Chinese nurses enter training for opportunities abroad

Caregivers frustrated by the disrespect their profession often endures in China enter training programmes that offer opportunities overseas

PUBLISHED : Monday, 24 March, 2014, 5:02am
UPDATED : Monday, 24 March, 2014, 5:54am

A German teacher stood before a classroom reading loudly from a projection screen. Thirty students repeated after him, in unison. Herr. Frau. Dame.

It was the first week of an eight-month German-language course in the coastal city of Weihai in Shandong province, and the students - Chinese nurses and nurse trainees - will jet to Germany later this year, where most already have job offers to work at residential care centres for the elderly.

"The morning I received the job offer, I felt my world suddenly brighten up," said Zheng Min, one student headed to Germany.

Once in Germany, class members will first work as auxiliary staff and later as fully qualified nurses for three years, for a monthly salary of €2,400 (HK$25,700). Afterwards, they will have the option to stay in Germany or return to China.

The Federation of German Employers' Associations for Care Providers launched the programme in January. The project, which aims to recruit 150 Chinese nurses this year, is expected help ease a nursing shortage that could worsen in the coming years. Similar schemes to attract nurses from other Asian countries, such as the Philippines and Vietnam, are also under way.

The same month the project was launched, five nurses who received training and passed a language test at the Shandong International Nurse Training Centre in Weihai left for Frankfurt. There they began training at a care centre for the elderly.

Such programmes are attracting a small but growing number of care professionals in China - even as the country tries to increase the number of nurses working at home.

Each year China churns out more than 200,000 newly trained nurses. In 2012, the country had nearly 2.5 million licensed nurses, 250,000 more than the previous year, according to Xinhua. But China says it's not enough. Nationwide, there were just 1.85 practising nurses for every 1,000 people in 2012, according to a report from the National Health and Family Planning Commission. The plan is to increase that ratio to 2.07 by 2015.

Nursing graduates are sought after by employers, even more so when they graduate with a bachelor's degree in nursing.

But China struggles to retain these professionals. There is a deep-rooted social prejudice against the profession, especially felt by male nurses. Patients and their families frustrated by or medical treatment have increasingly lashed out at medical staff, causing serious injuries, even killing some caregivers. Heavy workloads have prompted many nurses to quit.

Working overseas has become another option. The nurse training centre at Weihai, the largest such programme in China, has sent 1,200 nurses overseas since 2004 when it started the scheme, and the number of students is growing.

The number of nurse-recruitment agencies in China could not be obtained. Some recruiters are authorised and some are not. In 2010, after acquiring the largest web portal for nurses in China, the nurse training centre in Weihai became the largest nurse-recruitment agency in the country.

Ge Jiayu, 24, a nursing student in his final year of studies at Anhui Medical University in Hefei , says some of his classmates will not enter the profession after graduating.

"There are plenty of nurse jobs around. But some in my class have found better-paying and more respected jobs as sales representatives for pharmaceutical companies or health-insurance companies," he said.

Ge, who attends the German course in Weihai while working on his degree thesis, says pay is not his main consideration. A nursing graduate in China with a bachelor's degree can earn the same as or more than what the Germans offer in two or three years after graduation, he says.

His main concern is the lowly status of nurses in China, and males in particular. "People look down upon male nurses. They think our work is dirty, tiring and not decent."

Ge says he worries about the deteriorating relationship between patients and medical staff in China. The death of his teacher in an attack by a patient in November 2012 still haunts him.

Dai Guangqiong, 36, the head nurse of the urology department at No 2 affiliated hospital of Anhui Medical University, was killed by a patient wielding a kitchen knife.

Four other doctors and nurses were also injured, including one nurse who was six months pregnant. She lost the baby.

"There is little trust in China between patients and medical staff. It is the system that is to blame," Ge said.

While hospitals across China have tried to step up measures to protect their staff, the violence has continued. There are reports of nurses and doctors wearing helmets during work.

Ge says he expects that Germans will appreciate the nurses' work.

"For me, it will be a nice change," he said. "It will be a totally different social environment, where people do not regard us as inferior."

He is certain that the three years of working in Germany will create opportunities for his future. "I may stay for further studies after the three years. Or if I choose to come back to China, there will also be better opportunities in joint-venture hospitals in big cities where they value our overseas experience."

Min, 27, who is heading to Germany, says he is seeking better treatment. Last August, he quit his four-year nursing job at Guangzhou Psychiatric Hospital.

"At the hospital, patients, their families and even doctors treated the nurses badly. When things went wrong, it was always the nurses who took the blame," he said. "I wanted to take a break and travelled around until I found the German programme."

Zheng received a job offer from a care centre for the elderly at Schopfloch in the state of Baden-Wuerttemberg in southern Germany. He expects things will be run differently there.

"The elderly and patients with dementia need constant care from the nurses," he said. "But when each of us have too many of them in our responsibility like in China, it's impossible to provide them with quality care. I was told that in my new job, I will focus on only a few patients but will take good care of them."

Germany is not the first country to recruit nurses in China. In 2004, the centre in Weihai began training nurses for jobs with the Saudi government and a private hospital in Singapore.

The Weihai centre is a branch of a manpower-export company, Weihai International Economic and Technological Co-operative Co. That company once specialised in recruiting workers for overseas construction sites, garment factories and food-processing plants.

"Over the years, we have shifted our business focus from labour-intensive workers to skilled people such as nurses," said Ji Yunke, the Weihai manager. Demand is high in China's coastal cities for labour-intensive workers, he said.

In 2006, Britain's Health Department signed a health-care co-operation agreement with China's Ministry of Commerce to recruit nurses. The training centre was one of 10 authorised recruitment agencies. After that, there were agreements with Finland, Australia and New Zealand.

The training programme provides 100 nurses annually to Singapore. But demand slackened in Saudi Arabia, and stopped in Britain.

"And Australia has almost closed its doors to us because it has raised the language requirement too high for Chinese nurses," Ji said.

In 2011, Japan announced that people from overseas could work as registered nurses there if candidates passed a language test. In 2012, the training centre began sending a dozen nurses. This year, 50 are bound for Japan.

"Compared with nurses from India and the Philippines, our nurses have a very high success rate in passing the Japanese- language test. From next year, we plan to send 100 nurses every year," said Jiang Xiangyan, training manager for Japan-bound Chinese nurses.

Nurses who return from their overseas placements are employed as tutors at the centre.

"Our nurses are familiar with the practices at the hospitals there before they leave for that country," said Liu Xiaoyun, 32, a registered nurse placed by the centre to work in Singapore in 2007. She returned to her hometown after working there for six years.

"The Mandarin-speaking ability of Chinese nurses is an asset when working in Singapore because most of the elderly patients can only understand Putonghua," she said.

In the classroom of the German course, the students loudly repeated the new words after the teacher. On the wall hung a red banner: "I believe in myself. I work hard. I strive for the best. And I excel."

On another wall hung a large map of "Deutschland".

Mai Lihua, a nurse in the emergency ward of Guangzhou Women and Children's Medical Centre, is excited about her new adventure.

"I've grown used to the heavy workload there and people's little appreciation of our work," said the 27-year-old nurse, who has been offered a post at a nursing home in Stuttgart. "I cannot imagine myself being in Guangzhou all my life. I want to take a look at the world outside China."