As the SARS outbreak in Taiwan escalates, we hear official reports on the number of reported, sus-pected and probable SARS cases, as well as fatalities, every day.
Looking at these figures, has anyone noted that of all SARS-affected countries, Taiwan has the highest mortality and infection rates among nursing personnel? Is the nurses' professional training insufficient? Or do they not know how to protect themselves? It is neither.
To show the Cabinet's appreciation for medical staff treating SARS patients, Premier Yu Shyi-kun announced on April 27 that each doctor treating SARS patients would receive NT$10,000 per day and each nurse NT$3,000. Shouldn't the bonuses reflect the degree of danger each professional is exposed to? The amount given to nurses shows how little regard the nursing profession is given here.
When caring for SARS-infected people, nurses have to stand by their beds to draw out their phlegm, give injections and turn over and wash the patients. Their length of contact with patients is definitely greater than anyone else. Is the danger they face merely one-third of that facing doctors? Or are their lives worth only one-third of physicians?
In the anti-SARS war in this country, why have the nursing staff suffered such heavy casualties? Is it because nurses were not informed by hospitals that they were caring for SARS patients, causing them to be lax about taking precautions? Or did the hospitals fail to provide them with sufficient protective equipment? Did they have to work overtime without getting enough rest? Or were they taxed by unrelenting demands and criticism and unable to relieve the psychological pressure, they pushed themselves to the verge of collapse? Isn't the high casualty rate among nursing staff an issue that deserves the attention of authorities?
Nurses endure difficult working conditions and long hours. For example, when caring for SARS patients in isolation wards, nurses have to muffle themselves up in three-layers of air-tight, heavy isolation suits. Nurses in countries such as China work four hours per shift. But here, each shift is over eight hours. Nurses also have to suffer the humiliation of unreasonable remuneration. It is really inhumane.
Taiwan's nurses have long been the disadvantaged majority in the medical world. They are a silent group, carrying the biggest workload but receiving the low-est salaries. When hospitals want to reduce their costs, nurses are the first to be laid off. The nursing staff is viewed as a unit which spends money without making contributions. They face streamlining, wage cuts and growing quality demands.
In many countries, physicians are paid three to five times more than nurses. In Taiwan, however, doctors can make six to 10 times the salary of a nurse.
Nursing education did not teach us to be calculating or to pursue our rights and interests. Mentioning money is even viewed as a vulgarity, especially when fighting diseases and disasters. However, were it not for a handful of people stepping forward to speak out on the second day of Taipei Municipal Hoping Hospital's closure , I don't know how many more people would have died inside that den of contagion.
If we remain silent, nurses will be sacrificed. How then can they contribute? How can the burnt-out candles light up other people's lives? We want neither the title of anti-SARS heroes or heroines, nor the glory of being placed in the Martyrs Shrine.
We are willing to give but should not be overlooked. We would like to dedicate ourselves but will not make meaningless sacrifices. The authorities must speed up the formulation of measures to protect nurses' rights and interests.
Tseng Jean-lie is chairwoman of the National Union of Nurses' Associations.
Translated by Jackie Lin
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