They are hailed as 'angelson earth' but the personal and professional lives of nurses in India are rather 'miserable', especially of those working in private health sector, with low salary, poor working
conditions, among others, compounding their woes, a study has revealed.

Recent strikes and agitations by nurses in private hospitals in different parts of the country demanding better wages and working conditions have not made any significant change in their state of affairs, according to the recent study on Keralite nurses working in hospitals in New Delhi.

Verbal and physical harassment continued to be a major problem faced by nurses.They face ill-treatment not only from doctors and the management, but also from co-workers, said Sreelekha Nair, Junior Fellow at the Centre for Women's Development Studies, New Delhi, who conducted the study.

Corroborating her findings, Indian Nursing Council member P.K. Thampi said nurses are being exploited by hospital managements. "It is virtually a slave-landlord relationship between nurses and managements', Thampi said.

Referring to the modest salary the nurses get in private sector, he said a majority of them have done their courses by taking educational loans of Rs four to six lakh.The minimum instalment they had to pay would come to around Rs 6000 to Rs.10000 while the salary they receive is only around Rs.2500
to Rs.6500, Thampi said.

"Despite the poor state of affairs majority of them stick to their job as they have no other option," Thampi said.

According to Sreelekha, who published a book titled 'Moving with the Times-gender, status and migration of Nurses inIndia', "not just their superiors but even the relatives of the patients verbally and, like in some cases as reported in newspapers, physically harass them."

Nursing being a 'women majority profession' also contributes to their low status and this had been pointed out by most nurses interviewed as part of the study, she said.

"Nurses share several stories of their saving the patients' lives;However, they feel that their contributions in patient care were not valued.It is true that the name of doctors who participated in important events, for example, the first heart surgery or such historical occasion, are known to everyone but the nurse who is part of that event is not mentioned even in records," the study said.

Another method of exploitation of nurses is the bond system enforced on entrants to the profession by hospital managements.In most cases, managements 'confiscates' certificates and this would prevent them from seeking better opportunities in India or abroad. "Women who formed the sample of the study vouched for this fact and revealed this happens across the country", Sreelekha said.

Nurses in private sector hospitals are also cheated in many other ways. The actual amount paid to them is lower than what has been recorded in the payment register on which the nurses are compelled to put their signatures, the study said. In the private sector,their pay structure ranges between Rs.2500 to Rs.6500 at the entry level and there are instances of nurses being paid as low as Rs.1000 a month.

"Difference in salary in private and public sector hospitals is very high, especially after implementation of the Sixth Pay Commission recommendations.Increase in pay is core demand of the nurses who went on strike," the study said.

Regarding working conditions, both private and public hospitals are on the same footing. "Very poor nurse-patient ratio is a central characteristic of both private and public sector hospitals in India."

Public sector hospitals are so overwhelmed by patients that they are admitted even on floors because beds are not available, it was pointed out.

"Low salary, poor working conditions, special circumstances of work of nurses that involve caring for strangers and that include handling of body fluids make the status of nurses low in the society", the study said.

"Low status is not limited to professional sphere alone but rather spills over to their personal lives. All aspects of their personal lives are influenced by the fact that they are women nurses. There are stories of rejection and resistance by future in-laws just due to prejudices surrounding only this group of women workers...", the study said.

Referring to migration of Indian nurses abroad, mostly from Kerala, looking for better jobs, the study said they choose nursing as a career and undertake a number of adventures.

"Nursing is not a livelihood option alone but a life strategy for many.The moment they take the decision to be a nurse, a life plan, where they plan for their career, societal upward mobility and marriage and family, gets readied. But only time can tell whether every plan is executed on time", Sreelekha added.