Beyond pay, it's respect that counts with nurses

In October next year, public sector nurses will get their second pay rise in as many years.

The Health Ministry is dangling this carrot - part of a larger package - in the hopes that new faces will join the sector, and existing ones will stay.

But there is more to this than just a business deal, or a way to keep the lid on nurses' grouses a while longer.

As Health Minister Gan Kim Yong said of the pay rise: "I'm not Santa Claus, but I think these nurses deserve it."

In 2007, there was one nurse for every 205 people here. Five years later, this ratio was one to 154 - putting us slightly ahead of South Korea, with one to 211.

But in the same year, World Health Organisation figures show that Japan had one nurse for every 87 people in its rapidly greying population.

With Singapore's age profile headed in the same direction, the Health Ministry has projected a need for 1,400 new nurses a year between now and 2020 - when the health-care master plan comes to fruition.

Nurses are already in short supply, meaning that those already in the industry have to work that much harder.

For one thing, there is the arduous nature of the work.

Exactly how tough can a nurse's job get? For starters, there are some basic procedures every nurse must know: taking temperatures, dressing wounds, inserting feeding tubes and checking blood sugar levels.

Then, there are the specialists. Psychiatric nurses calm agitated patients; emergency department nurses resuscitate them. When the end draws near, nurses trained in palliative care will help ease their passing.

And of course, there is the dirty work involving bedpans and vomit bowls.

"The frustration as a nurse is plenty," said one, recounting how she had to rush from task to task with "no time to really think about what I was doing".

Another related how she used to be close to tears at the end of each shift. And yet another said that her job was like "being a punching bag".

This last description may not be too far off the mark. Last year, a Straits Times story showed how more health-care workers - most of them nurses - faced abuse from patients and visitors alike.

Sometimes they were shouted at, or had things thrown at them, or were treated like servants. Yet, they soldiered on - often with a smile.

There is also the fact that nurses are sometimes still seen as - in the words of one nurse - "handmaidens" to doctors.

Take this scenario: A patient needs an X-ray done to make sure that his feeding tube has been properly inserted.

But you, as a nurse with 10 years' experience, cannot order the X-ray. Instead, you must approach a doctor with that request.

Or perhaps you have a diabetic patient on your hands, one who is having a hypoglycaemic attack.

You will have to go to a doctor to prescribe the treatment you already know the patient needs, but may lose precious minutes of time doing so.

The ministry's new "care package" will allow senior nurses to make the call at times like these.

For it to fully succeed, doctors must also recognise that nurses do not play second fiddle but must be seen as competent professionals in their own right.

Finally, there is the perennial grouse of many enrolled nurses - that paper qualifications are worth more than experience.

These nurses - the lowest tier - had to meet certain grades at the Institute of Technical Education to become eligible for a course that would allow them to become registered nurses.

Those who fell short would stay enrolled nurses for the span of their careers.

The requirement has since been waived - as long as the nurse in question has at least three years' work experience and a good employers' report.

Take Madam Magaswary R. Balraju, 50, who is now a principal enrolled nurse after more than 30 years in the profession. Even with her degree of experience, she is still not allowed to administer certain controlled drugs. Until recently, this was as high up the nursing ladder as she could hope to rise.

"It's a very good opportunity for the younger enrolled nurses," she said. "Most of them are talented but didn't get the opportunity because of these restrictions."

As for herself? "If I get the chance, maybe I will try."

The changes are not a lowering of standards. Instead, they are an acknowledgement that real-world experience trumps paper qualifications - as it rightly should.

Perhaps, recognising nurses in this manner may even get patients to accord them a greater measure of respect.

So, look beyond the money when you evaluate the Health Ministry's announcement.

As one nurse put it: "Whether public or private, you don't go into this job for the pay."

Going by what nurses say, it is the acknowledgement of their dedication and competence that really makes the difference. This is what will have the greatest impact in lifting their morale and convincing them to stay.

When you meet a nurse, treat her or him with respect.

It is the least you can do for those who have made this profession their life's work.