The Dominica Nurses Association is blaming the government for “nurses leaving Dominica in droves”.
“We are very disturbed by what appears to be the inability of the Ministry of Health and by extension, government after government after government, to make the healthcare environment more positive, attractive and caring enough to retain adequate numbers of home-educated nurses,” Association president Rosie Felix said in a release.
The nurses’ statement on the matter follows recent comments by Health Minister Kenneth Darroux alluding to the problem.
Last month the Ministry of Health expressed concern over the number of nurses who have left Dominica since the passage of Hurricane Maria last September.
According to figures from the ministry, some 14 nurses including retirees departed the island since the hurricane.
In their release, the nurses indicate that the issue is for them a vexing recurring decimal.
Quoting the International Council of Nurses, the local association says nurses are the backbone of the health system and everything should be done to give them a quality work environment because quality workplace equals quality patient care.
“The biggest and most prolonged challenges facing our nurses include but are not limited to lack of professional pay for professional work, workplace bullying, lack of respectful and compassionate leadership, victimization, unsafe nurse:patient ratios, work overload and related burnout, plus lack of resources and support (International Council of Nurses, 2007)” the release states.
According to President Felix “Hurricane Maria is not the reason that nurses are leaving Dominica. This natural disaster is only the straw that broke the camel’s back”.
In terms of the numbers, she points out that “in 2016 an estimated 12 nurses resigned from the nursing service, an estimated 12 resigned in 2017; a further 12, have already disappeared so far this year”.
The reason for the nursing migration is apparently not only financial.
The Dominica Nurses Association release points out:
“Workplace bullying has been documented and reported at the Acute Pyschiatric Unit and DNA for two generations of nurses. In 2010 DNA requested a formal investigation into that matter. That investigation was carried out by Mr Gerard Burnette but the findings were never acted upon. In the last 5 – 10 years many nurses have verbally reported being bullied or witnessed bullying in other departments of the health sector. Written and oral complaints to the relevant heads have proven futile – instead the victims have been transferred, victimized or punished. This problem is leaving nurses battered, bruised, demotivated and deflated”.
According to the association, many nurses can take it no longer: “they are escaping like refugees as they seek to protect their sanity and peace in neighboring territories where the environment is safer and healthier and the pay far better”.
Lack of proper remuneration of nurses is described as a critical factor.
“Nurses have never been paid as true professionals in Dominica; we are the lowest paid in the region. We have been used and abused in that regard,”the association says.
In explaining that situation the DNA says that In 2013, consultants, of a job evaluation exercise, requested by government and conducted by the Caribbean Center for Development Administration, found it a justifiable cause and recommended a significant salary scale upgrade for nurses.
“The government has unequivocally ignored this recommendation hence the status quo remains – no professional pay for professional work. Consequently nurses leave for higher salaries which is complimented with benefits such as health insurance, duty free vehicles, and housing. The $5000 EC start off pay for new nurses in neighboring jurisdictions exceeds the start off salary of even the top nurse in Dominica”.
The nurses have been trying to get their long list of concerns addressed.
“We are disappointed that we have not received an appointment to meet the Minister of Health to discuss the problem and the solution, after three weeks of requesting one,” the health workers state in their release.
The nurses say they are aware that more of their colleagues plan to make their exit in the weeks and months ahead, and their Association is calling on the government “to intervene favorably and urgently to save a collapsing nursing service”.
Their recommendations include:
(1) That government implements, as a matter of priority, the salary upgrade for nurses as per the 2013 recommendation of the Caribbean Center for Development Administration;
(2) That the ‘magnet hospital’ concept (International Council of Nurses, 2007) be adopted with an unresfusable practice and benefits package to attract and retain qualified and experienced nurses.
(3) That the MOH investigates workplace bullying across the nursing service, develops and establishes anti-bullying policies; and disciplines and or provides counsel for the perpetrators;
(4) That the report of the workplace bullying investigation conducted at the Acute Psychiatric Unit be retrieved with a view to adopting, adapting and implementing proposed solutions and prevention measures across the health sector;
(5) That nursing managers from the community health centers, to the hospital wards and offices, to the government headquarters, incorporate compassion, respect, empathy, fairness, humility and honesty in their leadership and management styles beginning yesterday.
Health Minister Darroux admitted recently that the local nurses are under pressure.
“We know that we’ve had quite a bit of nurses leaving, some nurses are working extraordinary hours to make the place function,” the minister said.