International Nurses Day (IND), observed on 12th of May every year, is celebrated on also the birth anniversary of Florence Nightingale, who is remembered as 'The lady with the lamp' for her undying commitment to the cause of healthcare.
It is also a day when the world applauds the nursing fraternity for their 24x7 service to promote health. As healthcare demands are witnessing an upward trend, the theme for IND 2008 seeks to develop the role of nurses worldwide in "Delivering Quality, Serving Communities and Leading Primary Health Care", whilealso addressing the challenges to meet this objective.
Rightly, nurses are the backbone of the healthcare system. As keen facilitators of healthcare, they are the pivot in the 'Hospital-Doctor-Patient' paradigm. Whether it is preventive care, home care or hospital care, nNurses are an indispensable part of healthcare. Not only do they carry out prescribed treatment measures, they also provide the balm of comfort and advice to patients during troubled times.
But, is the Nursing Industry truly in the pink of health?
Healthcare demands are growing by the day. This poses newer challenges to the nursing profession, in the form of staff shortages, increasing number of patients, and the need to continuously improve deliverables and quality, amid constraints of time and resources. In a nutshell, the nursing fraternity is grappling stress from all quarters.
Dearth and Demand
The growing dearth of nursing professionals has placed a huge demand on the existing nursing workforce, resulting in deficient treatment, increasing the possibility of errors.
A recent report, complied by Dr. Peter Buerhaus and colleagues, in March 2008 has highlighted the problem of shortage of registered nurses (RNs) in The United States. The report has predicted a shortfall of 5, 00,000 nurses by 2025 if there is no improvement in the present trend. The situation might also worsen due to the healthcare pressures exerted by the aging baby boomer population.
In India, Healthcare is a sunrise industry, which has led to the growth of many hospitals. Big names like Apollo and Fortis have embarked on major expansion plans necessitating a huge workforce. Unfortunately there is a great imbalance between the demand and supply of nurses to effectively meet the objectives of such expansion plans.
The workforce crisis is manifold due to the high marketability of Indian Nurses in the overseas arena; India is losing its skilled nursing force to foreign hospitals. According to Crisil research, the consistent outflow of nurses to other parts of the world is going to give the nation one of its worst nursing shortages by 2011. According to Mr. Sudhir Nair, Head of Crisil Research, the scenario is disastrous for India, as Indian Nurses are hugely marketable abroad, fueled by the fast track corporatisation of healthcare.
One possible solution to tide over this potential crisis, according to Wockhardt Hospital's CEO, Mr Vishal Bali, is to have trained paramedical staff to chip in to meet the growing demands of healthcare.
Some hospitals like Wockhardt have also opened their own nursing schools to augment for the shortfall of nurses, a solution worth its weight in gold.
Paper Work at the Cost of Patient Care
Nurses are spending five million nursing hours on paperwork leaving them very little time to care for patients, a recent survey by the Royal College of Nursing (RCN) has shown.
A survey of more than 1,700 nurses has revealed the extent of dilution of their primary responsibilities - 88% agreed that administrative tasks like photocopying, filing and replenishing supplies took away precious time. 85% of them were of the opinion that employing additional work force would free up more of their time to care for patients. Nearly one in four nurses had absolutely no administration support at all, especially those in the outpatient department.
Offering a solution to this, Dr Peter Carter, Chief Executive & General Secretary of the RCN, said: "Nurses are clearly feeling the burden of non-essential paperwork. The danger is that this is undermining their ability to care for patients and support relatives. Of course there will always be a certain amount of paperwork that needs to be done, but wherever possible, these non-essential tasks should be carried out by clerical staff. To do this we need to see an urgent increase in the number of ward clerks and other clerical support roles."
The Royal College of Nursing has pressed for more administrative support for the nurses.
Uplift Nurses' Environment for Patient Safety
"Nurses are the hospitals' safety officers"
-Patricia W. Stone (Assistant Professor of Nursing, Columbia University Medical Center)
We all know that improving work environment for nurses translates into better patient care.
A recent report by a Columbia University School of Nursing has revealed hitherto startling insights. According to the report, improving working conditions for nurses also meant cutting the rate of infections for patients, especially those in intensive care units. This probably explains why hospital associated infections is the sixth leading cause of death in the United States.
A study of data of more than 15,000 patients in 51 U.S. hospital ICUs demonstrated the benefits of high staffing levels among nurses.
· Well-staffed ICU's portrayed lower incidences of central line associated bloodstream infections (CLSBI), a leading cause of death in the intensive care units.
· Further, infections associated with the use of ventilator like pneumonia and skin ulcers were on the high in under staffed ICU units.
· Increase in overtime hours saw a rise in hospital-associated infections, for instance catheter-associated urinary tract infection in ICU patients.
· Further, it was seen that patients had a good chance of surviving the first 30 days in well -staffed ICU's compared to the understaffed ones.
Andrew W. Dick, Ph.D., a senior health economist at the RAND Corporation and a co-author of this study said, "Our careful analysis found that decisions related to staffing, overtime, and overall work environment directly affected patient safety outcomes".
The study has also suggested some answers to this problem by way of enabling cross training with a motive to extending their availability as float nurses. In this manner hospitals could maintain a consistent strength of nurses in ICU's so that patient safety is not compromised.
Nurses Need Intensive Care
The issues of staffing, remuneration and working conditions of nurses need to be redressed in order to have an efficient nursing community. Clearly, the wealth of our healthcare system lies in the health of our nurses. Let us nurture our nurses to achieve the goals of International Nurses Day.