Building the Workforce Behind Patient Experience: Col. Binu Sharma of President of INS India

"What makes a difference is what the patient feels at the bedside. Those experiences are largely shaped by nurses."

In this episode of #TheExecutiveEdit, led by Akash Kalp, Chief Business Officer at Emversity, Col. Binu Sharma, President of INS India, shares insights from nearly five decades of experience across the Armed Forces, corporate healthcare, and nursing leadership.

Drawing from her journey of building nursing excellence across some of India's leading healthcare institutions, she unpacks one of the most pressing workforce challenges facing healthcare today: the gap between education and patient readiness.

The conversation explores:

• Why leadership begins from day one in a nursing career
• The gap between nursing education and patient readiness
• The importance of simulation labs and hands-on learning- Communication, confidence, and career growth in healthcare
• Why Indian nurses are sought after across the world
• How hospitals and colleges can work together to build better talent pipelines
• What healthcare organizations must do to prepare a future-ready workforce

More importantly, the conversation raises a critical question. Are we preparing nurses to qualify, or preparing them to thrive? 

Whether you're a healthcare professional, educator, student, or leader responsible for building teams, this conversation offers practical lessons on developing talent that can deliver exceptional patient care.

Transcript

SPEAKER_00 0:00

It is not nursing excellence. It is excellence in patient care. What will make a difference for patient care is what the patient feels at bedside. These experiences are a lot influenced by how nurses took care of them.

SPEAKER_01 0:17

A lot of people tell me this given a nurse what she studies in a college and what she has to implement on the hospital floor is a different beast. How do you get them ready?

SPEAKER_00 0:26

At the college level or school level, they study a lot. They get excellent marksheets. But how many of them have gone through a patient's bedside experience? How many of them have actually evaluated or assessed a patient from head to toe? How many of them have been engaged in doing basic procedures on a patient? These are questions to be asked. Very few places are center of excellence. Students do not get a chance to be patient ready.

SPEAKER_01 1:00

What are the best practices that you've seen globally in which colleges or even hospitals can adopt in India to train nurses better?

SPEAKER_00 1:07

Hospitals and colleges have to come together. Let the nursing senior managers, head nurses go to colleges to take some classes, and let the colleges, the faculty of the colleges come to the hospital to have a good integration, how care is managed. A hundred-buried hospital cannot take 500 students. Colleges need to have better trained faculties and write numbers.

SPEAKER_01 1:52

Nursing is a very important part of healthcare. It is one of the most noble professions as we know, and it is also something that shapes the experience of every patient who goes to a hospital. I'm very, very glad to have Colonel Biluk Sharma with me today to speak about this matter and also shed some light on how on how she has seen the whole nursing ecosystem evolve. Colonel Biluk Sharma has served as a lieutenant colonel in the Indian Army. She has also led nursing for reputed organizations like Columbia Asia, Max Healthcare. Today she has almost five decades of experience, and she has seen the complete ecosystem evolve right in front of her. She is today the president of INS India. And she is a prominent voice in the nursing ecosystem. And we are very, very glad to have her in front of us to discuss about this. Welcome, uh Colonel Venusharma.

SPEAKER_00 2:50

Thank you, Akash, and thank you, Mversity, for inviting me over. Actually, very pleasantly surprised that you wish to showcase nursing leaders in your podcast. I would go back the 50 years time. I never thought I would take up nursing as a career. And you see, I was a science student, was doing my statistics honors at Delhi University. And I chose nursing about that. I left it in between midway and I went and joined the armed forces as a candidate nursing officer. That was way back in 1977. So as we speak, I will be completing 50 years into the healthcare by next year. It's not easy to choose this profession. And it's just not easy to sustain, to stay in this most noble, most ethical, but yet most challenging, most demanding profession, I would say. In the healthcare ecosystem, you just said they are the framework, they are most critical, and they do the patient care. But the society knows that. Do the communities know that? Does our country really recognize the worth of nursing professionals? It's a big question to be asked. Why do I say that? I I belong to a very small village in Delhi where even schools were up to fifth standard. And I had the aspirations to do something different than the normal girls. So when I was going great guns with my mathematics and stats career, and I wanted to take up nursing as a career, my family, rather, the entire village was shocked what I'm going to be up to. You want to be a nurse? Because nursing did not stand anywhere those days as a profession. We all know that Miss Florence Nightingale laid the foundation of nursing in the world. She is the pioneer, the lady with the lamp. And globally, the profession has evolved quite a lot. But 50 years ago, it has not gained that dignity, respect, recognition in our country. Even now, there's a lot to be done. So this is how I chose nursing. And I never regret my decision because I feel I was destined to be a nurse. Not knowing what is nursing, I chose the profession. I came into nursing, and step by step, month by month, ear on year, the way life has evolved from a bedside nurse to the boardroom has been a fantastic and amazing journey. And uh that's how I look back at my journey of becoming a nurse.

SPEAKER_01 6:14

Very inspirational, ma'am. Ma'am, I would just like to bring in one more thing. You started from military services. How did that shape up your profession? And how did it shape up to the person that you are today?

SPEAKER_00 6:27

So much more. If I speak of myself, I was barely a 17 and a half years old girl when I started off from the Indian Navy. That's where I entered my starting point. So discipline, punctuality, physical fitness, patience, hard work, dedication, resilience, these were only in the dictionary for me. We had never practiced or imbibed these traits in the true sense. What military training does to you is bring all of it together and make you a very, very strong person. A strong human being who is physically fit, who is mentally sound, who is emotionally stable, and who is extremely resilient. Because in the armed forces, you may be in a peace zone, you may be in a war zone, even as a nurse, you may be in high altitude areas like Layladak, you may be in a difficult area, high-risk areas. You have to live all those like a soldier. So you are not just a nurse, you are a soldier and you are a commissioned officer. So a leader right from the time you get your first rank as a lieutenant. So it makes you a different person. You get to learn management skills, leadership skills. You become a leader right on day one when you take the command in the military nursing services. And you bring back all those fantastic traits back into your personal life as well. Even now, in the morning, unless I walk five kilometers, I don't feel complete. I have to keep up to my physical fitness, to my my own time of staying mentally fit. So I think it it transforms you into a different human being, into a great nurse, into a great leader, and into a greater human being. That's what armed forces do to us.

SPEAKER_01 8:47

Also makes me understand that the initial years that any nurse spends are very important for her to understand, and also the first steps to leadership are taken there. So today, if you had to think what should a young nurse be looking in the initial years of their service or career so that they step towards leadership, what will be those two, three points that they should be aware about?

SPEAKER_00 9:10

You see, uh a young nurse needs a lot of qualities. And nursing, as we say, is very, very demanding career. It starts with compassion and empathy because the core values for nursing are compassion and empathy. From compassion to passion, to be a competent nurse at bedside, practicing your leadership skills to take right decisions for patient care, to adopt the processes, to adopt technology in today's time, to be assertive at all times because you are managing a human life. Decision gone wrong from your side can cost a life. So there's a lot of burden on the nursing mind and the young shoulders. Nurses must remember they have to be knowledgeable, they have to be skilled. Apart from that, they have to be highly communicative, they have to have a collaborative approach, an open mind to learn every single day. If these are some of the things that are followed by the young nurses, I think they are on the right track. Although with every few years in the nursing career, your learnings would be different. You are wearing a hat of a bedside nurse, you become a team leader after a few years, you are managing a group of nurses, you become a mentor, you become a coach. So you keep changing hats. But these are some of the basic qualities a young nurse must remember to acquire, and which is a continuous process.

SPEAKER_01 10:58

Also, when you stepped out of military and you joined corporate hospitals, your brief would have been to set up nursing excellence at scale, and that brief still stands. How do you how did you look at that as a challenge, right? It was it was slightly diff different from what you were doing. How did you take that up? What were your first in like initial thoughts to take that challenge up?

SPEAKER_00 11:20

You see, I had never imagined I would leave the army and I would join the private sector for practicing nursing. It was nowhere in my dreams. So, like I moved in from stats to nursing, one disruptive move. I moved in from the secure, stable career of the armed forces, where I was doing extremely well. I had done my critical care nursing, I had done my nursing admin, and I was doing very fine. I was very happy. Army is a secure, safe job. And uh from then taking a leap and going and joining the corporate world without an orientation or a formal training to the corporate health care, which was a new buzzword those days. Uh, I'm talking of 2001, 2002, but I made my decision. I'm very uh adventurous by nature. I want to explore new things, I want to take uh risk. People say I have a risk-taking ability. Maybe I have. So, this is how I made my change. The corporate I joined was Max Healthcare, and nobody knew nursing there because it was a new chain of hospitals starting at that time. What was expected of the nursing leadership was to put policies and processes in order, the SOPs in order, hire the right team, get them groomed, and set them right for getting patient ready for the corporate level hospital, which will deliver a great quality. So it is not nursing excellence, it is excellence in patient care, which is quality care, which is safety, which is no error, and which is delivering, I would say, uh, outstanding patient experience and excellent clinical outcomes. This is what is expected, although it is not written in the books. It is an unspoken word. Be the best. We wish to be the best. And if you any hospital has to be the best, who will make it best? Only nurses, because patient care matters a lot. Doctors do their work extremely well. They may do a surgery, they may do interventions, diagnostics will happen, world-class equipment is there, there is absolute great infrastructure. What makes a difference? This all investors can put in. What will make a difference for patient care is what the patient feels at bedside, how much the patient has been cared for, what has been his experience in the emergency, in the intensive care unit, back in the ward, and back home. These experiences are a lot influenced by how nurses took care of him. So, nursing excellence, rather, excellence at patient care is expected of a nursing leader, and that is what we have been doing for the last few decades.

SPEAKER_01 14:34

And in this period, I'm very, very sure you would be hiring a lot of nurses across in your organizations. So, as a hiring manager, uh you would have felt that a lot of people tell me this given a nurse what she studies in a college and what she's in to has to implement on the hospital floor is a different beast. So, how do you how do you get them ready? And when do you think a nurse is ready to engage in complete patient care by herself? How does that happen?

SPEAKER_00 15:01

Akash, that's a question we are asked time and again in every conference, in every round table, rather in every board meeting. Nurses are hired through different channels. You will hire some freshers, they may be about 25-30% freshers. You may hire some experienced nurses, which are in today's time very difficult to come by. And hiring them, you want them to be job ready in the hospital. Hospital job is to manage patients. Hospital job is not teaching them, and teaching them, getting them ready happens, should happen at the nursing schools and colleges. Fortunately or unfortunately, at the college level or school level, they study a lot, they get excellent mark sheets, 80-90% marks. The college gets 100% results, they all get registered as well. But how many of them have gone through a patient's bedside experience? How many of them have actually evaluated or assessed a patient from head to toe? How many of them have been engaged in doing basic procedures on a patient? Have they communicated with the patient? Were they supervised for their work at the bedside? Were they given a chance to do something along with a buddy or a mentor? These are questions to be asked. Most of the nursing colleges do not have a parent hospital. They have to depend upon private hospitals for this experience. Many of the medical colleges, government hospitals, they give fantastic exposure to the nursing students. If I can speak for myself, I was in the armed forces as first year, second year, third year, fourth year, you are interacting and working with your seniors at patients' bedside. You are learning things right there because you are witnessing it, you are doing under supervision, and you are also given a chance to do independent things. That is not the case in the private colleges. So students do not get a chance to be patient ready, actually. Very few places are center of excellence. There are few examples, even in our country, but most of the time colleges have their own track of functioning, and hospitals want ready nurses, and colleges think they are ready, but there is a gap. The gap may be 20% to 70% in terms of patient readiness. So it is difficult. When we choose nurses, the fresher they are chosen based on their basic knowledge and their orientation to skills. They may never have practiced it. And more so after during COVID time, that couple of years of COVID actually did not provide opportunities to nurses, doctors, and others to go to hospital, but they did complete their studies. So it becomes imperative, very important for the hospitals to invest time, to have a structured induction program. It could go anything from four weeks to 12 weeks. And I think what works best for freshers is at least a 12 weeks program, which is more focused on skill-based, hands-on, whether it is through simulation lab, skill centers, mannequins, whatever the hospital has as infrastructure. Also, they they have to be assigned mentors who work with them, demonstrate, and work with them at patients' bedside. So it is a tough call for the nursing leadership in the hospital because first one to three months time, new nurses are not ready at all. It may also take six months' time. Actually, when nurses come from small colleges or schools, small towns for them, even communication, even the corporate infrastructure, the metro cities, the big buildings, a large team of doctors coming for around, everything is very overwhelming. Getting nurses ready, getting them out of the comfort of the classroom to the day-to-day dynamics of the hospital is a tough exercise for a nurse leader, and we all have to go through it. There's not the choice.

SPEAKER_01 19:46

Agreed. Another thing I what you kind of pointed out is a lot of these nursing colleges do not have a hospital with them. I think the way infrastructure of this country, specifically nursing customers built, I think it will be almost impossible to kind of provide a hospital to each of these colleges. Like tie-ups can be provided, but just because there are a lot of existing colleges. So I think for according to me, simulation labs become a very, very important part of the nurses' training. What are your thoughts on that? Simulation, maybe uh virtual reality, getting on. I think the Apex body of nursing has already mandated simulation labs to be part of a lot of curriculum. What are your thoughts on that? And if you had to give out, say, two-liner messages to a lot of these colleges about this, what would that be?

SPEAKER_00 20:37

You see, bedside patient care learning cannot be replaced by a simulation lab. That's my opening statement. Having said so, you cannot experiment on a live human being which is a patient. So, what is the next option to have that hands-on experience, which is near a patient's experience, is a simulation lab and the mannequins. For me, it will be very, very critical to say nursing colleges have been given a mandate to have a simulation lab, at least a basic one. And also the hospitals must invest in a simulation center. It is expensive, and sometimes hospitals and colleges think about return on investment. The return on investment is only one safe patient care with no harm and safety comes first in the hospital. So I think simulation-based training, AR, VR, I've explored all of this. Yes. And to some extent, we have gone through these routes in my career. So I think these are the ways in today's time when technology support is available, we must. Take the benefit from this, let the nurses practice disease scenario and take step-by-step training at the simulation centers, by which at least they would have at least 50 to 60 percent readiness in their mind how a particular procedure has to be done or how a particular disease management has to be done. The rest can be learned with a mentor at the bedside when they join the hospitals.

SPEAKER_01 22:27

I see a lot of uh young nurses today saying I'll complete nursing, I'll get a job. But I think today a lot of them do not pay a lot of importance to excellence in communication, uh, excellence in grooming, but a lot of them also have aspiration to go and work abroad because nursing is truly a global profession. So, how much uh what role does communication and grooming play in this? And lastly, to just sum it up, how does it fuel their international dream? Because a lot of them have that.

SPEAKER_00 23:01

You see, largely, why are we losing nurses to the global platform? That's my first question to you. We all know that nurses make a better quality of life outside the country, they they are better compensated.

SPEAKER_01 23:19

Yes.

SPEAKER_00 23:20

So they have a dream to go to some other country and make more money. If they go alone, fine. Sometimes their families are allowed, they get the work visas, work permits, etc. Nurses do require, apart from the skills and the knowledge, they require few more traits. And one of the important qualities they require is communication skills. Communication is not just speaking, it is also listening, it is also writing skills. All of these are mandated to be a nurse of today's time, of this century. And apart from communication, assertiveness and technology adoption also are becoming mandated needs. Nurses go out and we can't stop the brain drain globally. India is known to provide nurses to the entire globe. And we are very proud because our nurses are extremely adaptable, flexible, hardworking, and they adopt the culture very fast, whichever country they go to. They go to Saudi countries, they they learn Arabics very fast. So nurses are adaptable, they are keen to learn, they are keen to deliver their excellence wherever they go. I visited so many countries, and wherever I go, I always make it a point to go and visit some hospital. And I'm always surprised that our Indian nurses are everywhere and they are excellent out there. Whether you go to the United States, you go to Asian countries, you go anywhere. I went to Singapore General Hospital a couple of years back, and nurses from the Catholic lab to the ER to the ICUs, I could find a whole lot of Indian nurses and many from my organization. I did not recognize them initially, but they came over. Ma'am, we were trained by you. So whether nurses work in our country, whether they work in a public hospital or a private hospital or they work outside, we need to remember they are working for patients. They have to deliver patient care with the best standard. So communication is key to success for us within or outside. Even within corporate hospitals, they have to communicate with doctors, with so many other healthcare professionals, pharmacies, stores, diagnostics, patient family. They have to explain many things to the patient family. They have to do counseling, they have to talk to patients, explain the procedures. Communication becomes important. Local language also becomes critical in our country. Every state speaks a different language. So nurses have they learn also, and at least the basics of that language they require to learn. When they go to other countries, since you mentioned the global platform, they have to get themselves ready to be oriented to that country culture. They should not be in for a cultural shock. They have to know English very well, they have to know the culture of the country. They are going, apart from computer skills, which are a basic, whenever they are going outside. So nurses will always go out. There's no reason to stop them. We have thousands of colleges in our country, and we get so many nurses ready for GNM, BSE, post-basic, master's, PhD, doctorate. Our country can boast of the best of the education in the world in nursing. We can compete with the best of the countries in terms of education, and Indian nursing degrees are recognized everywhere. What we need to do better is get them more into leadership skills, into communication skills, assertiveness, critical thinking, decision-making skills, and be a leader. Nurse has to be a leader. There is no other way. So this is how they have to be ready.

SPEAKER_01 27:25

You also told you have traveled across so many countries, attended a lot of conferences. How do you think education-wise, right, in terms of education or training part of nurses, uh, what are the best practices that you've seen globally, which say colleges or even hospitals can adopt in India to train nurses better?

SPEAKER_00 27:44

See, I would have one primary message. Message is to hospitals and colleges have to come together, have to integrate more, have to interface more. Colleges are conducting education for getting nurses ready to be employed in hospitals. And hospitals are looking at colleges to get them ready nurses. So I think between the college and the hospital leadership, they should meet more often. They should come together to see how this can be best managed. Let the nursing senior managers, head nurses go to colleges to take some classes, practical-based classes, master classes, practical-based classes, speciality, disease-based, life-saving skills, all of these. And let the colleges, the faculty of the colleges come to the hospital to have a good integration, how care is managed or how care is required to be managed. We cannot just have a theory-based education. It has to be with practical requirements, practical skills, skills which are required to be an excellent nurse, patient safety requirements, infection control requirements, disease management requirements, all of these has to be taught to them so that they find it easier to be patient ready. So they have to come together. They can't be on a different platform. The curriculum is good, curriculum also gets updated from time to time, but the quality of training, colleges need to have better trained faculties and right numbers, right faculty and student ratio, which is student-teacher ratio. At the same time, when these students are brought for practical training to the hospitals, it should be right student and patient ratio. A hundred-beded hospital cannot take 500 students. For the sake of having an orientation and a requirement as per the syllabus, sometimes uh hospitals are infested with a high number of students, they will not get opportunities to learn. So we need to put the right practices and have a better integration between the colleges and the hospital nursing leadership.

SPEAKER_01 30:12

If uh if you knew somebody who's today in the final year of nursing or maybe third year of the nursing, uh, what would your top three or four points be to her to give when she goes out, when he or she goes out in the real world? There they qualify what is called as good nursing, right? What would those three or four points be?

SPEAKER_00 30:33

See, first of all, I wish to tell the the young students who are going to Vinurses, you've chosen the best career of lifetime. Nursing is a tough career, but it is the most rewarding, the most gratifying career. And what you do for the community, for societies, for human beings, nobody does. So you've chosen a great career, and you must decide your roadmap, your career roadmap, right when you're passing out. Whether you want to go into teaching later, whether you want to go into research later, whether you want to develop yourself into nursing administration and management, whether you want to be a bedside nurse, whether you want to be a bedside nurse and a specialized nurse in the operating room, in the dialysis center, in the critical care. So nurses have to invest in themselves. They should be highly aspirational. You can see a lot of role models. Find yourself a good mentor, find yourself a great role model. There are fantastic nursing leaders in our country who can be a role model. And nurses are into the decision-making bodies in the hospitals. They are in the boardroom, they are there are empowered nursing leaders. So invest in yourself, be assertive, empower yourself. Sky is the limit for you for a nurse because you are paid well only when you excel. So I would again say compassion to passion will lead you to excellence. And nursing requires nothing short of excellence. There is no midway, there is no cutting corners. Do the right thing, excel, continue to learn every single day. Be a better you at least by 1% every day, better than yesterday. Read, find out global benchmarks, get books in nursing. Today's time, you got the social media available, you got so many fantastic books available, the platforms, the nursing quality indicators, the dashboards. Learn yourself, invest in yourself. Don't shy away from the hard work and the investing. And don't ever forget, you are there to save lives. One right decision of you can change a patient's life and the family environment forever. And one wrong decision of yours, although unintentional, can damage a lot. So be an excellent nurse and keep investing in yourself.

SPEAKER_01 33:30

My last question from you. You've seen, as you told, almost five decades of nursing across the country. How do you think uh what has changed? How has it improved? Because when you told, when you started, there were hardly nursing colleges, there were hardly any infrastructure. How do you see that changing? And today, and I and you were telling me before the shoot that today nurses should be very, very hopeful of their future because of the improvement in not just infrastructure, uh, maybe at economic status also, all of that. So, how have you seen that change from 19 mid of 1970s to 2025?

SPEAKER_00 34:04

Every few years, every decade, we have seen uh healthcare transforming and we have seen nursing evolving and transforming. Even nursing practice. Way back in the 70s or the 80s, uh healthcare was primitive. We did not have technology, we did not have uh disposables, we did not have uh advanced equipment, and we we had a certain way of functioning, a traditional way of functioning in the hospitals. That's how our student time was and the early days were. I still remember the glass syringes which had to be boiled, the glass which had to be washed and dried and repacked. From then, I have seen nursing changing every few years. And now, in the last 10 years or so, nursing is completely evolved. Everyone is talking of nursing empowerment, nursing leadership, nursing management courses are there. Young nurses are going for masters in administration. Nurses are becoming CEOs of the hospital. Apart from being VPs and directors, they are becoming CEOs of the hospital. Why? Because a nurse has gone through the grind from bedside and she has evolved, evolved. She's come through the ranks, if we can use the word. So it is, I think times have changed. Now, almost every year, you find new things. There's new technology, there are robotics, there are laparoscopies, there are navigation systems. So I think nurses have to continue to learn the new things, new advancements. And in nursing training, the kind of advancements we have seen in last few years, we did not hear of virtual trainings much before the COVID time, and we did not practice it much. It was only the international seminars or webinars I used to join. But COVID has taught us that a different side of training. Now a lot of trainings are happening virtually, a lot of webinars are being done, and nurses are participating. They're learning through a nursing app, they're learning through the web. So LD side of nursing has really evolved apart from the hospital functioning side. Nurses are more assertive, nursing opinion is sought after, and hospital authorities, doctors with whom they work, and patients. Everyone has started seeing the contribution of nurses, their critical role in transforming healthcare, their important role in managing patients. You will see in future nurses will be doing much more beyond just this work. They will be care leaders rather than just caregivers. That's how nursing is going to change in the next few years, I would say.

SPEAKER_01 37:03

Thank you, Emma. I think that's a very, very powerful message. Uh I think nursing is not just a job, it's a profession where your skill, your confidence, and your compassion come together to make a real difference. And all of this has been demonstrated by uh Colonel Sharma. And I think Colonel Sharma is very, very uh grateful to have you on this chat and thank you for sharing your views. And I really like you're so upbeat about the possibilities and the way that nursing should come up. Uh, we need more voices and more leaders like you to speak up uh in this domain. Uh, really, really happy in our students and uh the young professional will be really happy to see this. Thank you, and we'll leave you with your last two words.

SPEAKER_00 37:44

My last two words. You are at the best spot as in us, and the global gates are open for you. Excel within the country, excel outside, but excel in patient care. That's it. And the word is at your feet. Thank you.

SPEAKER_01 37:59

Thank you, ma'am. Uh, this is Akash, signing off with this episode of Executive Elliott. We'll come back with a new episode very, very soon. Stay tuned.