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Black ribbons

July 22, 2005 -- Today the Lucknow Newsline posted an unsigned Express News Service piece about the effects of a brief nurses' strike in the Indian state of Uttar Pradesh. The story is notable for the apparent desperation of the nurses to have their demands considered, and for its account of what happens when nurses are absent, which suggests something of what nurses normally do for patients.

The piece, "Nurses strike called off after day's chaos," states that the Rajkiya Nurses Association called off its strike after only one day. The association's secretary said that government officials had agreed to seven of the 17 demands the association had made, which the piece describes vaguely as relating to the "creation of new posts at the hospitals and salary and arrear dues." Apparently, the nurses had been wearing black ribbons since July 1 "in protest against the government's lack of interest in their demands."

But the heart of the piece is its description of the strike day, which affected health services "all over the state." In "the city," presumably meaning Lucknow, "services were crippled at all the district hospitals." At King George's Medical Hospital, many operations were cancelled, and NICU "patients and their attendants were left to fend for themselves." One "worried" mother there was quoted as saying that nurses previously "took care of the child's medicines, temperature etc. Today we have had to call the doctors and interns every time for this. And they also find it difficult to do all this as it is not their routine job." Another NICU parent complained that whenever he asked physicians to take a look at his jaundiced five-day-old child, "they spoke to me in a very rude manner." The piece notes that "[a]t civil hospital, the wards were left on the mercy of the pharmacists." The piece does not report any negative patient outcome as a result of the strike.

The piece does not confront directly the issue of how and when critical health professionals like nurses may ethically go on strike. Certainly, it would have benefited from further explanation of what motivated the nurses to leave patients in the hands of physicians, pharmacists, or "attendants," and whether any provision was made for a skeletal nursing staff--were nursing managers on duty? However, though the focus on the strike's effects but not its causes may reflect a lack of balance, the piece does get across that nurses do things for patients that other professionals cannot do easily, if at all. Of course, the piece does not begin to convey the full range of things that nurses do to keep patients alive; giving medicines and taking vitals is the tip of the iceberg. Nor does it explain that other health professionals cannot do key nursing tasks not just because they are not used to it, but because they have not been intensively trained to do those tasks. Even so, the depiction of "chaos" and the concern of the distraught parents suggests that nursing is a factor in patient outcomes. The report, though lacking key details, also appears to be a cautionary tale about the potential effects of a failure to devote adequate resources to nursing, a problem that is hardly unique to Uttar Pradesh.

See the Express News Service piece "Nurses strike called off after day’s chaos" posted on the Lucknow Newsline on July 22, 2005

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