction among nurses, but more importantly, it is poor working conditions that are leading to high rates of leaving the profession and burnout. Conditions would improve, as indicated by recent studies in Canada and the United States, simply if more nurses were employed to ensure adequate staffing.
In 2021/2022, nurses in Canada accumulated 26 million hours of overtime. According to a survey conducted by the Canadian Federation of Nurses Union this year, 16% of them did not use any vacation time, either because their requests were denied or because they felt obligated to work, not wanting to add more to their colleagues’ load. This translated into high reported levels of burnout— as many as 9 out of 10 nurses said they were experiencing some degree of burnout—and a decline in the quality of care. Reflecting on the previous year, 56% of nurses observed a decline of this sort.
These findings are not new. The long-term consequences of staff shortages at all levels have been well documented for decades, including in a recent study by PSI, which looked into the mental health of health workers and its connection to conditions in the workplace. It is just that when it comes to choosing between cutting costs and employing more nurses, the former takes precedence—and nurses know it.
Read more: Trade union report illustrates mental health impacts of working in public healthcare
Because of this, researchers have suggested that we should reconsider how we speak about staff shortages in healthcare. “There isn’t a nursing shortage,” suggest Karen Lasater and Jane Muir from the University of Pennsylvania. “It’s nurses’ refusal to be part of a system that puts profits before safety.”
It is safe to conclude that this International Nurses’ Day will be spent struggling for better working conditions and for the upholding of previously won rights. That this can lead to concrete results is illustrated by the case of Brazil, where the nurses’ union won a long battle for a minimum wage. One year after the implementation of this measure began, at least 50% of Brazil’s nurses are receiving more dignifying salaries, said trade unionist Solange Caetano in an interview with Outra Saúde.
The road to reversing the damage done by administrations like those of Temer and Bolsonaro remains long, but ultimately, the struggle will bring a better health system for both “those who care and those who are cared for,” suggests Caetano.
People’s Health Dispatch is a fortnightly bulletin published by the People’s Health Movement and Peoples Dispatch. For more articles and to subscribe to People’s Health Dispatch, click here.
