‘One nurse for 35 patients’: Pakistan confronts growing crisis of caregivers

Mushfiq Ahmed 

KARACHI, Pakistan (MNTV) — Pakistan’s hospitals are running on exhausted hands. In overcrowded wards, a single nurse may have to care for dozens of patients during one shift, moving from bed to bed administering medication, checking vital signs, comforting anxious families, and responding to emergencies with little pause. 

Yet despite carrying much of the country’s healthcare burden, nurses in Pakistan continue to face low salaries, staff shortages, and limited recognition, pressures that are increasingly driving them overseas in search of better opportunities. 

As the world marks International Nurses Day on May 12, nursing leaders in Pakistan say the country is confronting a growing crisis: too few nurses, too much workload, and too little support to keep skilled professionals from leaving.

“The biggest reason is economic,” said Aijaz Kaleri, a senior nursing representative who serves as Chairman of the Supreme Council of the Young Nurses Association and a former member of the Pakistan Nursing and Midwifery Council. “An entry-level nurse in Pakistan earns around one lakh rupees a month ($358) in the government sector. With rising household expenses, children’s education, and living costs, it is very difficult to survive on that salary.”

The contrast with opportunities abroad is stark. According to Kaleri, Pakistani nurses working overseas can earn between five to 12 lakh rupees ($1,790 to $4,296) monthly, particularly in Gulf countries, Europe, and other international healthcare systems facing staff shortages. For many highly trained nurses, migration becomes less of a choice and more of a necessity.

The private healthcare sector has done little to close the gap. While private hospitals have expanded across Pakistan in recent years, many nurses say salaries and workplace conditions remain inadequate compared to the demands of the profession. 

At the same time, the qualifications of Pakistani nurses have steadily improved. What was once largely a three-year diploma-based field has evolved into a more advanced academic profession. Today, nurses pursue four-year bachelor’s degrees, followed by specialized master’s programs and even PhDs.

“This is no longer a basic technical profession,” the nursing leader said. “We are producing highly educated professionals who naturally want career growth and financial stability.”

That outflow is deepening an already severe shortage within Pakistan’s healthcare system.

According to nursing officials, Pakistan requires more than 900,000 caregivers, but the number currently available is just above 100,000. The imbalance has created dangerous nurse-to-patient ratios in many public hospitals. 

“In general wards, one nurse may be handling up to 35 patients,” the representative said. “Ideally, that number should be around five.” 

Healthcare professionals warn that such workloads not only exhaust nurses physically and emotionally but also affect the quality of patient care. Long shifts, staff burnout, and overcrowded wards are common across hospitals. 

Although nursing colleges have expanded nationwide, particularly in areas with large public hospitals, concerns remain about maintaining educational quality, qualified faculty, and professional standards. 

Leaders of nurses organizations say workforce planning has also lagged behind demand, leaving many trained nurses without sufficient job opportunities while hospitals continue facing shortages.

For many within the profession, International Nurses Day should be about more than ceremonial tributes to Florence Nightingale. It should serve as a reminder of how central nurses are to the healthcare system itself, they say. 

Doctors diagnose illnesses and prescribe treatment, nurses note, but it is nurses who remain beside patients around the clock — monitoring recovery, administering medication, educating families, and often serving as the first responders during moments of crisis. 

“Nursing is the backbone of the healthcare system,” the representative said. “But despite this role, the profession still has not received the respect, recognition, and support it deserves from society, government institutions, and even parts of the healthcare sector itself.”

As Pakistan struggles with rising healthcare demands and a growing population, nursing leaders argue that improving salaries, staffing levels, and professional recognition is no longer optional. Without meaningful reforms, they warn, the country risks losing even more of its trained nurses to foreign healthcare systems eager to recruit them.