Magdaléna Tupá

The lack of physicians is a serious problem in the Slovak Republic (SR More than 5,000 physicians will be missing in the health care system in the next two years. From the report on health care status in Slovakia, according to OECD (2017), the state of health care in the country achieves very negative results in the indicators related to the human and financial resources of the monitored sector (mortality of newborns, preventable and avoidable mortality, urgent traffic, and others). The study was based on the analysis of the labor market situation in the health care sector for the profession of physician in the SR to identify the state and future need of physicians working in Slovakia, find possible solutions to the identified situation and determine which pull and push factors are the most important. The contribution of the study will be based on the analysis to suggest the ways to facilitate the employment of foreign doctors in Slovakia. The problem of the lack of specialists was considered in two directions of solving it on account of the flow of specialists from other countries: stimulation in order for the foreign medical students to stay in the country after their studies; engagement of foreign qualified doctors. Real situation with doctor stuffing in the Slovak Republic was evaluated, the forecasts until 2022 were made, the proposals on improving the management in solving this problem at the state level were made.

Nurses are an essential resource in health systems. However, the shortage of skilled nursing workforce is a global phenomenon with negative consequences – many factors, including individual, occupational, and socio-political aspects, influence nurse migration. Thus, the aim is to explore the migration intentions of nurses and nursing students, forcing them to seek work abroad.
An online survey was conducted among nurses and nursing students as part of the APVV and VEGA projects. The questionnaire focused on the essential characteristics of the respondents and staffing approaches in hospitals in Slovakia. Data were obtained from a survey of 752 hospital nurses and 423 university nursing students. The statistical analysis consisted of factor and correspondence analysis. The findings highlight the factors influencing the migratory sentiments of nursing students and working hospital nurses. They are organization of work, staff remuneration, employee benefits, workroom equipment, shortage of nurses, bureaucracy, communication and relations with colleagues, superiors, and patients, training and career development, material and spatial security, instrumentation, digitization of work, the prestige of the medical profession, and current situation in the Slovak Republic.
The paper identifies and evaluates groups of push factors of migration intentions – satisfaction/dissatisfaction with hospital working conditions. The results of the factor analysis indicate that such factors as material and spatial security, communication and relations with colleagues, work organization, lack of personnel, bureaucracy, the prestige of the medical profession, and the current situation in Slovakia affect their working conditions and pleasure.

Acknowledgment
This study is elaborated within the framework of the projects APVV č. 19-0579 “Personnel management processes setup in hospitals and its impact on the migration of physicians and nurses to work abroad” and VEGA č. 1/0691/22 “Economic aspects of emigration of university graduates in health care departments in the context of the sustainability of staffing of health care facilities in the Slovak Republic.”

Type of the article: Research Article

Abstract
Hospital nurses are exposed to sustained cognitive, emotional, and organizational demands that elevate the risk of burnout. This study tests whether work engagement functions as a protective factor, whereas workload constitutes a risk factor for nurse burnout in hospital settings. We conducted a national cross-sectional survey of registered hospital nurses in Slovakia across public and private hospitals between September and October 2024. Given a finite population of 31,395 registered nurses in 2024, the minimum required sample at 95% confidence and a 5% margin of error was approximately 380; we analyzed 500 valid responses. Data collection was conducted using a standardized questionnaire, distributed online via Google Forms and in paper form upon request. Standardized scales captured work engagement (A1–A17), workload (Z1–Z6), and self-reported burnout; data were analyzed using multiple linear regression. Participation was voluntary and anonymous, and all respondents provided informed consent. The model was statistically significant and explained 39.3% of the variance in burnout (F = 64.09; p < 0.001). Higher engagement predicted lower burnout (β = −0.591; p < 0.001), whereas higher workload predicted higher burnout (β = +0.945; p < 0.001). These findings indicate that strengthening work engagement and managing workload represent complementary, actionable levers to mitigate nurse burnout in hospitals. The study provides effect-size estimates from a national sample, clarifies the protective role of engagement while controlling for workload, and offers direct targets for hospital HR policy (e.g., autonomy, recognition, staffing, and process optimization).

Acknowledgments
This study was supported by the ESG project No. D12_2024, “The impact of human resource practices on the sustainability of the nursing workforce (nurses) in hospitals,” and was also conducted as part of the completed APVV project No. 19-0579, “Personnel management processes set up in hospitals and their impact on the migration of physicians and nurses to work abroad.”