KARACHI: Nurses most oppressed group in health sector
By Nizamuddin Siddiqui
KARACHI, Feb 6: In the country’s health-care sector, particularly the state-owned part of it, nurses are the most oppressed group of people. The authorities pay them meagre salaries and the doctors take them for granted.
The education and training imparted to them can only be described as “inadequate”. And every nurse is supposed to look after an atrocious number of patients.
The Pakistani nurses’ situation is so bad that girls from the middle class families generally don’t aspire to become nurses even though nursing is universally considered to be a noble profession. And the few from the lower or lower middle classes who do become nurses, often due to an unfortunate turn of events, migrate to the western countries as soon as they get a chance to do so.
It’s not that the doctors don’t know of the nurses’ problems. They do. They realize also that until and unless they start getting a regular supply of good nurses, in adequate numbers, health care services simply cannot be improved. However, meaningful and effective work still remains to be undertaken in this area on a big enough scale.
The medical superintendent of the Civil Hospital Karachi, Prof Noshad Shaikh, said recently to Dawn: “Our nurses are not paid well. This is why we have a shortage of nurses in the country.
“Most good nurses prefer to go abroad. Many have immigrated to England and the US.”
The Pakistan Medical Association also seems concerned about the issue. Its secretary general, Dr Shershah Syed, in an open letter to the newly elected members of the national and provincial assemblies, has pointed out that for every nurse we have as many as eight doctors.
“This is despite the recommendations of the international agencies that say for every doctor there should be 15 nurses.” The PMA’s letter also said the country badly needed proper training programmes for midwives and nurses.
A senior nurse told Dawn on Thursday that nurses were required to do all kinds of work at their hospitals. “Look, we are supposed to have parchi clerks, money collectors and wardmasters who are supposed to help and aid us in carrying out our work properly.
“But where are these people?” she asked. Their absence affects the nurses’ work directly because it’s they who are forced to carry out the absent people’s work. Enquiries made by Dawn revealed that most of the absent people were usually detailed to offices of a government hospital’s many AMSs.
She said about 20 years ago no professor could start his or her round of the wards without the chief nurse’s permission. “But now the roles have been reversed.
“Now everything is managed by the RMOs and professors themselves. They run the show and nurses have been reduced to the position of mere onlookers and bystanders.”
The education and training imparted to the nurses is of a poor quality. The situation is so bad that every year only about 20 per cent of the students educated in the state-owned nursing schools manage to pass the examinations given by the Sindh Nursing Examination Board, Karachi.
In contrast, more than 80 per cent of the students belonging to private nursing schools pass the same, or similar examinations, every year.
Until recently the starting salary for staff nurses of government hospitals was only Rs3,500. This has now been increased to Rs5,110 per month.
“This looks adequate and I admit that this is a vast improvement on the previous salary,” said the president of the Pakistan Nurses Federation on Thursday. “However, look at the prices of the essential products.
“The new, increased salary is inadequate when you take into the account the needs of every citizen,” said Ilmiya Mughal.
She said many nurses were working both in the government hospitals and private hospitals. “Sometimes these ladies work one shift in one hospital and the next one in another hospital.
“This obviously affects their work. And obviously it’s the state hospital which gets affected more.”
Ms Mughal told Dawn that surprisingly the nurses’ salaries in the private hospitals were lower as compared to the government ones. “Only a few private hospitals pay Rs7,000 or more, but most private hospitals pay less than Rs5,000.”
Meanwhile, a very controversial issue with regards to the nurses’ image is the treatment meted out to them by doctors and other hospital staff. Three medical superintendents, belonging to state-owned hospitals, admitted that harassment cases were common.
“Hardly a month goes by when at least one case is not brought to my attention,” said one MS. He claimed that his hospital never tried to brush the issue aside and under the carpet.
The PMA’s secretary general expressed similar sentiments. “Our association has never supported any doctor who was reported to have indulged in such behaviour,” said Dr Shershah.
One nurse, however, said senior doctors and senior officials were not sincere in stamping out the menace. “They take the nurses for granted, as a lowly species which has no rights. What they don’t realize is that until this issue is resolved satisfactorily, we will not get girls from respectable families.”
Another nurse said most girls entering the profession were from very poor families. They were not in a position to raise a strong voice against injustices.
“This menace can be checked if we raise voices against it consistently. But what you people don’t realize is that most of us are hardly in a position to do much.”
The president of the Pakistan Nurses Federation claimed that harassment was no longer a big issue. “There has been a change in the trend.
“Now most of the staff nurses are married women. The problem has been contained,” claimed Ms Mughal.
