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Private hospitals offer an attractive alternative to such a tough working environment.

Susan says her peers in private hospitals have a smaller workload because the hospitals admit a smaller range of cases. Also, private patients often hire their own private nurses as well.

Apart from the lighter workload, there is a big difference in salaries between the public and private sectors. For instance, the starting salary for nurses at the private Hong Kong Sanatorium and Hospital is $32,000 plus a $2,000 allowance. They also enjoy year-end double or triple pay. The starting salary plus allowance for nurses working in the public sector is only $24,000.

Unsurprisingly, this has led to an exodus of nurses from public hospitals. Some leave for higher pay and a better working environment in the private sector while others have gone back to schools to teach nursing. Others have left the profession altogether.

According to the HA, the staff turnover rate of registered nurses in the public sector more than doubled from 2.4 per cent in 2005 to 5.3 per cent in 2010, the highest in five years. Among those who left, those with more than 10 years’ experience accounted for the largest proportion.

To alleviate the problem, the government allocated $200 million to training and recruitment in the medical sector for three years starting from 2012 in its 2011-12 Policy Address. Parts of it are earmarked to provide more opportunities for specialty training and promotion in the hope of retaining experienced nurses.

Eric Chan Lu-shek, the principal nursing officer of the HA, says the number of specialty training classes offered each year has nearly doubled.

The HA has also given nurses more promotion opportunities. For example, there are now more advanced practice nurses and nurse consultants and 50 nurses were promoted to nurse specialists in the year 2011-12.

But nurses are critical of the move. Kwan Chi-man, a nursing officer at the Queen Elizabeth Hospital, says the HA’s policy is ineffective in preventing nurses from leaving.

He points out that the nurses who have taken the specialty training courses are not necessarily promoted afterwards. “Taking the training course is only an entrance ticket, it can’t be cashed in for an immediate benefit,” he says. Kwan says there are just too many experienced nurses waiting for promotion.

Another registered nurse, Mary, not her real name, thinks the HA’s measures do not address the root cause of the problem. Mary left the hospital ward to work as a community nurse a couple of years ago due to the harsh working environment and duty-shift system.

She acknowledges the government has spent money on raising the number of advanced practice nurses. However, she points out this has not increased staff numbers on the wards.

“There were 10 nurses on the ward originally. There may just still be 10 nurses [after the promotion]. It is simply that one of them has changed his or her post,” she says.

As she sees it, the only way to tackle the work burden and stem the exodus is to increase the number of nurses on the wards.

The government has tried to cope with the increasing need for nurses. In 2008, it reopened nursing schools, which closed in 2000, to train both enrolled and registered nurses.