Nursing Science Quarterly , Global Perspectives 10. 1177/0894318406286597 19:2, April 2006 ARTICLE Global Perspectives Steven L. Baumann, Contributing Editor Nursing Issues in Hong Kong Steven L. Baumann, RN; PhD Associate Professor, Hunter College of the City University of New York, New York Changes in nursing in Hong Kong over the past decade have had more to do with the changes in the world and the region’s economy and population than the changes instituted by the Republic of China.
Hong Kong’s nearly 7 million people’s health is, like in other places, threatened by a shortage of skilled and experienced nurses. Hong Kong’s three major university-based nursing programs, if they can work together creatively, have the potential to avert a decline in quality of healthcare in Hong Kong and advance nursing at the same time. It has been 8 years since the government of The Republic of
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China took over control of Hong Kong from the United Kingdom, but from reading David R. Thompson’s well written column on nursing issues and challenges in Hong Kong today, it does not seem that political change has affected nursing or healthcare very much. Ironically, what has affected nursing and healthcare in Hong Kong, as it has elsewhere in the Pacific Rim and West, are the realities of capitalism, in particular the globalization of trade and commerce.
Thompson points out that before the central administration of the public hospital system in Hong Kong encouraged the early retirement of senior and experienced nurses to help close budget deficits related to city wide recessions, there was no nursing shortage in Hong Kong. Thompson suggests that if nurse leaders were more involved in such budget and staffing decisions, particularly those equipped with the findings of nursing research on healthcare and nursing, then the current shortage of nurses in Hong Kong might not exist, or at least not be so severe.
In other words, the issues that face nursing in Hong Kong today primarily transcend location and national politics, even though there are some interesting differences. One that does stand out is that because many Hong Kong nurses are well-educated, and speak both English and Cantonese, they are able to work elsewhere. Most Chinese nurses do not speak Cantonese, which is spoken by most people in Hong Kong, and they have a very difficult time getting the registration they need to practice in Hong Kong.
So while Hong Kong faces an aging population and increases from migration, they also face losing skilled and experienced nurses to work abroad, including those who are best prepared for specialty and advanced care areas. Nursing and the population of Hong Kong have in many ways benefited from its history, location, and international trade. The people of Hong Kong enjoy an income and life expectancy as good, if not better than, most of the population of the world’s large urban centers.
Nursing in Hong Kong has also benefited, in that it has been nearly totally universitybased for the past 15 years. Leaders are now seriously considering changing nursing from a 4-year preparation to a 5-year preparation, even while others would like to see the return of less expensive hospital-based nurse training. The return to a shorter and less intellectually rigorous nursing education in an age when nursing, medical, and technological knowledge are exploding makes as much sense as encouraging early retirement to experienced and skilled nurses to save money.
While Thompson states that nurses need work environments that encourage career and professional development, he fails to mention that they also need workloads that are reasonable and flexible. Nurses in general nursing practice and advanced practice roles need to be prized. Thompson suggests that inter-nursing school competition and inter-professional nursing organization conflicts are holding nursing back from having the unity the profession needs to address the challenges nurses and patients now face.
Editor’s Note: Send abstracts, outlines, or query letters about ideas for this column to Steven L. Baumann, RN, PhD, Associate Professor, Hunter College, City University of New York, 82 Sherman Avenue, Williston Park, New York 11596; phone: (212) 481-4344 ; email: [email protected] cuny. edu Nursing Science Quarterly, Vol. 19 No. 2, April 2006, 157 DOI: 10. 1177/0894318406286597 ?? 2006 Sage Publications Keywords: Hong Kong, nursing