A letter in SMH this morning caught my eye. A writer claimed that about half of those who completed nursing this year, including her daughter, cannot get positions, yet our hospitals are crying out for staff.

Is this correct and if so why? I am left wondering.

It seems that not long ago we were recruiting nurses from overseas and now our own trained cannot get positions.

Is it a shortage of money for health or simply incompetence at the government level.

I would like to know what is going on.

Dear Banjo,

I googled "nursing shortages in Australia,"
and came up with heaps of websites.
It appears that we do have severe nursing
shortages.

Anyway, this website may be of interest:

http://www.nurseinaustralia.com/nursing-shortages-in-australia/

Banjo, I can tell you why.
New Nurses coming out of their training need lots of supervision, and hospitals have been told to cut their budgets.
That means only the very minimum numbers of nursing staff are employed on the wards.

They would be wanting only experienced nurses who don't need supervision and who can be left alone to work their butts off!
New Registered Nurses need to work with experienced nurses for at least the first year out of training- that would mean the Government would be paying nearly twice as much to employ and supervise that new nurse.
Many new nurses end up in nursing homes, where the pay is awful- simply to get employment.

suzeonline: "New Nurses coming out of their training need lots of supervision, and hospitals have been told to cut their budgets. That means only the very minimum numbers of nursing staff are employed on the wards."

Please, tell me this isn't true. The last time I recall seeing such short sighted planning was when the Queensland and Auckland electricity authorities were run by accountants. We (Brisbane) came close to loosing our grid. Auckland lost normal electricity supplies for 3 months.

Even the hard hearted, purely for profit and privately owned company I work for mandates a minimum ratio of apprentices to fully trained staff.

Banjo,
My suggestion would be that the author has specific issues such as location, hours on offer, personal preferences, specialization etc.

If one lived at one side of Sydney and the only jobs that met their criteria we on the other side of the city then you have a problem.

At our local hospital they have issues with older nurses wanting to work selected hours on selected days (their convenience not the hospital).

Even funding can be an issue.

Some nurses won't work in geriatric homes etc.

Some reasonably won't work at certain hospitals, percieved safety, working conditions, etc.

Not all hospitals are equal. while in Qld An emergency put me in a particular hospital which while the nurses/staff were fine issues of fights in the wards between patients, abusive language were rife, another hospital has an appalling record etc.

Having spent some time recently in a rural hospital visiting a relative with cancer and spekaing to nurses, it was disappointing to see the way hospitals are now administered from afar by area health services (NSW anyway). The difficulty to even get the required pharmaceuticals and medicines to treat patients requires mammoth effort and red tape. Sometimes nurses and other medical staff have even run out to a chemist themselves to get goods needed to do their jobs properly.

I remember this was reported in other hospitals in NSW - Dubbo I think was one and there was one in QLD from memory.

This is exactly the problem with razor gang mentality by some politicians. They may not intend the consequences to be felt at the coalface but unfortunately that is where cuts are made.

The only way to reduce the costs of public service is to reduce the size of the senior bureacracy and make it a goal to reduce the SES by 'x' percent (whatever deemed appropriate) and get rid of bonuses for senior managers for just doing their jobs.

This is one of the biggest wastes in government and takes away from the 'citizen focussed' goal of the current government (as written about in today's CT).

Part of living in a democracy is for citizens to be able to participate more and this won't happen without having a serious look at the relevance of having a large Senior Executive Service that takes away from the actual work of the public service.

There is something inherently wrong when policy makers and strategists out number the delivery staff, or 'doers'.

Thanks to everyone for your opinions. Since posting I have been able to speak to a number of nurses both local and who work in Sydney region.

From your opinions and the others, it seems funding is the problem as the staff are needed and wanted but lack of funding limits their employment.

With massive ammounts going to health one has to ask why is there a lack of funds for nurses. The concensus seems to be that, since the abandonment of local hospital boards, there has been a massive build up in the administrative bureaucracy of the very large health service areas. This is taking a lot of the funding and leaves less for front line services. So much for the changes which were supposed to bring efficiencies and savings.

Suze mentioned the additional need to supervise new graduates. Funny that as I recall when nurses were calling for them to have academic quals in recognition of their professionalism, and so the training went from an apprenticeship type, on job training, to Uni based. They got their academic quals but now seem lacking in practical skills after getting a diploma. Strange that as I would expect an electrican or boilermaker to be able to do his work unsupervised once he has his ticket. Of course if one seeks to specialise in something then futher training is necessary, but for general duties it seems the old training system may have been better.

It seems a waste of 3 years training if nurses cannot get positions or enter the job only to find it is not for them. The academic quals then are meaningless.

I'm glad so many others got this thread before me or I might have taken it for a genuine enquiry, rather than an intro to some old-fashioned nurse-bashing.

Suze explained it fully: nurses in their first year require a graduate education program to ensure they practice safely and legally. That takes money and supervisory staff.

The old chestnut about university training for nurses being inappropriate comes only from people who understand zilch about nursing - and that includes doctors - or as a plea to return to traditional gender roles.

Hospital training was great when nurses were expected to be cleaners, porters, cooks, brow-moppers, and all-round nice ladies who held your hand while you died because the medical knowledge didn't exist to help you.

>>>>

>>>>

It's 2009, Banjo. Medical technology is among the most advanced and complex fields of knowledge in human history. Pharmacology alone requires intensive study before a practitioner can be considered safe to do so much as give out a cup of pills. The MIMS annual contains more than 2000 medications. Would you like to be cared for by a nurse who didn't have a broad understanding of pharmacological effects, side effects, contraindications and dangerous interactions? Many people die in hospitals each year due to mis-medication. Without proper education there would be many more.

Then there's medical machinery, case-management, evidence-based wound care and recovery, nutrition, psychiatric health aspects, the myriad legal and ethical ramifictaions of practice that nurses must understand to be able work legally...

Despite the howls of the AMA, Australia is moving toward a nurse practitioner model precisely because nurses here have the education and professionalism to be independent practitioners. If you take tertiary education away, we won't train nurses of sufficient calibre to fill that role.

I have a few questions for you, Banjo:

1. Which skills do uni-trained nurses lack? I hear this canard often, but have seen no evidence.

2. A recent UK study (http://news.bbc.co.uk/2/hi/8269729.stm) found that hospital deaths increased by up to 8% at the start of each year when inexperienced medical graduates begin working with patients. Senior doctors dub it "the killing season".

Would you argue, then, that doctors should be taken out of university and trained in hospitals? Tertiary education obviously isn't giving them the necessary skills to practice safely.

3. If you were in hospital would you like to be cared for by a nurse who can clean a bedpan in a jiffy, but knows knack-all about the half-dozen drugs he's giving you, or one who takes more time changing a dressing but knows that the pills the doc prescribed are likely to give you a seizure?

Can someone please tell me why Nurses have to pay a ridiculous annual fee to the Nurses Registration Board each year. The annual fee is currently $95.00. Apparently this fee is for maintaining your name on the Nurses Register. Does this country want Nurses? If so, Australia is certainly going about it the wrong way. Also if a Nurse wishes to work in other states they also have to register with that States' Nurses Registration Board and not only pay another annual fee but also an additional joining fee. How ridiculous is all this?