Pain of the Nursing graduates in current Nepal: Ms. Rameshwori Shrestha

The nursing profession has seen much change during my lifetime. I admit we needed to work much harder in an underdeveloped healthcare setting. With the changing time, the work that kept us very busy back in those days does not need our time at all in the current days. The olden day jobs of preparing Plaster of Paris bandage and sterilizing the glass syringes have become an errand of the past. But at the same time, new responsibilities have emerged. Nurses around the world are getting more and more patient centric and are even working independently in different areas after acquiring different kinds of specializations.

However, what is worrying in the land of ours is the massive exodus of the nursing graduates in search of a better future. Well you might say why is it a big thing? Especially when Nepali people are living the nation by hundreds on a daily basis (1400/day in 2018/19). I believe that the nursing graduates leaving for foreign land is the reason why we have not been seeing many changes in the field of Nursing. Despite having excelled in academic activities to the level of providing PhD degrees in Nursing Sciences within the nation itself, our roles have not evolved much in similar terms. The nursing graduates who could be a beacon of change in the profession are currently showing not much interest in the state of affairs of Nursing in Nepal. The ones who land on different jobs and start working get so much busy in their work they forget to work for their rights. Nepal recently made it mandatory that every educational institution should employ nurses. This has created lots of jobs for the certificate level nurses. Likewise it is about time to devise laws, so that our graduates are retained within the nation itself. 

The latest trend in Nursing is that most of our graduates, once they get their bachelor degree, sit down to prepare for nursing license examinations for working abroad. 'You ask why? Because our hospitals still largely employ Certificate level nurses and the number of Nursing graduates absorbed in the workforce is minimal.'

Some graduates, who do not feel like going abroad, even get into positions originally meant for certificate nursing. As a matter of fact vacancy opening for B Sc. nursing graduates is almost non-existent. Certainly, the hospitals are benefitting in that they can pay less for an educated professional and still get expertise of our graduates. But then that is exactly how the professional development halts, isn't it? She admits, 'I certainly witnessed many good changes in the healthcare system, but what I simply cannot digest is that while doctors started excelling in different fields and providing different services, we are yet to identify nursing specialists and get them working in the field thereby providing better patient care services.' Yes even now very few nursing specialists have landed on jobs they wanted, but still most of them have not got the recognition or a similar pay raise for being specialists in their field. This is really disheartening.

Probably the institutes providing BSc Nursing education should take the lead in hiring the graduates, thereby paving the way for assimilating them into their proper positions. The Nursing Council should also go for routine inspections of hospitals to check if the current protocols on the number of nurses employed is being met in the first phase. Side by side they also need to work for creating new positions for the nursing graduates. The government should then start opening vacancies specially meant for graduate nurses. Only then we can expect the private hospitals to follow the suit. Well even the private hospitals can take a lead and advertise that they provide improved nursing services via specialist nurses and graduates, but truly speaking the chances are very slim. Actually, we are used to the trends of hospitals making brand advertisements by hiring specialist doctors. Will the hospitals start marketing saying that they provide nursing services through specialist nurses in their respective fields? We need to wait and watch.

Some Genuine Questions

She asked some genuine questions, 'If you needed a cardiac surgery you certainly would not let an intern or a medical officer do it, would you? You would look for specialists, let alone the specialists, you would look for the top specialists in the field.' Her question continues, 'How many of you are aware of the specialists in nursing profession? Would they give better services? Definitely, but when are they to get a chance? When is the general public to get improved Nursing services from specialists nurses?' 

With a satisfied cheerful smile on her face, she said, “My lifetime I did the donkey work thinking of the patients. Would all others do the same?” 'When are we going to give credit to the Nursing professionals? Why would they toil so hard, if they cannot get credit for their contribution? Someone may argue you got into a wrong profession so you don't get to enjoy name and fame. Well you can't run a hospital without the nurses can you? Healthcare is increasingly getting more and more complex and under such situation the healthcare system should be more inclusive to bring in experts from different fields not repel the experts we already have working by our side.’'

'I would like to ingrain it into the new generation that it's about time we realize every job is important and that we should respect every profession. The new generation is demanding equal rights for women, soon there will be nurses demanding equal rights.' Are we as a society ready for change, it is about time to accept the change as “Change is the only thing that remains constant.” 





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