Attrition rates of both foreign and local hires in Singapore have been rising. - ST
SINGAPORE (The Straits Times/Asia News Network): Nurses in Singapore are seeing their pay go up as efforts are made to retain them in the face of a continued global shortage.
Attrition rates of both foreign and local hires have been rising. Some 14.8 per cent of the foreign nursing cohort left last year - more than double the figure in 2020 - many to countries that offer better remuneration.
Singapore is highly dependent on foreign nurses - more than half the new nurses who entered the profession in 2020 were non-Singaporean.
Some foreign nurses use Singapore as a jumping board to get to countries that offer much higher salaries, occasionally even as high as double what they get here, or other perks such as permanent residency.
Others, after a stint here, return to their home country to hold senior positions there, based on their experience in Singapore, which is highly valued.
Local nurses are also leaving the profession, with a 7.4 per cent drop-out rate last year - the highest attrition rate in at least five years.
While some are older nurses retiring from the job market, others leave for personal reasons. These include family commitments, which their fluid shift work makes it difficult to fulfil, and job stress.
A Ministry of Health (MOH) spokesman said: "The attrition rate of nurses across all hospitals in the first quarter of 2022 is 4.4 per cent, slightly higher when compared with the same period in 2019, 2020 and 2021, when nursing attrition rates ranged from 2.7 per cent to 3.3 per cent."
He was unable to say if the higher attrition rate continued in the second quarter of the year.
To try to keep nurses here, the Government announced this week that it will be giving more than 25,000 nurses working in the public sector a special bonus of 1.7 to 2.1 months of their base salary.
This is both to thank the nurses for their hard work during the Covid-19 pandemic, as well as to keep them in the profession - as the bonus will be paid over three separate periods with the final payment in September next year.
The MOH also said nurses' pay had recently gone up by between 5 per cent and 14 per cent.
The private healthcare sector too is facing a shortage of nurses, and the moves by the Government to keep nurses in the public sector will impact their ability to attract nurses.
Last year, The Straits Times reported that at least one private hospital was giving up to S$12,000 to people who bring in an experienced nurse. Even newly minted nurses would garner the introducer at least $3,600.
A spokesman for healthcare group IHH Singapore said: "We have always been short of nurses and the pandemic has further exacerbated the situation.
"More nurses have resigned this year compared with last year, with many citing their desire to return to their home countries as the main reason."
IHH Singapore runs four hospitals - Mount Elizabeth, Gleneagles, Mount Elizabeth Novena and Parkway East - more than 30 clinics as well as several laboratories, all of which require 2,200 nurses to operate optimally.
The spokesman added: "Despite our increased efforts, we have been unable to recruit enough nurses to make up for those who have resigned."
The Straits Times understands that the group has about 300 vacancies for nurses across its hospitals and clinics.
Thomson Medical Centre is also tight on nursing manpower, said Ms Amanda Yeo, 31, a nurse who works in the delivery suite there.
She said that when a nurse quits, a replacement has to be found quickly as "we are very tight in staffing". The same happens when a foreign nurse goes home for one to two months, after having not left Singapore for some time.
Other nurses ST spoke to echoed the manpower challenges they face. They said when colleagues leave, they have to pull extra shifts, although the situation is better now than at the height of the Covid-19 pandemic in 2020 and 2021, when some hospitals stopped staff from taking annual leave.
Nadiah Noraswan, 36, who has worked as a nurse in both the public and private sectors, said: "I have personally witnessed seven resignations in the last six months.
"Colleagues who resign mostly go to other hospitals (both restructured and private), vaccination centres, or agency nursing. A handful left nursing entirely. Even though there is high turnover, there is also an increase in new hires."
A public sector nurse who did not want to be named said some leave because of the clash between shift work and family commitments.
"The shifts could be from 7am to 3pm or 9pm to 7am. They quit because they have kids or elderly parents to take care of, and working shifts means they are unable to attend to them," the nurse said.
Another public sector nurse who has been in the profession for 13 years said the past two years have been tough as hospitals had to cope with the pandemic. Although the Covid-19 situation may have eased, the hospital she is working at is still short of staff.
She said: "Nurses may not be allowed to take annual leave or family care leave. The roster is pretty upside down. When there is a shortage of staff, nurses may be called back from their days off to report for work. If they fail to do so, they may have to do overtime in the form of double shifts."
The tight nursing situation is unlikely to improve significantly in the coming years, given Singapore's rapidly ageing population. Older people generally require more healthcare services, including hospital care.
Senior Parliamentary Secretary for Health Rahayu Mahzam told Parliament on Tuesday (Aug 2): "As our population ages, there will continue to be growing demands on healthcare manpower."
The ministry is looking at ways to increase nursing productivity.
Rahayu said: "This includes streamlining care processes and deploying dedicated administrative and support (staff) to assist nurses.
"Over time, we have also introduced innovations in automation, technology, robotics, and artificial intelligence technology to assist nurses and healthcare staff, to ease the load of non-clinical and administrative tasks."
She gave the example of the Nursing Software Suite where patients can check their test results, medications, schedules for tests, and indicate their requests to the care team.
The MOH spokesman said: "We will need both local training pipelines and foreign recruitment channels to meet the needs of our healthcare system."
The Ministry of Education said: "The nursing intake numbers in polytechnics have remained stable between 2017 and 2021, with an annual average of close to 1,400 students gaining admission to nursing courses."
While the polytechnics that supply the bulk of newly trained nurses have not increased their nursing intake in spite of an 8 per cent increase in students choosing nursing as their first course of choice over the past five years, there are other institutes, such as the National University of Singapore, that also provide nursing training.
The MOH spokesman said that overall, local nursing intakes have increased from around 1,500 in 2014 to around 2,100 in 2021.
He added: "The MOH will continue to work with public healthcare clusters on recruitment and retention efforts to ensure that there is sufficient manpower in hospitals."
