Bangladesh wants to export nurses but seeks foreign nurses asap

By definition, the intensive care unit (ICU) beds are intended for severely ill and unstable patients. But what differentiate the five beds at BSMMU from other general hospital ICUs are the care recipients – neonates and infants just brought out from the cardiac surgery rooms.

They are at risk of dying, and put in the ICU to save their life.    

With foreign surgeons, the highest level of medical care for babies was launched at the Bangabandhu Sheikh Mujib Medical University (BSMMU) in July 2021. Now it feels the need for specialised foreign nurses and BSMMU advertised in November last year for the skilled medical professionals as the country's nursing colleges do not produce such skilled graduates.

Amid Bangladesh's talks on health staff export, the university is going to republish the advertisement as none turned up by the 31 December 2021 deadline of the first one. The qualifications, as per the advertisement, include a diploma in paediatric cardiac surgical ICU and two years of job experience.        

"We are running the ICUs now with BSMMU paediatric nurses. But they are not trained to manage the specialised paediatric cardiac cases," Prof Mohd Zahid Hussain, chairman at the paediatric cardiology department of the medical university, told The Business Standard on Saturday.  

What make nursing in a paediatric cardiac ICU special are the age and weight of the babies, pacifying them who often would not stop crying and customised individual care, according to Prof ABM Abdus Salam, former paediatrics cardiology head at the National Institute of Cardiovascular Diseases.   

"Nurses without specialised training can get easily confused in finding out arteries, inserting cannula and providing appropriate drug doses to the babies often weighing below 5 kg," he noted.      

So desperate is the hospital for nurses with the right skills set that Prof Zahid said he would hire them on the spot if any eligible nursing candidate turned up right then.

Apart from recruiting foreign nurses, he said the department is also considering bringing in paediatric anaesthesiologists to establish a complete paediatric cardiac surgery unit at BSMMU – the lone such medical facility in any public hospital.    

Currently, a few private hospitals have complete cardiac treatment facilities for babies.  

Export plan exposes quality flaws   

In January this year, Bangladesh advertised jobs for nurses and medical technologists in Kuwait. The authorities then said at least six foreign nations have expressed interest to outsource nurses from Bangladesh.    

Though the interest of the foreign recruiters is not fully matured yet to conclude whether the skills of Bangladeshi doctors and nurses are in line with the requirements, the authorities say the recruiters' willingness is evident enough that the potential workforce has required skills and standards.    

Now with BSMMU seeking specialised foreign nurses, the medical staff export plan faces questions over the skills of Bangladeshi nurses. Preparation for a trade meeting with Australia last month brought the skill issue to the fore.  

The commerce ministry asked the Bangladesh High Commission in Canberra to include nurse export to that country in the meeting agenda. But the high commission responded in the negative.      

"Bangladesh has not yet reached the nurse exporting stage due to lack of technical capability and excellence. Even many hospitals in Bangladesh are relying on neighbouring countries for nursing services. This is especially true for specialised nursing services," Bangladesh commercial counsellor of the high commission told the ministry.

Referring to the BSMMU advertisement, the commercial councillor said some other public medical facilities in the country have undertaken similar initiatives. He suggested the authorities fix the flaws in the nursing curricula, take initiative for the accreditation of nursing certificates and make the nursing graduates more skilled in English.           

According to the Bangladesh Nursing and Midwifery Council, there are 271 BSc and 547 diploma nursing and midwifery colleges (public and private) in the country with more than 39,000 seats. Around 15,000 nurses enter the job market every year.

As of December last year, there were 80,739 nurses, while around 55,000 of them have been working at government health facilities. Others are employed at private hospitals and clinics.

Can we make our nurses specialised locally?   

Doctors said it is high time Bangladesh introduced specialised training for nurses and overhaul their curricula so that the nursing graduates can catch up with the country's increasing medical sophistication.  

According to Prof Abdus Salam, hiring nurses from abroad will not be required for now if paediatric nurses are trained to operate the cardiac surgery ICU equipment and the qualifications are relaxed a bit.          

"However, the health ministry should introduce a paediatric cardiac surgery course for nurses immediately. Even neighbouring India has trained nurses for neuro and paediatric cardiac ICUs," he noted.

There are around six lakh children in the country with cardiac diseases at birth, while 40,000 babies are born with congenital heart diseases every year.

Enamul Haque, additional secretary (nursing and midwifery) at the health ministry, said nurses are being trained for ICUs in Dhaka and Rajshahi. The training began during the pandemic. But he could not confirm whether there is any paediatric ICU training for nurses.