The fourth report of the Karnataka Administrative Reforms Commission has recommended a one-year compulsory government service for nursing students. The report, released on Friday, says this move would reduce nursing vacancies in the state.
The commission, headed by former Chief Secretary T M Vijay Bhaskar, was appointed by the state government in 2021. The recommendation comes at a time when medical graduates are protesting compulsory service.
The report says that one-year compulsory service can be introduced for B.Sc Nursing and GNM (General Nursing and Midwifery) diploma students and that they can be deputed to Primary Health Centres (PHCs), Community Health Centres (CHCs) and taluk hospitals with a stipend.
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The ratio of doctors to nurses recommended by the WHO is 1:3. But the ratio in Karnataka is 1:1.7 as per the National Sample Survey Organisation (NSSO), and 1:2.3 as per the National Health Workforce Accounts 2018, says the report.
The union health ministry's 2020 report 'Human resources for health in district public health systems of India' also mentions that 14 per cent of the regular staff nurse positions in Karnataka were vacant, along with 8 per cent of contract positions. Vacancies were higher in the urban PHCs and CHCs, at around 45 per cent.
Dr K Ramu, former dean of nursing department at RGUHS and currently Vice President of the Trained Nurses Association of India — Karnataka chapter, says there's indeed a huge shortage of nurses in the state but in case of one-year compulsory service, the government should specify nurses' salary and also assure that they would be regularised after the service period, he says. MBBS graduates who do compulsory rural service are paid Rs 35,000-40,000 per month, so a salary of around Rs 20,000 should be paid to nurses instead of a meagre stipend, says Dr Ramu.
"During Covid, the state government mandated nursing graduates to work and promised them a salary of Rs 15,000-20,000. But they were paid only Rs 8,000-10,000 despite the risk of infection at fever clinics," he says. "Generally, students prefer corporate hospitals as the pay is Rs 25,000-30,000 per month."
In fact, a government order for compulsory one year service for GNMs was already issued a decade ago, he says. "But this was never implemented. All government nursing colleges allow students to start work at private hospitals."
Need to upgrade nursing colleges
The Administrative Reforms Report adds that nursing colleges in the state have to be upgraded. Nine districts still don't have government nursing colleges.
And in the 27 nursing colleges that do exist across the state, only 3 to 4 have teaching posts sanctioned. In the other colleges, teaching is done by nursing officers from the attached medical colleges. Hence, the Department of Medical Education should create teaching posts, says the report. It also recommends starting B.Sc Nursing courses in all district and taluk hospitals with bed strength over 100, so as to meet the requirement of government hospitals.