A nurse is a caregiver for patients and helps to manage physical needs, prevent illness, and treat health conditions. To do this, they need to observe and monitor the patient, recording any relevant information to aid in treatment decision-making. Throughout the treatment process, the nurse follows the progress of the patient and acts accordingly with the patient’s best interests in mind. The care provided by a nurse extends beyond the administration of medications and other therapies, are responsible also for the holistic care of patients, which involves the psychosocial, developmental, cultural, and spiritual needs of the individual.
The patient is the first priority of the nurse. The role of the nurse is to advocate for the best interests of the patient and to maintain the patient’s dignity throughout treatment and care. This may include making suggestions in the treatment plan of patients, in collaboration with doctors and other health care professionals. This is important because often patients sometimes are unable to comprehend medical situations. It is the role of the nurse to support the patient and represent the patient’s best interests at all times, especially when treatment decisions are being mad
Planning of Care
A nurse is directly involved in the decision-making process for the treatment of patients. It is important that they are able to think critically when assessing patient signs and identifying potential problems so that they can make the appropriate recommendations and actions.
As other health professionals, such as doctors or specialists, are usually in charge of making the final treatment decisions, nurses should be able to communicate information regarding patient health effectively. Nurses are the most familiar with the individual patient situation as they monitor their signs and symptoms on an ongoing basis and should collaborate with other members of the medical team to promote the best patient health outcomes.
You see nurses in public and private hospitals in Malaysia or other work settings doing their best to treat patients, but how much do you know about them? Have you ever wondered what drives them to continue serving people despite the highly demanding nature of their profession?
As we know by now, the Nursing profession is a noble and selfless profession that requires compassion, empathy and above all, a deep internal desire to take away the pain and suffering of others who are in need.
In 2019, there were around 108, 000 registered nurses in Malaysia, an increase compared to previous years. The number of registered nurses in the country has shown an upward trend since 2016.
Female & Male Nurses
Nursing as a profession has long been considered “women’s work”. If you were to go to several nursing schools, you would notice that the number of female students was way higher than that of the males. This status quo is gradually changing as the number of men in the profession is slowly increasing. The demand for male nurses is on the rise and this is due to some unique characteristics that they bring to the table. Men being in the nursing profession is something new, this does not displace the women but only complements their efforts and skills.
What are the differences?
| Physical Strength | Men and women are biologically built with certain unique attributes. In this sense, men are naturally built to wield and exert strength. When nurses are in situations where they have to lift very heavy materials, it becomes quite obvious that a male nurse would be more suitable for the task. |
| Religious Inclinations | As a nurse, physical contact is a must but in certain countries like Malaysia where there is a large Muslim population, there are usually reservations when it comes to female nurses handling male patients and vice versa. Male nurses are required to create a balance and make the patient feel more comfortable |
| Work and Family Commitment | Most female nurses try to balance their work and family commitments, always going the extra mile in order to balance this. This responsibility is reduced for men, as they do not have to balance of being a mother and home daily routines |
| A Different Approach | Males & Females view situations differently, most females look from the emotional perspective, whilst men do not. Combining these two different views will provide balance in managing the health of the patient. |
Challenges for the Nursing Profession in Malaysia
The nursing profession first became known as early as the 18th century, the era of Florence Nightingale. Today, careers that are typically monopolized by women have undergone significant changes with the increasing number of men venturing into this field. The increase in academic level has also progressed up to the level of doctor of nursing philosophy. Nurses who are equipped with a variety of knowledge including research knowledge and information technology are able to plan and manage quality patient care. However, the nursing career is still lacking and its importance in society is almost insignificant.
Five of the biggest issues nurses face in their everyday working life are:
- Staffing – Short staffing in hospital settings is a top concern for nurses.
- Long working hours – To help make up for staffing shortages, nurses are often required to work long shifts. Many times, nurses must work extended hours and overtime, risking fatigue, that could lead to medical errors.
- Workplace hazards – Nurses face a number of workplace hazards such as exposure to bloodborne pathogens, injuries, hand washing-related dermatitis and cold & flu germs.
- Workplace Violence – Is also a pressing issue for nurses.
- Bullying and Harassment – Harassment such as “patients stalking, persistent attempts at communication, and inappropriate social media contact.”
The Covid-19 pandemic has proven the importance of the nursing profession in the national health sector.
The perseverance of nurses in carrying out their duties at the forefront, willingness to face all possibilities and dangers in order to save the lives of Covid-19 patients and the country from the threat of this dangerous epidemic can to some extent add value to society’s perception of the nursing profession. The contribution of nurses in fighting the pandemic in the country is one of the proofs that this profession is recognized to be very important. Every nurse has used her nursing expertise and skills as an advocate in protecting and improving the health of the patients under their care as well as the general public during this outbreak. Nurses remain professional in carrying out their duties and responsibilities sincerely and wholeheartedly in planning and implementing patient care. These educated and skilled nurses with cognitive, spiritual and emotional intelligence always view the task from a positive angle resulting in effective care in the patient’s healing process.
Nurses need to constantly strengthen their role so that society can assess the importance of this profession in healthcare. The perception of nurses in Malaysia can be further improved if all nurses can complete their knowledge and skills by continuing their studies to the next doctoral degree level. Higher learning accompanied by an attitude of lifelong learning can enhance thinking in quality patient care planning. Highly educated nurses can also engage with nursing research locally and abroad. Research activities are very important so that problems in nursing care can be identified and appropriate action taken to address them.
Every nurse needs to prioritize development in the nursing profession over self -interest. Ideally each nurse can demonstrate the ability to share ideas and suggestions for continuous improvement in the profession. They should always be prepared to work in groups and accept reasonable evidence-based recommendations in health management as well as patient care especially in dealing with the COVID-19 pandemic problem in our country, Malaysia.In conclusion, the excellence of the nursing profession can be enhanced if every nurse understands the needs of this profession. Every nurse is advised to always apply and practice the noble values in daily practice with a productive attitude so that the profession will continue to grow in line with the achievements of education and research. So far, the community’s perception of the nursing profession in Malaysia can be considered selective and according to the current situation. The importance of this profession will be more pronounced and appreciated if this profession can go through the comprehensive transformation in a clear direction
Will Malaysia Face Shortage of Nurses?
IN 2005 to 2010, with the mushrooming of nursing schools in the country, concern was expressed over a glut of nurses being churned out in the healthcare sector, with as many as 10,000 students graduating each year. This prompted the Malaysian Nursing Board to announce new regulations in August 2010 which increased nursing entry requirements to five credits to stem the tide of new nurses. Ironically, the measure has been so effective that the shrinking number of candidates pursuing the vocation is a very real challenge faced by the industry today.
“Previously, when the requirements to pursue nursing were only three credits, everybody jumped on the bandwagon and we had as many as 10,000 students coming out each year. Once the number of credits was increased from three to five, there was a vast drop in intakes for nursing.
“Now, there are less than 3,000 nurses graduating yearly.
“Many colleges which offered nursing courses closed down, resulting in fewer nurses being trained,” says Ng Kok Toh, head of nursing programmes at International Medical College in Subang Jaya. Another contributing factor is the drop in National Higher Education Fund Corporation (PTPTN) loans for students. “In the past, the loans were worth RM60,000 but now Bantuan Rakyat 1Malaysia (BR1M) recipients are awarded a maximum of RM38,000, while those who do not fall under this category receive only about RM20,000 to RM24,000. Students cannot afford to pursue nursing courses which cost more than this.”
Budget cuts by private hospitals to support training and sponsorship of students, as well as increased student interest in other more lucrative courses are other factors she cited. Because of the low number of nursing candidates, she believes that by 2018, with more new hospitals expected to come on line there will be a severe shortage of nurses.
“The shortage will be so severe that healthcare providers may resort to poaching nurses from each other,” says Ng, who has been in the nursing profession for 35 years. Compounding the problem is affluent Singapore, which is actively recruiting our girls. “Those days, they were particular about taking only experienced nurses but now they are willing to recruit anyone who is qualified, even paying off their bonds. “But one thing they are very particular about is that the girls must be able to speak English.”
She says in the past, nurses headed to Saudi Arabia, but Singapore is emerging as their preferred destination.
MAHSA University Faculty of Nursing and Midwifery dean Professor Zahrah Saad agrees that the promise of a better salary in Singapore is attracting younger nurses there.
“There are about 2,000 nurses working in Saudi Arabia. But because the Saudis are imposing taxes on their income and have cut down on their allowances, many of them are returning to Malaysia. “Sadly, it is just a stopover before they head to Singapore. Singapore is just waiting for them with open arms, more so if they have working experience in Saudi Arabia.” She says there is a shortage of nurses with specialisation in the country.
“We are lacking oncology, critical care and paediatric nurses. While a detailed study needs to be done on the shortage, nurses themselves admit they have to do double duty frequently which indicates there is a shortage”. In a short survey she conducted with nurses, they also complained of having to concentrate on non-nursing functions like documentation which impeded direct patient care.
“The new entry qualifications requiring nursing students to have five credits, including in Maths and Science, is also a stumbling block because rarely do candidates have credits in both subjects.
Meanwhile, Universiti Tunku Abdul Rahman (UTAR)’s lecturer in nursing, Sheela Devi S, says the ageing baby boomer generation in the country will result in a larger proportion of elderly people. “This will present an obvious challenge to our healthcare system, leading to the demand for more nurses.“The demand for nurses is very high — there are 130,000 qualified nurses in 2020.
“The data provided in the Malaysian Human Resources for Health Country Profiles for 2014 for the number of nurses in the country showed 64,348 in the public sector and 28,333 in the private sector, totalling 92,681 nurses. “Though the ratio of nurses to population has increased tremendously, it is still considered low than in the Organisation for Economic Cooperation and Development countries.” “The resolution involves academic-practice partnerships among nursing academic institutions and healthcare providers that can accommodate the capacity to produce well-prepared and ‘practice-ready’ nurses.”
To better facilitate the training of students, UTAR has embarked on a plan to set up a 300-bed specialist training hospital in Kampar, Perak. The hospital is expected to operate in 2020 as an advanced teaching-learning centre for UTAR’s medical and health science students, in addition to providing affordable medical services to the community.
Addressing the Shortage
“It is certain that in the near future, there will be a problem with the supply of nurses as a result of decreasing enrolments in nursing programmes, says Universiti Tunku Abdul Rahman’s Head of Nursing Sheela Devi S.“In an effort to look at this issue from a different perspective, we must identify the fundamental problems that nurses face today. Shortage of nurses cannot be tackled only by churning out new graduates. With the constant change in the healthcare system and reorganisation, the aspect of nurses working conditions and career satisfaction are neglected.
“A safe and supportive work environment is important to increase nursing workforce and retain them within the Malaysian healthcare system.” Ensuring high level of career satisfaction and organisational commitment is essential to minimise nurses’ turnover. Among other approaches that can be engaged is to change policies on recruitment, training, selection, induction, job design and salary scale.
The support in nursing educational research is needed to build a well-qualified healthcare workforce. It can help to determine the links between education and quality patient care outcomes. “The ultimate goal is to make significant improvements against the rising tide of nursing workforce shortage and facilitate the continued transformation of our healthcare system,” says Sheela Devi.
Nurses truly are at the heart of healthcare in Malaysia and their services to the community, in ever increasing demand. With the acceptance and shift to homecare nursing in demand for after-care after an operation or rehabilitation, Malaysians are able to employ nurses to do just that. SamaSamaJaga offers professional homecare nursing for all kinds of medical issues that your loved ones or yourself may have. With this affordable home nursing care, you will have peace of mind as you carry out your day to day, responsibilities.
Referrences
Malaysian Nursing Board – https://nursing.moh.gov.my