[Shortage of nurses in Spain: from the global case to particular situation. SESPAS Report 2024]. / Escasez de enfermeras en España: del caso global a la situación particular. Informe SESPAS 2024.

The nursing shortage is a multi-causal phenomenon that affects all countries and currently a global concern. The shortage of nurses jeopardizes the sustainability of health systems and the population health outcomes. Spain has historically had no difficulties in attracting new generations of nurses. The shortage of nurses is caused by the precarious working conditions and lack of professional development that have led to episodes of high international migration and abandonment of the profession. In this paper we focus on the evolution of different indicators of the working conditions of non-specialist nurses, who make up the bulk of the profession. These indicators allow us to analyse the abandonment of the profession, the duration of contracts, their full-time or part-time dedication and the excessive hiring. We have analysed the effect of COVID-19 and the labour reform on these indicators. COVID-19 reduced the abandonment of the profession and is currently at its lowest level, it has also accelerated the need to improve working conditions by increasing the percentage of permanent contracts and reducing the multiplicity of contracts in the same month. The labour reform has helped reduce the percentage of temporary contracts until reaching around 80% of the total contracts, and has reduced the number of nurses in Spain with more than one contract in the same month to below 3000 nurses on a sustained basis.

High hiring rate of nurses in Catalonia and the rest of Spain hides precarious employment from 2010 to 2019: A quantitative study.

AIM: This study aims to describe the hiring of nurses in Catalonia and the rest of Spain over 10 years. BACKGROUND: Precarious employment (PE) has negative consequences for nurses' quality of life and work performance. METHODS: Quantitative study using a retrospective, longitudinal, descriptive design. We analysed publicly available employment data from Catalonia and the rest of Spain. RESULTS: Nurses are among the health professionals with the lowest proportion of open-term (permanent) contracts, 25% during the first 4 years of employment. During the study period, each nurse hired had an average of 3.44 contracts per year. The proportion of nurses with a fixed-term (non-permanent) contract shrank from 25.3% in 2006 to 20.5% in 2012 and grew rapidly to 38.7% in 2018. We estimate that 14,800 nurses signed fixed-term contracts in 2018 without ever having registered as unemployed in nursing. CONCLUSION: High rates of fixed-term hiring and the high number of contracts per nurse are evidence of a high level of PE for nurses in Catalonia. IMPLICATIONS FOR NURSING MANAGEMENT: When policymakers and workforce planners design recruitment and retention programmes for nurses, they should consider improving working conditions by extending more open-term contracts to combat PE and, indirectly, the shortage of nurses.

Emigration and job security: An analysis of workforce trends for Spanish-trained nurses (2010-2015).

AIM: To analyse the relationship between Spanish nurses' intention to migrate and job security. BACKGROUND: Nursing emigration from Spain increased dramatically between 2010 and 2013. By 2015, emigration had returned to 2010 levels. METHODS: Single embedded case study. We examined publicly available statistics to test for a relationship between job security and applications by Spanish nurses to have credentials recognized for emigration purposes. RESULTS: Between 2010 and 2015, job security worsened, with poor access to the profession for new graduates, increased rate of professional dropout, increased nursing jobseekers and falling numbers of permanent contracts. CONCLUSIONS: The number of accreditation applications in Spain in 2010 and 2015 was very similar, but job security worsened on a number of fronts. The distribution of work through part-time contracts aided retention. IMPLICATIONS FOR NURSING MANAGEMENT: Policymakers and health care administrators can benefit from understanding the relationship between mobility, workforce planning and the availability of full-time, part-time and short-term contract work in order to design nursing retention programmes and ensure the sustainability of the health care system.