Understaffed and underpaid: Israeli nurses prepare to strike

Israel is in the thick of its second wave of infections and is averaging more than 1,600 new cases daily this week.

AT THE height of the crisis, the hospital was treating over 120 patients in five separate units and in a dedicated intensive care unit. (photo credit: TAL CHERES)
AT THE height of the crisis, the hospital was treating over 120 patients in five separate units and in a dedicated intensive care unit.
(photo credit: TAL CHERES)
Israeli nurses are preparing to go on a nationwide strike amid a severe shortage of medical workers and an explosion in the number of COVID-19 patients after the country reopened and many people tossed aside their masks.
Israel is in the thick of its second wave of infections and is averaging more than 1,600 new cases daily this week.
With hospitals reopening coronavirus wards to accommodate the ever-increasing number of patients, nurses are warning that Israel’s health care system remains woefully inadequate for what is to come.
“Even before the pandemic, there was a shortage of 1,500 nurses,” Ilana Cohen, chairperson of the Israel Nurses’ Association, told The Media Line. “Now they’ve reopened the coronavirus wards, so do the math. Where are they going to get the nurses for these coronavirus units? From existing staff.”
At the same time, more and more nurses are being quarantined because they have been exposed to coronavirus patients. As of Tuesday more than 837 nurses – in addition to hundreds of nurses’ aides – are in isolation, she said.
The situation is “absurd,” Cohen said.“We already have over 1,000 staff in quarantine and every day the number is increasing.”
“The nurses are collapsing. This is an impossible situation, also in terms of the anxiety they are experiencing.
“Until there is a strike, nothing will change,” she stressed, adding that a walkout date would be announced shortly.
In a letter to Finance Minister Israel Katz, Cohen demanded a meeting to avoid a strike and called on the government to take immediate action to address the shortage. The nurses’ union says the government must allocate enough money to hire at least 1,500 nurses and reinforce coronavirus wards with additional staff.
The government could hire some 1,500 nursing students who recently passed their exams and are waiting to be trained, she said.
“The [health care system] is not even bringing in these students,” Cohen asserted. “What’s going on is a catastrophe.”
In response to the strike threat, the Finance Ministry vowed to earmark additional funds for health care.
“The Finance Ministry will allocate about NIS 10 billion [$2.9 billion] to help the health care system cope with the coronavirus pandemic,” a ministry spokesperson said in a statement shared with The Media Line. “In this context, 800 new nursing positions have been added in recent months to reinforce hospitals and the public health system.”
However, it appears that government promises have done little so far to lighten the nurses’ workload.
Anan Khalaf is a nurse in the emergency medicine department at Beilinson Hospital in Petach Tikva, and a paramedic with the Magen David Adom ambulance service. On top of his already-packed work schedule, he is also completing an undergraduate degree in epidemiology and infectious diseases at Ben-Gurion University of the Negev.
“The second wave caught us unprepared,” Khalaf, who has worked at Beilinson for the past six years, told The Media Line. “This wave is much bigger than the first one. There are many nurses and [medical] staff in quarantine.”
Khalaf said that more patients in the emergency room are testing positive for the coronavirus than ever before, leading the hospital to expand its coronavirus unit.
“We’re also seeing young people come in sick and infected,” he said, adding that nurses feel that they are facing the surge without a support system.
“We’re really concerned about the coming winter,” Khalaf said. “Our emergency room has almost no more nurses’ aides.”
In order to avoid exposing his family members to the virus, Khalaf decided to live alone and is also socially distancing from his parents, who are elderly. Aside from the excessive workload, being separated from his family has been one of the toughest challenges of the pandemic’s second wave.
“The last time I sat down to dinner with my parents was maybe in early March,” Khalaf explained. “I am exposed on a daily basis to either coronavirus-positive patients or those who are suspected of carrying the virus…it’s mentally exhausting.”
According to the Organization for Economic Cooperation and Development’s (OECD’s) Health at a Glance report, released late last year, Israel has one of the worst nurse-to-population ratios, with 5 nurses per 1,000 people. This figure is significantly lower than the OECD average of 8.8, and the organization attributes it to Israel’s rapid population growth.
The looming strike is not the first time the country’s nurses have walked out to protest poor working conditions. Last July, a nationwide strike was called after the Nurses’ Association and Health Ministry failed to conclude a labor agreement.
Ben Rozenblit is the coordinator of the emergency-medicine division at the Ziva Tal Academic School of Nursing in Ramat Gan, home to the Sheba Medical Center, Israel’s largest hospital. For a decade he worked as an ER nurse at Sheba and at Meir Medical Center.
“The ER is divided into wings; with each wing having an average of 20 patients at any given moment,” Rozenblit told The Media Line. “If you’re lucky, there are two nurses for 20 patients in the ER. These patients require a lot of care and tests. Sometimes you find yourself taking care of five to eight patients who are really unstable, in addition to another 12 that appear to be stable.”
Nurses, he said, are required to remain professional, attentive and aware of their patients’ needs at all times, especially in ERs where the situation is often very dynamic. In addition to this challenge, the wards are understaffed.
“Every shift takes something out of you,” he said. “You go home feeling as though you didn’t do enough, help enough or succeed enough even though you really wanted to help. It’s a war you cannot win.”
To top this off, Rozenblit said, despite his seniority, graduate degree and numerous certifications, he is still earning the same salary as when he first started.
“From day one, we have the same conditions and salary until we retire,” he said. “I’m in a management position and earn 10,000 shekels [about $2,900] per month. You can’t live on this salary in Israel in 2020. It’s unbelievable.”
Nevertheless, Rozenblit noted, Israel’s nursing shortage is not due to a lack of interest on the part of the younger generation. Like Cohen, he stressed that new nursing graduates are simply not being brought into the workplace quickly enough to meet the demand because of a lack of government funding.
This situation hurts the nurses and the quality of care that patients receive, and is expected to worsen as the pandemic expands.
“The bottom line is that nurses are putting themselves at risk by spending hours upon hours taking care of” coronavirus patients, Rozenblit said. “In the pandemic, nurses are on the frontlines and are critically important.”
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