On May 12^th, the world-over, INTERNATIONAL NURSES DAY (IND) is celebrated.  May 12^th is the birth anniversary of Florence Nightingale.  International Council of Nurses (ICN), which is a federation of more than 130 national nursing associations, has celebrated IND from 1965.  However, in Jan 1974, ICN decided to celebrate the IND, uniformly and globally on 12^th May.  Each year, ICN creates and distributes an IND kit that contains the resources for celebrating International Nurses Day (IND), based on the annual theme.  The IND theme for 2022 is ‘Nurses: A Voice to Lead – Invest in Nursing and respect rights to secure global health’.

Nurses are the bulwark of healthcare profession.  Long before a surgeon enters the OT, the nurse would be there to prepare the patient – not only physically, but also strengthen mental make-up of the patient.  During the surgery, the nurse is alert to various bodily parameters of the patient and ensuring support to progress of surgery.  The nurse keeps a track of the swabs, and other surgical instruments in use.  She/he leaves the OT only after the patient moves to the ICU for post-operative care.  While this is the routine hard working story of an OT nurse, the non-OT nurses too have intensely long hours of care giving and providing support to patient recovery, including ensuring a positive attitude among patients.

Much is focused on the role of doctors and their ability to heal patients through proper medical, dental and surgical knowledge and techniques; however, doctors rely on the supportive nursing team for full deliverables of patient well-being.  A doctor is simply stressed without nursing support.  The role of nurses is indispensable for doctor and patient.

The other very vital role of nurses is managing and giving confidence to patient attenders and patient’s family members during the care giving.  Patient attenders are always stressed about the status of patient and the future course of disease, while the doctor does everything to heal the patient, the doctor has many patients to attend to.  One of the immediately accessible healthcare professional in the wards of a hospital, who is a picture of patience – is the nurse.  At the nursing station, the nurse is alert to all demands of patients and also provides timely interventions to ensure the doctor’s recommendations are carried through – such as administration of injectables, monitoring IV infusion flow, and providing other drugs.

In case of any emergency with the hospitalized patient, it is the nurse who has to spring into action – institute recovery measures and simultaneously call in the duty doctor and assist the duty doctor, in patient rescue.  The nurse also keeps tab on the patient ensuring adherence to diet.  Food is also medicine and supports healing of patients.  In the healthcare team efforts, the nurse professional is a sheet anchor for effective administration of medical and surgical therapy.  Rightly said, there is a quote on nurses: “Nurse: just another word to describe a person strong enough to tolerate anything and soft enough to understand anyone.” —Unknown

No patient ever forgets the support and care the nurse who has helped in meeting the requirements like use of bedpan, tube feeding, and administration of enema, body cleansing and other hygiene measures.  Patients always recall such moments of help with utmost gratitude and bless the ever supportive nurses.

Florence Nightingale: lady with the lamp

Popular as ‘lady with the lamp’ Florence Nightingale is considered the modern world’s first professional nurse.  She would go on her rounds tending to the wounded at Barrack hospital, Turkey with a lamp in hand, hence, the description: ‘lady with the lamp’.

Being a visionary & coming from a British aristocratic background, Florence Nightingale gave the principles and priorities for establishing modern nursing education and nursing profession.  Born on 12^th May, 1820 at Florence, Italy, when her British parents were on a travel tour, Florence had a comfortable and wealthy upbringing.  When she was in her teens, Florence took an inspired plunge into nursing, to care of the sick and poor – although Florence’s parents wanted her to marry and settle down.  Before making her mark as a nurse, Florence learnt nursing concepts in Germany and France, thanks to her supportive father.  In 1853, Florence Nightingale started to serve as Superintendent and Manager of a hospital in London, marking her formal entry into healthcare practice.

The Crimean war between Russia and the British (with France and Turkey) during the period 1853 and 1856 saw much death and distress.  Ultimately, the British emerged victorious.  However, during the war, wounded British soldiers were in dire straits at makeshift hospitals and in squalid conditions.  Thirty four year old, Florence Nightingale with a team of 38 women came to British Military Hospital (Barrack Hospital), Scutary, Turkey, and with intense dedication and resoluteness, Florence Nightingale focused on improving sanitary conditions and providing supportive care to wounded soldiers.  Her interventions not only gave her experiential learnings, her mission also saved thousands of British lives.  Hence, Florence Nightingale is called the Crimean war heroine.  Florence Nightingale’s work during the Crimean war revolutionized nursing treatment to wounded soldiers and also improved battlefield medicine.

The evergreen nursing profession

Today, nursing is a well-established and progressive global healthcare profession.   Opportunities exist in India and abroad.  Nurses are very well paid, with anesthetist nurse being the highest paid nursing professional in USA.  Qualified Indian nurses are in demand across the globe for their professional services.  Kerala is focused on becoming a hub to supply nurses to the world.  Nursing colleges are agog with learners eager to make a mark – professionally in the global nursing profession.

In India, nursing profession has advanced with immense growth opportunities, in Govt. and private hospitals (ward nurses, OT nurses, and ICU nurses), military and armed force service (military nurses), factories (industrial nurses), community health nurses, and in field of nursing administration there are various positions; and finally, nursing education sector has opened up lots of jobs as lecturers and so on.  Nurses in informatics and independent practice are also into a growth path.

On International Nurses Day (IND), 12^th May let us salute nurses: the noble care givers, often not acknowledged adequately in public domain; nurses are the professionals who strive to provide health promotion, health protection, health maintenance, health restoration, rehabilitation, and palliation.

Sunil S Chiplunkar M Pharm (Pharmacology) MBA (Marketing) PGDHRM (PhD)

VP – Business Development, Group Pharmaceuticals, Bangalore

E mail: 1969sunilchiplunkar@gmail.com

Mob: 63645 78669

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The COVID pandemic has clearly revealed the strengths and weaknesses of India’s healthcare system. While health care workers have been celebrated for saving lives, often at the risk of their own,the pandemic has also exposed the need to rapidly grow India’s health workforce by investing in their education, service and leadership. According to the State of World’s Nursing India profile, almost 47% of India’s health workforce consists of nurses and midwives. With 1.7 nurses per 1,000 population, India falls short of the WHO recommended rate of 3 nurses per 1,000 population.

India in need of 4.3 million more nurses by 2024

India in need of 4.3 million more nurses by 2024 to meet WHO norms despite recording two-fold increase in capacity in the last decade. The recently released State of the World’s Nursing Report 2020 and State of the World’s Midwifery 2021 also highlight that investment in nursing and midwifery will not only contribute to achieve health-related SDG targets, but also to education, gender and economic growth globally.Leadership, education and job creation are three top priorities for India to focus on as per these reports.

Mrs. Khurana, Secretary General, All India Government Nurses Federation says, “Nurses and midwives form the cornerstone of healthcare delivery in India and are the unflinching pillars on which our healthcare system rests. Despite their undeniable role and contribution, they are often denigrated to be insignificant sacrificing angels bearing the whole burden with minimal support and dignity.

#NurseMidwife4Change campaign

Today, four premier nursing and midwifery professional organisations have come together to launch a unique campaign to highlight the role of nurses and midwives and reinforce their contribution to the health care system of the country—through education, service and leadership. Aptly named#NurseMidwife4Change, the force behind this campaign are All India Government Nurses Federation (AIGNF), an umbrella organization of nursing associations, Trade unions in government sector and federations; Trained Nurses Association of India (TNAI), a national professional organization of nursing and midwifery professionals in the government and private sector; Society of Midwives-India (SOMI), an organization with a mission to strengthen midwifery in India and Indian Nursing Council (INC), the national regulatory body for nursing education in India & member of the International Council of Nurse (ICN).

The #NurseMidwife4Change campaign conceptualised by and for nurses and midwives of India aims to bring to light their true profile, status and contribution in the country by creating awareness about the multiple roles they play as educationists, service providers, specialist and leaders. Simultaneously, the campaign will spotlight some of the key issues facing this critical workforce today for example working conditions, remuneration and image in the society and highlight global and national recommendations for the overall growth and development of this professional cadre.”

In-line with the global campaigns like Nursing Now and the Nightingale Challenge,#NurseMidwife4Change is aimed at supporting nurses and midwives to lead, to learn and to strengthen the profession.The WHO Global Strategic Directions for Nursing and Midwifery 2021-2025 presents evidence-based practices and an interrelated set of policy priorities that can help countries ensure that midwives and nurses optimally contribute to achieving universal health coverage and other population health goals.

This pan India programme is a call to all quarters of society, including policy makers, government, civil society, nursing and midwifery training institutions, the private and corporate sector, non-government organizations, and the people of this country to support its nurses and midwives through this campaign—not only to ensure that nurses and midwives get recognized for their immense contribution and role in the health care system, but also to prioritize investments to further strengthen this cadre so that they are able to perform their roles optimally and help the country achieve its health and welfare goals and targets.

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The spread of COVID 19 infection has posed an unprecedented challenge to all of us. The healthcare fraternity have faced the brunt of the Covid 19, from doctors to nurses all healthcare personnel had to put in extra work hours to handle the additional influx of patients while maintaining all the safety precautions. With the Nursing faculty being the front line warriors in terms of patient care at the hospital, they have played a crucial role on many occasions to ensure the safety and recovery of the patients. Their selfless contribution in efficiently managing the COVID scenario is unparalleled.

Nursing profession is always considered as a noble, selfless and exhausting. Be it a patient who is terminally ill or a patient recovering from fever, nurses do not show any hesitancy in treating them. Along with the help of doctors and their team, nurses care for people when patients are at their most fragile condition– instilling hope in them.

Patient satisfaction plays a major role in any healthcare facility. Along with the treatment a patient receives for his/her health problem, getting that extra care and attention from the staff is vital to a quick recovery. Nursing staff work selflessly at this juncture to provide the required attention to the patient and fulfil their needs.

Unsung heroes of our war against Covid

The pandemic has highlighted the altruistic contribution of the nursing community. Nurses across the world have been working day and night without the fear of Covid 19 while safeguarding the patients from the novel corona virus. Though, they have to wear PPE kits and masks for hours together, the entire nursing team have taken a pledge to ensure their patients’ health and wellness. Most days, they don’t even get to drink water properly, use washroom or even have their meals on time.

However, that smile on the face never fades. They keep their worries and problems aside to make the patients comfortable. There could be a sick baby at their home or parents or their husband, the dedication for the patients and work starts as soon as they step inside the hospital. COVID-19 has brought in sharp focus on the need for every nation to invest in nurses and their well-being.

Taking care of their health becomes crucial for the continuous functioning of the healthcare system. Increased workload, more patient influx, lack of time to rest during the current situation is putting extra burden on the nursing community as well. They have to be more cautious about the surroundings as they spend more time with the patients – even covid positive patients where there is high chance of infection transmission.

Many nurses have already tested positive, recovered and are continuing their service to battle the pandemic. However, sometime the stress they are going through may lead to burn out or other health issues like anxiety, depression or insomnia. Therefore, taking care of the nursing staff becomes crucial to safeguard them from any kind of adverse effects. Nursing community is the vital link between the patient and the health care team. Hence take a moment to think about their well-being.

1. Acknowledge: Nurses work day and night taking care of the patients. But still sometime their work goes unnoticed. Acknowledgement from the patients and the family members can bring a cheer to them.

2. Recognition: Their tireless work and the continuous smiling face needs a big applause

3. Avoid criticism: A nurse has to attend to multiple patients in a short span of time. Give them time instead to criticising or blaming them

4. Be empathetic: Nurses are always compassionate about their patients. Let’s show empathy towards them as well. With increasing Covid cases everywhere, while dealing with the patients they may not get time to eat as well. Take time out to ask about their well-being.

It is imminent that no healthcare facility is complete without the presence of resilient, skilled and experienced nursing staff. They are the ones generally assisting doctors. Alongside, they are the ones offering solace and relief to patients. They provide timely care to the patients and boost their spirit. This is why they are considered to be the backbone of the healthcare sector.

Ms. Saroja Jaykumar
Chief of Nursing
Columbia Asia Hospital,Whitefield 

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[1]. India with an estimated 77 million people living with diabetes is the second most affected country in the world after China¹. According to International Diabetes Federation, one in six people in the world with diabetes is from India. The number is projected to grow to become 134 million by 2045. This statistic clearly shows that diabetes has become a major health issue in the country, and it is extremely important to raise awareness regarding its proper management.

Every year, 14^thof November is commemorated as World Diabetes Day. Based on this year’s theme,‘The Nurse and Diabetes’, it becomes even more important to raise awareness around the crucial role that nurses play in treating people living with diabetes.

Importance of safe insulin injection:

In people with type 1 diabetes insulin is the mainstay of treatment. However, people with type 2 who are not well controlled on oral drug therapy, diet and exercise may also need insulin injections to control their blood glucose levels and prevent long-term complications from cardiovascular disease, stroke, peripheral vascular disease, kidney disease etc. For optimal insulin absorption, insulin needs to be injected into the fat layer under the skin to avoid the muscle. It is also important to use a new site each time for every injection and to change the needle with every use.

“Reuse of needles and incorrect injection technique can lead to complications and medication errors. Needle re-use causes blunting and bending of the needle tip, increasing pain & bleeding, dosage inaccuracy, and Lipohypertrophy. Regular monitoring and  proper management of diabetes can help avoid serious health problems in the long and short term. Hence, it is imperative to adopt right insulin injection technique to manage one’s diabetes and lead a healthy life”, says Dr. Subramanian Kannan, Consultant and Head of Department of Endocrinology, Diabetes and Metabolism, Narayana Health City Bangalore.

One of the most effective ways to manage diabetes is by investing in training programmes for healthcare professionals. They should be aware of the right techniques and safe practices of handling insulin injection. Deploying effective education and training on safe and correct utilization of insulin injections to the nursing staff can significantly improve patient outcomes.

“We work with a dedicated team of clinicians and diabetes educators who train patients on various aspects of injection technique right from the first visit itself. Our team spends time with the patient making them confident to independently take their injections, follow correct injection site rotation, prevent re-use and the awareness and prevention of Lipohypertrophy. Looking at the larger benefit of optimizing insulin administration for better glycemic control, we must discourage the re-use of insulin needles.” said Dr. Ameya Joshi, Consultant endocrinologist, Endocrinology Department Bhakti Vedanta Hospital and Research Institute, Mumbai and Institute of Diabetes Endocrinology And Nutrition (INDEAN) clinic, Mumbai

Adherence to proper medication is essential to determine treatment outcomes for patients. In India, this is particularly true in the management of NCD’s such as diabetes. Insulin injections are life-saving medical intervention for proper handling of diabetes. An honest commitment and understanding of accurate technique by healthcare professionals and patients will certainly ensure effective diabetes management.

[1]https://www.diabetesatlas.org/en/sections/demographic-and-geographic-outline.html

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