Nursing Discontent

With the announcement of the HSE’s graduate training scheme for nurses, Aoife Valentine explores if these positions are taking advantage of those new to the job marketIn an already overcrowded job market, graduates in many industries will scramble to apply for any job announced in their area of expertise, often first spending a number of months doing unpaid internships or work experience to give themselves an edge. With the economic downturn has come a general acceptance of unpaid or lowly paid work for new graduates, until they can find their feet on the career ladder.However the announcement by the Health Service Executive (HSE) of 1,000 new jobs as part of a graduate training scheme for nurses has been met extremely negatively and with much derision, with the Irish Nurses and Midwives Organisation (INMO) calling for all graduate nurses to boycott the scheme. The controversy has largely been caused by the 80% pay rate, a yearly salary of €22,000, with no indication of a pay increment after the first year of the two year contract.Deputy Secretary General of the INMO Dave Hughes expressed his disappointment with both the announcement and the scheme: “On the face of it, it appears to offer nurses an opportunity, but in reality it turned out to be nothing more than a cheaper version of a nurse and now that it’s been extended to people who graduated in 2010, it really creates a lower grade of nurse.” Second year nursing student and Auditor of UCD NurSoc Tom Hefferon feels “insulted” by the pay-level, commenting: “It’s quite degrading. We’re thought so little of after working so hard for four years in university, and coming out with only an 80% pay when we’re 100% qualified.”Aside from being dissatisfied with the level of pay nurses will receive, Head of UCD’s School of Nursing and Midwifery Dr Martin McNamara is frustrated that this is being called a ‘training scheme’. “There has been no engagement with the higher education institutions in relation to the suggested educational elements of this so we’re not satisfied that there is a structured, adequate educational component to this scheme, so it does seem to be primarily about bringing in graduate nurses at a very, very low point, at a very low salary.”The scheme is designed to tackle the problem of an over-reliance on agency nurses and overtime, and it is hoped that it will save the HSE in the region of €10 million in 2013 alone. Hughes believes however, that hitting the payroll with cuts isn’t the answer to the HSE’s financial woes. He explained: “The costs overruns have nothing to do with the staff, they are all to do with the increasing levels of unemployment and higher levels of dependency on medical cards so that’s where the costs have gotten out of control. It isn’t that the pay budget went up or was overrun. The pay budget was lived within in its entirety, so that’s not where the costs are increasing.”Dr McNamara added that large savings are still to be made if the HSE pay the nurses a full 100% salary, as “the reason for announcing these posts beyond the employment control framework is to cut down on the cost of overtime and of temporary agency staff… There are approximately 1,600 nurses being employed essentially on a full time basis in the Health Service every day of the week, on considerably higher salaries than a first year staff nurse at the appropriate salary, so considerable savings would be made in any case without reducing the salary to 80%.”The HSE’s National Director for Human Resources Barry O’Brien defended the scheme saying: “I find it very difficult to understand the INMO’s reaction to this initiative, as in the past, they and other unions have criticised the HSE for not retaining graduates in the health services, leaving them with no other option but to go abroad for work.”However, according to Hughes, this will only increase the level of emigration in the industry: “From talking to the graduates themselves, many of them because of this initiative, have given up on the Irish state and have basically said they’ll go where the money is better.” Dr McNamara feels similarly, commenting: “I think it does send out an unwelcome message in relation to how they’re valued within the health system... We know from our students who do go abroad to countries like the US, the UK, Australia, New Zealand, Canada and elsewhere, that they’re highly valued and the thing that’s always said about them is that they hit the ground running.”Hefferon is less sure of the impact of the scheme on his future prospects, however, saying: “I think it will certainly plant seeds in people’s heads and possibly plant an idea but I don’t know that it will increase the number of people emigrating.”While a number of students aren’t in a position to emigrate no matter what their job prospects are in Ireland, Hughes is keen to hammer home the point to graduate nurses that there is work available to them outside of this scheme. He explains: “The reality is that nurses can get work abroad or they can get work in Ireland [through agencies] and this is an attempt to corral them into a situation where they have no choice but to take these positions. There’s a need for nurses; it isn’t that there’s a surplus.”Dr McNamara believes that it isn’t the School of Nursing and Midwifery’s position to decide for students whether or not they should apply for this scheme, however he is encouraging students to think about their place in the healthcare system. This is something that he feels is one of the most important factors for students considering applying for these positions. “I think each graduate need to know their own worth and I think nurses do need to value what they bring to the health system, and it’s a very considerable amount in relation to the quality of patient care, patient safety and patient satisfaction with healthcare delivery so I think it’s up to each and every nurse and midwife to value themselves and know what their value is as graduates and as registered professional people.”