Poorly treated at home, hailed abroad: Paradox of becoming a nurse in India

Overworked, poorly paid and discriminated — this is the end story of every Indian who wants to be a nurse in India.

As the world celebrates its  ‘International Nurses Day’, the economic and social position of nurses in India remains unchanged. They continue to be at the receiving end of systemic neglect.

The Indian nursing environment is defined by a poor patient-nurse ratio where one nurse is responsible for too many patients at the same time. This naturally elevates the risk for patient safety, higher rates of readmissions and an even higher probability of bedside infections.

For instance, the recommended nurse-patient ratio for a general ward is one nurse for 6 patients, however, in many Indian hospitals, this ratio gets mismatched up to one nurse for 20 patients.

As of 2026, lack of uniform minimum wages, particularly in the private sector, has been a source of concern for many nursing personnel in the country.

Kerala has become the first state to propose revising minimum wages for healthcare workers in private hospitals, the Hindu stated.

Less nurses for too many patients

The most gripping issue with the Indian nursing ecosystem is the uneven patient-nurse ratio which leads to burnout among the nursing staff and eventually contributes to medical negligence.

As per the Indian Nursing Council (INC), there are 42.94 lakh nurses registered in the country with 5253 institutions to train them.

Out of the 5253 schools of nursing, 809 are government-run and remaining 4,444 are private, churning out about 3.87 lakh nurses annually.

While the global benchmark of nurse to patient ratio is 3 per 1,000 people, in India, it is 2.23 nurses per 1,000 people. However, the ratio seems to have got better as opposed to the previous years where the ratio stood at 1.96 per 1,000 patients.

As per the data provided by the Press Information Bureau (PIB), India has a shortfall of about 2 million nurses to meet the global standards.

Every department in the hospital poses a unique demand for the nursing staff and it varies as per the intensity of care needed. In almost all recommended ratios, India lags in the number of nurses looking after a fixed pool of patients.

For instance, even in a critical care unit where the standard ratio must be one nurse for one critically-ill patient, the ground reality shows a different number where one nurse is looking after at least two to three patients at the same time.

The skewed ratio seems to get worse in emergency wards when one nurse might be tending to nearly eight to ten beds all at once.

As per nursing experts, in the government sector where the crowd is unmanaged, the ratio tends to distort more in comparison to private spaces.

Also, India also falls behind in the number of ‘skilled’ nursing staff who are required for advanced medical roles.

As per a study, four reasons that can be attributed to this shortage are: challenges in policy planning, training-related barriers, poor wage and burnout among the nursing personnel.

Another study published in Science Direct stated that though many Indian students are getting their graduation, post graduation and diploma degrees from the nursing schools, there aren’t many work opportunities for them to use those skills. 

In coherence with the subject, Anjali Ajaikumar, director at Milann Fertility and Birthing Hospital said: “ In environments where nurses are respected, involved in decision-making, and given opportunities to grow clinically, hospitals function more effectively and patient trust becomes significantly stronger.”

Multiple studies have demonstrated a connection between nurse shortage and increased risk of patient dying during the hospitalisation. 

Brain drain

With a high demand of nurses at home, India continues to be a key exporter of nurses to the West.

While migration to other countries gives a boost to their economic stability, it comes along with social challenges like living away from home and cultural integration.

Most Indian nurses migrate to Australia, the United States, the United Kingdom and Canada.

The common found cause behind Indian nurses moving to other countries is low wage and poor working conditions.

As per Indeed (a job search platform), the average base salary for a registered nurse in Bengaluru (Karnataka) is INR 22,804 which is also the highest in the state, followed by Davangere (INR 22,266) and Mysuru (INR 22,131).

Stigma

As per reports, the public perception of nurses in India is marked by unpleasant stereotypes.

An article published in the BMJ Global Health, nursing in India is often looked down upon as a ‘dirty’ job with gruelling night shifts and unpleasant uniforms. Also, the social forces deliberately tend to keep their position as sub-standard to medical doctors and fail to see the profession in its own unique strength.

When everyone leaves, including the doctor, a patient and their worried kin will always find a nurse at their bedside. The role of a nurse in a person’s well being is undeniable and less appreciated. This International Nurses Day, we celebrate their countless actions of compassion and sacrifice.