The major Dublin teaching hospitals say nurses working in the capital should be paid a special allowance to keep them there.
In a report on the problem of nurse shortages, the hospitals say a special allowance is justified because the Dublin hospitals are the national specialist treatment centres for many conditions which requires an "increased complexity and intensity of care" from nurses.
Measures taken by the hospitals themselves have brought about a significant fall in nurse vacancies, according to the chairman of the hospitals' nursing recruitment and retention project, Mr Michael Lyons.
Hospitals involved in the project include Beaumont Hospital, James Connolly Memorial Hospital, the Mater Hospital, St James's Hospital, St Luke's Hospital, Tallaght Hospital and St Vincent's University Hospital.
Research conducted among existing and former staff found 70 per cent of those who leave have three or more years of experience. Replacing them, the report says, is not just a matter of making up numbers but also of getting nurses with the same degree of experience.
The reason most often given for leaving was the desire to pursue further education allied to a lack of educational opportunity in the hospitals. The report urges hospitals to provide more in-house education for nurses and to ensure that their educational attainments are accepted in all the main Dublin hospitals.
Personal and family reasons came next and, for young nurses with less than two years' experience, the desire to travel was an important factor.
Management style also emerged as a key source of dissatisfaction for nurses.
Many complained of "hassle" from management and of not being able to influence decision-making. One complained of "too much interference and criticism from administration of the nursing staff at ward level instead of support."
Another declared that "unapproachable managers and managers who are too dogmatic for today's working environment" would lead her to consider leaving.
The research also found a "vicious circle" effect in that the loss of nurses from the hospitals created difficulties for the remaining nurses and could encourage them, too, to leave.
One typical nurse complained of "low staff morale due to low staff numbers leading to stress and increased demand from patients." Another nurse said that what would encourage her to stay was "having adequate staff on the ward to prevent being totally wiped out when it comes to your days off."
The hospitals have begun implementing the measures recommended in the report and these are already paying off, according to Mr Lyons. The average shortfall in nursing numbers had fallen from 15 per cent (621) of posts to 9 per cent (356) in the two years to September 2001.
The number of beds closed in the hospitals (excluding St Luke's which is producing its own programme) fell from 119 to 35 in the same period.
Measures implemented by the hospitals include joint recruitment from abroad through one company, making skills learned in one hospital transferable to other hospitals and maintaining databases of vacancies.