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 Who is a nurse or a midwife in the South-East Asia Region?
What is the standard ratio of nurse to hospital beds?
What is the standard ratio of nurse to doctor?
Who
is a nurse or a midwife in the South-East Asia
Region?
Answer1: “Nursing and midwifery personnel”
is used as a collective term for a wide variety of health workers in SEAR.
These include professionals, technicians and auxiliary health workers, as
well as nursing aides and nursing assistants. Titles include Nurse, General
Nurse-Midwife, Professional Nurse, Clinical Nurse, Nurse Practitioner,
Advanced Practice Nurse, Public Health Nurse, Technical Nurse, Health Nurse,
Assistant Nurse, Nurse Aide, Auxiliary Nurse-Midwife (ANM), Midwife, Public
Health Midwife, Auxiliary Midwife, etc.
In general, nurses and midwives
in the Region can be categorized into 3 groups.
Professional or fully qualified
nurses/midwives:
those who have received basic professional education for 3 years or more.
They provide basic as well as skilled nursing and midwifery care
independently.
Auxiliary nurse/nurse-midwife: those who received education in
nursing and midwifery for 1-2 years. They can provide basic nursing and
midwifery care in a limited scope and responsibilities. They normally have to
be supervised by professional nurses/midwives.
Assistant: those who received education or training
less than a year. They normally provide assistance to professional and/or
auxiliary nurse/midwife in carrying out care to meet basic physical needs of
the patients, such as bed bath, feeding.
What is the standard ratio of
nurse to hospital beds?
Answer2: There is no standard ratio of
nurse to hospital beds that will be applicable to all settings.
In considering numbers of nurses
for any health services, one has to take into account the context that nurses
are working. It depends greatly on patient’s needs for nursing (patient
acuity), support to nurses in giving patient care and their expected roles
and responsibilities.
For example, intensive care unit,
where patients are highly dependent, completely depending on nurses to
provide care which is intensive in nature, will require greater numbers of
nurses than a unit where patients require moderate or minimal care or can
help themselves. In addition, if there are some supportive workers to help nurses
to carry out non-direct patient care functions, the numbers of nurses
requiring for providing care in that unit will normally be less than the unit
that nurses have to carry out both direct and non-direct patient care
functions by themselves. Furthermore, in a setting where nurses also have to
assume expanded functions, such as providing basic medical care, numbers of
nurses required will be more than a similar setting where nurses only carry
out traditional nursing functions.
What is the standard ratio of
nurse to doctor?
Answer3: There is no standard ratio of
nurse to doctor.
However, the 1993 World Bank’s
World Development Report advocated that nurses and midwives could deliver
most of the minimum essential public health and clinical services, with
doctors providing clinical supervision and direct care of complex issues and
complications. It suggests, as a rule of thumb, that the ratio of nurses to
doctors should exceed 2:1 as a minimum with 4:1 or higher considered more
satisfactory for cost-effective and quality care.
The Commission of Macroeconomic and
Health (2001) also noted that many of the health care interventions provided
at community level can be carried out by people other than doctors: by
nurses, midwives and other paramedical staff of various degree of training.
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