Making nursing a popular career choice again.

Traditionally, nursing has been a popular career choice for young women. Many of today's nurses were part of groups of girls who commenced hospital-based training programmes, with intakes in large hospitals spaced only a few months apart.

Since pre-registration programmes moved into the tertiary education sector from 1973, many have enjoyed a history of being over-subscribed, with waiting lists of applicants unable to be offered places. But in recent years, many schools of nursing have expressed concern at declining numbers of applicants and that applicants more frequently do not have the ability to meet academic programme entry criteria.

At the end of 2004, following concerns expressed by heads of schools throughout the country about declining applicant numbers, Nurse Education in the Tertiary Sector (NETS) conducted an informal survey, which established that applicant numbers and quality were declining throughout the country, except in the Auckland area and for university-based programmes. This is of major concern considering the average age of nurses in the workforce, the global nursing shortage and projected numbers of health professionals required to meet the needs of an aging population.

No data has been collated at a national level about nursing applicant profiles and progression patterns through programmes. Anecdotally, individual education providers have noticed an increase in the age of applicants over the past decade, with no great changes in proportions of mate, Maori and Pacific students. With decreases in the number of domestic applicants, many schools have accepted international students, predominantly from China. NETS is collating information about 2004 graduates, including student loan figures. This data will be published on the NETS website: www.nurseeducation.org.nz.

What we do know is that patterns of progression through the three-year programmes are changing. Many students are studying part-time or requiring time off during programmes, attrition rates are increasing, and most students work part-time while studying to limit their liability for crippling student loan repayments later. This combination of factors, along with a tack of new graduate programmes, has meant many graduates have moved overseas where they have been able to take advantage of higher salaries and funded new graduate support. Hopefully the success of NZNO's Fair Pay Campaign will help arrest this pattern, which has seen not only the young, single graduates leave New Zealand as part of their traditional "OE" (overseas experience), but also order graduates choose to emigrate with their families to establish their career and escape the burdens of student loan repayment while on poor pay.

What has contributed to this decrease in the popularity of nursing as a career choice? There is limited evidence available, but anecdotally nursing has been losing out to career options such as business, marketing, tourism and hospitality that give entry to the perceived "glamorous" world of global commerce.

Certainly, nursing has had its share of bad press and this must surely contribute to its tack of attraction as a career. A decade of continuous restructuring in the health sector, toss of career pathways for nurses, along with publicity surrounding poor pay and working conditions, have all been part of creating an image that just simply does not inspire people to join the profession. This decline in popularity of nursing as a career is despite nurses being voted the most respected profession in National Business Review surveys for many years. (1,2) I guess "respected" does not necessarily equate with respectful pay and fair conditions for nurses.

In part, the campaign for pay parity with groups such as teachers and the police may have contributed to nursing becoming a less popular career choice, with potential future nurses put off by the publicity surrounding dismal salaries in comparison with other occupational groups. It will be interesting to note in this year's National Business Review survey whether nurses retain their position as most respected profession, if the public perceive that pay inequalities have been addressed and there is now a more level praying field in terms of financial recognition.

Looking to the future, what still needs to be addressed? District Health Board nursing positions with their significantly improved pay rates, and plans for expanded new graduate programmes should help keep our graduates in New Zealand. Improved working conditions and recognition go a long way in promoting positive workplaces. Areas such as primary care, aged care and the private sector will be affected by toss of staff as nurses choose to move to DHBs, where they are appropriately recompensed, unless similarly successful employment agreements are negotiated for non-DHB nurses. Hopefully, schools of nursing will find that programmes are able to be fitted by quality applicants, who will be able to work effectively across the health care sector.

It seems unlikely that any government in the foreseeable future will make major changes to the current student loan system and students will continue to amass large debts. The prospect of competitive pay and improved support and conditions, offers hope that our graduates, who will be the nursing workforce of the future, will choose to stay or return to New Zealand, because nursing is a personally, professionally and financially satisfying career.

Cathy Andrew, RN, BA, MA, is Head of School, School of Nursing, Christchurch Polytechnic Institute of Polytechnic. Prior to moving to a nurse lecturer position, she worked in intensive care, mental health and surgical nursing. She is completing her PhD at the University of Newcastle, New South Wales, Australia.

References

(1) http://www.umr.co.nz/nbr/NBR%2021%20Jan%202005.pdf Retrieved 29/05/05

(2)_http://www.umr.co.nz/Pdfs/UMR_SOTN_V7.pdf Retrieved 29/05/05