Shyama R, a nurse at a corporate hospital in Chennai, is busy preparing her documents for a job in the UK. It’s a decision many of her colleagues are also considering, she says. “We stay in a hostel, get food, but after sending money home, there’s barely anything left for ourselves,” says Shyama, who adds that her salary of 15,000 a month isn’t enough to provide financial stability. “My senior colleague, who’s been working here for years, isn’t making enough to live comfortably either,” she adds.While their counterparts in countries such as the UK can earn between 2 lakh and 4 lakh a month, those in Tamil Nadu are often stuck earning just 15,000 to 25,000. Those in rural areas are paid as little as 7,000 to 10,000 a month. For a skilled nurse with 10 years of experience, the average salary in Indian cities is 40,000.Drawn by huge pay incentives, aggressive recruitment drives, and immigration fast-tracks, many skilled nurses are leaving Tamil Nadu. Between January and April, more than 500 nurses from across the state collected good standing or foreign verification certificates from the state nursing council, so they could travel abroad for work.The exodus is posing a challenge to healthcare resources in the state, says Tamil Nadu Nursing Council Registrar S Ani Grace Kalaimathi. In 2020, the council gave 1,432 certificates – 601 foreign verification and 831 good standing certificates – to nurses who were seeking jobs abroad. The next year, when there was a nursing shortage during the Covid-19 pandemic, the council gave more than 4,000 certificates. The trend continued until 2023, when the council issued more than 5,000 such certificates.Beyond financial incentives, nurses are drawn by the promise of greater professional autonomy and more regulated, supportive working environments. Shyama and two of her friends have been getting information from their college seniors employed in the UK and other European countries. “The rules are stringent, but the scope of practice is broader. Hospitals allow nurses to make independent decisions and manage patient care within established protocols. People working there are trained better and are far more confident. They don’t just write doctor’s notes, administer IV, change beds, and diapers for patients,” says Shyama’s friend Thendralarasi E, who is also set to go to the UK. “Our seniors assist some of the most renowned surgeons in the best hospitals in the world.”Another attraction to most young nurses is the clear pathways developed nations offer to permanent residency and the ability to migrate with families, providing long-term security. “With the shortage of more than 30,000 nurses, countries such as the UK have relaxed testing norms for nurses since the Covid-19 pandemic,” says N J Gowrishankar of Hxplain, a company that offers continuing education for nurses.Unlike in earlier times, when nurses had several levels of testing to be eligible for employment, the UK now accepts nurses as assistants once they pass the basic test. “All they need for this is a refresher course in clinicals and training in soft skills. When they join hospitals there, they are trained on the job. After a few months, they clear competency tests, mostly practicals, for various nursing positions,” he says.At the nursing council, too, officials have noted an increase in the trend of nurses going to the UK and other European countries. Earlier, the popular choice was the Middle East. Now, however, the council has recorded an increase in the number of nurses applying for jobs in Europe. Nurses say it is because it gives them the opportunity for professional development, exposure to international healthcare protocols, and advanced practice techniques, coupled with the global recognition for competence and adaptability.While academicians say it is important for specialised training, professional nursing bodies have been pushing for more govt nursing colleges in the state, which will offer quality education at an affordable price. As per World Health Organization standards, Tamil Nadu is short of at least 65,000 nurses to achieve three nurses per 1,000 population. The state, which has 1.74 lakh nurses, has two nurses per 1,000 population. Colleges in districts such as Nilgiris, Ramanathapuram, Thirupattur, and Ariyalur, where no nursing colleges exist, can help bridge the rural-urban gap. “Our nurses need training in soft skills, better salaries, and a more professional environment,” says Ani Grace Kalaimathi. “The aim must be to retain the best ones for our people.”(Email your feedback with name and address to southpole.toi@timesofindia.com)