Indian nurses still an exploited lot: Study

Agencies Posted online: Sun Oct 14 2012, 11:15 hrs
Thiruvananthapuram : They are hailed as “angels on earth” but the personal and professional lives of nurses in India are rather ‘miserable’, especially of those working in private health sector, with low salary, poor working conditions, among others, compounding their woes, a study has revealed.

Recent strikes and agitations by nurses in private hospitals in different parts of the country demanding better wages and working conditions have not made any significant change in their state of affairs, according to the recent study on Keralite nurses working in hospitals in New Delhi.
continued to be a major problem faced by nurses.They face ill-treatment not only from doctors and the management, but also from co-workers, said Sreelekha Nair, Junior Fellow at the Centre for Women’s Development Studies, New Delhi, who conducted the study.
Corroborating her findings, Indian Nursing Council member P K Thampi said nurses are being exploited by hospital managements. “It is virtually a slave-landlord relationship between nurses and managements’, Thampi said.
Referring to the modest salary the nurses get in private sector, he said a majority of them have done their courses by taking educational loans of Rs four to six lakh.The minimum instalment they had to pay would come to around Rs 6000 to Rs.10000 while the salary they receive is only around Rs.2500 to Rs.6500, Thampi said.
“Despite the poor state of affairs majority of them stick to their job as they have no other option,” Thampi said.
According to Sreelekha, who published a book titled ‘Moving with the Times-gender, status and migration of Nurses in India’, “not just their superiors but even the relatives of the patients verbally and, like in some cases as reported in newspapers, physically harass them.”
Nursing being a “women majority profession” also contributes to their low status and this had been pointed out by most nurses interviewed as part of the study, she said.
“Nurses share several stories of their saving the patients’ lives;However, they feel that their contributions in patient care were not valued.It is true that the name of doctors who participated in important events, for example, the first heart surgery or such historical occasion, are known to everyone but the nurse who is part of that event is not mentioned even in records,” the study said.
Another method of exploitation of nurses is the bond system enforced on entrants to the profession by hospital managements.In most cases, managements “confiscates” certificates and this would prevent them from seeking better opportunities in India or abroad.
“Women who formed the sample of the study vouched for this fact and revealed this happens across the country”, Sreelekha said.
Nurses in private sector hospitals are also cheated in many other ways. The actual amount paid to them is lower than what has been recorded in the payment register on which the nurses are compelled to put their signatures, the study said.
In the private sector,their pay structure ranges between Rs.2500 to Rs.6500 at the entry level and there are instances of nurses being paid as low as Rs.1000 a month.
“Difference in salary in private and public sector hospitals is very high, especially after implementation of the Sixth Pay Commission recommendations.Increase in pay is core demand of the nurses who went on strike,” the study said.
Regarding working conditions, both private and public hospitals are on the same footing. “Very poor nurse-patient ratio is a central characteristic of both private and public sector hospitals in India.”
Public sector hospitals are so overwhelmed by patients that they are admitted even on floors because beds are not available, it was pointed out.
“Low salary, poor working conditions, special circumstances of work of nurses that involve caring for strangers and that include handling of body fluids make the status of nurses low in the society”, the study said.
“Low status is not limited to professional sphere alone but rather spills over to their personal lives. All aspects of their personal lives are influenced by the fact that they are women nurses. There are stories of rejection and resistance by future in-laws just due to prejudices surrounding only this group of women workers…”, the study said.
Referring to migration of Indian nurses abroad, mostly from Kerala, looking for better jobs, the study said they choose nursing as a career and undertake a number of adventures.
“Nursing is not a livelihood option alone but a life strategy for many.The moment they take the decision to be a nurse, a life plan, where they plan for their career, societal upward mobility and marriage and family, gets readied. But only time can tell whether every plan is executed on time”, Sreelekha added.




Midwifery scope of practice among staff nurses: a grounded theory study in Gujarat, India.

Sharma, B., et al., Midwifery scope of practice among staff nurses: A grounded theory study in Gujarat, India. Midwifery (2012),


Article history: Received 22 December 2011; Received in revised form 11 May 2012; Accepted 12 May 2012

Background: Midwifery is a part of the nursing profession in India.This current study explores and describes the midwifery scope of practice among staff nurses.


Methods: A grounded theory approach was used to develop a model. Twenty-eight service providers from the maternity sections of public health facilities, selected through purposive and theoretical sampling were interviewed in-depth. Unstructured observations in the labour wards were also used for developing the model.


Findings: The midwifery practice of staff nurses was limited in scope compared to international

Standards of midwifery.Their practice was circumstance driven, ranging from extended to marginal depending on the context. Their right to practice was not legally defined, but they were not specifically prohibited from practice. As a consequence, the staff nurses faced loss of skills, and deskilling when their practice was restricted. Their practice was perceived as risky, when the scope of practice was extended because it was not rightfully endorsed, the nurses having no officially recognized right to practice  midwifery at that level. The clinical midwifery education of nursing and midwifery students was  marginalized because the education of medical students was given priority, and the students only got exposed to the restricted practice of staff nurses.


Conclusions: Unclear definitions of the right to practice and the scope of practice have led to the un-utilized potential of staff nurses practicing midwifery. This is detrimental because India faces an acute shortage of qualified personnel to meet the need in providing human resources for maternal health.

 Download paper below

midwifery scope of practice

Domestic Violence against Nurses by their Marital Partners: AIIMSA, New Delhi #VAW

A Facility‑based Study at a Tertiary Care Hospital

Kamlesh Kumari Sharma, Manju Vatsa
College of Nursing, All India Institute of Medical Sciences, New Delhi, India

Background: In recent times, domestic violence against women by marital partners has emerged as an important public health


Objectives:1. To determine the prevalence, characteristics and impact of domestic violence against nurses by their marital
partners, in Delhi, India. 2. To identify nurses’ perceptions regarding acceptable behavior for men and women. Materials and

Methods: A facility‑based pilot study was conducted at All India Institute of Medical Sciences (AIIMS), New Delhi. Data were
collected using self‑administered standardized questionnaire, among 60 ever married female nurses working at AIIMS hospital,
selected by convenience sampling. The principal outcome variables were controlling behavior, emotional, physical and sexual violence by marital partners. Data were analyzed using SPSS 12 software.

The test applied was Fisher’s exact test and 1‑sided Fisher’s exacttest.

Results: Sixty percent of nurses reported marital partner perpetrated controlling behavior, 65% reported emotional violence,

43.3% reported physical violence and 30% reported sexual violence. About 3/5th of nurses (58%) opined that no reason justified
violence, except wife infidelity (31.67%). Of the physically or sexually abused respondents, 40% were ever injured, and 56.7%
reported that violence affected their physical and mental health.

Conclusion: There is a high magnitude of domestic violence
against nurses and this is reported to have affected their physical and mental health.



download full report here

Pakistan-Nurses ‘poisoning’: Christians call for inquiry


By Our Correspondent

Published: August 1, 2012


KARACHI: Christian leaders have called for an impartial inquiry into the alleged poisoning of nine nurses at a government-run hospital.

Nine Christian trainee nurses at the Civil Hospital Karachi fell ill Sunday night allegedly after drinking poisoned tea prepared at their hostel. They were claimed to have been deliberately poisoned because of their faith.

Parliamentarian Saleem Khokhar, while speaking to The Express Tribune, called on the government and the police to launch a joint investigation to find out the actual cause of poisoning. While rumours initially floated that the poisoning took place as the nurses were drinking tea when their Muslim colleagues were fasting, Khokhar ruled that out, saying that the incident took place late night when everyone had broken their fast.

Condemning the incident, Christian leader Michael Javed went a step ahead and asked for a judicial investigation.

Claiming that the society has become extremely intolerant and was not allowing the minorities to live in peace, the former MPA requested the chief justice to take suo motu notice of the incident. “The government has turned a blind eye to the persecution of minorities; our girls are being [forcibly] converted and our churches are being attacked,” he lamented. Javed said that it was unfortunate if the nurses were really poisoned because the religious minorities also respect the Muslim faith and refrain from drinks and food in front of them. Human Rights Commission of Pakistan’s Abdul Hai also expressed concern over the incident. “A large number of nurses are Christians and are [already] subjected to ill-treatment and prejudice,” he added.

Lambasting the incident, the Christian community members also organised a press conference at the Karachi Press Club on Tuesday.

William Sadiq, the coordinator of a welfare organisation working for minority women, was suspicious of the hospital administration and alleged that they were hiding the real matter. She suspected some other girls in the hostel may have poisoned the students over some rivalry.  “It could even be religious targeting,” said Sadiq. The Christian leaders also shouted slogans outside the Karachi Press Club against the hospital’s administration and the rising religious intolerance.

The Civil hospital medical superintendent, Prof Saeed Quraishy, ruled out the involvement of anyone from the hostel, however. “They made the tea themselves, how can there be someone else involved,” he said.

He added that the hospital has registered a case at the Eidgah Police Station and tea samples have been sent to the Aga Khan University Hospital for toxicology tests. He confirmed that except for one student who is still admitted to the hospital, all ‘poisoned’ nurses were discharged.

According to one of the affected nurses, a colleague had made the tea after 10pm and immediately after drinking the liquor they fell ill. They were taken to the Civil hospital’s emergency and sent back after treatment. But the students developed complications in the morning and had to be taken to the hospital again.

Published in The Express Tribune, August 1st, 2012.




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