Nurses: System increasingly dependent on seniors

The Polish health care system today functions increasingly thanks to nurses who could have already ended their professional activity. These are the conclusions of the report "Staffing analysis of nurses - an update," presented at a press conference of the Polish National Trade Union of Nurses and Midwives.

Although in 2024 the number of nurses working with patients rose to 219.9 thousand, 3.8 thousand more than a year earlier, almost all of the increase was provided by those over 60. Indeed, the number of nurses with pension rights increased by as many as 3.7 thousand.

- It is not the young cadres who are saving the system today. It is nurses who could have retired long ago who are saving it. The Polish health care system today stands on the shoulders of women who should already be resting after several decades of work. In the face of the systemic shortage of nurses, the competencies of midwives are being underutilized," stresses Krystyna Ptok, chairwoman of the OZZPiP.

Poland still far from European standards

Despite a slight improvement in indicators, Poland still remains one of the countries with the lowest number of nurses in Europe. Currently, there are about 5.8 nurses per 1,000 inhabitants, while the average for OECD countries exceeds 11.

The authors of the report note that the rate of growth in the number of nurses is more than twice as slow as the government's 2019 nursing development strategy assumed. Meanwhile, the public's health needs are growing rapidly. As of 2019, the number of seniors was growing four times faster than the number of nurses working with patients.

More than one-fifth of nurses already have pension rights, and the effective age of leaving the profession is about 64.5 years. For comparison - the average age of leaving the labor force for women in Poland is about 60.7 years. Some nurses work even in their 70s and 80s.

Experts emphasize that keeping older nurses in the system has been possible primarily by improving salaries and working conditions. However, they are concerned that possible salary changes could lead to mass departures. - We don't know how many nurses will leave after the salary changes. We know one thing - the system may not be able to withstand it," Krystyna Ptok points out.

Nursing shortage almost nationwide

The report shows that the staffing crisis is no longer a problem for single regions. According to the Occupational Barometer 2026, there is already a deficit or significant shortage of nurses in almost 300 counties. None has experienced a staffing surplus. At the same time, inequalities between provinces are widening. Regions that already had the fewest nurses continue to grow slower than the national average. Although a record number of people are entering nursing studies, many do not complete their training or enter the profession. There is also a growing group of new entrants to the profession between the ages of 35 and 50, who will be active for less time than young graduates. - It is not enough to open majors. It is still necessary to bring students into the profession and keep them in the system," stresses the OZPP chairwoman.

More responsibilities, old work standards

Experts point out that modern medicine has significantly changed the responsibilities of nurses. Although hospitalizations are shorter, patients are coming to hospitals in more severe condition, are older, multi-diseased and require more advanced care. More and more services are also being provided outside hospitals - in long-term care, community care or home care. Meanwhile, staffing standards and pricing of services are still based mainly on the number of beds or patients. - The development of new technologies and therapies does not reduce the need for nurses. On the contrary, it requires higher competence, more responsibility and more time devoted to the patient. Current staffing standards and service valuations are still based mainly on the number of beds or patients, rather than on the actual time and difficulty level of a nurse's work. The system still does not take into account the fact that one nurse today performs far more medical, administrative and coordination activities than even 20 years ago. In practice, this means increasing staff overload, less time for the patient and an increasing risk of errors and professional burnout," says Katarzyna Tyminska, a nurse with 40 years of experience working in a pediatric cardiac surgery unit.

Patients are already feeling the effects of the crisis

The authors of the report emphasize that shortages of nurses directly translate into patient safety. In many facilities, staff are working under overloaded conditions, with single-person on-call and unfilled minimum staffing standards occurring. - The shortage of nurses is not a statistical problem. It is a patient safety problem. The situation is difficult in many wards, and dramatic in psychiatric wards. Without staffing norms, unfortunately, the staffing is repeatedly too small and there are even single-person staff," says Jolanta Januszczak, a psychiatric nurse.

Norbert Bolek of the eFkropka Foundation also points out the importance of an adequate number of nurses for patient safety. - A nurse is often the first person we come into contact with when we are admitted to a ward or other places, such as mental health centers. For the safety of patients, a sufficient number of nurses is a guarantee of safety, he stresses.

Experts are also sounding the alarm about the dramatic situation in long-term care. - It doesn't matter to the patient whether a nurse works in a hospital, nursing home or community care. What matters is that someone is there beside them when they need professional help. Meanwhile, long-term care today is dramatically short of nurses, and staffing is extremely overstretched. The population is aging faster and faster, the number of people needing daily care is growing every year, and there are already not enough people to provide it. We must remember that nurses are needed not only at the hospital bedside, but also in patients' homes, nursing facilities and the entire, broader long-term care system," says Tomasz Michalek of the Coalition "To Help the Dependent.

Long-term strategy is lacking

The report's authors point out that while countries such as Germany, Norway and Switzerland are implementing multi-year strategies to secure nursing staff even up to 2040, Poland still lacks a comprehensive action plan.

The OECD, WHO and the European Commission are increasingly sounding the alarm about the deepening nursing crisis in Europe. Experts say urgent action is needed, including improving working conditions, developing career paths, mentoring programs for young nurses and updating employment standards.

- It is imperative that we review and update labor standards so that they correspond to the real procedures performed in the wards," called Dorota Ronek, vice president of the OZZPiP. The authors of the report have no doubt: without systemic changes, Poland may face a dramatic deepening of the staffing crisis in health care in the coming years.

Source: OZZPiP