Fieldwork Mandatory for Nurses Before Graduation

A plan has been developed to help address the problem of shortage of nurses. Final-year nursing students must compulsorily work for a year at hospitals before graduation.

“They should put in 140 hours per month and will receive a monthly grant,” said Alireza Irajpour, head of the Working Group for Development of Nursing Education affiliated to the Health Ministry, and a board member of Isfahan’s University of Medical Sciences.

The plan, developed jointly by the working group, universities of medical sciences and the Iranian Nursing Organization, has been sent to the ministry for approval, IRNA reported.

According to the ministry, currently there is a deficit of 100,000 nurses and many nursing students are not fully prepared for work after graduation due to lack of practical training and clinical skills. Therefore the scheme will provide students skills in the field after graduation, as they will gain valuable experience during fieldwork.

“Our aim is to fill the gap between theoretical knowledge and professional practice among nursing students,” he said, adding that the one-year program is perceived to be effective in development of nursing staff that can deal with “real clinical situations in hospitals.” Currently, general physicians (GPs) do 2-year fieldwork before graduation and a similar program is deemed necessary for nursing students.”

Experienced nurses in hospitals who will be designated as ‘education assistants’ will be selected to supervise and offer clinical education to the final-year nursing students.

Before joining the mandatory program, nursing students should pass a theoretical exam. “Those who fail should pass some specific courses again before working in hospitals,” he said.

At present, some final-year nursing students work as assistants in hospitals but after implementation of the plan, this work will become mandatory, he stressed.

“A monthly grant of $112 (4.5 million rials) and $150 (6 million rials) will be paid to single and married nursing students, respectively,” Irajpour said, adding that according to estimates, “10,000 nursing students in state and private universities will enter their final-year in the near future.”

  Acute Deficit

The shortage of nurses in Iran has reached critical levels. At present, the average nurse-patient ratio is 1.5 per 1,000. In order to achieve the minimum global standards, the figure should at least double; in some countries like the US, it is 9-10 nurses for 1,000 patients.

The reasons for the shortage as stated by Mohammad Mirza Beigi, deputy director for nursing services at the Health Ministry, are due to 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 in search of better opportunities in other countries.

“But measures have been taken to address the problem. 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 is one of the measures taken to resolve the issue.”

Nearly 10,000 assistant nurses were trained last year by the ministry and were recruited gradually at state-run hospitals. “For every four professional nurses, one nursing assistant is employed.”

Pointing out that the number of seats at medical universities for nursing students has increased from 6,000 in 2014 to 12,000 in 2016, the official said the two-fold increase should to some degree help compensate the shortage in nursing staff.

Nursing wages have also increased and they receive a minimum wage of $570 (20 million rials) per month.

  Integral Part of Healthcare

Nursing, as an integral part of the healthcare system, encompasses the promotion of health, prevention of illness, and care of physically ill, mentally ill, and disabled people of all ages, in all healthcare and other community settings.  

The unique function of nurses in caring for individuals, sick or well is to assess their responses to their health status and to assist them in the performance of those activities contributing to health or recovery.

Well-trained nurses also play an important role in reducing medication errors and preventing healthcare associated infections.

Annually, thousands of patients (10-15%) are affected by hospital-associated infections (HAI). Last year that ended in March, 600,000 people in Iran were affected by HAI. Urinary tract infections (UTIs) account for about 40% of all hospital acquired infections and more than 80% of those infections are associated with catheters. Nursing staff can be instrumental in preventing urinary catheter-related and other infections.