The number of nurses and nursing infrastructure available currently in the country will be grossly inadequate if the third wave of coronavirus cases hits the nation in near future.

India has only three million registered nurses and midwives for the country’s 1.3 billion population, each looking after 20 to 30 patients everyday in our hospitals. That is well below the World Health Organisation (WHO) norm of three nurses per 1,000 population. To meet this criteria, India needs to add more than 4.3 million nurses by 2024, experts said.

Participating in a roundtable on ‘Is India’s Nursing Infrastructure Ready for Another Wave’, organised by Think Change Forum, they said the optimum nurse-patient ratio recommended by the Government of India and the Indian Nursing Council (INC) has not been implemented, and as a result the workload of nurses is higher. This puts patients' well-being at a huge risk, makes the task of doctors difficult and frustrating, and adversely impacts the credibility of the India’s healthcare system, experts added.

“There is an urgent need to fill in the nursing cadre and positions to achieve an inclusive structure and adequate representation of nurses in policymaking. Currently, there are either few or no fully functional directorates across Centre or states," said Dr T Dileep Kumar, President, Indian Nursing Council.

While India has become a global supplier of nursing staff due to poor salary, dismal working conditions, absence of a proper career pathway, and outdated systems of professional governance, nurses and midwives continue to be short-staffed across Indian hospitals leading to poor nurse-patient ratio, increased workload, long working hours and double shifts which eventually leads to poor quality of treatment, said Dr Roy K George, National President of The Nursing Association of India (TNAI).

"If this trend continues, India’s healthcare infrastructure will be crippled and most of the hospitals in the country will have to close down in the next five years because of their (nurses) acute shortage,” he said.

The forum implored the government to urgently adopt the WHO norms as outlined in the Strategic Direction of Nursing & Midwifery (SDNM) 2021-2025. These directions were recently passed at the World Health Assembly 2021 and focus on investment in nursing education, creation of positions and leadership.

Further, it demanded that the government should fill sanctioned positions of nursing leadership at central and state levels immediately and set up additional nursing positions at the directorates of various states. The forum also called for fast-tracking the approval for National Nursing & Midwifery Commission Bill (NMMC) bill and repeal the India Nursing Council Act 1947.

Establishing a Live Register to replace the Nurses Registration & Tracking System (NRTS) and increasing investments into nursing and midwifery quality education are other measures to be taken immediately, the experts said.

nursing infrastructure

Covid pandemic alert! India short of 4.3 million nurses