Draft for Comments/Suggestions on Draft guidelines for governing working conditions of all categories of nurses in healthcare establishments/units/institutions.
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Section I: Workplace Facilities & Safety
- Office of the Chief Nursing Officer/Nursing Superintendent/DNS (In-position or Officiating) should be established in the administration block of the hospital with all facilities equivalent to Group A officers or Head of Department. Office of the Chief Nursing Officer/Nursing Superintendent/DNS (In-position or Officiating) should have attached toilet facilities.
- The nursing profession is known for its discipline and integrity, discipline is shown by the uniformity of dress code throughout India in all hospitals/health care institutions. Hence, changing rooms should be designated for male and female Nursing Officers with locker facilities and attached toilets.
- There should be a provision of a Nursing Officers lounge in every ward/department as Nursing Officers perform their duties round the clock (24×7). Hence, there should be a designated place for refreshment if required during duty hours.
- Every ward/department has an Assistant Nursing Superintendent for management of ward, so there should be a designated duty room for ANS in every ward with facilities equivalent to Group A officers.
- In every hospital, there should be a designated Nursing Officers common room cum classroom, where ANS/Senior Nursing Officer can guide / educate junior / subordinate staff for smooth functioning of Nursing services in the institutions.
- Creche facility must be provided all categories of nurses in all healthcare establishments/units/institutions.
- There should be provision of separate housekeeping department in every health care setting to look after the Civil faults so that nursing I/C of the unit will not be burdened with non-nursing responsibilities.
- All psychiatric health care organization should provide a good proportion of co-workers with nursing personnel so that a safe and efficient working environment can be created among mentally unstable and violent patients.
- All health care settings/organizations should give provisions of special leave to nurses / co-workers in case of any serious injuries or health hazards causes by patient’s violence and aggression.
- There should be a provision of immediate compensatory appointment to their family members in case of death of any nursing personnel caused by patients’ violence.
- Doctors should be stayed away from the part of the Internal complaint committees set up in the organizations due to their bias nature against Nurses.
- Nurses should not be victimized/harassed for moving animals like Cats/Dogs in wards/departments as seen already in various ESIC Hospitals.
Section II: Working hours & Staffing
- Monthly working hours should be specified along with 40 hours per week.
- Uniform working hours should be ensured along with the safety of female Nurses in healthcare establishments/units/institutions across the country. Not more than 6 Night Duties should be assigned to Nurses in a month. Resting time should be prescribed in continue 12 hours shift i.e. Night Shift. Duty timings for Nursing Officers, performing shift duties should be a standard and specified as following: –
CNO/NS/DNS/ANS: – 9.00am to 4.00Pm
Senior Nursing Officer/Nursing Officer:
Morning Shift: – 8.00am to 2.00pm
Evening Shift: – 2.00pm to 8.00pm
Night Shift: – 8.00pm to 8.00am
- Compensatory off should be given to all Nursing Officers in leu to their duties proportionally beyond the prescribed workings hours or working any Public holidays. 04. All Public holidays/Closed holidays must be granted to all categories of nurses in all healthcare establishments/units/institutions similar to all Central Government Officers and Employees.
- Night Off should be provided to all nurses performing shift duties beyond their regular 8 day off in a month.
- There should be a relaxation in performing Night Duties to the Senior colleagues beyond the service of 10 years. Not more than 3 Night duties in a month should be assigned to senior Nurses.
- Staff Inspection Unit (SIU) Norms for Nurses must be revised immediately as per current workload of patients in Hospitals and dispensaries. SIU Norms should also be applied for each shift separately and staff strength should be sanctioned accordingly to provide quality care nursing to the patients.
- Standard Nurse Patient ratio should be maintained in all healthcare establishments/units/institutions to provide quality care services to the patients
Section III: Promoting Nursing Leadership
- Separate Nursing Section should be set up in all healthcare establishments/units/institutions/Departments to deal the matters pertaining to Nurses and policy decisions.
- Separate Nursing Directorate should be set up in all State Governments to deal the matters pertaining to Nurses and policy decisions.
- DNS/ANS/Nursing Officers should be assigned as reporting authority for the Paramedical staff where Nursing Officers are made responsible for anything in their absence in departments of hospitals like Operation Theatres, MICU and many more etc. It will definitely improve the smooth functioning of the hospital and better health care services to the patients.
- Nurses in senior positions like Senior Nursing Officers, ANS, DNS, NS, CNO must have training in management and administration immediately before promotions.
- Representatives of Nurses Associations/Federations must be a member of all deliberation/discussions pertaining to any policy decision in r/o Nurses of the Hospital/Institutions.
Section IV: Miscellaneous
- International/National level/ Inter-Ministerial/Inter-Departmental Nursing conferences/workshops should be sponsored from the respective departments to promote the professionalism, leadership, communication and managerial skills of all categories of eligible nurses in all healthcare establishments/units/institutions.
- Dynamic Assured Career Progression (DACP) Scheme should be introduced in Nursing Cadre similar to Doctors cadre.
- Enhancement of Entry pay on Nurses was a main demand of AIGNF which should be considered immediately.
- Non-Practice Allowance should be provided to all nurses similarly to Doctors.
- Risk Allowance should be provided to all Nurses working in Hospitals/Dispensaries in all healthcare establishments/units/institutions across the country.
- Uniform Pay allowances should be granted to all Nurses working in Central, Autonomous, State and private Hospitals.
- Mandatory 3 spells of 30 Days Child Care Leave should be provided to all Female Nurses in Central, Autonomous, State and private Hospitals.
- Qualification pay should be granted to all B. Sc. (Hons.)/B. Sc./Post Basic B. Sc./Post Certificate B. Sc. In Nursing and Post Graduate Degree in Nursing i.e., M. Sc. (Nursing) nurses in all healthcare establishments/units/institutions.
- Uniform Nomenclature should be provided to all categories of nurses in all healthcare establishments/units/institutions
- Uniform Dress code should be introduced to all categories of nurses in all healthcare establishments/units/institutions
- Uniform policy for grant of study leave/education leave at least deputing 5-10% of In-Position strength should be formulated for all categories of nurses in all healthcare establishments/units/institutions
- Nurses should be deployed as per their job responsibilities. Nurses should not be utilized as Multi-Purpose health workers i.e. posting in Non-Nursing areas e.g. Laboratory, pathology, administration, pharmacy, reception etc.
- Outsourcing for all categories of nurses in all healthcare establishments/units/institutions must be stopped.
- All posts of nurses in all healthcare establishments/units/institutions should be filled through regular recruitment in time.
- Continue Nursing Cell (CNE) must be established for all categories of nurses in all healthcare establishments/units/institutions with separate budgetary provisions.
- Uniform and revised job descriptions/Job responsibilities for all categories of Nurses should be prepared by the M/o H & FW and circulated for its compliance.
- All Existing Guidelines/Instructions/Office Memorandums issued from M/o H & FW pertaining to pay and allowances and working hours should be recirculated with new dates and marked to all Ministries, all Chief Secretaries of the State Governments and UTs for its implementations.
- All Instructions issued from M/o H & FW should be marked to all Ministries, all Chief Secretaries of the State Governments and UTs for its implementation.
- Policies for breakage and losses should be developed and nurses should not be made responsible for breakage and losses.
- Scheme of special incentives in terms of awards, and special increments for meritorious work for nurses working in each Organization/Department/state/district/PHC to be worked out.
- As far as possible, Nurses should be considered for priority allotment of accommodation near to workplace.
- The move to restrict male nurses by introducing 80:20 reservations in hospitals like AIIMS and JIMPER as autonomous institutions under the central government and the move to impose unannounced restrictions on organizational activities should be abandoned.
- The Central Government should appoint a High-Power committee comprising retired High Court judges to study the various problems faced by nurses at the Central and state Hospitals and issue strict directions to implement the recommendations made at all levels.
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