𝐍𝐮𝐫𝐬𝐞𝐬 𝐅𝐥𝐨𝐜𝐤 𝐭𝐨 𝐆𝐫𝐞𝐞𝐧𝐞𝐫 𝐏𝐚𝐬𝐭𝐮𝐫𝐞𝐬, 𝐖𝐚𝐯𝐢𝐧𝐠 𝐆𝐨𝐨𝐝𝐛𝐲𝐞 𝐢𝐧 𝐆𝐫𝐨𝐰𝐢𝐧𝐠 𝐍𝐮𝐦𝐛𝐞𝐫𝐬

…𝒅𝒆𝒑𝒂𝒓𝒕𝒖𝒓𝒆 𝒐𝒇 𝒂 𝒔𝒊𝒈𝒏𝒊𝒇𝒊𝒄𝒂𝒏𝒕 𝒑𝒐𝒓𝒕𝒊𝒐𝒏 𝒐𝒇 𝒆𝒙𝒑𝒆𝒓𝒊𝒆𝒏𝒄𝒆𝒅 𝒏𝒖𝒓𝒔𝒊𝒏𝒈 𝒔𝒕𝒂𝒇𝒇 𝒉𝒊𝒈𝒉𝒍𝒊𝒈𝒉𝒕𝒔 𝒖𝒓𝒈𝒆𝒏𝒄𝒚 𝒊𝒏 𝒂𝒅𝒅𝒓𝒆𝒔𝒔𝒊𝒏𝒈 𝒓𝒐𝒐𝒕 𝒄𝒂𝒖𝒔𝒆𝒔 𝒄𝒐𝒏𝒕𝒓𝒊𝒃𝒖𝒕𝒊𝒏𝒈 𝒕𝒐 𝒓𝒆𝒔𝒊𝒈𝒏𝒂𝒕𝒊𝒐𝒏𝒔

By Krishna Kumar Sanyasi

The nation’s healthcare industry struggles with a notable obstacle amidst a wave of nurse resignations. The uptick in departures prompts apprehensions regarding the healthcare system’s capacity to accommodate rising medical needs. Addressing this urgent matter, the government proposes the recruitment of 100 nurses from India as a potential remedy to alleviate workforce pressures. Yet, this initiative triggers discussions on the ramifications of international healthcare staffing and the root causes catapulting the departure of domestic medical personnel.

A recent development within the healthcare sector has caused concern as a substantial number of nurses have tendered their resignations, totaling over 100 across various healthcare facilities. Notably, 47 of these resignations have come from the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), a renowned healthcare institution known for its commitment to patient care. This mass resignation of nursing staff comes at a critical time as the hospital is already grappling with a shortage of healthcare workers, including nurses.

With approximately 350 nurses on staff, losing nearly a seventh of its nursing workforce is expected to have significant implications for the delivery of healthcare services at JDWNRH. The impact of this departure goes beyond numbers, as experienced and dedicated healthcare professionals are crucial in maintaining the quality of patient care. The strain on healthcare services due to staffing shortages is likely to worsen if this trend continues unchecked. The hospital administration has acknowledged the nurse shortage and has implemented measures such as extended working hours to mitigate the impact of understaffing. However, the sudden departure of such a substantial number of nurses is anticipated to pose formidable challenges to the hospital’s ability to provide optimal care to its patients.

As of January 2024, the attrition rate for nurses had already reached 25%, and it is expected to cross 30% in March 2024 as many nurses had given their six-month notice period six months ago, which comes to an end in March. Nurses play a pivotal role in safeguarding the well-being of patients, and their absence can significantly affect the overall quality of healthcare services. The departure of a considerable portion of the nursing staff, comprising experienced professionals committed to their vocation, emphasizes the urgent need to address the underlying issues contributing to this exodus.

To address the nurse shortage due to staff retirements, the hospital management has implemented several strategies. One strategy involves extended clinical services, buying extra shifts from available nurses, paying them Nu 1500 for an additional six-hour shift beyond their normal working hours. The funds are sourced from JDWNRH’s own funds from cabins, not the Ministry of Finance. Another strategy is recruiting resigned and retired nurses and planning to recruit foreign nurses. Additionally, the hospital is collaborating with Khesar Gyalpo University of Medical Sciences of Bhutan (KGUMSB) and nursing schools or training programs to increase the pipeline of qualified nurses entering the workforce.

The Health Ministry has proposed to the Cabinet to hire 100 foreign nurses to address the growing shortfall and high attrition rate at JDWNRH. According to hospital management, “The proposal to hire 100 foreign nurses is expected to have a significant impact on overall healthcare services at JDWNRH. By augmenting the nursing workforce with skilled professionals from abroad, the hospital aims to mitigate the staffing shortage caused by resignations and maintain quality patient care. The influx of foreign nurses will help alleviate workload pressures on existing staff, reduce overtime and burnout, and ensure adequate coverage across various departments and shifts. Moreover, it may bring diverse perspectives, cultural competencies, and specialized skills to enhance the hospital’s ability to meet the needs of its patient population.”

The Health Minister, Tandin Wangchuk, highlighted the issue of attrition among Bhutanese health workers, acknowledging that they are leaving their jobs due to disparities in benefits compared to those offered in developed countries. He mentioned that many health workers abroad received salary increases during the pandemic, enabling them to save for their children’s future, while the working conditions in Bhutan are not as advanced. Additionally, he emphasized the influence of family and friends in seeking better opportunities outside Bhutan. To solve such issues, the ministry plans to provide better opportunities for future doctors studying at Khesar Gyalpo University of Medical Sciences of Bhutan (KGUMSB) and to improve working conditions for health workers.

Moreover, he accentuates that they are discussing with the Royal Civil Service Commission (RCSC) the possibility of rehiring resigned health workers who wish to return. However, if these efforts fail, the country may need to recruit health workers from outside Bhutan, as was done 30 years ago.

A nurse who requested anonymity from JDWNRH shared her thoughts on the challenges she faces in the healthcare industry. She expressed, “I have made the difficult decision to resign from my current position. The primary motivation behind this choice is my desire to advance my career. With only a diploma to my name, I believe now, it is the perfect time to climb the career ladder and enhance my skills. The opportunity to work in Australia promises not only a chance to earn more but also to learn and grow professionally. In light of the recent recruitment of 100 foreign nurses, I have mixed feelings. While it may help address the nurse shortage in our healthcare system, I am concerned about the potential impact on our economy. The influx of foreign workers could put pressure on our currency and create challenges for local professionals. I believe our country already has the resources to meet the demand for nursing staff.

With four institutes producing around 300 nurses annually, there is a pool of talented individuals well-equipped with practical experience from the beginning of their training. Instead of looking abroad for solutions, I suggest we focus on utilizing the skills and knowledge of our own graduates to meet the healthcare needs of our nation.”

Another nurse shared her thoughts on the challenges she faces working in the healthcare industry. She expressed, “It is just hand to mouth here. We cannot save money. Moreover, I have a child now, and I have to think about his future. I have a family to look after, and the salary we get here isn’t sufficient. We have to pay rent, and the cost of living has increased with inflation.”

She went on to explain that these financial constraints were the reason she decided to resign and pursue opportunities abroad. However, she added, “Maybe in the future, I will come back after maybe 5 years and build an old age home. That’s my plan.”

Another nurse said, “The main reason for me to resign is on the financial ground. Nurses are paid well in countries like Singapore and Australia. I have been given the opportunity to work in Australia, and after much consideration, I have made the decision to pursue this opportunity. I submitted my resignation in January, and it typically takes six months for the management to process it. I have worked here for almost two years, and it’s bittersweet to leave. However, I feel it is the right time for me to move out, especially considering my financial goals for the future. Despite working here for a significant period, I have struggled to save money. I want to ensure that I have a stable financial future, including owning a house when I retire. I believe this opportunity in Australia will not only provide me with a better financial foundation but also open up new experiences and opportunities for personal and professional growth.” She added, “JDWNRH is a referral hospital, and the majority of patients are referred from different parts of the country. I feel foreign nurses will have a tough time, especially with the language, and they might have a rough time coping with it.”
As the healthcare sector navigates these challenges, it is crucial to address the underlying issues contributing to the resignation of local medical personnel. Balancing the need for skilled healthcare professionals with concerns about the impact on the local economy and workforce remains a complex issue that requires careful consideration and strategic planning to ensure the sustainability and effectiveness of our healthcare system.