‘Pakistan has great shortage of trained high-quality nurses’

Pakistan’s nurses and midwives are playing a vital role on the front line of the third Covid-19 wave despite the ongoing shortage of healthcare professionals in the country, a seminar held at the Aga Khan University (AKU) on Tuesday to celebrate International Day of Nurses and Midwives was told by officials, policymakers and academics.

“Pakistan has one of the greatest shortages of trained high-quality nurses,” said Dr Faisal Sultan, special assistant to the prime minister (SAPM) on health, as he addressed the seminar from Islamabad through videoconferencing.

“No healthcare system can deliver quality care without the input of trained, committed professionals in the nursing field,” he said, adding that the government’s national health taskforce is working to expand the education and training of nurses to ensure that the country’s nursing workforce continues to grow.

While recognising how nurses have gone above and beyond the call of duty to serve the public during the pandemic, Sindh Chief Minister Syed Murad Ali Shah, the chief guest at the event, noted that the demand for nurses worldwide is increasing, which is creating incentives for nurses in Pakistan to move abroad.

“We are mindful of the fact that due to the global shortage of nurses, the demand worldwide has increased, which is giving our nurses the opportunity to migrate to high-income countries to improve their quality of life. This is definitely something we don’t want to happen, as in Pakistan there was already a shortage of 1.3 million nurses before the pandemic.”

In a recorded message, Sindh Health Minister Dr Azra Fazal Pechuho said that one of the reasons behind Pakistan’s shortage of nurses is that too few women are seeking admission to the profession.

Speakers at the event also noted that limited career pathways for nurses, inadequate compensation and respect, and unsafe work environments are some of the factors behind people leaving the profession or choosing to practice abroad.

They added that Pakistan is one of the five countries facing the largest deficits of nurses, with the World Health Organisation also calling on the country to take steps to double its nursing workforce.

“Nurses have grown used to double shifts, no days off and living at hospitals during the pandemic to keep the public safe,” said AKU’s School of Nursing and Midwifery Dean Prof Rozina Karmaliani. “They are also working at vaccination centres, hosting capacity building drives for their colleagues, volunteering at field isolation centres, as well as managing tele-clinics, hotlines and home-health initiatives. Despite being stretched, they are striving to do their best.”

Commenting on the steps needed to retain and encourage nurses to stay in the workforce, experts highlighted the need to promote advanced practice nursing, qualifications that enhance the skills of nurses and enable them to widen their scope of practice, as this would involve the granting of licences to nurses and midwives with specialist qualifications, enabling them to run their own clinics.

For example, they said, an advanced practice registered nurse, who has specialised in non-communicable diseases, would be able to run their own tele-clinic or community clinic to care for patients with high blood pressure, and holding a licence would enable them to provide a higher level of care by permitting them to diagnose and treat patients as well as prescribe drugs. However, they added, advanced practice nurses (APNs) would continue to refer complications to specialists, but granting regulatory approval for APNs would enable nurses and midwives to make a greater impact in fields such as maternal health, mental health, child care and non-communicable diseases.

The speakers said that if midwives could have run their own clinics during the pandemic, this would have eliminated the need for pregnant women to risk contracting Covid-19 by leaving their home to go to the hospital. Similarly, they added, APNs could run tele-clinics for vulnerable populations such as the elderly, making it more convenient for patients to access healthcare.

“Empowering nurses and midwives to take the lead in patient care would expand the availability of affordable care,” said Prof Rafat Jan, associate dean at the AKU’s School of Nursing and Midwifery. “It would also boost timely access to treatment, which would prevent the onset of complications that place a significant burden on tertiary care hospitals.”

While the panellists appreciated the federal government for setting up a taskforce on nursing, announcing measures to establish a new nursing university and to invest in expanding the nursing sector, they pointed out that many other initiatives are needed to promote the education of nurses.

They highlighted the need to convert nursing schools into colleges and to encourage faculty development initiatives so that academic institutions would have enough teachers. They also called on the government to invest in online learning to improve access to learning during the pandemic so that graduates could complete their education on time and join the workforce immediately.

In addition to online teaching and the use of digital platforms, introducing innovations in simulation can also help produce the best nursing graduates for the market, added the speakers.

“Nurses have left no stone unturned to support the healthcare system,” said Khairunnisa Khan, deputy director of nursing, Government of Sindh. “I salute their persistence, dedication and hard work, which they have exhibited especially in the ongoing battle against Covid-19.”

Speakers at the event also recognised the achievement of milestones by their colleagues during the year, such as Pakistan awarding its first nursing doctorate, and eight nurses from the country being named among the world’s 100 outstanding nurses.