The evolving role of nurses during Covid19 thoughts on International Nurses Day

Today we are in the midst of one of the largest epidemics that the modern world has seen. As we write this India has been under lockdown for the last 60 days. Covid19 has put healthcare back on the main agenda for most public policymakers. While doctors and hospitals being recognized in this fight, the real soldiers in this war are the nurses. In any healthcare set up, its the nurses who are in the trenches, fighting day in and day out against known and unknown elements. Some time ago we had written about how the nursing services were at the cusp of change. Today we focus on how the role of nurses evolves during pandemics.

Nurses today are leading from front. They are the managers at forefront at bedside of the patients, keeping them on the path to recovery. Therefore it is importatn that we keep nurses motivated and inspired to stay on with enthusiasm in the Covid Era. On this international Nurses Days, we spoke to Col Binu Sharma, Vice President for Nursing Services at Columbia Asia Hospital. Col Sharma entered the nursing profession almost 40 years ago in 1977. She has been in charge of nursing at Columbia Asia since 2007. Today her organization has more than 2000 nurses and technicians in hospitals across the country. Below are some excerpts from the interview

Healthcare India: Nurses are the backbone for our healthcare system, how does their day to day role change during epidemics?

Col Binu Sharma: Articulating the changes in the nurses’ role during a global health crisis is helpful for communicating a plan to decrease the spread of disease and for implementing improved policies, procedures, and supplies. The nurses are not only the backbone of the health care team but they are the most important link in the health care delivery system.

During epidemics, the nurses become the “role models “rather than merely playing various day to day roles. The role of the nurse changes to adapt to the needs of the patient, their families, the hospital, and the community. During such crises nurses take up leadership roles at the forefront like this time in the fight against Covid19. They not only add to the development of policies to fight epidemics or pandemics but they also prepare for, identify, respond to, and direct recovery efforts from global epidemics that require an informed, coordinated response.

Healthcare India: What kind of training is provided by the nursing colleges to handle these situations as part of the curriculum?

Col Binu Sharma: In the revised basic nursing curriculum the Indian Nursing Council has included 100 hours of theory & 160 hours of practical to teach budding nurses on the various aspects of epidemiology & standard treatment protocols.  For community health practical the nurses are put in clinical areas in the remotest villages  & they are introduced to nursing care services in resource limited setting and they are given ample opportunities to link theory to practice in these sort of situations.

In fact the entire nursing curriculum and training is about learning to face the most complex and adverse situation with positivity & humility.

Healthcare India: What measures and steps have you initiated in your career to help nurses deal with epidemics?  

Col Binu Sharma: We have initiated many steps including

·        Improved engagement and networking

·        Providing job security and reassurance, Flexi hours, psychological counseling and support to relieve anxiety

·        Encouraging fun activities, quiz and other relaxation measures

·        Focus on their health screening, regular meals, hydration, power breaks, resting zones in hospital. Transport to pick up and drop

·        Provided with digital platforms, webinars to connect for training, live demos and team communication

·        Provided scope for continual training & development. Formulate revised SOPs based on protocols from various authorized national and international resources. Training on Infection control procedures, employee safety, and patient-related revised disease protocols

·        Supporting with adequate resources, manpower, medical disposables. Ensuring quality and quantity of personal protective equipment and other safety attire

·        Encouraging team spirit by listening to their needs, regularly talking to them, helping them, guiding & mentoring them and most importantly leading the way

Healthcare India: What are your recommendations that we are better prepared for the future?

Col Binu Sharma: No amount of preparedness can predict success or failure in the future but being prepared always helps us to develop a positive outlook.

  • Factors like creating awareness among the community, development of infrastructure of the health care system especially in rural areas , educating the population at the rural sectors, providing safety & security to health care workers may help us deal with future occurrences of epidemics & pandemics in a much more coordinated manner.
  • Keeping our nursing workforce well trained with mock drills on disaster preparedness
  • Keeping database of ready nurses to be hired in case of such emergencies
  • Developing mentors for taking higher responsibility
  • Engaging and education society in some of the recommended measures of hand washing, social distancing, respiratory hygiene, sharing right information with hospitals  are some of the regular improved measures.

It’s good to see nurses leading the fight, but as Col Sharma says in her interview, a lot of care and thought has to be given to keep the nurses encouraged and prepared to deal with the ever-changing complex scenario that has become Healthcare in India.

Healthcare Delivery

How pollution might be damaging your skin?

Your skin wants to protect you. It protects your muscles and organs from the elements, and it is strong enough to stand up to the stresses we put on it on a daily basis. But skin can’t withstand everything we throw at it, and there are several things we encounter on a daily basis that can irritate and damage the skin.

The sun, of course, is one factor that can cause the skin to become damaged and prematurely aged. Most people know this, and make an effort to prevent skin cancer using sunscreen and common sense. Unfortunately, there’s another factor that can damage the skin—and you may not even notice it. Pollution, a major issue in urban areas, can have a major negative impact on your skin without you even realizing it. To know more we spoke to Dr. Sravya C Tipirneni, Consultant Dermatologist & Cosmetologist, Columbia Asia Hospital, Whitefield.

Healthcare Delivery

Columbia Asia Hospital’s Dr Nanda Kumar Jairam awarded “Healthcare Personality of The Year” by FICCI

Indian healthcare is growing at a tremendous pace today, owing to its strengthening expansion and services by both public and private players in the sector. Several healthcare organizations and individuals, through their dedication and determination for innovative solutions have contributed positively in countering the challenges that lurk large, on the healthcare sector.

Healthcare Delivery

Thoughts to combat Hepatitis on World Hepatitis Day

Viral Hepatitis is a major public health problem in the South-East Asia Region. Each year viral hepatitis infects millions of people across the region, causing the death of around 410 000 persons – more than HIV and malaria combined. It is also a major cause of liver cancer and cirrhosis, contributing to premature morbidity and mortality, and undermining economic growth and the push to achieve health and wellbeing

As per World Health Organization (WHO) statistics, India is among the top 11 countries which carry the global burden of chronic hepatitis. Since, it accounts for a huge burden of illness, outbreaks and epidemic spread, resulting in increased death cases.

Healthcare Delivery

3 points to consider while buying Nebulizers for Asthma and other breathing conditions

If do you suffer from asthma, bronchitis or other problems related to difficulty in breathing? In that case, your doctor will first analyse your medical condition and health and then recommend a way to deliver medication. The device thus advised would mostly depend on the nature of illness and in most cases, either an inhaler or a nebulizer is recommended.

A nebuliser is a kind of device that offers the medication in the same way as metered-dose inhalers (MDIs) do. A nebulizer  comes with benefits and this is the reason of its recent success in managing conditions like Asthma. In fact, the device is simple to use.

How they work?

Nebulizers are very important for those facing breathing difficulties or related problems. It is however important to understand how they work so that maximum benefits can be achieved.

Let’s look at how they work –

  • They are designed to turn liquid medicine into a mist to help treat asthma or other breathing disorders
  • The device comes with an air compressor, a small container (for liquid medicine) and a tube (for connecting the air compressor to the medicine container)
  • There is a mask or mouthpiece to inhale the mist containing the medication that is created by passing the air and oxygen through the stored liquid medicine inhaled by the individual
  • The dosage can be controlled through this process


 However there are some key points to keep in mind as you consider a nebulizer.

Indication and Contraindication

According to  Dr. Radhika Thappeta, Consultant – Internal Medicine, Columbia Asia Hospital, Whitefield, Bangalore, there are 2 key indicators why a patient should consider a nebulizer and they are

  1. During acute exacerbation of asthma or any obstructive lung disease for the ease of administration
  2. When patient is unable to do the breathing, coordination required for the inhaler usage, because of sickness/disability/extremes of age


A nebulizer should never be taken without a doctor’s advise or prescription. 

This is a key area of concern as many in India tend to self medicate and this causes grave consequences in the management of the condition and sometimes putting the patient at risk.

Where can you get one?

You can find a nebulizer online as they are also easily available in the market. They are quite a common sight in hospitals and clinics for offering treatment to those facing breathing issues due to asthma or bronchitis. They are also considered superior to inhalers in more than one way and that’s why, they are generally preferred.

Key steps to follow while using the nebulizer

  • Follow the instruction manual
  • Follow the maintenance and cleaning instructions as per the manual
  • Do not share the nebulizer mask/Tubing
  • Stop if you develop any of the following symptoms, and consult the doctor immediately if the patient shows any of the following symptoms :
    • Dizziness
    • Feeling shaky
    • Heart racing
    • Nausea
    • Chest pain
    • Uncontrollable coughing

Remember do consult your doctor before you consider this device, this is not meant to be used without a doctors’s prescription.

(This is a guest post by Irshad Alam, edited to add credible medical advice from Dr. Radhika Thappeta, Consultant – Internal Medicine, Columbia Asia Hospital, Whitefield, Bangalore)