The government's indifference towards nurse training results in poor quality nursing education which in turn deteriorates nursing service.
According to the Directorate of Nursing Services (DNS), 38 public nursing institutes have 248 posts of nursing instructors for around 1,500 nurse aspirants a year. However, 170 nursing instructors' posts are currently unoccupied.
According to recruitment regulations, a nurse instructor should have three years' experience as senior staff nurse and five years' experience as nursing supervisor but very few nurse instructors fulfil these conditions due to the sluggish nature of promotion process.
A significant number of nursing supervisors and senior staff nurses have been working as nurse instructors on deputation at the public nursing institutes, experts said adding that these instructors often do not have the qualifications to become a good instructor.
The instructors do not have any institute where they could be taught to teach.
If there were nursing instructors' institutes like Technical Teachers Training Institute for training teachers, they would be more capable of providing quality education to nurse aspirants, experts say.
They said the quality of most nursing instructors is not up to the mark.
"As nurses' promotions are seniority based, quality is not considered at all which eventually leads to poor quality nursing education," said a nursing supervisor stressing the need for a nursing teachers' training institute.
Apart from eight nursing institutes adjoining medical colleges, no institute has the post of principal, which increases administrative intricacy and slows down educational activities.
The nursing instructors, who do not have any Drawing and Disbursing Officer (DDO), run their institutes themselves spending a large portion of their time in administrative work rather than training people.
Of the four nursing institutes which were turned into nursing colleges this year, neither added more facilities to the colleges nor recruited manpower.
“The Dhaka Nursing College, which was an institute last year, has only six posts for instructors against 100 seats for nurse aspirants. The Mitford Nursing Institute has 20 seats and after becoming a college the number of manpower there has not changed, and no facilities or equipment were added," said Principal of Dhaka Nursing College Tahatun Nahar.
The colleges are running with existing infrastructure and manpower and there are no posts for professors, associate professors or assistant professors. There should be 100 posts for teachers in these colleges.
College of Nursing affiliated to Dhaka University offers a two-year Bachelor of Science (BSc) degree in nursing and Public Health Nursing. Around 125 nurses graduate from the college each year with leadership, management and teaching capabilities. The college does not offer master's programme in nursing.
"The country currently has around 150 nurses with master's degree in nursing. They achieved the degrees with the financial and technical help from foreign organisations," said Tahatun Nahar adding that NIPSOM is currently offering master's programme on Health Education but not nursing.
Despite the demand for specialised nurses, there is no scope for grooming specialised nurses in the country, experts said.
"After completing general nursing course, there should be scope for nurses to have specialised courses like cardiology, oncology, paediatrics, neurology, urology and traumatology and there should be a specific curriculum and separate budget for this," said Registrar of Bangladesh Nursing Council Shamsunnahar.
The government is indifferent to improving the quality of nursing here but allows nurses from India, Nepal and some other countries to work here in the name of technology transfer, experts said.
They said in spite of these nurses being very competent, their ability to provide services is not properly utilised due to language and cultural barriers.
"There are around 250 foreign nurses at different private clinics and hospitals being paid high salaries as per international standards. A large amount of foreign exchange is being spent to pay for these nurses," said former Bangladesh Bank governor Farashuddin.
Farashuddin, also the former vice-chancellor of East West University, tried to initiate a BSc programme on nursing at the university. He said it is possible to create international-standard nurses in this country if the government wants to and if the strict regulations on nursing education at private organisations are eased.
However, demand for nurses abroad has also risen which would give Bangladesh the opportunity to export once the shortage of nurses is gone.
"The country needs between 400 and 450 nursing education centres if we want 4,000-5,000 nurses to graduate every year. Government institutes, private universities and institutes should come forward in providing nursing education," said Coordinator of Refugee and Migratory Movements Research Unit (RMMRU) Prof Tasneem Siddiqui. Many private universities are willing to start nursing education courses but they cannot initiate the course due to strict government conditions, she said.
In the guidelines for offering courses on nursing, it is said that a private university must have a 100-bed hospital and a nurses' dormitory. These tough conditions discourage entrepreneurs as offering the course becomes uneconomical for them, she added.
Health Adviser AMM Shawkat Ali recently formed a taskforce with a view to update the curriculum of nursing education in a bid to take Bangladesh's nurses up to international standard and encourage private universities to initiate nursing course.