Nurse exodus: Implications of migration of specialised nurses

THERE has been mass exodus of qualified professional nurses from Zimbabwe in the past few years since the end of dollarisation.

This brain drain is not only witnessed with the migration of nurses only but generally the whole health cadre strata has not been spared as these health workers have joined the bandwagon moving to Zimbabwe’s northern and or Southern neighbours. Others have gone overseas where their demand is is high.

The current exodus of nurses threatens the gains achieved in health in the past decades after the previous mass exodus before 2009. The gains were in human capital retention as well as improvements in quality of life of the general citizenry. Customer service at health care centres has declined under a demoralised, understaffed and over worked healthforce. Most of the time, there are some health workers who are not fully experienced manning posts.

There has been a slow trend in general nurses manning stations supposed to be manned by specialised nurses, for example in maternity sections. Inasmuch as there is a reasonable ratio of midwives manning labour wards, it is a different scenario in other sections like the antenatal and post natal care wards.
General nurses man these stations because of the prevailing shortage of specialised nurses, that is the midwives responsible for handling such sections.
The same can be said in the Kangaroo mothers sections where midwives are hardly available. In the short term, the dilutional effects of specialised nurses with general nurses may not be so apparent and obvious, but in the long term the results are going to be devastating. Maternal mortality which is a sensitive indicator of health development in any country is at risk of further plummeting down.
Martenal mortality for 2020 was 614 per 100 000 live births versus target of 350 per 100 000 live births in Zimbabwe.
Not only is maternal mortality at risk, but other indices of health development are equally compromised.
The theatres have also been diluted as the number of theatre trained nurses is also below the recommended optimum with non-trained general nurses scrubbing and assisting cases which in the long term may compromise quality putting patients’ lives at risk.

The Critical Care section has not been spared by this dilution with trained and experienced Intensive Care nurses migrating leaving the stations to general nurses looking after the critically ill patients.

One might be forced, and justifiably so, that this trend of non-specialised nurses looking after patients in specialised areas is rampant in public health institutions but the private health space is equally complicit to the same.

The advantage of the private sector has been the temporary relief they get by hiring those few specialised nurses from government to cover for their shortages, but sgaps are still linger with some patients being looked after by general nurses even in specialised areas like ICU.
The threat imposed by the migration of specialised is real and requires urgent measures to curtail the trend. The intra-country migration (migration within the country) from public sector to private sector as well as the inter-country migration whether from public or private sector to other countries requires urgent attention.
Inasmuch as other political and health leaders view all nurses as being equal, the truth is otherwise.
Nurses are not equal and not all of them are at the same level. Just having a general nurse present to look after patients in a specialised area, is not just morally and professionally wrong, but a recipe for disaster.
Fulfilling staff head count and numbers is not enough, but quality should be guaranteed on all the sick who require help in their times of need so that care itself does not become a danger to the patient at the end of the day.
As challenges are espoused, solutions should also be proffered for the criticism to be constructive. It is imperative that as a country more specialised nurses are trained. The current output needs acceleration to mitigate the migrating numbers as well as the population growth in general. Some nursing schools should be considered for specialised nurse training. Retention of specialised nurses is key. The incentive should be real for one to consider specialised nurse training. More importantly remuneration should reflect such personal investment in comparison to a general nurse.
There should be an introduction of locums in the public institutions which are competitively paid at an equal rate to the private sector so that there is continued presence of specialised nurses at public institutions without them looking for locums at private institutions. Private institutions need to retain their specialised nurses by other innovative means including recognising expertise and experiences. The obvious excuse from any management whether private or public is money, and if leaders responsible for these institutions both in public or private continue to sing this song without being innovative, finding lasting solutions and taking for granted the large pool of nurses in the country, they will be surprised to find not a single specialised nurse as they will continue to assume that a nurse is a nurse and they all function at the same level which is WRONG. These are just a few suggestions out of the many at hand which may assist authorities in addressing the acute shortage of specialised nurses in Zimbabwe.

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