Explained: As COVID-19 fight rages, how short is the world of nurses?

As healthcare workers lead the fight against the coronavirus pandemic gripping the world, their working conditions have been under greater scrutiny.

Within the healthcare sector, nurses play a critical role. They comprise the largest component of health professionals, at over 59 per cent — or 27.9 million in absolute numbers — underling that their role, especially during the current health crisis, is paramount.

On Tuesday, the WHO, along with the International Council of Nurses (ICN) and the Nursing Now campaign, released a report titled, “State of the World’s Nursing”. This highlights that work nurses do is critical in fulfilling national and global targets related to universal health care, mental health, noncommunicable diseases, emergency preparedness and response, among others such goals.

Areas of concern

Globally, there are roughly 36.9 nurses per 10,000 people, with variations within and across regions. For instance, there are almost 10 times more nurses in the Americas than in the African region. While there are 83.4 nurses per 10,000 population in the former, there are 8.7 nurses per 10,000 population in the latter.

The report estimates that by 2030, there will be a shortage of over 5.7 million nurses worldwide.

Amid the coronavirus crisis, England’s National Health Service (NHS) called on nurses who had left previously to re-register and help them tackle the outbreak.

The report also notes that the largest shortfall in absolute numbers is in the South-East Asian region, while in the Americas and Europe, the problem is different since they are facing an ageing nursing workforce. Moreover, a number of high-income countries in Europe, the Eastern Mediterranean and American regions are “exclusively” dependent on migrant nurses.

In order to address these problems, the suggestion is for governments to invest in nursing education, jobs and leadership. Some of these measures include remunerating nurses according to the prevalent local, national and international labour market conditions.

In the past few years, nurses in India have often demanded minimum wages. For instance, in November 2018, nurses at the Batra Hospital and Medical Research Centre in Delhi went on a strike, alleging they had been forced to work extra hours but were not paid accordingly.

In July 2019, the Delhi High Court upheld the Supreme Court’s directions regarding setting the minimum wages for nurses working in the capital’s private hospitals to Rs 20,000.

Similarly, The Indian Express reported in July 2017 about nurses from Kerala’s private hospitals launching an agitation for minimum wages as recommended by an SC committee.

How do nurses contribute to patient safety?

Overall, nurses are important in ensuring the quality of care delivered to a patient, preventing and controlling infections and combating antimicrobial resistance, the WHO says.

According to the ICN, over 28,000 nurses went to Hubei province in China to help tackle the outbreak. These included over half of China’s intensive care nurses (5,500). ICN maintains that nurses’ efforts have helped in the recovery of more than 44,000 COVID-19 patients so far, which is about half of the total reported infected people in China.

“In outbreaks such as COVID-19 where hand hygiene, physical distancing and surface disinfection are central to containment, the infection prevention and control role of nurses is crucial,” the report mentions.

As nurses and other medical workers are at the frontlines of this global pandemic, some of the key issues they face include shortages of personal protective equipment (PPE) including face masks, eye-protective gear and gloves, and also the psychological stress faced by some medical staff.

A study published in the peer-reviewed journal JAMA pointed out that in a study of about 1,257 health workers in China, a “considerable proportion” reported feeling symptoms of anxiety, depression, and distress. (Here’s our explainer on that).

State of Nursing in India

As of 2018, there were over 1.56 million nurses in India and 772,575 nursing associates. Out of this, the share of professional nurses is 67 per cent, with 322,827 graduating every year with a minimum training period of four years.
Within the health workforce, nurses comprise 47 per cent of the medical staff, followed by doctors (23.3 per cent), dentists (5.5 per cent) and pharmacists (24.1 per cent).

Further, an overwhelming majority of the nurses are women — 88 per cent in India. This is in line with the composition of nursing seen globally as well, where 90 per cent are women.

The report also highlights India’s current expenditure on healthcare, which is 3.5 per cent of its GDP of over $1960 per capita, as of 2017.

Indian express