15 nurses resigned in 11 days in 2023

Lhakpa Quendren

An increasing number of nurses are leaving the profession, with many resigning voluntarily or leaving for other pursuits, burdening hospitals with manpower shortages.

In the past four years (2019 to 2022), 374 nurses left their job of which 323 nurses resigned voluntarily. In the first week of January alone, at least 15 nurses have resigned. Talks in the hospital – opportunities in Australia – indicate more could follow.

In 2022, 35 nurses availed themselves of the extraordinary leave (EOL) and some resigned after the EOL. While it is not possible to tell the exact reasons for leaving, high living expenses, work pressure, and stress, among others, are the reasons nurses cited for their desire to leave.

A nurse at the national referral hospital (JDWNRH) said that poor pay and benefits are the leading reason for quitting their jobs. “Along with stress, this could lead many of them to leave their job which is already happening.”

“Everyone is working to maintain a decent living, but it has now become difficult,” she said. “From buying groceries to house rent, the cost of living is too high, and this especially impacts low-income employees.”

“I am also planning to resign after a few years. More nurses quitting jobs would cause poor patient care and more errors would emerge,” she added.

More nurses leaving their jobs is a concern for those staying back, nurses say.

Another JDWNRH nurse said that existing nurses shoulder extra responsibilities. “We have to put in 12 hours of duty at a stretch during the day from the two 6-hour regular shifts in a day.”

“Given this situation, it would compromise the care service. We talk more about accountability, but on the other hand, more lapses would occur due to work stress and shortages of health care providers,” she added.

Nurses also say that the vacancies for nurses were not announced immediately after their graduation and many prefer to go abroad during their six-month internship period.

“The interns are not paid anything, and they feel demotivated. Many of them waited for so long expecting more contract vacancies would come,” said another.

The government should look into decentralising nurses from the districts to fill the shortages at the national referral hospital and regularising nurses on contract, nurses say.

A health ministry official said that the ministry is working on a contract recruitment plan. “We are collecting data from the districts,” he said.

The official added that while there are not many nurses resigning from the districts, the attrition rate at the national referral hospital is concerning.

“We are going to recruit nursing graduates from the private institutes in the country on a contract basis and also call back those nurses sent outside for professional grooming,” said the official.

JDWNR’s chief human resource officer Tshering Dorji said that retaining nurses with the hospital is an arduous task. “There is nothing we can do, but going forward, we have to accordingly put in longer-term plans.”

“We have to worry, but we will also ensure there are no severe shortages. Our healthcare workers are coming forward wherever required. Some are even not taking their day off,” he said.

Given the attrition rate, the national requirement for nurses in the next three years seems too far away.

According to the service and human resource standard 2022-2026 of the hospital, 3,107 nurses are required by 2026 with the expansion of health services and establishment of specialised health centres in the country.

There are currently 1,512 nurses serving in the 52 hospitals across the country and the national requirement for the next three years is a 100 percent increase from the current strength. The ministry’s intake for this year was 54 nurses.

The intake capacity for Diploma in Nursing and Midwifery programme for nursing colleges in the country is 50 students each per year.

The Royal Thimphu College has a four-year BSc Nursing and Midwifery programme with a total intake of 100 students a year. The first cohort graduated in 2022. Most, many say, are waiting to go abroad to work.

In March 2021, the cabinet directed the Bhutan Medical Health Council to change the eligibility criteria for the diploma in nursing to allow students from commerce and arts streams.