While it brought the globe to a standstill, the COVID-19 pandemic served to highlight the critical role of frontline health workers.
It also spotlighted the challenging and demanding conditions within the healthcare sector, exposing many parts of our health systems that have been chronically understaffed.
According to the Organisation for Economic Co-operation and Development (OECD), the latter has led to extended overwork and severe stress for healthcare workers.
This, in turn, has resulted in widespread job dissatisfaction, burnout, and an increased inclination among workers to reduce their hours or exit the profession entirely.
Nurses are at the heart of these challenges, and there are growing concerns that the nursing profession may become less attractive to young people.
Based on the Programme for International Student Assessment (PISA) data, the OECD has found that in many European countries, fewer young people are aspiring to become nurses.
Nursing interest declines in three out of four countries
Interest in nursing among 15-year-olds declined between 2018 and 2022 in 19 out of 25 European countries.
The decrease was particularly evident in several countries, where it exceeded 0.5 percentage points (pp), given that the average interest rate was 1.72 per cent across Europe.
Biggest fall in Nordic countries
Norway and Denmark reported the highest declines, each at 1.2 pp. Interest in nursing also dropped in Finland and Iceland, both by 0.4 pp, and in Sweden by 0.2 pp, highlighting a significant trend across Nordic countries.
Additionally, the decline exceeded 0.5 pp in Ireland, Czechia, Switzerland, the UK, and Slovenia.
Slovakia saw the highest increase in interest in nursing as a career among 15-year-olds at 0.5 pp, followed by Portugal and Spain (both 0.4 pp) and Germany (0.3 pp).
Interest is highest in Norway, the Netherlands and France
Despite the decline, Norway still reported the highest interest in nursing among 15-year-olds at 3.9 per cent in 2022.
The Netherlands and France followed, with interest rates of 3.3 and 3.1 per cent, respectively. These were the only three countries where interest exceeded 3 per cent.
The interest in nursing was less than 1 per cent in seven countries, including Poland, the Baltic countries (Latvia, Estonia, and Lithuania), Hungary, Italy, and Greece.
The OECD average was 2.1 per cent, while in 25 European countries, it stood at 1.7 per cent.
Heroes with difficult working conditions and heavy workloads
According to the OECD’s policy brief, the pandemic had a complex effect on young people's perception of nursing.
While healthcare workers are celebrated as "healthcare heroes," it also exposed the tough realities of the job, including difficult working conditions and low pay.
This duality has led to mixed feelings about the profession, emphasising the notion of nursing as a self-sacrificial vocation in many countries.
OECD also found that changes in students’ interest in nursing between 2018 and 2022 "do not seem to be closely related with the severity of the pandemic," as measured by reported COVID-19 death rates or infection rates.
Teen girls overwhelmingly dominate nursing interest
In 2022, the proportion of 15-year-old students in European countries expecting to pursue nursing at age 30 was overwhelmingly female, at over 90 per cent.
This proportion has remained consistent from 2018 to 2022.
In countries like Latvia and Poland, virtually no teenage boys showed interest in nursing.
The interest among boys exceeded 15 per cent in only five countries, led by Italy, Slovenia, and Spain.
Breaking down gender stereotypes and enhancing working conditions
Various countries have implemented strategies to attract more young people into nursing, focusing on financial incentives such as reduced tuition fees and scholarships.
However, the OECD emphasises that attracting both young men and women to nursing also requires improvements in working conditions and pay to enhance the profession's overall perception.
The organisation also highlighted the importance of increasing male participation in nursing and dismantling the persistent stereotype that views the profession as low-status, poorly paid, and traditionally suited for women.
OECD warns of staffing shortages and reliance on international recruitment
The OECD had warned that if countries cannot attract enough talented and motivated young people into nursing, "they may increasingly have to rely on international recruitment to meet their needs".
However, this could worsen the nurse shortages in the countries of origin.
Wide disparities in PPP-based nurse salaries
Examining nurse salaries based on purchasing power parity (PPP) reveals significant disparities across Europe.
In 2021, nurses’ PPP-based salaries ranged from €18,720 in Lithuania (2018 data) to €70,455 in Luxembourg.
The gross income for nurses in Luxembourg was nearly four times higher than that of their counterparts in Lithuania and Latvia.
Germany (€44,100, 2018 data) had the highest PPS-based salary among the "Big Four," followed by Spain (€39,150), France (€32,400), and Italy (€28,764).
At the bottom, Lithuania and Latvia were followed by Portugal, Slovakia, and Greece.
Number of nurses per person significantly varies across Europe
According to OECD data, in 2021, Finland boasted the highest number of practising nurses per 1,000 of the population, at 18.9, closely followed by Switzerland with 18.4 and Norway with 18.3.
In stark contrast, Turkey and Greece reported the lowest figures, with 2.8 and 3.8 practising nurses per 1,000 of the population, respectively.
