The shortage of nurses in Iran reached half of the national standard; Each nurse does the work of two people

The head of the nursing system organization, announcing the severe shortage of nurses in the country, mentioned forced overtime, salaries disproportionate to the cost of living, and the withdrawal of troops from the health system as the factors that exacerbate this crisis.

According to Ambassador Arjan, Ahmed Nejatian, head of the Nursing System Organization, referring to the severe shortage of nursing staff in the country, said: Iran has about one-third of the regional average of nurses for each patient, and if we evaluate the current situation based on national standards, the number of nurses in the country is about half of the required standard.

Ambassador Arjan wrote in a news: He stated that the lack of nurses is one of the serious issues of the country's health system. In the current situation, the number of our nurses per patient is about one-third of the regional average, and based on national standards, we are facing a significant shortage.

Nejadian continued: In fact, one nurse in the current situation has to work as much as two people, based on the national standard. The result of this situation is forced overtime and an increase in the number of patients that each nurse must take care of; An issue that ultimately affects the quality of nursing care.

The lack of nurses is not caused by a lack of education

In response to the issue of whether the shortage of staff is due to the lack of acceptance of the nursing field or whether nurses leave it after entering the profession, the head of the nursing system organization explained: We do not have a fundamental problem in the field of nursing education. Every year, about 18,000 people enter universities in different fields of nursing, and the graduates of these fields enter the labor market in the same proportion.

Emphasizing that the country has the necessary educational capacity for training nurses, he said: The main problem in this field is the inappropriate distribution of nursing staff. In some parts of the country, we have unemployed nurses, but in some other areas, we are facing a severe shortage of personnel, and even the number of nurses needed to provide services is not provided.

Referring to the lack of attractiveness for employment in some big cities and deprived areas of the country, Nejatian clarified: In some cities, even official employment is not attractive for nurses. For example, in Tehran city or Hormozgan province, some nurses do not want to accept employment, because their salaries and benefits are not proportional to the cost of living and the inflation rate in these areas.

He added: Therefore, in addition to the fact that we are facing problems in recruiting nurses in some areas, in parts of the country where there is a nursing workforce and people are applying for work, the necessary employment permits are not issued or the number of these permits is not sufficient. For example, in the western regions of the country, we are facing a shortage of nurses and there are also job applicants, but unfortunately, the necessary recruitment permits are not issued in these regions or not enough are provided to medical centers.

Nurses do not remain in the system even after being hired

The head of the nursing system organization pointed out that the problem of staff shortage is not limited to the recruitment of nurses and said: Another issue is the maintenance of nursing staff in the health system. Even when nurses are recruited and hired, after one year of work, they may conclude that the salary and benefits received are not commensurate with the workload and hardships of this profession, and as a result, they leave the system.

Stating that working conditions and livelihood issues have a direct effect on the longevity of nurses, Nejatian noted: When a nurse is faced with conditions after employment that does not match the difficulty of the work, it is natural that it becomes difficult for her to continue working in this profession. Therefore, in order to solve the problem of the shortage of nurses, in addition to increasing the absorption capacity, attention should also be paid to the conditions that cause the retention or departure of the staff.

Forced overtime of nurses to compensate for the lack of staff

Referring to the nurses' dissatisfaction with the high amount of overtime and not being paid in proportion to their demands, he said: "Due to the shortage of nursing staff, the Ministry of Health has practically created conditions for nurses to do an average of 80 hours of overtime in addition to their main shift working hours."

The head of the nursing system organization said about the situation of nurses' overtime payment: Two years ago, the amount of nurses' overtime was very low, and after follow-ups, an increase was applied in these payments. This increase at that point helped to improve the conditions to some extent, but due to inflation and increased costs, its effect has practically disappeared.

He added: In the year when the amount of overtime was increased, there was a relative improvement in the payment situation, but this improvement did not last due to inflation, and today it no longer has a significant effect on the living conditions of nurses.

The shortage of nurses is more visible in public hospitals

In response to the question whether the shortage of nurses is greater in the public sector or the private sector, Nejatian explained: The largest provider of hospital services in the country is the public sector, and the shortage of nursing staff is more pronounced in this sector.

Referring to the high volume of people's visits to government hospitals, he said: The services of these hospitals are public and a large part of people go to government centers to receive medical services. For this reason, the shortage of nurses in public hospitals is much more visible.

The head of the nursing system organization continued: Of course, there is a shortage of nursing staff in the private sector, but private centers can compensate for part of this shortage by using different mechanisms. In general, due to the wide range of services and the high volume of referrals, the problem of the lack of nurses in public hospitals is more noticeable.

Reducing the number of nurses per patient affects the quality of care

Warning about the consequences of the lack of nursing staff on the health of patients, Nejatian said: All domestic and international studies show that as the ratio of nurses to patients decreases, the probability of some complications due to hospitalization increases.

He explained: Hospital infections, prolonged hospitalization and risks such as patients falling are among the consequences that have been reported in connection with the decrease in the number of nurses per patient. This issue is scientifically clear and the lack of nursing staff can affect the quality of patient care.

The head of the nursing system organization pointed out that some of the consequences of the lack of nurses are not easily visible to the public, and stated: The patient or his companion may not realize how much a hospital infection or other complication can be related to the care conditions and lack of staff, but the effects of this situation can be seen in different treatment departments.

He added: Another part of these consequences is reflected in the way of providing services and the quality of the nurse's relationship with the patient. Patients expect the nurse to be by their side calmly and patiently, take care of their requests and respond to their needs with appropriate treatment. However, when the nurse is faced with a high volume of work and a large number of patients, fatigue caused by work pressure can affect the quality of communication and services provided and cause patient dissatisfaction.

Temporary solutions are not enough to solve the shortage of nurses

Referring to the measures and solutions needed to solve the shortage of nurses, Nejatian emphasized: Experience has shown that one-dimensional and cross-sectional solutions cannot solve the problem of the shortage of nurses.

He explained: At different times, decisions have been made in a specific field to compensate for the lack of nursing staff. For example, increasing the capacity of nursing education is on the agenda, but this measure alone has not been able to solve the problem.

The head of the nursing system organization emphasized the necessity of adopting comprehensive solutions and stated: To solve this problem, we must follow a set of measures simultaneously. These measures should include education and scholarships for nursing students, increasing salaries and benefits, improving working conditions, and eliminating injustice in the health system; Because part of the nurses leaving the system is also caused by these injustices.

He continued: In some areas, it may be necessary to provide facilities such as boarding houses for nurses to improve their working conditions and longevity. In general, there are various solutions to solve this problem that the nursing system organization has announced many times over the past few years, but these suggestions have not been taken as seriously as they should.

The salaries and benefits of nurses are not commensurate with the cost of living

In another part of this conversation, the head of the nursing system organization said about the most important demands of nurses: one of the main issues is the inadequacy of salaries and benefits of government employees with the cost of living; An issue that is not limited to nurses and includes many government employees as well.

Nejatian stated: Today, the salaries and benefits of public sector employees, especially in the public sector, do not match the living conditions and the inflation rate of the society. This issue is one of the main problems of employees and nurses are also facing it as part of the human resources of the health system.

Pointing to the difference between the working hours of nurses and other government employees, he clarified: Besides livelihood issues, nurses also have other complaints. For example, while the working hours of government employees have decreased and they currently work about 25 hours a week, nurses are still working about 40 to 42 hours a week due to the nature of their job.

The head of the nursing system organization stated that the working conditions of nurses are different from many other professions and continued: Nursing is a difficult job and the workers of this profession must be at work at night and on holidays. Even in difficult weather conditions, such as snowfall, or in critical situations such as war, the provision of nursing services does not stop, and nurses must be present in medical centers.

He emphasized: This difference in working conditions should be considered in the service compensation system and the system should respond to the demands of nurses in accordance with the difficulties and responsibilities of this profession. In our opinion, it is necessary to pay more attention to the working conditions of nurses and the differences between this profession and other jobs.

In the end, Nejatian considered the payment arrears of nurses as another serious issue of this group and noted: Nurses' arrears are still one of the problems they are facing and action should be taken to solve them.