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June 15, 2006
Better salaries needed
“I was nineteen when I joined the nursing profession. The primary reason of opting for this job was poverty, but with the passage of time taking care of patients has become a source of contentment and pleasure for me. Although the profession does not pay well and I have to financially support my eight-member family in Faisalabad with the small amount I earn, serving humanity has become my religion,” says Nagina, senior nurse at a public sector hospital in Lahore.
She has chosen to stay single for she thinks that marriage might affect the commitment and dedication she has with her profession. According to her, 40 per cent of nurses do not marry for a number of reasons. “A few share my reasons. Others do not find a person of their choice. Since the nursing profession is not considered very prestigious in our society it is always difficult to find a suitable match.”
Shanaz, working in a private hospital, does not agree with Nagina’s opinion that marriage affects a nurse’s commitment. “Lady doctors and other working women also get married, does their work affect their domestic life?” she inquires. “It is always the case of not finding a suitable match and other domestic issues that leaves a good number of nurses unmarried.”
Marriage, however, is not the only serious problem confronted by the nursing community. There are a number of issues which the nurses have to cope with on a daily basis. The most basic grievance of nurses is the meagre amount of pay structure offered to them from both public and private sector hospitals. The private sector pays almost half the amount that the public sector pays mainly because most of the nurses do not find a job in the latter and can’t wait for long and thus have to turn to the former. The private sector then exploits the situation.
The nurses also complain about the heavy workload they have to bear regularly. The number of patients attended by the nurses in Pakistan is much more than the internationally-followed patient-nurse ratio. According to international standards three nurses are required to attend 10 general beds in three eight-hour shifts in one day, while another nurse is supposed to act as a reliever if anyone of those on duty takes leave. But here each nurse is supposed to take care of 25 to 30 beds.
“We are bound to do a 12-hour night duty for one month at least on a rotation basis, which becomes very difficult for us. In ICU and CCU, ideally, there should be one nurse for one bed for a six-hour duty but a nurse ends up attending three beds,” says a nurse who wished to remain anonymous.
The strength of nurses in hospitals is quite low compared to the growing number of patients. According to an estimate, each nurse is serving 25 patients in the country. “The patient-nurse ratio has become ‘unrealistic’ here because the patient load has increased manifold in hospitals due to the population explosion,” she adds. The government has not created enough jobs for nurses to meet the patient load.
The autonomous hospitals’ management recruit nurses on contract. Some nurses serving on contract usually leave the job when they get a better opportunity abroad. A large number of nurses leave for the Middle East on a good salary package annually. “The government must provide better facilities and working conditions to nurses otherwise this trend will increase,” a head nurse opines.
Speaking on the loopholes in the recruitment policy of nurses, she points out that some 250 sanctioned posts of nurses are lying vacant in hospitals across Punjab. Considering the significance of the role of nurses in providing proper treatment to patients, she stresses that the government must upgrade the profession by offering better grades and salaries under the Health Sector Reforms Programme.
“Though the government has given BPS-16 to the nurses who were previously holding BPS-14 and the head nurses’ grade to BPS-17, there is still lot more to be done to improve their condition.”
Many nurses are under the impression that more and more girls are joining the profession but the Economic Survey of Pakistan 2005-06 shows the picture to be otherwise. There is ‘one nurse for 4,636 people’ as compared to ‘one for 3,175’ figure shown previously by the Economic Survey. As many as 33,427 nurses are registered with the Pakistan Medical and Dental Council (PMDC).
The government reportedly is revising the curricula of nursing. It has recently introduced BSc Nursing with a view that it will produce a better staff. The University of Health Sciences (Lahore) is establishing a Higher Nursing Institute with the financial assistance of the Higher Education Commission. UHS board of governors chairman Prof Mahmood Ahmed says that under the project the university will hire foreign nurses for the training of students so that they perform well in theatres as well as in patient care.
“Higher education is necessary to keep the nurses abreast of the latest developments in research and technology,” Prof Ahmed adds that the nursing curricula should be revised on a regular basis keeping in view the changes taking place in the field of medicine.
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