This time, the most patient and tolerant group in society are angry and protesting. Since August of this year, a new wave of protests has begun among the nursing community in Iran. In the past two years, nurses in the country’s major hospitals, along with other sectors of society, have unprecedentedly gone on strike and protested to convey their dissatisfaction and demands to the authorities of the Islamic Republic. These protests have intensified due to extreme work pressures and neglect of their basic rights. The country’s political, economic, and social problems, along with widespread diseases, have also greatly affected the healthcare sector and continuous mismanagement has exacerbated this crisis. The unfavorable economic conditions and lack of resources, along with the inefficiency of the government, not only jeopardize the health of nurses, but also the health of society, and this vital group that deals with people’s lives is increasingly worn down under these pressures. The nursing community in Iran, which in the past years continued its work in silence, began new strikes

Unsuitable working conditions, low wages in the midst of rampant inflation.

The most important and heaviest pressure on the shoulders of the nursing community in Iran is the economic and livelihood pressure, which becomes heavier every day under the weight of uncontrollable inflation. What is heard in the cries and anger of nurses in protests and strikes are fundamental demands: “Increase in low wages, payment of long overdue payments, and implementation of the nursing service tariff law.” But these demands have been left in a haze of ambiguity and neglect for years. From the wages of nurses to nursing students and official nurses, all are faced with lack of transparency and instability in receiving their wages. The minimum wage for nurses in 1403 (2024-2025) was around 8 million tomans and the maximum was 22.5 million tomans; a figure that is much lower than their actual needs, considering the poverty line of 30 million tomans in the country. In addition to increasing wages, payment of overdue payments and increasing the rial coefficient for overtime and bonuses are other

Nurses’ protest is for meeting their basic needs. When a nurse receives 2 million tomans for 100 hours of overtime work, with a delay, they cannot meet their basic needs such as housing, food, clothing, health and well-being, and recreational needs, especially with an inflation rate of over 60%. In addition to the working group in these critical economic conditions, according to statistics, 20,000 nurses are waiting for their employment status to be determined; despite the fact that they have put their lives on the line and served patients during the corona crisis. These difficult financial conditions create a major livelihood concern for nurses, especially in big cities. While nurses are forced to work hundreds of hours in hospital and medical environments due to staff shortages and financial problems, it is possible to understand the difficult situation and psychological and physical pressure on this group of society and the threat to the country’s healthcare sector.

The death of nurses as a result of work pressure and stress.

It is a strange tale that the Ministry of Health, responsible for ensuring the health and well-being of the community, cannot protect those who are the guardians of the health and well-being of the people. In order to achieve the mental and physical health of society, the ministry must provide for the basic needs and support its workforce, and by timely recruitment, prevent fatigue and shortage of personnel. Nurses, due to the nature of their profession, work in a stressful, anxious, and responsible environment and must always be patient and resilient while working alongside the patient and their family, and in their work environment, they are constantly faced with the death of human beings. As a result, individuals in this profession must have fewer concerns and work fewer hours in order to revive themselves physically and mentally, especially after the COVID-19 pandemic, where all the pressures were on the shoulders of the healthcare workers, yet in Iran, the economic, political, and social crisis did not provide any opportunity for them to breathe or have

Research shows that the COVID-19 pandemic has significantly increased the level of stress among nurses. Many of them have witnessed a high number of patients, shortage of personal protective equipment (PPE), and the vulnerability of patients without their families. According to these studies, nurses have been at a higher risk of mental health disorders during the pandemic, and many of them have experienced post-traumatic stress disorder (PTSD), depression, and anxiety due to months of worrying about their own or their family members’ health, inadequate PPE, long working hours, insufficient information, decreased sense of security, and post-traumatic stress disorder from witnessing the daily deaths of patients and healthcare workers. The healthcare workers in Iran not only did not have a chance to recover during the pandemic, but also after the protests on September 14, 2021 – following the death of Mahsa Amini at the hands of the Islamic Republic’s morality police – they were attacked and suppressed, and many were killed and injured. The

The patience that overflows: resignation, changing jobs, and migration.

When the minimum demands of nurses regarding heavy workload, mandatory overtime, low salaries, shortage of staff and refusal to hire them, non-enforcement of laws related to nurses’ rights and benefits, delayed payments, are not met, this pressure and despair has caused the nursing profession to lose its appeal in the past years and the nursing workforce is also considering resignation, job change and migration, to the point that today we are witnessing a crisis in this field. Reports from Iran indicate that more than 3,000 nurses have migrated in one year. In several cities, nurses have even resigned in groups. (2) According to estimates, as a result of each nurse leaving their job, 200 to 250 hours of work are added to the workload of the nursing staff in the same hospital. It should not be expected that a nurse with a salary of 10 to 13 million rials – while the poverty line is estimated at 30 million rials – can sustain their job, but unintention

Nurses play an important role in healthcare and community health, but today in Iran they face many physical, emotional, and psychological challenges. Without sufficient support, many are at risk of severe mental health problems, including depression and suicide. It is essential for healthcare organizations, policymakers, and society as a whole to recognize and address these challenges in order to protect the well-being of those who care for others. This is a great ethical and human responsibility for the government to support and fulfill the demands of those who dedicate their mind and body to caring for and treating patients, and to preserve the professional and human dignity of this profession and keep it free from security and political interference. According to human conscience, international conventions and human rights, medical and emergency services should always be free from war violence, political and security interference, and all forms of oppression, sanctions, and deprivation.

Notes

1- The problem of nurses is not delayed payment, it is the implementation of the law!, Jahan-e Sanat newspaper, August 18, 2024.

2- Nurses’ rights are even less than teachers’ rights, Fararu, 23 Ordibehesht 1403.