Dr Himadri Bisht, Research Associate and Dr Snehasish Ghosh, Research Intern, Health Parliament share their opinion on how nurses have failed to get the due recognition in the society, and why there is a need for a healthy and conducive working environment
Amidst all the glitz and glory of the doctors, we somehow tend to neglect the contributions of the gatekeepers of the healthcare system – nurses! They witness the circle of life from birth to death from close quarters and yet somehow have failed to get the due recognition in the society. Nursing is the most under-appreciated profession, to say the least.
We have a nursing workforce of 1.7 nurses per 1,000 population in our country which is almost 43 per cent less than the World Health Organization (WHO) norm (three per 1000), including nurses, midwives, auxiliaries and ante-natal care workers.
India is staring down the barrel to an acute scarcity of nursing staff in the near future. We recently observed the International Nurses Day on the 12th of May, but the gruesome condition of the nurses in our country gives “red flags” for the future of nursing as a profession.
According to a survey conducted by a Think Tank, Health Parliament, in association with the Disease Management Association of India (DMAI) on Nurses, nursing as a profession is facing a crisis of perception, relevance and existence.
Every one out of two nurses advocated that the working conditions are not good in India and the profession needs a major transformation. Due to this reason, a huge number of trained nurses are forced to move abroad every year which adds to the misery of the already overburdened workforce. The situation gets even worse when half of all the participants surveyed believe that the government has hardly done anything to bring about any change.
If you look at the reasons for nurses to leave the profession or move out to other countries, a staggering majority finds the payment for work to be too low. Moreover, another serious concern is the violence, bullying and harassment of the nursing staff at the workplace. According to the study findings, 30 per cent of the nurses have faced some kind of abuse in their professional career and even shocking is their awareness of the gravity of the situation.
Many of them consider the harassment just as a work hazard and nothing else, which they have to deal with. All of this paints a tainted image in front of the future generation, which heavily discourages them from opting for this profession.
The majority of the nurses (57 per cent) identified patient care as their primary job function. However, a significant percent (17.83 per cent) of nurses mentioned they have no clear or defined roles. This clearly shows the system does not realise the importance of nurses in delivering healthcare services, which could be one of the major reasons affecting the quality of healthcare in the country. Furthermore, when asked about reorienting the role of nurses in healthcare, 69 per cent of the respondents concurred that they could contribute more than their current job roles, if given an opportunity.
Why is it that when we hear the term ‘nurse,’ a female staff appears in front of our eyes? Why is it so that even after an extensive course duration of four years, many of the nursing staff don’t have any other role than patient care? Why is it that the National Accreditation Board for Hospitals & Healthcare (NABH) providers has specifications for only doctors and specialists for a speciality in healthcare organisations and not the nurses? Why are the nurses being ‘treated as second-class citizens?’
It is time for action at the highest level to bring back this profession, and contain the exit of people interesting in nursing.
The situation calls for a revision in the course curriculum to rope in some technical aspects which will not only bring excitement to the nursing profession, but also pay huge dividends to the healthcare industry by bridging the gap between doctors and patients.
By upskilling the current workforce in the latest digital health tools and technology, we can add another string to their bow. Following the footsteps of the private hospitals, government hospitals should also make provisions for training nurses in digital health technologies like Electronic Health Records (EHR), Electronic Medical Records (EMR), teleconsultation, telemedicine etc., and also the healthcare gadgets, patient portals and remote-monitoring systems so that they can improve their skill set and contribute more productively to healthcare.
Nurses should be provided greater autonomy by training them for primary-care settings, handling patients for acute conditions and prescribing non-emergency medicines under supervision, which will ultimately enhance the efficiency of the healthcare workforce.
A healthy and conducive working environment has to be promoted in the organisation in order to ensure the safety of the nurses. Proper training in reporting and identification of workplace misconduct has to be included in the nursing curriculum. It is high time that NABH defines a specific nurse-to-bed ratio.
We need to address these issues through immediate and appropriate policy interventions. We urge the Ministry of Health and Family Welfare (MoH&FW) and other capable organisations to keep the above points in mind so that we can see the light of progress soon.