Nurses are a key part of healthcare delivery; they are true frontline caregivers and healers. However, there is a huge gap in supply and demand for nurses in India. As per industry data, there are over 3 million registered nurses in India that are responsible for the country's 1.3 billion population, which is grossly inadequate. As per WHO norms, there should be 3 nurses per 1000 population. This means India needs to add more than 4.3 million nurses by 2024. The optimum nurse-patient ratio recommended by the Government of India and the Indian Nursing Council (INC) is yet to be implemented with one nurse bound to look after 20 to 30 patients in the current scenario.
On International Nurses Day, Saino Thomas, the Group Chief Nursing Officer at American Oncology Institute, CTSI- South Asia, highlighted the challenges facing India in filling gap in supply and demand for nurses, as well as solutions to overcome these challenges.
Reasons for shortage of nurses in India
Challenges in nursing have existed since the beginning and continue to evolve with modern-day staff shortages. At present, nursing is a varied and vast field, with advanced degree programs that will help expand their offerings and equip them with modern-day nursing needs. However, a lack of quality education creates a hindrance to career progression. Other challenges like poor remunerations, growing workload, low social status, and limited career opportunities often lead the nurses to explore opportunities outside the country or outside the profession, thus creating a gap in the availability of skilled nurses.
The movement of nurses across the states for career opportunities is also impeded due to the time taken and the cumbersome process for a nurse to register and migrate from one state to another within the country.
Solutions to overcome these challenges
To bridge the industry-academia gap and improve UG students' readiness for practice, there is a need to match the Nurse competency framework for B.Sc. Nursing, to current hospital practices. Accreditation of nursing colleges will further help to ensure quality nursing education and improve the employability of students graduating from accredited institutions.
There is also a need for up-gradation in undergraduate nursing curricula. The current curricula should be revised to create a competency framework that matches current hospital practices. To ensure practical knowledge, an internship for B.Sc. Nursing students to be mandatory with assigned weightage in exams. Training in soft skills with AETCOM (Attitude Ethics and Communication) modules 2-3 common languages is equally significant to ensure quality care and addressing language barriers.
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Private and corporate hospitals should open internships for UG nursing students to acquaint them with hospital setup and standards to help bridge the industry-academia skills gap. This will also help address issues faced by nursing colleges like limited infrastructure and shortage of teachers. Hospitals must also create career paths for specialized roles and showcase millennial nurses' lateral career opportunities (like nursing specialties, nursing management, or roles in accreditation bodies like NABH). Hospital administrators must include and empower nurses at the leadership level on hospital board and all levels of management. It is also imperative for the hospitals to involve nurses early on, in the design of facilities and the development of protocols.
The way hospitals plan to hire specialist doctors while a new specialty wing is planned, specialty nurses' hiring plan should be in place as well; which can be a part of the checklist of hospital accreditation bodies like NABH.
Taking a cue from the rising demand for home healthcare, nurses need to be given on-job training for home healthcare and specialized short-term courses should be developed to effectively cater to this demand. Introduction to patient-centred care, evidence-based practice, quality improvement, and use of IT in clinical practice (e.g. basics of HIS, EHR and Robotics) to accustom students to systems early lessons on patient expectations and awareness programs on available career paths. New roles like telemedicine Nurses, IT Nurses, Quality Nurses, IV Nurses, and Specialty Nurses should be given different weightage on their competencies.
Celebrated every year on May 12, International Nurses Day marks the birth anniversary of Florence Nightingale, who is hailed as the founder of modern nursing. The theme for International Nurses Day 2022 is "A Voice to Lead Invest in Nursing and respect rights to secure global health."