Nursing Shortage in Pakistan

The health workforce including Medical, Nursing and Allied Health Professionals is the foundation of any health care system. Investment in the health sector reduces disease burden, improves productivity and ultimately contributes positively in economic growth of the country. Pakistan is generally confronted with dire shortage of qualified health professionals especially the nursing staff that is the backbone of every healthcare systems across the world. Nurses have incredible contribution in assisting the doctors in every aspect of patient care, thus ensuring that individuals receive the best possible care at all stages 1. The nursing profession continues to face shortages due to a lack of potential educators, high turnover, and inequitable workforce distribution. The nursing staff employed in the hospitals is primarily responsible to provide all kind of nursing care to the admitted patients i.e., monitoring of vital signs, fluid management, and administration of medication in line with the orders of the attending physicians. Nurses are also responsible to monitor the nutrition intake, look after personal hygiene of patients and care of bowels, prevention of bedsores etc., maintain medical record and ensure the ambiance conducive to recovery. Their role therefore, requires essential nursing skills, apart from commitment and vigor. There are however, issues of quality in nursing education, particularly regarding development of proficiency in basic nursing & midwifery skills 2. Nursing Institutions lack in quality output, due to deficiencies in nursing faculty, infrastructure and professional supervision. It is expedient to remain abreast with contemporary advancements in nursing education and practices to produce competent and skillful nursing workforce for better clinical outcomes. According to the Pakistan Economic Survey 2020-2021, Pakistan had a total of 116,659 registered nurses in 2020 for a population of about 200 million people. In the general wards of Pakistani hospitals, the current nurse-patient ratio is 1: 40, while the Pakistan Nursing Council recommends a nurse-patient ratio of 3:10 3. The deficiency in the actual number of nurses rendering services is further aggravated by positions remaining vacant due to shortage of skilled nurses, thus compromising quality of nursing care. This shortage in nursing strength is also worsened by an urge to move overseas particularly the Gulf countries, as large number of nurses opt for employment abroad for better financial incentives 4. The situation is even worst in the private sector particularly, in the smaller hospitals that end up with hiring semi- qualified and poorly trained or self-trained staff on meager salary and poor employment terms on the pre-text of shortage of qualified nurses. Larger private setups often resort to make shift arrangements by engaging nurses employed in the public hospital for second shift. Such nurses are therefore, required to work for up to 16 hours a day, thus, further compromising quality of care. It is highly recommended to increase the number of nursing training opportunities and slots to overcome this serious shortfall and to ensure availability of sufficient number of nurses in the public as well as private sector to comply with the recommended Nurse: Bed ratio and to fill vacancies as per the sanctioned strength in public hospitals on priority basis. Also to improve the training facilities at Nursing Colleges in terms of qualified faculty and proper infrastructure to improve quality of training of the nursing cadre. Introduction of Continuous Professional Development (CPD) Programs for nurses with mandatory completion of credit hours on regular basis for continually building the skills and improving the quality of nursing and midwifery services can also prove to be a great initiative 5. Enrolling more male nurses can help provide nursing care at hospitals located in the relatively hard to reach areas.