Core of patient care: Nurses need a seat at the table

Claps don’t pay the bills,” reads a placard at a nurses strike in the United Kingdom. The unprecedented strike at UK’s healthcare backone, the NHS is for better pay, a call that resonates with the global nursing fraternity. 

Three years into the Covid-19 pandemic, the nursing fraternity is in need of much attention, in terms of better pay, working conditions or just sheer respect. And it’s an ask that health administrators will ignore at their peril, as the world stares at a global shortage of 5.9 million nurses, according to World Health Organization’s State of World’s Nursing report (2020).

A recent poignant observation by WHO’s executive director (Health Emergencies Programme) Dr Mike Ryan explains it, in a sense. “As the economic crisis hit, they (healthcare workers) were left behind and they are now looking at the stark future of less pay for more work. More stress for less recognition and many are choosing to leave the field.”

Closer home, nurse unions are fighting to be heard in policy changes that would frame their working conditions. Nurses recall how they worked through the peak of Covid-19, often having to rely on the hospitality of others, in the absence of basic amenities like changing rooms and places to stay, during the relentless onslaught of the SARS-CoV-2 virus and its multiple waves. 

Shortage post pandemic

As hospitals emerge from the workload of the pandemic, a key challenge they face is the shortage of nurses. And industry insiders say, countries are relaxing their rules to make it easier for nursing staff from India to join them.  

Gautam Khanna, Chair, FICCI health services committee, and Chief Executive at Mumbai’s PD Hinduja Hospital, agrees that availability of nurses is an issue. The attrition of nurses, that was about 20 percent annually is now about 30 percent at the hospital, and about 40 percent at an industry-level, he says.

Better pastures

Nursing colleges are seeing empty seats and trained nurses are moving abroad, as they see a better career pathway, he observes. Nursing as a profession needs to be made alluring, he adds.

President of United Nurses Association (UNA) Maharashtra state, Jibin TC, says that nurses are available, but hospitals were unwilling to pay market prices. Nurses get about ₹20,000 a month in private institutions he says, adding that Government packages are better, but come with tremendous workload. Comparatively, a nursing job overseas pays about ₹2.5 lakh a month, he says.

The profession needs more respect, he says, pointing to even nursing departments being headed by doctors. Nurses and doctors are independent professionals, working with each other, he says, adding that their job profiles need to be well defined.

Core of patient care

Having seen the healthcare landscape evolve over the last 30 years in India and abroad is Dr Santy Sajan, who has risen from being a bedside nurse to be part of top hospital management at multiple hospitals. She is Group Chief Operating Officer with Paras Healthcare.

“Nursing is a core and integral part of patient care,” says Dr Santy. Empowering a nurse is not only good for patient care and satisfaction, but also for the organisation, she says, adding, that they are unfortunately the weakest link today. Overseas, nurses are respected members of the core team, she says, adding, “There, it is what value you add to patient care.” 

It’s not just about the money, says Dr Santy, who calls for greater respect and responsibility to be given to nurses. “They need a seat at the table and their voices need to be heard,” she says.

Dr Santy uses the battlefield analogy to explain how nurses are like the soldiers who bite the bullet. They are with sick and dying patients, and it puts them under tremendous emotional stress, she says.  

The world faces a huge challenge, as the requirement for and of nurses increases, with a growing ageing population, and with the profession going high-tech. The shortage will continue, unless the profession is not seen as one that will help the individual grow, she says.

Nurses should be encouraged to improve their skills, study further and in the hospital. Tthey need to be give more responsibilities in handling patients, possibly with a small team of trained and certified practical nurses, who operate under clear protocols, she explains. Education needs to be rigorous, but with bedside orientation, says Dr Santy, herself a Phd. Clearly, a role-model for nurses wanting to up their game. But also an indication that hospitals can be part of change, to build the nursing profession.