The Global Nurse Crisis: Importance Of Building A Sustainable Workforce

Nurses are the reassuring presence that provides round-the-clock care and comfort to patients, whether they are recovering in the hospital or just coming in for a brief consultation. These trusted caregivers are dedicated to their calling and prioritize their patients' needs above their own. Their unwavering commitment to providing quality healthcare makes them an indispensable part of the healthcare system.

With over 3 million registered nurses in India, the number might seem like a lot. However, against the country’s population of 1.3 billion, and those who need care, this figure is alarming. India is facing a shortage of nurses and we are nowhere close to the WHO’s recommendation of 3 nurses for a population of 1000 people. 

In India, the current figure is 1.7 per 1000 people. A campaign called #NurseMidwife4Change started by a group of nursing and midwifery organizations highlighted this acute shortage claiming that India would need at least 4.3 million more nurses by 2024 to meet the WHO norms.

Despite facing numerous challenges, nurses continue to be the backbone of the healthcare system and a source of emotional support for millions of patients and families. The COVID-19 pandemic highlighted their crucial role as they worked tirelessly and selflessly, often at the risk of their own health and lives. The constant influx of patients, shortage of supplies, and mental fatigue took a toll on these caregivers, with some even losing their lives in the line of duty.

Understanding the reasons

Indian nurses are one of the most sought-after talent pools in the world and our own country is in dire need of this resource. However, the shortage can be attributed to three main reasons, among others.

Demographic changes and ageing population India is undergoing a major demographic transition and there is an increase in the number of elderly. Going forward, many of them would require care at home, which is likely to boost the demand for nurses.

Lack of adequate education and training programmes There is a need for better learning prospects for nurses who wish to continue their education beyond the regular curriculum. For instance, currently there are no specialized training and development programmes for nurses who wish to study further.

Migration and brain drain Many nurses migrate to countries outside in search of better prospects such as financial independence, higher standard of living, more exposure , and freedom of choice. Some even take their families with them after a point. Post COVID, the demand for well-trained nurses has increased and India is a country with ample supply of well-trained nurses, especially from states like Kerala. However, in this process of brain drain, we tend to lose many of these skilled healthcare workers.

Building a skilled and sustainable nursing workforce

Recently, the government announced a possible revision in the Indian Nursing Council Act 1947 to address the shortage of nurses. Currently, foreign nurses or those with a degree from outside India cannot work in the country. The draft National Nursing and Midwifery Commission Bill, 2020, is likely to change this scenario by allowing the registration of foreign nurses with state nursing councils.

There was also an announcement to open 157 new nursing colleges in the recent budget. But healthcare will always require more personnel. Quality alone may not be enough, and there is a need to retain talent through campus placements and healthy competition. 

While new nursing colleges are a step in the right direction, there is also a need to put in place systems that help in retaining talent along with imparting a sense of responsibility and duty which is imperative to this profession.

To enable them to progress in their career and upskill, it is also crucial to depute nurses for higher education. In India, nurses lack a clear career path and often switch hospitals. To build a skilled and sustainable nursing force, strategies are needed, such as investing in nurse education and training programs. 

The second aspect is to provide better working conditions, something that several healthcare companies are offering today. Public-private partnerships for coming up with innovative solutions such as nurse-led care models can also go a long way in retaining this essential workforce in the country and resolving the challenge of brain drain.

Given the fact that they work the closest with patients, nurses are also the people we must empower and even include in the hospital administration at large. In order to encourage more young talents to pursue nursing as a career, proper respect and recognition should be paid to the profession.

Bringing about change

Even as all these measures are discussed and implemented, there is also a need to review current organisational and management structures. It is imperative to invest in training apart from making nurses an integral part of the decision-making process. 

Nurses need to looked at as valuable resources, may be even more than other wings of healthcare. Their learning curve is longer, and they must be nurtured as limited resources. With a globally changing healthcare scenario, all stakeholders need to lead from the front in terms of restructuring health systems and the nursing profession.

Vaibhav Tewari

Guest Author The author is Co-founder and CEO, Portea Medical