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Nursing abroad

U.S. and Middle Eastern hospitals offer better pay and conditions

By Julie O'Shea
Staff Writer, The Prague Post
August 6th, 2008 issue

MICHAEL HEITMANN/The Prague Post
Pavla Kubiasová looks forward to relocating to Saudi Arabia soon and is "not afraid of the work" in a new country.
COURTESY PHOTO
Other Czech nurses have made the move successfully and enjoy the benefits.
MICHAEL HEITMANN/The Prague Post
ÚVN's Lenka Gutová fears nurses' low wages will deter potential students.
After 12 years in the Czech nursing industry, Pavla Kubiasová is restless. She has spent her entire professional career at the same hospital in Plzeň, west Bohemia near her family’s residence. She’s passionate about her work and couldn’t imagine doing anything else. But, at 32, Kubiasová, like so many other nurses in this country, longs for a new setting — one with higher pay, more respect and different challenges.
Her dream is to move to the United States, where she spent two years as an au pair and fell in love with the American way of life. As a board-certified nurse specializing in intensive care, Kubiasová could easily see her yearly income quadruple, which makes moving that much more enticing. However, while the United States’ nursing shortage, like Europe’s, is in a staggering upward spiral, hiring foreign laborers is still a lengthy and costly green-card process that can take up to a year, if not longer, according to Kubiasová, who is in the middle of applying.
Kubiasová, however, has no intention of staying in the Czech Republic while she waits for the United States to green-light her application. Instead, she will move to Jeddah, a large coastal city along the Red Sea in Saudi Arabia, by the end of the year and take a job at a local hospital there. It’s a position she’s spent months training for. Kubiasová knows she is in for a big cultural shock but says she is not afraid.
“I have friends there,” she says. “I’m not afraid of the work. I have 12 years of experience. I am more afraid of the hospital jargon.”
Kubiasová isn’t the only Czech nurse eyeing more lucrative positions abroad these days. Statistically, the number has been on the rise over the past several years while the number of trained nurses and nursing assistants joining the local work force continues to be on the decline, a point that has alarmed health administrators around the Czech capital.
“If I knew how to solve the situation, I would have done it already,” sighs Lenka Gutová, deputy director in charge of the nursing staff at Prague’s Central Military Hospital, ÚVN. “It’s not so easy.”
The cripplingly low pay — the average Czech nurse’s monthy salary is 22,900 Kč ($1,500), according to the Health Ministry — is just one factor. The lack of respect and increased educational requirements also rank high on the complaints’ list. Czech nurses must now hold a bachelor’s degree in order to work in the medical field. The new standard was introduced when the country joined the European Union. Previously, those interested in the nursing profession simply had to go to a secondary school that specially trained them for that field of work.
“We have to find solutions that would involve shortening the education for those nurses who already obtained one qualification, and they could study and work while obtaining the second,” explains Tomáš Cikrt, spokesman for the Health Ministry. “The hospitals also carry their deal of responsibility and can participate in solving this problem [by looking at, for example,] nurses’ incomes and the atmosphere in the work place.” But that may be easier said than done.
Gutová, for one, fears that potential nursing students might opt to study something that will ultimately pay more in the long run. Or, if they do earn a nursing degree, they might choose to take their education and skills to another country, where salaries are higher.
Gutová notes that she has seen a lot of young nurses leave for positions in the United States and the Middle East. Fewer turn to the United Kingdom, Gutová adds, because “it is difficult to become a nurse in Britain. They have to pass a test of their abilities. In the United States and the United Emirates, [for instance], they don’t have to pass a test, just an interview.”
Kubiasová can’t wait to leave. She’s been told that the Saudi visa process is a breeze and that she will be able to obtain all the necessary papers in just one afternoon. Not only will she be making a lot more money — somewhere between $2,500 and $3,540, according to the program she is going through — but Kubiasová will also get eight weeks of paid vacation.
She doesn’t know when, or if, she’ll ever move back permanently, but she hasn’t ruled out the idea.
“My home is still here,” she says. “It’s a pity they don’t keep [nurses] in the Czech Republic.” But, she adds, “it’s a question of money and work environments. It’s not a prestigious job. If you are a nurse, you must love the job.”
Martin Vrba is all too familiar with the predicament of the Czech nursing industry. As program director and co-owner of G5 Plus, a Prague-based recruitment and consulting company specializing in healthcare services, he has been helping Czech nurses find jobs in the United States and the Middle East for the past three years. It is the same company Kubiasová went through to find work abroad.
“The nursing profession is not valued as it should be,” Vrba says. “The nursing profession needs to become more attractive. More money and prestige will keep more nurses in their jobs and bring more nurses to nursing schools.”
More money, Vrba says, is one of the biggest reasons nurses turn to G5 Plus, which markets itself as one of the only companies in Continental Europe that is able to prepare nurses for the U.S. licensing exam.
Miloslav Ludvík, director of the Motol University Hospital, admits that, while the money issue is a huge source of worry, he would need at least 100 million Kč a year in order to give just a portion of his nursing staff a 25 percent raise. And that’s money, Ludvík says, he doesn’t have right now.
It’s a problem that many hospitals around the Czech Republic face, forcing administrators to limit the number of available beds so that patient care doesn’t suffer because of the shortage of nurses or nursing assistants on hand.
Despite these grim circumstances, however, Ludvík doesn’t think low wages are driving Czech nurses to other countries.
“Czechs don’t want to move,” Ludvík says. “They don’t like to be transferred. There are language barriers. [And] this country has such a high standard of living.”
The Czech Republic isn’t losing its nurses to the United States or the Middle East; rather, Ludvík thinks, the country is losing its nurses to pregnancy: Many are getting pregnant and then choosing not to return to work.
“They don’t want to go out of the profession, but they are very, very tired,” says the Motol director. As a result, some of them look for different ways out.   
— Hela Balinová contributed to this report.  

Julie O'Shea can be reached at joshea@praguepost.com


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Reader's comments:

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[05:37 10/10/2008] : wish Nurses in the United States could just get pregnant and leave the job. Doesn't work that way over here, you have a child, you pay for it. No social leverage with a child.
melissa
St. Petersburg
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