Each year about 25,000-30,000 nurses graduate after completing various courses in Maharashtra, yet the state is reeling under a shortage of nursing staff and forced to rely on nurses from Kerala as well as specialised doctors to fight the Covid-19 battle.
State heath officials they have received no response to several advertisements for nurses, while nursing associations have told The Indian Express there are hundreds of trained nurses in Maharashtra waiting for a job but have got no intimation from the government. Apart from what appears to be a communication gap between the associations and the government, many nurses are also unwilling to work because of the fear of Covid-19, the perception that hospitals do not provide adequate personal protection equipment, poor salaries and lack of job security.
Maharashtra Nursing Council data shows the state has 1.25 lakh nurses registered, including BSc, MSc, General Nursing and Midwifery (GNM), and Auxiliary Nursing and Midwifery (ANM). Of this pool, ANM form the largest chunk. “When Mahalaxmi Racecourse centre was set up, there was zero response to ads. Our guess is these nurses are not willing to work in a Covid hospital, or salary is too low, or they want a permanent and not temporary job,” said Rachel George, registrar of Maharashtra Nursing Council.
The council only updates its registry once in five years. The number of nurses registered with it may also include those who have migrated or given up nursing profession.
On June 22, the state government reached out to Kerala for a second time for specialist doctors and ICU trained nurses. In response, the Kerala government has asked for the number of medical professionals that Maharashtra requires. A fortnight before the Maharashtra government’s letter, six nursing associations jointly wrote to Brihanmumbai Municipal Corporation (BMC) chief Iqbal Chahal, saying that “instead of hiring nurses from Kerala, the 1,800 nurses who have cleared the DMER exam process and who are waiting to join work should be given appointment letters and recruited for vacant permanent posts at the earliest.”
Swati Rane, from Jan Swasthya Abhiyan, said salaries are low, and despite the difference in qualifications, all nursing staff are being offered the same flat salary. “BSc nurses and GNM diploma nurses have been treated at par and their salaries fixed at Rs 30,000. Nurses represent 60 per cent of the healthcare force, but are not represented in key decision making bodies related to the pandemic,” Rane said.
According to United Nurse Association, which recently tied up with three Pune-based private hospitals to provide nurses, a letter to BMC offering nurses has got no response. The association has 1,300 nurses registered and willing to work. N Ramaswamy, IAS officer in-charge of recruitment in Seven Hills hospital, said he is in touch with associations but has not got an encouraging number of potential recruits. The shortage is equivalent to nurse staffing for over a hundred ICU beds.
“We are thinking of outsourcing some beds in hospital to an agency just like we did for jumbo facility,” he said.
The shortage of nurses was first felt in private hospitals at the onset of the pandemic and has now extended to public hospitals. In March, 200 nurses from Kerala quit their jobs in Mumbai and went home. Risk of infection, poor salary, lack of transport and living facilities were driving factors.
Suman Tilekar, from Maharashtra Nurses Federation, said lack of trust in health system has also led to quitting. “Over the years, the number of nursing seats has reduced. Nurses are being offered contractual work. They want respect and job security. They fear after pandemic they will be asked to leave. Government has to engage in a dialogue.”
Dr Santosh Kumar, attached with Doctors Without Borders, who facilitated the movement of Kerala nurses to Mumbai after the Maharashtra government first contacted the Kerala government for help, said the shortage of nurses in Seven Hills and Thane’s new 1,000-bedded Covid hospital is acute. “BMC does not pay on time and that is a major complaint of Kerala nurses,” he said. Thane Municipal Corporation is also looking for nurses for its facility.
Nationally, a live tracking system for nurses has been started by the Indian Nursing Council to upgrade records of nurses working in public and private hospitals. George from Maharashtra Nursing Council said currently there is no data on nurses that are unemployed or have stopped working.
Meanwhile the BMC directed Seven Hills hospital dean to pay pending salaries of four nurses and 40 doctors of Kerala by Thursday. These nurses and doctors had joined two-month BMC duty in June but 40 doctors decided to return home after a month due to delay in salary and to join hospitals in Kerala. “There was paperwork delay. All that is sorted now, their salaries will be credited today (Thursday),” Ramaswamy said.
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