Nurses in government hospitals face a variety of challenges that can impact their job performance and overall job satisfaction.
There aren’t many of us who dare to write up to share our experiences but here I am, standing up for almost all of us.
Here are some of the key challenges:
Poor Welfare And Salary Scheme
Nurses in Malaysia often contend with a poor welfare system and an inadequate salary scheme. The basic pay for nurses is relatively low compared to other professions and international standards.
This insufficient salary does not reflect the demanding nature of their work, which involves long hours and significant responsibilities.
Additionally, the allowances provided for overtime, on-call duties, and other extra work are minimal, further contributing to their financial struggles. For example, those who have subspecialty in their respective area of interest (whether from post basic or advanced diploma) only receive an extra RM100 per month.
This is compared to the Middle East, where nurses are paid nearly RM13,000 per month, triple of what we receive in Malaysia!
Huge Workload
The workload of Malaysian nurses is immense. They often manage high patient-to-nurse ratios, especially in public hospitals, leading to physical and mental exhaustion.
This workload is exacerbated by a shortage of nursing staff, which forces the existing nurses to take on additional responsibilities, further straining their capacity to provide quality care.
Additional Paperwork And Administrative Duties
Nurses in Malaysia are frequently tasked with additional paperwork and administrative duties that are beyond their primary responsibilities of patient care.
This includes tasks such as updating patient records, filling out various forms, and handling administrative documentation. These duties are time-consuming and add to their already heavy workload.
Moreover, nurses often do not receive additional compensation for performing these extra tasks, which leads to feelings of being undervalued and exploited.
Most of our superiors are busy with achieving KPIs, putting unnecessary stress on us. What is the urgency to achieve all the KPIs? To satisfy the ministry?
Mass Migration To Work Overseas
Due to unfavourable working conditions in Malaysia, many nurses seek employment overseas where they are offered better compensation and working conditions.
Countries in the Middle East, such as Saudi Arabia and the United Arab Emirates, present particularly attractive opportunities with higher salaries, better benefits, and improved living conditions.
This brain drain further exacerbates the nursing shortage in Malaysia, creating a vicious cycle of overwork and underpayment for those who remain.
Slim Chances Of Promotion
Career advancement opportunities for nurses in Malaysia are limited. The hierarchical structure within the health care system means that promotions are rare and often based on seniority rather than merit.
This lack of upward mobility discourages many nurses, contributing to job dissatisfaction and prompting some to leave the profession or seek opportunities abroad.
From a trained nurse U29 to a position of Nursing Sister U32, this usually will take more than 10 years, but such promotions are usually offered to those with “cable” or who are good at sweet talking their superiors. Meanwhile, from a Nursing Sister to Matron, the selection criteria are not transparent at all.
Lack Of Educational Opportunities
Nurses in Malaysia have limited access to further education and professional development. Opportunities to pursue advanced degrees such as a Bachelor’s, Master’s, or PhD in Nursing are scarce.
This lack of educational support stifles professional growth and limits the ability of nurses to advance their knowledge and skills, which could otherwise improve patient care and health care outcomes.
I wonder if this is a scheme to suppress us and keep us at our grade so that we continue to work like a donkey. I guess if we were more educated, we would become more vocal. Hence, these superiors think that this is the best way to shut us up.
Abusive Work Environment
The work environment in many Malaysian hospitals can be oppressive. Reports of abusive behaviour from matrons and nursing sisters are not uncommon. This includes verbal abuse, intimidation, and threats, which create a hostile work environment.
Nurses often feel threatened and are discouraged from voicing their concerns or reporting issues due to fear of retribution from their superiors.
Apart from their superiors, nurses are also at times, abused by patients or patients’ family members. When they lodge complaints about the nurses, the Nursing sister and Matron never back their nurses.
Mental Health Issues
The mental health of nurses in Malaysia is a significant concern. The combination of excessive workloads, lack of work-life balance, oppressive work environments, and the constant stress of dealing with life-and-death situations takes a severe toll on their mental well-being.
The authority complex of some nursing heads exacerbates these issues, leading to feelings of oppression and helplessness among nurses.
Uniform
The classic white colour and the design makes it difficult to work in the situation that requires lots of movement in ward or during home visit. Nurses often exposed to bodily fluids from patients.
Once it’s stained, the chance for it to be completely cleaned is almost impossible. Not to mention the shoes.
It’s uncomfortable to walk around the hospital and to transport patients to various places (e.g. operation theatre, CT Room, etc.) while wearing formal shoes.
Conclusion
The nursing profession in Malaysia is fraught with challenges that undermine the welfare and morale of nurses. Addressing these issues requires a comprehensive approach that includes:
- Improve salaries and allowances: Ensure that nurses are fairly compensated for their work, including additional duties.
- Reduce workloads: Hire more staff to manage patient care more effectively.
- Provide better career advancement opportunities: Create clear pathways for promotion based on merit.
- Expand access to further education: Offer more opportunities for nurses to pursue advanced degrees and professional development.
- Foster a supportive and respectful work environment: Address workplace abuse and ensuring that nurses can voice their concerns without fear of retribution.
- Compensate for administrative duties: Provide additional pay for the extra administrative work nurses are required to perform.
- Allow wearing scrubs and sport shoes in clinical area: White uniform and formal shoes still can be used to attend formal events (seminar, courses).
By making these changes, Malaysia can retain its nursing talent, improve the quality of health care, and ensure that nurses receive the recognition and support they deserve.
The author is a U29 nurse at a public hospital in Sarawak. CodeBlue is providing the author anonymity because civil servants are prohibited from writing to the press.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
