Author: Sharif Mohammad Sadat
A few months ago, I was attending a health conference where I met a confident, brilliant professional from Thailand. She was speaking up in policy discussions, presenting ideas, and engaging with experts worldwide. For the first day, I assumed she was a doctor, maybe even a policymaker. When I later found out she was a nurse, I paused. I was surprised, but not because she wasn’t qualified. However, I come from a system where such visibility and leadership from nurses are rare.
In Bangladesh, nurses are seldom seen in national or global health policy conversations. They’re not invited into decision-making rooms. They’re rarely given platforms to lead. And most tragically, they are too often reduced to “support staff” rather than recognized as highly skilled professionals delivering critical care. But this isn’t just a cultural perception problem, it’s a health systems issue.
Doctors may prescribe the cure, but nurses ensure it is delivered safely, consistently, and compassionately. They make the healing process bearable. I’ve seen firsthand how nurses are the backbone of care in our hospitals. While doctors diagnose and prescribe, it’s nurses who monitor patients, respond to complications, carry out procedures, and often notice the first signs when something isn’t right. They are the first responders within hospital walls.
As a medical student, I’ve learned from nurses in ways that textbooks could never offer. I’ve seen senior nurses perform procedures more skillfully than fresh graduates. Their clinical judgment, intuition, and empathy come from experience, built through proximity to patients, not just formal training. This deep knowledge, however, is not adequately supported by the system. In Bangladesh, for instance, the outdated training and inadequate education infrastructure leave nurses ill-prepared to handle the complexities of patient care, especially in specialised fields like cardiology, oncology, and rehabilitation.
And yet, despite their essential role, nurses are frequently underpaid, under-recognized, and left out of decisions that directly affect their work. Their uniforms are plain. Their workspaces are often neglected. Their voices are ignored in rooms where healthcare policy and funding are shaped. The distance between doctors and nurses isn’t just symbolic; it’s structural, and it’s hurting our health systems.
The current workforce imbalance in Bangladesh, with only 85,000 nurses compared to a far higher number of doctors, speaks volumes about the systemic neglect of nursing as a profession. Global healthcare standards recommend a doctor-to-nurse ratio of 1:3, but in Bangladesh, it stands at a mere 1:0.75. This disparity contributes to the burden on nurses, leading to high burnout rates and job dissatisfaction. While doctors diagnose and prescribe, nurses are the ones who provide hands-on care, often under immense pressure, with inadequate support and recognition.
Today, as we celebrate International Nurses Day, we also remember Florence Nightingale, not just as a nurse, but as a reformer, statistician, and policy influencer. She didn’t transform healthcare by staying silent. She did it by stepping into the halls of power and speaking with data, strategy, and conviction. We must bring nurses into policy-making spaces, not as token voices, but as experts and leaders. They must be included in stakeholder meetings, national health committees, and global forums. And most importantly, they should be leading these conversations, not being spoken for by others.
We cannot strengthen our health systems while silencing those who sustain them. Nurses in Bangladesh, especially in rural areas, often work in environments where their roles are undermined by unqualified personnel, such as ward boys or critical care associates, who lack the formal training necessary to provide proper care. This compromises patient safety and highlights the need for qualified professionals in every corner of our healthcare system.
Investing in nurse leadership is not just a matter of justice, it’s a strategic imperative. It’s about making our systems more efficient, equitable, and resilient. We need to increase compensation, improve working conditions, and offer greater career opportunities to retain nurses and reduce the current high turnover rates. Additionally, we must prioritise specialisation opportunities to ensure that nurses are equipped to handle the growing demand for expert care, especially as Bangladesh’s population ages and faces an increasing burden of non-communicable diseases.
If we want stronger, more inclusive health systems, it’s time to close the gap and truly value those who have always been at the heart of health care.
Sharif Mohammad Sadat is a medical student from Bangladesh currently serving as the Regional Director for Asia Pacific at the International Federation of Medical Students’ Associations (IFMSA), a member of the WHO Youth Council. A passionate global health advocate, Sadat is dedicated to promoting sustainable health practices and ensuring health for all. His initiatives focus on making healthcare accessible and equitable, particularly for marginalized communities. He has a strong interest in One Health, emphasizing the interconnectedness of human, animal, and environmental health. His efforts aim to merge social growth with medical knowledge, contributing to a healthier and more equitable society.