There comes a time when silence becomes dangerous. A time when endurance is no longer admirable but destructive. For many nurses in our country, that time is now.
Nursing is constantly described as the backbone of the healthcare system, yet those holding that backbone together are increasingly overworked, underpaid, undervalued and unheard. We are expected to provide exceptional care under conditions that often make doing so extraordinarily difficult. Something has to give, and unfortunately, it is the nurses who are paying the price.
The nurse-to-patient ratio has become alarming. Imagine having one staff nurse and one nursing assistant responsible for a unit in the night with more than 30 patients. Thirty-plus lives, each requiring attention, medication, monitoring and care. When additional assistance is needed, there is often nobody available.
How is this safe? How can one expect quality healthcare when staffing levels make it nearly impossible to provide it?
To make matters worse, a new duty schedule has reportedly been sanctioned, requiring shifts of 7 a.m. to 3 p.m., 2 p.m. to 8 p.m. and two weeks of night duty. We are constantly reminded that ‘this was the duty of the past’. Why are we comparing the past to modern times? Are nurses expected to surrender their entire lives to the profession? Do we no longer deserve adequate rest, family time and a life outside the hospital?
Why has there been such a prolonged absence of meaningful recruitment and appointment of additional nurses? How much longer must the existing workforce compensate for staffing shortages?
Nursing school teaches us the standards of practice, evidence-based care and the importance of having the necessary resources to deliver safe patient care. However, the reality of the workplace often tells a different story.
We are forced to improvise, make do and find alternatives because supplies and resources are unavailable or scarce. We are expected to turn water into wine, even when there is barely enough water.
Resourcefulness should be an asset in nursing, not a permanent substitute for adequate supplies. We cannot continue demanding excellence from nurses while failing to provide the basic tools needed to achieve it.
Perhaps one of the most disheartening realities is the financial value being placed on nursing. Nurses are expected to maintain professional competence, pursue continuous education, keep abreast of current evidence-based practices and renew their professional licenses annually to remain eligible to practise. These are not optional luxuries. They are professional responsibilities.
Yet, despite these expectations, the remuneration attached to nursing remains grossly disproportionate to the responsibility, workload and level of accountability involved.
We are entrusted with human lives. We make critical observations, identify deterioration, administer medications, coordinate care, advocate for vulnerable patients and work through situations that demand physical endurance, emotional resilience and sound clinical judgement.
How is it reasonable to demand continuous professional development, financial commitments towards annual licensure, increasing workloads and unwavering dedication while offering compensation that leaves nurses feeling undervalued?
Nursing is not simply a job that requires someone to show up and complete a shift. It is a profession that carries enormous responsibility and deserves to be remunerated accordingly.
A serious and urgent review of nurses’ salary grades is needed. Such a review must consider the actual workload, clinical responsibility, professional qualifications, accountability and demands placed on nurses.
You cannot continually demand first-class healthcare from a workforce that is being compensated as though its responsibilities are insignificant.
There is also an increasingly concerning culture in which nurses who speak up or defend themselves risk being labelled disrespectful or insubordinate.
When did having a voice become an offence?
Ward managers, supervisors and senior officers were once frontline nurses themselves. They should understand the pressures of the profession. Unfortunately, some appear to forget those experiences once they occupy positions of authority.
Leadership should be about support, understanding and collaboration, not intimidation and fear. Respect must be reciprocal.
Even seemingly minor matters, such as enforcing the wearing of a cap, should never take precedence over a nurse’s overall health and wellbeing. Nurses are human beings. We get sick, we get tired and we have lives outside the hospital. We cannot be expected to function like robots while caring for everyone else.
How much more can nurses reasonably be expected to endure? Physical exhaustion, emotional strain, inadequate resources, insufficient staffing and poor remuneration are a dangerous combination.
We cannot wait until experienced nurses leave the profession, morale collapses or patient care suffers further before meaningful intervention takes place.
Nurses must begin standing together and demanding change. Through our recognised unions and professional representatives, there must be serious collective advocacy for improved working conditions. If legitimate concerns continue to be ignored, lawful and properly organised industrial action must remain an option for consideration.
This is not about abandoning patients. It is about protecting the profession and the healthcare system that depends on us.
To the Ministry of Health, healthcare administrators, policymakers and the wider public: please listen.
We are asking for adequate staffing, sufficient resources, fair remuneration, reasonable duty schedules and humane leadership. These are not extravagant demands. They are basic requirements for a functional healthcare system.
It is heartbreaking that a profession built on compassion has become an environment where its own practitioners are struggling to receive compassion.
We cannot continue celebrating nurses during Nurses’ Week, calling them heroes when lives are saved and applauding their sacrifices, only to ignore their cries when they ask for better working conditions.
A profession cannot survive on applause. Nurses cannot pay their bills with appreciation. And dedication cannot indefinitely compensate for systemic neglect.
We have spent our careers caring for this nation. Now, we are asking this nation to care about us.
When the backbone of healthcare begins to break, the entire system is at risk. Please, do not wait until nurses have reached their breaking point before deciding that their voices matter.
Signed,
A concerned nurse. One of many voices crying out to be heard.
