Why are Irish nurses and doctors leaving the Hse

Seshlord2020

The HSE has an overall shortage of nurses and imports a lot of nurses and doctors overseas. Is there any way the working conditions in the Hse could be improve to encourage them to stay in the system.

Swaine

Conditions are dreadful. Too many pen pushers who don't see a patient from one end of their lucrative career to the other. This is where the budget is wasted so not enough frontline staff. HSE is a bureaucrat's wet dream.

AndrewJRenko

The 'pen pushers' are the ones who make sure that the doctors and nurses get paid each fortnight, and that they have the supplies they need in theatre or on the ward, and they have the necessary IT systems to do their job.

I'm not sure why 'wouldn't see a patient' is a criticism for some staff. Not every staffer in the HSE is patient facing. That's a perfectly normal situation - it doesn't make them better or worse.

I'd have thought if we stopped the crazy six-month contracts for junior doctors with 100-ish hours a week work, they might be more inclined to hang around.

Wibbs

https://www.boards.ie/discussion/comment/117788224#Comment_117788224

Having had direct and indirect access to HSE bureaucracy behind the scenes the sheer level of wastage, duplication and double jobbing is staggering to observe for anyone coming from the private sector, or just walking in off the street. Never mind that even with that doctors on wards are often left doing enough pen pushing of their own. And don't make me laugh regarding the "necessary IT systems", the waste there, which I've had direct experience of is in a few areas a complete bloody joke. We spend a lot on healthcare compared to other nations but somehow don't see as many results of that spending and bloated bureaucracy is a large part of that. It's present in a few public sector areas but health is a major one.

As for why doctors and nurses leg it overseas? Better wages, shorter working hours and more chance of advancement for the most part, better climate would be a part of it for others.

Strumms

in any job, if you don’t have the support of the people you are busting your ass for, doing extra for, going over and above for.... ie. your employer, you’ll eventually quit... people carry only so much goodwill... they’ll only do that for a certain timeframe.

Plus if you are rostered to have two days off and you end up spending the first day off getting up at lunchtime and spending most of the day watching tv because you are beyond fûcked tired, you are exhausted, there is little quality of life.... your relationship is suffering because the night out...meal / cinema / drinks to boot seems about as appealing as climbing Everest...your relationship will suffer...you are risking your physical and mental health.... in the process of trying to support and enable the wellness and health in others...

if it was me I’d either seek a new career here or head to another country say Canada where doctors in the public system have a really good work life balance as well as being amongst the best paid it the world.

cnocbui

Because they would rather work in a first world health system, not a borderline third world one.

thoker

Australia is hard to beat snakes heatwave tarantulas but that is the Irish fantasy. Faraway hills look green or desolate in this case. My sister is a Nurse and has worked in the US and it’s not the conditions etc are driving them away but their own self interest Money. Meanwhile we will import more Filipinos to replace them. Isn’t a short flight to oz from the Philippines better for the climate?.

ma003

If you do the 4 year graduate medicine course, the fees are so high you owe Bank of Ireland 76k at the end of it for fees only so a lot of junior doctors head to places where they can pay it off and still afford to live.

murpho999

https://www.boards.ie/discussion/comment/117788314#Comment_117788314

Sigh, HSE certainly needs to be managed better but it's certainly not anywhere near the level of "third world" country (not a dated term and replaced by "developing").

If you ever been to any of those places which often don't have any type of health system whatsoever then you'd know that and appreciate the health system a lot more.

They're doing a very good job on the vacinne rollout and also once you're in the system the care you get from the professional doctors and nurses second to none.

amen

https://www.boards.ie/discussion/2058205251/why-are-irish-nurses-and-doctors-leaving-the-hse

How many Irish nurses/doctors leave the system each year to go work abroad? How many return in subsequent years? how this compare to other countries?

Strumms

whats going on in other countries doesn’t matter.

Up to 600 non-consultant hospital doctors may leave the Irish health system this summer to work abroad, the Irish Medical Organisation (IMO) has warned...

research says because of the hours required of them and conditions imposed on them.

amen

How many of them are Irish ? How many leave for additional training and return ?

jusvi2001

https://www.boards.ie/discussion/comment/117788224#Comment_117788224

80 bed HSE community hospital in my area has 1 director of nursing , 2 Assistant Director of Nursing, 3 Nurse Manager 2 , 8 clerical/ office staff. so this facility has 14 non patient facing staff for just 80 beds. 74 bed private nursing home in the same area is managed by 1 director of nursing and 2 office staff.

Mad_maxx

https://www.boards.ie/discussion/comment/117788411#Comment_117788411

76k is nothing, an American doctor would carry debt five times that

cnocbui

https://www.boards.ie/discussion/comment/117789984#Comment_117789984

Satisfaction ratings of helthcare in Ireland by patients are about the same as for Bulgaria.

"Ireland has the second-highest health spending ratio in OECD area which comprises of 34 mainly developed countries but it has some of the worst health outcomes among advanced countries." http://www.finfacts.ie/Irish_finance_news/articleDetail.php?Ireland-second-highest-OECD-health-spending-poorest-outcomes-506

I have personally had experience with the helthcare systems in both Australia and Ireland. The nurses are great, some of the doctors and consultants too, but some are not so great. Ireland doesn't come close to Australia, from my experience of the two systems.

Chris_5339762

At a wild guess- doctors have to do a period abroad to qualify in Ireland. They are also used to rotating around the country.

Then they see more money, less hours, a training budget that actually exists and a better work/life balance abroad. Since they have already experienced moving abroad, it works quite well for them.

In terms of partners, a lot of doctors seem to marry other doctors so they are at about the same level with no kids. So they move abroad, its must less hassle than for others.

https://www.boards.ie/discussion/comment/117788314#Comment_117788314

Ironically, there would be a number of individuals who actually go work in third world scenarios, even if just for a short while for a reprieve from the system. The system being something not particularly Irish and not exclusive to Doctors and Nurses but likely widespread throughout the profession of medical and health care. I feel like I'd end up falling down a tunnel I'd never be able to climb out of if I tried to go into detail but maybe Netflix will make a documentary about it one day. Needless to say, that time spent in those third world countries helps to alleviate the symptoms of losing your soul. (after you've sold it for 200k a year to the entity known as the HSE)

A1Cork

Probably because of all the years paying to get qualified and then finding there is no office space. Yet money well spent as they will always have the skills.

ma003

https://www.boards.ie/discussion/comment/117790327#Comment_117790327

Yes but they have higher salaries than you would ever earn in Ireland hence why Irish doctors leave to pay off the debt. 800-900 euro per month out of a 2100 euro salary is a lot for an intern before any other bills. The thread is about why doctors and nurses are leaving not a comparison of debt and if you can pay it back quicker working in a different country obviously you are going to do that rather than slaving away for 10 years to pay it back here and not being able to get a mortgage or other loans because of the debt etc

Mad_maxx

https://www.boards.ie/discussion/comment/117790930#Comment_117790930

Doctors and nurses are trained for free here relative to some other countries

A1Cork

https://www.boards.ie/discussion/comment/117791507#Comment_117791507

I always taught you had to go to UCC and pay to go to UCC etc to study to become a doctor or nurse, here in Ireland, and then go on to a hospital or health care setting which has been broken and overflowed for as long as I know. If we had a proper health system in Ireland we would have a good grasp on Covid by now. No bed spaces, no rooms spaces, no ward spaces, poor pay 10 years to build an unfished billion euro hospital. I think this is why they leave, frustration and unappreciated and lack of pay and bonuses.

MEGA BRO WOLF 5000

Because it's a absolute shït show and getting worse. A lot of the foreign nurses don't even have a basic grasp of English either. It's causing absolute mayhem.

Thelonious Monk

I have a friend who is an anesthetist and is currently working in the UK, but intends to move back here sooner or later, she has also worked in many hospitals here. Doctors (and nurses) can up sticks and work pretty much anywhere they want, so from ones I've known nearly all of them move away for a good few years to Australia, UK, etc. to gain experience and just because they can. I mean if you had a licence to go and work and earn good money pretty much anywhere, chances are you'd leave Ireland too at least for a while. There are also opportunities in certain fields of medicine that would not be currently available in Ireland if you wanted to follow a certain path. I would imagine most of them come back sooner or later but not sure there are any figures on that.

Kerry25x

I'm a HSE nurse and having spent time working in the NHS in England I feel that we are far better treated and better paid in Ireland. Personally, I absolutely love my job.

A lot of it comes down to ward level management, there are a lot of poor managers out there but luckily mine is fantastic. If management roles were paid better, then more nurses would apply for them but as it is some wards go for months or even years without a senior manager because they can't get applicants. Often the applicants they do get are people just using the post as a stepping stone to go higher up in the HSE. Working as a staff nurse earning premiums for nights and weekends you will often be earning better money than your manager without the responsibility of running an entire ward of 30+ staff. As you go up the chain of command to those with no direct patient contact (line managers etc) the management cares less and less about patient safety in my experience and can be downright petty.

Some nurses leave because of poor working conditions, short staffing and poor management, some leave because career expansion opportunities are better abroad and some leave because travel opportunities are good with nursing so why not.

Doctors are rediculously understaffed, even more so than nurses and under immense pressure. Night shifts are particularly poorly staffed and really need to have double the amount of medical interns that are rostered.

BrianD3

If we significantly increase the amount of nurses and doctors and give them big payrises, would we then have a functioning public health service? The system is so broken that I don't believe we would and we'd have increased the already huge expenditure on pay. How are we going to fund any additional spending, could we cut other public services to fund it e.g. cut our military spending? Oh wait, we already have a token military. Raise taxes? Chicken and egg scenario then. My interactions with the HSE (and GPs and other players in the health service) on behalf of my elderly mother are shocking and I'd have no confidence whatsoever that paying more tax would allow me to avoid the near constant stress I experience from dealing with these people.

By any measure of GNP, GDP, per capita, household wealth etc. we are one of the richest countries in the world and yet we are constantly dealing with this ****.

Some people ascribe God status to doctors and sainthood to nurses. You get idiots in every job including consultants on 200k and "caring" nurses. It's not just administrators that can be useless. Yeah the frontline staff are under pressure and if they have just worked 100 hours, how can they be competent. As a "service user", why is this being made my **** problem.

Absurd that we are being warned yet again that hospitals are under pressure, people are presenting with "complex illnesses" and "multiple morbidities". That sounds like code for elderly people who have been not been accessing healthcare services during the pandemic and now things have escalated.

This at a time when there are 50 something people in ICU "with" Covid and nearly 80% of the population over 12 vaccinated. And in August too which should be a quiet time of the year. Sounds like they are building up for the annual winter shambles before summer. is even over. Add in more Holohan, Nolan, Reid, Henry, Glynn et al. concerned about Covid. Well Holohan has been Deputy CMO or CMO for nearly 20 years. he should have been gravely concerned about the health service for at least the last 16 years since the formation of the HSE, was he?

Apart from Covid and A&E, so called elective procedures, I know someone whose child was in serious discomfort with an ENT issue and needed a procedure. Public system - 6 year waiting list. Private - done within couple of months. This family doesn't have much money or health insurance so was forced into borrowing from others to pay for the procedure. If you have to wait 6 years for a procedure on the public system, the public system basically doesn't exist for that procedure.

Tom Mann Centuria

Had a long reply typed out, but in short, It's not a good environment to nurse in, and I'd presume doctors feel the same. That's my opinion, having worked in the HSE for nearly 20 years, and it's not getting better any time soon.

shesty

My abiding memory of the HSE - my husband punctured a lung, ended up in a 10 bed high dependency ward in Beaumont a few years ago for a few days.After 2 days on a trolley in A&E and a day and night in the ward, he desperately wanted a shower.Mentioned it to the nurse - she couldn't do much but if "someone from home" could bring in towels and help him, she could change the bandage afterwards.

So that someone (me - at home on mat leave with a toddler and baby), went in that evening, he had his shower, and I went to the desk at the top of ward afterwards, to ask about bandage changing.I think there were 6 or 7 people hovering around the desk in various different coloured outfits.I asked the general question of "who can change that bandage" and everyone behind the desk looked at one woman - girl- who was busily scribbling away at something and said "Her". A 10 bed ward of high dependency patients, plus several private rooms, and she was the only one, with one student helping her.

To add insult to injury, an insurance bill arrived once he got home...billing as a "semi-private" patient.Given that he had no choice in the ward he was placed in due to his injury, this was very, very questionable.

Why would anyone stay to work in that system??

BrianD3

https://www.boards.ie/discussion/comment/117792530#Comment_117792530

The billing for a semi private room thing - they are always at that. No doubt if pulled up on it there would be some excuse or "it's complicated", maybe it is and maybe the insurers are in cahoots. To an onlooker, it seems more like fraud.

There are few things that the HSE won't stoop to when trying to avoid providing services, make someone else pay or justify their own ineptitude. E.g. my mother was being discharged from hospital without any supports, the staff seemed nice and were apologising about the waiting list for support, then the loaded questions started, "does she have any savings..."

Do these people have any shame - as a former public servant I was very conscious that my salary was being paid for out of public money and that fobbing people off, putting them on an absurdly long finger or suggesting they sort out issues themselves both undermined my position and seemed very wrong. As for enquiring about how much money someone had - Jaysus.

If I was on the receiving end of an eating for not being able to provide a good service, 99% of the time the person doing the eating was right therefore I wouldn't defend my employer.

Was criticised for that "You shouldn't have agreed with him that the situation is indeed a disgrace" .

Diemos

https://www.boards.ie/discussion/comment/117788277#Comment_117788277

I can second that, in a previous roll I was contracted to do a few days work in the HSE and it was as bad as I had seen regards the public sector (and that's a low bar)

Mad_maxx

https://www.boards.ie/discussion/comment/117791724#Comment_117791724

Third level fess in Ireland are a pittance compared to most countries

Health professionals have a big headatart on colleagues in other nations in this regard, very little if any student debt

Seshlord2020

https://www.boards.ie/discussion/comment/117791724#Comment_117791724

You do have to pay to study nursing or medicine in Ireland if you don't qualify for Susi to fund your fees. Also a lot of nursing students (not sure about medical students) may have to rent out a second accommodation during placement or have to commute long hours which isn't cheap.