Nurses are overworked, underpaid and unappreciated

In view of the recent International Nurses' Day, Homage Malaysia's Country Manager calls for the nation to improve the economic and social welfare of nurses in Malaysia.

by PC Gan

This opinion piece appeared on New Straits Times.

HEALTH Minister Khairy Jamaluddin talked about how nurses’ contributions should not be forgotten, especially when they were risking their lives — and still are — to treat Covid-19 patients in the early days of the pandemic.

If we were truly grateful, and in view of the recent Nurses’ International Day, we would do more to improve Malaysia’s nursing industry, currently facing a shortage of nurses due to many unresolved issues over the years.

The minister said he would look into “unlocking” the nursing degree holders to alleviate this issue. While it is fundamentally correct to start with the source of supply, we also need to look at where the leakages are and why they are happening.

A nursing diploma typically takes three years. Within the first year, a student would have covered physiology, microbiology, pharmacology, psychology and sociology, among other medical fields.

By end of the third year, they would have also learned urology, geriatric and dermatology. Many of the fields covered are also studied in MBBS (Bachelor of Medicine, Bachelor of Surgery).

The point is, nurses are not just administration staff or clerks, but highly trained medical professionals, often the first responder and the last barrier between life and death.

But, many treat them as though they are second-rate workers in the medical hierarchy, with no expertise of their own and assume they do nothing more than take orders from doctors.

Homage operates in Malaysia, Singapore, Australia and Japan. We have seen the differences within the markets in how nurses are perceived and treated.

It is with regret that Malaysia is one of the worst offenders in the ill treatment of and discrimination against nurses. Shockingly, this includes doctors, too.

The doctor-nurse relationship should be respectful, if not a joint partnership, given their complementary skillsets and what they have studied.

One of our nurses commented that in Singapore — in fact, in most countries outside Malaysia — doctors listen to nurses as they are part of the patient’s care journey. They provide an informed second opinion and the first port of call before escalation, which is often not the case in Malaysia.

Given a nurse’s educational background, wide scope of work and specialised expertise, one would expect that they would receive a commensurate remuneration.

After all, the prestige associated with doctors is partly due to the high salaries they can command, and nurses are also part of the medical profession.

Not so. In Malaysia, freshly graduated nurses are paid RM1,500 a month, lower than graduates in many other professions.

In Singapore, the average pay is about SG$2,500 a month. In Dubai, the next country of choice for Malaysian nurses, new nurses can earn 5,000 dirham a month — around RM6,000.

Employers often try to justify low pay with fewer working hours or lower job stress. I think it is evident to all that nursing is not a low-stress career.

Nurses also often need to work double shifts in a day (one shift is eight hours, so double shifts are 16 hours) and are stretched thin in caregiving due to a highly imbalanced nurse-to-patient ratio (1:16 in Malaysia, compared with 1:6 in Singapore).

Besides being a constant toll on their mental and physical health, this also means that Malaysian nurses have very little chance to upskill or pursue further education and training due to lack of time and energy.

As a result, they have few opportunities to further their career. Bottom line? They are overworked, underpaid and unappreciated.

It is small wonder that nursing is not popular or prestigious in Malaysia. It only makes sense that highly trained people want to pursue career opportunities where they can earn a liveable wage, be respected for what they do and enjoy work-life balance.

If we are serious about plugging the nursing shortage, we need to make nursing a more attractive career by ensuring our nurses are treated better.

Hence, I urge the minister and the Health Ministry to look into the nursing shortage from a reward and compensation perspective.

If these are not addressed, then it does not matter how many nurses we produce each year — they will all leave for better opportunities. Who, then, will be left to care for Malaysians?

About the Writer
PC Gan
Strong believer of unicorns 🦄, rainbows 🌈 and sunshine 🌤
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