The nursing sector in Iran is currently grappling with intensifying challenges, including severe staff shortages, overwhelming work pressures, and unsustainable low wages. This dire situation has sparked a wave of protests as healthcare professionals rally for enhanced professional standards and improved living conditions.
In the current climate, approximately 220,000 dedicated nurses are employed in Iran’s medical facilities, who are expressing growing frustration over insufficient pay and inadequate benefits. Alarmingly, about 20,000 trained nurses remain jobless, yet authorities have failed to remedy the ongoing staffing shortages, further exacerbating the burdens faced by those still in service.
Despite existing legislation that addresses nurses’ rights—including the right to retirement after twenty years of service, guaranteed paid annual leave, and increased compensation—these measures remain unimplemented. The neglect of these promised rights has only intensified discontent among Iran’s nursing workforce, prompting calls for urgent action.
Given these challenging circumstances, many nurses are making the difficult choice to migrate to Gulf countries, Europe, Australia, Canada, and the United States in search of better employment opportunities and working conditions. Those who have chosen to stay in Iran continue to protest daily, gaining substantial support from their communities. This collective action underscores a strong desire for genuine improvements within the health system.
On November 2, significant protest gatherings took place in the cities of Mashhad and Yazd, where nurses and other medical staff from various hospitals united to voice their pressing demands. Key issues highlighted by the protesters include:
- Implementation of Nursing Services Pricing Law: Establishing a comprehensive legal framework to delineate fees for nursing services, particularly for pre-hospital emergency care, with necessary financial support from the Ministry of Health and insurance companies, as these critical services are currently provided free of charge.
- Increased Compensation for Emergency Nurses: Should an independent compensation package remain unapproved, protesters are demanding an increase in emergency nurses’ compensation by at least fourfold, incorporating considerations like workload intensity, population density, and exceptionally challenging work conditions.
- Reduced Retirement Age and Increased Hardship Points: Under the recognized “hard and strenuous” job category, they are advocating for a reduction in retirement age specific to emergency workers, along with an increase in hardship points from 1,500 to 3,000, as previously outlined by authorities.
- Enhanced Productivity for Emergency Workers: Full application of the Productivity Improvement Law to pre-hospital emergency staff is sought, ensuring alignment with its implementation for laboratory and night clinic personnel.
- Special Allowance at Triple the Basic Salary: Advocating for the allocation of a unique allowance equaling three times the basic salary for nursing staff from the national budget, which should be incorporated into employment contracts.
- Full Implementation of Additional Benefits and Welfare: Mandatory enforcement of directives pertaining to additional benefits and welfare packages for Ministry of Health and emergency personnel should occur without requiring approvals from governing boards, thereby aligning with provisions for other government employees.
- Improvement of National Emergency Organizational Structure: A significant overhaul of the national emergency services’ organizational structure, granting wider decision-making powers to pre-hospital emergency managers, while also allocating a separate budget for provincial emergency centers to alleviate financial strain caused by fund transfers by university boards.
- Dedicated Budget for Ambulance Purchase and Maintenance: Allocation of a specific budget for 2025 is essential to procure new ambulances and maintain the aging fleet, which currently relies heavily on private revenue and sometimes personal funding, thereby endangering the lives of medical staff and patients alike.
- Amending the Nursing System Organization’s Charter: There is an urgent need to amend the nursing organization’s charter to ensure that at least one seat is designated for emergency nurses on provincial boards and three seats on the national nursing system council.
- Replacement of Ineffective Administrators: A call for the replacement of underperforming emergency department managers and their deputies in hospitals and health centers across the nation is critical, especially since their inability to address nurses’ concerns has led to the compounding of unaddressed issues.
These protests underscore a deep-seated frustration within Iran’s healthcare workforce, particularly amid mounting work pressures and the physically and mentally demanding nature of their jobs. They also highlight a significant disconnect between healthcare staff and sector leadership, indicating an urgent need to revisit management policies and structures to ensure stable and efficient operations within the healthcare sector.
**Interview with Dr. Sara Khatami, Nursing Expert and Advocate for Healthcare Reform in Iran**
**Editor:** Thank you for joining us today, Dr. Khatami. The nursing sector in Iran is currently facing significant challenges. Can you provide an overview of the current situation?
**Dr. Khatami:** Thank you for having me. The situation is indeed critical. Currently, we have around 220,000 nurses employed in various medical facilities across Iran. Unfortunately, many are experiencing considerable frustration due to severe staff shortages, overwhelming workloads, and, notably, unsustainable wages. We’ve seen around 20,000 trained nurses unable to find work, which adds strain to those already in service.
**Editor:** That sounds alarming. What has led to the recent wave of protests among nurses?
**Dr. Khatami:** The protests stem largely from a combination of unfulfilled promises regarding nurses’ rights and deteriorating working conditions. While there are laws in place that support nurses—like rights to retirement after twenty years, paid leave, and increased compensation—these have not been effectively implemented. As a result, nurses feel disillusioned and compelled to demand immediate action for change.
**Editor:** We’ve also heard that many nurses are leaving Iran for better opportunities abroad. What can you tell us about this trend?
**Dr. Khatami:** Yes, that’s an unfortunate reality. With the conditions as they are, many nurses are opting to migrate to countries such as those in the Gulf, Europe, Australia, Canada, and the US, where they anticipate better working environments and compensation. For those who remain, the protests are a means of voicing their concerns and rallying community support for necessary reforms in the healthcare system.
**Editor:** Could you highlight some of the key demands raised during the recent protests?
**Dr. Khatami:** Certainly. The key issues include the implementation of a Nursing Services Pricing Law, requests for a significant increase in compensation for emergency nurses, and reductions in retirement age for those in strenuous roles. They are also advocating for improved productivity measures aligned with other healthcare workers, unique allowances to reflect their critical work, and better enforcement of welfare benefits.
**Editor:** It looks like there’s a strong consensus on what needs to change. How do you see the way forward for the nursing profession in Iran?
**Dr. Khatami:** There needs to be a serious commitment from authorities to address these issues. The government must prioritize the healthcare sector and implement existing legislation effectively. Engaging in genuine dialogue with nursing representatives is crucial, as is the need for transparency and accountability in providing adequate support for these essential workers.
**Editor:** Thank you, Dr. Khatami, for sharing your insights. Clearly, the voices of Iran’s nurses deserve urgent attention, and their plight reflects broader challenges within the healthcare system.
**Dr. Khatami:** Thank you for shedding light on this vital issue. It’s essential we advocate for those who care for our communities.