Last week, Irish Times Abroad published a feature about the difficulties emigrant nurses are experiencing in their attempts to return to Ireland to work, particularly when registering with the Nursing and Midwifery Board of Ireland.
We invited nurses who had been through the process, or who were considering it, to share their experiences. This is a selection of the stories we received.
Breda Ryan, Dublin: ‘Nursing is not a vocation and we are not all called Florence’
As an intensive and cardiac care nurse with 20 years experience, I look on at the current chaos in the Irish health system with dismay.
I am a proud Irish nurse who worked in the US over an 11-year period. I worked in intensive care units in New York University Hospital, Massachusetts General Hospital, and UNC Hospital, all top US hospitals that were delighted to have a highly skilled Irish nurse. I was paid a salary up to $80,000 in a challenging and rewarding working environment.
I returned home after 11 years and applied for an ICU job, receiving €21 per hour before tax, which also had to cover crèche fees, travel etc. Overworked and underpaid, I didn’t last long. Maybe I should “go back” to North Carolina, was one suggestion I received.
There are thousands of experienced Irish nurses living in Ireland who are not working due to the pay and the conditions. Nursing is not a vocation and we are not all called Florence. Nursing is a skilled profession with huge responsibilities, and nurses deserve to be paid and treated properly.
Anonymous: ‘My wife’s experience would not encourage any Irish nurse to come home’
My wife has three nursing qualifications, each gained in the Irish system: general, midwifery and psychiatry. After working six years as a ward sister in a geriatric unit, she took the career break offered in 1988. We headed for London and she started as a psychiatric nurse for the NHS, and after 10 years, had worked her way up the ranks to acting nursing officer, where she was in charge of the hospital on her shift.
After returning home in her mid-40s, she was offered the post of ward manager in the secure unit of a “centre of excellence” hospital. There were questions raised about her managerial experience in psychiatric care, and she was put on one of the lower grades of the pay scale. After almost three decades working in the nursing profession in multiple disciplines and multiple management courses and posts under her belt, this was a hard “pill” to swallow.
Only for family circumstances we were tempted to pack our bags and return to a country that appreciated my wife’s qualifications and experience, and paid her accordingly. After union intervention, she was put on the highest grade.
With the Irish healthcare system in meltdown and crying out for nurses to return home, my wife’s experience and that of other nurses would not encourage any Irish nurse to come home. The lofty standards of the Irish healthcare system and management are clearly out of kilter with the realities on the ground. The Irish patient is not so much concerned with the minutiae of nursing qualifications, and could do with a dose of “old fashioned” nursing care.
Ciaran O’Liain, Canterbury: ‘The levels of bureaucracy attached are prohibitive’
I am a mental health nurse, trained in Ireland and currently living in the UK. My An Bord Altranais membership is dormant and has been since I left Ireland to work in London in 2010.
I have a vast amount of experience in different areas of mental health care. I have looked into returning to work in Ireland, but the levels of bureaucracy attached are prohibitive and to my mind, from my NHS experience, unnecessarily so. A case in point would be where I applied for a community psychiatric nurse post in Ireland but was rejected because my MSc (in Social Research Methods) was not in a mental health specific subject, despite the fact I focused my course work and thesis on stress and burnout of staff working in psychiatry, and that I have worked as a community psychiatric nurse in the UK for the past six years.
I have a partner here, who is English and a senior mental health social worker. When she looked into getting registered to look for work in Ireland, she also found the process laborious and unnecessarily bureaucratic. One request was to detail every placement she had as a student, information which is not readily available given that she qualified a decade ago.
I realise the current “panel” system is there to enhance fairness for applicants, but if we were to apply again to work Ireland, we would like to know what exact job we were applying for and where we would be based. We have a home here in the UK, and responsibilities, and would only move back to Ireland if we could both know where we would be working, and if we could afford to purchase a home within commutable distance.
Whenever I listen to news segments on healthcare in Ireland, commentators bemoan the problems with employing and retaining staff, the amount of vacant posts and how to make returning home attractive to nurses who have left. I think one option worth considering is setting up a HSE recruitment agency, that deals with relocation of Irish trained nurses from abroad and assisting their families to integrate and find work, housing and navigating the process. There is a lot of Irish talent outside Ireland with a lot of experience that could be used to great effect in the Irish healthcare system.
Annie Mathews: ‘The process was horrendous and stressful’
It was my husband who wanted to return to Ireland. I am an American-trained nurse and have both a BSN and MSN in nursing. My thought I could be a nurse anywhere with my degree and experience, so agreed to the move. I was wrong.
I applied in January 2016, as I had a job offer in Dublin to start in April. I was denied registration, then had to appeal the denial with no appeal guidelines. I was refused registration again in August 2016 and was not able to work until January 2017.
The process was horrendous and stressful. Nobody is asking for the NMBI to lower their standards, more like update their review process and realise that nursing is a international qualification, and the frameworks of nursing education varies between different countries.
Anonymous: ‘I feel rejected by my own country’
My husband and I went home in March 2017 after 12 years in Sydney. My husband likes living in Australia but I’d prefer to live in Ireland despite having made a good life here. We had €20,000 saved, so we were ok financially for six months or so.
I had re-activated my registration using a friend’s address early in January 2017. I joined an agency and had all necessary paperwork with me, including evidence of work on the wards in public hospitals, and ongoing annual training.
I had to undergo the Irish standards of annual training in hand washing, manual handling, elder care, abuse, and basic life support. I had to cover the cost to stay in Dublin and pay the agency for the training, of €1,000 in total.
I had bloods costing €80 done to determine my immunity, and despite being immune, they wanted me to have my vaccinations repeated which would cost €500, as I wasn’t employed by the HSE where staff vaccinations are covered.
We were given a car but it cost €2,800 to insure as the insurance company did not see us as Irish residents.
It was extremely difficult to open a bank account even though the local bank officials knew me personally all my life. I didn’t have enough official documents to prove I was Irish even though I was in my hometown and had an Irish passport; they said I needed a bill to prove my address and another Government letter of evidence of address.
We presented at the social welfare office to reactivate our social welfare stuff, that took four visits before we met a staff member who overlooked a bit of the paperwork and she signed us off.
Our effort to return to work in Ireland was an expensive nightmare. I was so disappointed. I trained as a nurse in Crumlin and Drogheda many years ago and have been engaged as a nurse across many areas of nursing all my working life. I am a very experienced ward nurse with many skills to offer, but I feel rejected by my own country.
I gave up trying to overcome the Irish bureaucracy and enjoyed my holiday before returning to Australia in August. I’ve spent the last five months working in the country city of Broken Hill in a very remote 100-bed hospital, which appreciates my broad skill set and experience. My husband picked up work in the caravan park as a maintenance man, and we had a wonderful experience in the Australian country town. I am now classified as a rural and remote nurse and will be welcome to work anywhere in Australia.
We are tied to Australia as we have adult children here who we won’t leave, so it was our plan to work in Ireland every second year for the next eight years until we retire.
We will continue to visit home in alternate years for a month or two, but have realised it’s just too hard to sort out the documentation to work in Ireland.
Áine Byrne, Liverpool: ‘I have received no explanation regarding the delay’
I went to Ormskirk in Lancashire in 2010 after completing a FETAC nursing course and receiving an offer to study nursing at degree level. I qualified three years later and after working in England for a year, I decided to look at the options to return to Ireland. I contacted a number of Dublin hospitals, both public and private, and all advised me to get my Irish PIN before applying for jobs, as the applications were taking months to years to be assessed.
I notified the UK Nursing Council of my intention, and applied for my Irish Nurse PIN in May 2015. I was informed that the waiting period was two to three months by the NMBI. I emailed for an update four months later, then emailed again, then telephoned; none of my phone calls were answered nor did I receive a reply to my emails.
I sent a letter of complaint to the head of the NMBI in October 2015, but received no reply. I was granted my PIN in January 2016. I have received no explanation regarding the delay to my application to this day. But the end result has been that I remain in the UK as my living situation and the rental costs in Ireland now makes returning difficult.
Caitriona Tippett, Surrey: ‘I would not be tempted to work in Ireland if I have to go through the NMBI’s processes’
I trained in Ireland then came to the UK to do further training and to work. My last role involved managing services across two counties and three hospitals, and I have a Masters degree. I have maintained my various registrations in Ireland as best I can but the systems at An Bord Altranais and then the NMBI do not help. Despite having contact addresses for me, my registration “lapsed” when the Bord became the NMBI as I was not contacted - that has since been remedied.
However, despite sending my marriage certificate and asking for my name to be changed on the register, they have returned my certificate but left my registration in my maiden name. I have no faith in the integrity of their organisation, and would not be tempted to work in Ireland if I have to go through the NMBI’s processes again.