In Bulgaria every third practicing nurse is over 65 years of age, and in order to work peacefully the health system and to have someone to take care of the patients, we need over 50 thousand nurses.
This is what Milka Vasileva, president of the Bulgarian Association of Healthcare Professionals, said in an interview with BTA.
The motto of May 12 this year is “Our sisters are our future– the economic power of health care”. According to the association's data, 21,860 nurses work in Bulgaria. Reform and “reordering” of the health system, as well as developing work standards to be followed. Otherwise, the health system will go bankrupt, Vasileva also said. Every year, 800-1000 nurses leave the profession, some of them go abroad, and those who remain in Bulgaria leave the healthcare system.
The joint organization insists
For several years, the class organization has been alarmingly pointing out the problems related to the personnel crisis, such as in 2023 in an open letter sent to the prime minister, to the chairman of the parliamentary committee on health care, to the minister of health, etc. called for the creation of a system for planning, appointment and retention of the medical staff, for a framework for sustainable career development, for a sustainable increase of salaries in relation to the acquired knowledge, skills and competences, for a requirement for a minimum number of medical specialists in health care for the optimal functioning of medical facilities establishments.
Governors only promise
The managers promise, but when they start to manage, they see that the problem is very, very serious because of the commercial nature of the medical facilities, because of their different ownership, because of the fact that the state has abdicated its regulatory function in relation to health care. We cannot boast of successes related to our demands, Vasileva also said. We have always said that our profession is undervalued and disrespected. Our colleagues work in two or three places and because of that our health system still exists, but our managers cannot make sense of this fact, she added. Everyone knows that new hospitals are constantly being opened or new activities are carried out in existing hospitals, but there is no real staff to work there. Very soon there will be no one to complain to, and the rulers will have no one to complain to, as nurses, midwives and medical assistants are leaving the system or the country, Vasileva added. According to her, even the hospitals that currently offer higher salaries cannot provide staff. Due to the fact that the colleagues work in several places, the medical facilities continue to exist, she added.
Solution?
The decision is very difficult, since the system is extremely conservative and in order to have any effect, it is necessary to start with many revolutionary steps, one of them being the provision of decent salaries, Vasileva also pointed out. In most hospitals, the basic salary for a nurse specified in the Collective Labor Agreement (CLA) is not provided – BGN 1,500, which is also extremely insufficient for support and continued professional development of a nurse.
Besides an increase in remuneration, it is necessary to have respect for the profession and for the people who practice it, as well as good relations within the medical teams. According to her, it is necessary to provide an opportunity for career growth and realization, to create health care standards.
The beginning must be made with the development of a long-term strategy that indicates what will happen in five, ten, twenty years, because according to the World Health Organization, by 2030, a shortage of nine million nurses is expected. Bulgaria is one of the countries with the fewest nurses per capita, and if the future rulers do not reach a political agreement and prepare the strategy, I am not convinced that there will be anyone to celebrate the next May 12, Vasileva also said.< /p>
The project of a new KTD
In the project of the new KTD, basic salaries are expected to be 30% higher, Vasileva pointed out. Unions, employers and the ministry are currently working on the issue, but employers' organizations have refused to sign such a collective bargaining agreement because it would oblige them to change starting salaries, and they claim they do not have the financial means to do so. The lowest salaries are in municipal hospitals, Vasileva added.
Legal violations due to lack of personnel
From the class organization, we insisted that the profession of nurse and midwife be prohibited from being practiced by people who do not have the necessary educational and qualification degree, added Milka Vasileva and pointed out that in some hospitals midwives, paramedics, physician assistants, even students, which is completely illegal. According to her, this legal violation is being done because of the shortage of nurses. Employers hire people who don't have a basic nursing degree.
Responsibility in the event of an accident
If an accident occurs when the activity is performed by a person without the necessary qualifications, the responsibility will be borne either by the senior nurse or by another nurse who is on shift, Vasileva explained. Many students are assigned as caregivers, which is not in violation of the law, but they are also forced to perform nursing functions, not even under the supervision of a licensed nurse, Vasileva added. According to her, some medical facilities lack a nurse during the night shifts.
We want to show the good sides of our profession, because it is wonderful, but everything I have said so far repels young people and they have no motivation to learn, Milka Vasileva also said. I continue to maintain that the Bulgarian training of nurses and midwives is one of the best in the world. Governments must finally understand that health care is not an expense, but a huge investment, and the health care professionals need to be invested in to have someone to care for people. This thesis is either not understood, or there is no desire to understand, Vasileva added.