RESPECT and remuneration.
To address the critical shortage of nurses in Malaysia, the profession must be given the respect it rightly deserves and wages which are reflective of the professional qualifications and contributions of nurses, say those in the industry.
In 2022, there were more than 117,000 registered nurses in Malaysia, the largest number compared to any other profession, says Malaysian Nurses Association (MNA) president, Dr Aisyahton Suhaimi.
High demand has resulted in the Ministry of Health increasing its enrolment for nurse training, with 1000 trainees currently enrolled in the Jan 2024 intake, she says. The same number is expected for the July session.
Aisyahton says currently, the nurse to population ratio in Malaysia is 1: 283 compared to the World Health Organisation's target of 1:225.
"This ratio clearly indicates the shortage, which is probably caused by lower wages, poor working conditions, inadequate support and conflicts with management, which have resulted in demoralisation and burnout."
The intensity of the daily workload increases when the nurse to patient ratio is higher and poor working conditions, long working hours, lack of career advancement and lack of job satisfaction drive nurses to migrate, retire early or even leave the profession, she explains.
While the Ministry of Health is increasing the intake of students for nursing (1000 - 2000 per intake), Aisyahton says there needs to be a salary adjustment or review by the public service department to effectively address this issue.
Recruiting individuals for nursing in Malaysia is not an issue as there is always a demand for the profession, but retaining them is a challenge, says Tun Tan Cheng Lock College of Nursing Assunta Hospital principal, Theresa Arul.
Malaysian nurses are much in demand in countries like Singapore and the Middle East, and given the exchange rate, these countries are able to offer a much more attractive salary package. This has resulted in a brain drain, she explains.
Malaysian nurses are leaving to seek greener pastures overseas, contributing to the shortage locally.
"In Malaysia, we can't provide the kind of salary offered overseas. Even established hospitals can't afford it, so working overseas has become an attractive option for Malaysian nurses. We are producing enough nurses but we are unable to retain them."
Nursing is a challenging profession and in other countries nurses are highly regarded so respect for the profession is also there, she adds.
Many experienced nurses have also chosen to leave hospitals and explore career prospects with pharmaceutical companies, elderly care centres and other areas of healthcare where their experience and expertise is invaluable.
Theresa says the shortage must be urgently addressed. Without nurses one can't run a hospital or open wards.
The ideal nurse to patient ratio would be 1:1 in the intensive care unit and 1:5 in wards.
"Any shortage would result in compromised patient care as existing resources would have to be stretched," says Theresa.
The profession does call for more recognition and respect, adds Assunta Hospital assistant head of nursing Sharma Kalidass.
Nurses are the backbone of the healthcare sector and this shortage will have a significant impact on our healthcare system, he says.
"Unfortunately, nurses are still viewed by the public as mere caretakers of patients when in fact, their job scope and responsibilities has expanded significantly."
Encouraging more men to join the profession would, to some extent, address this shortage but the bigger issue of Malaysia losing its existing nurses needs to be managed first, adds Sharma.
"It's not just recruitment that needs to be addressed, but the brain drain."
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