The Bhutanese Leading the way.
Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) is facing a shortage of nurses, as many of the nurses are either resigning or on Extra-Ordinary Leave (EOL). The latest figure, from January to mid August 2022, shows that 50 nurses have resigned, applied to resign and taken EOL -most of whom are not expected to rejoin.
Most of these nurses who have left in large numbers are experienced nurses whose absence will be felt.
In 2021, 46 nurses had resigned from JDWNRH.
Of the 50 in 2022 so far 22 have resigned, 10 more have applied to resign and 18 have taken EOL.
The resignation and EOL numbers are much higher than previous years.
There were also two doctors who have resigned in 2021 and 2022, and there are five doctors on EOL. There are also other clinical and non-clinical professionals and support staff who have resigned in 2021 and 2022.
On paper there are more than 500 nurses, however, many of the nurses are on EOL, study leave, and maternity leave, with no replacement for them, unlike in the other agencies where they can fill the vacant spots by hiring people on a contract basis.
Most of those resigning are heading to destinations abroad like Australia and others where there is a shortage of nurses.
The resignations in the last six months are the highest till date compared to past years.
The Chief Human Resource Officer of JDWNRH said during the global COVID-19 pandemic situation from 2020 to 2022, there were not many clinical professionals who resigned to avail themselves of employment opportunities elsewhere.
However, it is expected that there will be more resignations now, also the number of which will depend from year to year.
The officials from JDWNRH said right after the pandemic, nurses sought recommendation letters on a daily basis, and there has been an increasing number of experienced nurses leaving for further studies, and many contract nurses are resigning too.
Contract nurses are those who could not or do not get through the Preliminary Exam. The official said, every year a few numbers of nursing students get through PE and the rest join on contract basis. And being contract nurses, they do not have any security and not many opportunities, so after getting experience, they resign and they don’t renew their contract. They just work for two to three years to get experience and head out.
Experienced nurses who take the EOL have hardly returned back. So, when nurses take EOL, it is the same as resignation. Meanwhile, JDWNRH is waiting for new nurse recruits.
The official said many senior nurses are resigning, which is a serious concern, especially when nurses from the Intensive Care Unit, Emergency Room, and Adult Intensive Care Unit leave. If in case five ICU nurses are leaving or are on EOL or maternity leave, they can be replaced by another five new recruits, but the capability of experienced nurses are hard to match.
“Our concern is many skilled and trained nurses are leaving. JDWNRH has become an institution where nurses get trained and then leave. People think that if old and experienced nurses are leaving then they are making rooms for new nurses, but nurses are dealing with human life, where emotions are involved more. It is not just a treatment for the disease. It has to be dealt with holistically, and that only comes from an experienced nurse,” the official said.
The official said they have a mentoring system where new recruits are taught the practical part during on-the-job training by their seniors. So, this system will also be affected due to a shortage of experienced nurses.
Nurses are required and there is an issue of retention. “We don’t know how to retain our nurses, but we have informed the health ministry of this issue,” said the official.
The official said something has to be done to retain nurses otherwise, down the line, the quality of care will be affected.
The health sector has been fortunate with the allowance, but even with this, nurses are leaving. The official said money is one factor but there are many reasons for nurses resigning. A main factor is that nurses are not given recognition for their work. The entire working environment must be looked into.
The official said nurses have to work 24/7 and they don’t get government holidays nor Sundays. Outside countries, nurses can take off days during the weekends, and nurses who want to work during their off days, are paid on an hourly basis apart from their monthly salary. In Bhutan, nurses on night duty are paid a night allowance of Nu 500 per night and that is 12 hours.
It has become a trend since everyone is leaving, and now nurses are also leaving to have a better life, said the official.
And now with the expansion of services where a greater number of experienced nurses are required, but JDWNRH already has a shortage of nurses.
(The online version of this story has been updated with the numbers of nurses who resigned or went on EOL.)
