Israel’s Health Sector Needs More Female Leaders, Hadassah Head Nurse Says
In honor of International Women’s Day, Dr. Rely Alon outlines what can be done to address country’s severe nursing shortage
Israel needs to push for greater female representation in senior health care positions and invest in the sector in order to solve the country’s nursing shortage, Hadassah Medical Center’s head nurse says.
Israel has long suffered from a chronic shortage of health care workers, an issue that has only gotten worse since the start of the COVID-19 pandemic. As of 2020 the country had only five nurses per 1,000 people on average, far below the OECD average of 9.4 per 1,000 inhabitants. The United States, for example, has 11.7 nurses per 1,000 people.
Nursing belongs to the so-called pink-collar professions, meaning jobs that are predominantly held by women.
According to a survey conducted by the Women’s International Zionist Organization (WIZO) ahead of this year’s International Women’s Day on March 8, 20% of women working in pink-collar jobs like nursing, teaching or social work are considering leaving their profession due to poor work conditions. Out of those wishing to leave, 70% cited low salary as a principal reason for quitting; 34% cited a demanding workload and long hours; and 45% cited burnout/stress.
Dr. Rely Alon is the director of Nursing and Health Professions at Hadassah Medical Center in Jerusalem. As the hospital’s head nurse, Alon has been on the frontlines of the COVID-19 pandemic and witnessed the impact it has had on medical professionals firsthand.
The Media Line sat down with Alon to discuss how the COVID-19 pandemic has changed the nursing profession and how she hopes to empower more women to get into leadership positions.
The Media Line: The COVID-19 pandemic shed light on nurses and the crucial role that they play, but we also know that there are severe labor shortages in this field, not just in Israel but around the world. What are you seeing here?
Dr. Rely Alon: In Israel, the first priority is defense and [issues] that we have at the border with our neighbors. The thing is that they didn’t give much of a budget for the health [sector]. This pandemic showed us that when you don’t give a budget for many years to the health sector, then when there is a problem you face many, many issues. We have a shortage of nurses and we have very few ventilators or ECMO [machines].
TML: How has the pandemic affected nurses and the nursing profession in general? Are you seeing fewer people wanting to go into this profession? Are you seeing more people leaving?
Alon: I have 2,000 nurses in the two hospitals – Hadassah Mount Scopus and Hadassah Ein Kerem. My nurses at the beginning were terrified, like everyone else, from this pandemic. They were under a lot of stress because of it. Husbands [wouldn’t] let the women go and see their children because they were afraid that they would bring COVID home.
I’ve had a few nurses that said: “OK enough, I’m tired. I want to go home to rest a little bit, to breathe a little bit, to work in the community and not to work so hard.”
I had asked them to work six or seven shifts a week from 7 a.m. until midnight.
When you’re studying to be a nurse you know that if you want to work in a hospital you’re going to have to work in shifts. It makes a lot of issues for families, for raising children, for getting pregnant and for taking care of children.
TML: Why did you personally decide to become a nurse?
Alon: I was a commander in the army many years ago and I was a medic in Magen David Adom.
When I came to nursing school, I knew that I was going to be a midwife because to give birth and to be part of a couple that gives life is the [most] amazing thing in the world. I felt that I wanted to be a part of it so I decided to be a midwife and since then I recommend that to many other people.
I was the head of the nursing school before I came here. To teach students to be nurses in Israel or all over the world is a mission. It’s really a mission that I wanted to take on myself and that’s why I did it.
TML: What’s the ratio of male nurses to female nurses in Israel?
Alon: Five years ago, we were at something like 13% [male] and now it’s 19% this year in Israel. It rose because in the last five years the number of nurses [has gone up]. The government gave a bonus to have more students. At Hadassah, we also have 130% more students in nursing because of the nursing shortage all over Israel.
In the pandemic, many professions didn’t work; they stayed at home and there was no salary. There will always be sick people and people will always need you. There’s no nurse that sits at home and doesn’t have work.
TML: But there are also reports that many are choosing to leave the profession because of burnout or stress. What have you seen on this front?
Alon: Everything is true. We have a lot of burnout; we have a lot of stress. We have lot of people that said “I’m tired.” I have a nurse that worked in the ICU COVID for 6 months and now he said “I want to go back to my hometown; I don’t want to work for half a year.” Too many patients died. He was at home and I said to him: “OK, I’m waiting for you and I know you will come back. So, take your time and when you decide to come back the door is open.” And he came back.
Today there’s a pandemic; tomorrow there’s a terror attack; the day after there’s a car accident. When you’re in a hospital you see a large variety of things. This is my job.
TML: What’s interesting is that this shortage of nurses seems to be a universal issue. It’s not just in Israel. It’s all over the world, so what do you think can be done to address this shortage?
Alon: More money. We need more money for the health [sector] because in Israel for many years we were starving, Hadassah especially. For years nobody took care of the health care system all over the world and in two months from now nobody will talk about it. Next year, you’re not going to interview anyone from the health care system because people will forget. We have a very short memory.
TML: What kind of support is being given right now to nurses to help them cope with stress and burnout?
Alon: From the first day of the pandemic, I saw what was going on in the hospital. I arranged to have a meeting every week on Monday at 9 a.m.. We have a meeting with all the head nurses from COVID [units].
I was sitting with the head nurses of the hospital and I was talking with staff nurses and asking them: tell me how you feel? [I would] give them, for example, small candies and small presents, and bring in psychologists and social workers to the departments.
I cried with them because I’m not afraid to cry. We are stronger together. Every week we sit together and talk about the problems.
TML: What is your vision for empowering women in leadership roles?
Alon: I think the health care system needs to [raise] more leaders, especially female leaders, because I think they’re much better listeners.
For the first time in Israel, I opened at Hadassah [a leadership course] and we are teaching nurses from the beginning how to be a leader. You lead the patient’s treatment, you lead the department and later on you lead the hospital and the unit that you’re in charge of. I teach them tools to be leaders because you have to [raise] leaders.
