Nursing Working Conditions: Cause And Solution Of The Nurse Shortage

The COVID-19 pandemic has highlighted the urgent need for 15,000 nurses in health units, but the needs of nursing must also be raised to public debate. The General College of Nursing estimates that some 20,000 nurses trained in Spain are currently working in other countries, a process that was accentuated between 2010 and 2013 when unemployment among nurses grew by 173%, surpassing the 18,000 professionals without work.

Scientific evidence concludes that nursing professionals are dissatisfied with the salaries they receive, the contracts sometimes for days or on the phone “if necessary”, the lack of prospects for improvement within the profession and the educational opportunities available to them. offers.


When nurses were asked if they were able to complete their work during their last shift, the vast majority answered no due to workload and lack of time. Tasks that would be considered markers of good practice such as speaking, comforting and educating patients and their families were left pending in their last shift for more than half of the nurses. In addition, it is common for a considerable number to start the day without knowing the unit in which to spend the shift, or to assume responsibilities of jobs for which they are not prepared.

Most nurses report that they are not enough, which is reflected in the ratios of patients per nurse in Spain, which are double those of countries such as Norway or Sweden. Not only do they lack opportunities to participate in political decisions, but many intermediate and supervisory positions also fail to respond to their concerns and needs.

Many Spanish nurses try to alleviate this situation by migrating abroad.

There are numerous international recruitment agencies that have emerged in recent years, funded by hospitals and governments of other countries to recruit nursing staff. Their offers generally seem the solution to all the problems of Spanish precariousness: permanent contracts, reasonable salaries, up to 6 weeks of vacation, numerous economic bonuses, and in some cases they even offer accommodation or food vouchers. The reality of arriving in the host country is usually more complex.

Before working in the desired position, you start working at a lower professional rank that does not require any academic qualifications and with minimum wages, until you reach the level of English necessary to apply for the registration number. These are typically lengthy bureaucratic procedures that take anywhere from 6 months to a year at best. During all this time, highly qualified professionals occupy jobs that have been abandoned by the majority of the natives of the country due to precarious wages and labor rights that are increasingly deteriorated as workloads increase.

Adapting to a new culture and language, navigating a different healthcare system, creating a new social network with other rules of socialization, is complicated. The abandonment of the family and social circle in the country of origin, as well as the challenges of adapting to a new city with a generally higher cost of living can generate stress and discomfort. Therefore, it is impossible to avoid isolation and discrimination.

At this point, many nurses may consider returning to the country of origin, but in most cases a contract of permanence has been signed with financial penalties. Nurses also stay because they are offered a respected professional space, with permanent contracts or even with continuing specialized training paid by the employer. There is a desire for nurses to be able to reconcile personal and professional life, which is reflected, for example, in the planning of shifts for several weeks, or the ability of nurses to choose the shift that suits them best.

Traditionally, policy responses to the nursing shortage have focused on improving recruitment and retention, as Minister Yolanda Díaz intends with the current reform of active employment policies. However, we consider that these efforts are in vain if the conditions of employment and work of nurses in Spain are not improved, which happens by ratifying the convention of the International Labor Organization (ILO) on Nursing Personnel, 1977 (No. 149) and follow the ILO Recommendations on Nursing Personnel, 1977 (No. 157).



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