1st December 2011, a typical chilly day of winter in Kashmir, when after getting admission to pursue Nursing, I stepped into a Nursing college. With all the formalities done, I along with my father got the instructions regarding the commencement of regular college activities from a madam, who seemed to be very calm and composed in her approach. On 15th December, I joined classes in this college. For a couple weeks, I barely interacted with my new colleagues or my seniors because of my shy nature, but few of my classmates had the courtesy and seemed very kind to accommodate me into their group. We had our theory classes till the end of December, and then the session was closed for one-month winter break.
Once the break was over the college activities were back to normal. This time though, our seniors paid a visit to our class for a healthy interaction. I still remember one of our senior saying this in low tone, “hey, akhbaar chew na toeh paraan. Yoarr kyazi aaaiweh”. Which means “hey, don’t you read the daily newspapers, why did you join this institution?”. That very moment sounded very unpleasant and awkward to the group. These lines confused us and we wondered why would a senior say something like that when he has been a part of the institution for at least a year. Later, we came to know that the institution we took admission in, though run by local recognized and influential bodies, was lacking National registration. Which meant, after completion of our degrees, we were eligible for a job or a post-graduation within the state but not outside it.
To shorten this story, the student’s association scheduled a protest program and with some help from the influential people from outside, we managed to get our college in the recognition list and it gave a sigh of relief to all of us. We continued our college activities like we used to. This time though, theory was blended with lab procedures and demonstrations. Most of times, we were made to assume a few situations and articles which the college lacked. After theory and lab sessions were over, the clinical postings started and we were assigned different units of a hospital (not owned by our institution). The staff of the hospital seemed to be very cooperative and after being rotated to different units on a weekly basis, the practical portion of first year was over. This marked the end of learning activities of my college first year with timely unit tests, followed by a pre-final examination. The next thing to follow, was to test our mettle and hence we went on to appear in the final examination. We managed to qualify and enter second year. Similarly, we passed next year followed by another and all the efforts of our teachers, students and parents paid dividends when we finally completed our bachelor’s degree program.
After I completed my graduation with no state sponsored jobs, I was left with no other option, but to join a private paramedical institute with a salary of Rs 5000/. With terms of 5 lectures/day (each for a period of one hour) to be delivered and salary deduction for every day when, I failed to be present in the institution with no leaves assigned. So, basically I was a daily wager after all. It was tough to be in that position but, with no other options available, I had to accept the only offer I had. Also, if I had to join a post-graduation course, I needed mandatory one year clinical or teaching experience post results. So, no matter how tough it was, I was left with no choice. The experience of job had to end after a certain period since, I had completed my tenure of 1year experience required for a master’s degree program. I took post-graduation admissions somewhere in Maharashtra, which I am on the verge of completion.
WHO decided to designate the year 2020 as “Year of Nurse and midwife” in honour of the 200th birth anniversary of Florence Nightingale (founder of Modern nursing) and If I were asked to describe my experience being a professional Nursing scholar, “baptised with compassion and creativity yet disappointed”, would be my answer.
Few reasons that I believe keep on adding throughout our professional careers, which create a vicious cycle of disappointment later, are highlighted below:
- Shortage of staff: Deficient Manpower leads to unmanageable patient load and disparity in the Nurse: Patient ratio
- Long working hours: Short staffing pattern in a health care unit often results in long working hours and double shifts of staff Nurses. It is evidently affecting the health of the Nurses.
- Workplace violence is widespread in healthcare settings. Although the responsibility is not necessarily of Nurses, yet Nurses are ultimately responsible for patient care environment in their wards.
- In almost all healthcare settings, Nurses are forced to undertake roles which are not of their forte, hence they are left with minimal time to carry out their actual roles and responsibilities
- Lack of Autonomy: In India, a Nurse has limited autonomy and authority. In other countries, Nurses play vital role in decision making.
- Financial Issues: In the private sector, pays are pathetically low and lacks standardization.
- Ethical Issues: Another aspect that has not been highlighted much anywhere is of human rights violation in the form of sexual harassment to them. Lack of work place ethics and lack of respect, with harassment by staff or hospital management by constantly accusing them of dereliction of duty makes it more difficult for them.
- India is the only country, where a Nurse who has worked in the ICU for 20 years is legally not allowed to prescribe a simple painkiller or give an injection without the presence of a doctor.
- Lack of infrastructure and required equipments at institutional levels
- Occupancy of more than one administrative positions by Nursing leaders for monetary benefits, without doing justice to all those positions.
- Nursing job given to non-professional persons based on hospital development funds for lack of budget.
- Personal bias and prejudices between members at institutional levels affecting professional work.
- Unethical Support by Nursing heads to influential owners for the sake of developing personal benefits and rapport for recognition of new Nursing colleges, failing the norms of infrastructure, basic supplies and equipments set by regulatory bodies.
- Lack of awareness among masses regarding the fact that a professional and trained Nurse does know lot more than giving iv infusions and administering injections.
- Approval to various Nursing institutions by Nursing bodies to run various diploma and degree programs in Non-attending mode (where a student only appears in final examination and is awarded the degree certificate).
“It was the British ICU Nurses of the National Health Service hospitals who taught me how to manage a patient in the ICU. Our Nurses could have taught future cardiac surgeons how to manage a patient in the ICU, the same way. Unfortunately, we have reduced them to the level of a pair of hands to give sponge baths”.
Dr Devi Shetty (Padma Bhushan-awarded cardiac surgeon)
Mohammad Owais is a Nursing Research Scholar
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