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Busy Nurses
How to combat the shortage in nurses
By Yin Pumin | NO. 23 JUNE 9, 2016

Yu Hongli, a nurse of the No.1 Affiliated Hospital of the Harbin Medical University, teaches a patient to practise rehabilitation training on May 9 (XINHUA)

When the world celebrated its 105th International Nurses Day on May 12, Xiao Yang was still busy caring for patients at the Intensive Care Unit (ICU) of the Zhengzhou-based Henan Provincial People's Hospital.

Xiao, 30, has worked as a nurse for seven years and one word that he believes can precisely describe his job is "busy." He often jokes about his job as being in a "five plus two" mode: five days doing routine business and two days a week in a state of emergency.

One of the main reasons for this state of affairs, Xiao believes, is the lack of nursing staff at his hospital, especially male nurses like him. According to figures provided by the hospital's personnel department, the hospital has 2,580 nurses, but with more than 3,000 beds, such number of nurses cannot meet the demand.

"Especially in the ICU units and pediatrics department, running all day is common for us," Xiao told Beijing Review.

In fact, the situation is a nationwide phenomenon. According to the Chinese Nursing Association (CNA), China currently has 2.86 million nurses and the proportion between doctors and nurses has reached 1:1.

However, compared to the lowest 1:1.25-ratio standard set by a government plan for the national medical development between 2011 and 2020, there is still a 1-million gap in the number of nurses needed around the country, CNA estimated.

"It is the gap that causes the common overloaded working status of nurses. The government must hammer out some efficient policies to turn around the situation," Feng Gang, a professor with the Department of Sociology of Hangzhou-based Zhejiang University, told

A worrisome condition 

The outflow of professionals has further worsened the lack of nurses. A survey of 630 nurses held by Jilin University last year found that more than 50 percent of the nurses had thought about leaving the nursing profession.

Zhang Rui, 25, is a nurse working at the Department of Pediatrics at the Beijing Chao-Yang Hospital. In the three years of her work, Zhang witnessed many nurses around her leaving the hospital. "Some went to community hospitals, some went to enterprise hospitals, and some even chose to abandon the nursing career," Zhang told Beijing Review.

One of the causes for this exodus is the overload of work in the nursing industry. According to Zhang, working over eight hours a day is normal. "Under such conditions, we don't even have time to have a date," Zhang joked in a pathetic tone.

However, despite the overloaded work, nurses are often underpaid. According to Huang Renjian, former Council President of the CNA, in order to save expenditures, many hospitals chose to limit the number of nurses and their salaries.

Zhang said that her salary is still 3,000-4,000 yuan ($459.42-612.56) per month after three years of work.

"The low salary plus high-intensive work have sped up the outflow of professionals," Huang told Beijing-based Life Times, a newspaper sponsored by the People's Daily and Global Times.

Another reason for the drain is the absence of respect from patients and their families.

"Especially under the current difficult relationship between doctors and patients, some patients and their family members regard nurses as dispensable persons and show little respect to them," Ni Xin, President of Beijing Children's Hospital, told Life Times. According to him, such low respect has led to many nurses leaving his hospital in recent years.

Besides, Ni said that the low growth prospects of the career also caused nurses to quit. "Usually, the top of their career is just to become head nurse. This has little attraction for them," Ni said.

Ni suggested promoting those nurses who have rich experience and special medical skills to more important positions.

"Of course, the first step we should take is to give them more respect and make more effort to safeguard their dignity and interests," Ni said.

Feng with Zhejiang University believes that to lift nurses' status, the nursing profession should be separated from the doctor's management system and be regarded as an independent system similar to the doctor's. "Then we can enrich the contents of the system and make nurses earn their own dignity and opportunities," Feng said.

Zhou Xiaozheng, a well-known sociologist with the Beijing-based Renmin University of China, suggested solving the problem with market methods. "The easiest way to improve nurses' status is to raise their salaries," Zhou said.

In Zhou's opinion, China's nursing industry is in an imbalanced state between supply and demand. If the situation continues, hospitals will have to raise their salaries to attract nurses.

Han Xiaofang, Director of Beijing Municipal Office for Medical Reform, told that one important aspect of Beijing's medical reform is to include nurses in its personnel-building measures. "We have realized the severity of the outflow of nursing personnel. We will make more effective measures to turn over the situation," Han said.

Li Xiuhua, another former Council President of the CNA, suggested laying down a special law for nurses to protect their rights and interests.

With all these efforts, China is expected to have 4.45 million nurses by 2020, with more than 1 million new nurses to be trained before then, Ma Xiaowei, deputy head of the National Health and Family Planning Commission, said at a symposium marking International Nurses Day on May 12.

Gao Binlin, the only male nurse at a community clinic in Hefei, Anhui Province, attends a patient on May 7 (XINHUA) 

Mr. nurse 

Like Xiao at Henan Provincial People's Hospital, more male nurses have appeared before patients at hospitals in China.

In Henan, the number of male nurses was 4,851 by June 2015, accounting for 1.7 percent of the total number of nurses in the province, according to figures from the Henan Provincial Health and Family Planning Commission.

In 2011, there were only 1,839 male nurses working at the province's hospitals.

Song Baoyun, Director of the Nursing Department at Henan Provincial People's Hospital, told Zhengzhou-based Dahe Daily that 105 male nurses out of the total 2,600 are currently working at his hospital. In 2011, there were only 32 male nurses out of the total 1,600. "The increase is apparent," Song said.

The situation at Zhengzhou People's Hospital is similar. "The number of male nurses increased to 74 from 56 in 2012," Wang He, Director of the hospital's Nursing Department, told Dahe Daily.

Most medical insiders believe male nurses have many advantages at work. They can easily bear the stressfulness of the nursing job, such as working long hours, moving heavy equipment, and caring for patients with serious illnesses.

Compared to female nurses, the number of male nurses is still minor. According to CNA figures, there are only about 30,000 registered male nurses in China, mostly working at ICU units, emergency departments and operating rooms.

"Due to the gender expectations, it is hard for patients to accept male nurses in ordinary wards," Song said.

Xiao shared a story about the time when he just entered the nursing career seven years ago. One day, when he went to provide help to an elderly patient at the hospital, the old man was shocked and screamed.

After he explained the situation, the patient shook his head and told Xiao to change his career. "I was ashamed at the time," Xiao said sadly.

According to Xiao, patients' misunderstanding is in fact bearable. "Misunderstandings from parents and relatives are also common," he said.

Xiao joined the Nursing School of Zhengzhou University in 2005 after he failed to enter the university's Medical College. At the beginning, his parents felt ashamed and dared not to tell people that their son was studying the nursing courses.

"It was only after I had worked as a nurse for three years that my family started accepting the reality. In recent years, I have used my professional skills to prove myself," Xiao said.

"Society needs to adopt a more reasonable attitude toward nursing," Song said, adding that gender diversity contributes varying thoughts and perspectives, which are meaningful for patients.

In fact, with rising acknowledgement from society, more students are ready to choose the nursing career today. Take the Yanjing Medical College for example; the proportion of the male students who have enrolled in the college's nursing department has increased from 10 percent in 2002 to 15 percent in 2015.

"The change testifies the social acknowledgement. I believe there will be more men appearing in the nursing troupe in the future and making their contributions to the country's medical cause," said Shang Shaomei, Dean of the Nursing School of Peking University.

Copyedited by Sudeshna Sarkar

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