By 2020, Malaysia’s healthcare sector is expected to acquire a total number of 174 000 Registered Nurses (RNs) in order to reach the 1:200 nurse-patient population ratio. This demand for nurses retention is very high since the total number of nurses in 2014 were 92 681, as reported by the Malaysian Human Resources for Health Country Profiles.

With the urge to provide the best mechanisms for nursing workforce sustainability, the fundamental problems should be clearly defined and discussed. This article provides potential solutions that may address the nursing shortage issue in Malaysia.

Review the subject’s requirement

Since August 2010, the Malaysian Nursing Board announced of new entry requirements to enroll nursing schools or colleges, from three credits into five credits inclusive of Mathematics and Science subjects. Prior to embarking on this new academic regulation, there were almost 10,000 nursing student graduates each year. However, student intakes have significantly dropped to less than 3,000 nurses graduating yearly, consequently resulting in fewer nurses.

In response towards this shrinking number of nursing candidates, the Malaysian government has increased the number of public and private institutions offering nursing courses. Along with this, perhaps, the Malaysian Nursing Board can consider reviewing the subject’s requirement by considering the minimal credit so that it opens up more nursing student intakes in the future. For better expectations upon their graduation, the students should be well acquainted with real nursing practices as well as meet the minimum requirements for the amount of clinical training that they need to have.

Increase PTPTN loan amounts

Currently, the average total of fees for a Diploma in Nursing is around RM45,000 to RM60,000, depending on the institution. Therefore, the high costs of a nursing diploma may cause students to need higher loans for their studies and daily expenditure.

A current maximum loan from the National Higher Education Fund Corporation (PTPTN) is RM38,000 for eligible recipients, a vast drop from previous loans which were RM60,000. Those who do not fall under this category will receive only about RM20,000 to RM24,000, resulting in fewer students pursuing nursing due to them being unable to fork out the amount. In addressing nursing shortage as a main concern, Malaysian authorities should allocate a greater proportion of their budget for student loans, as an initiative to improve nurses’ retention.

Improve remuneration

At present, RNs who are working in government hospitals or sectors will be given RM1,797 (with RM145 annual increment) for diploma holders, while RM2,429 (RM225 annual increment) will be given to nurses with a bachelor’s degree. However, due to the highly competitive enrollment in public sectors, more nurses are turning to private places, while some are turning away from the nursing field.

Nurses who choose to work in private institutions could have a minimal average salary of RM1,500, depending on work location, education and clinical experiences. However, some private nurses claim that they are supposed to get a greater starting salary due to the higher costs of living. Perhaps in the future, the authorised bodies and organisations could standardise the salary for nurses who work in private settings and clinics as well as ensure that they are compatible with their duties and working hours.

In order to address the nursing shortage and also to enhance healthcare capacity, Malaysia has also implemented some strategic decisions to increase the number of students undertaking nursing courses and thereby increase the supply of new graduates. Along with this, the authorised organisations should consider reviewing the requirement subjects and providing scholarships and loans. Over time, this is likely to increase the number of nurses working in Malaysia. MIMS

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