Caregivers must not remain uncared for

You find them in position round the clock in hospitals, nursing homes, old age homes, etc catering to the healthcare and assorted needs of the patients or others in need. To most of the hard-pressed nurses of India, witnessing the predicament of inmates, some never to return home, is routine. They interact with people like no other professionals probably do.

Like Maya Angelou said, “As a nurse, we heal the heart, mind, soul and body of our patients, their families ... They may forget your name, but they will never forget how you made them feel.”

A nurse goes above and beyond the call of duty, the first to appear and the last to leave, trailing an abiding impact. “Life’s most persistent question is”, said Martin Luther King, “What are you doing for others?” On this scale, nurses’ role is nothing short of an angel’s. “The trained nurse has become one of the great blessings of humanity, taking a place beside the physician and the priest,” said William Osler, co-founder of John Hopkins Hospital, Baltimore, US.

The annual event awaited by theglobal nursing community is the International Nurses’ Day on May 12 that coincides with the birth anniversary of Florence Nightingale, a legend who set benchmarks in nursing. The celebrations are held globally under the aegis of the International Council of Nurses, the apex federation of over 130 national nurses’ associations representing over 13 million nurses worldwide.

Besides meetings and seminars, a major initiative is the release of a kit that highlights region-specific nursing interventions, successes achieved along with SDG targets, and comments on current strategies. In India, the President confers the National Florence Nightingale Awards on nurses for outstanding contribution to the profession.

Acute shortages

The shortage of nurses in our country puts them under enormous pressure, thus affecting the quality of care and services they provide. There are only 17.90 lakh registered nurses including midwives as against the required 24 lakh. The current nurse-doctor ratio of 1:6 in India is well below 1:4 as recommended by the Indian Nursing Council, the national nursing regulatory body.

The existing 1.7 nurse per 1000 population is also below the WHO norm of 2.5 nurses. Ideally, one nurse is required per patient with critical illness and five nurses per patient in psychiatric cases. Compare it with the US norm of two nurses per patient for critical care units.

Referring to a strong correlation of shortages of nurses with morbidity and mortality rates, nurse leader Lois Capps and Senator Kirsten Gillibrand have been pleading for the right number of nurses to provide quality care for all.

In India, the dearth of nurses is mainly attributable to their low wages, particularly in the private sector. Globally, meanwhile, the demand is huge and salaries lucrative, so they move out at the first opportunity. In developing countries, the elderly population as well as chronic diseases like cancer and AIDS are consistently on the rise. This triggers a huge demand abroad for expert personal caregivers from developing countries, including India.

Attracting young men to join the nursing career could ease domestic shortages, as it continues to remain primarily a female domain with hardly 10% males. Male nurses like St. Camillus de Lellis (patron saint of nurses who developed the first ambulance service — use of Red Cross sign is attributed to him), Edward Lyon, Joe Hogan, etc have contributed immensely to the profession.

Given the knowledge, skills and knowhow of nurses in managing patients, some degree of authorisation in discharge of their duties can bring better outcomes, apart from unburdening the doctors. A nurse having worked in the ICU for decades is not allowed to prescribe simple painkillers or injection on her own. If in the US, 67% of anaesthesia is given by nurses, so why not in India?

Upgrading the skill of nurses in advanced technology is direly needed. To this end, apart from other bodies, the Trained Nurses Association of India, a national body with over three lakh nurse-members and branches has initiated Daksha, a National Skill Lab project with the help of Liverpool School of Tropical Medicine (LSTM) and Ministry of Health & Family Welfare (MoHFW) where batch-wise programmes are being conducted to upgrade the skills of medical and nurse practitioners.

Nurses are obligated to dispense comfort and compassion to the needy, which involves, as Florence Nightingale said, “an exclusive devotion and as hard a preparation as any painter’s or sculptor’s work” since one interacts with “the living body, the temple of God’s spirit.”

(The writer is Consulting Editor at The Trained Nurses Association of India, New Delhi)