India’s beauty is in its cultural diversity. Today is RakshaBandhan, a day when brothers promise to support their sisters. The Twitter handle of the President handle states that “President Kovind celebrated RakshaBandhan with nurses of The Trained Nurses’ Association of India, Military Nursing Service and nurses of the President’s Estate Clinic. The President appreciated the role of nurses as saviours in the fight against COVID-19.”
Yes, it is indeed nice to see these symbolic gestures from the honorable President, nice of him to consider them for such honor.
Is the honorable President ready to listen to the problems of nurses and take any initiatives and efforts from his office to support and strengthen this profession? I would like to highlight the issues of these sisters to him. This article is not to criticize the act of the President but to present to him, our status and the grave problems we face in providing nursing care in the hospitals.
Strengthening the Nursing Governance: There were attempts to establish nursing directorate in all the states, but only few states have set them up, and almost all the posts are occupied by the non-nursing personnel. Within the Ministry of Health and Family Welfare, there is not even a singleto represent the nursing profession -the Nursing Directorate post is occupied by a non professional. We requestMr President to take steps to ensure nurses’ involvement and participation in nursing governance, as per the high power committee recommendations.
Stop Privatisation of Nursing Education in India: This table depicts the status of nursing education in India. Unfortunately, majority of them are in private sector (only 1, 3, 7, 14 percentage of M.Sc, B.Sc, GNM and ANM colleges respectively are government institutions) (Nursing and Midwifery in India: A critical Review, National Institute of Health and Family Welfare In collaboration with WHO, 2012).
Source: Snapshots, Indian Nursing Council, 2014
The existing government nursing institutions do not have sanctioned teacher post and some buildings are in the unbelievably dilapidated conditions. Many institutions are running non attending classes and have made this as their core business. We request you to take steps to restore the standard of education standards and save the future of health care.
Dignity of work to nurses working at Private Hospital: As per the Supreme Court directions a committee was formed in 2014 by MoHFW, which recommended that salary given to nurses in private hospitals should not be paid less than Rs 20,000 even in less than 50 bedded hospitals, and in hospitals with more than 200 beds they should be paid the same salary as in corresponding state government hospitals. It also recommended that the working conditions of nurses in private hospitals including working hours, leave, medical care, transportations etc should be at par with those in state government hospitals. Till date no state has implemented this recommendation. Instead private hospitals owners, through organizations like AHPI (Association of Healthcare Providers of India), have filed a case to stall the implementation of the orders to this effect passed in states like Kerala and Delhi. We request you to call for a review for the implementation of this committee recommendations and reassure the basic minimum standards of work to these sisters.
Stop Contractualisation in Public Health institutions: Last week 700 nurses at AIIMS, Patna protested demanding sufficient PPE and equal wages for equal work . These nurses were recruited through a third party – Bedi and Bedi Company. There are many nurses in the federal government hospitals that are recruited on direct contract basis, doing same work as other permanent staff but not getting equal pay and benefits and living with a fear of loss of job. This is the same situation for all the nurses who are working under National Rural Health Mission and many more hospitals in each and every state. This is a step towards bonded labor system where workers are left without any rights. We request you to intervene in this matter and come out with a direction to not recruit any health workers on contract basis.
Stop workplace violence: Majority of the health workers are females and their number is very less at the top of the pyramid of administration and governances. While many laws and committees have recommended setting up of committees to address workplace violence very few hospitals have a structured committee and routine interventions to make the workplace safe from violence. We request you to take an initiative to check the status of committees (Vishakha) in all the hospitals and their status.
Career pathways and skill recognition: Nurses provide round the clock services for years at one specialty or department. Those medical students who practiced and studied from them become Directors and Specialists. But these nurses who gained the skills over the years of practice and knowledge are not even given permission to practice. We request you to look at the skills performed by these nurses and form a commiitte to create a skill based career pathways.
Mr President, I thank you again for giving us an opportunity to tie Rakhi to you at your residence. I hope you will look into our problems and take steps to improve our remuneration and other employment conditions.
He is a clinical nurse and did his doctoral study on the policy issues of human resource for health. Since a decade, he has engaged himself in building a team of nurses to address large public health issues, rights around the professional and working conditions of nurses. He attended 146th Executive Board Meeting of WHO at Geneva as a fellow of Medico Mundis International.