Dutch home care suffers shortage in staff

Edition 26 April 2018, by Bárbara Luque

In the last years the Netherlands has suffered from an acute shortage of district nurses, jeopardizing home care provision specifically in the Amsterdam, Rotterdam, Tilburg, Breda and Nijmegen regions. There exist different organizations throughout the Netherlands that provide home care, in which the nurse visits several times a day and there is a 24-hour attention to the patient, generally an older person. The type of care patients require differs from one patient to another and may include daily care, help with eating and drinking and taking care of wounds. Home care is needed given the fact that elderly people live independently but still need medical care. And today, there are not enough nurses to fill the many vacancies to allow elderly people to live longer at home in a responsible manner. This shortage problem goes back to 2016, when there was already a shortage of 750 to 1000 district nurses around the country. Later, in 2017 home care institutions in Eindhoven and its surrounding areas had to set up waiting lists as they could not handle the high demand for district nursing. Back in 2017, reports from Zuidzorg, the largest home care provider in the region, showed a huge increase in demand, “We cannot keep up”, stated Nina Vos director of home care at the organization.

The trade association Actiz pointed out the shortage to both: a lack of nursing students and an increase in life expectancy. This second point given that by March of last year, the Netherlands had a total of 700,000 people aged over 80 years old, age group with the most home care needs. They are expecting this number to double over the next 10 years. In addition to the shortage of staff, current nurses will go beyond their working hours to provide for patients. Jos de Blok, director of home care organization Buurtzorg says, “We warn teams not to go beyond their limits, but nurses feel responsible and find it difficult to refuse people, especially when it comes to people who are terminally ill”. This results in increased risk of burnouts of district nurses, thus shortening even more the home care staff. Organizations have also noticed that there is something wrong with the image that nursing has attained, given that society has come up with a wrong idea of what home care has to offer.

Hanny van Diest, a district nurse at ZuidZorg explains, “It’s so much more than putting on stockings, the biggest advantage is that you can deliver that warm care”. To stop wrong preconceived notions of the job, organizations created initiatives and campaigns to make the job more attractive, so potential students could appreciate the beautiful side of this vocation. Moreover, according to the ED Newspaper, homecare got busier with the introduction of the Long-term Care Act of 2015, which stated that only people with a complex demand for care can go to a nursing home, while the rest must stay at home.

De Blok thinks other causes to the shortage of nurses are that patients who are in the hospital must go home faster, creating a greater need for home care; as well as home care institutions being more cautious about attracting new people because of agreements with health insurers that state a fewer number of patients for whom they will get reimbursed. The Ministry of Health commissioned a study which shows that by 2019, between 10,000 and 13,500 district nurses will be required. In the intent to cover this need, on March the country resorted to recruiting nurses from Italy and Spain. These new employees started working in Amsterdam as district nurses taking care of elderly, sick or weaker people at home. “Here we have a big shortage, but in Italy and Spain there are many unemployed nurses, they have a university degree and the level of education is high”, said André Brand of Cordaan Thuiszorg.

In addition to a language course, the Southern Europeans are also updated on Dutch healthcare, administration and computer systems to start working as soon as possible. Regardless of this, the director of Branchebelang Thuiszorg Nederland stated, “If the government wants older people to live longer at home, they must invest in district nursing”. Nevertheless, money isn’t the issue according to Zorgverzekeraars Nederland, “The enthusiasm for the nursing program is too low, the graduates prefer to choose a job in a hospital.” The professional association of nurses and caretakers has since started a campaign to ask politicians to pay attention to this very needed sector, indispensable for people to grow old in their own environment with the quality of life they deserve.