Dominica Nurses Assn blaming Government and the Health Ministry for ‘nurses leaving Dominica in droves’

President of the Dominica Nurses Association Rosie Felix said in a Press Release, “We are very disturbed by what appears to be the inability of the Ministry of Health and by extension, government after government after government, to make the healthcare environment more positive, attractive and caring enough, to retain adequate numbers of home-educated nurses”.
 
The Dominica Nurses Association is effectively blaming the government for “nurses leaving Dominica in droves”. The nurses’ statement follows recent references to that problem by Health Minister Kenneth Darroux. Last month the Ministry of Health expressed grave concern over some 14 nurses including retirees, who have left Dominica since the passage of Hurricane Maria in September 2017.
 
The Nurses Association Press Release indicated that the issue is a vexing one for them. Quoting the International Council of Nurses, the local association says nurses are the backbone of the health system, and everything should be done to give them a quality work environment, because quality workplace equals quality patient care.
 
The Release stated, “The biggest and most prolonged challenges facing our nurses include, but are not limited to lack of professional pay for professional work, workplace bullying, lack of respectful compassionate leadership, victimization, unsafe nurse to patient ratios, work overload and related burnout; plus lack of resources and support (International Council of Nurses, 2007)” the release states.
 
According to President Felix “Hurricane Maria is not the reason nurses are leaving Dominica. This natural disaster is only the straw that broke the camel’s back”. She pointed out that “in 2016 an estimated 12 nurses resigned from the nursing service, an estimated 12 resigned in 2017; a further 12, have already left so far in 2018”.
 
The reason for their migration is seemingly not solely financial. The Release points out that “Workplace bullying has been documented and reported at the Acute Psychiatric Unit and DNA for two generations of nurses. In 2010 DNA requested a formal investigation into that matter. That investigation was carried out by Mr Gerard Burnette, but the findings were never acted upon. In the last 5 to 10 years, many nurses verbally reported being bullied or witnessed bullying in other departments of the health sector”.
“Written and oral complaints to the relevant heads have proven futile, and instead, the victims have been transferred, victimized or punished. This problem is leaving nurses battered, bruised, demotivated and deflated”. According to the association, many nurses cannot take it any longer,  and “they are escaping like refugees as they seek to protect their sanity and peace in neighbouring territories, where the environment is safer and healthier, and the pay is far better”.
 
Lack of proper remuneration of nurses is described as a critical factor. The DNA explained that In 2013, consultants, of a job evaluation exercise requested by government and conducted by the Caribbean Center for Development Administration, found this to be a justifiable cause, and recommended a significant salary scale upgrade for nurses.
 
 
“The government has unequivocally ignored this recommendation hence the status quo remains – no professional pay for professional work. Consequently, nurses leave for higher salaries which is complimented with benefits such as health insurance, duty free vehicles, and housing. The EC $5000 start-off pay for new nurses in neighbouring jurisdictions exceeds the start off salary of even the top nurse in Dominica”.
 
The nurses release further stated, “We are disappointed that we have not received an appointment to meet the Minister of Health to discuss the problem and the solution, after three weeks of requesting one”. The nurses say they are aware that more of their colleagues plan to make their exit in the weeks and months ahead, and their Association is calling on the government “to intervene favourably and urgently, to save a collapsing nursing service”.
 
Their recommendations include:
(1) That government implements, as a matter of priority, the salary upgrade for nurses as per the 2013 recommendation of the Caribbean Center for Development Administration;
(2) That the ‘magnet hospital’ concept (International Council of Nurses, 2007) be adopted with an unrefutably practice and benefits package to attract and retain qualified and experienced nurses.
(3) That the MOH investigates workplace bullying across the nursing service, develops and establishes anti-bullying policies; and disciplines and or provides counsel for the perpetrators;
(4) That the report of the workplace bullying investigation conducted at the Acute Psychiatric Unit be retrieved with a view to adopting, adapting and implementing proposed solutions and prevention measures across the health sector;
(5) That nursing managers from the community health centres, to the hospital wards and offices, to the government headquarters, incorporate compassion, respect, empathy, fairness, humility and honesty in their leadership and management styles beginning yesterday.
 
Health Minister Darroux admitted recently that the local nurses are under pressure. He said, “We know that we’ve had quite a bit of nurses leaving, some nurses are working extraordinary hours to make the place function”.