Nurses are required to be willing to carry out responsibilities according to their calling with altruism, human dignity, integrity, honesty and social justice as core values. As a profession with an altruistic nature that strives for people’s well-being from cradle to grave, risking one’s safety is inevitable at times. All nursing personnel are expected to put others before themselves and are selfless in conducting their daily responsibilities.

As the major workforce in the healthcare setting, nurses make a major contribution to the health of people nationally as well as globally.

Particularly during this COVID-19 outbreak, Indonesian nurses can reduce the suffering of the people of this nation.

Nurses work closely with other healthcare professionals such as physicians, nutritionists and pharmacists to provide the best health care for patients as well as supporting their families.

In caring for patients around the clock, nurses can be the best companion for COVID-19 patients through their role in assisting patients in isolation to meet their needs physically, psychologically and even spiritually.

In isolation rooms as well as in the intensive care unit, COVID-19 patients face the toughest physical and mental challenges, with no visits allowed from family and friends.

However, the public by now has witnessed at least some of the challenges of health workers in dealing with patients amid the pandemic. The Indonesian Medical Association (IDI) stated that, as of mid-April, at least 25 physicians had died from COVID-19; while the Union of Pharmacy and Health Workers/Reform (FSP FARKES/R) said 12 nurses had died from contracting the virus.

As frontliners in the pandemic, nurses are continually exposed to the risk of contracting the coronavirus. Too many lack the standard personal protective equipment (PPE) such as medical masks, respirators, gloves, hazmat suits and eye protection.

Apart from sometimes resorting to raincoats, the masks used are often below standard. For instance, the guidelines of the United States’ Centers for Disease Control and Prevention state that masks should be N95, N99 or N100 type with particulate respirators that have a submicron filter capable of excluding particles that are less than 5 microns in diameter such as the coronavirus.

Further, with the increase of COVID-19 patients in Indonesia, more nurses are inevitably needed. According to Statistics Indonesia (BPS) in 2019, Indonesia had 345,508 nurses largely across the Java area, and only 26,950 nurses in the capital.

As of May 6, Jakarta, the epicenter of the COVID-19 outbreak in the country, had 4,709 positive cases with 2,194 patients hospitalized apart from thousands of other non-COVID-19 patients.

Although the government has reported that cases are declining in the capital, health workers have already been overworked under highly stressful conditions — not to mention social stigma and excessive fears of infection due to a lack of information among the public. A number of nurses have been asked to leave their rented homes and one community even rejected the burial of a nurse who died of COVID-19.

This fact proves that in Indonesia the nursing profession is not well-known to the public as a profession that contributes to improving public health. Instead, nurses are seen as a risk to society. The World Health Organization has thus urged the need to raise public awareness of the importance of the profession and the urgent need to protect health workers.

While the shortage of health professionals, including nurses, was a chronic problem even before the pandemic, COVID-19 has exposed the shortage to a much more severe level. At the grassroots, nurses are essential to curb the transmission of COVID-19; yet nurses are also lacking in Puskesmas (community health centers).

No wonder that despite all the news on health workers being hailed around the globe, many in the community remain unaware of their central role in preventing the disease and in treating patients, apart from acquiring misinformation, for instance, that health workers will undoubtedly pass on the virus, even though they follow a strict protocol even when leaving their shift to return home.

Despite the existence of many nursing academies, the lack of nurses is caused by a lack of people interested in the profession. Nursing is not a popular choice of profession among the young generation as many other professions promise higher pay. Here nurses are often paid a salary equal to or smaller than that of caregivers with no health education background.

In conjunction with International Nurses Day this year, the government needs to be reminded again to pay more attention to the nursing profession, which along with physicians plays a central role in fighting the COVID-19 pandemic.

We do appreciate the government’s effort to provide incentives for nurses involved in caring for COVID-19 patients through a new health ministerial decree. However, raising the salaries of nurses in this country is vital so that younger people are interested in the profession.

The low interest in nursing also results from the fact that the majority of nurses lack job security. Thus the government should continue to increase the number of nurses who can become civil servants in hospitals as well as in community health centers, to increase nurses’ participation in health promotion and disease prevention in the community.

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Lecturer, School of Medicine and Health Science, Krida Wacana Christian University (Ukrida)

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