Students at the Caribbean School of Nursing (CSON), University of Technology (UTech), Jamaica, who pay $500,000 to $800,000 annually for tuition, are motivated to leave Jamaica upon completing their programmes, in pursuit of a better quality of life.

This comes amid a local deficit of approximately 1,000 nurses across all specialties, and at the same time, few job opportunities for freshly graduated nurses.

Last year Prime Minister Andrew Holness said the Government was committed to addressing the shortage of nurses, which is largely due to attrition. Simultaneously, he said, efforts would be made to encourage more young Jamaicans to enter the profession.

Dr Adella Campbell, associate professor and dean at the College of Health Sciences, UTech, which has oversight for CSON, told the Jamaica Observer that the migration of nurses and midwives is not new; however, mass migration is a “recent phenomenon that is depleting” the public health sector of its best practitioners.

“It is often said that nurses’ migration is due to poor remuneration, but the truth is, that is only one factor. Nurses and midwives are motivated to leave our shores because they need better quality of life. They need basic things such a house, car, and incentives; both tangible and intangible,” she said.

“Additional reasons for dissatisfaction in the current work environment include having responsibility without authority, poor and under-resourced work environment, limited opportunities for scholarships and grants to pursue undergraduate and post graduate studies, inequality and inequity in owning businesses and lack of opportunities for nurses and midwives.”

Following a local recruitment drive for specialist nurses for overseas employment in 2016, Minister of Health and Wellness Dr Christopher Tufton had said that the ministry was aware and was taking steps to ease the shortage of specialist nurses in the public health sector.

Tufton pointed out that such recruitments happen from time to time, as Jamaican nurses, particularly specialist trained nurses, are in high demand due to their excellent training and capacity.

The remuneration offered by the developed countries, he said at the time, couldn’t be matched by Jamaica, though there were several incentives in place for nurses. The minister said it was difficult to keep all Jamaican trained nurses, and so, the ministry was also exploring options for recruitment abroad from countries such as Cuba and India. Holness, too, said, “it comes down to what is the local remuneration”.

And whilst the ministry is currently gearing up to recruit 270 newly graduated nurses, Campbell told the Sunday Observer that a concern frequently expressed by nurses and midwives is that the Government continues to recruit overseas nurses who are offered better remuneration packages than those offered to the natives.

“Of note is that recruiters are very strategic in that they have removed prohibitive factors such as years of experience in order to improve the ease with which Jamaican nurses and midwives are recruited. By all indications, this phenomenon will be with us for some time. While migration has contributed to the shortage of nurses, concern is often raised about the manner in which new graduates are absorbed in the public health sector locally.”

Campbell also said that some nurse managers have lamented that the regional health authorities (RHA) are not recruiting new nurses and midwives. But instead, they are replacing those who have resigned.

“For example, one institution has a new unit which is yet to be staffed, despite submission of a staffing plan to the particular RHA. This has resulted in other staff members having to take on additional work hours to ensure proper functioning of this new unit. The ripple effects include burnout, frustration, demotivation and consequently, resignation,” she explained.

Some students, who have shared concerns through Campbell, agreed that nursing and midwifery are callings, but feel that their callings have to be achieved at a cost, and require the relevant support systems and structures to be in place for them to practise.

One student is concerned, “About how the shortage of nurses is negatively impacting the nurse-patient ratio in hospitals, which makes working in these institutions intimidating because of the burden that will be on nurses to maintain patient safety and offer quality care.”

Another is worried, “That upon graduation, there is no positive indication that we will be offered a job in the Jamaican public health sector and the lack of urgency by the Government to address the matter. There is no opportunity for employment.”

One student said, “Students have to fork out between $500,000 to $800,000 per year for tuition, while those who obtained loans, after graduation, they are forced to migrate, take up jobs in hotels, in call centres and in other non-health organisations in order to generate income to repay loans, pay bills and meet personal and family needs generally.”

Campbell noted that other students have communicated that they believe that nurses and midwives should be free to migrate as are other professionals, especially where they cannot be employed in the local health sector.

“Students struggle to meet financial demands on a whole. They argued that while they value the patients, they place greater value on their family members whose needs they have to satisfy and as such, their choice is to seek greener pastures to meet their needs.

“They also believe that nurses and midwives should receive remuneration packages that are commensurate with their work and worth. Generally, the students’ overall posture is that the attitude to the professions of nursing and midwifery needs to change. Until this is done, the shortage of these professionals locally, will not improve,” Campbell told the Sunday Observer.

Speaking during the International Nurses’ Day press briefing in March, Tufton suggested that nurses pursuing job opportunities overseas opt for a flexible contract which will allow them to continue working in Jamaica as well.

He said he is prepared to put a policy in place.

Further, another student is concerned that the shortage is related to the fact that nurses and midwives are not valued.

“Political leaders need to invest in the profession. Currently, there is very little sponsorship opportunities for students despite financial hardship encountered while pursuing the career of our choice. And we don’t want a health sector where nurses and midwives are overworked and taking home less than $100,000 per month.”