Recently there was hue and cry over the National Medical Services applying the BCSR rule to delay the resignation of around 50 nurses by six months.

The decision was taken to prevent a collapse of the health system and allow a seamless transition in which time new nurses can be trained to fill up the vacancies.

Nurses do the heavy lifting in medical care and the departure of experienced nurses will have a huge impact on our health system.

The above case shows that the attrition from the civil services has reached a very critical level in certain sectors and especially in the health sector.

The fact that such a mass resignation comes even after a 50 percent pay hike shows that the nurses want better working conditions and even better pay that Bhutan cannot match.

The talk of national service and patriotism is not enough for them as they now want a better life for themselves and their family which they know they can get overseas. 

It must be acknowledged that at the global level there is a huge movement of medical staff and skilled people to developed economies that need them and will pay much better.

Bhutan started seeing this brain drain form the early 2000s with first senior doctors leaving,  and then as awareness grew and time passed more medical staff and especially nurses started leaving.

Nurses, especially at JDWNRH, are hugely overworked with huge patient loads, grueling working hours, limited holidays and not much appreciation.

In other countries the presence of private medical care ensures that good nurses can be absorbed by private hospitals that pay them well. The problem in Bhutan is that nurses can only work in the public medical system that is free for all and has a huge workload with a limited career path and facilities.

The mass resignation of nurses despite a pay hike is not just about the nurses but also raises questions on our entire health system.

While we build one building after another it seems that the medical staff who are supposed to staff these big new hospitals are leaving.

It is true that money is the main push and pull for leaving but that cannot be all of it. The health ministry and other health managers need to have a heart to heart talk with nurses to see what can be done to to reduce the high attrition rate.

It could mean better working conditions, better facilities, better career path, more training opportunities, more recognition etc. Perhaps nurses also need better managing with their concerns not only heard but also addressed.

When the government moves to give even the slightest additional allowance for nurses there is a lot of unhappiness from other civil servants.

However, if these civil servants even spent a day or night in the shoes of nurses then they would realize that nurses deserve that and so much more.

“America’s nurses are the beating heart of our medical system.”Barack Obama

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  1. The rate of attrition in Bhutan is at peak and its elusive that Bhutan will retain its civil servant for the years to come. Pay hike is one of the initiative that has motivated people to remain back but only to certain extent. Unlike other civil servants, nurses are not having enough time to spend with their family and loved ones. Money is not always everything that matters the most. Having enough holidays, good working environment and other social welfare to nurses has greater impact on attrition rate. Therefore, government should look after recruiting more number of nurses and making working hours flexible with reasonable holidays.

  2. Tshering Phuntsho

    I appreciate how the nurses works and stays with the patients until it recovers.
    But what about the technicians of DHI and other companies who’s pay hasn’t increased yet and still risking their life at work.

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