A narrative of the difficulties of nursing in Golestan; a shift that never ends

Gorgan- Nursing is not only patient care; Standing in high-pressure shifts, enduring lack of power and waiting for demands are also part of the reality of this profession.

Ambassador Arjan of the Provinces Group: Behind the doors of the hospital, where every minute can be fatal for the disease, there are nurses who have to balance between caring for patients, heavy shifts, lack of auxiliary staff and livelihood concerns; Those who sometimes after a long shift, instead of resting, go to another workplace to meet the living expenses. In such a situation, the question is not only about the number of nurses; The issue is how much of the power of these forces is spent on specialized patient care and how much of their energy is depleted under the burden of occupational and economic problems.

The director of nursing of Golestan University of Medical Sciences, in a conversation with Mehr reporter, talks about the realities that, along with the commitment and responsibility of nurses, cast a shadow on the state of this profession; From the lack of nursing assistants and job burnout to the delay of about six months in the payment of tariffs. At the same time, it also talks about trying to maintain forces, developing public education and moving towards new technologies; The path that he believes will not reach the desired result regardless of the conditions of manpower.

nursing; A career beyond hospital care

To explain the scope of nurses' activities, Mohammad Yadgari first points to the province's therapeutic capacity; Golestan has 17 public hospitals and about 10 social and private hospitals, and Army Mission Hospital also provides services to the people. In these collections, nurses form an important part of the treatment body; Forces whose presence is not limited to taking care of the patient in the hospital bed.

According to the director of nursing at Golestan University of Medical Sciences, Nurse Week is an opportunity to pay attention to the different aspects of this profession. This week's programs started on 18 Mehr with the theme of nursing sacrifice, and the following days are dedicated to nursing culture, management and knowledge. But from a commemorative point of view, the importance of this occasion is not only limited to appreciation and congratulations; Rather, it should be an opportunity to review the responsibilities of nurses and the problems they face on the way to service.

He considers one of the examples of this social responsibility to be teaching students cardiopulmonary resuscitation; The program was implemented with the coordination of the Ministry of Health, the country's emergency organization and the cooperation of education at the national level and included 17 schools in Golestan.

Yadegari believes that familiarization with first aid and cardiopulmonary resuscitation from a young age can increase the community's readiness to face accidents. From this point of view, the nurse does not only play a role during illness and in the hospital environment; Teaching health and transferring life-saving skills to people is also part of his mission.

From the Corona days to the Aqqla flood; The nurses who did not leave the square

When it comes to the difficulties of this profession, Yadgari points to the years when nurses worked in conditions beyond the normal routine of the hospital. According to him, from the era of holy defense to the corona epidemic and natural crises, the nursing staff has been placed in situations where professional responsibility has been accompanied by danger and double pressure.

He considers the Corona period as one of the difficult periods of this profession; A period when nurses were directly involved with the disease and its consequences for nearly three years, and in this way, a number of health workers lost their lives. Remembering the martyrs of health, Yadegari emphasizes the necessity of preserving the sacrifice of those who gave their lives to take care of patients and save people's lives.

According to him, in the recent incidents and attacks, the pictures published from the hospitals showed that the medical services are not stopped even in dangerous conditions. The treatment staff, despite the concerns and threats, try to continue the care of the patients; A responsibility that is not limited to a specific city or province.

Golestan has also gone through its difficult experience. Referring to the flood of 2018, Yadegari says that Aqqola Hospital was one of the centers that faced the consequences of the flood and the process of providing services in such conditions had many difficulties. However, the nurses tried to continue their duty.

In his view, these experiences clarify the nature of nursing: a profession in which cold and heat, floods and earthquakes or other crises do not destroy the principle of responsibility towards the patient.

Technology is coming; But hospitals also need human resources

Today's nursing, according to Yadgari, does not rely only on clinical experience and traditional methods. Increasing specialized knowledge, research activities and the introduction of new technologies, including artificial intelligence, are changing the way services are provided. He says that among the nurses of the province, there are people working in the field of research and innovation, and some of them have achieved inventions.

One of the programs that is supposed to be followed in this direction is the electronicization of nursing reporting; A method that can change part of the traditional processes and help to better organize information and the care process.

According to Yadgari, the experimental implementation of this method has been followed in universities such as Shiraz and Tabriz, and Golestan University of Medical Sciences has also planned to enter this stage. It is planned to hold a training workshop related to electronic report writing for Qutb 1 universities, including Golestan, Mazandaran, Gilan, Semnan and Shahrood.

After training the troops, providing the infrastructure and making the necessary arrangements, the trial implementation of the plan will be provided in one or two hospitals of the province. However, Yadgari emphasizes that its full implementation in all Golestan hospitals is not certain until the end of the year.

Along with these developments, the issue of human resources still remains. The director of nursing at Golestan University of Medical Sciences says: Although the ratio of nurses to hospital beds seems acceptable based on some statistics, the operating conditions of hospitals have another picture. An image in which the work pressure, the early departure of some workers and the desire to retire affect the actual capacity of the nursing staff.

Lack of nursing assistants; When part of the nurse's energy is used for other tasks

One of the most important challenges faced by Yadgari is the lack of nursing assistants. According to him, providing these forces can reduce part of the workload of nurses and create more opportunity to focus on specialized tasks and direct care of patients.

When the auxiliary force is not available enough, part of the nurse's time and energy is spent on responsibilities that can be divided among the members of the treatment team. As a result, it is not just an increase in workload; How to use the specialized power of nurses also becomes important.

Yadgari considers job burnout as one of the factors affecting the state of human resources. Some forces tend to leave the service cycle early or apply for retirement due to work pressures. This issue can aggravate the shortage of personnel and put more pressure on the employees who are still working in the hospitals.

The university has also followed measures to maintain the existing forces. According to Yadgari, with the follow-up of the officials of Golestan University of Medical Sciences and consultation with the Ministry of Health, it has been possible to extend the activities of some project forces. In the situation where the nursing plan period was usually two years in the past, now it is possible to continue the activity of some forces up to six years and even six and a half years; An opportunity that can help the troops to stay, so that they can follow the path of entering employment if recruitment calls are announced.

Livelihood concerns; A shift that does not end with the end of working hours

For many nurses, the end of the shift does not necessarily mean the end of the job. Referring to inflation and the increase in the cost of living, Yadegari explains that some of the forces work in private centers or provide care services at home after finishing work in the government hospital to support their families.

He emphasizes that the increase in nursing tariffs in recent years, despite the follow-ups, is still not enough to fully compensate the economic pressures. Living expenses and family responsibilities, along with the income received, have created conditions that some nurses are forced to accept more activities.

This concern is also associated with the issue of late payment of tariffs. According to the nursing director of Golestan University of Medical Sciences, the tariffs for 1405 have been announced, but the last payment was in March 1404, and the delay in payments in the province is estimated to be about six months. On the other hand, the overtime payment of nurses is up to date.

Yadgari explains: The amount of the received tariff is calculated with specific indicators and may not be the same in different hospitals. Large, referral centers that experience more patient visits and operating room activity may pay differently than smaller hospitals.

He also says that the retirement conditions of nurses depend on the type of insurance and related regulations. This year, more than 25 nursing colleagues with about 25 years of experience have retired at their own request; However, this possibility is not the same for all forces, and it cannot be said that all nurses with such a history receive full 30-day salaries. On the other hand, some forces continue to serve with more than 30 years of experience.

Regarding new recruitments, Yadgari explains that the recruitment of nurses is done centrally and through the Ministry of Health. Until this conversation, a new call had not been announced, and the possibility of holding it in the coming months depended on the completion of administrative procedures and the issuance of necessary permits.

respect for the treatment staff; Part of the patient's treatment path

According to Yadagiri's belief, one thing that should not be ignored in addition to providing manpower and improving working conditions is respect for health workers.

He reminds: service in the hospital is not only on the shoulders of nurses; Service workers, secretaries, guards, doctors, midwives and other members of the medical staff also play a role in the service delivery process and they all deserve respect.

According to him, the hospital staff are present at the place of service in different weather conditions and when incidents such as floods and earthquakes occur, but sometimes they face inappropriate behavior, insults and even physical conflicts with some clients. Encounters that can impose additional psychological pressure on them.

Yadgari wants people to be more patient when visiting medical centers and consider the sensitive conditions of hospitals. He believes that just as the medical staff strives to preserve the health and lives of patients, maintaining the peace of the work environment and respecting their dignity also helps to provide better services.

The narrative of the nursing director of Golestan University of Medical Sciences finally comes to one point: the commitment of nurses, although it has shown itself many times in crisis days and difficult moments, should not be an excuse to ignore their needs. Maintaining this human capital, from providing auxiliary staff and handling financial claims to reducing job burnout and strengthening the culture of respect, is part of the path to which the quality of patient care is also tied.