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If Plastic Surgery Won’t Convince You, What Will?

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.

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