Botswana: Nurses Wants Inclusion in Public Service Bargaining Council

Speaking at Botswana Nurses’ Day and NAB/BONU 50th anniversary celebration in Gaborone today, Rahube said they strongly felt it was time to be included in the bargaining council where they believe their voice needed to be heard and their concerns addressed. He said nurses are an invaluable asset to the Ministry of Health and Wellness (MoH&W) arguing that the strategic competitive edge depends on them.

“The government of Botswana should see nurses as a partner in the journey towards the new Botswana and we shall under no circumstances condone nurses being left out. We also want to be seen playing a part in the new Botswana as His Excellency a baakanya lefatshe. We are proud of our nurses, mostly young people dispersed across the country doing their job diligently and with honour, at times under unbearable conditions,” he said.

Rahube further stated that government through MoH&W should give an undivided attention to the nurse’s needs and wellbeing. He pointed out that nurses were crying out loud that their wellbeing should be addressed as a matter of urgency. He also acknowledges their strides that MoH&W had done to nurses so far. He pointed out that the ministry had marked allowance of educators, responded on the petition about safety of nurses, the newly introduced savingram which states that nurses upgrading up to C1 salary scale should be done at DHMT level.

However, he pointed out that there were still key areas on their welfare issues that needed to be addressed such as overstaying at C1 salary scale for even up to 11 years saying that they were made aware that there had been 79 approved promotion of D4 and D3 which will be completed by end of August 2018. He said that shows that the DPSM and MoH&W were moving in the right direction. He said there were more than 400 nurses who had reached the ceiling of C1 salary scale, that is nurses who got promoted on 2008 saying nurses list was still long of those of 2009 and beyond.

“There is also an issue of poor

deployment and lack of numeration of specialised nurses, lack of accommodation for nurses who are the frontline healthcare workers and lack of further training for nurses. Competent, well-trained and skilled nurses improve health care quality for all sustainable health care. Capacity building of nurses and midwives enables them to meet the demands of the people they serve,” he said.

For her part, the permanent secretary at MoH&W  Ruth Maphorisa pointed out that her ministry came up with a roadmap to achieve these stretching goals and some of the initiatives embarked upon such as strengthening of legislation in order to improve quality of care and protect high standards in the practice of health care and protect the welfare and interest of the public, revitalisation of the primary health care through harmonisation of community health structures and restructuring of the MoH&W to devolve authority to the DHMTs and implementation of integration of health services for efficiency and effectiveness in health delivery.

“The changes require the right skills and competencies. In order for the nursing profession to effectively play their role, there is need for training and professional practice to continuously align to meet emerging demands and expectations of the public and the health workplace. Transformation of nursing training, education and scope of practice to reflect current needs and realities,” she said.

Speaking at the same gathering, the Minister of Mineral Resources, Green Technology, Energy Security Eric Molale pointed out that it was high time nursing was decentralised. He said this was because he was aware that even though MoH&W promised to buy nurses uniforms, some had to buy their won uniforms with their own money due to the ministry’s failure to do so. He said there was need to empower extension teams to do their work efficiently and diligently.

Molale added that there was need to promote and move nurses from lower salary scales as done in other ministries. He also said nurses had to be taken for in-service training for at least once every year so that they could keep up with everyday changes.

Source: http://www.mmegi.bw/index.php?aid=77102&dir=2018/august/16

Ghana: Health Ministry Says There is No Financial Clearance to Recruit Nurses

Health Minister Kweku Agyeman Manu has stated that the Ministry has not received financial clearance from the Finance Ministry to recruit nurses.

Speaking on the AM Show on Joy News Thursday, Mr Manu explained that the ministry has not posted nurses who have completed their training because of financial constraints.

He told Joy News’ Seth Kwame Boateng that the Finance Ministry has assured them of giving them the financial clearance to recruit nurses in due time.

“…they gave us close to September or October so we are still waiting. As soon as we get this financial clearance, we will start working on them,” he stated.

“The financial clearance is an assurance that when we put them [new recruits] in your facility we can pay them,” he added.

Mr Manu also noted that in March, the Health Ministry began gathering the data of nurses who have stayed home for a while and they will use that data to aid them in the posting process.

He explained that the numbers have become a lot because the previous government bequeathed the same to them.

“We came to meet an existing challenge so we need to take care of that,” he said, adding that the ministry successfully posted 17,000 nurses in 2017.

“And this year, we budgeted to post 15,000,” he stated.
Mr Manu further explained that due to the financial situation, the Ministry is restructing staff to work at new commissined health facilities instead of posting new ones.
Source : Myjoyonline.com

Nurses and Doctors Protest in Venezuela over Poor Pay, Shortage of Manpower

Riot police have blocked hundreds of doctors and nurses from marching to Venezuela’s presidential palace to protest against low pay and shortages of medical supplies amid the nation’s deepening crisis.

Thursday’s demonstration in Caracas was the first attempt by protesters to reach the presidential palace since massive anti-government protests last year.
The medical professionals are demanding action by President Nicolas Maduro, who is overseeing a crisis marked by widespread shortages and mass migration from the country.

The once-wealthy oil-producing nation is in crisis economically and politically after two decades of socialist rule.

Rows of heavily armed riot police blocked roughly 400 medical professionals shortly after launching their march.

Ana Rosario Contreras of the Association of Illnesses says they are demanding the government provide basic supplies to treat patients.

The protest ended without violence.
Press Association
https://m.independent.ie/world-news/doctors-and-nurses-take-to-streets-in-venezuela-protests-37224560.html

UK: A shortage of nurses calls for the recruiting of more men

-Coventry University is offering male nursing students a new £3,000 ($3,800) stipend to encourage men to choose Nursing

“ONE reason I can do stand-up comedy is because of all the material I have from being a male nurse,” says Adrian Matei. False stereotypes about nursing make for good jokes. But they may also put men off the job. Just under 11% of nurses registered in Britain are male, a share that has been steady for over four decades after climbing from 1% in the 1950s.

At a conference in May of the Royal College of Nursing (RCN), the profession’s union, David Ferran, a nurse in Belfast, proposed a campaign to promote nursing to men. His motion did not pass, as the view was that nursing should be pitched to anyone with the right skills, regardless of gender. Undeterred, Mr Ferran started a group, Northern Ireland Men in Nursing, which visits schools to promote nursing as a career for men. Similar groups are being set up elsewhere. Several universities have launched social-media blitzes to draw men into nursing programmes. Coventry University is offering male nursing students a new £3,000 ($3,800) stipend.

Britain is not an exception in having relatively few male nurses. But with a growing shortage of nurses across the National Health Service (NHS), attracting men is becoming more urgent. In 2017, for the first time in a decade, more nurses left the profession than joined. Applications to nursing programmes are down by a third since 2016. And the shadow of Brexit makes it tougher for the NHS to fill its 40,000-odd nurse vacancies from abroad. Doubts about whether they will be able to stay dissuade nurses from EU countries.

Last month the NHS launched its biggest-ever nurse recruitment campaign. TV advertisements show them in action in hospital wards and ambulances, and on home visits. Some are male—an improvement from previous campaigns, but not enough to draw men in, reckons Mr Ferran. Paul Vaughan from NHS England, who leads an initiative to change perceptions of nursing and midwifery, thinks recruitment should avoid playing to gender stereotypes. He takes a dim view of slogans like “Are you man enough to be a nurse?”, used in an American campaign.

Views of nursing as a “woman’s job” have deep roots. Florence Nightingale, who established the principles of modern nursing in the 1860s, insisted that men’s rough hands were “not fitted to touch, bathe and dress wounded limbs”. The RCN did not even admit men as members until 1960. Outdated titles such as “sister” and “matron” (used for men as well) do not help. Mr Ferran says some patients are surprised when he shows up, because they thought only women could be nurses.

Boys do not see nursing as a career because they lack role models. In films, female nurses are cast as helpers of heroic male doctors. (In reality, nurses are the first responders when a patient is in crisis.) “If I had a pound for every time I’ve been called doctor,” says Richard Dowell, a third-year nursing student. When he does ward rounds with his nurse mentor and she asks questions, patients often turn to him to respond, says Mr Dowell.

Unsurprisingly, just two-fifths of British parents say they would be proud if their son became a nurse. Men who go into nursing usually follow in the footsteps of a parent or realise that it could be a career after seeing a male nurse care for a relative. Mr Vaughan’s team at the NHS is trying to boost the prestige of nursing by highlighting that it is a professional job in which careers can be made, that it includes specialisms such as cardiology or intensive care, and that it has a use for skills in technology, innovation and leadership. Most young people also do not realise that the job can take them round the world.

For men, there is another bonus. According to a study of more than 20,000 advanced nurse practitioners by Alison Leary of London South Bank University, men reach the seventh band (a mid-career level) four years sooner than women—partly because women are twice as likely as men to work part-time and are more likely to accept a lower band to secure a job they really want. When Mr Dowell started his nursing studies, he was promised: “You’ll go further because you are a man.”
Source : https://www.economist.com/britain/2018/08/18/a-shortage-of-nurses-calls-for-the-recruiting-of-more-men

Nurses, Doctors Abandon Hospitals in Cameroon’s Troubled Region

Medical staff are fleeing hospitals in Cameroon’s troubled English-speaking regions after attacks this month left several nurses dead and many others wounded. Medics say they are stuck between a military that accuses them of aiding armed separatists and rebel fighters who say hospitals betray them to the army.

Elvis Ndansi, of the Cameroon trade union of nurses, says the killings and abuse provoked outrage in the medical corps.

“The military comes, chase them out of the hospital, brutalize them, beat them. As medical personnel, we all stand to condemn these acts and say they are very wrong. Medical personnel are supposed to be protected in times of war. They are there to take care of all casualties, be they from the military, be they from the Ambazonians or secessionists. Their role is to save lives,” Ndansi said.

Governor Bernard Okalia Bilai of the English-speaking southwest region denies the military is responsible for the attacks, saying the separatists seeking an English-speaking state in Cameroon are the ones to blame. He says he has instructed the military to protect hospitals from armed gangs.

Despite the danger of traveling in the region, hundreds of medics showed up Wednesday for a funeral to honor Nancy Azah and her husband Njong Padisco. The couple, both nurses, were shot dead last week, reportedly by Cameroonian troops.

Nurse Arrey Rose says the association of nurses called on the medical community to show solidarity by attending the funeral service.

“We have mobilized to let the world know that doctors, nurses, laboratory technicians and pharmacists are tortured and killed just for saving lives,” Rose said. “God spared mine when I was pulled out of hospital and beaten just because I was accused of hiding terrorists. Many are dead, many are wounded.”

The violence has led patients and medical staff to desert hospitals in both the northwest and southwest.

Eighteen-year-old Mundi Ernestine says that when she took her younger brother to Bamenda regional hospital, there was no one to treat him.

“God has been sustaining him,” Ernestine said. “We were not attended to in the hospital for a week because the staff was absent. We had to carry him on our back through the bush to Bamenda, which is a bit calm. He is recovering, but my fear is that many are dying in the bushes just because there is no nurse to help.”

The Cameroon Medical Council says, due to the ongoing conflict, the exact number of medical staff who have fled the two volatile regions is unknown.

Governor Bilai is calling on them to return. He says all political leaders and civil society groups should educate runaway staff to go back to their work, especially now that the military is protecting medical facilities.

More than 300 civilians and security forces have been killed in Cameroon’s English-speaking regions since 2016, when separatists launched their drive for an independent state they call Ambazonia.

The United Nations says at least 200,000 people have been internally displaced in the conflict and tens of thousands have fled to neighboring Nigeria.
Source :https://www.voanews.com/a/medical-staff-abandon-hospitals-cameroon-troubled-region/4531373.html

Husband Writes Ministry of Health in Zambia Over Transfer of His Nurse Wife

THE PERMANENT SECRETARY,

Ministry of Health,

P.O. Box 30205,

Ndeke House,

Lusaka.

16th August, 2018.

Dear Sir,

RE: MINISTRY OF HEALTH PERSONNEL TRANSFERS

It is with a very heavy heart and degree of frustration and desperation with which I am compelled to write this letter. If past and present experience with regard to the matter in subject is anything to go by, I will not expect the courtesy of an answer, or even an acknowledgement, however I would be happy just to have you read and take note of the concerns expressed.

I am based on the copperbelt and working in the mines as a process engineer.

My wife has served the Zambian Government under the Ministry of Health, Samfya District Hospital since her first appointment in July 2011, having entered as a registered nurse rising to a midwife (whose confirmation she is awaiting), so I think I can safely say I speak with some degree of knowledge in civil service matters, and in particular your ministry.

As a civil servant it is always my wife’s policy and that of other hard working colleagues that they serve the government of the day, and in so doing serve the people of Zambia to the best of their abilities. With the aforementioned, it is my considered opinion that I would be remiss in my duty if the issue of transfers was not brought to your attention.

If one has regard to the workforce in civil service over the past few years to now particularly in your Ministry, one sees glaring, obvious and hugely costly mistakes. Mistakes that can only be described as unperturbed, inhuman, unthrifty and inconsiderate with regards to the precious human resource.

Allow me to bring to your attention these lacunas in your Ministry. I know that one of the requirements for one to be transferred such a person needs to find a replacement to swap with. But how many people would voluntarily be willing to relocate from the urban to go and serve in the rural setup where there isn’t any tangible inducement? In as much as the old adage ‘’patience pays’’ might be apt, I have news for you sir, there is a limit to which patience indemnifies. Beyond that limit, it starts to pain and bleeds despair and frustration. It makes the heart spiteful. I know that this sounds mundane and perhaps a little condescending, and I am by no means making light of the issue, but someone can only be truly patient if he or she is able to see some form of light at the end of the tunnel. That however has not been our case despite many attempts of fighting for a transfer.

My wife and I are just one of the many couples who are constantly living away from each other in an effort to make ends meet. We are a couple who do not even know how it feels to stay under one roof as husband and wife. Our children are living as though they were orphans with only one parent. Our conjugal rights as a married couple and the rights of our children to enjoy interactions with both parents have unsympathetically been trampled upon by the authorities entrusted to defend them.

In as much as we would pride ourselves in being Christians of sound morals, we are also aware of how treacherous a heart can be. We cannot always be 100% confident that things will continue the way they are. My wife is only human. I am too. Any of us can give in to infidelity as this thread of love that holds us together keeps growing thinner and thinner with the passing of time and long distance.

How on earth are you expecting such a zest-drained and frustrated workforce to perform to full capacity? A workforce whose plight has been thrown into desuetude? How would you feel being incriminated as a reason for the collapse of your son’s and daughter’s marriage? Please try to put yourself in our shoes!

I am well aware of the procedures you have put in place to effect transfers. However I am very sceptical about their effectiveness and in my view they favour those with strong connections or the corrupt. I have seen people being transferred barely a year after being deployed. What criteria do they use? If my allegations sound spurious, kindly take time to check through your transfer records and confirm in all honesty how many were purely effected according to the laid down procedures. Were they all done on swapping basis, ill health related or are there those with unexplained circumstances and how many?

As this letter is intended not only to bring the above to your attention, but also to perhaps try and assist in alleviating the problem, herewith my humble thoughts on the matter. Firstly with regards to postings; why can’t your ministry introduce some deliberate provision where you give a specific period of service to those in the rural areas after which those who have served especially the married ones can be allowed to move and join their spouses? Let the newly appointed occupy the vacancies created in those areas. It is my deep conviction that the said steps will help build strong marriages, cut down on divorce cases, reduce on STI transmissions and raise responsible children. Secondly, introduction of some special incentives will encourage people to work in rural setups. This will ease urban-rural cross transfers.

I do hope that the above gives you some punctilious food for thought, and perhaps I can expect your office and the ministry at large to take the lead in addressing these issues, which affect us all each and every day. Please help save our marriages!

Kind Regards,

Humphrey Chiswaswa (Mr)

+260-969-641-007/+260-973-560-955

humphreychiswaswa@gmail.com

Cc: Minister of Health

Professor (Nursing Science) Vacancies at Achievers University, Owo

Achievers University, Owo – The Motto of the University is Knowledge, Integrity and Leadership with a very clear vision to be the best University in Africa and indeed one of the best in the world. The mission of the University is to produce a total man, morally sound, properly educated and entrepreneurially oriented, that would be useful to himself and the society.
Applications are invited from suitably qualified candidates to fill the academic position below:
Position: Professor
Location: Owo, Ondo
College: College of Natural and Applied Sciences (CONAS)
Discipline: Nursing Science
Qualifications and Experience
* Applicants should possess Ph.D. in respective discipline and good record of scholarly publications in reputable journals, with relevant years of post-qualification experience in teaching, research and academic administration.
Salary, Allowances and Benefits
* Salary and allowances are as obtainable in Nigerian public universities. However, salary and allowances for this position is negotiable and at enhanced levels above those presently in public universities in Nigeria.
* Successful applicants with Master’s Degrees will be given adequate support in the pursuit of their Ph.D. programmes.
Application Closing Date
7th September, 2018.
Method of Application
Interested and qualified candidates are required to submit Ten (10) copies of their Applications and Curriculum Vitae, including Names of three Referees to:
The Registrar,
Achievers University,
P.M.B. 1030, Owo,
Ondo State.
Alternatively, candidates could send soft copies of their Applications and Curriculum Vitae to: registrar@achievers.edu.ng
Note: Applicants should request their referees to forward their reports under confidential cover directly to the above address.
For further information: Contact, +234-813-400-2221 Email: registrar@achievers.edu.ng

Nurse Justina Ejelonu Tells her Story From The Grave

I had lofty dreams of living a fulfilled live and having kids. My fiancée and i had fixed our traditional marriage for October, I was two months pregnant. My name is Justina Ejelonu and this is my story.
I was ecstatic when i secured a job at first consultant hospital in Lagos. On the day i was to resume officially, I was reluctant since i had started experiencing morning sickness. I finally got myself together and resumed on the 21st of July.
In an unfortunate twist of fate, my first patient was a Liberian senior diplomat named Patrick sawyer. A 40 year old man with complaints of fever, headache, extreme weakness and haemorrhagic symptoms. Patrick died on Friday the 25th of July, it took the joint collaboration of the state, federal and international agencies to confirm he died from the Ebola virus (zaire strain). Our hospital was temporarily shut down.
On the 25th of July, i updated my facebook wall and wrote “Friends, thank God for me o. i had a close contact with the first Ebola case in Nigeria..:.Long story cut short, God saved me dearly. join me in thanking God”. The next day i posted this update on my facebook wall “”Friends,up to our uniforms and all linens were burnt off.  We are on surveillance and off work till 11th.
Our samples have long been taken by WHO and so far we have been fine. For me,  kudos to my hospital management because we work professionally with every patient considered risk because that’s the training. Had it been its a hospital where they manage risky patients with ordinary gloves like Government hospitals and some  Janjaweed private hospital..:lol….wahala for dey o. I must also thank Lagos Govt….infact! Even federal govt self….all have been supportive. I’m good and so are the others in the hospital…..”
Dr Adadeveoh and Dr Ohiaeri jointly released a press statement thanking the hospital staff for our diligence and professionalism. What was to follow became a national nightmare!
The anxiety awaiting our test results was heart wrenching, Yes, i checked his vitals, helped him with his food (he was too weak)..i basically touched where his hands touched and that was the only contact. Not directly with his fluids. At a stage, he yanked off his infusion and we had blood everywhere on his bed.. but the ward maids took care of that and changed his linens with great precaution”
Days went by and i began to feel feverish, it persisted at a very high temperature. By the 14th of july, My test result was out. It was positive for Ebola. I was devastated and heartbroken. By then, i had started stooling and vomiting. All of a sudden, I started bleeding per vagina. I cried because i knew i may have lost the pregnancy.
Dennis my fiancée got a cab and we rushed to first consultant. We were refereed to IGH, yaba. In panic, i disembarked the taxi and laid on the floor for over 30 minutes begging for attention and screaming “I was dying”, The bleeding had become profuse.
At the quarantine center, Even when the bleeding subsided, I waited in vain for the doctors to carry out an evacuation. They never came. They insisted that an evacuation was too risky as my viral load was high. I was left at the mercy of God to complications as a result of retained products of conception. If Ebola didnt kill me, sepsis surely would
The stooling and vomiting persisted, I was dehydrated and extremely weak. My abdomen was bloated and my legs swollen. The fever caused excessive diaphoresis and fluid loss. nobody dared touch me, i was left on top of my excretions in soiled and over soaked pampers on soiled beddings, We were quarantined at the mainland hospital yaba where there was no water hence we had not had our bath since the day before, I was hypoxic but no provision of oxygen was made. It seemed we were dumped there to die with little care and separated in two groups with one group in rooms called VIP while myself and some other victims were in the ward.
At some point I had messed myself up, Dennis put his life on the line and looked for water to clean me up, change my pampers and arrange my bedding. I was shivering. I knew the end was near, I didn’t deserve to die in such an undignified manner.
On a Sunday morning, As i lay dying, I understood the reason and purpose for my life, my fears slipped away, I was at peace with my country Nigeria, I forgave sawyer, I didn’t hold any grudge against my colleagues in the medical field who deserted me, I was finally at peace.
I felt God hold me in the hollow of his hands. I went to be with the Lord.
As a proud Nurse, I had paid the ultimate price in service to humanity and my country.

Lassa Fever: No Symptoms in Enugu –Commissioner

The Enugu State Government has said that none of the people under surveillance of the Lassa fever has symptoms of the disease.
The state Commissioner for Health, Dr Fintan Echochin, said this in an interview with the News Agency of Nigeria  in Enugu on Thursday.
“The people who had primary and secondary contact with the patient that died of Lassa fever are all under surveillance, we got them through effective contact tracing and active search.
“None of them has come down with symptoms of Lassa fever talk more of testing positive, we are happy that the infection was contained and we have only lost one life.
“Those that had primary contact with the patient, we decided that they should have treatment, we have the drugs free of charge in Enugu state and we have started treating them immediately, in fact nearly all of them have completed the treatment,” he said.
He explained that the state has established a public health unit and emergency operation centre as well as rapid response team with support from the National Centre for Disease Control to contain the disease.
The commissioner said that the state government was willing to train people who wish to know more on environmental health issues, adding that the state health ministry has environmental health unit with well trained staff.
Echochin expressed happiness that the disease was contained without further spread.
By: (NAN)
The Punch News

Evidence Shows Nurses Save Lives, Reduce Costs and Improve Patient Outcomes

The International Council of Nurses (ICN) has released a new position statement on Evidence-based safe nurse staffing which calls for increased investment in safe, effective and needs-based nurse staffing levels in order to improve patient outcomes and create positive practice environments.
“There is clear evidence of the importance of safe nurse staffing in relation to patient safety in all healthcare sectors. Inadequate or insufficient nurse staffing levels increase the risk of care being compromised, adverse events for patients, inferior clinical outcomes, in-patient death in hospitals and poorer patient experience of care,” said Howard Catton, Director of Nursing and Health Policy at ICN. “ICN recognizes that safe staffing is a key priority and major issue of concern for many of our members and the nurses they represent.”
Research shows an increase of one Registered Nurse (RN) per 10 beds is associated with an 11-28% reduction in death 30 days following a stroke and with an 8-12% reduction one year following the stroke. Evidence further demonstrates that hospitals with higher proportions of baccalaureate prepared RNs have better patient outcomes and lower mortality rates.
In addition, inadequate staffing levels can lead to lower job satisfaction, increased levels of stress, staff burnout, a higher inclination to leave and increased staff turnover. This also has resource implications which a number of studies have shown are very significant.
The substitution of healthcare support workers for RNs and the development of new non-RN roles have been implemented in some countries as a possible solution to address a shortage of RNs and to reduce the wage bill. However, research shows that substituting RNs for less qualified cadres of workers may worsen patient outcomes and may not be cost-effective.
“Patient safety and the health of the nursing workforce are two sides of the same coin,” said Catton. “Many nursing associations are concerned that staffing decisions are being driven by financial considerations rather than improved patient outcomes and practice environments. IN order to deliver quality, patient-centred care, there is a real need for positive practice environments with an adequate number of staff, manageable workloads, managerial support, high quality leadership and the ability of nurses to work at their full scope of practice.”
The position statement, which was developed with the input of international experts and in consultation with ICN’s members associations, sets out both principles and key elements of approaches to ensuring safe staffing which is intended to help and support all those involved in determining staffing levels and ensure there is clear nursing leadership on this vital issue.
It calls for:
• establishment and implementation of safe nurse staffing systems based on real-time patient information
• sufficient healthcare funding to deliver needs-based safe nurse staffing
• effective staffing systems based on both patient safety and the health and wellbeing of staff
• public awareness of the impact that safe nurse staffing has on patients, families and communities
• an end to the creation of substitute roles for Registered Nurses
• promotion on nurse staffing research that includes economic analysis
The evidence presented in this new ICN position statement goes hand-in-hand with similar issues raised in two recently released ICN publications: one on nurses’ salaries and the other on retention of nurses. These show that many nurses around the world have experienced a real terms’ fall in their purchasing power over the past 10 years, and that when nurses are enabled and supported to do the job they were trained to, they are less likely to leave the profession.