The Role of Jamaican Nurses in Health Care Sectors
October 13, 2017 in Human Rights, Peace, and Conflict Resolution / Legal Studies tagged Health care / Health Care reform / Jamaican Nurses / NHS / Nursing by Angela Pupino
Mary Seacole was in London in 1854 when she heard about a shortage of nurses on the frontlines of the Crimean War. The Jamaican nurse offered her services but was turned away. Some contention remains about whether Seacole was rejected because she was a mixed-race woman or because she did not apply properly, but Seacole regardless navigated her own way to the battlefield. After opening a hotel and caring for soldiers near what is today Kadikoi, Ukraine, Seacole wrote a best-selling autobiography about her experiences travelling the world.
On its face, the story of a Jamaican nurse stepping forward to try and fill a need in the United Kingdom’s healthcare system seems like a relic of the colonial era. But fifty-five years after Jamaica gained its independence, Jamaican nurses are still heading to the United Kingdom. Unlike Mrs. Seacole, they are not being turned away. On the contrary, they are being given job offers that they cannot refuse.
The Caribbean Community and Common Market estimates that between 1996 and 2006, 50,000 nurses left Jamaica to work in other countries. This migration resulted in a loss for Jamaica of $2.2 million dollars in nurse training expenses. According to Janet Coore-Farr, head of the Nurses Association of Jamaica, Jamaica lost around one fifth of its specialized nurses in 2016 alone. The chairman of the University Hospital of the West Indies reports that around half of specialized nurses trained by the hospital are recruited by foreign organizations before they even graduate.
The nursing shortage has had dire consequences for the Jamaican healthcare system. Reports of short-staffed hospitals cancelling surgeries due to a lack of specialized nursing staff appear frequently in Jamaican newspapers. The impacts of the nursing shortage are not limited to any one sector of the healthcare system. According to a UN Development Programme report on Jamaica’s ability to meet the Millennium Development Goals, nursing shortages have adversely impacted Jamaica’s immunization and maternal health clinics. In 2006, the World Health Organization published a report providing evidence of a correlation between density of healthcare workers and population health outcomes.
Decades of nursing migration have caused a sizeable decline in nurses relative to Jamaica’s population. According to the World Bank, Jamaica had 1.65 nurses and midwives per 1,000 people in 2003. By 2008, that number had decreased to 1.08. For comparison, the World Bank listed the average number of nurses and midwives for OECD nations at 7.7 per 1,000 population in 2012. Meanwhile, the demand for nurses in Jamaica is expected to grow as the population ages. The World Bank estimates that the English-speaking Caribbean will need 10,700 more nurses by the year 2025. Nurses are a key component of any healthcare system, and a shortage of this magnitude could leave the nation unprepared to handle disease outbreaks and other public health emergencies. But nurses are also a key component of Jamaican society, often serving on the frontlines of public health provision and education in their communities. Without an adequate number of nurses, these communities will suffer.
Push and Pull Factors in Jamaican Nursing Migration
At its core, Jamaica’s nursing shortage is the product of decades of nursing shortages in the developed world. A rising demand for nurses, due in part to increasingly complex needs of an aging population, has been coupled with a decreasing supply of qualified nurses in many countries. A 2007 study of nurses in the American Midwest region found that 38% of surveyed nurses reported feeling problematic burnout associated with their jobs. Young nurses are even more likely to experience burnout, with almost 44% of nurses under the age of 30 reporting the same level of burnout. The stressful nature of the nursing profession has been compounded by staff shortages, driving more nurses away from nursing. Ironically, the nursing shortage also been exacerbated by a shortage of nurses qualified to teach in nursing schools. Over 75,000 qualified applicants are turned away yearly from US nursing schools because of a shortage of qualified faculty.
As nursing shortages ravaged healthcare systems in places like the United Kingdom, United States, and Canada, these countries began working to attract qualified nurses from other countries. In the case of the United Kingdom, the migration of nurses from other parts of the Commonwealth began with the formation of the National Health Service. A BBC documentary drawing attention to Britain’s black nurses reports that as staff shortages threatened the nascent NHS, thousands of nurses from Britain’s colonized countries stepped in to fill the need. According to a 2017 report by the British parliament, around 1,700 Jamaican medical staff currently work for the NHS.
In the face of these staff shortages, Jamaican nurses are attractive candidates for international recruiters. As part of the English-speaking Caribbean, Jamaican nurses are usually native English speakers. Due to their English fluency, Jamaican nurses passed the National Council Licensure Examination, a test used in the licensing of nurses, at higher rates than other international applications.