More Hospitals, Less Nurses
The national health sector suffers from critical shortage of nursing staff, and with the increasing number of hospital beds the problem has been compounded, necessitating training and recruitment of more nurses on priority, said a lawmaker.
More than 7,000 hospital beds have been added in the past four years, 2,000 in the last fiscal (ended March 20).
Based on 2016 official data, the average nurse-patient ratio stands at 1.5 per 1,000 and should at least double in order to achieve the minimum standards of nursing care. At present, there is a deficit of 140,000 nurses in hospitals across the country.
Citing Health Ministry data, Heidar Ali Abedi, member of the Majlis Health Commission, says more nurses have to be hired to meet the growing demand, Mehr News Agency reported.
He called on the state Administrative and Recruitment Affairs Organization of Iran (ARAO) to take steps to redress the problem.
“Although the Health Ministry can hire nurses on contract basis, full-time nursing professionals must be recruited in state-run hospitals to meet the current shortage,” he said.
There is also lack of adequate trained nursing staff. A well-trained nursing cadre can play an important role in reducing medication errors and preventing healthcare-related infections. Annually, thousands of patients (10-15%) are affected by hospital-associated infections (HAI) as a result of lack of adequately-trained nursing staff.
Abedi proposed the launch of non-profit nursing colleges as the first step to increase the number of professional nurses.
“The ministry alone cannot educate the needed personnel,” he said pointing to the recently approved in-home nursing care plan based on which 15,000 nurses must be employed in homecare of patients, particularly the elderly and the disabled.
As per the relevant bill, clause 5 of Article 89 of the sixth economic development plan (2017-2022), a medical reference system incorporating nurses for in-home care will be implemented under the national healthcare network with the family physician plan on priority.
Several Reasons for Shortage
Mohammad Mirza Beigi, deputy director for nursing affairs at the Health Ministry had earlier pointed to several reasons for the nursing deficit.
“The fact that nursing staff normally leave for better paid jobs, lack of young people entering the profession, increasing demand from a growing population with high risks of non-communicable diseases (NCDs), and migration of health workers abroad in search better opportunities, are among the reasons for the present shortage,” he said.
Measures have been taken to address the issue including the recruitment of 7,500 final-year nursing students as well as providing them with the opportunity to continue working in the same hospital after graduation.
The number of seats at medical universities for nursing students was also doubled from 6,000 in 2014 to 12,000 in 2016.
Since many nurses quit the job due to the low wages and hard working conditions, the minimum monthly salary of all officially employed nurses was increased to $570 (20 million rials) in October 2016. But it seems that too has not produced the desired results.
A nurse-to-patient ratio is the minimum number of nurses working in relation to the number of patients in a particular ward. The ratio is calculated on the basis of patient acuity or intensity of nursing care required by patients.
In the past several years, there has been a growing need for more registered nurses in hospitals due to rising acuity. Safety and quality of patient care is directly related to size and experience of the nursing personnel.
Inpatient working conditions have deteriorated in some hospitals because they have not kept up with the rising demand for nurses. Regulatory measures should be enacted to assure adequate or minimum level of nursing staff at all hospitals.