Nursing graduates: Struggle to avoid low paid jobs

Nursing graduates: Struggle to avoid low paid jobs

Each year between 3,000 and 4,000 nurse graduate and they will have to do this all over again. (Bangkok Post file photo)
Each year between 3,000 and 4,000 nurse graduate and they will have to do this all over again. (Bangkok Post file photo)

Senior & junior nurses working together have overcome govt policy of low pay for entry level nurses.


Nursing graduates: Struggle to avoid low paid jobs

Penchan Charoensuthipan

Thailand has long had a shortage of nurses.

To alleviate this shortage, the government hires more nurses.

Most new nurses, even though much needed, are only hired now on a temporary contract basis with lower pay and benefits than regular full nurses.

The government does not provide enough full nursing positions to the nurses that graduate and enter the profession of nursing every year.

To justify this, the government typically hides behind laws or regulations, saying that the laws only allow a certain small number of nurses to be hired each year (e.g. "We cannot do this because it is the law").

So why not change the law and adapt it to solving the problem of the nursing shortage? After all, a law that merely perpetuates a problem rather than solving it, is not a very useful law.

Perhaps, the government can get away with this because public government hospitals account for such a huge fraction of the hospitals in Thailand, so they have monopoly power. Whatever the reason, the prospect of low-paid temp jobs must a reason that some capable people choose not to study nursing.


In response to this government intransigence, the nurses typically challenge the government.

Nurses threaten to quit their jobs en masse and eventually the government gives in and provides at least some of the nurses with full nurse jobs.

Every year, another 3,000 to 4,000 nurses graduate from universities but they have to wage the battle for permanent civil servant status once again.


Mullika Lunnajak who is a chief nurse at Nong Wua So Hospital in Udon Thani, was an advisor to the Contract Nurses' Network.

This network spearheaded the latest social movement to get full nurse jobs for temp nurses.

The 53-year-old nurse led a similar social movement for a better career path for fellow nurses back in 2012.


This social movement is the force behind the recent success which saw the cabinet on May 16 grant nurses working under temporary contracts 8,792 civil servant positions over the next three years.

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 full status, Ms Mullika said their move was justified.


Delays in becoming civil servants are unfair to the young nurses 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 so-called "bamnan pension", a life-long monthly payment, after retirement, but if their working period is shorter than required, they will only be given a lesser bamnet, or one-time pension package.

A benefit gap between contract nurses and those in the official government bureaucracy is also seen in medical welfare benefits which do not cover the parents of contract workers, she said.


These limited benefits can discourage contract nurses who fear they will have to endure heavy workloads.

Some hospitals that do not have enough nurses order nurses working a morning shift of eight hours to work yet 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 (SSF), 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 make a 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" that empowers labour unions, has been in effect in the private sector, there have been no organic laws to facilitate its establishment within the government 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.

Learn from listening

Click play to listen to audio for this story, or download to save the file
: :


  • accident (noun): an unpleasant event that happens unexpectedly and causes injury or damage - อุปัทวเหตุ, เหตุบังเอิญ
  • account for: to be a particular amount or part of something -
  • adapt: to change something to suit different conditions or uses - ทำให้เหมาะ, ทำให้เข้ากับ, ปรับ
  • advisor (noun): a person who gives advice, especially somebody who knows a lot about a particular subject - ที่ปรึกษา
  • alleviate: to make something less painful, severe, or serious - ทำให้บรรเทา ทำให้น้อยลง
  • allocate (verb): to give out an amount of or share of something - แบ่งส่วน
  • allow: to let somebody/something do something; to let something happen or be done - อนุญาต, ยอมรับ
  • at least (adv): used to add a positive comment about a negative situation - อย่างน้อย
  • bargain: a deal that someone gets after negotiation and discussions -
  • basis (noun): the idea or system that something is "based" on - พื้นฐาน,รากฐาน,หลักสำคัญ
  • battle: a fight; serious disagreement, strong competition, etc. - การต่อสู้
  • benefits: the part of an employees compensation or pay that consists of things like health insurance, vacation time and other special privileges not measured directly in money -
  • bureaucracy: the people employed to run government organisations - กลุ่มของข้าราชการ
  • cabinet: the group of government ministers who make and approve government policy - คณะรัฐมนตรี
  • call for: request or ask someone to do something - ขอ, ขอร้อง, เรียกร้อง
  • capable: able to do something; very good at a job - มีความสามารถ
  • career: a job or series of related jobs that you do, especially a profession that you spend a lot of your working life in - อาชีพ
  • career path: a series of jobs of increasing responsibility and pay that a person does during the whole length of their career -
  • challenge: to invite someone to compete or fight - ท้า
  • civil servant: someone who works for a government department - ข้าราชการ
  • claim: to demand or ask for something because you believe it is your legal right to own or to have it - อ้างสิทธิ, ยืนยัน
  • co-: done together with another -
  • colleagues (noun): people who work in the same organisation, department or field as you do - เพื่อนร่วมงาน
  • consider: to give careful thought to something before making a decision - พิจารณา
  • contract: an official written agreement - สัญญา
  • contribution: a regular payment that you make when you are working - การลงทุนหรือช่วยเหลือ
  • demand: to ask for something very firmly - เรียกร้อง, ต้องการ
  • determine: to decide what will be done or happen - กำหนด
  • discourage: to make someone feel like something should not be done - ทำให้ไม่อยาก (ทำสิ่งใดสิ่งหนึ่ง)
  • en masse: all together as a group - เป็นกลุ่ม,ด้วยกันทั้งหมด
  • endure: to suffer something difficult or unpleasant in a patient way over a long period of time - อดทนเพื่อให้ผ่านเวลาหรือเหตุการณ์ที่เลวร้าย
  • establish: to start a company or organization that will likely continue for a long time - สถาปนา, ก่อตั้ง, จัดตั้ง
  • eventually: at the end of a period of time or at the end of a process - ในที่สุด
  • evident: clearly seen; obvious - เห็นได้ชัด
  • fact: something that is true - ความเป็นจริง
  • fell on deaf ears (idiom): not listening or acting on a request, order, statement, etc. -
  • fellow: of a person that you work with or that is like you - ซึ่งอยู่เป็นกลุ่มเดียวกัน
  • force (noun): an effect that causes things to move in a particular way - กำลังแรง, แรงบังคับ
  • found: to start an organization, company, political party etc - สร้าง, ก่อตั้ง, สถาปนา
  • fraction (noun): a small part of something - ส่วนน้อย, จำนวนเล็กน้อย
  • fund: money provided for something - เงินทุน กองทุน
  • gap (noun): a difference between people or groups - ช่องว่าง
  • get away with: do something wrong for your own benefit, and not get caught and punished for doing it -
  • give in: surrender, to give up - ยอมแพ้ ยอมจำนน
  • graduate: to get a degree from a university or college; to complete a course in education, especially at high school - ได้รับปริญญา,สำเร็จการศึกษา
  • grant: to officially give something - ให้
  • hide: to cover something so that it cannot be seen; to keep something secret - ซ่อน, ซุกซ่อน, ปกปิด
  • hire: to pay someone to work for you - จ้าง
  • huge: very large - ใหญ่โต
  • illness (noun): the state of being physically or mentally ill - ความเจ็บป่วย, ความเจ็บไข้
  • intransigence: the umwillingness to act or do what someone asks you to do -
  • justified: showing that there is good reason for something - มีเหตุผลที่ดีพอ
  • justify: to show that there is good reason for something - แสดงเหตุผลที่ดีพอ
  • latest (adj): newest; most recent - ] ล่าสุด, See also: ทันสมัยที่สุด, เกิดหลังสุด
  • leading to: causing -
  • medical: connected with illness and injury and their treatment - ทางการแพทย์, ด้านการแพทย์, เกี่ยวกับการแพทย์
  • member: a person, a country or an organization that has joined a particular group, club or team - สมาชิก
  • move (noun): action -
  • movement (noun): a group of people who share the same aim and work together to achieve it - การเคลื่อนไหวเพื่อวัตถุประสงค์ทางการเมือง
  • network: a large system of connected parts, organisations, people, etc. - เครือข่าย
  • nurse: someone who is trained to look after ill or injured people, usually in a hospital - พยาบาล
  • nursing: the job or skill of caring for people/animals who are sick or injured - การพยาบาล
  • once again: to do again, to happen again, for a second or third time - อีก
  • order (verb): to use your position of authority to tell somebody to do something or say that something must happen - สั่ง
  • pension: money that someone regularly receives after they have stopped working because of their age, paid either by their company or by the government - บำนาญ, เงินบำนาญ
  • perhaps (adv): possibly - บางที
  • permanent: happening or existing for a long time or for all time in the future - ถาวร  
  • personal: your own; not belonging to or connected with anyone else - เป็นส่วนตัว
  • position: a job - ตำแหน่ง
  • profession: a type of job that needs special training or skill, especially one that needs a high level of education - อาชีพ
  • prospect (noun): the possibility that something will happen - ความคาดหวัง, โอกาส, ความหวังข้างหน้า อนาคต
  • provide: to give someone/ something that they want or need - จัดหาให้, จัดเตรียมไว้ให้
  • public: open to people in general - สาธารณะ
  • rack up: rack up a big bill; run up a big bill; spend a lot of money so that the business gives you a big bill asking you to pay a lot of money -
  • reason (noun): why something happened or exists - เหตุผล
  • recent: happening or starting a short time ago - เร็วๆ นี้
  • regular (adj): normal; following a pattern, especially with the same time and space in between each thing and the next - ปกติ, เป็นประจำ, เสมอๆ
  • regulation: an official rule that controls the way that things are done - ระเบียบข้อบังคับ
  • require: to make somebody do or have something, especially because it is necessary according to a particular law or set of rules - บังคับใช้ (กฎหมาย) กำหนด
  • resign: to leave a job permanently - ลาออกจากตำแหน่ง
  • response: a reaction to something that has happened or been said - การตอบสนอง
  • retiree: a person who has stopped working because of their age - ผู้ที่หยุดทำงานแล้ว, ผู้ที่เกษียณแล้ว
  • retirement (noun): the time when you stop working, especially because of old age - เกษียณอายุ, การอำลาวงการ
  • right: a moral or legal claim to have or get something or to behave in a particular way - สิทธิ
  • shift: a period of work time in a factory, hospital or other place where some people work during the day and some work at night - เวร, กะ หรือระยะเวลาทำงานเป็นช่วงๆ,
  • shortage (noun): when there is not enough of something - การขาดแคลน
  • similar: like somebody/something but not exactly the same - คล้ายกัน
  • situation: all the circumstances and things that are happening at a particular time and in a particular place - สถานการณ์
  • social movement: a group of people who share the same aim and work together to achieve it - การเคลื่อนไหวเพื่อวัตถุประสงค์ทางการเมือง
  • social security: money that the government pays regularly to people who are poor, unemployed, sick, etc - สวัสดิการสังคม,ระบบการประกันสังคม
  • spearhead: to begin an activity or lead an attack against somebody/something - นำหน้า
  • status: legal position - สถานะ
  • stress: mental pressure or worry - ความตึงเครียด
  • success (noun): achieving the goals you wanted to achieve or made a lot of money - มีผลสำเร็จ, ประสบผลสำเร็จ, ประสบชัยชนะ
  • temporary: done or used for only a limited period of time, i.e., not permanent - ชั่วคราว
  • threaten (verb): to say or indicate that you might do something bad or harmful, especially in order to make someone do something - ขู่เข็ญ คุกคาม ทำให้กลัว
  • threaten: to say you might or will do something bad or harmful, especially in order to make someone do something - ขู่
  • typically: usually; normally - อย่างเป็นแบบฉบับ
  • unfair (adj): actions that are not acceptable and appropriate - ซึ่งไม่ยุติธรรม
  • union (noun): an organisation of workers, usually in a particular industry, that exists to protect their interests, improve conditions of work, etc - สหภาพแรงงาน
  • university (noun): a school where students study for BA, MA, MS and PhD degrees and where research is done - มหาวิทยาลัย
  • upgrade (verb): to give something a higher level of importance - ยกระดับ
  • vacancy: a job that no one is doing and is therefore available for someone new to do - ตำแหน่งว่าง
  • wage: to start or continue a war or fight - ประกาศสงคราม
  • welfare (noun): good care and living conditions - ความสะดวกสบาย, ความมีสุขภาพดี, สวัสดิภาพ
  • workload: the amount of work that has to be done by a particular person or organisation - ปริมาณงานที่คนหรือเครื่องจักรทำได้ระยะเวลาหนึ่ง
Do you like the content of this article?