The importance of nursing has been seen in the COVID-19 epidemic situation worldwide (Gunawan et al., 2020). This letter prompts discussion about contradictory issues among nurses in Bangladesh.
Firstly, in our country, since 2008, the Diploma in Nursing Science and Midwifery course has been upgraded, and the Bachelor of Science in Nursing degree has just been started (Bangladesh Nursing and Midwifery Council, 2018). Nursing has been considered a second-class job since 2011 (Ministry of Health and Family, 2011). However, there is a disparity between diploma and graduate nurses in Bangladesh. Diploma nurses have more priority than graduate nurses. Diploma nurses have 90% of the seats allocated for government jobs. On the other hand, graduate nurses are allocated only 10% of seats despite being more qualified (Bangladesh Public Service Commission, 2020). This inequality is a contemporary issue in Bangladesh. That is why undergraduate nurses in Bangladesh have an uncertain future. New meritorious students are also confused about these courses. Where should they be admitted? Diploma in Nursing or Bachelor of Science in Nursing?
Secondly, most nursing students graduated from private institutions every year. The ratio of nurses graduating from private and government institutions is 25: 8 (Bangladesh Nursing and Midwifery Council, 2020). There are approximately 71,369 registered nurses in Bangladesh (Bangladesh Nursing and Midwifery Council, 2020) and 14,686 nurses working in government (Ministry of Health and Family Welfare, 2020a). Although more than 70% of nurses work in the private sector, those who work in the private sector face limited seats in higher education than government-employed nurses. Only 3% of the total seats allocated in the Master of Science in Nursing (MSN) program are for privately employed nurses (Bangabandhu Sheikh Mujib Medical University, 2020). New graduate nurses are being deprived of their careers because of these limited opportunities.
Thirdly, there are inequalities for graduate nurses and graduates from other departments. Graduate nurses are considered a second-class profession, but graduates of other departments are considered a first-class profession. So, nurses are feeling dissatisfied working for this less value (Morsheda et al., 2016). Bangladesh bears 76 percent of the deficit of nurses. The country needs another three lakh nurses (Siddiqui, 2020). According to the World Health Organization (WHO), at least three nurses must be hired against a physician (Imam, 2020). But there are 2.85 times more doctors than nurses in our country (Alam, 2019).
Fourthly, in Bangladesh, nurses join as senior staff nurses and retire in the same position due to lack of promotion (Ministry of Health and Family Welfare, 2020b). Only senior staff nurse posts are available in Bangladesh, and some nurses are promoted to the position of Nursing Supervisor, Matron, Nursing Instructor. However, this process takes a long year of works.
Fifthly, if nurses with a diploma course join the job before a postgraduate degree nurse, they will be promoted with experience without educational qualifications. The first joining nurse gets them promotion first whether they qualify or not; the only experience is evaluated. Academic qualifications are not considered. However, qualified nurses are needed to establish a nurse-patient interpersonal relationship.
In conclusion, nurses are central to the health care setting. We need to welcome qualified nurses to improve the nurse-patient interpersonal relationship and provide equal facilities to higher education for those who are qualified. Otherwise, nurses will not be interested in pursuing higher education. Thus, every job field needs to provide equal opportunities for graduate nurses. Not only that, but a new post needs to be created for graduate nurses, educational qualifications also need to be considered for promotion to ensure the quality of care. The honor should also be given to the graduating nurses as first-class employees like other graduate departments in Bangladesh. It is because the satisfaction of nurses’ work has a positive relationship with patient outcomes and satisfaction. Otherwise, the quality of care will never be improved.