Health (and residences) will collapse this summer due to the lack of nurses

It’s like groundhog day. Every summer, nursing homes, health centers and hospitals raffle the few nurses who are neither on vacation nor have been exiled to Europe in search of opportunities. This year, the competition is even more fierce. The regrowth map grows unstoppable and the professional deficit can be “deadly”. Diego Ayuso Murillo, a nurse (by training and vocation) and secretary general of the General Council of Nursing (CGE), speaks openly of the risk behind this black hole: “If there is a regrowth in the fall, we will have a problem again and it will be very serious”. Unlike gowns, masks, or respirators, there is no 3D printer to fill a chronic lack of sanitation.

In the last decade, Spain has doubled the number of graduate doctors, but has only raised the number of nurses by 20%, leaving the country at the bottom of the 36 OECD states in the nurse / doctor ratio. “They graduate and retire almost in the same proportion”Ayuso says. The WHO figures clarify this idea: 31% of professionals are under 35 and 21% are over 55. Despite the advanced age of staff, Spain is not at risk of not having generational replacement of nurses . Last year in Spain there were 316,094 nursing graduates. The CGE put the country’s nurses corps at 246,138.

The problem goes beyond the National Health System. “The deficit has also spread to private clinics and many have been forced to close healthcare areas due to lack of personnel“Ayuso regrets. If the hospitals take out a place, the residences are emptied.” When someone studies nursing, they generally do so to end up in a hospital and not in a residence, “he points out. Pilar Ramos, president of the Madrid Association for Dependency Care (Amade). Your organization figures in 2,000 nurses requiring private senior centers to avoid debacle.

UCI hospital coronavirus

There is a whole salary pyramid. Nurses in public hospitals charge around 400 euros more per month (€ 1,500 without guards) than those in private and public residences. The latter receive about 300 euros more than those of private centers. “We are at the tail of the national team”, he regrets Recesvinto Valiente, Geriatrics nurse in a public residence in Madrid and spokesperson for the SATSE union. The gap explains that, in residences such as Colmenar, Arganda or El Carmen, a single nurse had to take care of about 400 patients. “If this happened to us once or twice … now it will be a constant”. The problem is even more serious when looking beyond the summer. The echo of a massive outbreak in the fall leads one to think that Health will not give up the recruited corps of nurses when the summer ends. If then there is a rebound, the residences (public and private), will be disarmed and without the possibility of reinforcing templates.

“We are alerting councils of some CCAA. The listings for new hires have been sold out and they cannot find personnel to fill the vacancies, “Ayuso warns. Things do not come from now. Spanish Healthcare has one of the worst nurse / patient ratios among European countries in the environment. With more than twelve patients for each professional , compared to the average of eight that prevails on the other side of the Pyrenees. When things started to go wrong, in the middle of the coronavirus debacle, the General Council of Nursing flew (literally) to repatriate professionals, since around 8,000 Spanish women work in the Foreign. “We embarked half a hundred back to Spain”recalls Ayuso. The tide has calmed and the nurses have packed their bags.

Nursing homes

“There were no nurses, when I had to prick morphine on a resident”

In the months of July and August, the deficiency is chronic. When the heat picks up, beds are closed and healthcare personnel are kept to a minimum. But this is not just any summer. “There is no job bank because the nurses were already hired during the pandemic”, Explain Brave. The recent graduates will come across this summer with an unusual scene: there will be jobs for everyone in the hospital setting. Valiente has been working for more than thirty years in public residences in Madrid. He gives as an example to Rafa, a fellow student who studied with him and now practices Transfusiones at the Gregorio Marañón: “They tell him about his professional career, not me. The translation is a gap of 7,000 euros a year that your payroll does reflect, mine does not“When hospital work is scarce, residences save furniture. This year, “apart from few we are less”.

The lack of nurses, in turn, affects another link in the care chain: auxiliary nurses. The social and health centers stand on three legs: the hotel, health and healthcare sectors. The latter falls on the techniques of Auxiliary Nursing Care or TCAEs. The presence of a 24-hour nurse in the residences is practically non-existent in Spanish centers. They can neither prescribe, nor cure, nor practically anything that goes beyond the script that the doctor writes on her punctual visits. But in a war scenario like the one triggered by Covid, competitions take a back seat.

L.F. is TCAE in a private social health center. “The law does not allow me to administer a paracetamol if the doctor has not left it in the resident’s box … however I had to put morphine on a resident with rales“The professional assures that they have not had the support of the medical personnel more than in sporadic moments.” In theory we cannot make cures, if the nurse comes once a week, the rest of the time the resident has the wound bandaged … and we can not do anythingWhen she had to face the death of that old man, she suffered an anxiety crisis. “If they catch me, I go to the street. We needed help that didn’t come”. You panic at the thought of a regrowth that will catch you again on the front line and without assistance.

During the peak of the pandemic, nurses from across the country mobilized to the epicenters of the virus such as Madrid or Barcelona. Few remained. “If you don’t take care of the professionals, in the end they leave”, ugly Brave. It is not a good year for cuts. Pilar Ramos points to another measure: “During the crisis, public health accelerated to hire professionals with a foreign degree. The private sector did not have that option.” Accelerating the validation of titles would appease the deficit of professionals, but it does not tackle the problem: Spain is a talent drain. The temporality and the salary gaps that the profession suffers will not remit based on patches, but with future planning. In this country there is no lack of nurses, but recognition.

* The initials of the TCAE are fictitious to protect your identity.