If Plastic Surgery Won’t Convince You, What Will?
Reported June 01, 2009
PRAGUE — When Petra Kalivodova, a 31-year-old nurse, was considering whether to renew her contract at a private health clinic here, special perks helped clinch the deal: free German lessons, five weeks of vacation, and a range of plastic-surgery options, including complimentary silicone-enhanced breasts.
“I would rather have plastic surgery than a free car,” said Ms. Kalivodova, who opted for cosmetic breast surgery that would normally cost €2,600, or about $3,500, as well as liposuction on her thighs and stomach. These were physical enhancements, she said, that she could not afford on her €1,000 a month salary.
“I feel better when I look in the mirror,” she added. “We were always taught that if a nurse is nice, intelligent, loves her work and looks attractive, then patients will recover faster.”
Critics lament the plastic surgery inducement, saying it is the most drastic sign of an acute nursing shortage that health officials say is undermining the Czech health-care system. In the past year alone, nearly 1,200 nurses have migrated to countries like Germany or Britain in search of better wages, according to the Czech Nurses Association. Health analysts estimate that this has contributed to a shortage of 5,000 nurses in an already overstretched public sector.
The nursing shortage is part of a worrying global trend that doctors and nurses say is hurting patient care and potentially risking lives. In Britain, hospitals have been forced to temporarily eliminate dozens of beds because of the dearth of nurses, while in the United States, the government predicts there could be a shortage of one million nurses by 2016. In the Czech Republic, the lack of qualified nurses recently forced a hospital in Brno, the country’s largest city after Prague, to shut its intensive care unit.
It is not just private clinics that are offering creative benefits in a country where the average monthly nurse’s wage, about €900, is less than that of a bus driver. Na Bulovce, a large state-funded hospital in Prague, lists incentives on its Web site that include lunch vouchers, child day care and “aesthetic operations at reduced prices.”
Institutions across the country are offering incentives to attract nurses but the more expensive and exotic efforts have been largely limited to Prague, the capital.
The offer of plastic surgery has infuriated some advocates for women’s rights, including Jirina Siklova, a gender studies expert and sociologist, who argued that motivating nurses with offers of breast implants amounted to turning them into “prostitutes.”
“If any institution offers this incentive, then it has lost all credibility,” she said. “I would expect such behavior from an erotic salon — not from an institution devoted to health care.”
While the plastic surgery perk does not appear to have been embraced in other European countries, in the Czech Republic — which has an obsession for female beauty pageants and where decades of communism shielded the Czechs from the political correctness that has prevailed in the west — the offer of free tummy tucks or remodeled breasts is considered by many of both sexes to be a generous inducement no different from offering a free trip to the Bahamas.
Jiri Schweitzer, managing director of Iscare, the private surgery clinic where Ms. Kalivodova works as a surgical nurse, said there was nothing sexist about helping women look beautiful. He said that after months of struggling to attract qualified nurses, the plastic surgery offer had helped increase applications by 10 percent over the past three months.
Under the incentive plan at Iscare, nurses can choose from an assortment of cosmetic surgical procedures, ranging from a €1,425 tummy tuck to a €1,300 face lift, in return for signing a three-year contract. Mr. Schweitzer said the cost of the surgical makeovers was less expensive than raising overall salaries.
Of the 50 nurses working at the clinic, Mr. Schweitzer said 10 had opted for plastic surgery, while several more were considering it. One male doctor is also looking at getting liposuction. The incentive, Mr. Schweitzer added, had proven to be far more popular than the free German lessons. “It helps to improve the morale of both our employees and our patients,” he said.
He noted that the need to recruit nurses to staff the plastic surgery department had become particularly acute because of a surge in demand for cosmetic procedures by women who said they hoped to improve their job prospects during the financial crisis.
That contrasts with the trend across the Atlantic, where a recent report by the American Society of Plastic Surgeons noted that the recession had contributed to a nine percent decrease in plastic surgery procedures last year in the United States, including declines in breast augmentation, liposuction, eyelid surgery and tummy tucks.
Irena Pejznochova, spokeswoman of the Czech Nurses Association, said she saw nothing wrong with hospitals offering free plastic surgery. “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 bed pans and cleaned hospital rooms,” she said.
Whether undergoing plastic surgery will help improve their image is debatable. But nurses insist they are under enormous pressure to look good in a society where attractiveness is often as highly prized as clinical skills. Ms. 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, since the Velvet Revolution that overthrew communism in 1989, women had ascended the corporate ladder. But she said this empowerment had also been accompanied by added social pressures — fanned by women’s fashion magazines and television — to be thin and attractive. She insisted, however, that the breast augmentation had been her choice alone.
“People of my mother’s generation look down on me for getting the surgery,” she said. “I see it in their eyes. But I don’t care. I did this because I wanted to and I didn’t ask anyone’s permission, including my boyfriend.”
Dr. Patrick Paulis, head of plastic surgery at the clinic, who himself recently underwent liposuction on his hips, said he had no reservations about offering the perk. He said he studiously warned patients about the potential side effects of plastic surgery — which can include leaking breasts and scar tissue — and stressed that nurses, more than most, were aware of the risks. “If you want to have good employees, you have to have good incentives, and we are offering free breasts,” he said. “Others could offer free Mercedes.”
Dana Juraskova, the Czech minister of health and a former nurse, said in an interview that she would not favor free plastic surgery becoming a nationwide incentive. She said there were other ways to motivate nurses: for example, the recent introduction of a €1 fee for visiting a doctor — which spawned a national outcry in a country accustomed to free health care — had resulted in cost savings that were now being passed on to nurses, she said.
Some nurses at the clinic said they were torn about whether to opt for surgery or something more pragmatic. “We all want to be sexy and to look good,” Linda Havranova, 33, said. But she added: “Surgery is cutting into the body, and there are risks. So for now, I would rather get a Peugeot car.”