MAJURO — As the Marshall Islands celebrates National Nurses Week with health promotion activities this week, the country is faced with a sobering fact: the number of nurses at the main hospital is about half the number an independent report said is required to maintain adequate services, while for the second year in a row, no Marshall Islanders are graduating from the nurse training program at the College of the Marshall Islands.
Why more Marshall Islanders are not signing up for nursing course at the College of the Marshall Islands continues to be a vexing problem for local health professionals who are attempting to boost the sagging nursing ranks. During the last few years, barely a handful of Marshall Islanders have graduated from the local college’s nursing program, while dozens from the neighboring Federated States of Micronesia–-who come to Majuro to this regional nursing program-–have gained their degrees.
A CMI nursing program official thinks that the wide range of career choices now available at CMI, coupled with the demands of the training and the job, are leading students to choose training in other areas.
Hospital officials see relatively low salaries, and the hard work required of its understaffed nurses as leading reasons that younger people don’t see the profession as attractive.
“Maybe young people think it is a lousy, difficult job,” said Majuro Hospital’s chief nurse, Cathy Antolok. Twenty or more years ago, “so many people wanted to go into nursing,” she said.
Antolok also commented about the challenge of the course work needed to gain a nursing license. “Maybe one of the problems is weakness in English and math,” she said of Marshall Islanders who try and end up dropping out of nursing courses.
One of the biggest problems is the lack of staff at the hospital that puts a huge burden on the 77 nurses on staff, she said. An analysis of hospital staffing needs done in the 1990s estimated that Majuro Hospital would need 145 nurses by 2000. “But we have just 77,” she said. “It’s a critical problem.”
A tough job gets tougher when a nurse has to work two or three eight-hour shifts in a row, she added.
But one thing about today’s job environment in Majuro, while it’s often difficult to find jobs in the capital, if you’re a nurse, you don’t have to worry. “If you’re a nurse, you’re guaranteed a job,” she said.
Hospital administrator Sandy Alfred observed that nursing is one of the few professional jobs that requires working on the “graveyard shift” from midnight to morning. Nursing may be seen as a not really attractive profession because of this and the low salaries, he said. The Ministry is pushing for increases in the salary structure for nurses, he said, adding that management is currently reviewing salary structures in Palau, FSM, Guam and Fiji for comparison. “We’re dependent on the approval of the government for a new budget,” Alfred said. “But we’re trying to remedy the concerns.”
But Alfred disagrees with the negative picture that seems to be being painted about the nursing profession. “It’s a great profession, Marshallese need it and people need to go into it,” he said.
This year, nurses salaries are increasing. “We’re doing things to make it better,” he said.
The ministry is also promoting nursing and other medical professions at the hospital through advertising and direct promotion in local schools.
“We’re spending money to encourage people to go into medical professions,” he said. “We have a long-term plan to keep up advertising. We’re very serious about getting Marshallese into medical professions.”
Alfred said that the hospital is currently 24 nurses below the staffing level needed to provide just basic minimum services. “We’re in bad shape as far as nurses go,” he said.
Last week, Majuro Hospital staff were in Fiji recruiting new nurses for the hospital.
Registered nurse Rosina Korean, who heads the CMI nursing program, believes that expanding academic choices at the college have reduced the number of Marshall Islands students picking the medical profession as a career choice.
In 1985, when the nursing program started in Majuro, lots of Marshallese were taking nursing courses, Korean said. At that time, she said, the college offered only two majors: teaching and nursing. “Now, there are lots more choices,” she said, adding that students tend to gravitate toward computer science, business and other courses available.
But, despite these challenges, the nursing program actively attempts to recruit new students. Korean noted that a special school health academy run through the US federally funded School to Work program at Marshall Islands High School resulted in 25 high school seniors participating. A substantial number of these students then enrolled in CMI and are in developmental—non-credit—program courses aiming to enter the nursing program when their grades improve.
Korean feels that low salaries that are paid to nurses at the hospital are a real disincentive to encouraging Marshallese to go to nursing school and to keeping nurses at home once they’ve graduated. She said that a number of Marshall Islands CMI nursing school graduates have left for the U.S. because of better paying opportunities.
“If the government considers nursing as a valuable job, why does it pay such low salaries?” she asked.
