As the Royal Civil Service Commission approves the recruitment of foreign nurses, health workers, including doctors and nurses, share concerns about how it will affect the morale of local health workforce.

Doctors at the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) say the decision will have several repercussions.

A doctor said integrating foreign nurses into the Bhutanese system would be challenging. “It will be difficult for them to cope with our system, and familiarising them with how things are done at the national hospital might be challenging,” he said.

The doctor added that another challenge would be the language barrier as the medical staff at JDWNRH use generic terms for drugs. In contrast, most foreign nurses would be used to using trade names of drugs in India.

At the fourth Meet the Press session earlier, Health Secretary Pemba Wangchuk said that the attrition of nurses at JDWNRH had reached 30 percent, necessitating the recruitment of foreign nurses.

“We will not compromise quality and expertise,” he said. “What we need and require, they will have to shoulder.”

Secretary Pemba Wangchuk added that foreign nurses will be selected following an assessment. “To ensure high standards, the selection criteria will comprise qualification, experience,and ability to adapt to the specific needs of our healthcare environment,” he said, adding that a continuous monitoring and evaluation process will be put in place, which will include regular assessments and feedback from patients and medical colleagues.

As the attrition rate of nurses is the highest at JDWNRH, most foreign nurses will be deployed at the hospital.

Responding to the concerns health workers share, Secretary Pemba Wangchuk said that foreign nurses will undergo an orientation on the Bhutanese culture and healthcare system for efficient integration.

“Training on medical protocols, patient care and effective communication will also be carried out,” the secretary said.

However, for the Bhutanese doctors and nurses, the concerns are not limited to integration. A major concern for them is the disparity in salaries between the local and foreign nurses.

Foreign nurses are expected to be recruited for two years. They will be paid between USD 800 and USD 1,000, approximately Nu 66,000 to Nu 80,000.

A nurse at a regional referral hospital shared that even senior Bhutanese nurses do not draw the amount proposed for foreign nurses.

“Clinical nurses with more than 10 years of experience are paid less than USD 1,000. We also have staff nurses who do the same work that clinical nurses do, and are paid much less,” the nurse said.

A doctor shared similar concerns, highlighting that paying foreign nurses more than local nurses would further demotivate the latter. “If the disparity in their salary is high, I’m worried that the attrition of nurses will be even higher,” he said.

Another doctor with almost 10 years of experience shared the same concern. “Even doctors don’t get the salary proposed for foreign nurses,” the doctor said. “I fear that the services may get hampered.”

A nurse said that foreign nurses come in with preferential treatment. They are paid more than some senior Bhutanese nurses to do the same job.

Another nurse said it is more about how valuable local nurses feel. She said the government has invested less in upgrading the skills of nurses. Young nurses give more importance to career development, which is currently lacking.