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Why Bangladeshi nurses avoid 'nursing': Social and structural factors on hospital wards in Bangladesh

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  • Hadley, Mary B.
  • Blum, Lauren S.
  • Mujaddid, Saraana
  • Parveen, Shahana
  • Nuremowla, Sadid
  • Haque, Mohammad Enamul
  • Ullah, Mohammad

Abstract

In response to concerns that nurses spend less than 6% of their time on direct patient care, this study explored factors that influence nurses' behaviour in the provision of 'hands on' care in hospitals in Bangladesh. Through in-depth interviews with female nurses and patients and their co-workers in six hospitals, we identified conflicts between the inherited British model of nursing and Bangladeshi societal norms. This was most evident in the areas of night duty, contact with strangers, and involvement in 'dirty' work. The public was said to associate nursing activities with commercial sex work. As a consequence, their value on the 'bride market' decreases. To minimise the stigma associated with their profession, nurses in government hospitals distance themselves from patients, using nurse surrogates in the form of patients' relatives and hospital support workers to carry out their work. These adaptations are supported and sustained through unofficial activities developed over time within hospitals. In contrast nurses in NGO hospitals give more direct patient care themselves and do not rely on carers as much because of tight supervision and limited visitor hours. Initiatives undertaken to improve the quality of patient care, such as enlarging the nursing workforce or providing clinical instruction, which do not take into account the prevailing culture in hospitals and social conflicts faced by nurses, are unlikely to succeed. Fundamental decisions on how to care for the sick in Bangladesh are required. If the present nursing curriculum is followed, adequate supplies, supervision and accountability are prerequisites for its implementation.

Suggested Citation

  • Hadley, Mary B. & Blum, Lauren S. & Mujaddid, Saraana & Parveen, Shahana & Nuremowla, Sadid & Haque, Mohammad Enamul & Ullah, Mohammad, 2007. "Why Bangladeshi nurses avoid 'nursing': Social and structural factors on hospital wards in Bangladesh," Social Science & Medicine, Elsevier, vol. 64(6), pages 1166-1177, March.
  • Handle: RePEc:eee:socmed:v:64:y:2007:i:6:p:1166-1177
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    References listed on IDEAS

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    1. Gruen, Reinhold & Anwar, Raqibul & Begum, Tahmina & Killingsworth, James R. & Normand, Charles, 2002. "Dual job holding practitioners in Bangladesh: an exploration," Social Science & Medicine, Elsevier, vol. 54(2), pages 267-279, January.
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    3. Kim, Julia & Motsei, Mmatshilo, 2002. ""Women enjoy punishment": attitudes and experiences of gender-based violence among PHC nurses in rural South Africa," Social Science & Medicine, Elsevier, vol. 54(8), pages 1243-1254, April.
    4. Pilgrim, David & Rogers, Anne E., 2005. "Psychiatrists as social engineers: A study of an anti-stigma campaign," Social Science & Medicine, Elsevier, vol. 61(12), pages 2546-2556, December.
    5. Klumb, Petra L. & Lampert, Thomas, 2004. "Women, work, and well-being 1950-2000:: a review and methodological critique," Social Science & Medicine, Elsevier, vol. 58(6), pages 1007-1024, March.
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    1. Biswas, Debashish & Hossin, Raduan & Rahman, Mahbubur & Bardosh, Kevin Louis & Watt, Melissa H. & Zion, Mazharul Islam & Sujon, Hasnat & Rashid, Md Mahbubur & Salimuzzaman, M. & Flora, Meerjady S. & Q, 2020. "An ethnographic exploration of diarrheal disease management in public hospitals in Bangladesh: From problems to solutions," Social Science & Medicine, Elsevier, vol. 260(C).

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