Why Are Nurses Missing From The Scene, By The Way?

by Joziea Farooq

Every profession provides a platform to people who have competence, skill and talent and gives them visibility and exposure but where is the visibility of nurses.

Staff nurses of the Super Speciality Hospital in Srinagar stage a protest demanding Personal Protective Equipment (PPE) kits for front-line employees of the health department. The protest was the outcome of one of their colleagues testing positive for Covid-19 in the SSH Srinagar. The cancer patient who was allegedly carrying the infection is already dead along with his son. KL Image: Bilal Bahadur

In Islam, the nurse provides health care services to patients, families and communities as a manifestation of love for Allah. In Islamic traditions, caring is more than the act of empathy; instead, it consists of being responsible and sensitive to and concerned with those in need.

This act of caring is further divided into three principles; intention thought and action. Intention and thought to refer to who, what, where, when and why to care, whereas action refers to the knowledge necessary to be able to care. In short, healthcare is deemed as service to the patients and to Allah, as opposed to other professions that are commercially based. This ethos was the fundamental motivating factor for the majority of the Doctors and the Nurses in the history of Islam.

The first professional nurse in the history of Islam is a woman named, Rufaidah bint-e-Saad. This evidence proves that the nursing profession is universal and has not evolved from any other profession.

Universalization of the modern nursing profession is an incipient concept describing the next phase of human development, marking the transition from trans-national to interplanetary relations and much more opportunities that lie beyond the confines of Earth. Inter personnel relationship, communication, technological explosion, socialization, economic and cultural challenges and opportunities extending into our profession.

Competent nursing care is a vital sign of efficient health care delivery system.

The registered nurse has done a basic qualification of B Sc nursing of four years with 25 subjects in four years journey. Nurses role has been limited to the administration of fluids, drugs and dressing that is the traditional role of the nurse but her role is also as a nurse manager, team coordinator, educator, advance nurse practitioner, primary caregiver, and even researcher. But these roles are hardly visible to the public as nurses give competent care and do not take credit for their care- this is really a human heart.

The public hardly know the qualification of nurses. They had consider every person who injects medicines as a nurse. If only injection administration had been the role of nurses then why they are doing late night studies, going for M Sc and PhD in nursing, conducting researches. Even a nurse when gives good care and is competent is called a doctor by the public.

Doctors and nurses are equally important in the health care delivery system. If only technology and competent doctors are contributing to patient quality care then irrespective of both why India ranks 115 number in health care in the world. The Indian health system has given the power to a doctor to make decisions regarding patient care without taking into account the effect of the decision on the entire team. This dictatorship in the health system in India plays a crucial role in reducing the visibility of nurses. If parochialism in nursing is found to exist in excess, it can cause hindrance to the formation of strong and efficient health care delivery system. India is particularly susceptible to this evil.

Mostly parochialization in the nursing profession has occurred because of the following reasons:

Lack of effective training programmes provided by the hospital.

The hospital does not pay much heed to the nurses up-gradation skills.

A gap kept between skill, competence, knowledge, opportunity and incompetence

Invisibility of nurses in society irrespective of their important role in rendering care to the patients in a variety of health care delivery system.

Social stigma towards the nursing profession.

Media portrays an inaccurate image of nurses in the public. The professional image of nursing has been vulnerable to inaccuracies and negative stereotypes and the role that mass media plays in reinforcing negative nurse stereotypes cannot be overstated.

Nomenclature issues pertaining to varied specialities in the profession.

The studies concluded that a fairer image and stronger position can be realised by following ways:

Tsering Yangzom Skurbuchan, and Angmo Likir, the two nurses of Sonam Norboo Hospital In Leh, whose role is being lauded in managing the initial Covid-19 cases.

The nurse practitioner (NP) role was created in 1965. The nurse practitioner was not a substitute for the physicians; their relationship was envisioned as a collaborative and collegial. Some believe that role of the nurse practitioner has changed to that of a more independent provider who can substitute for physicians in primary care. Nurse practitioners have evolved into a large and flexible workforce. Far too, often nurse practitioners and physician professional’s organizations do not work together but rather expand the considerable effort in policy arenas. A combined, insistent effort is urgently needed for studying, training and deploying a collaborative, integrated work-force aimed at improving the health-care system of tomorrow.

The American Academy of Nurse practitioners (ANNP) now defines Nurse Practitioner( NP ) as unique in the constellation of Advanced Practice Nurses(APNs) functioning independently and collaboratively like APN’s but active in a broad array of specialities and settings and managing both medical and nursing problems. The potential for professional autonomy, respect and higher incomes may be attractive to Nurse Practitioners. Health insurers may welcome another front-line competitor in the market place. The nurse practitioners workforce has provided to be quiet flexible and could fill positions not wanted by doctors or could outcompete them for others. In this option NPs functioning as a disruptive technology within the health care system. Disruptive technologies in other industries like cellular telephone services, personnel computing have revolutionized cost, quality and availability. Some health economists feel that health care is ripe for such innovation. This outcome is entirely possible, given steady evolution of NP autonomy and the persistent failure of physicians to fulfil unmet patient expectations, and its potential fuels aggressive protective behaviour, such as the petition developed by physicians.

A second option is for physician and NP organizations to work with other health care professions to develop model integrated, patient-centred care, each profession bringing the best of its discipline to the table. In this approach differentiation of work is appreciated, and teams are made accountable for performance.

Introduction of health care as a vocational subject in government school all over the country have invoked interest in a number of students making them competent to deal with common health problems in families and community level.

Jammu and Kashmir can also beat parochialism in the nursing profession into an effective collaboration by the following strategies:

Revise the payment system to reward high-quality care and to permit the development of more effective ways of delivering care to improve the value of resources spent.

The nurse: patient ratio should be justified according to the INC guidelines.

The proper grading system should be used according to the seniority but the higher nursing educative persons should also be given an opportunity to work in higher ranks.

Joziea Farooq

Rounds should be conducted by supervisors to discuss the patient’s disease and necessary management.

Every month there should a grand ground related the ward management and patients care management.

Staff nurses should be encouraged for research-related activities to promote the visibility of the nursing profession.

Provision to the protection of service rights.

Media should be involved in removing stigma related to this profession.

(Author is a Post Graduate scholar in paediatric nursing at SKIMS Srinagar. She is currently posted as in-charge nursing officer at accident and emergency department GMC Anantnag.)

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