Comment

Fair pay: the only option that helps us keep the nurses we have

The international nurse stopgap is no longer a possibility, and COVID-19 demands a values shift

The international nurse stopgap is no longer a possibility, and COVID-19 demands we invest in UK nursing

A nurse holds her pay slip during a protest at Harare Central Hospital, Zimbabwe Picture: Shutterstock

Pay is so much more than just the money nurses have in their pockets it is literally the currency that indicates how valued they are by society.

Since the start of the COVID-19 pandemic, countries across Europe, Asia and the Americas have been using different measures to reward nurses.

Agreeing fair pay for nurses everywhere

These include increasing basic pay and allowances, allowing extra leave, awarding tax breaks and even offering bonuses.

But the opposite is also true, with some nurses in Africa facing pay freezes

The international nurse stopgap is no longer a possibility, and COVID-19 demands we invest in UK nursing

A nurse holds her pay slip during a protest at Harare Central Hospital, Zimbabwe
Picture: Shutterstock

Pay is so much more than just the money nurses have in their pockets – it is literally the currency that indicates how valued they are by society.

Since the start of the COVID-19 pandemic, countries across Europe, Asia and the Americas have been using different measures to reward nurses.

Agreeing fair pay for nurses everywhere

These include increasing basic pay and allowances, allowing extra leave, awarding tax breaks and even offering bonuses.

But the opposite is also true, with some nurses in Africa facing pay freezes and even pay cuts, leading to unhappy workforces and talk of strike action.

The International Council of Nurses (ICN) has written to some heads of state – including the president of Zimbabwe, where nurses were on strike over pay – to urge them to enter into negotiations and agree fair pay settlements.

View our COVID-19 resource centre

The economic value given to what nurses do

There is something important going on here.

Not about some sort of COVID-19 bonus or danger money, but the fact the pandemic has shown the gross inadequacy of the economic value that societies place on what nurses do.

This is deeply rooted in gender and the history of our great profession.

‘It feels like the barriers in the way of proper recognition of what nurses do are breaking down at last – the pandemic has helped the public to see nurses in a different light’

The UK government’s recent decision to award pay rises to large numbers of public sector workers, but not to those on NHS Agenda for Change pay scales, has been described as a kick in the teeth to the country’s nurses.

Successive governments have allowed nurses’ salaries to fall. I’m not surprised nurses are feeling angry about it.

Around the world, nurses deserve a pay rise for their selfless contributions in tackling the COVID-19 pandemic and in keeping their countries’ healthcare systems functioning.

Nurses are the lifeblood of these systems and governments should remember that hospitals without nurses are as effective at caring for the sick as empty warehouses.

Funding nursing is not a cost but an investment

A global change is needed in the way governments think about funding healthcare and nursing. The pandemic has vividly shown such spending is not a cost, but an investment.

We can see the results, in our health, economic freedoms and security, ability to meet friends and relatives, and overall safety.

With a global shortage of six million nurses, governments of wealthy countries have routinely recruited nurses from overseas to fill the gaps in their workforces.

This short-term fix meant they could just about fill enough posts to keep their healthcare systems running, without having to pay for education and training of large numbers of professional nursing staff.

But the wholesale recruitment of some countries’ nurses – to comparably more lucrative positions in wealthy nations – has had negative effects on their health systems that will take years to repair.

Fair pay is fundamental for countries to maintain the nurses they have

ICN’s recent COVID-19 and The International Supply of Nurses report shows the ready supply of overseas-trained nurses has now dried up.

Nurses cannot move because of pandemic travel restrictions – there aren’t enough of them to go around, anyway – and big ethical issues remain about stripping poorer countries of valuable human resources.

‘The new normal should include a more highly valued nursing workforce, reflected in the esteem nurses are held in and the salaries they are paid’

One answer to nursing shortages is for each country to retain the nurses it has by showing how much they are valued: pay is fundamental to that.

Employers have got away with underpaying nurses because they deem their work to be all about caring and ‘soft skills’ that are hard to put a monetary value on.

Now, it feels like those barriers in the way of proper recognition of what nurses do are breaking down at last.

The public have shown they value nurses – now it’s the turn of governments

Nursing students are saddled with debt
before they even begin earning
Picture: iStock

The pandemic has helped the public to see nurses in a different light.

The crisis has revealed the complexity of nursing, the technical skills involved, the risks taken on behalf of others and the sheer commitment and leadership of front-line nurses.

With warm words and applause, the public have shown how much they value nurses. Now it’s up to governments to do the same.

Nurses in the UK and elsewhere have had years of austerity and promises of jam tomorrow, but their pay has fallen far behind in real terms compared to what it was ten years ago.

They have stoically carried on, but nurses still have to put food on the table, and pay their mortgages, rent and bills.

Today’s new nurses leave university with big student loan debts, another financial burden to carry.

The ‘new normal’ must reflect the esteem in which nurses are held

Nurses must feel valued and respected, because the pandemic is not over yet, and there are other accumulated healthcare needs and demands to address.

It’s not difficult. What’s needed is proper, long-term planning and investment in the nursing workforce.

This will produce massive dividends in terms of improved health and well-being for local communities, and economic benefits for the whole societies.

Post-COVID-19, the ‘new normal’ should include a more highly valued nursing workforce, reflected in the esteem nurses are held in and the salaries they are paid.


Howard Catton is chief executive of the International Council of Nurses


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