KOTTAYAM: After completing her BSc Nursing in a reputed private college in Mangaluru around two years ago, Ashna Viswanathan, hailing from Ulikkal near Iritty in Kannur, was confident about getting a job in one of the leading hospitals in Kerala so as to look after her family as well as to repay the education loan she had availed. Ashna’s parents are rubber tapping labourers and her younger brother is pursuing higher studies. She availed an amount of R2.5 lakh as loan from Kerala Gramin Bank’s Iritty branch in 2011.
When Ashna’s immense search for a job with a fair salary in Kerala yielded no results, she decided to accept the job offer of a staff nurse in a leading private hospital in Bengaluru. She found her new job a great relief to allay the financial woes of the family. However, she couldn’t proceed with her wishes with a remuneration of R12,000 per month, of which she gets only Rs 10,000 in hand. After two years, she is still struggling to make ends meet with the same salary.
Though she started the repayment of her loan during the initial days of the job, it got defaulted seven months ago. Ashna’s case is not an isolated one. It is almost the same saga for 6,500 nursing students passing out every year in Kerala. Though the state government issued a notification ensuring a minimum wage between R20,000 and R30,000 for nurses working in private hospitals in April 2018, their opportunities have shrunken after hospital managements abstained from recruiting fresh candidates for a salary stipulated by the government.
“I tried for an opportunity in several hospitals across Kerala. But, they said openings were only for those having a minimum experience in Kerala,” Ashna said. Meanwhile, openings are there for fresh candidates in some hospitals, where they get posting as trainees with a salary ranging from R4,000 to R6,500.
The irony is the managements seldom absorb these trainees into their own staff. Rasmi Ravikumar, hailing from Kottayam, who worked in one of the leading hospitals on the outskirts of Ernakulam, said she resigned after working as a trainee for two years. “I was getting R6,500 per month, which was not enough to meet any of my needs,” she said.
Rasmi managed to find a job in a hospital in her hometown, with a comparatively better salary and is now searching for opportunities abroad. Aswathi Aniyan, hailing from Kallissery near Chengannur, wanted to stay back in Kerala if she got a fair salary here “I worked in one of the major hospitals in Bengaluru for 15 months after my studies. I was offered R17,000 per month, but I was getting only R11,000 in hand. Even though remuneration is much better in Kerala, there are no vacancies for freshers and nurses with below three years of experience,” she said.
Aswathi had availed an education loan from Federal Bank’s Kallissery branch and is now unable to repay the amount. The experience was similar for Jitty Jose of Manimala. Though she didn’t avail an education loan, she couldn’t find an opportunity in Kerala after she quit her low-paying job in a hospital in Mangaluru. It was in 2012, the state government through an order brought in the post of trainee nurses, where only staff nurses existed until then.
According to Jasmine Sha, national president of United Nurses Association (UNA), as per an order of the state government in 2013 that revised the salary of staff nurses, trainees would get R6,000 in the General Nursing (GNM) category and R6,500 in the BSc Nursing category. “The proposal to revise this pay scale to R10,000 and R10,500 respectively is under the consideration of the government. But, the government has not issued an order in this regard so far. Taking advantage of the situation, many of the hospitals are taking experienced nurses as trainees,” he said.
As per guidelines, the trainees will be fresh graduates and they should not exceed 25 per cent of the total workforce of staff nurses. However, some of the hospitals violate this guideline. Moreover, trainees are forced to work in some sections where an experienced hand is needed, which often leads to mental stress. It is learnt the suicide of a young nurse at a private hospital in Tiruvalla a couple of days ago was related to such issues.
Meanwhile, Kerala Private Hospital Association (KPHA) denied the allegations about the ‘undeclared recruitment ban’ in the private sector. “Earlier, the university authorities had cut short the duration of the GNM and BSc Nursing courses by reducing the internship period and students were not getting adequate on-job training during their studies.
It was in such a situation that private hospitals had come forth to offer training. As per the government order, the training will be for one year and the candidate should leave the hospital on the 365th day.This is no way connected with the recruitment process of the hospitals,” said Adv Hussain Koya Thangal, KPHA honorary general secretary.
Burden of education loan repayment
The sad part is a large number of trainees do not get a permanent job in their hospital even after two years. The management can easily avoid them citing low marks in ‘performance appraisal’. With nothing to place in the column of ‘experience as staff nurse’ in their curriculum vitae, these nurses are forced to join again as a trainee nurse in some other hospitals. In the meantime, the burden of loan repayment gets worse following default over default.
“We can’t manage loan repayment and daily expenses with a salary of I6,500 per month. I have to remit a minimum amount of I6,500 in the bank, when repayment commences,” said a nursing student. As per the data received from the banking sector, there is a steep increase in the statistics of non-performing assets (NPAs) in the education loan sector, escalating banks’ stress. “The NPA in 2015 was 10 per cent of the total outstanding amount, which has been increased to 20 per cent in 2018,” said a bank officer.
According to officers, a major share of the education loans belongs to the nursing sector. As per statistics, the outstanding amount in education loan sector in June 2015 was I9,587 crore and the NPA was I958 crore. Meanwhile, the outstanding loan amount in June 2018 was I9,982 crore and the NPA rose to I2,045 crore. This is the figure for loans issued by private and public sector banks alone. The outstanding amount rises to I10,049 crore when considering the loans issued by cooperative sector banks and small finance banks like Ujjivan.
Responsibility of the State Govt
A section of nurses and their parents believe the issues in the nursing sector can be resolved to a certain extent with an effective intervention of the state government. “There are a lot of vacancies in the government sector. The job crunch can be resolved to a certain extent if the government fills these vacancies.
At the same time, the government has to take steps to ensure that minimum wages have been implemented in all the hospitals,” said Dr D Surendranath, state president, Indian Nurses Parents Association (INPA). According to him, private hospitals brought in trainee category when the bond system was abolished. He also alleged private hospitals increased treatment charges when they implemented minimum wages and thereby they passed the burden to the public. “There must be social control over private hospitals to resolve the issue,” he added.
Rising opportunities abroad
Even though Nitaqat and other issues had shrunk the opportunities in the Gulf countries around two years ago, the situation has changed with countries in the Middle East and Europe as well as in the US and Australia inviting nurses. “Germany and the United Kingdom urgently require a large number of nurses and we are trying to equip our members to apply there.
This apart, Qatar, Saudi Arabia, Bahrain, the UAE and Kuwait have already invited nurses in bulk numbers,” Jasmine Sha said. Moreover, after the nurses’ recruitment scam related to sending nurses to Kuwait and the ensuing arrest of the prime accused Uthup Varghese, recruitment of nurses to the Middle East became transparent in the entire process.