By Minha Khan, Impact Fellow at Noora Health, Mark Butcher, Associate Head of Donor Partnerships & Communications at STiR Education, and Sumbul Siddiqui, Manager of Donor Partnerships and Communications at STiR Education.
The COVID-19 pandemic taught us so much, including by shining a light on how much we rely on those who provide care for our communities. In particular, we came to realize that the nursing and teaching professions are on the frontlines of community care to help us reach our physical, mental, and emotional potential.
To ensure that nurses and teachers can continue to play the vital roles that they do, we explored the similarities and differences between their respective experiences to understand: who takes care of community caregivers?
Together, Noora Health and STiR Education, international NGOs respectively supporting nurses and teachers to equip them to best meet the needs of their communities, gathered four public sector nurses and teachers from across India for a candid discussion about the realities, struggles, and bright spots of two essential professions. Here is what we learned.
Appreciation is a great motivator…
Participating teachers and nurses identified the appreciation that they receive from children and patients respectively as a key motivator. This joy and gratitude encourage them to continue in their roles. As Komal, a Delhi school teacher, says: “Students are very giving. If you make any effort, they appreciate it very much. Through letters and gestures, they let you know how important you are to them.” Arti, a nurse from Madhya Pradesh, adds: “I am inspired when patients leave the hospital happy and satisfied.”
…but society does not value these roles
However, this appreciation does not always follow outside the doors of the hospital and school. Megha, a maternity nurse from Karnataka, says: “Everyone appreciates teachers and nurses when they see us work. When they need us, they realise how important we are. But otherwise, the image is different.” They discussed how their roles are seen as inferior to doctors or engineers. Arti shared the perception that “nurses are skilled but not educated”, while Komal noted that teaching is considered the last resort for individuals who failed to get their first choice of profession. It was interesting to learn that none of our four teachers and nurses had picked their current career as a first choice, but had instead followed family members or been unsuccessful in other careers previously. Today, however, all participants express deep love and respect for their fields.
Expectations are unrealistic
Despite the lack of value often assigned to both roles, our communities simultaneously have high expectations of teachers and nurses. Rohit, who has taught in both Uttar Pradesh and Delhi, says: “Parents expect that in six hours of school, their child will be educated.” As a society, we do not properly acknowledge that these jobs are difficult or our own responsibilities in ensuring the education of our children, and our own personal health. These challenges can also be observed within systems themselves. Arti also talked about negative attitudes from doctors towards the work of nurses, sharing that “all the blame is put on nurses, not on doctors” when things go wrong.
Pay is low and hours are long
We were unsurprised to hear that all respondents felt that their pay was much less than other careers despite the high levels of time and effort that they invest at work. In some cases, salaries are also not paid on time. But with shortages in both careers, our teachers and nurses feel forced to put in extra time. Arti described working six 12-hour night shifts each week, while Rohit talked about classroom overcrowding and the impact this has on the attention they are able to provide to each child.
Based on these findings, Noora Health and STiR Education make the following recommendations:
Consider mechanisms to increase the appreciation of nurses and teachers
While teachers and nurses continue to receive low pay relative to other professions, these roles will continue to be devalued. Governments must find a way to increase salaries, recognising the years of training required to fulfil these roles, and encourage young people to pursue nursing and teaching as first choice careers.
However, we can also encourage greater appreciation in other ways. It is disheartening to hear that doctors can have negative attitudes towards nurses, while education leaders in many systems have long dismissed teachers as part of the problem in improving education outcomes. We must work to improve relationships within our systems, developing trust and understanding of the challenges faced by all roles, and then role-model this appreciation in our interactions with patients, parents and children. Both Noora Health and STiR Education are pleased to be addressing this aspect through our activities.
Invest in the development and wellbeing of nurses and teachers
All of our interviewees also told us that they were motivated by investment in their personal development. For systems, this can be a valuable and relatively low-cost mechanism to encourage retention and improvement of the existing workforce.
For example, STiR Education partners with state governments in India to improve their support for teachers and reignite their passion for teaching. A core focus on intrinsic motivation puts teachers at the heart of education transformation, and encourages systems to ensure that they have the autonomy, mastery and purpose to effect meaningful change.
Make nurses and teachers as co-designers in the health and education systems
Nurses and teachers are best-positioned to understand the ground realities of our health and education systems. They know the community needs, context, and individuals. We must invite them to be co-designers in hospitals and schools.
Noora Health works in collaboration with nurses to develop tools and resources with which to train family caregivers to provide care for their loved ones, thereby reducing readmission rates and frequent trips to the hospital. We are able to turn hospital waiting rooms into classrooms and empower family caregivers because our training materials were co-developed with the very people who care for the community every single day, and best understand the patients, their families, and the illnesses.
In conclusion: empathy to action
For a brief moment, COVID-19 evoked within many of us a sudden and overwhelming sense of appreciation for nurses and teachers. As Megha shares: “What we do is an everyday job but because of COVID it’s been seen”. We must channel the empathy we felt during the COVID-19 pandemic into action: speaking kindly to our teachers and nurses, appreciating their efforts, and recognizing that these individuals put care for the community before they put care of themselves.
Ravi is hopeful that a positive change is coming. Through education, he shares, it is possible to “improve the fabric of society so that kids learn to regard nurses and teachers as valuable.” Change, he explains, comes from the inside. As Megha told us, “teachers and nurses are doing such great jobs. We need to reimagine and redefine our perceptions of what these professions really are.” Let’s reconsider our own preconceptions of nurses and teachers – and encourage our systems to do the same.