Wanted: Czech nurses. Bonus: free breast implants
Prague, Czech Republic » When Petra Kalivodova, a 31-year-old nurse, was considering whether to renew her contract at a private health clinic here, the offer of special perks helped clinch the deal: complimentary German lessons, five weeks of vacation and free liposuction and silicone breast implants.
"I would rather have plastic surgery than a free car," said Kalivodova, who could not have afforded cosmetic surgery on her monthly salary of about $1,400. "We were always taught that if a nurse is nice, intelligent, loves her work and looks attractive, then patients will recover faster."
As the Czech health care system faces a dire nursing shortage, clinics and hospitals are resorting to some unusual incentives to retain talent, including free or reduced-price plastic surgery.
While such perks do not appear to have been embraced by other countries with nursing shortages, they hardly seem out of place in a post-communist culture that is obsessed with beauty pageants and that sees many of the social changes in the West in recent decades as merely political correctness.
Health-care managers here consider free tummy tucks or remodeled breasts no different from a free trip to the Bahamas, one-shot bonuses that cost less than salary increases.
At Iscare, the clinic where Kalivodova works as a surgical nurse, the plastic surgery offer helped increase nurse applications by 10 percent in the
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past three months, said Jiri Schweitzer, the managing director. Nurses can choose from an assortment of procedures, including a $2,013 tummy tuck or a $1,836 face-lift, in return for signing a three-year contract.
"It helps to improve the morale of both our employees and our patients," he said, and it has proved far more popular than the free German lessons.
But critics say the offers of cosmetic enhancement demean what remains a largely female occupation, reinforcing a cultural view here of health care professionals as Barbie dolls.
"If any institution offers this incentive, then it has lost all credibility," said Jirina Siklova, a gender studies expert and sociologist. "I would expect such behavior from an erotic salon, not from an institution devoted to health care."
Doctors and nurses say the nursing shortage is hurting patient care and potentially risking lives. Health care analysts estimate that the Czech Republic has a shortage of 5,000 nurses in the public sector alone. The lack of qualified nurses recently forced a hospital in Brno, the country's largest city after Prague, to shut its intensive care unit.
While the shortage is global, relatively low-paying countries like the Czech Republic are particularly vulnerable. A nurse's average monthly wage here is about $1,270, less than that of a bus driver. In the past year, nearly 1,200 nurses migrated to countries like Germany or Britain in search of better wages, according to the Czech Nurses Association.
Institutions across the country have begun offering incentives to attract and retain nurses, but the more expensive and exotic efforts have been largely limited to Prague, the capital. Na Bulovce, a large state-financed hospital in Prague, offers lunch vouchers, day care and "aesthetic operations at reduced prices."
'Nothing degrading'
Irena Pejznochova, spokeswoman of the Czech Nurses Association, said she saw nothing wrong with such offers. "There is nothing degrading in this kind of benefit," she said.
She argued that innovative incentives were being introduced because nurses worked 12-hour shifts, were underpaid and could not even prescribe an aspirin without a doctor's permission. "The problem is that the public still perceives nurses as they were represented in communist-era television shows: as low-level workers who emptied bedpans and cleaned hospital rooms," she said.
Dana Juraskova, the Czech minister of health and a former nurse, said in an interview that she would not favor free plastic surgery as national policy. She said there were other ways to motivate nurses. For example, the recent introduction of a fee of one euro, or about $1.40, for visiting a doctor -- which spawned a national outcry in a country accustomed to free health care -- has translated to helping improve pay for nurses, she said.
Whether plastic surgery will improve the nurses' images is debatable. But nurses say they are under enormous pressure to look good in a society where attractiveness is often as highly prized as clinical skills. Kalivodova recalled that at a recent interview for a nursing job, the male recruiter asked her to walk in a straight line, as if modeling on a catwalk.
She argued that the empowerment that women had achieved since communism collapsed in 1989 had been accompanied by added social pressures, fanned by fashion magazines and television, to be thin and attractive.
At Iscare, one factor driving the nursing shortage is a surge in demand for plastic surgery by women seeking to improve their job prospects during the financial crisis.
Of the 50 nurses there, Schweitzer said 10 had opted for plastic surgery and several more were considering it. One male doctor may get liposuction.
"If you want to have good employees, you have to have good incentives, and we are offering free breasts," said Patrick Paulis, head of plastic surgery at the clinic. "Others could offer free Mercedes."
Not all the clinic's nurses are convinced. "We all want to be sexy and to look good," said Linda Havranova, 33. But she added: "Surgery is cutting into the body, and there are risks. So for now, I would rather get a Peugeot car."
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