Staffing crisis - shortage of nurses, physician assistants and paramedics

Half of the hospitals in the country would need to be closed if health care standards related to staffing were strictly adhered to.

Due to this issue, three professional organizations have issued an open letter to the government, calling for urgent measures to address the staffing crisis.

The shortage is not only in the nursing profession but also among physician assistants. Currently, there are over 2,000 physician assistants nationwide, but only about 150 graduate each year.

Ivan Georgiev is one of the few remaining paramedics in the country. He works in Emergency Services in Ruse, where the staffing shortage is increasingly severe.

“We don't have enough personnel, so we have to take extra shifts to cover the teams,” said Ivan Georgiev, a paramedic in Emergency Services-Ruse.

There is also a shortage of staff in hospitals, and the use of physician assistants has proven inefficient.

“You may encounter a situation where one nurse is on duty alone, along with one doctor covering two wards, and one orderly for two wards, which is absurd,” commented Tatiana Atanasova, a nurse.

“One anesthesiologist might be responsible for five, six, or even ten operating rooms, with physician assistants caring for each patient. In this way, physician assistants can be better integrated into the Bulgarian healthcare system, and they can also be integrated into hospital emergency departments,” added Aleksandar Aleksandrov, president of the Bulgarian Society of Physician Assistants.

They can also be used more efficiently in schools, where there is a shortage of medical staff. For four years now, Desislava has faced regulations that limit her skills as a physician's assistant.

“A child with an allergy, with an acute allergic reaction that starts with hives, can escalate into an emergency in five minutes, potentially ending fatally. Yet, with the medication in my pocket, I am not allowed to administer it in my office because I am employed as a medical specialist,” explained Desislava Tsenova, a physician assistant.

“During the time I have been a school principal, there was a fatal incident at school. Emergencies happen, and adequate medical care is needed, not just basic healthcare, as is currently the case,” commented Danko Kalapish, principal of the 107th Primary School "Khan Krum."

While the medical staff crisis is worsening, one in three nurses is of retirement age and works in several places.

“At the moment, there are only 0.95 nurses per doctor. If this does not change, in the next three to five years, about 10,000 nurses will leave the system, meaning there will be no one to care for patients,” warned Milka Vasileva, chair of the Bulgarian Association of Healthcare Professionals.

According to alarming statistics, the number of nurses in the country has dropped to nearly 22,000, compared to more than 55,000 thirty years ago.