In the present Covid19 situation, nurses are at the front, combating the pandemic and therefore, their professional services play a vital role in preventing the spread. As per the recent data, India has 1.7 nurses per 1,000 population that is 43% less than the World Health Organisation (WHO) prescribed norm of three nurses per 1,000 population. The statistics includes nurses, midwives, women health visitors and auxiliary nurse midwives. Overall, India has 3.07 million registered nursing personnel, the Government told the Rajya Sabha on March 3, 2020. As India keeps on reeling under the Covid19 second wave with gigantic spread among the communities and more deaths, the requirement for more nursing staff in the country's medical services is the need of the hour. As per the Nursing Council report of 2021, India has 2.34 million registered nurses and midwives, and there is a shortage of 1.94 million nurses.
At the same time, many nurses are migrating to abroad due to low wages, job insecurities, lack of political leadership and unregulated norms of private hospitals prevalent in the country.
The World Health Organisation (WHO) declared the year 2020-21 as the International Year of the Nurse and Midwife in the honor of the 200th anniversary of Florence Nightingale’s birth. For years, nurses have worked relentlessly, often sacrificing their own health and wellbeing, to care for those in distress. They form the backbone of the healthcare system, and therefore, it is necessary for us to recognize their contribution and express gratitude.
In one of our recent research studies, we found that nurses are tormented with long working hours, working in shift basis, untimely and sudden surge of workload coupled with reduced sleep, stress, fear of infection to self and family members etc.
The unprecedented time demands moral courage to encounter and battle it for a better life. During these pandemic hours, nurses are pushed into physical and mental exhaustion due to long hours of duties so as to save their patient’s life. Our study says that, stress and fatigue lead to irritability, behavioural changes and leading to insomnia etc. In few cases, due to excessive workloads nurses are getting worried and forced them to quit the jobs.
To cope with the problems, we have suggested the nursing fraternity to, a) watch the stressful triggers and counter them with positive reinforcement, b) set the clear limits between work and personal life, c) self-relieve with the help of deep breathing, meditation, walks etc, d) practicing mindfulness and finally if required to obtain professional help.
It is seen that in Indian healthcare system, there is a lack of a system in place to address the abuse the nurses get from the patients and even they do have a lack of support from colleagues or the administrators. If they want to make a complaint against the abuse or the problems they face, there is nobody to listen. During our conversation with nurses we found that, they are reportedly being threatened by patient’s attendants in case of patient’s death or unavailability of resources and sadly, the hospital management is not taking adequate steps to ensure their safety.
Mindfulness holds enormous worth in the field of nursing as it assists attendants with acquiring better information on themselves and
moreover, it helps in creating a better relationship with the patients by giving a climate of trust and care. The Nursing Council can help the nurses by providing adequate behavioural and psychological training.
Such kind of training will prepare them to exist together calmly and help them to better prepare for all kinds of adversities. Mindfulness is basically the initial move towards work-life integration. Nurses need to recognize that work-life incorporation is a moving objective and not something that is fixed all through.
Increased mindfulness will empower them to incorporate work and life better as their jobs, duties and needs develop over the long run. Mindfulness and a sound self-character additionally empower one to acknowledge that work and life exist together with one another and not contend.
Nurses are facing many challenges and ethical dilemmas at work, and to address such dilemmas moral courage is the foundation for such ethical workplaces.
Different educational programmes and training by healthcare institutions for their nurses will enhance moral competence and moral courage needs to be built and delivered. The best way to deliver these programmes is in the form of a team-based environment with the help of case studies. Healthcare establishments can appoint ethics officer, similar to many audit / consulting firms, who can act as the official channel for not just moral communication but also for reporting and handling grievances and enforcing the organisation’s code of conduct.
(Dr Jena is Assistant Professor, School of Human Resource Management, XIM University Bhubaneswar Ph: 9800172570Email: lkjena@xub.edu.in. Panigrahy is Joint Manager-HR, Dredging Corporation of India Ltd, Paradip Ph: 9030174956 E-mail: npanigrahydci@gmail.com)