Nurses across Iran are protesting into a second week, with picket lines spreading to several more hospitals across the country, Jahan-e Sanat reported paper on August 19.

The protests started in the hospitals of Karaj, a metropolis adjacent to the capital, Tehran, but spread quickly to other cities, including Shiraz, Jahrom, Zanjan, Yazd, Arak and Mashhad over low pay and poor working conditions. A lack of proper implementation of nursing payment tariffs, forced overtime, long shifts, and low overtime pay are reasons for the protests.

A typical Iranian nurse earns about $200 per month in part due to the collapse of the Iranian rial against the dollar; this, in turn, has forced many nursing staff to leave Iran for other countries, including Canada, France and Australia.

The surging emigration numbers has increased the workload on the remaining staff, who are not sufficiently compensated for the additional pressure and long hours.

Currently, around 240,000 nurses are employed nationwide, but this number needs to be tripled to meet the standard nurse-patient ratio which has only worsened as Iran continues to age.

The heavy workload and poor working conditions have driven nurses to emigrate, resign, or, in more tragic cases, commit suicide. Some reports have suggested that around 3,000 nurses have emigrated over the past year.

“Now that we are on strike, instead of responding, they are endangering the lives of patients by using unprofessional replacement forces in hospitals, and protesting nurses are being threatened with dismissal and salary cuts,” said one of the nurses who has chosen to quit work instead of being “exploited” by the healthcare system.

The nursing community has been outraged with the government’s response, criticising officials for downplaying their demands to merely addressing payment arrears, while their actual demands are at a higher level: the uncompromising and non-discriminatory implementation of the law.

In response to the escalating situation, Iran's Supreme National Security Council has given the Ministry of Health a three-day deadline to compile and present the problems faced by the nursing community. However, union representatives express scepticism about the ministry's ability to adequately represent nurses' interests.

Mohammad Sharifi Moghaddam, secretary general of Nurse’s Home, a guild association, says the health ministry pursues doctor-dominated policies and neglects the rights of nursing staff.  

“Health ministry staff, from top to bottom, are all doctors,” he said.

According to Moghaddam, a doctor who is a member of a university’s panel of experts receives a fixed salary of around $1,100 and several thousand dollars in bonuses.

“How can they understand the situation of a nurse who earns a monthly salary of $200 and receives $2 for a 7-hour overtime night shift, deposited into their account after several months of delay?” he said.

After days of unprecedented strikes, the nursing community expected that the new President Masoud Pezeshkian, who is a surgeon himself, would send a representative to hear their demands, Moghaddam said.

“But they ignored the protests again and did not hear the nurses’ voices.”

"The Ministry of Health is part of the problem," Moghaddam argued. "Those who are themselves part of the problem cannot represent nurses' demands to the Supreme National Security Council."

According to Jahan-e Sanat, the Secretariat of the National Security Council held a meeting on August 17, hosting representatives from the Ministry of Health, medical universities, and several other related organisations to discuss the demands of the country's nurses.

As a result, the Ministry of Health was tasked with presenting a summary of the nursing community's issues and their solutions within three days.

It was decided that necessary actions be taken based on the reports over a three-month period to address the nurses’ problems.

However, the decision does not seem to have appeased the discontented nurses, whose protests are continuing to spread nationwide.