Ukrainian nurses in Slovakia need to be given a chance.
The solution exists, we just need to listen.
The fact that the Slovak healthcare system is collapsing is probably nothing new to anyone. However, the reason is not only the lack of doctors but also the acute shortage of nurses. Over the past three years, nearly two thousand nurses have left Slovakia and their age category indicates the continuation of this negative trend. "If we want to have a healthcare system at the average level of European Union countries we have to acknowledge that we lack about 15,000 nurses in the system," the Ministry of Health claims in a press release.
Ukrainian nurses, who have found refuge in Slovakia from Russian military aggression, could be a great help to the weakened Slovak healthcare system. They live here and would like to work here to support themselves and their children. In our system, we still have a shortage of nurses, and unless competent individuals intervene, there will still be a shortage of them.
Let's consider a specific example to describe the problem in more detail.
Mariana also came to Slovakia with her daughter due to the war. In Ukraine, before the war, she worked as a senior nurse. According to Ukrainian legislation, she has a lower high education degree in the field of nursing and had a suitable job. In Slovakia, she wanted to work and not just rely on state benefits. That's why she applied to have her education recognized. Her practical nursing education was recognized, even though she had two years of training in a nursing school and two and a half years of university education as a junior specialist (bachelor's degree). According to our standards, she is just an assistant to the doctor, not an actual nurse (see the scheme below). As a practical nurse, she cannot even register at the Chamber of Nurses or the medical technical workers. Her current salary is around 600 euros net, which does not even cover her basic needs. "If the goal was to obtain a position similar to the one I held in Ukraine, I would definitely fight for the recognition of my qualifications, even if it took me three years. However, I find it illogical to engage in a process that would not allow me to perform the work which I am qualified and experienced for. I would like to work as a professional nurse, not a medical assistant."
Scheme: Ukrainian nursing education system
There are four nursing qualifications from non-EU countries that can be recognized in Slovakia:
What is the problem if Marianne has a college degree? The European Credit Transfer and Accumulation System (ECTS) has been in place in Ukraine since 2005. ECTS allows you to count credits earned at one institution of higher education in a program studied at another institution. This is a central tool of the Bologna System, which aims to achieve better international comparability of national educational systems, which the Ukrainians also envisaged in the Law on Higher Education, even earlier than the Slovaks.
However, Ukraine started to use ECTS not only in universities, but also in secondary schools and has established a process of credit offsetting between secondary schools and universities. We do not know about anything similar in Slovakia. An interesting marketing move in Ukraine is the nursing school, which trains "junior" bachelors based on a regulation of the Ukrainian Ministry of Education. In our understanding this is a secondary vocational school, but in Ukraine it is a college and lasts 2 to 2.5 years. It is a bachelor's degree, which allows you to accumulate credits from the so-called 3rd level of school (lyceum and gymnasium).
So in Ukraine there are also such combinations...
- Nurse (higher education), a bachelor's degree with a minimum of 3 years of education
- Nurse (higher professional education), secondary education of at least 4 years
- Nurse practitioner-assistant, secondary education of at least 2 years
- Midwife, with higher education only
What is the problem if Marianne has a college degree? The European Credit Transfer and Accumulation System (ECTS) has been in place in Ukraine since 2005. ECTS allows you to count credits earned at one institution of higher education in a program studied at another institution. This is a central tool of the Bologna System, which aims to achieve better international comparability of national educational systems, which the Ukrainians also envisaged in the Law on Higher Education, even earlier than the Slovaks.
However, Ukraine started to use ECTS not only in universities, but also in secondary schools and has established a process of credit offsetting between secondary schools and universities. We do not know about anything similar in Slovakia. An interesting marketing move in Ukraine is the nursing school, which trains "junior" bachelors based on a regulation of the Ukrainian Ministry of Education. In our understanding this is a secondary vocational school, but in Ukraine it is a college and lasts 2 to 2.5 years. It is a bachelor's degree, which allows you to accumulate credits from the so-called 3rd level of school (lyceum and gymnasium).
So in Ukraine there are also such combinations...
It was a success for pediatricians, we need to get inspired
I wrote about the shortage of nurses back in March 2020. I researched the reasons and suggested a solution - to look for nurses from countries with the same educational system as in Slovakia. That is, with higher education. We could motivate them with a clear system of integration. I was already pointing out at the time that most nurses in Ukraine have only a high school education and very limited opportunities for recognition of their education in our country. However, if we change the legislation, there will be such opportunities.
It is fair to say that the problem was not created by Slovakia itself. Its essence lies in the already described incompatibility of the education system in Ukraine and EU countries.
We had the same problem since 2016 with Ukrainian pediatricians. Fortunately, it has recently been successfully resolved. All that was needed was the will of those in charge and motivation in the form of more than 30,000 refugee children that our health care system could no longer handle. As with the nurses, the problem was the difference in the training system. At the time, Ukraine had separate pediatric faculties in addition to medical faculties, similar to those in Slovakia before 1993. Thanks to the legislative bridge, it was possible to harmonize the two systems. Thanks to the legislative project, the two systems were harmonized.
It is fair to say that the problem was not created by Slovakia itself. Its essence lies in the already described incompatibility of the education system in Ukraine and EU countries.
We had the same problem since 2016 with Ukrainian pediatricians. Fortunately, it has recently been successfully resolved. All that was needed was the will of those in charge and motivation in the form of more than 30,000 refugee children that our health care system could no longer handle. As with the nurses, the problem was the difference in the training system. At the time, Ukraine had separate pediatric faculties in addition to medical faculties, similar to those in Slovakia before 1993. Thanks to the legislative bridge, it was possible to harmonize the two systems. Thanks to the legislative project, the two systems were harmonized.
Statistics show the truth
I heard a lot about how things were getting better, that the integration mechanisms were already well set up. After all, a year ago the long-discussed and also supported by me temporary professional internship was approved. I insisted that nurses should be part of it. Today, I am happy to see the statistics on doctors as it develops. However, I note with frustration that we have not established these processes for nurses.
Here is the official response from the DOH about the current number of trainees in our system
Here is the official response from the DOH about the current number of trainees in our system
Here is the official DOH response on the current enrollment in our system
Finally, I would like to add statistics on the number of nurses
Solution
Our common goal should be to bring experts into the system on the basis of their real knowledge and experience. This difference can be solved by recognizing part of the training through credits, which,in Ukraine, are based on European standarts. It is also worth considering whether to create high schools for foreign graduates, who could work part-time in health or social care facilities alongside their studies, but so that they can have their nursing specialty recognized in the country of destination.
For help in preparation of this article, thanks to Angela Kirichuk, a Ukrainian attorney living in Slovakia.
For help in preparation of this article, thanks to Angela Kirichuk, a Ukrainian attorney living in Slovakia.
Alona Kurotova