International Nurses Day 2024: ‘In India, nursing is deemed as a low-level job’, express Mumbai nurses on dealing with challenges and misconceptions

Mumbai-based nurse Rashmi Sawant has been a nurse for 18 years now and has grown immensely in this time. However, she has seen that people still have misconceptions about the job. "In India, people think nursing is deemed as a low-level job," she expresses, continuing, "I think people don't understand the job hierarchy for nurses in India. People only think that we are a nurse, they don't know we are registered nurses that also have different administrative positions." If only they knew better, Sawant says, they would know it is a huge misconception because if you are consistent and credible, then there is a huge growth in the job.

Every year, International Nurses Day is observed on May 12 around the world to mark the contributions that nurses make to society. While doctors are hailed for their medical genius, the contribution of nurses may often be relegated to the shadows of the hospital corridors. However, times are changing and one of the biggest examples in the recent past has been that of the Covid-19 pandemic. Even though all nurses dealt with patients, their families who were coming to terms with their death or sickness on a daily basis took out their frustration on them. At such times, nurses put on a brave front and do their best to give them hope and continue to do so even today and Sawant is only one of them.

Need for more awareness
Incidentally, Sawant's sister inspired her to become a nurse. She explains, "When I saw her studying and working, I instantly thought I could fit into this profession. She had no ideals and was the first one in the family. The main thing about being a nurse is growth. I joined as a staff nurse, and today I am a deputy chief nursing officer after 10 years." It hasn't always been smooth sailing because the 44-year-old says every position had its own challenges but that helped her build her professional efficacy over the years. "It is refreshing to have a profession that is female dominated," she says while adding that there is a confidence among patients that female nurses are more efficient. "How people treat nurses depends on how you are," Sawant adds.

Even as she has reached a leadership role today, the Mumbaikar says there are many challenges that nurses face daily but not many people know about it. She explains, "The challenges are the emotional burden that we get while dealing with the patients, relatives, senior doctors and our seniors. It takes a lot to be calm and patient and go on. We have to always maintain a smile and show the confidence that everything is fine." It came out most during the pandemic and it got really stressful too. "People were really scared to talk to each other. We nurses had to move the fear aside to help the people and make them recover from serious conditions. We have played a role in that and been by their bedside 24x7 because people didn't want to come to the hospital," adds the deputy chief at Gleneagles Hospital Mumbai, where she has been working for the last eight years.

As more and more films and web series depict nurses as a part of the story, Sawant says she has seen them but is unhappy with the way they are depicted. "Nursing is a very advanced profession. We are into continuous training, education, audits, research â€" so many things. We have only been shown bedside, listening to the doctors and relatives. There needs to be more research in depicting them," says the Mumbaikar. With several protests happening in the city and country from time to time, she believes nurses should be paid well monetarily, treated well and their talents need to be recognised.

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Making a difference in people's lives
Elsewhere in Mumbai, Dr Elizabeth Joseph, chief of nursing at Wockhardt Hospitals Mumbai Central, says even though dealing with patients is their daily job and may often be challenging, it is important for nurses to empathise with their patients, understand their needs, and provide comfort in times of vulnerability. "While the journey may be challenging, the rewards of touching lives and making a difference every day make it all worthwhile," shares Joseph, who has been a nurse for three decades now.

It has changed a lot from the time she first started out thirty years ago. "My journey in nursing began with a subtle nudge from a friend who had already embarked on this path. Back then, career choices might not have been as clear-cut as they are today. However, fate led me to pursue nursing, and I found myself enrolled at SNDT, one of the most esteemed universities for aspiring nurses. While I didn't initially feel a profound calling towards this profession, stepping into it ignited a flame of passion within me."

Once she got into the thick of things during her days as a nursing student, she couldn't tell night and day. She reminisces, "My days were spent in the halls of the bustling municipal and general hospitals (in Mumbai), where the shortage of nurses was palpable. The workload was staggering, leaving little time for doctors and nurses to connect with patients on a personal level. Yet, it was during these clinical postings that I discovered the essence of nursing â€" the ability to make a difference in someone's life every single day. Whether it was through small gestures of kindness or attentive care, I realised the profound impact nurses have on their patients' well-being."

Even though nursing faces many different kinds of challenges that go beyond dealing with patients like attrition, which Joseph says has become a prominent issue, there is work to be done. One of the most important issues is ensuring patient safety amidst staffing shortages, which requires coordination and dedication behind the scenes. "From obtaining doctor's orders to coordinating medication delivery, every aspect of patient care demands meticulous attention to detail. It's crucial for people to recognise that while nurses are the primary caregivers directly interacting with patients, they also play a vital role in coordinating with various departments behind the scenes."

With nurses emerging as the frontline heroes during the pandemic, showcasing their crucial role in healthcare, the 58-year-old says there has been a heightened visibility that has led to a growing appreciation for their dedication and expertise. "As societal norms evolve towards greater equality, the nursing profession is rightfully gaining respect and recognition. However, there are still areas where progress is needed to ensure equitable opportunities and support for nurses," she adds.

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Changing role of nurses today
One of the easiest ways to do this, believes Lissymol Saji, nursing head at Wockhardt Hospitals Mira Road, is by raising awareness about the vital role of nurses in healthcare. In fact, it was what made her want to become a nurse. "I wanted to help people and make a difference in their lives. The best thing about being a nurse is the opportunity to provide compassionate care, and support to patients during challenging times," she shares. Over the years, she has seen many different kinds of misconceptions play out in the hospital and outside of it. She explains, "One common misconception about nursing is that it's all about following a doctor's order. However, the reality is that nurses play a crucial role in patient care, often making independent decisions and advocating for their patients."

Even as they deal with these misconceptions, Saji agrees with Sawant as she says apart from emotional strain, nurses also face psychological strain as they regularly witness suffering,trauma and death, which disturb their mental state too like anybody else. "Nurses often work long shifts and sometimes without adequate breaks which can lead to physical exhaustion," she adds. This may often escalate when dealing with family and friends of people in the hospital but her experience and training kicks in. "When dealing with stressed or angry family members, it's important to remain calm, and empathetic, communicate effectively and listen to their concerns, provide information, and involve them in the care process by eliminating tension and building trust," she explains.

Just like Saji even Dr Sneha Vaidya, regional director-nursing services, Western Region Apollo Hospitals, believes that people think nurses are just assistants to doctors but they are so much more than that as they don't just do basic tasks anymore and in fact are from a growing pool of specialised nurses who provide advanced care to patients. With Vaidya, who has over 26 years of experience, saying the challenging part of being a nurse is also maintaining a work-life balance. "We need to work in shifts and manage family at the same time and that becomes stressful sometimes," she explains. Interestingly, the nurse has a big role model in her life. "My mother inspired me to be a nurse who was one of the pioneering nurses in her times enduring compassion and care,which eventually developed the confidence in me to take up this arduous role. The best thing about being a nurse is you can touch millions of lives," she explains.

In all this time, Vaidya says things have changed a lot and nurses have gained a lot of respect among the other medical professionals. However, there is still more room for improvement. "The fact that a nurse is more than an assistant to the doctor needs to be furthermore accepted in some of the pockets in the country especially out of tier 1 and 2 cities," she concludes.