I read with great interest the referenced article in a recent issue of Indian Pediatrics [1]. I worked in India as a consultant for over 24 years, but then moved on – first, to Saudi Arabia, where I worked for about 4 years, and then, until the present day, in the United Kingdom.

My observations are that nurses here are appreciated much more than in my motherland. They are excellent team members. We expect them to participate actively in patient care – and they do this with a gusto hitherto unseen by me with the nurses in India. The reason is not too far to seek. They are afforded the respect that was written eloquently about in this article [1].

My understanding is that unlike the nurses in India, the nurses here are much more integrated into the medical team even though they might have fewer skills than the nurses I worked with in Mumbai. While the latter could cannulate and take blood samples easily, the nurses here are not allowed to do these tasks unless they undergo training to become advanced nurse practitioners. Thus, simply put, we underestimate, undervalue and underpay our nurses in India.

On the other hand, the managerial skills of nurses in UK are generally ahead of those in India. They can do what is called "nurse-led" activities like looking at patients in GP practices in off-hours, referring patients to higher units like the Accident and Emergency services or urgent care, coordinating patient discharges, and so on. Even more important, they are trained in communicating with patients and their caregivers in a professional but compassionate manner.

Not just this, they are not shy of pointing out errors that doctors make and help chart a better course of action in patient management. They are required to file an incident every time they see a doctor or any other member of the medical team do something that is not correct, be it an error of omission or commission. These incidents are then fully investigated by the senior team members who will, in most cases, resolve the issue without victimizing the erroneous staff member.