Doctors have also been vocal about the lack of personal protective equipment (PPE), including masks, coveralls and face shields, and other facilities to help health workers perform their duties with some degree of safety. The needs of nurses, who do a lot of the hard work of care-giving, are often overlooked.
“Nurses serving in this crisis have not been provided proper PPE or accommodation, transport or food services and quarantine facilities,” said Sujanapal Achuthan, Kerala general secretary of Thrissur-based United Nurses Association.
“Nurses spend 10-12 hours a day in covid-19 wards. Most live in hostels and there is a high probability of other nurses being infected if we do not provide safe accommodation and PPE. Even big hospitals are not able to provide PPE to nurses,” said Achuthan.
The association has moved the Supreme Court for a direction seeking protection for health workers and seeking formulation of a national covid-19 management protocol.
Going back home daily also opens them up to prejudice and abuse. When Suguna R., who works in a covid-19 ward in a hospital in Bengaluru, returned home last week, her neighbours called her “corona nurse”. “Nothing could be more insulting,” said the 32-year-old, who has been clocking 12 hours daily without break for the past 45 days.
A recent World Health Organization report said there is a need for about 6 million more nurses worldwide. Nursing is the largest occupational group in the healthcare sector, accounting for roughly 59% of health professionals. India has a shortage of an estimated 2 million nurses, according to a 2019 report by Center for Disease Dynamics, Economics and Policy in the US.
“If the number of patients surge, we will be short of nurses. We cannot dedicate all nurses to covid-19 care. We need them for patients with other ailments too,” said the chairman of a Bengaluru-based private hospital, on condition of anonymity.
Nurses feel they have been treated unfairly by the government and private entities, when compared to doctors.
Last month, the Delhi government tied up with luxury hotel The Lalit to house all doctors serving in its two covid-19 hospitals, but it has been slow to respond to pleas from the Delhi State Hospitals’ Nurses Union for housing during posting as well as quarantine facilities for covid-19 ward nurses of LNJP Hospital.
The LNJP nurses have now been provided separate accommodation. “Nurses have been provided accommodation in Gujarat Bhawan in 72 rooms for 144 nurses,” said Jeemol Shaji, general secretary of the Delhi State Hospitals’ Nurses Union.
In a petition to Karnataka chief minister B.S. Yediyurappa last week, P. Girijamba Devi, secretary of Trained Nurses Association (TNA, Karnataka unit), sought accommodation and transportation for nurses serving in the state’s covid-19 hospitals. TNA has 500,000 registered nurses countrywide, of which 32,670 are in Karnataka.
“We have always been given second-class treatment. We understand that we may not be as important as doctors, but people must realize that we are a critical part of the healthcare system,” said a Bengaluru-based nurse on condition of anonymity.
On average, a nurse in India earns ₹8,000 to ₹12,000 per month, despite working long hours and extra shifts with few days off, said Jibin T.C., UNA’s national working president and Maharashtra secretary. “More nurses are testing positive for coronavirus but nobody seems to care. They cannot be expected to work without basic protection and facilities,” he said.
On 6 April, Mumbai’s Wockhardt Hospital was declared a containment zone after more than 40 nurses tested positive for covid-19. Nurses have alleged that the hospital did not keep a patient suspected of carrying the virus in a separate isolation facility, and the nurses in the general ICU were not provided PPE.
Suganda K., a 32-year-old nurse posted in a covid-19 ward in Karnataka’s Belagavi, has not met her three-year-old daughter for two weeks. “She does not understand why I don’t come home every day. So many nurses have left behind their families to fulfil their responsibilities,” she said.
Public health experts say nurses are emotionally drained and psychological counselling sessions must begin. “Nurses in Italy, Ireland and Canada have said that working for weeks in covid wards is starting to take a toll on their mental health. That is dangerous,” said an official from the Public Health Association.
TNA has urged the government to commence the second phase of training for nurses. “This will provide some reprieve to the current lot who are overburdened. We have recommended a four-tier roster for nurses on covid-19 duty, with those in ICU having only a four-hour shift. Trained nurses (those who serve in intensive care units) are very critical and we cannot afford burnout,” said Girijamba Devi at TNA.