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Why we emigrated: Irish healthcare professionals on what pushed them to leave

“I was in a theatre all day with one surgeon and I worked every day with him for a year and he didn’t know my name.”

NEWLY QUALIFIED DOCTORS, nurses and other medical professionals are leaving Ireland in pursuit of a work-life balance, better pay and more opportunities. 

Although the emigration of medical professionals is not uniquely an Irish problem, there are a number of push factors within the healthcare system which drive people to leave, according to a number of people The Journal spoke with. This can be seen in the numbers: there has been a 44% increase in the number of Irish doctors granted visas to work in Australia since 2018. 

The Journal spoke to several healthcare professionals who have worked both in Ireland and abroad about their lives and experience of working in different healthcare systems and what it might take for some of them to return to Ireland. 

They describe having to take second jobs just to keep afloat in Ireland, “traumatic” degrees and a new found respect for them and their work in Australia and the UK.

Becca (28) studied general nursing in Tralee and now lives in Perth.

“There’s no such thing as a patient ratio in Ireland. I used to have eight patients on a day shift in a private cardiac unit,” she explains. “In Australia, it’s such a massive contrast -  it’s strictly four patients to one nurse in the public hospitals.” 

Becca could have had 12 patients to herself on a night shift when she was working in Ireland. “It’s so dangerous. Would you be happy for one of your grandparents to be looked after by someone that has 11 other patients? It’s not safe for the patients and it’s not safe for the nurses,” she says.

Becca explains that any mistakes made in the workplace almost always come down to poor fatigue management and too much of a patient workload. Her workload in Australia is manageable compared to Ireland.

“I’m way less stressed. I used to wake up at 3am worried that I didn’t give someone a glass of water that they asked for. You would get text messages from other nurses that were working that day, saying that they just woke up and that they forgot to document something and asking if I could double-check.”

Becca felt that she was never able to switch off from work while in Ireland, saying that annual leave or days off were almost always accompanied by phone calls asking to come in to cover shifts.

“When I moved to Australia, I didn’t nurse for ten months. I was so bitter. I was so angry at the health system. Once I realised how well respected and well paid nurses are here, I decided to get my registration and work agency shifts in hospitals, I was getting paid stupid money to be looking after four patients a day, which I thought was hilarious when I first started. We have pharmacists and phlebotomists here which is everything a nurse does in Ireland.”

Becca describes the pay for nurses in Ireland as “absolutely horrendous,” before adding, “I’m making two times the amount a nursing manager is in Ireland.”

She explains that nurses that have trained in Ireland automatically go to the top of the job application pile in Australia, because Irish nurses are used to having ten patients instead of 4. “We don’t complain here because we’re so grateful for what we have in comparison to home.” 

“Unless things change drastically at home, I will never nurse in Ireland again.”

Maud

Maud (27) from Cork also studied in Tralee and worked in two different hospitals in Cork once she qualified. In Australia, she now works in home care for palliative patients. Maud echoes Becca’s comments about hospital work in Australia, noting a much lower patient load. 

“I had a nice run while working in Ireland because I was in a private elective ward. You’d know what’s coming in the door but training was a different story. I trained in a public hospital and there were staff shortages, long hours, and some days you were expected to be a staff member despite being on training, so it was sink or swim.”

“I don’t think I’ll ever go back to hospitals in Ireland. Pay would need to change, [plus] better working conditions, higher staff levels, lower patient to nurse ratio.”

“At the moment, we get $50 (€33) an hour here. A friend of mine went home and looked into doing agency shifts while she was there and we converted what she would earn and it worked out at $23 (€15) an hour.” Minimum wage in Australia is currently $20.33 (€13.46).

Out of Maud’s friends from college that studied general nursing, one is now a teacher, one is a GP nurse, and two have gone into office jobs. “A lot have gone into completely different careers. One girl I know didn’t even take her pin when she qualified.”

Aoife

Aoife (31) from Clare, studied in Castlebar and qualified in 2013. “I was paid €5.35 an hour during my training,” She describes doing her nursing degree in Ireland as “traumatic.”

“We were treated so badly; the senior staff were quite nasty.”

She tried to get a job immediately but they were paying minimum wage. “I was earning more working in a bar,” she says. Aoife then worked in a hospital in Liverpool for four years. “The pay still wasn’t good but you’re treated better there than you are at home. The people were much nicer, they were all about helping the new nurses.

“There’s no respect at all [in Ireland]. Nurses don’t have respect for other nurses, the managers don’t have respect for the nurses. The doctors certainly don’t have respect for the nurses, [particularly] doctors aged 40 and over. I was in a theatre all day with one surgeon and I worked every day with him for a year and he didn’t know my name.

“If I moved home to Ireland, I would never work in a hospital again. The culture in a hospital has to change, it’s terrible.”

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Physiotherapists

One physiotherapist from North County Dublin studied and qualified in the UK ten years ago before studying a masters degree in sports medicine at Trinity College Dublin. She is currently studying for a postgraduate diploma in clinical leadership in the Royal College of Surgeons.

She worked primarily in the NHS before working in the HSE for three months. “I had to go to a lower-paid job. I was a senior physiotherapist in the UK for six years. I had to take a junior position and a significant pay drop just to get into the health sector here. It wasn’t worth it, I was commuting for an hour and a half every day so I resigned.”

She found the standards a lot lower in Ireland’s public system compared with the NHS. “It’s under-resourced. One thing I remember the most is that patient dignity isn’t as respected as it is in the UK because of a lack of staff and standards. There were no prospects of promotion and the pay was incredibly low so I left and went into the private sector here.”

Recruitment issues surrounding physiotherapists is an aggravating factor.

Another physiotherapist from Cork studied in London and qualified in 2009 and worked in London up until recently. “I’m still trying to crack the HSE. I’m working in a private practice, there have been no opportunities in the public sector,” he says.

The last round of interviews for physiotherapists was in 2016. “There was supposed to be a round of interviews in 2019 which were cancelled because they said they couldn’t get enough people to sit on the interview panel so they never happened.

“I had an interview last week, and they had four rooms to carry out interviews over five days. I don’t know how many jobs they have but they don’t have that many anyway.

“I’m actually considering applying for graduate entry jobs. I have 13 years of experience and I’m questioning if I should go back and start at the beginning again because that seems to be the only way to get in. 

“Then again, new grads are sitting on basic grade jobs for 10 years because there’s no movement above them, they can’t move up the ladder.”

For people who have trained abroad and developed niche areas, he says there are no opportunities here for them, “I wouldn’t advise coming here to work.”

This work is also co-funded by Journal Media and a grant programme from the European Parliament. Any opinions or conclusions expressed in this work are the author’s own. The European Parliament has no involvement in nor responsibility for the editorial content published by the project. For more information, see here

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