There is an acute shortage of Registered Nurses, especially in hospitals. Hospitals are caught in a vicious cycle. They find it difficult to retain their nursing staff. Nurses often resign because of their responsibilities and tremendous work pressure. This forces the hospital to distribute the work on remaining nursing.

Effectively, the workload on remaining nurses is at times four times more than what it should be. Nurses have struggled to gain acceptance as skilled medical professionals. Now, they are recognized as such by both medical fraternity as well as general public.

There is an increase in their remuneration as well. After being elevated to this level, why are nurses still unhappy, and why are hospitals forced to cope with such erratic nursing work. Perhaps the present system has failed because everyone seems to be at the top of the ladder, with nobody standing below him or her. Nurses were once trained within hospitals.

But this is no longer the case. This is because nurseries are now trained in nursing schools or nursing universities rather than at hospitals. This lack of trainee nurses has created a gap hole in hospital's nursing department. Trainee nurses did many chores such as checking the patient's vital statistics, feeding the patient, comforting the patient, giving the patient a bed pan, and tidying the patient's bed.

There seems to be no one around to do these chores now. To be fair, nurses who come with a degree from a university are better equipped in handling responsibilities. They are also better in assessing the problems with patient, and capable of diagnosing the ailments.

Effectively, such nurses are able to reduce the workload of doctors, who can now concentrate on more serious cases that arrive at the hospital. Nurses have gained respect for these capabilities. Despite this, if nurses are resigning citing excessive workload as their reason then it is obvious that the new system is not working.

The new system has a position called “enforced nurse”. This position is subordinate to the position of qualified or registered nurses. Trainee nurses once filled this position. The new system offers good pay packets and recognition to these nurses as well.

But these nurseries are moving towards Aged Care facilities rather than sticking to hospitals, even though the remunerations at these facilities are lower. Such Aged Care facilities do not have proper hierarchy of nurses. Despite this, many nurses opt for this type of work.

They are aware that both public as well as medical fraternity would appreciate them more if they served in the usual hospital like environments. One possible reason for them seeking such employment may be because at Aged care facilities that they offered a contract. This gives them a lot of flexibility to choose.

The reason other than this freedom to choose is more disturbing. Sometimes nurses are unwilling to be subordinate to others from their profession. The new system has responded in deterioration of the nursing care quality. Public is no longer satisfied with the present system. They dread the nursing services at hospitals. Today people have to use buzzers to get the attention of a nurse.

Nurses arrive after reasonable time, which can be a problem if the person needs a bedpan, or has to go to the urinal. Formerly, nurseries did regular rounds, and confirmed whether patients needed anything. Now, the tired nurses find any such request a nuisance. Sheets are only changed if necessary.

The table beside the patient's bed remains dirty. Fresh water is not provided without the patient requests for it. Nurses no longer hesitate in telling the patient that they are short of hands or they do not have time as there are more patients waiting for their attention. At times the nurses have also refused to do some of the nursing chores declaring that it as not their job.