Feature - Mature choices for the future

Initiatives such as flexible hours and job-sharing should be widely adopted and marketed to entice mature nurses and students back into the nursing profession, writes Anne Henrichsen

We are all acutely aware of the urgent need for more nurses in the health system but how can we make the concept of recruiting and retaining them a reality?

Currently the existing vacancy rate is running at 10% and the Irish Nurses Organisation estimates that there is a net requirement of 1,800 additional nursing posts which are not available in the current climate.

According to the Nursing Recruitment and Retention Group Report 2000, carried out by the Dublin Academic Teaching Hospitals, over 60% of nurses leaving the profession are aged between 20 and 29. The report recommends that this group should be targeted in order to attract them back to the profession.

The report which is based on detailed staffing level and job satisfaction surveys carried out in 1999 also recommends that a full-time nursing recruitment officer, with sole responsibility for recruitment and retention of nursing staff be appointed in every hospital. Recommendations in the report include:

Back to nursing courses

Another answer to getting more nurses into the system lies in attracting mature nurses back into work or mature people who are looking for a change in career into nurse education and then onto the wards.

Indeed there are encouraging signs that this has already begun to happen. Of the 8,822 applications for the Direct Entry Degree programme in Nursing for 2002 1,846 were mature students which is a welcome development.

There are also welcome initiatives to get nurses who left the profession back into practice. Currently there are 15 hospitals around the country offering return to nursing and midwifery practice courses. These are offered on the basis of demand and run from four to six weeks.

Course content

St Jamess Hospital, Dublin has run two five-week courses a year for the past 10 years, with 15-20 participants on each course.

Since last December applicants get paid for four weeks of the course. The fifth week is optional and is spent in different departments within the hospital, said nurse tutor, Imelda Duffy, who runs the course.

In a typical four week course the student receives a combination of clinical and theoretical instruction.

The first week is spent in bloc where the students learn skills such as updates in CPR skills, moving and handling.

This is followed by one week in a clinical area, for example cardio or respiratory. The third week is spent back in bloc and the final week is back in the clinical ward setting.

Usually we try to allocate them to an area where they havent been before, she said.

Retention

It is no surprise that the number being retained following completion of the course seems to increase once flexible hours and part-time hours are on offer.

Judging from the last few courses there are more staying on. Here in St Jamess most dont want full-time, they want flexible, part-time hours, according to Ms Duffy.

Management are beginning to get their heads around this but there is a long way to go, she adds.

In previous years there was no incentive for recruitment but things have changed, she said.

The James Connolly Memorial Hospital in Blanchardstown offers a six week course yearly.  Out of the five applicants on last years course, two are working back in the hospital according to Gervaise Maher, nurse tutor, who runs the course.

Encouragement and support

For many, a return to nursing can be physically and emotionally exhausting.

Many nurses who return or start late find the wards very tough physically, these nurses need more formal support similar to a preceptor, said Ms Duffy.

Gervaise Maher, nurse tutor at The James Connolly Memorial Hospital in Blanchardstown agrees.

They are a great bunch of people who need to be supported. They have a huge amount to offer nursing. They have life experience which can only be beneficial to the patient,  she said.

Payment

In a recent move, the Department of Health has agreed to pay those who applied to do the return to nursing courses once they had previously completed two years service.

According to the Health Services Employers Agency, on commencement nurses should receive salary rates commensurate on previous nursing experience.

Centralisation

Plans are underway to merge all the courses at the Dublin hospitals.

The Dublin Association of the Teaching Hospitals (DATHs), which includes Beaumont Hospital, JCM Blanchardstown, The Mater, St Jamess, St Vincents and Tallaght Hospital, are  behind the initiative and havegot course approval from An Bord Altranais.

The courses are not rationalised yet but are in the process of joining up. A lot of work has been done on drawing the courses together. It is planned that later this year a central course system will be developed, according to Catherine Guihan, part-time education officer with An Bord Altranais and nurse tutor in the Mater Hospital.

Following a late vocation
When Eileen Finnans daughter began studying nursing, little did Eileen know that a year later she herself would be embarking on a journey toward a full-time nursing career. For Eileen nursing has always been close to her heart. Since my school days I had my eyes set on nursing but didnt get in so I decided on a future in insurance. When she married and had children Eileen gave up her job. However, the intervening years were not exactly quiet as Eileen balanced children, an ageing mother with Alzheimers, as well as finding time to write short stories. She is also involved in community work. I trained as a relationship counsellor and was involved in giving premarriage courses, she says.

When her daughter took up nursing in St Vincents in the autumn of 1997 Eileen decided it was time to pursue her long-standing ambition. When I heard that the course took mature nursing students I decided to apply. In the summer of 1999 following seven months of studying Eileen resat her Leaving Certificate and received three honours in Biology, English and Business Studies. She then passed a Bord Altranais aptitude test and received her first preference and in September of 1999 Eileen, at 46 years old, entered Beaumont Hospital as a student nurse. She qualifies this month hopes to begin a higher diploma in palliative care.
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