The high turnover rate of nurses has caused tremendous stress to practitioners in the healthcare and medical profession, which had led to pressure in the Hong Kong's healthcare system. As such, Hospital Authority is stepping up measures to recruit and retain nursing professionals. In particular, a range of new policies and tools are now in place to boost passion and confidence for a meaningful career in the field.
According to Eric Chan, Principal Nursing Officer, Hospital Authority (HA), the turnover rate of registered nurses who have about five years of experience has increased from 28 per cent in 2006/07 to a staggering 39 per cent during the first nine months of 2007/08 alone. While some nurses in the public sector opted for a career move across to the private sector, others left the profession for family obligations or personal reasons.
"One of the key objectives of our endeavour is therefore to make public hospitals a better workplace and a training ground for both freshmen and senior nurses to pursue professional advancements," Dr Chan says.
Historically, a career in public hospitals meant a future in the management areas, leaving senior nurses with limited choice but to take up supervisory and departmental management roles.
"This narrower career structure had an emphasis on clinical professional development but with the creation of the nurse consultant role, nurses are now provided with career advancement opportunities in the clinical stream as well as other opportunities for specialisation in the wider healthcare spectrum," Dr Chan notes.
Under the new structure, nurses enter the field as registered nurses. Upon completion of a two-year "preceptorship programme" which includes rotation to different units for on-the-job training under a mentorship scheme, nurses can be better prepared for further development as advanced practice nurses or ward managers. Advanced practice nurses are also newly created roles with increased clinical responsibilities such as care for patients suffering from diabetes and hypertension in nurse-led clinics.
Experienced advanced practice nurses and ward managers can then progress to the next level and become nurse consultants or department operations managers.
Previously, permanent employment contracts were offered only to nurses who have completed six years of service. As part of the reform, Dr Chan says a more flexible contract structure has been implemented, allowing contract nurses an earlier conversion to permanent staff based on their performance. Salaries for new nurse recruits are also now determined by clinical experience.
Dr Chan notes that many nurses who enter the field with the passion for patient care prefer to pursue expanded specialist roles such as nurse practitioner, case manager and nurse consultant.
"Specialisation in nursing is inevitable given the pace of change in medical care technology as well as the extent of healthcare services these days," Dr Chan comments.
To cope with this trend, a new nursing development scheme, which will provide nurses with training and practicum opportunities leading to advanced clinical nursing, is being implemented. Dr Chan says the specialist training for clinical development as well as the clinical exposure that public hospitals have to offer are unmatched in the private hospital setting.
"For instance, the extended patient services offered in HA's nurse clinics —s uch as diabetes care, continence care and renal care — allowing expert nurses to provide drug dosage adjustments, compliance monitoring and continuous patient assessment, are only available in public hospitals," Dr Chan adds.
HA nurses are also given the opportunities to extend their specialist roles in community nursing services, such as support for the elderly, as well as hospice and discharged patients.
"Currently, there are about 30 post-basic courses in the specialisation training, helping to equip nurses with the skills and knowledge necessary for specialist roles in a diverse range of areas such as the intensive care unit (ICU), paediatrics, and accident and emergency department (A&E)," Dr Chan says.
Regarding recruitment, Dr Chan notes: "We're looking to recruit at least 600 nurses to fill the gap and our recruitment exercise is expected to continue for the next two years."
Apart from a university degree in nursing, aspiring candidates with satisfactory A-level exam results may enter a three-year nursing programme administered by HA. The programme, leading to a higher diploma in nursing, entitles graduates to break into the field as registered nurses.
While passion and compassion are the prerequisites, interpersonal skills are also essential as nurses interact with people from all walks of life.
In Dr Chan's opinion, the nursing profession offers a lot more than meets the eye. He says, "The moments we see newborn babies or when we see patients recovering, we share with them the happiness and these are the experiences that make me feel I'm making a contribution to Hong Kong society."