Nursing and medical Students emigrating?

v638sg7k1a92bx

I was with a family member in a&e in Tallaght and subsequently in the ward afterwards. I noticed that it was almost non Irish staff in the A&E and a high proportion of non Irish staff in the ward but not to the same extent. Why is it that when there's discussion on TV or radio about nursing and medical staff emigrating because there are no jobs for them in Ireland and yet the staff in the hospitals appear to have been recruited from abroad???

RGS

Theres a recruitment embargo in the HSE therefore any newly qualified nurses have no jobs so therefore they emigrate.

Secondly most of the newly qualified are not applying for the graduate programme as they can get better terms and conditions abroad.

Most nursing staff employed have been here for some time.

hfallada

Its well known within the medical field that certain hospital are career killers and therefore no Irish doctors want to work there. Even during the celtic tiger most Irish doctors refused to work in certain hospitals around the country due to the hospitals poor reputation. But most non-national medical workers are excellent and have a unique way at looking things as their medical training was in a different country. And if your doctor is a non-national, they probably were educated in Ireland

token56

The only jobs in the public service being offered to graduate nurses is through the new government graduate nursing/midwife program, with I think around 1000 positions in total being offered.

The INMO has publicly discouraged new graduates from taking these positions for a number of reasons. The first of which is that graduates are being forced to sign up on a two year contract with a salary of 80% of what former nursing graduates were offered. There are two problems with this, the first, as an employee you will be doing the exact same work as the rest of the nurses on the same level as you but getting paid only 80% of their wage. Now fair enough this is happening in some extent throughout the public and private sectors but a 20% decrease is hard to stomach and if I were in their shoes I'd find that very difficult to take too. The other problem is that once the two years are finished there is no guarantee that you will be kept on after this or any sort of job security. With two years experience nurses would rightly expect for their wages to be increased given they are already on lowered wages if they were to sign a new contract. But the most financially sound thing for the government to do would be to just hire a new batch of graduates at the lower rate of pay again. This is the most likely scenario as they will have budgeted a certain percentage of the nursing workforce to be paid at this lower rate and will have to maintain this and possible increase it with the ever decreasing health budget.

The next problem with this scheme for new graduates is that it will be mandatory for them to take a certain number of academic modules over the course of the two years. I do not think this mandatory element was there in previous years. Now further education should always be encouraged in my opinion but this would happen normally in a lot of nursing jobs with course to become qualified to carry out more advanced medical procedures that a graduate nurse not might be qualified to do coming straight out of college, for example taking blood, putting in and IV line, catheter placement, etc. With the proposed scheme they are academic modules more in line with doing a masters requiring a significant amount of outside study. The biggest problem with this element is that it had not been well defined until very recently I believe. With little or no detail given as to the expected number of hours nurses would have to study, what type of modules exactly they would be expected to do. Nurses have therefore ben asked to sign up for a job with one part of the contract not yet being outlined or defined. This is something that is not acceptable at all in my opinion.

So this is what a new graduate nurse is signing up to if they want to go public. My sister has recently graduate and as far as I'm aware not one person from her year have signed up for this scheme. People are either going abroad, signing up for agency work or looking for work in private practices, e.g. private nursing homes. The main reason being the pay conditions are more competitive.

dissed doc

Mariam Faint Goggle wrote: »

I was with a family member in a&e in Tallaght and subsequently in the ward afterwards. I noticed that it was almost non Irish staff in the A&E and a high proportion of non Irish staff in the ward but not to the same extent. Why is it that when there's discussion on TV or radio about nursing and medical staff emigrating because there are no jobs for them in Ireland and yet the staff in the hospitals appear to have been recruited from abroad???

The HSE has been abroad multiple times in the past 2-3 years on recruitment drives to try and get doctors, all have failed due to the well known abusive reputation Ireland now has towards doctors. The latest attempt was a recruitment drive in South Africa just before Christmas a few months ago, but they got no-one.

The reason there is no discussion is because Pravda don't want to hurt the guys who make the TV license laws; don't bite the hand that feeds.

v638sg7k1a92bx

dissed doc wrote: »

The HSE has been abroad multiple times in the past 2-3 years on recruitment drives to try and get doctors, all have failed due to the well known abusive reputation Ireland now has towards doctors. The latest attempt was a recruitment drive in South Africa just before Christmas a few months ago, but they got no-one.

The reason there is no discussion is because Pravda don't want to hurt the guys who make the TV license laws; don't bite the hand that feeds.

Abusive reputation towards doctors???

walrusgumble

Brilliant, the tax payer spends millions each year to train Irish doctors and nurses in Univerisities and IT's, only for them to leave, and be replaced by cheap and inferior non EU medics.

djpbarry

walrusgumble wrote: »

...inferior non EU medics.

Excuse me?

dissed doc

Mariam Faint Goggle wrote: »

Abusive reputation towards doctors???

Yeah. It's well known about unpaid salaries, illegal shifts, random salary cuts focussed oj doctors (consultants especially). That is why applications have dropped off the planet completely and rcruitmentndrives are failing. 4 years ago he medical forums abroad would regularly have someone ask aout ireland and work, conditions, etc. .

Internet = god of information when planning a move in medicine. You quickly find out the score when talking to people on e ground, before committing to anything. Reputation of ireland is down the pan for a decade or more, because it takes that long to train up the next gen (with university = 15 years+).

Memnoch

Ireland is not an attractive place to be a NCHD. Which is why so many Irish graduates emigrate. The HSE are constantly trying to shaft doctors. The workload is increasing, most teams are understaffed, consultants are bullies and the pay is down severely in real terms.

You can spend ten years training to reach consultant level, constantly kissing people's behinds to get the references you need and there aren't really a lot of positions available. Much better to go to Australia, or do the USMLE and go to the U.S. where after three years training your doing the same job as a consultant.

Also NCHDs double here as clerks, nurses, porters. In the US nurses take blood, give the first dose. Doctors do what they are trained to, make decisions.

Son Of A Vidic

Memnoch wrote: »

Also NCHDs double here as clerks, nurses..

Nurses? Eh, a NCHD is not qualified to practice as a nurse. Similarly to how a nurse is not qualified to practice as a NCHD. Both are separate professions with separate career paths and qualifications. I can therefore only assume that was a typo on your part.

Memnoch

Corvus Maximus wrote: »

Nurses? Eh, a NCHD is not qualified to practice as a nurse. Similarly to how a nurse is not qualified to practice as a NCHD. Both are separate professions with separate career paths and qualifications. I can therefore only assume that was a typo on your part.

I'm not interested in turning this into an NCHD vs nurses debate. But please tell me what part of the nurse's job an NCHD is not qualified to do? There are many hospitals where nurses refuse to do basic things like take blood because they haven't been on the appropriate 'training course.' Or perform an ECG or give first dose antibiotics. Forget about putting in canulas. I can't fathom how these basic skills are not part of standard nursing training here.

Most of these are artificial barriers to avoid the work and are hoisted onto interns and SHOs. Despite being members of the team you will rarely see nurses chase up X-rays, results or even checking bloods to fill in flow sheets etc.

All of this stuff is done by nurses in the USA as standard.

Most infuriating is when some nurses will hide behind protocol as an excuse to avoid taking any responsibility.

When there is no ward clerk around, rather than share the work, the nurses will leave it to the NCHD to chase up all the ward clerk's jobs as well. Because if it doesn't happen no one can touch them, but the NCHD is always the first to be held to account.

Nurses are protected by a strong union so they can get away with it. In the end all the jobs that no one wants to do end up falling to the intern/sho because they have the least protection and job security. So don't be surprised then if people don't want to come work here as a result.

djpbarry

This discussion has thus far been very heavy on opinions and very light on evidence. If working conditions for health professionals in Ireland are as bad as people are saying they are, surely there must be some sort of report that could be used to support such an argument?

K-9

Memnoch wrote: »

Nurses are protected by a strong union so they can get away with it. In the end all the jobs that no one wants to do end up falling to the intern/sho because they have the least protection and job security. So don't be surprised then if people don't want to come work here as a result.

I had the impression nursing unions had always looked for more responsibility. IIRC it was one of the things they wanted in previous strikes and talks.

TCDStudent1

djpbarry wrote: »

This discussion has thus far been very heavy on opinions and very light on evidence. If working conditions for health professionals in Ireland are as bad as people are saying they are, surely there must be some sort of report that could be used to support such an argument?

A simple google search shows lots of reports:

http://www.imo.ie/news-media/events/nchd-regional-meetings/LRC-Proposal-151013.pdf

http://www.lenus.ie/hse/bitstream/10147/292359/1/Article7389%5B1%5D.pdf

http://hse.openrepository.com/hse/bitstream/10147/46569/1/1680.pdf

Lots more of them if you search

Memnoch

djpbarry wrote: »

This discussion has thus far been very heavy on opinions and very light on evidence. If working conditions for health professionals in Ireland are as bad as people are saying they are, surely there must be some sort of report that could be used to support such an argument?

Another poster has provided some links above. These are a good source of information for many of the issues I mentioned.

I know that there was quite comprehensive research article published a few years ago about bullying in the health service, and the numbers were truly staggering.

I know the consultant (now retired) through some personal connections and he later got into trouble. The feeling was this was punitative. The HSE does not look kindly upon 'trouble makers.'

The problem is that comprehensive data on things like working hours are only available to the HSE internally, and they aren't really inclined to publish a report on how they are exploiting doctors.

Let me give you an example. Many hospitals around the country have declared that doctors should not work unrostered overtime and that this will not be paid. The problem is with most teams being understaffed, its not possible to NOT end up working the overtime. So people end up staying late till 7-8pm but they will not be paid for those extra hours. The hospital will say that that work can be handed over to the doctors rostered on call. But if every NCHD in the hospital handed over whatever work they had left at 5 pm. It would be impossible for the small team on on-call doctors to cover all of it. In fact, it would be dangerous because they have their hands full dealing with emergencies as it is, never mind trying to do everyone else's routine work.

In psychiatry, this policy has resulted in very patient unfriendly working practices. Many psychiatric NCHDs will not see a new patient after 4:30pm because they will not be able to sort it out by five pm when the on call takes over. Some are quite sneaky in that they will try and leave routine work or paper work to finish at the end of the day so that they are doing this from 4-4:15 or 4:30. The consequence is that new patients turning up for psychiatric assessment in the afternoon from almost 3:30 pm on might be waiting till 6 or longer to be seen. If there is more than one of them this prolongs the waiting time even more.

Don't even get me started on the shennanigans that psych consultants engage in.

The bottom line is that the HSE's corner cutting is having a bleed through effect. You are having a lot of doctors who have poor working conditions, not much prospect for the future and thus are just seeing the work as a service job rather than a rewarding vocation and they are working like any other state beaureaucrat.

Memnoch

K-9 wrote: »

I had the impression nursing unions had always looked for more responsibility. IIRC it was one of the things they wanted in previous strikes and talks.

They want more responsibility in terms of creating avenues for nurses being allowed to prescribe medication etc. with additional training.

There are already some specialist nurses around the country that pretty much do this anyway. Often oncology or haematology nurse specialist. A lot of these nurses are actually fantastic, they are experienced, really know the patients and know what needs to be done.

But in terms of actual ward work, there is endless shifting of basic responsibility. For example there is a new view score system being implemented around the country that is supposed to work as an early warning system. If implemented correctly this could be a great tool, but the reality is going to be something liek this.

A nurse gives a patient a sleeping tablet. This patient is now drowsy and a little confused and they have a temperature because they have an infection. This pushes their score to 4, and protocol dictates that they must now be reviewed by a doctor. It's a complete waste of time of course and the nurses should be able to exercise some basic judgement on this kind of stuff. But it's much easier to call the intern and pass the buck.

The whole system of protocols in the HSE is one complicated and grotesque contraption of endless ass covering.

So the nurses want some extra responsibility in terms of being able to prescribe etc. but this is in a few specific instances. By and large, they are pushing everything onto the NCHDs that they can conceivably do so, examples of which I listed in my previous post.

Zambia

Plenty of Irish accents in hospital here.

gctest50

Memnoch wrote: »

I'm not interested in turning this into an NCHD vs nurses debate. But please tell me what part of the nurse's job an NCHD is not qualified to do? There are many hospitals where nurses refuse to do basic things like take blood because they haven't been on the appropriate 'training course.' Or perform an ECG or give first dose antibiotics. Forget about putting in canulas. I can't fathom how these basic skills are not part of standard nursing training here.

Huge difference between refusing to do something and having the ability

If they are not supposed to be doing it, they shouldn't do it
-otherwise they will be on their own and have little protection if something goes wrong.

Memnoch wrote: »

Most infuriating is when some nurses will hide behind protocol as an excuse to avoid taking any responsibility.

If they are not supposed to be doing it, they shouldn't do it
-otherwise they will be on their own and have little protection if something goes wrong.

dissed doc

gctest50 wrote: »

Huge difference between refusing to do something and having the ability

If they are not supposed to be doing it, they shouldn't do it
-otherwise they will be on their own and have little protection if something goes wrong.




If they are not supposed to be doing it, they shouldn't do it
-otherwise they will be on their own and have little protection if something goes wrong.

Protection from what? Space fairies? The issue is that they *are* supposed to be doing it, and an artifically created blockade has been fabricated by the nurses union over decades now to use as negotiation tools in contract discussions.

It has nothing to do with safety, and in reality compromises healthcare delivery, and the hospital indemnifies all employees anyway.

"Protection if something goes wrong" - can just as easily happen when you do anything else at work.

gctest50

dissed doc wrote: »

.........The issue is that they *are* supposed to be doing it, and an artifically created blockade has been fabricated by the nurses union.......

This blockade - any more information about it ?

It sounds real even if you are a little upset how it arrived

Is it a series of "tickets" ?

How exactly do "they" use it to refuse doing something ?