The Indian healthcare sector is now facing the dual challenge of migration, attrition and drop-outs of nursing staff at government and private hospitals due to poor working conditions, said Dr Usha Manjunath, Director IIHMR (Institute of Health Management & Research) Bengaluru.

Large scale migration of nurses to the United Arab Emirates (UAE), Canada, Australia and Europe has been quite common among Indian nurses. Better salaries, facilities and quality of life are the obvious reasons. Many fresh graduates who take up jobs in hospitals and other healthcare organizations tend to learn skills in the first two to four years and decide to go abroad, she added.

Indian Nursing Council (INC) and WHO have shown that India is short of 1.94 million nurses. Nearly 38% of the total healthcare work force is represented by nurses, largest as a group. Even though the number of Nursing Colleges has increased across India, the shortage and the quality of nurses are not up to the mark.

Among the government hospitals, many may not prefer rural postings due to lack of support and access to services, facilities, and good working environment. Salary structure in private organizations is not always very attractive. Smaller hospitals and nursing homes tend to pay less and hence get less competent nurses. Remuneration of nurses in large private hospitals even with over a decade of experience will not go beyond Rs.30,000. Unfortunately, Indian hospitals will never be able to match the salaries and incentives given in the west and Middle East countries, Dr. Manjunath told Pharmabiz in an email.

Due to shortages on a day-to-day basis at the hospitals, the workload and schedule gets hectic for nurses. This leads to ‘work-life imbalances’ among young nurses and stress. Fresh graduates may not have competencies and the hospitals have less time to train. Attrition of nurses leads to ‘double trouble’. While the attrition is pegged at 2-3 per cent in government hospitals in private medical facilities, it is around 15 to 40% or more. The nurses who stay back bear the brunt: more work load and hectic schedule, she noted.

Healthcare industry is often referred to as ‘recession proof’ and ‘sun shine’ industry. Robust health system requires adequate and rightly qualified human resources to deliver quality healthcare. Physicians and nurses shortages in rural areas are quite well known in India. Nursing services are an integral aspect of preventive and curative services of our health system. There are very limited opportunities for the nurses to grow professionally in India, which leads to massive shortage driven by attrition and dropouts, said Dr. Manjunath.