The nursing profession is facing a major crisis worldwide. The World Health Organisation says there’s a huge shortage of nurses, and the problem is only getting worse.
Today, May 12, is International Nurses Day, celebrated worldwide to mark the birthday of Florence Nightingale, the founder of modern nursing. As a surgeon who performs complex operations every day, I can fully understand the value and importance of a nurse’s service.
After a successful surgery, it is the loving and dedicated care of nurses that helps a patient fully recover and return to their life. No matter how much modern medicine advances, there’s one thing that high-tech machines and expensive drugs can’t replace: the human touch of a nurse. But here’s the harsh reality we often ignore: these very healthcare workers, who soothe others’ pain, are themselves facing immense challenges and pain in their workplaces. I feel today is the perfect day to share my thoughts on this issue with the readers of Manorama Online.
The Global Crisis Facing Healthcare
Globally, the nursing sector is going through a crisis like never before. According to the World Health Organisation (WHO), there is a massive shortage of nurses worldwide. In Western countries, as the population ages, the demand for healthcare is rising. But they just don’t have enough nurses to keep up.
The COVID-19 pandemic made this crisis even worse. Nurses worked tirelessly during the pandemic, often risking their own lives. The extreme workload and mental stress during that period led many nurses worldwide to leave the profession altogether.
In many developed and developing countries, the nurse-to-patient ratio is not being followed correctly. This means one nurse often has to look after too many patients. On top of this, physical and mental abuse from patients’ relatives has become a major global challenge for nurses.
The State of Nursing in India
When we look at India, the problems get even more complicated. We are one of the world’s biggest producers of nurses. Yet, it’s a strange paradox that most of our hospitals, especially in rural areas, don’t have enough of them. The main reason for this is the huge gap between the private and public healthcare sectors in India.
While government hospitals offer job security and better pay, a majority of nurses in private hospitals face severe exploitation. Many are forced to work for 12 to 14 hours for very low salaries. They don’t get proper rest or the leaves they are entitled to.
There are thousands of small hospitals across India that don’t even provide basic employment benefits like PF and ESI. These poor working conditions are forcing our most skilled nurses to migrate to countries like the UK, America, and the Gulf. This ‘brain drain’ is a huge blow to India’s healthcare system.
The Unique Problems of Nurses in Kerala
We often say with pride that you’ll find a Malayali nurse anywhere in the world. They play a huge role in providing world-class healthcare globally. However, the condition of nurses working in their own home state of Kerala is more pathetic than we can imagine.
We boast about the ‘Kerala Model’ of healthcare, but we still haven’t been able to fully solve the basic problems of the nurses who are its backbone. Even though we claim to have strict labour laws, there are widespread complaints that many private hospitals in Kerala don’t even pay the government-mandated minimum wage.
With the cost of living rising every day, nurses in Kerala find it extremely difficult to manage their lives on such low salaries. Many can’t even repay the education loans they took for their nursing studies. To make matters worse, private managements often cut staff to save costs, which just doubles the workload for the remaining nurses.
There are scientific standards for how many patients one nurse should handle. But in many Kerala hospitals, it’s a sad state of affairs where one nurse in a ward has to care for 10 or even 20 patients at once. This not only ruins the nurse’s health but also affects the quality of care patients receive. The lack of safe transport and proper rest areas for those finishing night shifts are other major problems they face in Kerala.
Constant Physical and Mental Pressure
Compared to many other jobs, nursing is filled with intense physical and mental challenges. Standing for hours on end leads to physical problems like varicose veins, which are very common among nurses. Also, by constantly caring for patients with infectious diseases, they are always putting their own health at risk.
The mental trauma is even greater. They have to see patients in pain, and deal with death and grief daily. Often, the families of patients take out their anxiety and anger on the nurses standing in front of them. To handle all this with a smiling face causes immense mental stress. Many nurses admit that this stress seriously affects their family life and how they raise their children. Irregular shifts mess up their sleep and eating habits.
Where Should the Change Begin?
The first thing that needs to change is society’s attitude of seeing nurses as just ‘helpers’. They are professionals who work based on scientific knowledge and years of training, just like doctors. Society must start giving them the respect they deserve. The government must also bring in strict laws and ensure they are actually implemented.
It is the government’s duty to ensure fair wages for nurses in private hospitals. At the same time, they must make sure that the nurse-to-patient ratio in hospitals is strictly followed. Making counselling services mandatory in hospitals is also crucial to support their mental well-being.
A society’s health index is high thanks to the hard work of its nurses. They forget their own families and health to live for others. So, on this Nurses Day, let’s not just clap for them. Let’s also start a collective effort to improve their living and working conditions. Only then will the next generation be inspired to join this noble profession. Let’s hope that just as healthcare changes with time, the lives of our nurses will also see a positive change.
(This article is by Dr. Baiju Senadhipan, a leading gastroenterologist and the Director of the Senadhipan Institute of Medical Sciences.)