Inside India’s Nursing Readiness Gap: Usha Banerjee of Apollo Hospitals

“Many say nurses are the backbone of healthcare. I believe nurses are the heartbeat of healthcare.”

In this episode of #TheExecutiveEdit led by Akash Kalp, CBO at Emversity, Capt (Dr.) Usha Banerjee, Group Director of Nursing at Apollo Hospitals, shares her perspective on the evolving realities of nursing education and workforce preparedness in India.

Drawing from over 35 years of leadership in nursing, she unpacks some of the biggest challenges healthcare institutions face while onboarding young nurses today:

• Limited exposure to high-pressure clinical environments

• Gaps in communication, decisional confidence, and bedside preparedness

• Overdependence on theoretical and exam-oriented learning

• The growing need for simulation-led and hospital-integrated training

Through real-world insights from one of India’s leading healthcare systems, she explores why modern nursing education must move beyond credentials and focus on preparing nurses for working inside real hospital wards.

More importantly, the conversation raises a critical question.Are we preparing nurses not just to qualify, but to truly thrive in the future of healthcare?

Watch the full episode to understand what it will take for hospitals, educators, and healthcare leaders to build a stronger, future-ready nursing workforce for India and the world.

#TheExecutiveEdit #HealthcareWorkforce #HealthcareEducation #NursingEducation #HealthcareLeadership #HospitalManagement #FutureOfHealthcare #HealthcareIndia #SkillDevelopment

Transcript

SPEAKER_00 0:00

To me, organizations and the healthcare does not succeed or fail only on infrastructure technology. It actually succeeds or fails at the precise moment where human life interfaces with human judgment. Many of them say nurses are the backbone of healthcare, and I always say nurses are the hard ecoscare. It is not just the numerical deficit of nurses. It is the deficit of decisional preparedness in the country. Our education has to be structured around being syllabus-driven. Exam-oriented. I think what we fail to teach is escalational intelligence. Young nurses who have never been a witness to a highly complex environment that we have to make. From a very protected structured supervised learning to a highly volatile, complex, ambiguous environment, which is high pressure. Do you need to have the ability to judge under pressure? And react immediately.

SPEAKER_01 1:34

What a some piece of advice that you can give to a person who's like a baby finally of nursing.

SPEAKER_00 1:39

A qualification will get you an entry into a organization. We need nursing, so we will hire you. But where people like us have reached ascend in your career, you need to be competent. You need charisma. You need communication. You need compassion, empathy. And every single day in your life is going to be a pressure.

SPEAKER_01 2:12

Welcome to the Executive Edit, a series where we speak with leaders of the healthcare ecosystem. In every healthcare system, there are certain roles which are irreplaceable and are of paramount importance. Nursing is one of such roles. Nurses are the professionals who interact with patients daily, plan their entire life cycle at a hospital, and also are the primary caregivers. These are the people that patients connect to most. But as the healthcare ecosystem grows, a question is always there. Does the Indian nursing ecosystem today enable the young nurses to be ready with modern healthcare ecosystem? To explore this, today I am joined by someone who has decades of experience into nursing. She has been one of the top leaders of nursing in India. She has an experience of over 35 years. So welcoming uh Captain Dr. Usha Benerjee. Dr. Banerjee brings extensive experience in nursing leadership. She has trained and mentored thousands of nurses, and she has done this across top organizations in India. She has spent last two decades with Apollo hospitals. So, Dr. Benerjee, welcome to the executive edit.

SPEAKER_00 3:24

Thank you, Akash, and thanks to Mverse City for engaging in a meaningful dialogue and talking to me on such an important topic here today.

unknown 3:33

Dr.

SPEAKER_01 3:34

Manaji, we'll start with your own journey. You have had a long and impactful career in nursing, spanning across top organizations and spanning actually across decades, right? Could you walk us through your professional journey? How did it start? And how are we here where we are today?

SPEAKER_00 3:52

Well, let me just set a context before I speak about my personal journey. I think today, this dialogue that we have strikes at the very evolution of healthcare. And I think it's very, very important for us to understand that whenever we've had a discourse on healthcare today or the future of healthcare, invariably our conversations and discourse talks about infrastructure, technology, and probably the bigger aspects of regulatory reforms and so much more. And to me, organizations and the healthcare does not succeed or fail only on these crucibles. It actually succeeds or fails at a precise moment where a human life interfaces with a human judgment. And invariably, if you notice, in the middle of all that is the nurse. Many of them say nurses are the backbone of healthcare, and I always say nurses are the heartbeat of healthcare. And once the heartbeat stops, I think it's finished. Today in our country, it is not just the numerical deficit of nurses, it is the deficit of decisional preparedness in the country. And if you really look at where we have come, we've come a long way, and the past two decades has been phenomenal. The country has transformed, nurses have transformed, and we have arrived today. And it's important for us to calibrate our pace and accelerate our speed in order to position nurses into the future. And if you talk about my journey, I I've had a great career, a meteoric career, and I owe that fundamentally to where I come from, my alma mater. You know that I'm commissioned into nursing through the armed forces, which teaches you dedication, devotion, duty, discipline, so much more. And then I've had this wonderful journey of being absorbed into the best brands in the country, Manipal Hospital, Max Healthcare, and now Apollo, which is the biggest canvas of my life where I can paint the strokes that I desire and partner along with healthcare to take nursing to the next level. So if you ask about my opinion, today nurses cannot be conferred their preparedness to enter the industry just by credentialing alone. Nurses are prepared when they are able to anticipate risks. They can identify deteriorations, they can have sound judgment under pressure. And sadly, we have not got there as yet. And I'm happy that people like you are having this conversation probably to create a bigger awareness to our healthcare ecosystem so that things can change.

SPEAKER_01 7:18

When you started, right, I think as a when you started with nursing, right, the main aim is always patient care. So what was that point, or I would say an inflection point, where you decided that that is not enough, but I want to uh mentor, nurture uh new talent in nursing, right? And uh have, as you told right now, you have thousands of people that you have trained, that you have mentored, who are right now doing well across India and globe. When did that point come in your life when you thought that I would look for a bigger uh mission, bigger outcome?

SPEAKER_00 7:52

Thank you for asking that question. I think in a very early stage of my career, in the formative years, leadership is taught to us, especially when you are an army nurse, because you need higher intellectual capabilities to be in the armed forces. Reasoning, judgment, thinking, acting decisively, and uh being there, right there. So that comes very naturally, and it's probably been in my DNA and my ethos of working. But I also realized that individual brilliance alone cannot make a significant difference in a frail healthcare ecosystem. And whatever brilliance I bring as an individual, I might be a great nurse at the bedside. That's very finite. It's inherently finite. But when I assume leadership roles and I mentor generations of nurses, and I'm able to influence policy and I'm able to make regulatory decisions, I think that is more enduring. And I've had this faith and belief that when I sit at the helm of affairs in my leadership role, I not only preserve institutional wisdom, I also strengthen the professional resilience, and I can have the influence to mentor generations of nurses for leadership stewardship. So that came very early in my life, and that's been my journey, and that's been my conviction. And if you really distilled my journey, I did not merely practice nursing. I tried to make its influence be known to the ecosystem.

SPEAKER_01 9:46

Yeah, and I and I saw your academic profile too. I think you've done a lot. So I think nursing for you has been not just a choice, but also a matter of pride for you that you've endured for so many years.

SPEAKER_00 9:57

Yes, it's it's something I owe to the profession. And I think being at the leadership mantle, it is not something that I have done as a favor, it's a mandate. And I'm glad that's the minimum moral threshold that I can offer back to this wonderful profession that I chose.

SPEAKER_01 10:19

Now let's talk about young nurses who are entering the professional fold right now. Every year, companies and hospitals hire thousands of nurses, young professionals, right, as freshers, including you. Uh, you are hiring quite a lot of freshers across. From your perspective, who someone who's hiring nurses at scale, right? When fresh nurses enter hospital, what are the challenges do hospitals face, right? As an employer side, what are the kind of challenges that you face that you think can be done away with?

SPEAKER_00 10:54

Well, I think before I get to the nurses and their challenges, I think we should touch upon education.

SPEAKER_01 11:01

Yeah.

SPEAKER_00 11:02

And largely if you notice, our education has been structured around being syllabus-driven, exam-oriented, regulatory compliant. And we emphasise a lot on pedagogical teaching, demonstration of lectures and procedural rehearsals. But I think what we fail to teach is escalation intelligence, risk perception, decisional confidence. Somewhere it has never been driven to the level that we expect. The curriculum is designed wonderfully. It's all about its implementation. So when nurses, young nurses, who have never been a witness to the highly complex environment that we are today. Today we do a lot of high-end clinical work in even the basic hospitals. The disease patterns have changed. There's emerging new disease. And we do innovative, first of its kind breakthrough, evidence-driven work. And nurses have not been exposed to that kind of environment. And when they come from a very protected, structured, supervised learning to a highly volatile, complex, ambiguous environment, which is high pressure, they need to have the ability to judge under pressure and react immediately, escalate, which I feel is very overwhelming for a young nurse. And I think we can mitigate that when we have structured mentorship, we have graded clinical autonomy, and we have supervised deployment and clinical skill management. And I think that can happen only when we have deeper integration with hospitals. We need to have our clinical resources teaching the students, and students should be exposed to high-end simulation environments where they can practice these high-risk environments in a controlled manner.

SPEAKER_01 13:37

So I think it is then more about transitioning from theoretical learning to practical experience and getting that vocation in practice? Understood. Now that leads me to a broader question about education, right? When we talk to top hiring partners, including yourself, right, we always come to know that same problem that it's while the curriculum is great, it's still theoretical. It's not practical. What is the biggest gap in nursing today that you think the nursing colleges and nursing colleges run wide and far across the country, right? Right from Kashmi to Kanya Kumari, we have nursing colleges across. What do you think are the problems that they have not been able to address till now? And what do you think are the primary reasons for the same?

SPEAKER_00 14:28

Like I told you already in my previous statement that you cannot be just focused on procedural rehearsals or, you know, how does a student get a qualification? I think it's about capability cultivation. You can get a degree or a diploma very easily by recall, by being exam-oriented, hours completion. And that's what generally the faculty is exposed to. Many of the educational institutions do not have a high-end clinical environment where nurses can be exposed to the real scenario. And it's important, as I said, to drive deeper collaboration between hospitals. Today, if you look at hospitals, we have become remedial academia. You know, we have to retrain nurses on almost every single procedure that they should have mastered before coming to us. And then being exposed to a high-end clinical environment is not optional, it is foundational for every single nurse. And for them to practice a high-risk environment in a graded manner through their education is critical.

SPEAKER_01 15:57

Got it. I think you you have also seen the international standard of nursing education, right? Through your years of experience. What do you think the uh international fraternity is doing b better in terms of getting this practical experience to young nurses, which we have not been able to do?

SPEAKER_00 16:17

I feel um, you know, internationally, when we talk about nursing education, their standards are of the highest possible. Their governance is good, the implementation of the curriculum uh, I guess, is very, very thorough. And most of the learning happens in a very simulated environment where nurses can practice real-time scenarios before they are released into the clinical environment. And faculty of the highest order. Like, for example, I've always said this in my earlier conversations that I am who I am because what my faculty taught me. An army has exposed me to that high-end clinical environment. And until date, I can say that I have an unshakable academic foundation and I have an unmatched clinical acumen, along with my leadership traits. And that's what makes you stand out. So I think they've got it right because they invest a lot into a simulation environment.

SPEAKER_01 17:26

Great. I think uh what I understand is it's also about how we give students the uh best practices, uh, best environment to practice their skills. And that brings me back to the question of these high fidelity simulation labs. Uh, in you you've been talking before the interview also, you were talking about it. What, in your view, how how much is it important to have these high fidelity simulation labs across the country? And I think today the nursing council also mandates parts of it, but uh the implementation on the ground has been very, very difficult. What are your views on these simulation labs and how, when you have seen across, how has it helped the young nurses to be better professionals?

SPEAKER_00 18:11

When young nurses come into the clinical environment, they would have probably never seen a real-time scenario of a deterioration or a complex situation. I think simulation enables that. But simulation cannot be just an investment of an infrastructure. It is important for us to use our simulation centers as cognitive conditioning laboratories. Otherwise, your advanced simulators will become an expensive mannequin. It has to teach the nurses how to interpret risks. There has to be structured briefings after the simulation scenario has been created. You have to analyze deeply what decisions were taken. There have to be escalation drills and a lot more which a simulator can provide. And I think what's most important is you should use nursing education and training with multidisciplinary teams in the simulation environment in order to get the larger value of that investment. And I'm very happy that INC has mandated it. And it's all about implementation. And implementation has to happen across every single institution in the manner that it was conceived to be implemented.

SPEAKER_01 19:46

Got it. And uh and I also think very, very important that these practices are included in across all colleges in India. Another thing that uh we always hear is the part of communication and empathy. Because nurses, when you think of nurses, communication with patients, showing that right amount of care becomes a very, very important part of their job role. Uh, and that when we go in India and abroad, it's it's very different. The communication and the people say bedside manners, empathy standards. What do you think has led to it? And do you think it's improving? You've seen this evolving through quite a lot of time. Do you think it is improving?

SPEAKER_00 20:31

Well, let me be brutally blunt here. When I started my career, I've always had legends teach me, and they were role models. People spoke well, they carried themselves well, they were very authoritative, they had social etiquettes, and their presence was larger than life in the ecosystem. And now sitting at the helm of affairs, I feel deeply saddened to see that communication has really gone down in the nursing fraternity. There are exceptional people, but largely there is a challenge of communication. And that bothers me quite a bit. And we have to uh start looking at it as a basic mandate. It's not optional. It is foundational for nurses to have very good communication, addiction, command of the language, interpret therapeutic communication, and then deliver it in their day-to-day patient care. When you talk about empathy, compassion, kindness, that is the ethos of the profession. And not just for nurses. I think any and every healthcare employee must practice empathy, kindness, compassion at any given point in time. Any interaction with any patient, be it at the front desk, be it at the registration counter. Beer at the billing, even if an FNB, security, and of course for nurses, it has to become the very fabric of their DNA. I don't say that empathy and kindness or compassion has come down. It definitely needs to be elevated. And I think today organizations are investing a lot in building that capability within nurses. Today for a nurse, the environment is very, very complex. So much that rides on their young shoulders. So sometimes it does get eroded, but I think every nurse tries to bring their best to the forefront. I would pivot back to education. Whatever a nurse practices in the hospital is all dependent on the institution and the education that they have received before being credentialed to practice.

SPEAKER_01 23:06

One very important question, and I think you will have a very short answer to it. Today in nursing, are numbers a problem or quality a bigger problem?

SPEAKER_00 23:18

Both are a problem. As I said in the beginning, that numerical deficit of nurses or shortage of nurses, yes, is growing to a crisis proportion. But whatever is generated, we need to have a higher quality, definitely. And competence cannot be continuous. It needs to be validated and it needs to be acquired day in, day out. So a good nurse today may become invalid tomorrow, unless she has acquired higher and better skills.

SPEAKER_01 23:55

Coming back to my last question today, as someone who hires a lot of young nurses, young professionals, what are some piece of advice that you can give to a person who's right now, maybe in final year of nursing or maybe third year of nursing, who's looking at this, uh hearing this, maybe looks at you as a role model and wants to be better when they come to get employed? How can they get employed better to better organizations? What will be your two, three uh sense of advice to them?

SPEAKER_00 24:25

Well, I can talk about it the whole day. And if you ask me to sum it up in two, three sentences, it's going to be hard. Because I've had a more than three decades of journey into just building nursing, you know. And my whole journey is to influence the healthcare to rightfully position nurses. And we have arrived. I'm an example, and of course, there are many of my colleagues who are examples. And many of us in the country have got together as leaders, even to do a lot of voluntary work for nurses. And one of the associations that I belong to is the Association of Nurse Executives of India. And we spend a lot of our personal time. We have the Trained Nurses Association of India. We have uh a lot of such associations that we as leaders have formed in order to benefit our generations to come. So my piece of advice to the young nurses who come out today is a qualification will get you an entry into a good organization. We need nurses, so we will hire you. But to rise to where people like us have reached, to ascend in your career, you need to be competent. You need charisma, you need communication, you need compassion, empathy, and every single day in your life is going to be high pressure. You need to demonstrate excellence at the bedside and also work your journey towards boardroom stewardship. And that doesn't come easily. Many of you actually quit nursing very early in life because you're not able to balance your personal and professional life. And if people like us have walked ahead of you in this journey, why don't you take that chance? Judgment, reasoning, reasoning, intellect, all belongs to the nursing profession. So I wish every single nurse great success, much beyond what we have received, and a great future for nursing as a profession.

SPEAKER_01 26:48

Great. I think uh you've been a strong voice in nursing. And we've been hearing uh not just in this interview, maybe in previous interviews also, your views uh remain constant and are very important to anyone who's coming up in life, right? And I very, very honestly feel it applies to almost every field in life that if you really want to go up, you have to be like that sponge that absorbs a lot of information all through your life and be a student all through your life. Uh very well said. Um, Dr. Made, thanks for sharing your insights. Uh, this has been great. It is clear that a strong healthcare ecosystem will only be created when the nursing ecosystem of a country gets stronger and stronger. Uh, and all the points that you told us today stand very valid. Uh, when we also go out and talk to various young professionals, when we talk to various colleges and universities, they echo the sentiment and everybody is looking to bring a change, right? Uh, and conversations like these are very, very important because we want young nurses to see these conversations, not just get inspired, but take some learnings out of it and build up to their career. To everyone who's watching and listening to this, thank you for joining us. Uh, this is the executive edit. Thank you, ma'am. Uh, I'm Akash, and we'll see you soon in our next episode. Thank you.

SPEAKER_00 28:08

Thank you so much. Thank you.