The Wrongologist

The Daily Escape:

Chopin’s Piano at his birthplace, Zelazowa Wola, Poland. Chopin is far and away the most famous Polish national – 2018 photo by Wrongo

Sometimes there can be unintended consequences, even when the intended consequence is a good idea.

The focus of Wrongo and Ms. Right’s visit to Poland is to learn more about the current state of Polish nursing (Ms. Right is a PhD nurse). Over the past few years, Poland has worked very hard to create national qualification standards for nurses in practice, and to dramatically improve the quality of their education. Prior to 2004, most nurses attended vocational schools, they entered practice after two years, and most of their education was on-the-job training.

Today, most nurses entering practice have Bachelor’s degrees. Both Master and PhD degrees are offered as well. There is a detailed, nation-wide standard for nursing education that is required in all 420 schools of nursing.

This all happened in a period of about 14 years, and is a direct result of Poland joining the European Union in 2004. The EU’s interest was that Polish nursing education and practice standards would be raised to meet the overall standards for EU member countries. To that end, the EU provided Poland with funding that was used for “bridge studies”, designed to bring the vocational school graduates up to the new standards, and university programs for new nurses.

The results are impressive. Today, Polish nurses meet the standards of the EU. They are in demand for jobs all across the other EU countries.

This has led to an unintended consequence: a nursing shortage in Poland. In Poland, the average nurse’s salary is about $10,000/year. But as you can see below, Polish nurses can earn substantially more elsewhere in Europe. These are pre-tax monthly averages in Euros:

Source: Nursingcee

Nurses earn less than the average worker in Poland. The average salary in Poland in Q1 2017 was 4,449 zt, or about $1215/mo. Compare that to a nurse’s average salary of $833/month, and the reason for the shortage is clear. About 20,000 nurses migrate annually from Poland to elsewhere in the EU.

The result is a current 60,000 nurse shortage in Poland, where there are 5.4 nurses per thousand of population. That ratio is 9.1/thousand in the OECD countries. And it is the younger, educated nurses that are leaving: The average age of a Polish nurse is 51.

Over the past two days, we met with the chief nurse executives at two hospitals, the vice-minister for nursing in the Ministry of Health and the president of the Polish equivalent of the American Nurses Association. None could articulate a clear strategy for ending the nursing shortage, or for increasing the average nursing salary sufficiently to slow outward migration for economic reasons.

Most Americans were unaware of how the EU imposes standards on member countries for many aspects of economic life until the Brexit issue arose in the UK. Those in the UK who voted to leave the EU felt that the requirements to stay were not worth the costs. That may have been a shortsighted decision.

There will always be costs when a degree of sovereignty is surrendered when joining an organization like the EU.  Consider Jan and Thera Kuiper, dairy farmers at Kuiper’s dairy in the Netherlands, who Wrongo and Ms. Right met in 2017. The Kuiper’s went from being simple dairy farmers supplying a local market, to now selling 4000 pounds of cheese a week throughout the EU. It wasn’t easy to comply with the EU’s requirements to sell cheese, but now their business is thriving.

It looks like Mr. Market will continue to determine where Polish nurses work, at least until Poland comes up with a solution that leads to better pay at home.

Until then, those who are most confident in their skills will continue to move elsewhere in the EU for better pay.

And Poland will continue to have a first-world system of nurses’ education, without a first-world career path for their graduates.

Since Wrongo is returning to the US on Saturday, there can’t be our customary musical interlude to start the weekend. But, Wrongo and Ms. Right had the pleasure of hearing a private performance of three pieces by Chopin on Friday by the remarkable 23 year-old Polish pianist, Wojciech Kruczek. Among the pieces Kruczek played for us was Chopin’s Ballade No. 1, in G minor. Chopin’s four Ballades are one-movement pieces for solo piano. Ballade No. 1 was completed in 1835 when Chopin was 25. The Ballades are considered to be some of the most challenging pieces in the standard piano repertoire. Here is the Ballade #1 by Mr. Kruczek

While the video says the artist is Kayo Nishimizu, Wrongo assures you that it is Wojciech Kruczek.