#Internationalnursingday2016 Challenges in Nursing Profession in Nepal

#Internationalnursingday2016 Challenges in Nursing Profession in Nepal

by Radha Paudel
My Nursing education always remains as my boon during Maoist insurgency, Jan Andolan II (people war 2006), devastating earthquake 2015, Terai blockade 2015 though I enrolled it accidently when my dad’s brain washed by foresters who were briefing that I couldn’t negotiate with masculine characters including men folks, claiming mountains, fighting with wild animals and wood smugglers.
Today, it is already 21 years of my graduation of my first nurse school and life following in anti-current or anti river direction. In my dictionary, I don’t have word of impossible and later due to leading emergencies as an Anaesthetic Nurse for 24/7 hours for 4 years with my six senses or no machines at all. Consequently, I took role of pilot for kicking of blood transfusion and C-Section in Jumla, first time in Karnali region.  No matter how much credentials I gained from other faculties or in what position I served, my knowledge and skills from Nursing is always principal. More importantly, I never ever regret my single moment, it is my pride and power always and will be so grateful towards the lady with lamp Florence Nightingale’ and my four nieces are following same path today.
The nursing profession is choice of profession in USA, UK and Australia where many Nepalese nurses are doing great in aboard. Thus, many parents like to send their daughters to Nursing school by selling their ancestral property or taking loans from cooperatives etc. Nursing profession is considered as secure profession for work and marriage in Nepali context which was as hated profession just 25 years back. There are many changes includes increasing specialization in various themes, PhD education in Nepal, networking and collaboration at international level, privatization of nursing education and so many competitive scholars. Sadly, the nursing profession is flowing downwards as I have been observing since childhood. Recently, I have visited few hospitals and interviewed with nurses from Kathmandu, Bharatpur, Janakpur, Dharan and aboard etc. as a patient, visitor and an activist. My heart is shrinking day by day while seeing the quality of nursing profession.
The quality is compromised in many ways; i) Production flaws: the nursing colleges are mushrooming and considered as a business than education for humanitarian work. There is no any basis of demands within and outside of the country and also not seriously consider the mandates for operating nursing school. Many students are depriving from exposure of patients, procedures due to overflow of students as well as mismatch at clinical setting, ii) Demand flaws; the government is not putting nursing profession as priority. The patient nurse ratio is 1:30 even today at referral level hospitals e.g. Bir Hospital where as WHO recommends 1:4. There is very irregular and irrational way of placement of nurses in to the government process through Public Service Commission. The government closed its eyes to create avenues for nurses for placement e.g. educational and private institutions as occupational nurse, iii) employability: there is merely hopeless scenario for employability as a result of incompatibility between demand and supply. Except handful nurses, are neither applying their acquired knowledge and skills nor getting decent pay. Many nurses are unemployed, underemployed and many working voluntarily. More importantly and sadly, many nurses are working under severe exploitation, iv) Politicization: though nursing profession is for regardless of class, caste, greed, politics or anything as its ethics but it is heavily influenced by the politics. There is known political panels during each election of NAN (Nursing Association in Nepal) and heavily divided in any agenda. So the campaigns for professional enhancement abort during conception phase, and v) Passive role of NAN and Nursing Council: The NAN is in existence since 1962. In a 54 years span, there are 17 presidency is running but there is no significant results for the professional improvement. It says that non-political institution but everything is based on party cadre. Nurse leaders are pleasing two types of people; political leaders and Doctors who are the primary decision makers at hospital as Dr or administrator. The nurse leaders hurriedly visited to the ministers, prime ministers for congratulate them if they represent their political party but they never speak when a women die at Mugu due to retained placenta or dying people in Darchula or Taplejung. Even the devastating earthquake, many nurses who hold the positions in NAN and council joined the political parties with their logo. There is no single voice or agenda for NAN for advocating yet. It is like open secret that everyone knows the ground reality but they don’t like to speak because they worried for their personal privileges.
The Forbes, Harvard Business school, nursing leadership schools claimed that female leaders are the best leaders even for the top management level after 1982 AD. They are efficient, bravery, risk takers and so on. The feminine attributes are assets for bringing collaborative approach and societal transformation. In contrast, these all theories are failed in Nepalese context specially nursing profession. Since 1962, the NAN has occupied by nurses who are female except few men. The Nursing Council is also started to work since 1996. NAN and Council members involve while providing the approval for nursing colleges and its requirement. The nurses who are playing key role either in government or private hospital or NAN or council, they are playing dual role which is perfect example of corruption and crime. They are compromise the quality while serving to two institutions at once, they closed their eyes while giving approval and remain silence while the children (students) exploited at hospitals as volunteers.  No matter where nurses are working, they just follow their male folks as doctor, as administrator, as political leaders and enjoying personal benefit rather benefit of group or nursing profession.  
If the nurses are really like to stand on their profession, they have to stand on the pledge and philosophy of Florence Nightingale. The nursing profession doesn’t care how many times NAN organize the blood donation program or meeting with Prime minister. But it does care whether NAN able to unite the nurses and their concerns regarding quality, safety and policy at community and hospital with specialized care in 21rst century.
Thank you very much for felicitated me and extend my sincere thanks and congratulate all nurses across globe.

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