Are Nurse Practitioners The Answer to Growing Healthcare Shortage?

The U.S. is facing growing healthcare shortages, particularly in rural areas. A complicating issue is there are fewer and fewer primary care providers.

Research from the University of Delaware suggests one answer is the enlistment of more highly skilled nurse practitioners (NPs), who tend to choose primary care as a field at a much higher rate than doctors. There are currently some 248,000 nurse practitioners in the U.S., and about 87 percent are trained in primary care.

Hilary Barnes, an assistant professor in the College of Health Sciences’ School of Nursing at the University of Delaware, says primary care is important, particularly in underserved areas, because it is often the first point of contact with the healthcare system.

First point of contact

Primary care providers conduct screenings for major health conditions, such as diabetes and heart disease, and help patients manage those conditions. Barnes says that as primary care physicians retire, they aren’t being replaced at a fast enough rate.

Barnes’ research finds that NPs are increasingly being tapped for a primary healthcare role, accounting for about 25 percent of healthcare providers in rural areas, a 43.2 percent increase overall from 2008 to 2016.

However, some states limit what they do. In these states, laws specifically bar NPs from serving as primary care providers and require them to be supervised by a physician.

“Some states are very restrictive,” Barnes said. “An NP has to maintain written agreements with a physician to practice and prescribe medication. In the most extreme examples, the law states that an NP must talk about every patient with a physician. Or that the physician has to sign for prescriptions.”

Restrictions vary by state

The level of restrictions varies from state to state. Barnes says Pennsylvania is among the most restrictive, requiring an NP to have a collaborative agreement with a physician. If there is no physician in the town, Barnes says an NP is unlikely to practice there.

Some states, such as New Jersey, give an NP more autonomy to practice but still require a relationship with a physician in order to prescribe medication.

“Without prescriptive authority, you are limited on the services that you can provide to patients,” Barnes said.

Since 2015, Delaware has given nurse practitioners full autonomy to practice medicine without being supervised by a physician. Barnes says states with more NP-friendly laws tend to attract more nurse practitioners.

Typical education requirements to become a nurse practitioner include a bachelor’s degree in nursing, experience as a registered nurse, and a graduate degree in nursing.

By Mark Huffman
Consumer Affairs

NIGERIA NURSING: ARE WE MAKING PROGRESS? A WAKE UP CALL

Nursing being the one of the fastest growing profession in the world but Sometimes if you look back into nursing in this country you will begin to ask yourself whether this profession is really making progress or regress and this has been a question especially to some of us as a student, there comes with doubt whether there is future for us or not. Different news emanate from medias about nursing everyday but nothing is encouraging there order than pitiful situation of nursing profession. When other sisters professions are moving, we remain stagnant we refuse to move, when other are thinking how to align themselves with 21st century practices. To stand still means to move backward.

Over the years pharmacy has undergo a tremendous transformation in metamorphosing from DISPENSERS to CHEMIST AND DRUGGIST (C&D) in 1960s which was solely diploma program then to degree program in 1962 which started in university of Ife (now OAU)
Also physiotherapy started in Nigeria in 1945 as 3 years diploma program has transformed from 4 years bachelor degree in 1966 to 5 years program across the country and university of Ibadan was first in Nigeria and west Africa to award degree in physiotherapy.

Even medical laboratory science have also follow the same pursuit of transformation from laboratory assistant to technician to full fledge degree. This happened between 1960s to 2003 where it fully gain her stand.

Nursing education started in 1949 at school of nursing Eleyele Ibadan and not until 1965 department of nursing was established in the university of Ibadan to commence a degree program in Nigeria and other universities have been following the suit. Some months ago department of nursing ABU Zaria celebrated her 20 years anniversary since it’s establishment in 1997.

One would begin think what has this history has to do with problem facing nursing profession but I strongly believe if we delve into history of nursing as compared to so called sister professions and we’ll see that nursing has faced major setback and these professions have took some (not a) steps ahead of nursing and this call for a serious concern if at all we see them as sisters. Let me give examples; the so call sister professions have started internship training for their graduates for years but nursing internship was unable to get approved until late 2017 for the fact that internship training has been part of NUC nursing curriculum for graduate of bachelor of nursing science since it’s inception. Furthermore between 2017 and 2018 pharmacy, medical laboratory science, and physiotherapy were able to get the approval from NUC to commence doctor of pharmacy (PharmD), doctor of medical laboratory science (MLSD) and doctor of physiotherapy (DPT) programs respectively but BNSc which has been in existence since 1960s is still fighting for space with hospital based school of nursing. Hnmnn is this what we call progress? and this is one of the thing that prompt me from writing.

Another area of concern in nursing profession is the Nursing in West is advancing towards 21st century best practice with serious improvement in nursing credentials both in professional and educational in order to discharge nursing to the best of their ability. Even our so called sister professions have passed the era of diploma instead Nigeria nursing is advancing towards awarding of diploma and higher national diploma to Nigeria nurses which Nigeria government had just scraped because of it’s irrelevance in the 21st century education system…well done, is that how we define progress?

Did I hear merging of state and federal schools of Nursing, midwifery and post basics to state universities and federal universities respectively? How is this possible? It’s saddening to not that despite obvious limitations and shortcomings of hospital based nursing education program, it has continue to wax stronger with almost every teaching hospitals, federal medical centres within the country compelling to have their own. State governments and missionary organizations are not left out. It will interest you to know that there are over 200 nursing, midwifery and post basic accredited institutions in Nigeria. There are 81 accredited schools in 19 northern states alone. How are you preparing to merge these schools with 7 universities offering bachelor of nursing science with Unilorin and Unijos (north Central), Unimaid (north East), ABU Zaria, BUK, UDUS, and FUBK(all in North West).

Since antecedent it has been observed that Nigeria nurses respond less to changes(education). According to Adeleke Araoye Ojo(professor of Nursing) of Igbinedion university Okada, Edo state shared his personal experience in his inaugural lecture in 2010 that when he resigned from Adeoyo state hospital Ibadan in 1974 to pursue a bachelor of Nursing science degree at University of Ibadan summarizes Nigeria nursing. His registered nurses colleague mocked and queried “Do you need a degree to serve or remove bed pan?” About 35 years after, university based nursing education in Nigeria can still be described as abysmally low in term of number of university offering nursing. This can be evidenced if you go through Bayero university bulletin when Adelani Tijani was promoted to rank of professor.

It was there I read that Adelani Tijani a professor of public health Nursing is the first indigenous professor of nursing in the whole northern Nigeria and number 13th professor of nursing and 11 of them are active as of 2016. Yes! It’s an achievement in nursing but the question you should ask yourself is why number 13th since 1965? Are you still wondering why the sister professions grow faster? Just few months ago Unilag Pharmacy celebrated Prof Coker as Emeritus professor of pharmacy. Are you seeing the differences?

I hope Nigeria can learn from these write up, despite the higher number of nurses, Nursing has been sideline and has suffered from setbacks and this tells you that its not only by numbers but by intellectual capacity which can only we widen through education. We need people who think beyond today, the future is now, let change people perspective about nursing.

Nigeria nurses should wake up and save the profession of Florence Nightingale, Nigeria nurses need to embrace changes As changes is constant in life, the changes we have been clamoring for , only you can bring the changes. Nigeria nurses should break the jinx, accept changes through education, education makes the future more clearer and brighter. Let see nursing as calling and profession and don’t forget to encourage and give hope to young ones.

Thank you,
ÃMANULLAHI ISMAIL NASIR,
DEPARTMENT OF NURSING SCIENCES,
USMANU DANFODIYO UNIVERSITY, SOKOTO.

amanullahiismailnasir@gmail.com

Bathing of Nurse with infected Wound Water, An Act of Domestic Violence Against Women

Is it because She is a woman or a Nurse?

I write with sorrow in my heart because as i would like to think we are making progress on the fairness of gender relationship and safe workplace, a member of the medical profession has decided to draw a reality of backwardness on this point, enough to bring sadden my mood.

Making rounds on whatsapp today and few blogging sites is the news of the Nurse that was rained with dirty water by a doctor after a Not-much-heat-to-light-a-candle conversation. As much as i would like to remember the yoruba saying _agba gbo ejo enikan da, agba osika_, i want to say that this is an embarrassment to humanity that such even happened in a hospital ward.

It is as well laughable that in this century where we kick against domestic violence around the globe, a medical officer named Ajibola (Trauma Centre, Ondo) has not only caused a domestic violence scene, but showed how unethical the medical profession has been represented in his act and further blended with the reflective exposure of hostility bred in the heart of our medical officers to other healthcare workers. It begs me to the question, is it because she is a woman or a Nurse?

The humiliation that nurses reportedly suffer from patients now extends to what could be gotten from the supposedly educated colleagues at workplace.

i don’t want to react much on the ugliness of this scene but then, it is worthy to appreciate the heroic display of maturity by the nurse affected to ensure that retaliation was made in legal forms by reporting to appropriate quarters and not raising urine on the medical officer. I also see it right to awake everybody to the monitoring of the local judiciary process on this matter in order to ensure that the outcome of the crazy act is brought to a definitive point that would make the offender a scape goat enough to serve an example to others with this terrible culture and mean to the public that the act is really bad. It is well to be conscious of this because as much as we want to hide some background facts, it is said that the medical association always loom for a way to rub things off.

As we continue to push for a zero tolerance on domestic violence and workplace rift, Olumide Olurankinse will end this write-up by asking ” what do we expect from those meant to care if they get treated with harshness and hatred ?”

Goodnight..

Trouble Looms in Ondo as Doctor Poured Water from infected Wound on a Nurse

Healthcare activities in Trauma Center in Ondo Town, Ondo State might be brought to its knees if news coming from the Sunshine state is anything to go by.

Report from multiple sources have confirmed that a medical doctor poured water from infected wound on a nurse. Here is the account of the incident as obtained from Nairaland :

One Dr. Ajibola from the Accident and emergency unit, ondo state trauma and surgical centre has decided to pour wound irrigation fluid on a nursing officer, Nrs. Oladele Olayinka of the same institution at about 11:30pm on Saturday 9th of June 2018.

Nrs. Oladele was said to have sent a porter to the pharmacy to get drugs for a patient but instead of the porter to finish this delegated task, he was hijacked by the doctor who delegated another task for him, the Nurse after waiting for his return with no success eventually got to know of the development from a medical student.

This angered the nurse, went to where the said porter was carrying out the new task assigned by the doctor and demanded that the porter should go back to complete the previously delegated task while she offered to continue the care of the patient with the doctor.

Instead of the doctor acceding to this, he resulted to calling the Nurse all sort of abusive names and verbal assaults. As if this wasn’t enough, he took the wound irrigation fluid and pour on the Nurse in the presence of the patient and other members of staff.

According to the report made available to fellow Nurses Africa, no disciplinary action has been taken on this doctor 5 days after this incident however, the National Association Of Nigerian Nurses And Midwives, NANNM of the hospital is working on the said issue to ensure the mater is not swept under carpet like cases of assaults against Nurses had always been.

The nurse has also made an official report through the Director of Nursing services to the management of the institution.

In a related development, the Ondo State NANNM Chairman Prince Abel Oloniyo has summoned all Unit chairmen and the affected nurse, in a post circulating on social media the Comrade said:

We have waited enough for the Trauma unit to officially brief the State Council of NANNM of the recent happening in the centre. Consequence upon this all unit executives are hereby summon to report at the state secretariat latest by 8 am on Thursday, 14th Jun, 2018. Kindly come with the affected nurse. Thank you.

An anonymous source said the State NANNM had earlier directed the Nurses in the hospital to begin indefinite strike today if nothing is done to address the issue but could not ascertained why the proposed strike was shelved

Nurses Outperform Doctors In colorectal Cancer Surveillance Model – Research – Research

Putting nurses in charge of colorectal cancer surveillance instead of doctors has shown to reduce the number of unnecessary colonoscopies and the number of cases progressing to cancer.

The South Australian audit of 732 colonoscopies over three months in 2015 found that 97 per cent of procedures adhered to Australian guidelines in the nurse-led model while compliance was just 83 per cent physician-led surveillance model.

Led by Flinders Medical Centre Senior Research Scientist Dr. Erin Symonds, the research has been published in the Medical Journal of Australia.

Colorectal cancer (CRC) is one of the world’s most prevalent cancers. Early diagnosis has a major impact on survival and can be achieved by screening with faecal occult blood tests (FOBT) or colonoscopy.

Performing colonoscopies too frequently increases costs and the risk of complications, but delays can increase the risk of CRC.

“A family history of CRC or a personal history of adenoma can increase a person’s risk of CRC as much as fourfold, and such individuals are advised to undergo regular surveillance colonoscopy,” Dr. Symonds and colleagues based at the based at the Flinders Centre for Innovation in Cancer wrote.

“Screening and surveillance guidelines aim to optimise the effectiveness of CRC prevention, with surveillance intervals generally ranging between one and five years.”

“Compliance with those recommendations is poor, however, with as many as 89 per cent of patients receiving inappropriate surveillance, usually a colonoscopy before the recommended date.”

Based in the South Australian capital of Adelaide, the Southern Co-operative Program for the Prevention of Colorectal Cancer (SCOOP) was established in 1999 to improve surveillance rates to match the Australian National Health and Medical Research Council (NHMRC) guidelines on CRC prevention.
SCOOP was expanded to use two models: one nurse-led in public academic hospitals, where nurses make recommendations based on NHMRC guidelines, which are then confirmed by a physician; and the other, physician-led in private non-academic hospitals where the specialist physician manages the entire process.

Following the introduction of the nurse-led model in 2000, adherence to guidelines increased from 46 per cent to 96 per cent within two years and has since been maintained, demonstrating the long-term sustainability of the model.

In the latest research, the nurse-led model of colorectal cancer surveillance improved compliance with guideline recommendations, reduced the number of unnecessary colonoscopies and reduced the number of cases progressing to cancer by a significant number when compared to the physician-led model.

“Having a process in place that allows for long-term compliance with surveillance guidelines will promote optimal health care, as procedures performed too frequently can increase risks to patients, are expensive, and lengthen waiting lists,” Dr. Symonds and colleagues wrote.

“Continuous monitoring of and education about colonoscopy surveillance intervals for patients at elevated risk of CRC promotes adherence to recall guidelines and efficient use of limited endoscopy resources.”

Dr. Symonds and her colleagues concluded that the nurse-led model for decisions about colorectal cancer surveillance intervals achieves a high degree of compliance with guideline recommendations, which should relieve burdening of colonoscopy resources.

Source : http://medicalworldupdate.com/nurses-outperform-doctors-in-colorectal-cancer-surveillance-model-research/

Check out How UK Health Tax Law is Hurting Foreign Nurses, Separating Families

“Mr Ken from Kenya earns £1,800 a month after tax. But, once the bills and rent have been paid, he is left with only £500.”
-Indian, Filipino, Nigerian, Zimbabwean and Pakistani Nurses are top non EU nurses in UK

When a Kenyan nurse took up a job in the UK a few years ago, he felt his family’s future had been secured.

But now the distraught father-of-three is struggling financially to reunite his family.

Ken, not his real name, lives with his wife and daughter.
But his twin children, a boy and a girl, remain in Kenya where they live with relatives.

That’s because Ken is unable to raise enough money to cover a British health tax, known as the immigration health surcharge (IHS).

‘Struggling to stay afloat’

Migrant workers coming to the UK from outside the European Economic Area (EEA) and their dependents have to a pay an annual fee of £200 ($268) each.

Ken is also required to have £2,185 in his account for three months before he can apply to bring his twins into the country – on top of the £400 he will need for their health tax.

“It’s very difficult to explain to them when they ask me when they will join me here.

“Ideally, every parent would love to be with all their children.”

Top five nationalities of non-EEA NHS staff in England

Indian – 18,348
Filipino- 15,391
Nigerian – 5,405
Zimbabwean – 3,899
Pakistani – 3,375

One in eight National Health Service (NHS) England staff are not British nationals, and people from a total of 201 foreign nationalities work for NHS England.
Source: House of Commons Library

The time difference and the nature of his job also make it difficult for him to give the twins the attention they need.

“Sometimes when you’re at work, they call and you cannot speak with them as you’d love to, since you’re really busy,” he says.

The health surcharge was introduced in 2015 to boost funding for the National Health Service (NHS) and as a way to discourage health tourism.

Later this year, the annual charge is to be doubled from £200 to £400, with the discounted rate for students set to increase from £150 to £300.

If Ken does manage to bring his twins over to the UK, the annual health tax for the whole family in future will total £2,000.

He earns £1,800 a month after tax. But, once the bills and rent have been paid, he is left with only £500.

“The £500 is for food, transport and other needs, and can’t satisfy my children’s needs,” says Ken.

“The IHS is causing families to separate and I don’t feel we’re being treated fairly,” he says.

“I’m struggling to keep afloat.”

‘Morally questionable’

At the annual conference for the Royal College of Nursing (RCN) last month, union members unanimously voted to demand that the government waive the fee on work permits for nurses and their dependents.

The union’s resolution said it was “morally questionable” for foreign nurses “to pay the health surcharge, given that they pay national insurance and income taxes, as well as providing a vital service to the public”.

For the nurses’ union, recruiting and retaining qualified nurses is a major issue.

The NHS faced a shortage of nearly 88,000 workers between July and September 2017 in England alone, statistics from NHS Digital show.

“Nursing staff are increasingly caring for sicker patients with multiple long-term conditions,” says Janet Davies, general secretary of the RCN.

“This demands safe staffing levels and the right specialist skills. Yet as patients get sicker, the number of nurses continues to decline, due to years of cost-cutting and poor workforce planning.”

The government needs to address these shortages, especially as the UK has an ageing population, she says.
A patient’s ability to recover is determined by the number of nurses on duty, she adds.

A double tax?

A Home Office spokesperson reiterated that the government was aware of the “contribution” made by international professionals “to the UK and to our health service”.

But it said the surcharge offered access to healthcare that was “far more comprehensive and at a much lower cost than many other countries”.

“The income generated goes directly to NHS services, helping to protect and sustain our world-class healthcare system for everyone who uses it,” the spokesperson said.

But Ken says foreign nurses already pay income tax in the UK.

“I think it’s an issue of double taxation, because once you’ve paid taxes you should enjoy these services,” he says.

“You work so hard, do the nights and heavy 12-hour shifts helping the sick, but you end up feeling not supported and you can’t help yourself.”

Ken is considering leaving the UK if he is not able to raise the funds to bring over his twins, as the situation is causing him and his family a lot of stress.

“I have thought of going to other countries – Canada or maybe Australia – and starting the whole application afresh with everybody on board.”

Source : BBC Report

Angola: Luanda Nurses Go On Strike Over Govt Failure to Honour 2012 Agreements

Nurses Union instructed Monday the class in the public hospitals in Luanda to halt work, as part of the general strike called on May 31st.

According to the secretary of the Union, António Kileba, the strike is being observed in all Luanda-based hospitals.

With the exception of National hospitals such as those of Américo Boavida, Josina Machel, Luanda Sanatorium and Neves Bendinha.

“This strike is based on the demands that we have been submitting since 2012, and we reached a conclusion that the employer failed to meet them,” he said.

Despite the decision, a meeting was held Monday among the Union, the Provincial Health Department and the Provincial Government of Luanda, to evaluate the aspects contained in book submitted to the competent body in 2012.

In its Monday round, Angop learned that until Monday at 4:00 p.m., nurses in some provincial hospitals such as Augusto Ngangula Maternity, Neves Bendinha (specialised in treatment of burns) are working fully.

Whereas, Rangel Health Center is operating on duty system
Source : ANGOP.

World Health Organization (WHO) Certifies Paraguay Malaria-Free

The World Health Organization (WHO) today certified Paraguay as having eliminated malaria, the first country in the Americas to be granted this status since Cuba in 1973.

“It gives me great pleasure today to certify that Paraguay is officially free of malaria,” said Dr Tedros Adhanom Ghebreyesus, WHO Director General, in a recorded statement. “Success stories like Paraguay’s show what is possible. If malaria can be eliminated in one country, it can be eliminated in all countries.”

WHO Director-General, Dr Tedros Adhanom Ghebreyesus commended Paraguay on its achievement and briefly outlines the success factors that enabled the country to become malaria-free.

In 2016, WHO identified Paraguay as one of 21 countries with the potential to eliminate malaria by 2020. Through the “E-2020 initiative,” WHO is supporting these countries as they scale up activities to become malaria-free. Other E-2020 countries in the Americas include Belize, Costa Rica, Ecuador, El Salvador, Mexico and Suriname.

“I take pride in saying that PAHO has accompanied Paraguay in the crusade of malaria elimination since the beginning,” said Dr Carissa F Etienne, Director of the Pan American Health Organization (PAHO), WHO regional office for the Americas. “This is a powerful reminder for the region of what can be achieved when countries are focused on an important goal, and remain vigilant after achieving that goal. We are hopeful that other countries will soon join Paraguay in eliminating malaria”.

Achieving malaria-free status in Paraguay

From 1950 to 2011, Paraguay systematically developed policies and programmes to control and eliminate malaria, a significant public health challenge for a country that reported more than 80 000 cases of the disease in the 1940s. As a result, Paraguay registered its last case of Plasmodium falciparum malaria in 1995, and P. vivax malaria in 2011.

A five-year plan to consolidate the gains, prevent re-establishment of transmission and prepare for elimination certification was launched in 2011. Activities focused on robust case management, engagement with communities, and education to make people more aware of ways to prevent malaria transmission, and about diagnosis and treatment options.

“Receiving this certification is recognition of more than five decades of hard work in Paraguay, both on the part of public sector workers, as well as the community itself, who have collaborated time and time again in order to achieve the elimination of malaria,” said Dr Carlos Ignacio Morínigo, Minister of Health of Paraguay. “Reaching this goal also implies that we must now face the challenge of maintaining it. Therefore, Paraguay has put in place a solid surveillance and response system in order to prevent the re-establishment of malaria.”

In 2016, in the next phase of the elimination drive, the Ministry of Health launched a three-year initiative to build Paraguay’s front-line health workers’ skills. Backed by The Global Fund to Fight AIDS, Tuberculosis and Malaria, the country strengthened its capacity to prevent disease, identify suspected malaria cases, accurately diagnose malaria and provide prompt treatment – key strategies to tackle the on-going threat of malaria importation from endemic countries elsewhere in the Americas and sub-Saharan Africa.

“Paraguay’s success demonstrates the importance of investing in robust, sustainable systems for health, and I’m very pleased that the Global Fund supported this achievement,” said Peter Sands, Executive Director of the Global Fund. “We need to remain vigilant and prevent resurgence, but we also need to celebrate this victory.”

In April 2018, the independent Malaria Elimination Certification Panel concluded that Paraguay had interrupted indigenous malaria transmission for the requisite 3 years and had the capacity to prevent the re-establishment of transmission. The Panel recommended the WHO Director-General certify the country malaria-free.

They highlighted factors such as the quality and coverage of health services, including malaria awareness among front-line health workers, the universal availability of free medical treatment, and a strong malaria surveillance system.

Between 1960 and 1973, seven countries and territories from the Americas were certified malaria-free: Cuba, Dominica, Grenada, Jamaica, Saint Lucia, Trinidad and Tobago, and the northern part of Venezuela. In the Region of the Americas, malaria cases declined by 62%, and malaria-related deaths decreased by 61% between 2000 and 2015. However, the rise of malaria cases reported in several countries in 2016 and 2017 show that major challenges remain, including the diagnosis, treatment, and investigation of malaria cases, particularly in remote areas.

Check out How UK Health Tax Law is Hurting Foreign Nurses, Separating Families

“Mr Ken from Kenya earns £1,800 a month after tax. But, once the bills and rent have been paid, he is left with only £500.”
-Indian, Filipino, Nigerian, Zimbabwean and Pakistani Nurses are top non EU nurses in UK

When a Kenyan nurse took up a job in the UK a few years ago, he felt his family’s future had been secured.

But now the distraught father-of-three is struggling financially to reunite his family.

Ken, not his real name, lives with his wife and daughter.
But his twin children, a boy and a girl, remain in Kenya where they live with relatives.

That’s because Ken is unable to raise enough money to cover a British health tax, known as the immigration health surcharge (IHS).

‘Struggling to stay afloat’

Migrant workers coming to the UK from outside the European Economic Area (EEA) and their dependents have to a pay an annual fee of £200 ($268) each.

Ken is also required to have £2,185 in his account for three months before he can apply to bring his twins into the country – on top of the £400 he will need for their health tax.

“It’s very difficult to explain to them when they ask me when they will join me here.

“Ideally, every parent would love to be with all their children.”

Top five nationalities of non-EEA NHS staff in England
Indian – 18,348
Filipino- 15,391
Nigerian – 5,405
Zimbabwean – 3,899
Pakistani – 3,375

One in eight National Health Service (NHS) England staff are not British nationals, and people from a total of 201 foreign nationalities work for NHS England.
Source: House of Commons Library

The time difference and the nature of his job also make it difficult for him to give the twins the attention they need.

“Sometimes when you’re at work, they call and you cannot speak with them as you’d love to, since you’re really busy,” he says.

The health surcharge was introduced in 2015 to boost funding for the National Health Service (NHS) and as a way to discourage health tourism.

Later this year, the annual charge is to be doubled from £200 to £400, with the discounted rate for students set to increase from £150 to £300.

If Ken does manage to bring his twins over to the UK, the annual health tax for the whole family in future will total £2,000.

He earns £1,800 a month after tax. But, once the bills and rent have been paid, he is left with only £500.

“The £500 is for food, transport and other needs, and can’t satisfy my children’s needs,” says Ken.

“The IHS is causing families to separate and I don’t feel we’re being treated fairly,” he says.

“I’m struggling to keep afloat.”

‘Morally questionable’
At the annual conference for the Royal College of Nursing (RCN) last month, union members unanimously voted to demand that the government waive the fee on work permits for nurses and their dependents.

The union’s resolution said it was “morally questionable” for foreign nurses “to pay the health surcharge, given that they pay national insurance and income taxes, as well as providing a vital service to the public”.

For the nurses’ union, recruiting and retaining qualified nurses is a major issue.

The NHS faced a shortage of nearly 88,000 workers between July and September 2017 in England alone, statistics from NHS Digital show.

“Nursing staff are increasingly caring for sicker patients with multiple long-term conditions,” says Janet Davies, general secretary of the RCN.

“This demands safe staffing levels and the right specialist skills. Yet as patients get sicker, the number of nurses continues to decline, due to years of cost-cutting and poor workforce planning.”

The government needs to address these shortages, especially as the UK has an ageing population, she says.
A patient’s ability to recover is determined by the number of nurses on duty, she adds.

A double tax?
A Home Office spokesperson reiterated that the government was aware of the “contribution” made by international professionals “to the UK and to our health service”.

But it said the surcharge offered access to healthcare that was “far more comprehensive and at a much lower cost than many other countries”.

“The income generated goes directly to NHS services, helping to protect and sustain our world-class healthcare system for everyone who uses it,” the spokesperson said.

But Ken says foreign nurses already pay income tax in the UK.

“I think it’s an issue of double taxation, because once you’ve paid taxes you should enjoy these services,” he says.

“You work so hard, do the nights and heavy 12-hour shifts helping the sick, but you end up feeling not supported and you can’t help yourself.”

Ken is considering leaving the UK if he is not able to raise the funds to bring over his twins, as the situation is causing him and his family a lot of stress.

“I have thought of going to other countries – Canada or maybe Australia – and starting the whole application afresh with everybody on board.”

Source : BBC Report

Touching Essay About The Life Of A Nurse To Be Made Into A Drama

“I’m A Nurse, I’m A Person” (working title), the beautiful but sad essay about the life of nurses, will be made into a drama.

A source from production company Raon IT said that they recently secured the rights to “I’m A Nurse, I’m A Person” and are planning to start the production of the drama with the goal of airing it in the second half of next year.

Published in April, “I’m A Nurse, I’m A Person” contains the ardent confessions and courageous voice of a nurse who tirelessly worked and took care of patients in the Surgical Intensive Unit for 21 years and 2 months.

Author Kim Hyun Ah is the writer of “A Nurse’s Letter,” which moved many Korean citizens during the 2015 MERS outbreak, and went on to receive the “Nurse of the Year Award” in 2016.

This essay has received positive reviews for its candid descriptions of the strict workplace that doesn’t allow a single mistake, and the important role and responsibility of nurses who take care of patients’ safety and citizens’ health in poor working conditions.

The production of this drama is bound to attract lots of attention as the human rights and better treatment of nurses were a hot social issue recently. Unlike past medical dramas where doctors were the focus of the storyline, “I’m A Nurse, I’m A Person” will be a meaningful drama that makes nurses its main characters.

Park Kyung Soo, the CEO of the production company, said, “We’re trying to tell a different story about nurses that’s real and not distorted. I think the story about nurses who could be our family, friend, and colleague can resonate and move viewers. We’re planning to tell a drama with a new perspective on nurses, their reality, and some dramatic fun, so please look forward to it.”

“I’m A Nurse, I’m A Person” will be written by the original author Kim Hyun Ah and directed by Kang Chul Woo of “1% of Anything” and upcoming drama “So I Married An Anti-Fan.” Director Kang Chul Woo was also the winner of the 2017 Cable Broadcasting Daesang for the New Media Category.

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