On this occassion, BioSpectrum interacted with Col. Binu Sharma, Senior Vice President Nursing Services, Columbia Asia Hospital-

1. How different is nursing in different areas of the hospital?

The hospital has various departments from outpatient care to a non-critical area which are patient rooms and then highly critical areas like intensive unit, the operating theatres, catlab, emergency & trauma area, labour room services, etc. Nursing is a care which is specialised in all these areas. For example, in an operating room (OR) you need a different skill set to be a nurse (OR nurse), so a regular nurse cannot work in an operating room. Similarly, you need a neuro OT (Operation Theatre) nurse for a head surgery, a laparoscopic nurse for laparoscopic surgery, a robotic trained nurse for robotic surgery, a cardiothoracic nurse for heart surgery, etc. Within the OT itself there are super specialities. Just as we have an eye surgeon, the ENT specialist, the plastic surgeon, all of whom perform their specialised surgeries; likewise, a super speciality trained nurse is needed for each specific surgery. Hence, their skill set is specialised in care based on the hospital department, the surgeries or the emergency areas they work in.

Each department comes with its own required skill sets, experience in terms of knowledge, skills handling equipment’s and medical technology.

2. What is the different kind of training given to nurses depending on the different areas they are posted?

Nurses usually come from different nursing colleges with a degree, a masters or a diploma in nursing. However, that is a basic qualification; there are various registered nursing requirements in our country. Either after bachelors or a diploma holder joins nursing but that is not enough to be a practicing nurse. They must be given basic hands-on training; post which they are deployed in different departments. Based on the department’s requirement or specialisation, either one hires pre-trained nurses which are very few in the country, hence a specialised certification program is to be carried out for all these nurses.

In last 10 years, Columbia Asia has developed 45 certifications for masters. These are developed with experts (doctor and senior nurses). These programmes have been made available for Columbia Asia Nurses on Learning Management System (LMS).This can be accessed by nurses on a desktop, laptop or their mobile phones. These modules have been developed ranging from1-day module to a 7-day module and these training modules have got evaluation method. Post this knowledge, we give them relevant skill based training in those areas and every nurse goes through up to a three months of speciality orientation program for the department he/she is working. Only after they have been certified, they are considered competent and empowered enough to work in those areas independently. 

We also have a buddy system or mentor system for every nurse. The nurse has to work in the same shift like her mentor for three months and complete her various orientation skills for that department. Only after evaluation of 3 months and the confidence to work in those areas independently isthe buddy taken away otherwise the buddy is also extended for a month or so.This helps us to develop their confidence, knowledge, skill level and we get to know at what level they are evaluated and accordingly assign them duties to ensure safetyof patient.

3. What is the career progression at a hospital right from the time trainee nurse joins the hospital?

Columbia Asia has a very well structured career progression system. Be it a fresh graduate or an experienced nurse joining us, everyone is kept under probation for a period of 6 months. After this they get confirmed, based on their written and oral evaluation.

Once the nurse completes 3 years of experience, based on her annual performance appraisals, her periodic which is every quarter evaluation by her HOD, the nurses can become senior staff nurses and after that they can apply for a charge nurse position. Charge nurse is like a head nurse of the department. After going through some objective criteria, they can become charged nurses. Post which they can go on to becomes supervisors in the area of general administrative supervisors. So have lateral growth like an infection control nurse, a clinical educator, a patient counsellor. They can become super speciality nurses like the wound care nurse, a lactation nurse, new born care nurse. They can also become a trichotomy nurse and get into the super speciality modules. Post this they can even apply for administrative jobs like an executive nurse or an assistant manager or a manager in nursing. We have got so many examples in Columbia Asia where young nurses have joined in the emergency room ICU with 3-4 years of experience and are now chief of nursing services in my system. My Pune Chief of nursing services has grown from young ER nurse to chief of nursing services, a very dynamic role. We have such examples in many cities across the country.

We have an excellent well-structured and very fast moving ladder for the nurses. They can move upwards into the same department, they can move sideways into super- speciality roles, they can move into a specialized nurse role. They can also choseteaching and hence become a clinical educator. The career progression is structured and is extremely well implemented at Columbia Asia. We groom and nurture people within the setup. 

4. What are the kinds of remuneration in different areas for the nurses?

We have a very well defined salary structure which varies with years of experience in general areas, there is a speciality allowance added to all specialized areas. A nurse starts at a base level which is competitive in the market. We compare ourselves with the competition hospitals in that particular city and accordingly pay. Hence, our salaries are not same across India. It is competitive with the market we are located in. For every additional year of experience, the salary goes up by nearly 10%.

For us on-boarding a nurse is a very important and critical activity. If the on-boarding for a job role is not well defined or not well executed, a nurse is likely to fail in that role. We have a nursing induction programme, followed by a 3 months’ mentor’s programme which is runs parallel to the departmental orientation programmes. The nurses have speciality modules as well that allows them a uniquely learning management system. Every nurse has her login ID and password, for which we invest through an external agency and nurses go through the entire training, content on the elements. It’s very easy and feasible for them; they can do it whenever and wherever possible for them.

We also have many nursing engagement programmes some of which are on academics, while some are non- academic involving a general personality and grooming, language training, communication training, confidence building, time management, and goal setting. Every nurse has their position guidelines handed over to them on the day of joining, a goal sheet is also made available to each nurse for the year and KRA setting is done. This provides them the clarity of their role, and about their KRA’s for the year which are evaluated every 3 months to know their progress. There is also a monthly anonymous survey every year, Nurse Engagement Survey, to know the nurses’ concerns and any challenges they are facing.

Different activities like a cricket match between our different hospital nurses in Bengaluru are also conducted. There also go out on picnic, two-days away from work, movie, etc. Recently, we took them out for Avengers and we also take them out for lunch. This month being International Nurses Month, we are running a series of activities at the hospital.

We have some activities with the industry partners, some within the team. They do not get burdened by the challenges and hardships of the nursing profession which is really challenging. They need to learn to let go, they need to de-stress themselves. We celebrate every festival, every event and every special day, so that a happy work atmosphere is created for them. Many of them stay away from their homes, so we need to really make them feel at home and as a family.