The nurse is your first point of contact in a hospital, and yet usually remains faceless and invisible. Typically, they say, they are either ignored, sidelined or stereotyped; in smaller cities the discrimination can include being barred from doctors’ lifts and parking bays.
A recent episode of comedian Kapil Sharma’s TV show reiterated some of the worst stereotypes, with one actor playing an obnoxious, loud-mouthed nurse while another trotted about in a tiny white uniform and blow-dried hair.
“This kind of portrayal is rubbish,” says Suchita Sawant, principal at the Bombay Hospital College of Nursing. “When have you ever seen a nurse with open hair?”
That may have been just a TV show, but such perceptions, they say, are their biggest bugbear. They’re tired of being seen as either a sexist joke or unidimensional and faceless.
“We’re all specialising today. Some of us have Masters, MPhils or PhDs in super-specialty courses like cardiology, nephrology, critical care and oncology,” says Malathi Rao, deputy director of nursing at Bombay Hospital. “But people don’t even seem to notice.”
These people include patients, patients’ relatives and even doctors and hospital staff.
“When I was enrolling for a Masters in 2004, for instance, a doctor at the hospital where I then worked was surprised to learn that nurses could even opt for a Masters degree,” says Sawant. “That’s how much we are underestimated.”
Pointed discrimination within the hospital hierarchy is an issue too.
In some Chandigarh institutes, nurses aren’t allowed to use the same elevators, canteens or parking bays as doctors. “In one of the buildings at Postgraduate Institute of Medical Education and Research, one canteen is for patients and another is for doctors. Where will the nurses go,” asks Lakhwinder Singh, president of the PGI nurses’ association.
At the city’s Government Medical College & Hospital, the nurses’ demand for a canteen has gone unheard, but a second canteen has been opened for doctors. The staff parking lots are also not accessible to nurses. “Each block has a lift just for doctors. Some time ago a few nurses were asked to leave after they entered a lift along with a doctor,” says Vijay Kumar, president of the nurses’ association at GMCH-32.
“Big boards reading ‘Only for doctors’ hang outside lifts, canteens and parking lots. It makes us feel discriminated against,” says Singh.
Promotions too come after years. “An assistant professor is promoted to the next level of associate professor within three years, but a promotion from staff nurse (Grade II) to staff nurse (Grade I) can take about 18 years. Salaries too are raised only after a decade,” says Singh.
As most hospital directors are doctors, they overestimate those from their own profession and underestimate nurses, says Malthi Iyer*, a nurse at a medical college in Delhi. “We are given step-motherly treatment,” she adds.
The lack of recognition and basic privileges, poor work conditions and relatively low salaries force many nurses to head overseas in search of better prospects, some even accepting jobs in high-risk countries like Iraq. Two years ago, 46 Indian nurses had to be rescued by the government from that country amid an offensive by ISIS militants.
“Besides the salaries being on average five times higher than those offered in India, respect for labour is also higher in foreign countries,” says A Sindhu, a nurse from Ernakulam who is back in India after a seven-year stint in Bahrain. “For instance, the initial diagnosis, in many countries, is done by nurses. But in India the nurse’s job is seen as limited to administering injections and maintaining a patient’s health chart.”
In the doctor’s absence, patients trust young resident doctors fresh out of med school more than a nurse with decades of experience, adds Sheetal Tanna*, a nurse at a Mumbai government hospital. “It is a matter of perceptions not having changed.”
Attrition rates, meanwhile, are climbing in India’s hospitals. “I am concerned; we are losing our best nurses to other countries,” says Usha Banerjee, director of nursing at Delhi’s Apollo Indraprastha hospital. “As healthcare needs rise rapidly in India, this is a matter of grave concern. We have the best trainers in this part of the world, but everyone today seems to join the profession to work abroad.”
With newer avenues opening up in areas such as clinical research, corporate offices and schools, the future looks set to change. But there’s a long road ahead, and the first step is updating the traditional image of the Indian nurse.
“Nursing is already moving beyond the bedside,” says Rao. “The need is to create public awareness about this changing image, while simultaneously upgrading nursing skills in terms of education, training and soft skills.”
(* Names changed on request)