Nursing: Indispensable but not acknowledged

Published: February 5, 2011

Health sector faces acute shortage of nurses due to relatively low salaries and tremendous workload.

ISLAMABAD: Nurses are considered the backbone of the healthcare system. The value of this centuries-old profession is acknowledged throughout the world because of patient care save for, it seems, Pakistan.

The health sector in the country is currently facing acute shortage of nurses due to restricted growth, relatively low salaries and tremendous workload. Moreover, nursing ranks lower than medicine, further lowering the profession’s prestige. A total of 162 nursing schools and colleges are registered with Pakistan Nursing Council (PNC), which also acts as an advisory body on issues pertaining to the curriculum in various nursing programmes.

These colleges are unable to fulfil the demand of nurses within the country.

At present, only 67,000 nurses are registered with PNC, for a population of about 170 million. Make allowance for the nurses that are no longer working and those that have left the country to pursue better career options, and the actual number is even lower. This shortage of nurses is adversely affecting patient care in hospitals.

Nighat Durrani, registrar of PNC, said that a new curriculum for Bachelor of Science in Nursing (BSN) has been approved by Higher Education Commission (HEC), which requires a four years degree programme.

BSN will replace the already-existing diploma course in Nursing, which takes three years to complete. The change will be gradual, however, she added. “For BSN we need to equip the existing colleges with modern laboratories and clinical equipments,” Durrani said.

Clara Pasha, former principal of Nursing College, Pakistan Institute of Medical Sciences (Pims), said no appropriate measures are taken to train new nurses. She added that the newly proposed BSN will not be easy to implement because Pakistan lacks qualified teachers. Pasha was of the view that save for a few major hospitals in big cities, others are reluctant to spend good amount on training nurses. Similarly facilities given to nurses are very bad, which is why many people are discouraged from considering nursing as a viable profession.

Kulsoom Akhtar, former nursing superintendent at Pims, said that many consider a nurse’s job to be stressful, consisting of long and odd working hours.

Akhtar believes the situation can be mitigated to an extent if the government provides accommodation to nurses within hospital premises. She added that nurses working during the night be given extra allowance as an incentive.

Stella Ayub, Nursing Adviser to the Ministry of Health, deplored the fact that nursing has been restricted to women in Pakistan. She said the nursing schools are in an awful condition, with lack of funds, laboratories and clinical equipment. Making things worse is the fact that the faculty members in these schools lack adequate qualifications, she added.

In her opinion, many women join nursing schools because their parents cannot afford to send them to a university. So they join a nursing school where, instead of paying fees, they also receive a monthly stipend of Rs6,800.

Ayub added that even though the Ministry of Health was trying to improve the working conditions of nurses, it will be a long a time before the results are visible. She said the ministry had approved a new service structure for the recruitment and promotion of nurses from Basic Pay Scale 16 to 20, but its implementation is still far from reality.

The Ministry of Health recently issued termination letters to all contractual nurses, which forced the nurses of Pims and Federal Government Services Hospital (Poly Clinic) to take to roads. They have been protesting for four days now and even staged a sit-in in front of the Parliament House on Friday.

Improvement in the nursing field will ultimately lead to a nurse-friendly environment, thus improving staff satisfaction and retention as well, which is important to increase the number of nurses to meet the growing demands of our increasing population.

What we need is for the government to co-ordinate approach to strengthen nursing services and acknowledge that they are needed most in crises or conflicts.

Published in The Express Tribune, February 5th, 2011.

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