Need to to recognise Nursing Service in true perspective

The members of Military Nursing Service (MNS) are of Commissioned rank appointed by a notification in the Gazette of India as Officers of MNS forming part of regular Army (Section 5 Military Nursing Service Ordinance 1943). As they are Officers holding a Commissioned rank, they are Commissioned Officers ranking equally with any other arm/service Officers of same titular rank [Defence Services Regulations (Army) Para 733 (b)]. As other Officers are not addressed as Members of EME or AMC, JAG etc. the increased tendency in the Army to refer the MNS Officers as Members of MNS is inappropriate and misleading.

The sense of fairness of today's Officers has been seriously affected by the propaganda campaign unleashed by few of the AMC Officers or Commissioned Members of AMC (in their own language). The Members have convinced the entire Army and including the supposed to be wise Generals of other arms/ services that the MNS Officers are an out cast and shall be lowered from the Commissioned Officers Status. The proof is the Army Chiefs letter asking to lower the pay scales of MNS Officers. The Army Chief through his letter dated 20 Jun 2008 asked the Cabinet Secretary to lower the pay scales of MNS Officers to ensure patient care in armed forces hospitals!

The army doctors like the army nurses, also does not undergo the Services Selection Board (SSB) interview to test their Officer Like Qualities (OLQs). The doctors, dentists and nurses are given Commission not because of their OLQs, but merely for their professional qualifications. Therefore the army Doctors supposed fears of 'nurses pay adversely affecting the patient care in the long run' should be correctly interpreted as their 'lack of leadership qualities adversely affecting the management of the medical establishments'. Due to their inferiority complexes, many of the doctors after wearing army officers uniform tries to become more officer like than the true Officers and end up being an 'Army Nurse Basher'. They have misplaced notions about officer like qualities. Such army doctors tries to vent their frustrations originated out of their professional inabilities and lack of leadership qualities by pulling down the Army Nurses. The survey conducted by the WHO in 2008, ranked the Indian Army Nurses as the best Nurses in the world.

The USA became the first country in 1901, to constitute the Nursing Services as a Corps of its Army and placed all the Nursing Personnel under it. Now the Army Nurse Corps Officers (Nurses) are considered equally for even Command positions in their Army Medical Service (US Army Nurses routinely Commands Military Medical Establishments and Army Medical Commands). The logic is that, in a system when neither (doctor/nurse) is tested for OLQs, any one who has the requisite leadership abilities should be given the opportunity to Command. A Nurse can be a better Commander than a Doctor, because Command is a test of Leadership. Any army nurse is also equally qualified to perform in leadership positions like the doctors in the army, but both are not tested for OLQs. In India the Command of medical units is a sacred act performed only by the Doctors! Let it remain that way, I don't think any army nurse will demand for such posts due to our "caste- mindedness".

In 1943, the Nursing Services of all the Imperial Forces (Armies of India, Canadian, Australian, South African and including British etc.) had the same status as 'auxiliary force of army'. After the war, all these Countries including Pakistan have formed Army Nurse Corps out of their own Military Nursing Service. The nursing personnel (Nursing Assistants/ Nursing Orderlies) previously part of Army Medical Corps were then transferred to the Nurse Corps for proper management by the professional Nurses. But in the Indian Army the Nursing Assistants are still part of AMC. Many of them are being misused as 'sahayaks' at the AMC Officers houses and Messes, whereas they are meant for assisting the Nurses in the medical units. Almost every country has constituted Army Nurse Corps in their Armies after the WW-II. However, the MNS still continues as an 'auxiliary force of Indian Army'.

The Nurse to Doctor Ratio in Indian Army is 1:2 (3000 nurses and 6000 doctors). The ideal ratio is 4:1 as recommended by the Indian Nursing Council and being followed by Civil Hospitals. Such low ratio of Nurses is being justified by showing the 20000 strong Nursing Assistant tradesmen of AMC, as available for assisting the Nurses. This is theoretically true but practically exists only on paper. The Army manages by making the Nurses to work for 72 hours a week as against the 48 hours in Civil. The minimum hours of work to be performed by the Army personnel in a week are also 48 hours.

The most of the Countries including Pakistan have Army Nurse Corps as part of their Army. In USA the Army Nurse Corps Officers (Nurses) even commands Army Hospitals and Medical Commands. Is the Patient Care in those Army's have been adversely affected due to this? The answer is no. The Indian Army Nurses are the best professionals in this field. The patient care in the Indian Army is better than the Civil. However, the Army's discriminatory attitude to the MNS Officers is going to adversely affect the patient care (if not already affected). It will further erode in the coming years unless immediate corrective steps are taken. The supposedly wise Generals will realize it only post retirement, when there is nobody else to look after them, other than an Army Nurse. Every General like the Deepak Kapoor should get an opportunity to point out to an Army Nurse while lying on a Military Hospital bed, that she is an 'inferior class of Officer as being from an auxiliary force'. He is assured of a good care from her.

The need of the hour is to strengthen the Nursing Services by allowing it to be managed by the professional Nurses. Presently the Nursing Services in Army is managed by the Doctors. We shall follow in the steps of other nations by re designating the Military Nursing Service as a Corps of regular Army. And then transfer all the nursing personnel to the Nursing Corps for proper management of nursing resources. This is the only way the Nursing Services and thereby the Patient Care can be improved in the Indian Army.

Col Mathew Thomas (Retd)
Related: Need to reorganise the Nursing Services by by Brig (Dr) C P Joshi