Finding ‘cure’ for nurses shortage

Health Minister Dr Fuad Khan has already drawn fire with his suggestion earlier this week to deal with the shortage of nurses. This is a perennial problem with which successive health ministers have grappled for years. Indeed, it seems to be an intractable one. The main problem is that after they are trained locally, nurses migrate northwards to fill gaps in the US health system.

This problem has persisted despite incentives added to nurses’ salaries, despite attempts to increase the numbers of nurses being locally trained, and despite schemes to import nurses, along with other healthcare professionals, from Cuba. The latter scheme, says the Health Minister, has cost the country $150 million over the past four years, between the costs of advertising and recruiting and the need to pay attractive salaries to bring in foreign nurses.

Nevertheless, at present, Dr Khan revealed on Monday, there are still 3,000 vacancies in the profession. Now it is Dr Khan’s turn to find ways to address the issue. Some are unobjectionable, such as his plan to increase the number of places available for student nurses at institutions that include COSTAATT and the University of the West Indies.

Another reason for the shortage, he points out, is that in order to be licensed to practise in this country, all nurses—no matter how highly qualified and experienced they may be—must pass an exam set by the Nursing Council. This has proved a major stumbling block. Nevertheless, it is Dr Khan’s proposal for removing this obstacle that has been the target of criticism.

It has been argued that Dr Khan will be lowering standards by doing away with the stipulation that all nurses must pass the Nursing Council exam before being licensed to practise. Dr Khan, however, points out that 40 per cent of the trained nurses who sit this exam fail it—and argues that this shows not that there is something wrong with the nurses, but that there is something wrong with the exam.

Indeed, if nurses who already have degrees and diplomas from recognised institutions cannot pass this test, that suggests that either the standards are unrealistically high, or that the exam is not administered fairly or objectively. That worryingly high failure rate must also be a major deterrent to numbers of young people who are contemplating entering the profession.

Why invest years in studying for a degree when, at the end of it, there is no guarantee that, even after graduating, one will be allowed to practise? What use, then, is a nursing degree if it does not allow one to become a nurse? So the minister is proposing to do away with this exam—for nurses who already have a degree or diploma from a recognised institution.

They will instead be required only to demonstrate to the council that they are fit and proper to practise nursing. This new system would be on par with the regulation of the medical profession with regard to doctors—who are not required by the Medical Board to sit any further examinations, once they can demonstrate that they have professional credentials issued by a recognised, accredited institution.

Why should the requirements set for nurses be more stringent than those for physicians? Dr Khan’s proposed solution, then, is a reasonable one. It should be borne in mind, too, that it is still only a proposal, and must be subjected to the scrutiny of both Houses of Parliament before it can be put into practice. Any practical approach that will help reduce the size of this healthcare headache, which is not only chronic but severe, is worthy of consideration.