The recent news of a planned mass resignation by state sector nurses came as a shock to society. Nobody expected it. Not even the cabinet that initially rejected the listing of over 10,000 contract nurses as civil servants, which prompted resignation threats by a network of nurses who feel they are not getting what they deserve for all the efforts they've been putting in to care for people.
Eventually, the government caved in last week. It announced that it would meet the nurses' demands and grant civil servant status to 10,992 nurses who are under temporary contracts with state hospitals, with the first batch reportedly to be hired this year to fill 2,200 vacant positions under the Ministry of Public Health. The rest of the positions will be granted over the next three years.
Video by Jetjaras Na Ranong and Melalin Mahavongtrakul
Rungtiwa Panomkae, head of the Nurses on Temporary Contract Network that has been at the forefront of this campaign, told Life that the network finds the outcome quite acceptable. She thanked the government for taking into consideration the significance of the nursing profession and asked nurses to keep on doing their good work.
While the government has promised to grant the status, the final decision still awaits formal approval by the cabinet. The network has since released a statement saying that, if the state doesn't follow through with their promise, the nurses will promptly resign on Oct 1.
This whole debacle clearly shows that state-granted civil servant status still remains, to many Thai people, something very much coveted. It entitles the position holder various perks, such as healthcare reimbursements for themselves, their parents, spouses and children, getting loans or mortgages at a very low interest rate, tuition for their kids and pensions after retirement. The salary of a civil servant may not look too good compared to those working in the private sector, but at least this permanent status is laden with benefits.
Being a civil servant is the definition of career stability, especially to many nurses who have been vying for the status for years.
Dungkamon Karawek, 26, a contract nurse working for Bang Pahan Hospital in Ayutthaya, said she chose to study nursing because of the level of stability this career path offers through civil servant status.
Performing daily tasks on the ward. Jetjaras Na Ranong
"Today, it doesn't feel so stable anymore," she admitted. As a nurse hired on a temporary contract with the hospital, she is not entitled to any welfare or benefits.
"It seems so drifting, so insecure," said the nurse of her job. "It's like I work each day with no purpose. I can't leave this job because this is what I studied to be. I can't continue my studies because we don't have enough nurses to fill in. I can't get a day off to go to classes. If I want to study, then it has to be in the area they want. There are so many limitations. And I think I should be able to choose for myself. But these limitations are pushing me down."
Bang Pahan Hospital currently has a total of 12 nurses, with five of them on a temporary contract. In a day, they work for eight to 16 hours to cater for about 200-300 outpatients a day, plus another 30 in-patients. And they only get four or five days off per month. They rarely ever get to go anywhere for Songkran, New Year or any long holidays for that matter.
Dungkamon provides care for countless people as part of her job. But in doing so, she said it's almost impossible to care for her own ageing parents.
"Everyone has a job and responsibilities: a husband, kids and parents. So if my parents were to get sick, and if I can't find someone to replace me during my shift, then I can't leave to see them and care for them," she tearfully shared.
The nurse further revealed that she once broke her leg, and was able to take only 15 days off as sick leave before she had to come back to work, all with the cast on. She was assigned paperwork during that period.
"If I don't come back, I'll get fired," she said.
Dungkamon Karawek. Jetjaras Na Ranong
After four years at the hospital, she said her salary -- after the social security deduction -- only amounts to 14,000 baht a month.
Dungkamon said there have been times she wanted to leave, and many of her friends have already left for private hospitals. Still, she chooses to stay in the hope she will eventually attain civil servant status, and continue to work close to home instead of leaving her family behind to search for other jobs.
"My parents have been worried, too. But they did say that if I have other options, then I can leave if I want to. They have themselves covered, as they are both civil servants."
But while Dungkamon has quite a few options, things are not the same for her younger colleague Pittawan Chansopha, 23, who has four more years to work and pay off her college debt to the Ministry of Public Health.
She's not going anywhere just yet, until she can pay back that student loan.
"After four years, if there's still no advancement, then I may consider looking for work in other places that offer better welfare," said Pittawan.
"In the beginning, my family was really happy that I became a nurse, that I would become a civil servant." Her mother and father are not civil servants, so one of the perks that comes with the position, like healthcare that covers her parents, could be highly beneficial to her family.
"However, my parents now fear that my future seems uncertain, that I may not get the status, and that I may have to wait for a long time. Even those who are older than me are still waiting."
Even with the news that the government plans to grant civil servant status to contract nurses within three years, these ladies in white aren't too convinced just yet that the situation will change so easily. "It will probably be a long wait," Pittawan speculated.
Pittawan Chansopha. Jetjaras Na Ranong
"I graduated four years ago, and I have countless juniors following this path. The government will need to pick up those who are being left behind, as well as prepare for those coming in," added Dungkamon.
The two young nurses agreed that they would probably not recommend that their family members become nurses. But Jongkon Intasarn, 58, head nurse at Bang Pahan Hospital, would still encourage people to study nursing.
"If not for anyone else, you can study it for yourself and use the knowledge to take care of your own family," Jongkon said optimistically. She has been with Bang Pahan Hospital since its opening in 1995, and has witnessed the ups and downs of the health sector through the years.
As a committee member on the Thailand Nursing and Midwifery Council, Jongkon noted that the government is putting a big piece of cake on the platter with the promise to give civil servant positions to contract nurses. Everyone wants their share, and it will be interesting to see how the process plays out. Jongkon hopes it will work out fairly for all nurses, with no one receiving unfair advantage.
The work for nurses is ever expanding, added Jongkon, especially due to Thailand's ageing society. She said the government will need to provide adequate resources to match demand.
It's unfortunate that hospitals throughout Thailand, especially state-owned ones in rural areas, are lacking in staff. Workload per person is heavy, as can be seen with the Bang Pahan nurses. To lessen the burden on hospitals, Jongkon advised that perhaps it's time we all look into public education and instil a body of knowledge in people so they learn to treat their own health with care, and rely on medical institutions only when they have to.
"People aren't well informed," said Jongkon. "Perhaps they lack the access to this knowledge. Or maybe it's us who have yet to reach out to them. If nurses don't come out and raise their voices today, everything will turn silent. Nothing will change. They're doing this as a way to help themselves and the people, so that in the end we will see development throughout the entire sector and improve the care for our patients."
