Nurses are encountering more opportunities and challenges than ever before in the rapidly changing dynamics of modern medicine and healthcare delivery. Lt Col (Retd) Binu Sharma, VP-Nursing Services, Columbia Asia Hospitals, India, shares invaluable insights on the evolving role of nurses and make them future-ready
How has the role of nurses become more diverse and complex in the current healthcare scenario?
The nursing role is evolving very rapidly as nurses are entrusted with a lot more responsibilities than ever before. The changing demographics, disease profiles and other factors have broadened and deepened the field of nursing. Today, nurses are giving talks, engaged in scientific research and actively addressing healthcare policy among other things. They also have the opportunity to pursue medical specialisations. Technology too has opened up new avenues of growth. Thus, nurses today have a very varied and multi-faceted role which can have significant impact on the healthcare system.
Moreover, the current scenario has also made it necessary for nurses to don several hats as they deliver care and act as the first point of contact with the families of patients. They have to culturally wise, knowledge-oriented and agents of care innovation. Thus, nursing has become more complex in ways that couldn’t have been imagined earlier.
How can nursing leaders be the agents of quality improvement and care innovation today and in times to come?
Not all nurses think of becoming a leader as they start their career. Yet, nursing leaders are pivotal to the healthcare system to collaborate with other health professionals and leaders. All nurses must be leaders in the design, implementation, evaluation and advocacy of ongoing reforms to the healthcare system.
Research and practice in nursing should be encouraged to ensure evidence-based improvements to care delivery. Nursing leaders are essential to convert new research findings to the practice environment and into nursing education and from nursing education into practice and policy. Nurses need strong leadership skills to contribute to patient safety and quality of care.
Nurses should have a say in health policy decision making and serve on advisory committees, commissions, and boards where policy decisions are made to health systems for improved patient care.
In the current IT-enabled healthcare delivery sector, how has the scope of nursing practice expanded?
Nursing technology includes several devices, systems and software which reduce the time expended on tasks like tracking down equipment, collaborating and co-ordinating with other staff members, updating patient charts etc.
Technology can also be crucial component to improve patient care and outcomes as it can help improve response times, increase accuracy and ensure safety. Technology also aids nurses and other clinical staffs improve communication and enable better efficiencies in clinical workflow thereby freeing up time to improve patient care.
Columbia Asia has a policy of ensuring that nurses are key participants in the digital health initiatives. We have a proprietary Health Information System (HIS) called ‘CARE 21’. It was developed by the internal IT team at Columbia Asia. Today, there are hardly any paper forms at Columbia Asia. The few paper formats you might get at the hospital are the consent form, a few checklists. Most patient related forms are in electronic format.
Today, all patient related processes are done through HIS-registrations, admissions, out- patient and inpatient assessments and consults, inpatient transfers, progress notes and communications from ICU, operating rooms and wards are done through the system. It also connects all the diagnostic departments like radiology and pathology and even here all records are maintained digitally. There is a business intelligence portal that sits on top of the medical record, this helps the nurses pull out the dashboards including key performance indicators (KPIs) for performance.
What needs to be done to make the nurses future-ready?
Nursing in India is at crossroads. While digital technology has enabled patients to seek the best in care, but nurses in India have to wage a constant battle against rising stress levels, lower pay and growing demands of the modern healthcare system. This has led to high rates of attrition among nursing staff, which is around 40-60 per cent. In this scenario, healthcare leaders striving to improve working environments should undertake digital transformation initiatives and continue to improve standards of care.
There is a vital need to empower nurses by upgrading their skills, knowledge and becoming specialists. However, the existing system of nursing education and practice is inadequate to meet the future healthcare needs and challenges. There is an urgent need to understand the scope of nursing practice with clearly defined educational curriculum and licensure.
What are the immediate and long-term steps needed to revitalise the nursing profession in India?
Nursing has a lot of potential for career growth and professional development. A nursing career begins as a registered nurse but it doesn’t have to end at that. It can branch into several directions, including advanced practice nursing, healthcare administration, government healthcare policy making, nursing education and nursing research.
Skilled and specialised nurses are in high demand by the health organisations.There are wide employment opportunities for B.Sc/ M.Sc Nursing/ GNM/ ANM Degree holders in the public as well private sector. They can also be employed in schools, orphanages and old age homes. They can also look at getting employed in industrial houses and factories. Besides, these they can opt for teaching in training institutes as educators.
However, there are some issues that need to be addressed urgently, such as
- Nurses should receive their due recognition for the service they render humanity
- Measures should be taken to ensure and enhance job opportunities in government-run hospitals and prevent exploitation of the nursing fraternity at private/corporate hospitals.
- Prevent workplace harassment by doctors and the hospital management.
- Standardise wages as per the the minimum wages fixed by the government. Revise the wage structure recording to the current cost of living, with mandatory yearly increments.
- Start overtime allowances to be started