Goan nurse finds recognition on the international healthcare mapping

Nilima Rane’s selection for this prestigious award shines a spotlight on India’s nursing community on a global platform, underscoring the critical role nurses play in improving patient outcomes and strengthening healthcare systems worldwide. Serving in the profession even after retirement, she is voicing the issues that nurses face in Goa and India.

With an impressive tenure of 37-years in healthcare, Rane currently serves as the President of Nursing Association – Goa State branch and is a member of the Indian Nursing Council. A decade ago she played a pivotal role in establishing the Goa Nursing Council, which has championed the rights and welfare of nurses State wide. Under her leadership, accredited nursing schools were set up, increasing the number of qualified nurses entering the profession annually and addressing a critical healthcare workforce gap.

Rane has been shortlisted as one of the top 10 finalists for the Aster Guardians Global Nursing Awards 2024 which is given to outstanding individuals who have significantly contributed to the field of healthcare. Competing for Rs 2-crore prize, this nomination emphasises on the critical role that the nurses play in improving patient outcomes and healthcare systems worldwide.

“This award will help highlight the importance of such initiatives and may open doors to further advancements. It also gives me a platform to advocate for better policies, improved working conditions, and recognition for nurses not just in Goa, but across India. It’s a step towards ensuring that nurses receive the support and resources they need to excel in their roles and deliver the best possible care to patients,” states Rane who started her career as a staff nurse at Goa Medical College and Hospital (GMC), and eventually retired as assistant matron.

“In Goa, we've already seen improvements such as the establishment of accredited nursing schools, which have enhanced educational opportunities for aspiring nurses,” mentions Rane who successfully petitioned Goa’s Public Health Department for study leave for nurses pursuing part-time graduate and post-graduate degrees, fostering professional growth. Her efforts have led to progress in ensuring fair compensation for nurses, particularly addressing pay discrepancies faced by Auxiliary Nurse Midwives (ANM).

Additionally, at Goa Medical College and Hospital, where she served as assistant matron, she implemented initiatives to improve healthcare practices, including biomedical waste segregation by implementing colour-coded bins, reducing food waste, and enhanced workplace safety standards.

According to Rane, to make India a more attractive place for nurses to work, several key interventions have to be made, and this includes the improvement in nurse-to-patient ratio. This will ensure that nurses will not be overburdened with workload which will reflect in the quality of care they provide. Alongside this, better working conditions, including reasonable working hours, access to modern equipment, and support for mental health and well-being, are essential to retaining nursing talent.

India is currently facing a significant nursing shortage, and several factors contribute to this issue. According to statistics from the Indian Nursing Council, our healthcare system is strained by a growing population, especially an increasing elderly demographic that requires more medical attention and long-term care. The demand for nurses has skyrocketed in recent years, further exacerbated by the Covid-19 pandemic, which placed immense pressure on healthcare professionals across the country. The pandemic exposed gaps in healthcare infrastructure and underscored the urgent need for more trained nurses to manage patient care effectively. Additionally, the number of training facilities for nurses is relatively limited in India, which hinders the ability to produce enough qualified professionals each year.

Rane points out that the nurse-to-patient ratio is currently inadequate. “To meet the growing demands of healthcare, particularly with the rise of chronic diseases and aging populations, we need a stronger workforce with better working conditions. Along with physical infrastructure, we must focus on the human resource aspect of healthcare. That means hiring and retaining more qualified nurses, doctors, and support staff, as well as providing them with continuous education and training,” she asserts.

No doubt that India has made significant strides in healthcare over the past few decades, particularly in urban areas where the population has now access to advanced medical technologies and specialised care. However, the healthcare infrastructure in rural regions still faces significant challenges. Rural areas often struggle with a lack of healthcare facilities, a shortage of trained professionals, and inadequate medical supplies and technology.

“For quality healthcare to be available to all, we need to bridge the urban-rural healthcare divide by investing in infrastructure and ensuring that rural populations have access to trained healthcare professionals and modern medical technology,” points out Rane who had pursued a General Nurse Midwife Course at the Government Nursing School in Panaji, followed by a BSc Nursing degree from IGNOU. Growing up in Canacona she was inspired to become a nurse after volunteering at a health camp where she saw firsthand how nurses worked hand-in-hand with doctors to help patients.

Rane recalls that during this time, she worked with countless patients across a wide range of healthcare needs, giving her valuable hands-on experience and deep insights into the challenges and rewards of nursing. Alongside her nursing duties, she became increasingly involved in advocating for nurses' rights and improving nursing education, which led to the establishment of the Goa Nursing Council in 2014.

Admitting the fact that many nurses choose to migrate abroad, seeking better salaries, working conditions, and career growth opportunities in countries like the US, UK, and the Middle East, Rane agrees that this leaves a void in the Indian healthcare system, further contributing to the shortage. According to her, In India, the opportunities for growth within the nursing profession can be limited, especially in the public sector.

This is because many nurses feel they face stagnant career paths, coupled with lower pay and less support for continuing education and training. Additionally, working conditions in India, particularly in overcrowded hospitals, can be challenging, with nurses often dealing with long hours, high patient loads, and inadequate resources. “The combination of these factors drives many nurses to seek better opportunities abroad,” she affirms.

Rane feels that providing nurses with opportunities for career development is an intervention. Offering in-service education, specialised training, and professional growth pathways will encourage nurses to stay back in India and continue to enhance their skills. “Initiatives like providing study leave for part-time degree courses, which I personally advocated for in Goa, could make a significant difference in helping nurses balance education and work. Recognising nurses for their contributions through awards and incentives can also foster a more rewarding professional environment,” feels Rane.

Sharing her experience with the Diabetic Foot Project in Germany, Rane says that she was impressed by the collaborative approach between nurses and doctors in providing patient care, particularly in community settings. “In Germany, healthcare professionals work together to ensure holistic patient care, including at-home wound care for diabetic patients. This close-knit team-based approach can significantly improve patient outcomes, and it’s something India can adopt, particularly in managing chronic diseases that require long-term care,” she feels.

India has much to offer other countries in terms of community-based healthcare. India’s focus on rural healthcare and family-centered care, particularly in areas like antenatal and postnatal care, can provide valuable insights for countries looking to strengthen their community health programs. India’s emphasis on educating rural populations and involving local healthcare workers in the care process has been effective in improving maternal and child health outcomes, and this is something other countries can learn from, feels Rane.