Many Norwegian nurses are planning their escape

Even before the pandemic, Norway was 7,000 nurses short according to figures from Statistics Norway. One in five nurses left within ten years after graduating. When the Corona pandemic hit Norway in early 2020, the Norwegian Nurses Organisation and the employer organisations the Norwegian Association of Local and Regional Authorities (KS) and Spekter entered into a new agreement.

The Nurses Organisation agreed to increase the cap for weekly working hours from 54 to 69 hours, as long as this is discussed with employee representatives in advance. It also agreed to a 25-hour cap on overtime. 

Without discussions with employee representatives, the number of working hours in a 24 hour period could be raised to 16 hours. This increase in workload led to a negative spiral with many nurses buckling under the strain. 

One in five nurses experienced a major increase to their workload due to the Corona pandemic. Photo: Björn Lindahl

One in every three nurses in intensive care units has had their working hours changed because of the pandemic, according to a report from the Sintef research institute mapping the first phase of the pandemic from March to October 2020. More than one in five nurses (21%) have experienced a major increase in their workload and 14% of all nurses have got longer working hours during the pandemic. 

“When more people leave the occupation it becomes very tough for the few who are left. The workload becomes even heavier. We see that fewer and fewer will accept only applause as pay. I don’t think nurses will put up with it anymore,” says Kenneth Sandmo Grip. He is the regional head of the Norwegian Nurses Organisation in Trøndelag.

How to survive as a nurse

“Many nurses ‘survive’ by moving from positions involving rota work and on-call systems to doing only dayshifts. Many take further education to become specialist nurses or midwives. Many also study pedagogy and apply for teaching jobs in upper secondary schools. A few also go to pharmaceutical companies. This has been going on for years,” he says. 

His story is supported by a new survey among nurses carried out by the Nurses Organisation’s magazine Sykepleien. In it, 72% say they have considered quitting or changing jobs in the past 12 months. This is a serious increase on earlier years. 

1188 Norwegian nurses took part in the survey. Some of the most common reasons they gave for considering quitting the occupation included

• Poor staffing (69%)
• Not happy with the pay (64%)
• Psychological strain (59%)
• Physical strain (57%)
• Not enough time and space for professional discussions with colleagues (51%)

Kenneth Sandmo Grip also points out that it is becoming increasingly common in the Norwegian health service to use staffing agencies. Nurses sign up to these in order to better control their own working hours.

Nurses who are temping often have better conditions than those in full-time work, he points out. 

“As a temp, you have a bit more control over your own working hours. Quite a few nurses chose this in order to get better working conditions. I think this is important for nurses, as their workload makes them tired over time. Many want to have as much control as possible over what is controllable by working as a temp.”

He gives an example from Trøndelag county, where a staffing agency has some 2,000 people on their books, and as such has become the biggest employer in the north of Trøndelag.

“Staffing agencies will often cover travel and accommodation for the nurses on their books. One agency offered a bonus in order to get nurses to sign up with them. Everyone knows that the public health service has become completely dependent on the staffing agencies,” he says.   

The pandemic has also made it harder to use temping staff from other countries. 

"Permanent staff the best solution"

The Norwegian Nurses Organisation argues the use of temporary staff in the public health service must be cut. The best solution is permanent staff which creates continuity and quality, argues Grip.

“The use of temporary staff has become a vicious circle. The public sector seeks to save ever more money and nursing staff leave. This creates a shortage, which means temporary staff are in short supply too. Many millions of kroner are being spent on staffing agencies in Norway every year. We need some temporary staff but we would not need to use just quite so many as we do if there was a willingness to secure permanent staff in the public sector. This would have saved enormous sums of money,” he and the Nurses Organisation argue.

“The pandemic has also increased the workload for many of our members. In addition to doing their normal job, nurses often have to organise testing, tracking and vaccinations. More responsibilities and poor pay seem to be the most important reasons for nurses quitting or moving jobs,” conclude the trade union leader.