The role of contract nurses as activists demanding the government upgrade their status to permanent civil servants can be traced back many years to their mentor in Udon Thani.
A 53-year-old nurse who, in 2012, led a similar movement for a better career path for fellow nurses, is behind the success which saw the cabinet on May 16 grant nurses working under temporary contracts 8,792 civil servant positions over the next three years.
"That's just one step of the success," said Mullika Lunnajak, a chief nurse at Nong Wua So Hospital in Udon Thani, who shared advice with to the Contract Nurses' Network which spearheaded the latest movement.
Each year between 3,000 and 4,000 nurse graduate and they will have to do this all over again. (Bangkok Post file photo)
Still, there are plenty of non-hospital jobs for them, a type of work that deals directly with their so-called "career ill", not patients' sickness. In Ms Mullika's view, the success in making authorities respond to the contract nurses' demand is just a short-term solution as, along their future paths, more problems are waiting, ranging from heavy workloads to meagre promotions and limited salary packages.
"There must be more contract nurses coming out again to make the same call in the next four or five years," she said.
Every year another 3,000 to 4,000 nurses graduate from universities but they would have to wage the battle for permanent civil servant status again.
During the 2012 movement, 17,000 nurses at public hospitals signed their names to call for permanent status. The situation remains similar as this year, when more than 10,000 nurses supported the call for the same upgrade. The government eventually agreed to allocate a total of more than 10,000 civil servant positions -- 8,792 new ones and others drawn from the vacancies of, for example, retirees -- to nurses within three years, after the Contract Nurses' Network threatened to resign en masse this September if their call fell on deaf ears.
It was a serious bargain, but considering the contract nurses' long wait for the bureaucratic status, Ms Mullika said their move was justified.
Delays in becoming civil servants are unfair to them because the number of the service years will determine the benefits they receive from the government.
State officials who work for 25 years have a right to a bamnan pension, a life-long monthly payment, after retirement, but if their working period is shorter than required, they will only be given a bamnet, or one-time pension package.
A benefit gap between contract nurses and those in bureaucratic system is also seen in medical welfare benefits which do not cover the parents of the former group, she said.
These limited benefits can discourage contract nurses who fear they will have to endure heavy workloads. Some hospitals with not enough nurses "order" those working in a morning shift of eight hours to work for another eight hours in the afternoon shift, Ms Mullika said.
As a result, they rack up stress and have little time for their family, leading to personal problems, she said.
It is a fact that contract nurses are members of the Social Security Fund, but they are given fewer benefits than company employees. While they are required to make monthly contributions to the fund like other employees, they have no right to claim for compensation for illness or accidents caused by their work, Ms Mullika observed.
That is why several thousands of nurses support the Contract Nurses' Network in demanding the government upgrade their career status. Their movement is a good start to clear up the problems, Ms Mullika said.
Some other problems will be further handled by the Nursing Union of Thailand, also established in 2012. Spearheading the group, a kind of labour union within state agencies, was never part of Ms Mullika's plans when she graduated from Si Maha Sarakham Nurse College in Maha Sarakham.
But its importance became increasingly evident when she and her colleagues encountered problems related to their work.
The 2012 movement to call for permanent civil servant status led her to co-found the nursing union after realising the group would be a powerful voice in calling for the fair treatment of nurses at state-owned hospitals.
Even though the act on labour unions in bureaucracy has been in effect in the private sector, there have been no organic laws to facilitate its establishment within the bureaucratic system. Yet Ms Mullika and other co-founders were determined to give it a birth by registering it with the Office of Civil Service Commission and Khon Kaen labour protection and welfare office for the sake of "transparency," she said.
Besides a continuing role to push for the status upgrade, the nursing union, currently with about 3,000 members, is also representing nurses to call for appropriate salaries, welfare, promotions and a better working environment for nurses.
"We need reform in nursing affairs," Ms Mullika said, suggesting the number of nurses must increase to relieve their hard working routines. She said Thailand should have a total of 130,000 nurses or one nurse per 600 people, which is just slightly more than the international standard of 1:400. But at present, one or two nurses have to take care of between 6,000 and 7,000 people in some areas, she said.
Career advancement is another issue her union wants to improve. Many nurses feel discouraged when they learn they will face the "dead end of C", Ms Mullika said.
The Common Level, known as C, which classifies positions of state officials into 11 levels, are relatively short for nurses.
It is known that teachers at state-run schools can move up to C9 level while non-management nurses usually stop at C7.
Among her doubts is that teachers with higher C levels tend to have higher salaries and fewer workloads, which is contrary to the senior nurses.
These problems are still waiting to be solved even though many contract nurses have successfully managed to secure their permanent civil servant status.
It is not easy to make a change, but Ms Mullika never gives up.
She enjoys working and continues to be a conscientious nurse. Ideology, she said, feeds her relentless efforts.
It is a unique feeling she and other nurses share when they realise they not only work to earn a living but also to achieve a better living standard for other people.