Creches, 40-hour work week — how Modi govt wants to improve nurses’ working conditions
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Creches, 40-hour work week — how Modi govt wants to improve nurses’ working conditions

Health ministry releases draft guidelines to improve working conditions of nurses, invites comments from public and stakeholders over the next one month.

   
Nurses flashing victory sign on International Nursing Day on 12 May 2021 | ANI

Nurses flashing victory sign on International Nursing Day on 12 May 2021 | ANI

New Delhi: Creches in every healthcare institution, an annual health checkup, fixed 40 hour work weeks with comp offs for additional hours during emergencies — these are some of the provisions in the draft guidelines put together by the Ministry of Health & Family Welfare (MoHFW) for improving working conditions of nurses in all healthcare institutions. 

The ministry has invited comments on it from the public and stakeholders over the course of the next one month before the draft guidelines are finalised.

However, with health being a state subject, even after the guidelines are finalised and notified, the onus will be on states to implement these rules in respective healthcare institutions, officials say.

In its draft, the ministry has cited World Health Organization’s (WHO) Global Strategy on  ‘Human Resources for Health: Workforce 2030’, that calls for upholding “the personal, employment and professional rights of the health workforce, including safe and decent working environments and freedom from all kinds of discrimination, coercion and violence”. 

The draft guidelines also mandate healthcare institutions to provide accommodation to nursing staff either within the hospital premises or within a reasonable distance.

“All nursing staff to be provided with annual health check-ups, necessary immunization and utilization of hospital services within the healthcare establishments where they are employed,” the draft guidelines propose.

They add: “All healthcare establishments to ensure adequate infrastructure and well equipped workstations in all units/wards to enable efficient functioning of nursing staff. All healthcare establishments to have separate washrooms and changing rooms (including providing drinking water, pantry facilities, lockers, clean uniforms etc.) for nursing staff.”

According to the draft guidelines, the onus to provide nurses with personal protective equipment as required, free of cost, will fall on the hospital or clinic employing them.


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High attrition rate among nurses

India has a shortage of nurses. Moreover, the attrition rate among nurses is very high even in big hospitals owing to the availability of opportunities abroad and difficult working conditions in India. The guidelines are aimed at addressing the latter.

India has about 1.7 trained nurses per 1,000 people, against the WHO norm of four.

A senior nursing official employed by a Delhi hospital told ThePrint: “Nurses have a very tough job, they face the frustration of patients and sometimes also the anger of doctors. Shift duty is a given but duty hours can sometimes far exceed set limits. 

“That happens not so much in hospitals like ours but more in smaller establishments in Tier-II and Tier-III cities where they are often also poorly paid.”

According to another senior nursing executive working with a reputed private hospital chain, the hospital witnesses an annual attrition rate of about 40 per cent. 

Many young men and women join nursing colleges with the aspiration of working abroad and join hospitals in India to gather the requisite experience. But difficult working conditions add to the attrition rate. 

Industry estimates suggest India is 3.5 million nurses short.

There are no reliable estimates of exactly how many nurses are currently employed in India but the Nursing Registration Tracking System has updated data of about one million nurses, according to officials in the Indian Nursing Council — a national regulatory body.

This figure of one million, they estimate, is about 65 per cent of the total workforce in the country.

Nursing officials in prominent healthcare establishments say that some of the provisions such as clean and separate toilets, resting rooms and an eight-hour work day exist in many places, but only on paper. 

Protection of nurses 

The draft guidelines mandate that all health establishments should set up an internal complaint committee as per the provisions of ‘Protection of Sexual Harassment at Workplace Act, 2013’. 

“All healthcare establishments should take suitable measures to promote a healthy and safe work environment to prevent mental and physical violence against nurses. All healthcare establishments should take necessary measures to ensure the security of nurses during night shifts. Appropriate measures may be taken to ensure proper lighting in and around work settings to promote the safety of nurses,” the draft guidelines say. 

Necessary measures also need to be taken for the safety of nurses on night shift, including the provision of adequate lights. 

In a section which mandates that healthcare institutions should promote nursing leadership, the draft guidelines lay down that nurses should also have a say in how to treat a patient.

“Nurses may be given a fair opportunity to actively participate in the triaging of patients in emergencies and counselling of patients in wards so that they can become part of the decision making process for treatment of patients. They should be provided optimum say in decisions related to the nurses,” reads the section.

(Edited by Amrtansh Arora)


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