A lamp burns by spreading light outwards, but also leaves darkness beneath it.” The saying stands true for nursing — one of the most prestigious caregivers is the backbone of health infrastructure. Its instrumental role is unequivocally lauded in the public eye. But behind the curtains, these professionals remain neglected.
Among the host of issues that needs to be reformed, the latest one is targeting the established hierarchy of the nursing cadre and is being vehemently opposed by the professionals. Last month, the Union ministry dissolved the posts of Deputy Nursing Superintendent (DNS) at 4 centre-run hospitals — Safdarjung, Ram Manohar Lohia, Lady Hardinge and Kalawati Saran — and merged it with Assistant Nursing Superintendent (ANS) which downgraded 40 nursing professionals to a rank lower.
The move has perturbed nursing professionals and has led to the announcement of a strike by the impacted group. According to them, the decision is against the government’s own promotion rules and also breaks the hierarchy system given the different nature of the jobs entailed.
“It has never happened in history that a promotional post is merged with the feeder cadre and the promotional post is downgraded. It’s like holding the post of Deputy Director and being ordered to serve as an Assistant Director from the next day onwards,” said Jodhraj Bairwa, Joint Secretary, All India Government Nurses’ Federation (AIGNF).
According to the nurses, the move will create an imbalance in the cadre as well as affect the quality of care provided to the patients. “Both the posts have designated certain duties and responsibilities which are absolutely necessary for the smooth functioning of the hospital in the interest of quality patient care,” Bairwa explained.
Nurses also ask that in the absence of DNS, who will manage the administrative work since the ANS are only responsible to manage the patient care mechanism? “The post merged is a senior management post. The lack of supervision will severely impact the quality of care. The junior staff and fresh recruitment will not be trained properly. It has also not been clear who will manage the duty of DNS,” said G K Khurana, secretary general, AIGNF.
‘Decision will affect our progress, patients will suffer greatly’
Nurses say that the Centre’s order to merge two nursing positions in city hospitals will lead to stagnation profession and adversely affect patient care. Anita Panwar, president of All India Govt Nurses Federation (AIGNF) speaks to Ashish Srivastava about issues facing the profession.
What is the issue in accepting the merger of nursing posts when the pay grade remains unaffected?
Promotion will be limited to 2 by this step. The other health professions are growing and creating more supervisory posts through cadre restructuring but in case, restructuring is not taken seriously. Disease and treatment procedures are becoming much more complicated now, and require specialised treatment and care. This decision will affect the progress of the nursing profession, patient care and hospital services.
Nursing is perceived as a female-dominated profession and many males complain about gender discrimination. What are your thoughts on it?
Nursing was a female-dominated profession till a few years back but over the last few years, males have started entering it and I feel soon it will be taken over by them, especially in government healthcare facilities. Of late, the recruitment process started in Safdarjung Hospital and other central government hospitals and the selection of males is approximately 70-75 %, up from 14% in the year 2007. Govt has adopted gender reservations in AIIMS recruitment which definitely has limited the strength, but male nurses don’t wish to work in private set-ups due to the exploitation they face there.
Any other issues you would like to highlight?
There are many issues. In the private sector the most pressing issue is low wages while in the government sector, it is the massive patient load. Another issue is the quality of education in private colleges and schools of nursing.