The Impact of Portuguese Economic and Financial Assistance Program on the Employability of the Azorean Nurse after the Financial Crisis of 2009-2010
Keywords:
Unemployment, nursing, economic crisis, youth unemployment, employment precariousness
Abstract
The economic crisis that followed the financial crisis that began in the United States of America in 2008 quickly spread to the whole world, leaving structural problems in several countries unveiled, particularly in those that, due to successive deficits and high external indebtedness, were in a more fragile situation. In the Portuguese case, external assistance was needed, made available in exchange for structural reforms and the abrupt, and severe reduction in public expenditure. The applied austerity had repercussions throughout society, but the public sector felt the weight of the used measures concretely, with health services being no exception. The shock waves caused by public expenditure containment policies were particularly felt in the Azores, an ultra peripheral region marked by geographical discontinuity. These are significant asymmetries at various levels from island to island and across several sectors. The public sector is the primary employer. This paper focuses on understanding if the Portuguese Economic and Financial Assistance Program, implemented between 2011 and 2014, affected the employability and dynamics of the labour market of new graduate nurses in the Autonomous Region of the Azores. This quantitative study used descriptive, inferential, and correlation statistics to establish relations with a statistical value between the sample's employability dimensions and the Portuguese Economic and Financial Assistance Program. From the analysis carried out, the study revealed that the restrictions imposed due to the external assistance program led to an increase in precariousness among new graduate nurses and, among other conclusions, a strong contraction in the capacity of hiring nurses by the public health services. As a limitation to the study, there is the need to emphasise that data on unemployment reflected the reality when the questionnaire was applied (May 2019), and the fact that the study did not explore the reasons underlying the unemployment rate found among the participants (although residual).
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References
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2. Al-Sawai’e, K. M., & Abdul A’aL, S. (2015). The impact of trade account deficit on unemployment scenario: An empirical study on Jordan during the period of 2000-2012. European Scientific Journal. 11(16), 318-333. https://eujournal.org/index.php/esj/article/view/5871.
3. All-Party Parliament Group on Global Health (2016). Triple Impact – How developing nursing will improve health, promote gender equality and support economic growth. Key Points and Recommendations. House of Commons, London.
4. Anderson, M., O'Neill, C., Clark, J. M., Street, A., Woods, M., Johnston-Webber, C., Charlesworth, A., Whyte, M., Foster, M., Majeed, A., Pitchforth, E., Mossialos, E., Asaria, M. & McGuire, A. (2021). Securing a sustainable and fit-for-purpose UK health and care workforce. The Lancet. 397(10288), 1992 - 2011. https://doi.org/10.1016/S0140-6736(21)00231-2.
5. Arulampalam, W., Booth, A. L. & Taylor, M. P. (2000). Unemployment persistence. Oxford Economic Papers. 52(1), 24-50. https://doi.org/10.1093/oep/52.1.24.
6. Auerbach, D. I., Buerhaus, P. I. & Staiger, D. O. (2017). How fast will the registered nurse workforce grow through 2030? Projections in nine regions of the country. Nursing Outlook. 65(1), 116-122. https://doi.org/10.1016/j.outlook.2016.07.004.
7. Banco de Portugal (July 30, 2021) – Programa de Assistência Económica e Financeira. Banco de Portugal, 2015. https://www.bportugal.pt/page/programa-de-assistencia-economica-e-financeira.
8. Benach, J., Vives, A., Amable, M., Vanroelen, C., Tarafa G. & Muntaner C. (2014). Precarious employment: understanding an emerging social determinant of health. Annual Review of Public Health. 35, 229-253. https://doi.org/10.1146/annurev-publhealth-032013-182500.
9. Bloom, N., Propper, C., Seiler, S. & Van Reenen, J. (2015). The Impact of Competition on Management Quality: Evidence from Public Hospitals. The Review of Economic Studies. 82(2), 457–489. https://doi.org/10.1093/restud/rdu045.
10. Boeri, T. & Jimeno, J. F. (2016). Learning from the Great Divergence in Unemployment in Europe during the Crisis. Labour Economics. 41(C), 32-46. https://doi.org/10.1016/j.labeco.2016.05.022
11. Britnell, M. (2019). Human: Solving the global workforce crisis in healthcare. Oxford University Press, Oxford.
12. Cabrera, E. (2020). Nurses workforce and competencies. A challenge for health systems more than ever. Nurse Education in Practice. 48,102858. https://doi.org/10.1016/j.nepr.2020.102858
13. Calvo, F., Carbonell, X. & Badia, M. (2018). Homelessness and Unemployment During the Economic Recession: The Case of the City of Girona. European Scientific Journal. 14(13), 59-74. https://doi.org/10.19044/esj.2018.v14n13p59
14. Chang, H. Y., Friesner, D., Chu, T. L., Huang, T. L., Liao, Y. N. & Teng, C. I. (2018). The impact of burnout on self-efficacy, outcome expectations, career interest and nurse turnover. Journal of Advanced Nursing. 74(11), 2555-2565. https://doi.org/10.1111/jan.13776
15. Clark, A. E. & Milcent, C. (2011). Public employment and political pressure: The case of French hospitals. Journal of Health Economics. 30(5), 1103-1112.
https://doi.org/10.1016/j.jhealeco.2011.07.007
16. Clark, A. E. & Milcent, C. (2018). Ownership and hospital behaviour: Employment and local unemployment. Social Science & Medicine. 202, 151-161. https://doi.org/10.1016/j.socscimed.2018.02.027
17. Cvecic, I. & Sokolic, D. (2018). Impact of public expenditure in labour market policies and other selected factors on youth unemployment. Economic Research-Ekonomska Istraživanja. 31(1), 2060-2080. https://doi.orr/10.1080/1331677X.2018.1480970
18. Diário da República Eletrónico (July 30, 2021) – Estatuto do Serviço Regional de Saúde dos Açores, 2007 [Statute of the Azores Regional Service] – Decreto Legislativo Regional n.º 2/2007/A, de 24 de janeiro de 2007.
https://dre.pt/web/guest/pesquisa/-/search/522648/details/normal?l=1
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20. Duffield, C., Roche, M. A., Twigg, D., Williams, A., Rowbotham, S. & Clarke, S. (2018). Adding unregulated nursing support workers to ward staffing: Exploration of a natural experiment. Journal of Clinical Nursing. 27(19–20), 3768–3779. http://dx.doi.org/10.1111/jocn.14632
21. Edwards, D., Hawker, C., Carrier, J., & Rees, C. (2015). A systematic review of the effectiveness of strategies and interventions to improve the transition from student to newly qualified nurse. International Journal of Nursing Studies. 52(7), 1254-1268. https://doi.org/10.1016/j.ijnurstu.2015.03.007
22. Faramarzi, A., Javan-Noughabi, J., Sadeghi, A. & Rezapour, A. (2019). Impact of the economic crisis on healthcare resources: A panel data analysis in Eastern Mediterranean countries during 2005 to 2013. Clinical Epidemiology and Global Health. 7(1), 98-101.
https://doi.org/10.1016/j.cegh.2018.02.004
23. Frenk, F. (2010). The World Health Report 2000: Expanding the horizon of health system performance. Health Policy and Planning. 25(5), 343–345. https://doi.org/10.1093/heapol/czq034
24. Gardiner, I. & Sheen, J. (2016). Graduate nurse experiences of support: A review. Nurse Education Today. 40, 7-12. https://doi.org/10.1016/j.nedt.2016.01.016
25. Gilmour, J., Huntington, A., Slark, J. &Turner, C. (2017). Newly graduated nurses and employment: A dynamic landscape. Collegian. 24(3), 247-253. https://doi.org/10.1016/j.colegn.2016.02.004
26. Gontkovičová, B., Mihalčová, B. & Pružinský, M. (2015). Youth Unemployment – Current Trend in the Labour Market? Procedia Economics and Finance. 23, 1680-1685.
https://doi.org/10.1016/S2212-5671(15)00554-7
27. Park, H. & Yu, S. (2019). Effective policies for eliminating nursing workforce shortages: A systematic review. Health Policy and Technology. 8(3), 296-303. https://doi.org/10.1016/j.hlpt.2019.08.003
28. INE (2021). Estatísticas da Saúde – 2019. Instituto Nacional de Estatística, Lisboa.
29. Karanikolos, M., Mladovsky, P., Cylus, J., Thomson, S., Basu, S., Stuckler, D., Mackenbach, J. P. & McKee, M. (2013). Financial crisis, austerity, and health in Europe. The Lancet. 381(9874), 1323-1331. https://doi.org/10.1016/S0140-6736(13)60102-6
30. Keegan, C., Thomas, S., Normand, C. & Portela, C. (2013). Measuring recession severity and its impact on healthcare expenditure. International Journal of Health Care Finance and Economics. 13(2), 139-155. https://doi.org/10.1007/s10754-012-9121-2
31. Kentikelenis, A. E. (2017). Structural adjustment and health: A conceptual framework and evidence on pathways. Social Science & Medicine. 187, 296-305.
https://doi.org/10.1016/j.socscimed.2017.02.021
32. Kentikelenis, A. & Papanicolas, I. (2012). Economic crisis, austerity and the Greek public health system. European Journal of Public Health. 22(1), 4-5. https://doi.org/10.1093/eurpub/ckr190
33. Kim, J., H. & Shin, H. S. (2020). Exploring barriers and facilitators for successful transition in new graduate nurses: A mixed methods study. Journal of Professional Nursing. 36(6), 560-568. https://doi.org/10.1016/j.profnurs.2020.08.006
34. Leão, T., Campos-Matos, I., Bambra, C., Russo, G. & Perelman, J. (2018). Welfare states, the Great Recession and health: Trends in educational inequalities in self-reported health in 26 European countries. PLoS One. 13(2), e0193165. https://doi.org/10.1371/journal.pone.0193165
35. Liotti, G. (2020). Labour market flexibility, economic crisis and youth unemployment in Italy. Structural Change and Economic Dynamics. 54(C), 150-162. https://doi.org/10.1016/j.strueco.2020.04.011
36. Livanos, I., Ilaria Maselli, I., Imanol Núñez, I., Riddell, W. C., Scarpetta, S., Song, X., & Sonnet A. (2012). Challenges Facing European Labour Markets: Is a Skill Upgrade the Appropriate Instrument? Intereconomics. 47(1), 4-30. https://doi.org/10.1007/s10272-012-0402-2
37. Marelli, E., Choudhry, M. & Signorelli, M. (2013). Youth and total unemployment rate: The impact of policies and institutions. Rivista Internazionale Di Scienze Sociali. 121(1), 63-86.
http://www.jstor.org/stable/26477700
38. Melly, B. & Puhani, P. A. (2013). Do Public Ownership And Lack Of Competition Matter For Wages And Employment? Evidence From Personnel Records Of A Privatized Firm. Journal of the European Economic Association. 11(4). 918-944. https://doi.org/10.1111/jeea.12024
39. Needleman, J., Buerhaus, P., Pankratz, V. S., Leibson, C. L., Stevens, S. R. & Harris, M. (2011). Nurse staffing and inpatient hospital mortality. New England Journal of Medicine. 364(11), 1037-1045. https://doi.org/10.1056/NEJMsa1001025
40. Numminen, O., Leino-Kilpi, H., Isoaho, H. & Meretoja, R. (2015). Newly Graduated Nurses' Competence and Individual and Organizational Factors: A Multivariate Analysis. Journal of Nursing Scholarship. 47(5),446-457. https://doi.org/10.1111/jnu.12153
41. OECD (2017). Health at a Glance 2017: OECD Indicators. OECD Publishing, Paris.
https://doi.org/10.1787/health_glance-2017-en
42. Ordem dos Enfermeiros (2020). Anuário Estatístico 2019. Ordem dos Enfermeiros, Lisboa.
43. Ortiz, J. (2016). New graduate nurses' experiences about lack of professional confidence. Nurse Education in Practice. 19, 19-24. https://doi.org/10.1016/j.nepr.2016.04.001
44. Parisi, M. L. (2017). Labor market rigidity, social policies and the labor share: Empirical evidence before and after the big crisis. Economic Systems. 41(4), 492-512.
https://doi.org/10.1016/j.ecosys.2017.08.003
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Published
2022-02-21
How to Cite
Rego Furtado, L. C. do. (2022). The Impact of Portuguese Economic and Financial Assistance Program on the Employability of the Azorean Nurse after the Financial Crisis of 2009-2010. European Scientific Journal, ESJ, 18(5), 49. https://doi.org/10.19044/esj.2022.v18n5p49
Section
Special Editions
Copyright (c) 2022 Luis Carlos do Rego Furtado
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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