Shortly we will have doctors also the same way. At present we have these type of doctors in kerala passed out from china and Russia, (but these doctors under go screening test and they do internship in india, some gain good knowledge during that period). Same way now nurses are passing out in most of the nursing schools and colleges ( but they don’t under go any internship any where).
Many of these nurses after obtaining a degree they come to us for clinical experience, with lot of political and public obligations hospital management allow them in, when we don’t need any more staffs.
None of the Kerala government hospitals or NRHM projects accommodates these nurses in their hospitals due to lack of clinical knowledge. These nurses we used pay them some travelling and food allowance (not salary) as they are having a degree and they should not go and ask their parents for money as they spend lot of money on their education( now this is being projected as salary by them). It is very difficult to run a hospital by paying the salary fixed by the government to these types of nurses who doesn’t have clinical knowledge. And we have lot of other expenses other than salary in maintaining a hospital. We are paying good salary to well experienced nurses.
In non urban hospitals it is difficult to get qualified and experienced nurses. Most of these nurses who come to us for basic clinical experience work only for 6 – 12 months with us and after that they go and join in corporate hospital for further experience in advanced technology.
And they work there for 1 year to 2 years and fly abroad. To train a nursing staff labor room and OT work and ICU work will take six months to one year, by the time they get adjusted to the hospitals they leave and go to corporate hospitals for experience to go abroad.
Hospitals in non urban areas cannot charge heavily on patients also, as paying capacity of patient s are very less in non urban areas hospitals in non urban areas earn less compared to a corporate hospitals and we are having more expenses than them in maintaining hospital on equipments , pay of doctors and other staffs. Government has fixed salary for hospital staffs in urban and rural areas as same scale.
Most of the hospitals in non urban areas is in verge of closing down, many are already closed. Many of the nurses are gone abroad with fabricated experience certificates and got caught and many hospitals in western countries now prefer phillippino and manipuri nurses than Kerala nurses due to their lack of clinical knowledge.
Kindly consider and understand our problems in managing non urban hospitals. Otherwise we may have to close down and go and join some corporate hospital for salary as managing a hospital in non urban areas is not viable and cost effectiveness because we are not ready to squeeze patient for money..patients paying capacity is very less in rural area.. government charges same on electricity, water bill, medicines purchase, staff salary and doctors pay is high in rural area cost all same in rural and urban..medical instruments comapny service charges are very high in rural area...