Perspectives in Health Magazine
The Magazine of the Pan American Health Organization
Volume 8, Number 2, 2003

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Index

Hasta la vista, PARADISE!
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Year of the nurse

As part of their stepped-up efforts to keep trained nurses from leaving home, the countries of the Caribbean recently declared a "Year of the Caribbean Nurse" from May 2003 to August 2004. The 16-month-long "celebration of nursing and nurses" is aimed at increasing recruitment and retention, strengthening nursing and midwifery services and "recognizing the best of nursing and nurses in the region."

"I cannot overstate the significance or potential that the Year of the Caribbean Nurse holds for all people in the region," says Marjorie Parkes, chairperson of the Regional Nursing Body.

The year was kicked off at a gala event in May in St. Kitts, with Prime Minister Denzil Douglas presiding. Each month throughout the year, two different countries will host special events showcasing nurses' contributions. Among the highlights will be special welcoming ceremonies—complete with media coverage—for nurses returning to the Caribbean from abroad, whether for vacations or for good. In return, they will be asked to contribute "a few days to a week" of mentoring activities to pass their skills on to more junior nurses.

With the theme of "Nurses Lighting the Way to Professional Excellence," organizers have produced a special Caribbean nursing symbol featuring a lighted lamp against a backdrop of the flags of all the region's countries. It will be passed from one country to the next until the celebration culminates in Curaçao in August 2004 at a meeting of an estimated 400 nurses from throughout the region.

The main organizers of the year are the Caribbean Nurses Organization and the Regional Nursing Body, also lead actors in the region's Managed Migration program. Supporters include the Pan American Health Organization, Johnson and Johnson, the Lillian Carter Centre for International Nursing and the Department of Advanced Nursing Education at the University of the West Indies.

Nursing brain drain
The impact of the nursing crisis is being felt throughout the Caribbean region. Many of the most experienced, skilled and specialized nurses have left for greener and more professionally rewarding pastures. Many of those remaining are nurses near retirement (mandatory at age 55 in most Caribbean countries), and the number of new nursing graduates is declining. About 35 percent of nursing posts in the region's health sector are currently vacant. Many patient care units have had to be merged and elective surgery often cancelled in many hospitals. "Sick outs" by nurses demanding better pay and working conditions have cost governments almost $3 million.

As a result of the nursing brain drain, the loss in public investment in training nurses at the basic level is estimated at nearly $17 million. One senior nurse in Trinidad, who prefers that her name not be used, says that many young nurse trainees make no effort to disguise their intention of using the profession as a means of getting a "green card" to work in the United States.

"It makes me upset," she says, noting that this further reduces the standard and quality of nursing care.

In the larger sense, the nursing crisis feeds widespread fears among the taxpaying public about the availability, safety and quality of health care. "It has, and will continue to have, a profound impact on nursing services both quantitatively and qualitatively," says Noel. "This shortage is unlike those of the past and requires bold action and innovative and creative solutions."

With the problem gaining attention, a Caribbean response to the challenge has now emerged. At the national level, ministries of health, with support from PAHO, are partnering with local nursing associations and other stakeholders to address the roots of the problem. At the regional level, the Regional Nursing Body, the Caribbean Nurses Organization, other professional associations and teaching institutions are similarly involved. Also participating are the ministries of health and nursing and health organizations in recruiting countries, as well as private companies and foundations.

A central focus of these efforts has been the development of a new Managed Migration program, defined as "a regional strategy for retaining adequate numbers of competent nursing personnel to deliver health programs and services to Caribbean nationals at the highest level of quality." It addresses the recruitment, retention, deployment and succession-planning issues inherent in the exodus of nurses from the Caribbean. A newly established "implemention team" is coordinating efforts in several priority areas, including the terms and conditions of work; use and deployment of nurses; recruitment, education and training; management practices and the value of nursing.

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