COVID-19 and lessons on nursing

COVID-19 brought into focus the key role played by nurses in our healthcare system as well as the step motherly treatment meted out to over 16 lakh nurses working in India. Within weeks of the onset of the pandemic we christened them “corona virus warriors”, clanked plates, lit candles and showered flowers from the sky in solidarity with them. But the pandemic brought untold miseries to corona virus warriors, especially nurses.

All over the world, nurses and the paramedical staff are the first to come in contact with the patients when they reach a hospital. In the beginning nurses, especially women nurses who were pregnant, panicked and wanted to return to their native places. With the cancellation of international flights and the sudden imposition of lockdown without adequate notice in India, these nurses were stranded without proper accommodation, food or medicines for weeks on end.

The lives of nurses working in the Middle East and the India cities of Delhi, Mumbai, Kolkatta and Chennai were very badly affected following the onset of the pandemic. To start with, nurses were initially not even provided with personnel protection equipment (PPE). At many places they were forced to strike work to get authorities to provide them with basic safety medical equipment.

In Mumbai, nurses who tended to corona virus infected patients were quarantined in an abandoned building under unhygienic conditions. In Kerala, which became a model for the rest of the world in controlling the spread of the virus, landlords went to the extent of asking nurses working in dedicated corona wards at Kottayam Medical College to vacate their accommodation.

Unable to work under unbearable conditions, in the absence of PPE kits, accommodation, food and medical care, more than 300 nurses resigned from various hospitals in Kolkata in April and May this year. They did not want to risk their lives for a monthly salary of Rs.10,000, which was what a majority of them were earning after working for more than three years.

In other words, hundreds of nurses chose to give up their jobs and return to their homes in rural India than work for a pittance in private hospitals in the cities and expose themselves to the virus. The crisis on the nursing front demands careful study and remedial action.

In spite of the important role played by nurses in the health care system, nursing has not been recognised as a profession. Since healthcare is dominated by the private sector, most nurses work in private hospitals where they are treated much like bonded labour. Some hospital managements take into their possession the original certificates of the nurses at the time of appointment.

The nurse-patient ratio is severely weighed against the nurses and their duty hours stretch up to 14 hours a day. The salaries of nurses in the private sector range from Rs.3000 to a maximum of Rs.15,000. The private sector in the country is unmindful of the 2018 Supreme Court directive that nurses be paid a minimum monthly salary of Rs.20,000.

Even though they value the services of nurses, for some strange reason Indians tend to turn a blind eye to nurses when it comes to their upkeep and prestige. How else can one explain the Indian Army’s decision a few years ago to change the colour of the nurse’s uniform from olive green to the unattractive beige. This and other serious issues of discrimination against the nurses are under the consideration of the Supreme Court.

To make matters worse, even the Union government is lately violating all norms with regard to recruitment, salaries and other facilities for nurses. The National Rural Health Mission has been appointing nurses on contract on salaries ranging between Rs.5,000 and Rs.15,000, which is far lower than the starting salary of a government nurse.

Similarly, the Delhi government has been appointing nurses on contract against permanent vacancies on very low salaries. In July, the Delhi government terminated the services of scores of nurses on the ground that the credentials of the private recruiting agency it engaged is questionable! The nature of the “crime” of the aggrieved nurses remain a mystery.