“We already lack the visibility in the health sector,” said a nurse, adding, “it feels good if someone writes about us.”
TAKING care of Covid-19 patients “24 hours at a stretch” for over a month now, Rubina (not her real name) badly misses her home while serving her homeland at the war-front against the invisible enemy.
Shuttling between her quarter and ward, the sleep-deprived staff nurse at Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Soura, remains on toes while attending the sulking and sorrowing patients. And yet, she feels sidelined in the current Covid limelight on the healthcare workers.
“We nurses already lack the visibility in the health sector,” Rubina, the 26-year-old nurse from Baramulla, said. “It feels good if someone writes about us.”
Her tribe is on the emergency calling since March 18, when Kashmir reported its first viral case. Till May 15, Jammu and Kashmir had already reported 983 confirmed cases of Covid-19 with 11 casualties. Since the vaccine for the disease is still work in progress, the healthcare workers treating Covid-19 patients are the most vulnerable group.
“To tell you honestly,” said Shaheena Ismail, a nursing officer at GB Pant hospital, Srinagar, “we fear whether or not we’ll be able to go back home safely, while tackling this warlike situation in our hospitals.”
Despite taking every precaution, she said, the nursing staff doesn’t know which patient will be positive and which will be negative.
To avoid the distress, the nursing officer handles every patient as positive because she’s at the risk of getting herself and her family infected.
“Many of the nursing officers don’t go home for weeks,” she said. “The nurses’ working roster is to work for 3 days in a week for 24 hours duration.”
Given the paucity of healthcare staff in J&K hospitals, most of these nurses are putting up the extra efforts as frontline warriors. With the result, they’re not able to give time to themselves.
According to a manpower audit report of health and medical education department 2018, J&K is “severely short” of nursing staff.
The report says that the doctor-patient ratio in J&K is the lowest in India.
Against a requirement of 3193 nurses as per the IPHS Norms, there are only 1290 sanctioned posts of staff nurses in the J&K with a deficit of 1903 posts that need to be created, the report notes. “There is also an urgent need for creating Staff for the proposed Nursing Colleges to train a requisite number of good quality Nurses in the State.”
Mindful of this crisis situation, Mahapara Mushtaq, a junior grade nurse at Government Medical College (GMC) Anantnag, said the deficit infrastructure and manpower is creating impediments in Covid fight back in her hometown.
“Active cases are coming down in Srinagar,” Mahapara said. “However in a district like Anantnag the numbers continue to soar up. And to tackle the health crisis, we’re certainly running short of staff.”
But instead of coming to the rescue of the understrength and overburdened nursing class, Jammu and Kashmir administration amidst pandemic terminated around 250 nurses – employed in five Government Medical Colleges.
The move only drew raging flak in locked down region.
The nurses recruited under an academic arrangement program last year were removed from duty and replaced with permanent recruits to fill the vacancy.
The permanent recruits being freshers are not as experienced as the incumbent nurses who were told to discontinue.
Taking a strong note of the move, senior Congress MP Shashi Tharoor requested New Delhi to take the matter and protect the nurses from being terminated.
“Have received urgent SOS from nurses that on 12 April, the J&K Govt dismissed 181 trained professionals of the Health and Medical Education Department, including 97 staff nurses and paramedics, in the midst of COVID-19,” tweeted Tharoor.
“How can frontline warriors against the deadly virus be fired at the very time when they are needed most? These healthcare professionals had been selected under SRO 24 by following a proper procedure and are now being arbitrarily terminated. Pls protect them,” added the MP.
As a face-saver and fill the void, students pursuing Post Graduation were soon called, to work as a nursing staff.
“I’m currently on a 2-year study leave doing my PG,” said Rubina, the SKIMS nurse. “But I was called to the hospital along with my friends recently and put on the Covid duty.”
Some of these developments amid pandemic fail to make news. And since the administration has already debarred the healthcare workers from reporting to media, the nursing staff continues to suffer in silence.
Perhaps that’s why many of them went on their routine job, than celebrating International Nurse Day on May 12.
The day commemorates the birthday of the founder of modern nursing, Florence Nightingale. During the 1854 Crimean War, Nightingale brought 38 volunteer nurses to care for soldiers. This year’s theme for the International Nurse Day was “A Voice to Lead – Nursing the World to Health”.
While the world took to social media in praise of nurses for being the frontline warriors amidst the pandemic, some Kashmiri nurses reported stigma for doing their job during the current Covid crisis.
Speaking about the problems faced, Rubina recollected an incident of being stigmatized in her hospital.
“I was waiting along with my colleagues outside our own hospital administration room to apply for Covid passes that would make our movement possible,” said the staff nurse at SKIMS.
“But to our surprise the moment they came to know that we’re posted in Covid isolation wards, they closed the door with a bang, saying, ‘Look at them! They’ve come here after being posted with Covid patients’. I don’t think we deserve such a disheartening treatment for leading from the front during this crisis!”
Kashmiri nurses are reporting this ill-treatment when many people are standing on their roof banging plates and lightning diyas to express their gratitude to the healthcare workers.
And yet, in reality, the healthcare workers, especially nurses are facing social discrimination from neighbors and landlords.
Mahapara, the Anantnag-based nurse, mentions a case of social stigma when one of her colleagues was asked to vacate her room by the landlord.
“People are reluctant to get in contact with healthcare workers coming from direct or indirect patient care areas,” the junior grade nurse said.
But nurses, said Wani Azhar, a staff nurse at SKIMS, cannot maintain a gap while dealing with any patients, even if some of them might be infected with the coronavirus.
Not only social discrimination, many nurses have to deal with patients’ rude behaviour as well. “Most of them are not ready to cooperate with us,” Rubina said. “They keep demanding and over expecting.”
The staff nurse at SKIMS said that the patients know that they are being monitored closely by the government as well as media and they are taking full advantage of it.
“They have demands like one would have in a hotel rather than in a hospital,” Rubina continued. “While everything is provided by the hospital administration, the patients still want to go home and if their demands are not met, they abuse the staff.”
But on the question of the protective gear, each of these nurses who spoke with Kashmir Observer gave a positive response.
Mustaqeem Jahan, a nursing officer at SKIMS, said the hospital administration has provided Personal Protective Equipment (PPE) to each staff for “fighting this disease and for protecting ourselves”.
“While I’m not sure about other hospitals,” Shaheena, the nursing officer at GB Pant Hospital, said, “the nurses are well equipped with the PPE in our hospital.”
According to her conversation with her colleagues, seniors, and batchmates, the nursing officer claimed that other periphery care hospitals where there is much more burden on healthcare have limited facilities with meager staff members.
“In those hospitals, where there should be an adequate number of PPEs, nurses are burning the midnight oil at the risk of their lives,” Shaheena said.
On these nursing challenges during pandemic, Dr. Mir Mushtaq, spokesman of Doctors Association Kashmir (DAK), and a doctor at District Hospital Pulwama, said these healthcare workers should be taken care of and given due credits.
“Nurses are the wheel of healthcare,” Dr Mushtaq said. “They’re the ones who’re mostly in touch with the patients.”
Since a majority of the nurses are females, the doctor emphasized, they should be given a proper environment where they feel comfortable.
The doctor is of the view that though clapping and showering flowers are good gestures by the government but not good enough to appreciate the work done by healthcare workers. The government, he said, needs to come with some plans to provide incentives to the nurses so that they stay motivated.
“Healthcare is a team effort,” he said. “Doctors cannot work if one part of the team is missing. Our work relies on teamwork and we need to appreciate everyone.”
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