Coronavirus disease (COVID-19) outbreak has imposed a severe toll on the health care delivery system of India and across the globe. Health workers, especially nurses are in the frontline of this pandemic and are working round the clock to meet the increasing health care needs of the society. Most of them are staying away from their homes; due to the fear of transmitting infections to their family members and neighbourhood. Despite these efforts and sacrifices, they are facing discrimination and inequality from their workplaces and society. The majority of them have serious health problems due to the long working hours, stress, and continuous use of personal protective equipment. As a result of the impending needs brought by the COVID-19 pandemic, many hospitals have increased the working time of nurses from 6 to 8 hours. Acute shortage of caregivers in the country, and insufficient personal protective equipment (PPE), often demands the nursing fraternity to work for uninterrupted extra hours in a day without enough breathing time in between the shifts. Extended use of PPE (which is airtight) during the entire working hours has resulted in profuse sweating, dehydration, weight loss, fatigue, giddiness, blurred vision, nausea, vomiting, urinary tract infections, menstrual health problems and skin injuries in nurses.
Nursing staffs in many hospitals across India have shown their disagreement in donning PPE for more than 4 hours. A group of Delhi State Hospital’s Nurse’s Union has already submitted a written letter to the Ministry of Health and Family Welfare requesting to reduce their duty timing. Jeemol Shaji, the general secretary of Delhi State Hospitals Nurses’ Union said – “We strongly oppose the 12-hour duty since this affects physical and psychological health of the health care providers. Staffs’ in All India Institute of Medical Sciences (AIIMS) has also raised their voices demanding a 4-hour working schedule donning the PPE kits. AIIMS Nurse’s union president Harish Kajla said-“Due to the 6 to 8 hours shift wearing the PPE kit, nurses are sweating extensively, many of them have fainted, vomited and have lost their body weight. He also added, since the PPE is airtight, they can’t even eat, drink or go to the washroom and female nurses are unable to meet their menstrual needs. A nurse working in the AIIMS trauma center said- “Almost four staff fainted due to severe dehydration in her duty time”. Many of them have reported multiple times, regarding their concerns to their superiors, but no action supporting nurses has been taken so far by the administration.
What measures can be adopted to address the health issues of the nurses?
- Good quality and adequate PPE’s should be made available to all nurses.
- Working hours in the hospital should be shortened, in order to minimize the health – effects due to donning of PPE. Alternative approaches to promote wellness of nurses, such as 4 working days in a week followed by 3 days off, may offer enough rest to the nurses and help them to cope with the physical and mental stress.
- Rotation of the staff from non-COVID wards to COVID wards must be initiated, to increase nurses’ the efficiency and emotional health. At the same time screening nurses should be facilitated to prevent exposure to non –COVID cases.
- Provide employer -friendly environment to ensure good physical and mental health.
- Warm-up sessions and online counseling services must be in place for the psychological well-being of nurses.
- Separate cafeteria’s / refreshment facilities, which provide nutritious meals or beverages, should be made available within the units, to boost up the nurses’ energy level.
- Monetary incentives in the form of salary hikes, verbal appreciations and insurance services are essential to increase the motivation of nurses’ especially working in COVID-19 setting.
- A clear and concise policy for recruitment and retention should be there in an organization to enhance better support and care thereby, decreasing the nurses’ workload.
- Equal task distribution among all the health care staff is essential to reduce unnecessary work pressure.
Nurses are the backbone of every health system. They are unsung heroes who risk their lives to save the lives of their fellow beings. On International Nurses’ day 2020, WHO has urged nations world wide to invest more in nurses’. Let us show our dignity and gratitude towards them by providing a safe and healthy working environment.
The issues mentioned in the blog have been referred to the following newspaper clippings and online magazine.