'How can we cope?': Doctors and nurses speak out on system at breaking point

New Straits Times

5 days ago

KUALA LUMPUR: Severe staff shortage caused by the migration of healthcare workers and burnout among existing staff have pushed nurses to the brink of despair and helplessness, said medical frontliners.
A staff nurse who only wanted to be known as Nini, 42, said she started her nursing career at a hospital in Johor in 2005 and was transferred to Kuala Lumpur in 2010.
She said the work culture in Kuala Lumpur was different and she hardly had any time for breaks. She is now a senior and is on duty at wards where she has to take care of eight to 12 patients at a time.
"Although the World Health Organisation recommends one nurse for every four patients in a general ward, we are doing double the amount and more sometimes when a nurse calls in sick."
She said staffing levels had dropped steadily in her ward over the past five years.
"This is not new. But these past years, the situation has worsened as more colleagues leave for greener pastures in."
Nini now manages her shift with fewer nurses, saying it has caused burnout among her colleagues, especially if there are demanding superiors.
"An ex-colleague joined a hospital in Dubai, where she works eight-hour shifts, earns RM12,000 monthly and gets free housing.
Two more moved to Singapore and another is in Perth now. They were senior staff. Losing them is a big blow. We're trying to hold the fort, but we are not sure how long we can do it.
Patients sometimes blame us when they do not get the care they deserve, but that is not because we don't care. It's because we just physically cannot keep up."
In a hospital in Kota Kinabalu, an emergency medical officer who only wanted to be known as Dr Mohamad, 42, said the emergency department was running at almost 200 per cent capacity on some days with fewer than 10 doctors on duty.
"We should have at least five medical officers per shift.
Some nights, we're down to just three. Imagine one stroke victim, one asthma patient and one road traffic victim.
How can we manage? You can't be everywhere. We used to spend 10 to 15 minutes with each patient.
Now, it's sometimes three minutes, just enough time to prescribe and move on. We're not proud of it, but this is the reality.
I've had three of my closest colleagues leave in the last 12 months.
Two to Australia and one to a telehealth firm in the United Kingdom that pays more than double of what he used to earn here.
They left because their applications to be relocated to the peninsula were rejected several times."
He said doctors wanted to remain in Malaysia, but the Health Ministry must improve the perks, salary and incentives.
According to statistics from the Malaysian Medical Association, more than 4,000 healthcare workers, including more than 1,500 nurses and 900 doctors, migrated or entered private practice between 2021 and 2024.
The Health Ministry has acknowledged a nationwide shortage of 20,000 nurses and 8,000 doctors, including specialists. And this gap is expected to widen as more resign or retire.
A specialist from Klang, Dr Menon, 48, said her unit delivered up to 20 babies a day with increasingly junior and overstretched staff on some days.
"We need at least six medical officers per 24-hour cycle to handle these cases safely.
Some days, we barely have three medical officers. I'm in the operating theatre for hours, then straight to clinic or ward rounds with no break. One of my best registrars left for Dubai.
She told me, 'In one shift, I deliver five babies and get to eat lunch. Here, I would have to deliver 10 babies before I could even go to the toilet'."
Dr Menon said one of her most dependable nurses resigned after a decade of service recently. "She went to Singapore.
She sent me a voice note last month and said, 'Cikgu, I finally feel like a normal human again'. It broke my heart." She said the workload was not only overwhelming,
it was affecting quality of care for patients as well as staff morale. "The system is bleeding and we're using our hands to plug the holes."
Asked why she chose to stay despite getting offers abroad, she said her elderly parents and in-laws kept her here. "I'm more concerned about the new generation as it is getting harder to convince the younger ones to stay.
They don't see a future here. And without a strong pipeline, we're heading towards collapse." Dr Menon believed that better pay, structured career paths and more specialist training slots could slow down the collapse.