For a country where the human resources in health care will always fall short of the recommended patient-professional ratio, it is important to make sure that every single resource is harnessed. However, government data tabled in the Lok Sabha have shown that the Nurses Registration and Tracking System, created over seven years ago, has registered less than a third of the total nurses in the country. Only 14.24 lakh of the 46.02 lakh registered nursing personnel have been enrolled, leaving 31.78 lakh outside the national system. Clearly, the move to create an accurate national registry and streamline registration-related services on a single platform for all nurses is far from yielding satisfactory results. There are also stark regional disparities, and unexpected performances with the large southern States (Tamil Nadu, Karnataka, and Andhra Pradesh) figuring among the laggers, while Bihar, Jharkhand and Odisha show between 80%-99% enrolment rates. The Indian Nursing Council has attributed the delays to issues rooted in jurisdiction, and federal tension, on the grounds that primary registration is legally the responsibility of individual State Nursing Registration Councils. To receive a National Unique Identity card and nurse passbook, nurses rely on verification by their respective State Nursing Councils. Further, the charge is that several State councils have resisted migrating fully to the central portal and continue operating independent parallel systems.

Poor nurse registration — irrespective of whether it is caused by incomplete digital tracking systems, outdated State registries, delayed licensing, or regional autonomy — has widespread consequences across health-care systems, apart from personally affecting nurses. For nurses, there will be delays in sanctioning their requests for inter-State transfer and credential verification for overseas employment. For the nation, without a centralised live registry that can provide a true measure of how many nurses (with specialisations) are available where, there might be artificial surpluses or deficits on paper, leading to less-than-ideal deployment of resources, and implementation of policy decisions. Fragmented registries also make it easy for unverified individuals, impersonators, or personnel with revoked licences to practise using fraudulent credentials, thus compromising patient safety. A live tracker would be of utmost use during public health emergencies — including disease outbreaks and natural disasters. Else, it could be impossible for state agencies to track, mobilise or deploy specialised nursing personnel to high-alert zones. Given the crucial complementary role, and in some areas, even the primary role that nurses play in the health-care system, efforts must be made to ensure that all nurses are brought into the portal.