Today, people’s lifestyle, economy, and health management have changed in the world owing to various reasons particularly the Covid-19 pandemic. Despite growing population in Bangladesh, there is no salient improvement of our health sector due to lack of government policy support. Mismanagement and irregularities made the sector’s evolvement at snail pace.
During spot visit at different hospitals and clinics in city or village sites, we notice a misery situation of patients particularly pregnant women as they don’t get proper service having a shortage of nurses there.
In this context, today is the time to find out the way of improvement the health management and capacity building of the hospitals and clinics in the country so that patients get proper treatment.
However, when the discussion comes to light about health care, the first thing that comes to mind is the nurse. Dealing with corona shows how important a role nurses play in healthcare. But the nursing sector has not been looked at for a long time. As a result, the sector has been neglected. Nursing posts have been created in many new hospitals. Seats are being increased in public and private nursing institutes but those were not enough.
According to World Health Organization standards, the physician-nurse ratio in Bangladesh needs to be 1: 3. As compared to 12,359 government doctors across the country, there is a need for 36,006 nurses in the respective hospitals. There are only 14 thousand 338 people. Besides, out of 16,989 posts of nurses in government hospitals, 2,020 are vacant. The situation in the private sector is similar.
There are 51,993 privately registered dentists and 3,913 dentists in the country. And there are only 26,899 privately registered nurses. To fill this gap, the number of student admission seats in the existing nursing colleges and nursing institutes of the country needs to be increased and more institutions need to be created through new initiatives. With a severe shortage of nurses and midwives in Bangladesh, various crises and limitations in their education and training have made healthcare inefficient and unsafe.
Emphasising nursing education is a must
The nursing education system is poor in Bangladesh following old curriculum, infrastructure crisis, lack of faculty, poor condition of teaching materials, mismanagement etc. There is also an acute shortage of nursing teachers in Bangladesh. One-third of the approved posts of Nursing Instructors in Government Nursing Institutions are vacant. As a result, the teacher-student ratio is 1:56, with a standard value of 1:20. There is a greater shortage of skilled nurse teachers in private nursing education institutions than in government, making it impossible to ensure quality nursing education.
Hospital nurses have to work according to roster in different departments or in a specific specialized unit or outdoors. One of the main reasons for this is the shortage of nurses. So they cannot become proficient in a particular subject. In this context, no registered nurse can develop as a specialized nurse in any case. At the time of entering the nursing profession, everyone has to join as a senior staff nurse. Diploma-in Nursing Science and Midwifery, Diploma-in Midwifery (3 years) and BSc-in Nursing (4 years) degree holders join the same position even though the scope and time of their education is different. Despite the differences, they have been given the same scale of rank and salary.
Only one government institution in Bangladesh has introduced higher degree MSc Nursing in Nursing, with only 50 seats. Most of this (about 98%) is allocated to government employees; 3% for foreign and non-government organizations. There is also extreme mismanagement in nursing colleges. No posts of Professor, Associate Professor, Assistant Professor, Lecturer have been created.
As a result, development of nursing education sector is at snail pace. But the nursing education sector is very important for the sake of providing health care. Nursing education sector makes a big contribution to medical services.
Again, the total number of subjects in BSc Nursing was 33 and the total number was 5200. At present there are a total of 23 subjects (the first paper and the second paper are taken as separate subjects as the examination is on separate question papers) and the total number is 3600. The Diploma in Nursing Science and Midwifery previously had 34 subjects (2 separate books per semester per year) and a total of 110 credits.
There are currently 16 subjects and the total number is 3100. This huge shift in the nursing sector has weakened the nursing education system. The scope of students knowledge has become narrow. As a result, they are failing to solve complex problems because they are not aware of multiple problems.
All we have to do in this regard is: 1.We need to form a committee with stakeholders from the public and private sectors;
2. Initiatives need to continue dialogue with strong action;
3. The post of cadre service for BSc-in Nursing graduates should be introduced by the Bangladesh Public Service Commission and the nursing curriculum should be streamlined;
4. An expert curriculum committee should be formed with skilled nurses and educators in collaboration with Bangladesh Nursing and Midwifery Council DGNMS;
5. Both Diploma-in-Nursing and Midwifery and BSc-in-Nursing programs need to increase the practical time.
Therefore, in order to make the health sector more developed and service oriented and to cope with this turbulent time of corona, the nursing education system must be streamlined and implemented with the necessary measures.
The writer is a nursing student. She can be reached through: muniamoon21@gmail.com
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