If the doctors complain about the social service, the nurses don’t wake up

If doctors claim poor pay and deplorable conditions in the social service they provide in order to qualify, it turns out that they are kings compared to what nurses live.

Just looking at the level of scholarships for one and the other, a discriminatory difference is evident: If they do social service in the urban area, the medical intern receives 2,000 pesos; the nurse 600 pesos, that is, not a third part. For the semi-urban area, the doctor receives 2,400 pesos and the nurse 900 pesos; while if the service is provided in a highly marginalized place, the payment is 3,500 and 1,600, respectively.

It is not that the doctor receives fair compensation, but it is even more unfair for nursing professionals with a bachelor’s degree, and whose work is also essential in medical care, but is not sufficiently recognized.

Nursing, which represents more than 60% of health personnel and is involved in more than 85% of interventions, is positioned by the health system in the most precarious situation. During their social service they receive even less than any of the scholarships for children in primary, secondary or upper secondary education that range from 800 to 900 pesos.

Another piece of information: medical interns are no longer sent to highly marginalized towns, but nursing interns are. In the cities they are also sent to many hospitals to fill spaces that should be filled by registered nurses with tabulated salaries.

Every year some 25,000 nursing interns carry out their social service in one of the institutions of the National Health System, and one of the demands of this guild is that the scholarship amount be equal to that of medical interns. Especially in the case of those who graduate at the undergraduate level, which are about 20% of those 25,000.

It is a work force that is not treated or recognized as such and is very cheap for the system, says Juana Jiménez, regional director of U-Nursing-Latam and who headed the Department of Nursing of the Ministry of Health for 13 years and coordinated the Permanent Nursing Commission.

For the health sector, it has been very convenient and comfortable to maintain without change the service of thousands of young people who give their time and professional work for a year to public health institutions.

Another problem that requires fixing is that of the more than 311,000 nursing professionals who work in health institutions in Mexico, a significant proportion -40,500- were hired as nursing assistants with less than the regulated income. The problem comes from 2006 when the SS recognized the undergraduate level, despite the fact that since 1968 there has been a professional nursing degree in Mexico. From 2006 to date, 16 years have passed and the situation has not been regularized. In the IMSS, for example, the professionalization program is just beginning.

Discriminatory treatment towards nursing professionals is an international problem. In Spain, great controversy has been generated in recent days due to the dissatisfaction of the Seville medical union with the appointment of a nurse heading the Ministry of Health in Andalusia -the position of maximum representation of health professionals- because they consider that the position should be for a doctor who has more training.

2020 was designated by the World Health Organization as the international year of nursing and midwifery, and in this framework it urged member countries to overcome the decades of insufficient investment, which was more evident as a result of the pandemic and the poor response of many governments, and called for investment in the health workforce, particularly nursing and midwifery.

Perinatal nurses, for example, are an essential pillar to reduce maternal mortality.

Among other challenges identified by the WHO for nursing, apart from precarious working conditions, low pay and little professional recognition, is the low number of professionals, low qualifications and limited professional autonomy at the first level of care, as well as an incipient participation in the formulation of national policies.

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