June 14, 2011

THAILAND: Health Crisis - Another 40,000 nurses wanted!

BANGKOK / The Nation / National News / June 14, 2011

Large incentives being offered as state hospitals fighting for graduates

By Pongphon Sarnsamak, The Nation


State-run hospitals across the country are competing strongly to grab newly graduated nurses because of a severe shortage blamed on government inattention over the past few years.

Khon Kaen Hospital director Dr Peeraphan Suwanchaimart said even though his hospital had 800 nurses, it was not enough because of the National Health Security Office's policy to extend medical services under the universal healthcare scheme. The hospital also had to provide medical treatment for patients transferred from other hospitals, especially from rural facilities. Currently, the hospital has to provide medical services to about 3,000 outpatients and 300 emergency patients a day. The hospital also has to treat about 900 in-patients.

But nurses could no longer shoulder the heavy workload, as many were getting older. So, the hospital had to recruit younger nurses to keep up its treatment standards. However, the hospital now faced challenges from other centres with staff shortages.

"We have to compete with other hospitals for nursing students and provide scholarships or grants, otherwise they will sign long-term contracts to work at other hospitals," Peeraphan said.

The hospital had been forced to provide Bt60,000 scholarships to attract new graduate nurses and asked them to sign a contact to work for two years to resolve the nursing shortage. During the past few years, there had been intensive rivalry among state hospitals for nursing graduates.

"We had to step back [in the race for] nursing students, as some hospitals had offered over Bt150,000 to them. We could not offer so much money," he said.

At Khon Kaen Hospital about 300 of the 800 nurses are employed as temporary workers. But such employees have been resigning due to the heavy workload, and going to work at private hospitals.

Chon Buri Hospital is another that has faced a severe shortage of nurses. Director Dr Chatri Tantiyawarong said the hospital needed over 900 nurses to work there but now had only 500.

"Even though the hospital has tried to recruit newly graduated nurses, no one has walked in and submitted a job application," he said.

To resolve the problem, Chon Buri set up a booth at the local university to recruit nurses. The hospital offers scholarships and a monthly salary, together with Bt13,500 when graduates sign a contract. New recruits also get benefits such as over-time and special allowances.

"Only 10 newly graduated nurses a year come to talk with us and want to work at the hospital," he said. "Some just work for a few months and then resign due to the workload." The hospital now has teamed up with a local university and other educational institutes to train its "own" nurses, by supporting them with Bt30,000 scholarships.
According to a recent survey conducted by the Thailand Nursing Midwifery Council, Thailand needs about 180,435 nurses in the health system but has only 138,710.

Human Resources for Health Research and Development Office (HRDO) manager Nongluck Pakraiya, who conducted a study, said many general and provincial hospitals, especially in the Northeast, had to resolve the problem by themselves.

They offer student nurses grants of Bt60,000 up to Bt160,000 and other benefits while in their first year of university. Nursing students were also asked to sign deals so they stayed with the hospital for four years.

The high demand for new nurses or nursing students at state hospitals has been caused by many senior nurses leaving over the past few years. Many experienced nurses could no longer bear the heavy workload, she said.

Another problem is most new nurses don't want to work at health ministry hospitals, as they are designated as temporary employees - not civil servants. They prefer to work at private hospitals instead, where they get higher wages for less work.

A 23-year-old nurse, who did not want to be named, who works at a state-run teaching hospital with a university, said she was offered a Bt150,000 scholarship by a state hospital while doing her first year at nursing school. She had to sign a contract with the hospital and promised to work there for four years. Failing to complete the contract would have meant having to pay Bt300,000 back to the hospital in compensation. She could get over Bt20,000 a month in salary to lift her quality of life but had to face a heavy workload everyday in the emergency department.

"Even though I face heavy workloads I will continue to work at this hospital as I can get an opportunity to improve my life," she said.

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