The story of nurses who do not have holidays

The nurses who kept the lights on in the medical centers during the days of war, under the sound of explosions along with other health workers, today, along with the memory of their sacrifices, they say about the lack of manpower, the overwhelming pressure of shifts, unfair salaries, and unfulfilled promises; Nurses who have to work in several medical centers in order to earn a living and demand recognition of their role, expertise and the difficulties of their profession.

According to the report of Ambassador Arjan, quoted by Ambassador Arjan, at the same time as Nurse's Day, the narrative of nurses from the days of war and crisis presents an image of a profession that does not know holidays; Professionals who, at the height of crises such as the Corona pandemic, wars, floods, and earthquakes, at the same time worry for their lives and their families, bear the responsibility of caring for patients and continuing the activities of medical centers.

Of course, the difficulties of the nursing profession are not limited to serving the days of war and crisis; They say the lack of manpower, the pressure caused by long and consecutive shifts, physical and mental tensions, exposure to infectious diseases, and the lack of fit between the capacity of medical centers and the number of patients as part of the daily challenges of this profession; so that sometimes the capacity of emergency beds is full, but the arrival of patients continues; Conditions that make it more difficult to provide services and finally, an important part of dissatisfaction is directed at nurses who have to respond to the many needs of patients within the limits of facilities.

In addition to work pressure, livelihood issues and what they call "inequality in the payment system" are among the most important demands of nurses; So that they emphasize the uncertainty of the criteria for calculating nursing tariffs, the lack of proportionality between receipts and the inflation rate, and the complexity of complaint payment formulas, and the need to review the structure of the health system and clearly define the position of different groups.

The nurses say that the economic conditions have led some of their colleagues to simultaneously work in two or three medical centers; Conditions that, along with intensive shifts, also increase the risk of job burnout, and on this basis, they demand real reform of the payment system, paying attention to the level of education and the difficulty of work, regulating shifts in principle, and involving experts and workers in medical environments in decision-making.

From their point of view, appreciation of nurses should not be limited to one day a year and congratulatory messages, but should be reflected in improving working conditions, fair payment, providing human resources, reducing the pressure of shifts and making their voices heard in health system decisions.

The nurses who stayed with the patients during the corona epidemic, the days of war and other crises and helped to keep the lights of the medical centers on with other medical staff, now they want that the difficulties of this responsibility can be seen all the days of the year and the protection of their sacrifices leads to concrete and sustainable measures.

Nurses who should be responsible for all hospital issues

In this regard, Reza Kohkhel - the head of the emergency department of Bharlo Hospital, on the occasion of Nurse's Day, said: "Nursing has different dimensions, and the views about this profession are different, from the perspective of people and medical staff to different nursing groups." However, people usually consider the nurse who takes care of the patient to be responsible for all the issues and events of the hospital and expect her to be the answer to the existing problems and shortcomings.

He continued: Experience shows that if the patients are satisfied with the way the services are provided, they leave the hospital without criticism, but if they are not satisfied with the services, they convey their protest to the nurses, and these nurses are the ones who should be held accountable. We do our best to provide services and spare no effort, but judging the performance of nurses must be based on the existing realities and the conditions in which we serve.

The need to modify the definition of the positions of occupational groups in the Ministry of Health

Stating that part of the problems of nurses are due to the structure of the health system, Kohkhel said: the structure of the Ministry of Health and how to define the position of different groups in the health system are associated with problems. In this structure, some groups have a special position, but the position and role of other groups have not been clearly defined. Therefore, the current structure needs a fundamental revision. It should not be assumed that achieving a goal is only the result of the efforts of a person or a group; Rather, all the groups that try to realize it have a share in this path. However, the position of different groups in the Ministry of Health is still not clearly defined.

Uncertainty of nursing fee payment formula

Stating that the unfairness of the payment system is one of the basic problems of nurses, he clarified: Years have passed since the issue of nursing tariffs was raised, but there is still no specific standard for payment in this field. As the head of the emergency department of Bharlo hospital, I have to announce the numbers and figures related to the nursing fees, but even I am not clear about the exact criteria for calculating these payments. On the other hand, the salary of nurses is not proportional to the inflation rate and the conditions are such that the salary of this group is not acceptable considering the responsibilities and job difficulties.

The need to pay attention to the difficulty of work and the level of education in paying salaries

The superintendent of the emergency department of Bharlo Hospital said: The need to pay attention to the level of education and the difficulty of work is very important in determining the salaries of health system employees, and these components should be one of the main criteria for salary payment. In addition to having difficult working conditions, nurses have university education and some colleagues also have doctorate degrees.

However, their income does not match the economic conditions. Some people may think that nursing work is not so difficult, but they should be asked if they can be in the hospital for only five hours even without providing a service. Is it psychologically possible for them to bear such conditions? The reality is that the pressures of the hospital environment and the responsibility of caring for patients cannot be ignored.

Decision makers have no knowledge of nursing

Referring to the distance between decision makers and the realities of the treatment environment, Kohkhel said: People who make decisions about nurses sometimes do not have enough knowledge of the issues and problems of this group. In such a situation, a law is approved and communicated to the hospitals, which does not have the correct structure and basis, and the medical centers face new problems. While the best approach is to get the opinions of experts and people who are directly related to the issue before passing any law, so that the decisions are based on the existing facts.

We have a weakness in connection with payments

He continued: We have been facing problems in the field of justice in payment for years, but these issues are still not resolved. We have gradually become numb to problems, while the core of the problem remains. The significant difference between the income of different groups is not limited to nurses, but the lack of justice in payment in this profession has become one of the serious concerns.

Criticizing the complexities of the payment system, this nurse added: How can a law be passed and based on that, a specific amount is considered for payment to a group, but after a while, several notes were added to it? If no payment is to be made or the final amount is not known, why should this number of notes be considered? The problem is that the payment system is not defined properly and it is not clear what amount should be paid to the people.

Stating that the problems of nurses are not limited to financial issues, Kohkhel clarified: the challenges in the hospital environment also put additional pressure on this group. The lack of human resources, the lack of balance between the number of beds and patients, and the lack of treatment space are among the problems that nurses face on a daily basis.

Sometimes, hospital emergency beds are fully occupied and no new patient can be admitted, however, the patient is still referred to the hospital. When the number of patients exceeds the available capacity, it is natural that service delivery will be difficult and people's dissatisfaction will increase. In such a situation, nurses have to work in an environment whose facilities and capacity are not proportional to the amount of existing needs, but in the end, a significant part of the dissatisfaction is directed at them.

The head of the emergency department of Bharlo hospital, pointing out that an important part of the nurses' activities are not visible to the public, said: "Nursing duties are not limited to being at the patient's bedside and providing direct care." Writing reports, completing files and doing things related to patients are also part of nurses' responsibilities, but many people are not aware of this.

For this reason, sometimes we have to explain why the nurse is sitting at the nursing station, while we may be busy recording patient file information at the same moment. However, such a situation sometimes gives the impression that nurses are sitting in a corner and talking.

He said: There are good and bad people in all professions, and nursing is no exception to this rule, but in many cases, nurses are in a situation where they have to respond to multiple expectations. For example, in a hospital ward with 20 beds, each nurse should consider the condition of other patients in need of care in addition to the patient they are treating. At one moment, the patient's companions may want to urgently attend to their patient's condition, while another patient also needs care. The nurse must balance these responsibilities and at the same time bear the psychological pressure caused by these conditions.

Employment in two to three medical centers to provide livelihood

Kohkhel continued: Despite these pressures, nurses are sometimes asked why they are bored or why they look tired. While they have to spend extra energy and use all their strength to perform their duties. The economic conditions have also caused some nurses to go to another medical center after finishing a work shift and work in two or three centers to meet their living expenses. It is normal for a person who experiences such conditions to gradually face exhaustion and extreme fatigue.

actual correction of conditions; The request of the nurses

Stating that the reform of working conditions should be considered along with the reform of the payment system, he said: One of the demands of nurses is to reform the performance of the group of people who work in hospitals. All employees must perform their duties properly and be accountable for their responsibilities. Of course, like any other profession, among nurses there are also people who do not perform their duties properly, but it is possible to improve the conditions when the performance of all groups is considered and the responsibilities are performed properly.

The difficult conditions of nurses in the last 10 years

Kohkhel said about the many crises faced by nurses: People who have worked in the nursing profession in the last 10 years have experienced many difficult events and situations, and the Covid crisis is one of the most important of these events. However, during the epidemic, some days around 700 people died in the country and the number of daily deaths in this hospital reached 15. In that period of time, the disease had outstripped the treatment for various reasons.

He also said about the continuation of the activities of nurses in war conditions: many groups closed their activities during the war, but the nurses remained at the service and provided services. Being at work in such conditions was not only scary for the nurses themselves, but their families were also worried about the health of their loved ones. Some nurses could not resist the demands of their families and went with them, but for various reasons they returned to the place of service.

This nurse said: The efforts and difficulties of the nursing profession are less noticed throughout the year, and nurses are usually not seen, and if attention is paid to them, this attention is very limited. In fact, nurses are noticed only once a year, that is on the occasion of Nurse's Day; While their problems and responsibilities continue all the days of the year.

Many duties of nurses in the health system

Mahnaz Jafari, a nurse at the VIP Department of Bharlo Hospital, also said about the nursing profession: Nursing is a specialized profession that educated people at bachelor's, master's and doctorate levels work in various fields such as health, healthcare and treatment. Teaching patients is one of the most important duties of nurses; Trainings before hospitalization, during hospitalization, during the treatment process, and when patients are discharged.

financial and livelihood issues; One of the main problems of nurses

Stating that nursing faces many challenges, he clarified: Livelihood and financial issues are one of the most important issues for nurses. The salaries they consider for nurses are unfair. The financial challenges of nurses are not only limited to salaries, but there are also injustices related to labor.

The problems of nurses are not limited to financial issues

Stating that the problems and problems of nurses are not only limited to financial issues, this nurse of Bharlo Hospital said: mental and physical tensions caused by the nursing profession, shift work hours, and the number of continuous shifts are among the other problems of this group. When dealing with patients, nurses are exposed to infectious diseases that threaten their physical and mental health.