Bengaluru: Poor career prospects, low pay and overwork are driving nurses abroad and the hospitals in the country are facing an acute shortage of nursing staff. The situation in the city’s major hospitals is no different and the poor nurse-to-patient ratio is taking a toll in providing affordable and effective healthcare.
"The nurse shortage is a big issue as currently most of the nurses go abroad, lured by attractive career options, where they are treated with respect. Nursing is not a good career option here in India," says, Dr. Alexander Thomas, Executive Director, Association of Healthcare Providers (India) AHPI.
Currently, the country is facing a shortage of 2.5 million staff nurses. With such tremendous numbers of nursing providers not available, the city could face a major health care crisis.
Regarding shortage, the former medical superintendent of Victoria Hospital, Dr. Durganna T, said, "We have 300 vacancies for nurses; 100 nurses are on contract, while 200 are still needed." He continued, “At Victoria Hospital, the number of patient beds have increased, including those in the ICU, so we need more nurses as acute cases require more nurses."
"We have written to the State and Central Health Ministry to look into the issue. Nurses are in direct contact with patients every day, while doctors cannot remain at the patient’s bedside all the time for medical supervision," added Dr Alexander.
Based on feedback received from healthcare organisations, assessors and other stakeholders regarding clarity on the requirements for nursing personnel, the NABH has suggested that the nurse-to-patient ratio at ICU beds ought to be one-to-one, but due to the city's nurse crisis, a quick solution is needed.
"The issue is not about ventilators. The ICU at Nimhans requires four nurses for every patient. A few of these nurses draw salaries above Rs 40,000. We also need more nurses to handle emergency cases," said Dr. P Satish Chandra, director of National Institute of Mental Health and Neuroscience.
“The nursing staff at hospitals would be enough for one big ward earlier, but sadly with the advancement of medical care and intensive care management, three nurses are required every day for one critical patient, so more nurses are needed who are adequately trained too," says Dr R. Premlatha, of Vanivilas Hospital, BMCRI.
At Vanivilas Children’s Hospital, the NICU has 32 nurses at the Neonatal Intensive Care Unit (NICU) and thirty nurses at the Pediatric Intensive Care Unit (PICU). "We have a total of 62 nurses and we have around 25 admissions every day at our hospital," she added.
The salary and expertise are also a major impediment in the hospital’s functioning. “Permanent nurses earn Rs 30,000 to Rs 40,000 while nurses on contracts earn from Rs 8,000 to Rs 15,000 which de-motivates them,” Dr Premlatha said.
However there are some hospitals that do have adequate staff nurses. “We have 560 staff nurses and 110 ventilators. Basically, it all depends on the recruitment. It is not only about pay but more posts should be created and funds should be channeled into strengthening the staff nurse contingent and technicians as well,” says Dr. CN Manjunath, Director and Professor of Cardiology at Sri Jayadeva Institute of Cardiovascular Science.
Nursing colleges needed
It’s not just the numbers that count, but also the expertise and skill in patient care management. This is another issue faced by government hospitals.
“Hospitals should have nursing colleges on their premises. Trainee nurses should be allowed to be separate from the workforce, so in that way they will learn and garner the required expertise. Many nurses from private nursing colleges cannot be hired, as they are not even trained to monitor a patient’s temperature,” said Dr. Premlatha of Vanvivilas Children Hospital.
“Quality staff are certainly needed. The hospitals also need to have some in-house training programs after hiring them. Not every nursing school is well equipped; we should not try to fill the gap,” said Dr. CN Manjunath, Director and Professor of Cardiology at Sri Jayadeva Institute of Cardiovascular Science.
Dr. Premlatha, also the former director of Indira Gandhi Institute of Child Health, added, “To be utilised properly, they should be made to focus exclusively on nursing duties. Additionally, more nurse-aides or doctor-assistants should be hired, to optimise the use of nurses. Nurses should also be made to attend to issues like bed making, temperature monitoring, patient monitoring, injecting intravenous medicines and nursing and feeding patients, while other types of work should be given to nurse-aides who are less qualified than nurses.”
