They are crucial not in hospitals where they are already lacking as it turned out with Covid but they are also irreplaceable for care in the area, those in which the PNNR invests 7 billion that will see nurses as protagonists inside and outside the new structures, such as community homes and hospitals. Too bad they are nowhere to be found in the face of a shortage of at least 70,000 operators. To remove many young people from this crucial health profession that keeps the Italian health on its feet are the low salaries: with 1700 euros a month, Italian nurses are in 25th place among the OECD countries. Not to mention the lack of career progression and the risks of violence in the ward that affects one in three nurses. Hence the appeal to the policy of the National Federation of the orders of the nursing professions on the eve of the vote of 25 September to strike a blow, because “without nurses there is no health“.
The appeal to politics
The more than 460,000 nurses registered in the Register in Italy, represented by Fnopi, are now asking for precise choices in a document sent to politics, ensuring an indispensable change of pace: “Nurses are few compared to the needs and the profession is less and less attractive”, it is the alarm of the Orders of the nursing professions that identify three essential priorities, sent to the forces running for the elections: increase of the contractual base and economic recognition of the exclusivity of the nursing professions; recognition of specialist skills; evolution of the university training path. “Politics – concludes Fnopi – must set itself specific objectives: without nurses there is no health, Italy must demonstrate that it is a nation that invests in nursing, citizens can no longer wait”.
The emergency in the hospital and in the area
Today in Italy, according to Fnopi estimates, there are about 70 thousand nurses missing, 45% in the North, 20% in the Center and 35% in the South. Compared to the international situation, the nurses-inhabitants ratio in Italy is 5.5 -5.6 nurses per thousand inhabitants, “one of the lowest in Europe according to the OECD where the average reaches 8.8”, explains Fnopi. Nurses-doctors, which should be according to international standards 1 to 3, is according to the OECD of 1 to 1.5 (the OECD average is 2.8: the United Kingdom is on the OECD average, Germany reaches 3.2 , France i 3.3, Switzerland i 4.1). The pandemic, Fnopi points out, through the injection of staff in 2020 to cope with the emergency, has allowed nurses (with about 8,800 more units) to recover all the losses suffered between 2009-2019. However, Fnopi specifies, these are numbers that “do not alleviate the shortage or the needs linked to the new standards of the territory, but only recover the losses suffered due to the cuts linked to the rationalization of expenditure”. However, Fnopi still points out, nurses continue to be too few even to cope with the new standards set by the NRP for the new territorial healthcare. “The number of family and community nurses needed according to the new standards alone is over 20 thousand (1 for every 3,000 inhabitants)”.
Salaries in Italy too low
An Italian nurse earns on average according to the Annual Account of the General State Accounting Office 2020 (just published) 34,711 euros per year gross, that is about 22,600 euros net which on thirteen months is about 1,700 euros per month. The salary has been practically at a standstill for about 8-10 years, from the 2009 contract, except for the contractual holiday allowances. The OECD average is 48,100 euros gross per year. But for example in Switzerland (where many Italian nurses go to work) it is close to 56 thousand euros, in Spain 55 thousand, in Germany 59 thousand up to the top in Luxembourg where in 2019 a nurse earned an average of just over 100 thousand euros a year. gross.
The proposals to the next Parliament
Three blocks of intervention proposals proposed by Fnopi to politics. The first must provide for the enhancement of the contractual item defined as nursing specificity indemnity (salary item established by the 2021 Budget law and already contractually identified), to be increased by at least 30%: today Italian nurses are in 25th place as an annual average among the OECD countries (followed only by eight other countries). The economic recognition of exclusivity is also essential for nurses who work in the clinical setting and with the role of managerial management in organizational services in public and private structures under agreement. The second block must provide for the insertion within the Lea (essential levels of assistance) of the specialist care branch to give uniformity of services at regional and national level, with the establishment of the specialized skills that already exist today, but which they are not officially recognized for nurses. The third block concerns the enhancement of nursing education in universities, with the establishment of clinical master’s degrees and specialization schools.