Hindustan Times: "No option but to nurse themselves"

June 29, 2006 -- Today the Hindustan Times ran a short piece by Surya Agarwal about the ill effects of a nursing strike on patients and physicians at King George's Medical University hospital (KGMU). The piece seems likely to create bad feeling toward the nurses--it makes no reference to why they are striking, or whether they made any effort to provide continuity of care. And some parts suggest that physicians (or even patients) could provide the nursing care if they only had the time and energy. Other parts do seem to suggest that nurses have unique skills, and that they cannot be replaced.

The piece focuses on the second day of a strike by 280 nurses at KGMU. It says that "the patients...are bearing the brunt" of the strike. Surgical patient Rachna lies in bed with her eyes "glued to [the] IV fluid level" in a nearby bottle, as a physician "taught her how to monitor the flow," and now she "has to play nurse to herself." Mamta, who just had a Caesarian section, says she is suffering from the lack of nurses because it is her first baby and she is "not even sure as to how [she] should handle him." She is quoted as saying: "The doctors are helping us but they can't be there all the time." Patient Ranjan notes that the "nurses used to take good care of me. The doctors are trying their best to give us our medicines on time and take care of us but it is difficult for them. Now, they have taught my wife how and when to give me medicines." These statements may suggest that physicians could replace nurses if they had the time.

However, other parts of the piece suggest that the striking nurses may have unique skills. A pediatric physician reportedly notes: "Children require more attention and care. The resident doctors are doing their best to provide optimum care but still, we can't match the care that the nurses provide to these children." The Superintendent of KGMU, Dr. Gurmeet Singh, is quoted as saying: "It is the nurses who administer the patients once the doctors have given their diagnosis and prescribed medicines. KGMU anyway is short of the nursing staff and when the existing staff is not present it becomes difficult for both the patients and the hospital." These comments suggest, albeit somewhat vaguely, that the nurses play a vital role in patient care and that they are not easily replaced by physicians. The Superintendent's comment also alludes to the nursing shortage, and we wonder if short-staffing was a factor in the strike.

Of course, it's possible to read even these statements as holding out the possibility that physicians could do the work if they had time. In fact, nursing is a unique discipline with its own scope of care. While nursing obviously overlaps with medicine, a physician can no more act as a nurse than a nurse can act as a physician. For instance, while the piece has several references to physicians trying to teach patients and families to give medications, nurses are specially trained to engage in such patient education, as well as the full range of psychosocial care, patient monitoring, and other care.

On the whole, the piece's focus solely on the effects of the strike rather than the reasons for it reflects a woeful lack of balance. Of course the suffering of the patients is regrettable, and it is newsworthy. But the piece should also have included quotes from nurses, and, some indication of whether the nurses had made any provision for patient care in their absence, and whether any nurses (such as nurse managers) remained on the job.

We hope the Hindustan Times will make a better effort to tell both sides of the story in the future.

See the article by Surya Agarwal "No option but to nurse themselves" (pdf) from the June 29, 2006 edition of the Hindustan Times.