Coming home is a journey. It starts with a dream. And on April 23, Ila dreamed.
A nurse at the 250-bed Max Hospital in North Delhi, she has been away from her home in Kerala for eight years. Tired of spending two hours handing out to her patients at the end of her eight-hour shift, she still manages to smile. She missed lunch in a hostel she shared with other nurses, all living apart from their families. So we catch a bite at McDonalds nearby. Food is not her habit, but she has learned to live with it. “I correspond to Delhi,” she said in a heavily accented Hindi. She is happy, because there may be food and a narrow living space soon. Because she can finally go home. Sooner than later.
At midnight on April 23, Kerala became the first Indian state to set a minimum wage for nurses. With a base rate of Rs 20,000 ($ 292) per month, such nurses are regarded as respected professionals whose value needs to be recognized. This sentiment grows and expands nationwide, it believes. And she’s not alone.
Approximately 2.1 million Indian nurses, most of whom work across the country, and minorities who are employed or retired abroad, are hoping for better salaries and working conditions. Importantly, they seek more power in the private health care sector.
Since the late 19th century, it has been associated with nursing service and training in India. It is mostly known as the British social reformer and statistician Florence Nightingale, the founder of modern nursing, who spent some time in India. However, since the turn of the century, the rise of privately funded hospitals in the country has given birth to a new idea – the right to nurses.
Traditionally, doctors viewed nurses as mere helpers. The hospitals saw them as less labor intensive. Patients regarded them as customer care employees. The lack of appreciation has taken its toll. For an Indian nurse, the first priority is employment abroad; Second, the government job. Only when these two are absent do nurses want to work with private hospitals. As a result 60% of private hospitals are overcrowded.
In 2011, the Working Delhi-based Trained Nurses Association of India (TNAI) approached the Supreme Court seeking better working conditions and better pay. The Supreme Court has directed the government to set up a committee to determine the appropriate wages for nurses. This committee is undoubtedly in its view – private and public hospitals pay a minimum wage of Rs 20,000 per month to nurses. This was quite a relief as nursing wages ranged from Rs 2,500 ($ 36) to Rs 17,000 (8 248). Since then, nursing unions have been mushrooming throughout the country, lobbying to implement committee recommendations through drills, threats and strikes. Kerala is their first taste of what has already been a long struggle.
Other states have not tended to enforce the law. Some, like Chhattisgarh, went as far as arresting 600 nurses to punish them for landing a strike. However, it has been shown that some hospitals in these states are in favor of the idea of fair wages and are willing to discuss salaries if nurses take on more responsibilities. Now the obstacles are doctors and patients, they are reluctant to give up the advanced nurse.
It will be a difficult negotiation, but Indian patients and hospitals need nurses, so doctors will come around and hope so. In 2010, the World Health Organization estimated that India needed 2.4 million nurses by 2012. Recent estimates suggest that India will face a shortage of six million nurses by 2030. Indian nursing colleges can cut 300,000 seats, hospitals have created an insidious shortage of hiring fewer nurses and, alarmingly, the profession is losing its charm as nursing seats are filled. The Ministry of Health has begun writing the Nurse Practice Bill, specifying the rights and responsibilities of nurses. What’s more important now is a higher salary; She feels that greater responsibility, inevitably follows.