Irregularities in nursing and midwifery department

Nurses are entitled to independently assess and monitor patients. They provide care, and also alert doctors about the health conditions of their patients. At the emergency department, they deal with incoming patients to coordinate with the doctors to deliver medical assistance.

They also assist those patients with inadequate healthcare knowledge to protect their interests. They monitor patients' intake of medicines, as prescribed by physicians. Overall, nurses and midwives work in providing preventive, curative and rehabilitative cares to patients.

Before independence from British colonial rule, nurses in this part of the world used to be trained at three junior nursing schools, under the Bengal Nursing Council. The first professional senior nursing school was established in 1947 at Dhaka Medical College and Hospital. The Nursing Council was established after independence. In 1949, a few local nurses were sent to England to receive basic training.

They were later appointed in leadership positions in the nursing sector. In 1952, the East Pakistan Nursing Council was formed as a regulatory body for nursing education and services. After Bangladesh's liberation in 1971, it was renamed as Bangladesh Nursing Council (BNC).  In 1960, the junior nursing training schools were abolished. From 1962 to 1970, senior nursing training schools were established and attached to eight medical college hospitals, to provide diplomas in nursing and midwifery.

According to BNMC's latest count, as of March 31, 2019, Bangladesh has a total of 56,733 registered nurses and midwives, working in different positions, including nursing superintendent, deputy nursing superintendent, nursing supervisor, senior staff nurse, and staff nurse.

They are employed at different government, private, and army institutions, and NGOs. According to government rules, nobody can join the nursing service before registering with BNMC, and that only after obtaining degrees in nursing and midwifery. There are 43 nursing institutions in the public sector across the country, each of which has 50-80 seats.

These institutions offer three-year diploma course in nursing science and midwifery. Both male and female candidates can avail the course, after sitting for their Higher Secondary Certificate (HSC) exams. Additionally, there are seven nursing colleges at the divisional headquarters in the public sector, which provide bachelor's degree after a four-year course in nursing (basic) education. Every year, 700 fresh nursing professionals from this program enter the workforce. Four nursing colleges provide BSc in nursing (post-basic) education, each with places for 125 students.

In Bangladesh, nursing is considered as a second segmental job. That is why the work value and social recognition does not encourage the brilliant boys and girls to join the profession. It creates an ill impression and contributes as one of the major causes of shortage. In order to increase the number of nurse and fulfill the actual need both government and private sector should come forward with the initiative to open more nursing institutes, colleges to attract new generation to join in nursing.

There is also urgent need to uphold the significance of this noble profession. Among other barriers negative social attitudes and more restricted policies, undefined status of nurses, lack of appreciations, cultural barriers and lack of financial supports for nursing education are also the central factors behind the shortage of nurses.

Although the question of whether nursing is a profession may not be settled, nursing possesses qualities that entrust education to institutions of higher learning, has established policies for practitioners while allowing the nurse to function autonomously in practice, has a code of ethics in which to practice and has clear set of educational standards for continuing education.

So, the discussion is particularly important when it is viewed from the perspective of a RN with an ADN degree who is enrolled in a RN to BSN program, that is, the nurse is seeking to increase the current level of education under which he or she practices. Nurses have specialized education and training validated by professional licensure in each state.

We have a code of ethics and established practice standards we are bound to adhere to, a violation of which can result in our license being revoked or sanctioned. We have our own body of ongoing research that shapes and governs our practice. Nurses work autonomously without our scope of practice. We formulate and carry out our own plan of care for clients (when applicable); we apply judgment, use of critical thinking skills, and make nursing diagnosis.

It is known that, ineligible persons are sent abroad in the name of study tour. It does nothing to do the job. A strong syndicate has been formed in the nursing training sector, with an officer in the health and education department of Health and Family Welfare Ministry, an officer in the Department of Nursing and Midwifery Administration and an officer of the training project. In the meantime, investigation is going on against an officer of this syndicate for allegations of irregularities in posting and transfer of nurses.

Top local expert doctors said that modern medical treatment including bone marrow transplant, kidney transplant, cardiac surgery, bypass surgery is being successfully conducted in the country including operation of complex diseases, which are not possible in many countries.

Our expert nurses training must be modern and necessary reformation must be taken into consideration our honorable Prime Minister Sheikh Hasina has emphasized to take various measures to improve the quality of training with the world. But strong syndicate send the non ineligible nurses for training in abroad who are not involved in nursing or teaching, they are nominally nominated for training of ineligible persons. In the back, billions of money of the training project went to the syndicate pocket.

It has been learned that Prime Minister Sheikh Hasina has announced the promotion of nurses as well as the standard of development, but a syndicate ministry has stuck their promotions for a long time due to various complications. Although there are higher degree holders in the country and abroad, they are recruited for their posts in important positions, including the Directorate, Nursing College.

Their main terms are senior staff nurses. But none of them is acting assistant director, deputy director, director, principals and other posts. Many have already retired from the job. But they did the job of high level officer. Financial services have got senior staff nurses. However, under the same ministry, diplomatic pharmacists get the selection grade.

Despite the sincerity of the Prime Minister and the Health Minister, nurses have been deprived of getting their dues and selection grade for which the nursing associations of Bangladesh and its Dhaka Medical College Unit have expressed sadness, disappointment and anger.

There is a strong syndicate in the control of nursing sector. The posting and transfer is being illegally regulated under the control of this syndicate. This syndicate is issuing diploma certificates.

This will have negative effects on healthcare. Bangladesh Nurses Association (BNA) Secretary General stated that the nurses who have been approved by the government recognized nursing and midwifery council will only be registered. Apart from this, the registration of the applicants as a nurse cannot be given from the nursing council.

Several sources of the health ministry said that a few days ago, complaints of transfer and posture related to a group of three to four influential officials and employees, including Director General of Nursing and Midwifery. But the most awkward incident among these has become the 'pilgrimage of India' and 'to allow pilgrims to travel to Saudi Arabia, under which the allegations of financial transactions are discussed in the face.

In addition, the complaint has also been filed against the Director General in connection with the allegation of corruption, harassment, shopping and transportation, although there is the possibility of involvement of some officials from ministry in this regard. In particular, the names of several officials, including the PS of Health and Family Welfare, have been named for sending some of the last few nurses to Hajj and to some countries for training.

From the above discussion, it is clear that one is blaming another. Now who is to bell the cat? Actually, the problem lies with co-ordination. There is most probably lack of co-ordination between ministry of health and family planning and religion. Again, there is also gap in between concerned ministry and directorate general of nursing and midwifery (DGNM).


The writer is a researcher and columnist