Nurses, the heroes of the pandemic
Through their tireless work, nurses have saved countless lives during the Covid-19 pandemic. One of those lives was that of British Prime Minister Boris Johnson, who was hospitalised with the Coronavirus at the beginning of the pandemic (after shaking hands with infected patients against expert advice) and believes the reason he is alive today is thanks to the medical care by two NHS nurses. Particularly at the start of lockdowns, the great service to our communities by nurses, doctors and other healthcare professionals received audible support by the public with people clapping and cheering from their balconies. But given that nurses are literally risking their lives for our communities, shouldn’t they receive more than applause as thanks?
Applause does not pay the bills
Many countries are currently considering giving a Covid-Bonus to healthcare staff. While this idea has generally seen support, many argue that a one-time bonus simply does not cut it. Despite the significant responsibility they carry, nursing jobs are not well paid across Europe (though there are differences between countries). Yet already before the pandemic nurses struggled under tough working conditions, like stress and overtime due to understaffed wards – add a pandemic to that and many nurses and doctors found themselves completely burnt out. In the UK, Boris Johnson’s conservative government believed that the services of healthcare staff should be rewarded with a 1% pay-rise. This suggestion sparked fury among nurses, who had already endured a decade of austerity imposed on the NHS by conservatives. In defence of the proposed pay-rise health minister Lord Bethell argued that “nurses are well-paid for the job” and that health workers at least had secure jobs during a pandemic that many people would “envy”. What do you think, how should health workers be rewarded for their services during Covid? Should nurses be paid more in general?
What do our readers think?
Our reader Daniela, thinks that the Covid crisis “ is showing everyone’s true colors and especially nurses are fighting in the frontline very courageously.” But given the incredible work nurses are doing to fight Covid-19, shouldn’t they be awarded financially as well?
For an answer to this question, we took Daniela’s comment to Joséfine Declaye, who is a Belgian intensive care nurse next to working in scientific research and development at the Medical Simulation Center at the University of Liège. As a nurse who is fighting against Covid-19 on the frontline, would she agree with Daniela?
Thank you for your question. In the first wave, we received a lot of support and I thought “it’s kind of cheesy and like in Hollywood”, but it actually really cheered us up. So, it really made a difference. Regarding the question of money: Of course, if you give me more money, I’ll take more money! That’s not the question, but there’s also a lot of different ways to recognize the sacrifices made by our profession. Increasing money is one option, but for nurses specifically, we could put more people on the wards, recognize the tough nature of the work, so you get retirement sooner, and you could also have some other advantages that are not money. So, I would not only focus on money, even though it is of course important, because when I need to get my car fixed, I cannot pay the repair shop in “Thank yous” and applause, I still need to pay.
For another perspective, we also took Daniela’s question to Ulrike Beilenhoff, who is an endoscopy nurse, lecturer and the chairperson of DEGEA (German Society for Endoscopy Professions), as well as the Scientific Secretary of ESGENA (European Society of Gastroenterology and Endoscopy Nurses and Associates). What would she say to Daniela?
Thank you very much, Daniela, for the important question. Yes, we nurses are working on the front line and all over Europe nurses do not really earn much money. It depends on the academic level nurses have, so if they have a bachelor’s or master’s degree, like in the UK or in Scandinavian countries, they earn more money than other countries, like in Germany, where they have a normal education. It is also a question of self-awareness: “What is my work worth?” and also a question of official recognition and so “What is my work worth for the society?”. Therefore, nurses should definitely get more money, and that would also keep the job attractive for younger people.
On the other hand, our reader George thinks that “better healthcare” does not automatically result from more money. Instead he thinks that the solution is improved management of human resources and facilities. Is better management the solution or do we also need to raise nurses’ and doctors’ salaries to improve our healthcare?
What would Ulrike Beilenhoff, the chairperson of DEGEA, say to George?
George, thank you very much for your comment. You raised an important topic, because facilities also influence your work environment. You definitely need a good environment to provide good care. The facilities influence our daily work, but on the other hand, a higher income would also make job more attractive for younger people. Because, as we know, we already have a shortage of nurses all over Europe and worldwide, so we need to make the job attractive for younger people. And the higher salary makes it more attractive.
What does intensive care nurse and researcher Joséfine Declaye think? Is better management the solution or do we also need to raise nurses’ and doctors’ salaries to improve our healthcare?
I think there is a huge problem and it has many layers. Money is one layer, but there is a danger that if you focus on one layer only, you forget everything else. I think that in terms of money, healthcare is a really special case. Because if you invest money well in it, then the demand for money will be less later. If your first line of care is really strong, then you don’t have to end up with the worst case scenario. If you catch a disease really early and you improve the literacy in health of your population, your community, you need to spend less money in the end. So, we need more money, but I would focus especially on the “first line of defense” and prevention, education and not only focus on increasing salaries. Because we will all be happy if we get more money, but this is not the only solution.
We all need rethink how healthcare is finance-able and stable. We need strategies and research about where to invest. I’m part of an Intensive Care Nurses Association (SIZ Nursing) in Belgium and our aim is to recognize nurses and the ratio we need in an ICU unit: is the way we work still effective? Is it still up to date? In the year 2021, how has ICU care changed from what it was like in the 1980s? So we should rely on research to set our goals for the ratio. In general, we need more evidence based public health.
Finally, our user Blagovest from Bulgaria is observing that healthcare professionals in poorer countries often move abroad as soon as their training is finished, because the pay in their own countries is so low. He thinks that this situation leads to a brain drain in those countries. Is he right? We took his question to Ulrike Beilenhoff for an answer.
Thank you, Blagovest, you raised a very difficult problem. This is a problem for your home country Bulgaria, because you lose a lot of qualified staff. You lose your brain, as you said. But on the other hand, the nurses who go to other European countries, like Germany, Belgium, France, they get a lower salary than the local nurses. That is also form of modern slavery. So, for both situations it is unfair: In your country, you lose the nurses and in the host country, it keeps the recognition of the nurses low. Because there is a feeling that you can get “some lower qualified staff from other countries”. This really is a problem, and we have to solve that.
Based on her experience, would Joséfine Declaye agree with Blagovest?
I’m no expert on migration, but I can share my own experience. I think that brain drain is happening, but again it’s a problem with many layers. During my nursing courses I got to go abroad, I went to the UK and to Morocco and it was really inspiring. I expected there to be many differences, but actually we all related to the patients, how we cared for them and we connected as nurses. With regards to the brain drain, I would say countries need to improve the quality of living for nurses there. Because going abroad for your work is also a huge sacrifice, as you’re leaving your family and everything behind. So, money is definitely a factor here. But as I said, I went abroad and it really helped me to learn to think outside the box and it helped me to sharpen my expertise and my knowledge about European nurses. So, to summarize, going abroad is a good thing and I would recommend it.
But there’s a responsibility for European leaders to harmonize everything so that people feel good in their own country and they wouldn’t need to go abroad to make sufficient living. As a nurse you’re doing a great job and it needs to be recognized by the salary you get, and the way your country sees nurses. Apart from that, it can also be a problem when nurses or doctors come here from abroad and don’t speak French well, but have to work with old patients. Migration abroad for nurses shouldn’t be about money or recognition in their own country, it should be about education, research and learning other aspects of nursing. In Canada, they are developing nursing studies and a master’s degree in nursing. So, there’s an academic recognition in Canada, that we don’t have in Belgium.
Should all nurses be paid more?
How should nurses be rewarded for their work in fighting the Coronavirus? Would higher salaries lead to better healthcare or is better management the solution? Let us know your thoughts and comments in the form below and we’ll take them to policymakers and experts for their reactions!