Alarming Nurse Shortages in Iran Expose Healthcare Crisis in Hospitals

Iranian_nurses_14102020
Written by
Mansoureh Galestan

A recent report by the state-run Donyaye Eghtesad, published on October 23, has brought to light the challenges faced by Iranian hospitals, particularly their severe shortage of tens of thousands of nurses. The newspaper aptly described the situation as an “emergency,” highlighting the dire condition of patients, especially those in critical states.

Donyaye Eghtesad interviewed a nursing professional referred to as Enayati, who revealed that in certain hospitals, only two nurses are available to care for an astonishing 35 patients within a single ward. This dire scarcity of healthcare staff in Iranian hospitals is attributed to the aftermath of the COVID-19 pandemic and the subsequent unemployment of nurses as the virus abated.

The consequences of this unemployment are not limited to the nurses themselves; it significantly jeopardizes the lives of patients. In late August of this year, Abbas Ebadi, the Deputy Minister for Nursing at Iran’s Ministry of Health, disclosed a staggering shortage of approximately 100,000 new nurses. This shortfall is especially concerning when considering that the current number of nurses in Iran stands at 215,000.

The report from Donyaye Eghtesad examined three hospitals specializing in infectious diseases, maternity, and recovery units, all of which grapple with the crisis of nurse shortages. In the maternity unit, for instance, a single nurse is entrusted with the care of 15 patients, a significant deviation from international healthcare standards.

This nurse shared that there is a prevailing public misconception that nurses are “immoral and rude.” But in reality, they are overwhelmed with the number of patients they must attend to. On a global scale, the nurse-to-patient ratio averages around 2.5. However, in Iran, this ratio plummets to a mere 0.8 nurses per bed. In some areas of Iran, this ratio drops even further to 0.6.

The hardships faced by Iranian nurses are further exacerbated by mandatory overtime. These dedicated healthcare professionals are required to work 130 hours per month, which includes a compulsory 150-hour overtime. The added workload effectively compels nurses to perform the duties of an additional staff member. To their dismay, they are often denied their well-deserved 30 days of annual leave.

In August of this year, Mohammad Sharifi Moghadam, the executive secretary of the Nursing House, emphasized the dire situation. Grappling with a shortage of nurses, hospitals resort to enforcing overtime, offering meager compensation, typically ranging from 16,000 to 20,000 tomans per hour in state-run facilities. Paradoxically, some nurses, despite working 100 hours, are remunerated for only 80 hours. To worsen matters, these minimal overtime wages are at times delayed by five to six months.

In Iran, the average monthly earnings for a nurse range from 10 to 12 million tomans. However, for these additional overtime shifts, which are distinct from regular work hours, nurses receive a mere one to two million tomans in compensation.

According to Mohammad Bagheri Banai, a member of the parliament’s economic committee, the poverty line for residents of Tehran, is approximately 30 million tomans (approx $600) per month, which is three times as much as the minimum wage in Iran.

 

Sharifi Moghadam underscored that the Ministry of Health’s reluctance to hire permanent staff over the past two years, coupled with nursing graduates opting against contractual work due to low wages, has left hospitals with no alternative but to overburden their existing staff.

The influx of inexperienced healthcare staff and the growing trend of nurse migration present additional challenges. An influx of less-experienced healthcare personnel can be attributed to their recruitment outside standardized hiring procedures. These non-standard hires bypass official clinical training and interviews, contributing to increased medical errors and a higher mortality rate. This concerning situation is exacerbated by the fact that over two years have passed since the Ministry of Health’s last round of hires.

 

Reports from nursing unions reveal that each year, due to retirement, resignations, or emigration, the number of nurses continues to dwindle. Mohammad Mirzabeygi, the president of Iran’s Nursing Organization, recently reported a concerning trend, with five to six nurses leaving every day and 100 to 150 nurses emigrating each month from Iran.

Importantly, the actual numbers may be higher, as many nurses do not seek certification. In fact, some sources suggest that around 3,000 nurses emigrate from the country annually. Official statistics indicate that between 1,200 and 1,500 nurses depart Iran for other countries each year, with many opting to work in Persian Gulf countries and other international destinations.

Given these challenging conditions, Iranian nurses frequently explore alternative careers, ranging from construction work and ridesharing to bus driving and bakery positions.

 

Alarming Nurse Shortages in Iran Expose Healthcare Crisis in Hospitals

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