Max 40 hour per week duty, creche facilities at Hospitals: Health Ministry releases draft guidelines for working conditions of nurses in hospitals

New Delhi: Concerned about the working conditions of all categories of nurses in healthcare establishments/units/institutions across the country, Union Ministry of Health and Family Welfare has released draft guidelines for governing working conditions of all categories of nurses in healthcare establishments/units/institutions. The draft guidelines have been released for comments from the General Public/Stakeholders.

The comments may be furnished to Nursing Section via E-mail on nursing mohfw@gov.in within thirty days from the date of notification on the website of the Ministry of Health and Family Welfare.

The guidelines deal with various aspects of the working conditions of the nursing professionals including limiting their working hours to 40 hours per week and 8 hours per day. Further, the guidelines also require all healthcare establishments to provide rest rooms for nurses on duty, creche facilities, locker rooms etc. 

Following are the further details of the guidelines 

Guidelines Governing working Conditions of All Categories of Nurses in Healthcare Establishments/Units/Institutions.

The WHO Global Strategy on 'Human Resources for Health: Workforce 2030' calls for upholding: "the personal, employment and professional rights of the health workforce, including safe and decent working environments and freedom from all kinds of discrimination, coercion and violence". Conducive working conditions would enhance patient care and contribute substantially to the overall healthcare outcomes. A safe and healthy work environment for nurses is imperative in order to envision quality nursing care.

Therefore, the Ministry of Health & Family Welfare has drafted the following guidelines to give effect to the resolution towards improving working conditions of nurses in various healthcare establishments. The recommendations to improve the working conditions of nurses are as below:

Section I: Workplace facilities & safety

i. All nursing staff to be provided with annual health check-ups, necessary immunization and utilization of hospital services within the healthcare establishments where they are employed.

ii. All healthcare establishments to ensure adequate infrastructure and wellequipped work stations in all units/ wards to enable efficient functioning of nursing staff.

iii.All healthcare establishments to have separate washrooms and changing rooms (including providing drinking water, pantry facilities, lockers, clean uniforms etc.) for nursing staff.

iv.All healthcare establishments to identify designated resting rooms for nurses working for a prolonged duration.

v. All healthcare establishments to ensure the prevention of occupational hazards as per standard operating procedures and implement appropriate occupational safety norms.

vi.All healthcare establishments should provide adequate personal protective equipment free of cost for all nurses.

vii.All healthcare establishments to provide for creche facility as per the provisions of 'Maternity Benefit (Amendment) Act, 2017'.

viii.All healthcare establishments may, as far as possible, provide accommodation to their nursing staff within or near the hospital premises. 

ix. All healthcare establishments to establish an internal complaint committee as per the provisions of 'Protection of Sexual Harassment at Workplace Act, 2013'.

x. All healthcare establishments should establish appropriate time-bound mechanisms for redressal of workplace-related grievances.

xi.All healthcare establishments should take suitable measures to promote a healthy and safe work environment to prevent mental and physical violence against nurses.

xii.All healthcare establishments should take necessary measures to ensure the security of nurses during night shifts. Appropriate measures may be taken to ensure proper lighting in and around work settings to promote the safety of nurses. 

Section II: Working hours & staffing

i. Normal work hours for nurses shall not exceed forty (40) hours a week and eight (8) hours a day except where the exigencies of the service require otherwise.

ii. Compensatory day-offs can be considered for nurses working overtime during exigencies.

iii.Duty rosters may be prepared and informed to nurses well in advance and nurses should seek prior approval for any change of duty/leave.

iv.All healthcare establishments may promote flexible working hours and shift duties.

v. As far as possible, nurses may be posted in their areas of specialization and interest for optimal utilization of their professional knowledge and expertise.

vi.All healthcare establishments should practice routine transfer/ rotation of nurses from high-demand to low-demand settings to prevent fatigue and exhaustion among nurses.

vii.All healthcare establishments to provide an adequate number of qualified, trained and competent nurses in every ward/ unit of the healthcare facility, as per approved standard norms.

viii.All healthcare establishments to promote safe staffing levels by posting adequate support staff as per patient load.

Section III: Promoting nursing leadership

i. All healthcare establishments should conduct regular staff development programmes and in-service training to promote professionalism, leadership, communication, and managerial skills among nurses.

ii. Nurses may be given a fair opportunity to actively participate in the triaging of patients in emergencies and counseling of patients in wards so that they can become part of the decision making process for treatment of patients. They should be provided optimum say in decisions related to the nurses.

Section IV: Miscellaneous

i. All healthcare establishments to provide induction training to all newly recruited nurses to familiarize them with various hospital departments, facilities, guidelines, and standard operating procedures.

ii. All newly recruited nurses to be posted under the mentorship of senior nurses for a minimum of one-month duration to acquaint them with all protocols and procedures of the facility before placing them on independent duties.

iii. All healthcare establishments to provide paid maternity leave as per 'Maternity Benefit (Amendment) Act, 2017' and other authorized leave/ allowances and facilities as per Government guidelines/ existing policies.

iv.All healthcare establishments may, as far as possible, provide equal opportunities to all nurses to pursue in-service/ higher nursing education and research.

v. All healthcare establishments to provide a supportive work environment for nurses and facilitate teamwork to improve patient-related outcomes.

vi.All healthcare establishments to promote well-being measures for nurses, such as yoga and meditation, counseling services etc.

vii.All healthcare establishments to implement fair remuneration on the basis of qualification and experience.

viii.All healthcare establishments to take initiatives to recognize outstanding nurses and take measures to upkeep the morale and motivation of nursing staff.

All State/UT Governments are requested to take appropriate measures to implement the above guidelines in all healthcare establishments in their State/UT. 

To view the official Notice, Click here :  https://medicaldialogues.in/pdf_upload/222english-182501.pdf