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Opinion: Prioritise nursing services and pump investments in it By K Srinath Red - News - Nurses Arena Forum

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Opinion: Prioritise nursing services and pump investments in it By K Srinath Red by Idowu Olabode : July 30, 2017, 01:05:12 PM
As we gear up to implement our ambitious National Health Policy and strive to strengthen our wobbly health system, the challenges of inadequate numbers, skewed distribution and suboptimal skills in many categories of health professionals need to be addressed with urgency. In particular, expansion, skill enhancement and better utilisation of nursing services is a high priority. The case for increased investment in nursing is based on the following five arguments:

Efficiency Gains:
Nurses are currently used in a limited way for low-skilled types of service provision, with much of their potential untapped. Not utilising that potential, by relegating nurses to minor or even menial roles is highly inefficient. With skill enhancement and redefinition of their roles, they can make stronger contributions to healthcare. Training in special skill programmes will also make them valued contributors to advanced healthcare, in intensive care units and surgical theatres. From nurse practitioners to nurse anaesthetists, the role of nurses is being redefined in many countries. Enabling nurses to take up more responsibilities also frees up doctors to focus on areas which demand specific expertise.

Effectiveness Evident:
Even as they are currently deployed, with varying responsibilities assigned across different health systems, there is consistent evidence of nurses’ effectiveness in improving health outcomes, whether in mother and newborn care, or in the treatment and control of hypertension and diabetes. Nurses are better at following check lists and evidence-based standard management guidelines.

Economic Rewards:
Enhancing the role of nurses reduces the cost of healthcare by reducing dependence on doctors for several elements of healthcare. Improved health outcomes, especially in preventive and chronic care, reduce healthcare costs. Expansion of the nursing workforce also creates employment opportunities, especially for young women. Such job creation is not only important for delivering better healthcare, but also as a stimulus to the economy at a time when jobs in other sectors are shrinking. A September 2016 report of a High Level Commission of the United Nations on health workforce makes a strong case for such investment as an economic growth factor. Increasing the wage-earning potential of women also alters household power dynamics, leading to better utilisation of household incomes.
Equity Enhancement:
Nursing is predominantly a feminine profession. Investment in nursing education opens doors for more women to enter the workforce. Once employed, giving them more opportunities for continued development through skill up-gradation and leadership training will reduce the asymmetry of power and status between doctors (majority male) and nurses (majority female). This move towards gender equity through nurse empowerment will have wider societal benefits. Investing in training and employment of youths from the tribal and economically backward areas, will also address other forms of inequity.

Empathetic Care:
Nursing presents the most humane face of the health system. ‘Caring’, which carries concern, compassion and courtesy have always meant more than mere ‘treatment’. Even as the practice of modern medicine is made more impersonal by a growing wall of technology that separates doctors from patients and their families, the nurse remains the friendly figure of personalised care. Since emotional well being is an important ally to physical recovery, the supportive and comforting role of the nurse is of immense value in healthcare.

As a society, we must recognise that we cannot achieve our health goals without raising the skills, salaries and social status of nurses. Enabling them to realise their untapped potential is the best investment we can make to increase the outreach, effectiveness and equity of our health services.

K Srinath Reddy

President, Public Health Foundation of India

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