Nurses Day 2010

Declining standards of nursing care worrying

The declining standard of nursing care in hospitals is the most serious problem affecting the noble and age-old profession that is dedicated to the care of the sick and dying. This should rightly be the theme of Nurses Day this year. Any medical personnel with some experience would be quick to realize that the quality of our nurses has deteriorated tremendously over the years. The major cause of this unfavorable situation is the over-commercialization of the medical profession that has led to the rapid mass over-production of nurses.

The recent announcement that there are a total of 106 nurses training institutions in the country was shocking. We wonder why we need such a large number of such training schools. In fact what we need is about a dozen or two such colleges that can be adequately monitored so as to maintain high standards of those being trained as nurses. The decision by the government to freeze fresh applications to set up nursing colleges is a wise move which was long overdue. It should not have allowed the mushrooming of so many nursing colleges in the first place as maintaining the quality of such a large of schools is by no means an easy task.

It appears that the health ministry’s main aim is to achieve the recommended World Health Organisation nurse to population ratio of 1:200.Well that may be the ultimate goal but it should be carried out in a well planned and gradual manner. In its preoccupation with fulfilling some statistical requirements, it appears to have forgotten to ensure the basic standards in nursing care.

The privatization and commercialization of the medical and health services has tremendously increased the demand for nurses which had resulted in the mushrooming of a large number of nursing schools especially private ones. In the enthusiasm to turn out more nurses, the selection criteria for nursing courses have been compromised with those with sub-optimal results in the SPM examinations being recruited. Many of them have a poor command of English which put them in a disadvantage position.

Furthermore many nursing schools lack qualified experienced and dedicated teachers. Clinical training in the wards are left to those who themselves lack such experience. As a result these schools may churn out large number nurses who are of questionable standards. Many of these newly minted nurses are totally lost when they first sent to the wards. Managing patients these days have become very demanding that can only be mastered by years of experience not by just obtaining some certificates.

The extremely strict hierarchical system of administration of the nursing profession of the past might have had its flaws but was largely responsible for instilling discipline and dedication among the nurses. In that system the superiors were exemplary senior nurses themselves who led by example. Today that time-tested system appears to be disintegrating, being instead replaced by a system that tend to adopt a more cooperate outlook where the superiors being reduced to mere administrators and directors of companies that produce nursing.

Privatization and commercialization has dealt a major blow to the quality of patient care. Such care, when available, has become beyond the means of the vast majority of Malaysians who are toiling to make ends meet. Furthermore it has made the nurses mere tools for churning out profits for the huge co-operations that own hospitals. To make matters worse, now we are planning to embark on large a scale medical industry fashionably termed ‘medical tourism’.

Despite this commercialization of medical care in general we are fortunate to still have nurses who are dedicated, caring and compassionate.Regrettably these qualities are the least sought for in our nurses these days as they are not readily sale able commodities.

The Higher Education and Health Ministries and the Malaysian Nurses Association together with concerted efforts of those who are involved in the training of nurses, have some serious problems to address – to arrest the declining standards of nursing, putting the brakes on the massive and indiscriminate commercialization of patient care that is threatening the ethics of the medical profession, ensuring quality nursing schools and above all bringing back the glory and respect the nursing profession once commanded.

Meanwhile they must look out for those true Nightingales who are dedicated to serve their patients in silence despite all the odds arrayed against them. They must show their appreciation and gratitude in cash, kind or the least in some kind words of encouragement. We never know when we will need their services?