In times of a surge in nurses resigning and seeking opportunities abroad, the newly elected government plays a vital role in addressing the critical issue of nurse attrition with a series of comprehensive measures aimed at retaining experienced and specialised healthcare professionals.
As the country faces the negative consequences of a widening gap in the patient-to-nurse ratio, the working nurses are hopeful that the new government will help in reducing the attrition.
A nurse with eight years of experience at ERRH emphasised key factors contributing to nurse attrition and proposed solutions. She highlighted the challenges of being overworked and underpaid in comparison to other countries, especially during government holidays and Sundays. The nurse suggested that the government should devise compensation strategies for nurses working on such occasions. Additionally, she expressed concern about the inadequacy of the current payment for night shifts, pointing out that the Nu 500 per night for a 12-hour shift is insufficient considering the demanding nature of the work during odd hours.
Additionally, she stressed the importance of timely recognition for nurses, and expressed a desire for the elimination of the IWP system, which is perceived as causing unnecessary chaos.
A 25-year-old nurse currently employed in Samdrupjongkhar conveyed her perspectives and recommendations. She shared that the workload of nurses is a topic that has been discussed internally during college and also in workplaces. She believes that the government, as a whole, lacks a comprehensive understanding of the workload nurses undergo.
She said, “Establishing a distinct autonomous nurse body and administration might prove effective in addressing these issues, given their firsthand experience with the difficulties encountered.”
A 28-year-old nurse at Gelephu CRRH, having over two years of experience, provided a set of recommendations. She has put forth several constructive suggestions aimed at enhancing the overall work environment. Emphasising the importance of a conducive workplace, the nurse stressed the need for an adequate number of human resources. Additionally, she advocated for the transition of contract nurses into regular positions, highlighting the significance of aligning salaries with working hours. Furthermore, the nurse emphasised on the urgency of addressing staff shortages, recognizing the detrimental impact of understaffing on the workload of nurses and urging measures to alleviate this burden.
A senior nurse with over 9 years of experience at JDWNRH recommends introducing incentives for experienced nurses specializing in particular fields, and creating avenues for professional development. She specifically emphasized on the importance of supporting diploma-holding nurses, who currently face the financial burden of self-funding further education.
The nurse also highlights the challenging nature of evening duties, noting that the shift concludes by 8:00 pm, but the commute home often results in reaching home around 10:00 pm, leading to significant exhaustion and compromising family time.
She recommended introducing flexibility in working hours, stating, “At times, it feels like we are working under intense obligation.” She added that the existing shortage of staff could worsen with strict rules, potentially demoralizing nurses and negatively impacting the quality of patient care
Another nurse at JDWNRH, who is also a breastfeeding mother, has brought attention to the absence of childcare facilities at the national hospital. She recommends that the government consider establishing an Early Childhood Care and Development center and providing staff housing near the hospital. Such facilities would alleviate the daily commuting challenges, particularly during peak traffic hours, enabling the staff to concentrate on their duties without concerns about family and childcare.
The nurse said, “The need for an ECCD at JDWNRH has become crucial for the hundreds of staff dedicated to serving in the hospital.”
The People’s Democratic Party (PDP) has committed to mitigating attrition in the health sector through a comprehensive set of strategies. These include establishing the Khesar Gyalpo University of Medical Sciences of Bhutan (KGUMSB) as a regional center for excellence in medical and health education. The party aims to boost MBBS programs to produce 30 doctors and 20 international doctors annually. Additionally, PDP plans to address healthcare professional shortages by recruiting retired personnel, incentivizing specialists to offer e-consultation services, and enhancing degree courses in nursing, traditional medicine, and allied health sciences.
To further support the medical field, PDP proposes strengthening doctor specialization, introducing fellowships in selected specialties, and initiating a Master’s in Public Health program to fortify preventive and promotive services. There are plans to revamp the health governance system at both central and dzongkhag levels, aligning it with decentralization policies and providing greater autonomy in human resources, finance, and public health activities.
While these pledges outline ambitious measures to counter attrition and enhance healthcare, the perspectives and suggestions of working nurses, who are at the forefront of healthcare delivery, remain crucial for a holistic understanding of the situation.