A beautiful phrase by Margaret Mead on nurses reads: “Never doubt that a small group of thoughtful committed people can change the world, indeed it is the only thing that ever has.”
Nurses, unarguably, play a pivotal role in patient care. From being the first responders to health emergencies to initial assessments, treatment, recovery and rehabilitation, they spend maximum time with the patient in a health care setting, doing everything to heal them at multiple levels–physical, mental and emotional. Research shows that patients who are attended and treated by well-trained nurses, deployed at the right time, report significant improvement in outcomes.
Despite this, we see a huge gap in the training and treatment received by nurses across the world and what’s truly needed to empower them for modern healthcare challenges. This brings us to two critical questions:
How essential is it to invest in nursing and build an ecosystem for nurses that is safe and growth-driven?
And how does that really impact economic growth and resilience?
Globally, nearly 4.5 billion people are still without access to basic healthcare, and system breakdowns continue to claim as many as 60 million lives. The situation is already dire—with a shortfall of over six million nurses worldwide. And the future demands are even more staggering: To meet rising health care needs and ensure quality care, experts estimate that the world will require more than 30 million additional nurses. This creates the need for actively investing in training our nursing workforce, building capacity and providing an environment that is friendly and supports career progression.
However, the ground reality starkly contrasts with the action required. Our nurses are in the midst of an unprecedented crisis, challenged with unsafe work environments, chronic understaffing and inadequate pay- causing severe burnout, high attrition rates, workforce exodus, and their large-scale migration to countries providing better opportunities. These factors, coupled with the rising demand for healthcare services, is pushing the sector to the brink. Around 65% of nurses report that their country’s health care system is failing to ensure safe patient care—largely due to critical nursing shortages that are stretching resources dangerously thin.
Nurses, other than being critical to health care, also serve as key economic drivers. Investing in their health and well-being enables them to deliver better health outcomes, further translating into increased life expectancy for patients and a healthier overall population. Every extra year people live adds real value to a country’s economy—boosting overall growth by around 2.4%. Moreover, better health and smarter use of resources could raise productivity by up to 20%—leading to real cost savings and more effective health care delivery.
On the flip side, failing to invest in nurses comes with serious economic consequences. With an increasing number of nurses choosing alternate career options, it is important to note that each nurse departure can cost up to ₹31 lakh worth economic loss annually – incurred on their recruitment, training and lost productivity. Additionally, shortage of well-trained nursing staff coupled with mounting pressure at work can have cause patient harm during care, accounting for 13% of global health spending.
With only 1.9 nurses per 1,000 people, far below the World Health Organization’s recommended ratio of three nurses per 1,000, India’s health care system is under severe strain. A high attrition rate, lack of adequate training opportunities, and the absence of standardised nursing education and practice guidelines only compound the challenge. Attracted by better paying opportunities and healthier working environment, nurses in India are quitting their jobs here and settling abroad, further straining an overburdened system. The migration is being further supported by the easing of eligibility criteria by several European countries.
“If I work for five years in India, my salary would reach a maximum of ₹40,000. However, in the UK, I can earn around ₹4 lakh a month after five years of experience,” says Harsha Elizabeth Michael, a 26-year-old nurse from Kerala who relocated to the UK a couple of years ago.
Together, these challenges underscore the pressing need to take decisive actions to strengthen India’s healthcare system.
Though India’s nursing sector is currently grappling with many challenges, its future looks promising. The rising integration of technology in health care is transforming how nurses work, positively impacting their efficiency and care outcomes. The growing ageing population also presents an upcoming opportunity for nurses in the field of geriatrics care, requiring them to develop special skills to cater to the unique needs of older adults. A notable uptick in the demand for caregivers in critical care, oncology, neonatology and paediatrics also serve as excellent upskilling and advancement opportunities for our nurses as does the Indian government’s emphasis on preventive care and health promotion.
Looking at the current nursing trends, providing skill-based and role specific training, including technological training, to our nurses must be prioritised at all levels. Efforts are being taken towards this end by the Indian government who is investing in training programmes. The programmes aim to strengthen our nursing workforce and contribute to the government’s ambitious goal of positioning India as the ‘care capital of the world.’
“While it is the need of the hour to focus on increasing the number of nurses, it is equally important to invest in upskilling the existing workforce. By arming our nurses with advanced training and specialised knowledge, we don’t just fill staffing gaps, we unlock a cascade of benefits: Better patient care, reduced healthcare costs and happier and motivated nurses,” explains Dr Girdhar Gyani, director general of the Association of Healthcare Providers (India).
Next thing is to ensure an enabling and safe working environment for our nurses. By formulating nurse-centric policies at the workplace, organising a structured induction programme, providing hands-on training and continuously reviewing nursing operations and incorporating nursing feedback, hospitals can prevent burnout and empower the nurses to upgrade their capabilities, become more productive, experience improved job satisfaction and offer better care to the patients. Developing leadership skills through close mentoring and offering leadership opportunities is equally important to boost job satisfaction and lower attrition by supporting career progression.
Establishing a fair compensation framework is certainly another crucial strategy to retain our existing nursing workforce and stop the migration. This may include merit-based compensation that aligns with the nurse’s knowledge and skill and ensuring a transparent mechanism for appraisal and career advancement. Eliminating gender-bias and creating a culture of equality are also vital components of this.
Other than upgrading and retaining our existing nurses, the healthcare crisis in India can only be addressed by adding more nurses to the workforce. In view of this, the Indian government has decided to set-up 157 new nursing colleges providing high-quality education with access to latest technologies. We must also look at revamping the existing course and curriculum to align it with the current trends and evolving needs of the industry.
Equipping our nurses through training, leadership development and career progression is no longer a luxury, it is a necessity and also the cornerstone for India’s economic resilience and growth. While the Indian government is implementing various measures in support of this, the public and private health care institutions must commit themselves to the growth and well-being of our nursing workforce, empowering them to build a thriving, more powerful nation.
This article is authored by Dr Annu Kaushik, director, nursing, Cloudnine Group of Hospitals.
