Nurses worldwide are hitting their breaking point, and many are already walking away desperately from the nursing profession and even the healthcare sector, because the politicians and policymakers, due to their ongoing cuts, left frontline nurses exhausted, unsupported, and struggling to keep up with quality and safety. Violence, nursing shortages, and unrealistic workloads, with every shift being a battle for frontline nurses, lead to physical and emotional exhaustion, making it impossible for nurses to stay in the nursing profession. If nothing concrete is done, the global nursing shortage will hit 13 million by 2030 (WHO).
Therefore, the EU Institutions need to better support frontline nurses and not hide behind subsidiarity! Let’s create a healthcare system where nurses choose to stay without sacrificing their own health and well-being.
What we need is ACTION, CONCRETE ACTION, not endless reports and recommendations
In the last decade, a growing number of research studies have focused on human resources for health and aimed to explore conditions for a more effective and optimised operation of health systems. Emerging topics, such as the need for more upskilling and reskilling, the impact of AI and digitalisation on workflows, even task shifting and mental wellbeing are thoroughly investigated. BUT nothing changes at the frontline! We have a lot of publications, EU project deliverables, BUT no frontline impact, with the millions spend! This is unacceptable for EFN.
The European Commission: limited joint action but more impact is needed
The European Commission supports Member States in several ways; through a EU4health Joint Action on forecasting and planning of health workforce; Actions on digital and green skills development under the BeWell project; the WHO-led Nursing Action addressing the recruitment and retention of nurses in the EU, with a specific focus on Nursing Student Mentorship and Safe Staffing Levels. Importantly, Safe Staffing Levels is a priority of the DG SANTE Health Systems Performance Assessment (HSPA) Expert Group. Furthermore, the health workforce challenges become more reflected in the European Semester Country Reports. Good start, but not enough!
While the EU Member States must be self-sufficient in educating and training their nursing workforce, the European Commission must urgently develop EU legislation on safe staffing levels, and on zero-tolerance to violence against healthcare professionals, which must be implemented by the Member States to keep nurses in the profession. These Directives would fall under Occupational Health and Safety (OSH), on which the EU has already developed more than 20 individual Directives! This is crucial to improve the working conditions of nurses, the quality and safety of patients’ care, and to build a resilient healthcare workforce that is prepared for the next health and civic crisis.
The subsidiarity argument cannot stand as a justification anymore, as national legislation on safe staffing levels is available in 21 EU countries, and many countries already have some legislation to protect healthcare professionals from violence. So, it is simply a question of pushing for upward harmonisation of what is available already in the Member States! Reform needs to build on a reviewed Recovery and Resilience Facility (RFF), pushing for a renewed focus on building the EU domestic healthcare workforce’s capacity in quantity and quality to be better prepared for any health crisis.
European Parliament – the Own-Initiative (INI) Report on Health Workforce Shortages
The European Parliament EMPL and SANT Committees are currently working on a Joint INI Report on Health Workforce Shortages. This is a key opportunity to push the European Commission towards concrete actions. The CPME-EFN-PGEU joint-statement focuses therefore on the 3R²: “Recruitment, Resilience, and Recovery and Resilience”. Integrating these actions into the INI Report will be key to support the development of a resilient, highly educated and motivated EU domestic nursing workforce. The EMPL and SANT Committees joined INI Report will need to be very concrete, limited in actions, focusing on frontline impact, moving past the countless reports lacking substance and impact.
Council of the EU
The Council of the EU’s Presidencies, especially the upcoming Danish, Cypriot and Irish ones, need to put the nursing workforce, safe staffing levels, and violence against healthcare professionals at the top of their priorities. But Council conclusions have often very limited impact on the daily work of frontline nurses. Therefore, the Council and its Members, need to go beyond Council Conclusions, looking instead at concretely investing in the health workforce from a defence, security and preparedness perspective. If the EU is preparing for war as the worst possible scenario, nurses need to be well-prepared, which means that they need to be informed of their wartime placement, and they also need to be adequately trained to deal with the health crisis which will follow a war outbreak. EU and National policymakers must therefore not forget that healthcare systems and preparedness for any crisis are inextricably linked, and our healthcare systems depend on the resilience of our nursing workforce.