Nurse practitioners head to Australia

The UK, India and the Philippines remain Australia’s top feeder countries for nurses arriving on temporary long stay visas, writes Natasha Egan.

The number of nurse practitioners coming to work in Australia on 457 visas is up this year, with the majority originating from the Philippines, the latest immigration data shows.

457 visas granted to nurse practitioners have grown from 11 in 2010-11 to 20 in the first eight months of this financial year.

Nine of the 20 arrived from the Philippines followed closely by 8 UK nurse practitioners who chose to hit our shores. The majority settled in NSW and Victoria, followed by QLD, WA and the NT.

Helen Gosby, president of the Australian College of Nurse Practitioners, says the economic downturn in Europe could explain the migration of British NPs to Australia who are in search of better employment prospects.

Recent aged care initiatives from federal government and 2010 legislation which gave nurses access to the Pharmaceutical Benefits Scheme and the Medicare Benefits Schedule have supported the growth, she says.

“We’ve been making a lot of advances in that legislation field that sees us moving ahead and that might be attractive to people coming here,” she tells Nursing Review.

According to the data, the fields of mental health, critical care and emergency, surgical, perioperative and aged care have also attracted a higher number of nurses on temporary long stay visas compared to the previous year. The 457 visa allows registered nurses to work in Australia for an approved business sponsor for up to four years.

The Department of Immigration figures show the number of 457 visas granted to all registered nurses so far this financial year is 2206. That total looks set to overtake 2010-11 full year total of 2227 but not hit the 2008-09 peak of 4073. In 2009-10, 2707 visas were granted. Figures include registered nurses, midwives, nurse managers and nurse practitioners up to February 29, 2012.

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Similarly, other nursing specialties are also experiencing growth. In the first eight months of 2011-12, 287 critical care and emergency nurses have been granted visas up from 209 in the entire 2010-11 year. Likewise more visas have already been granted to mental health nurses this year (143) than all of the previous year (128).

The same goes for surgical nurse visa numbers, which are 313 so far this year up from 269 in 2010-11. Perioperative nursing has also seen an increase with 157 nurses in that speciality being granted a visa in 2011-12 compared to 138 in the previous year.

NSW has gained the most nurses this financial year to date (732), followed by Victoria (497) and Western Australia (338).

The United Kingdom and India have been the top two feeder countries for the last five years, with the Philippines coming in as the third most popular country of origin in four of those years.

From July 2011 through to the end of February 2012, visas have been granted to 799 nurses from India, 576 from the UK and 333 from the Philippines, which is up from 754, 529 and 252 respectively on the previous year’s total. Numbers are significantly lower than in the peak year of 2008-09 for the UK (1202) and India (946) but comparable for the Philippines (367), whose figures have remained steady.

The number of nurses coming to work in the aged care sector in Australia on 457 visas is also on the rise. In the first eight months of this financial year, 418 aged care nurses have been granted visas, up from 382 in the entire 2010-11 year.

Stephen Kobelke, CEO Aged and Community Services WA, says a number of his members - mostly larger metropolitan organisations - are sponsoring nurses via the 457 visa. “The word from the providers that are doing this is that they are getting quality employees,” he says.

Kobelke says feedback tells him the processing time for the 457 visa is good but one of the challenges for the regional and remote areas is retaining the employee after arrival.

“Some of the people that they are bringing in [registered nurses] are leaving within a short space of time to take up other employment in other locations, most likely metropolitan.”

Once in Australia, if a 457 visa holder can find an employer to take on the sponsorship, they’re free to move to them. Despite this, Kobelke says most members report positively on the 457 scheme.

“Even in the regional situation where some leave, they are very happy that they are able to get nurses to come to regional areas.”

Julie Christensen, CEO of Narrogin Cottage Homes in WA’s wheatbelt region, says she agrees that the 457 scheme is positive in terms of access to nurses for rural and remote WA.

“Our biggest challenge is finding staff who can recognise the rural deficiencies in terms of the location but recognise the positives of a rural lifestyle,” says Christensen.

As the co-ordinator of a network of rural providers in the south-west of the state, she agrees that retaining staff in remote areas has its difficulties. She gave the example of a provider in Esperance, on WA’s southern coast, which is experiencing difficulty retaining nurses on 457 visas. The RNs who arrive are well-qualified and have gone through the process of the 457 application, she says, but once they get to Esperance and realise it’s nine hours from anywhere with no movie theatre or shopping centres, they want to leave.

“Their biggest challenge in Esperance is they’re not keeping those 457s for a period of time that is acceptable to continuity of care.” Christensen says rural 457 visa holders should be required to make a time commitment to the area they’re going to. A minimum of 12 months would be about right, Christensen says.

Currently, some people move to a location without doing enough research then after four to six weeks transfer to a metropolitan area, she says. “The money has been wasted, there’s been a lot of stress involved in the transfer and the community loses a potential carer.”

However, Christensen says if a country community can have someone for 12 months and marry them into the town’s social structure, there’s a better chance of retaining them. In the meantime, while the community is trying to win over the new arrival, it has continuity of care at whichever organisation the worker is joining for 12 months, she says.

Case in focus

Three Filipino nurses are ready to begin work with Grange Aged Care Residences in Albury-Wodonga following a rigorous recruitment and training program in the Philippines run by the recruiting facility. Cecilia Torre, Viela Martin and Brisbane Sapno are among six registered nurses selected from hundreds to work for the provider.

The Grange’s managing director, Paul Phillips, says a business review two years ago identified a need to develop avenues for recruiting RNs and they decided to look overseas. “Had there been a sufficient supply of Australian registered nurses to meet the growing care needs of aged care residents, we would not have needed to undertake this initiative,” says Phillips.

The Grange recruited nurses from overseas in the past but through an agency. Phillips says while they were happy with the quality of the staff and the expected $10,000 fee, shortcomings of the agency model for the provider and the nurse left them looking for an alternative. Still motivated to look overseas, the provider researched a number of places including Africa, Ireland, England and India.

“We elected to commit heavily to this and ensure that we would select nurses who would make a long-term commitment to working in aged care in a regional location.”

Phillips says the organisation chose the Philippines because it found Filipino nurses to have a strong work ethic, a commitment to training and further education and many have experience working overseas. Additionally, they are highly intelligent, have English as a second language and the provider had positive experiences with current Filipino staff, he says.

Phillips and fellow director, Justin Smith went to the Philippines in May 2011 where they presented to over 200 nurses. About 100 people submitted applications and 53 were shortlisted for interview. Of those, 15 were chosen for a week’s in-house training program in September that addressed the RN competencies in aged care. All nurses who took part in the training produced outstanding results, Phillips says.

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“We intentionally trained 15 staff even though we only required six so that we could assist the other nurses find a role in Australia.” That assistance includes a local network and support structure, all which also increase the likelihood of retaining its own new staff, he says.

Phillips says retaining the staff is a concern, but they have put support structures in place and he’s confident it won’t be a major issue. However, the time from making the decision to recruit from overseas to the nurse commencing employment has been a significant hitch in the process, he says.

“The nurses must complete an AHPRA approved IRON course (Initial Registration of Overseas Nurses) that takes three months and then the visa process plus the AHPRA registration can take six to eight weeks after completion of the course,” Phillips says.

The first three nurses are due to commence in late April meaning the process has taken nearly 12 months.

All three have completed their bridging courses but are waiting for their 457 visas to come through.

One has been lodged by a migration agent and the other two online as e-visas. Phillips says they recently began working with a Skilled Migration Co-ordinator at Wodonga city Council, who can assist with visa applications already lodged. The co-ordinator, he says, is proving to be helpful in speeding up the process for the e-visas.

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