ICU Nurse

Mission and objectivesUNDP is the UN’s global development network, an organization advocating for change and connecting countries to knowledge, experience, and resources to help people build a better life. UNDP works in about 170 countries and territories, working with national counterparts on solutions to global and national development challenges. In Bhutan, over last 50 years, UNDP has been supporting the Royal Government to attain its national priorities. In 2024, UNDP started implementation of the Country Programme Document 2024-2028, aligning to the country’s 13th Five Year Plan (13th FYP).

ContextBhutan’s 13th Five-Year Plan emphasizes improving high-quality primary and tertiary healthcare. The UN Sustainable Development Cooperation Framework (2024-2028) supports strengthening Bhutan's healthcare system, while the UNDP Country Programme Document prioritizes enhancing national and subnational healthcare capacities. Bhutan is facing significant challenges with clinical staff attrition, with a current rate of 9% for doctors, 7% for dental surgeons, and 20% for nurses. The Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) has a nurse-bed ratio of 1:6, below the recommended 1:3 for teaching hospitals and 1:5 for general hospitals. The country has only 4.6 doctors and 20.9 nurses per 10,000 people, far below the WHO's recommendation of one doctor per 1,000 population. These ratios, combined with rising attrition, threaten healthcare access, quality, and progress in health equity. In response, the Royal Government of Bhutan (RGoB) is implementing measures and opportunities to increase the number of trained nurses through national institutions within the next 1-2 years via initiatives that create short term bridging measures and to fill immediate gaps within the Bhutanese health system.

Task DescriptionThe Volunteer will serve as a qualified international ICU nurse, working closely with the Ministry of Health and healthcare facilities to enhance service delivery and address urgent healthcare challenges in Bhutan and overall supervision of the UNDP’s Deputy Resident Representative. This role will also focus on leveraging the skills and expertise of Bhutanese professionals to contribute to sustainable development in the healthcare sector. Key Responsibilities: Capacity Strengthening • Collaborate with national health system stakeholders to enhance capacities through knowledge transfer from international expertise, addressing the urgent need for trained professionals. • Provide mentorship to Bhutanese nurses, promoting their professional growth and advancing their ICU skills and knowledge. Curriculum Development • Participate in the development and delivery of training programs within national nursing educational institutions, incorporating international best practices and innovative techniques to improve educational standards. • Share lessons learned and effective practices regarding professional engagement, fostering a culture of continuous improvement and quality care within the healthcare delivery system. • Advocate for the integration of international best practices in critical care nursing, supporting Bhutan’s health equity and quality improvement objectives. Collaboration with Local Stakeholders • Work closely with national healthcare professionals and institutions to facilitate capacity support, ensuring effective skill transfer and strengthening the local workforce. • Foster collaboration between international volunteers and local health professionals, cultivating a supportive and innovative healthcare culture that enhances service delivery. Monitoring and Reporting • Assess and report on the impact of training and mentorship initiatives, providing actionable feedback for ongoing program improvement and ensuring alignment with Bhutan’s 13th Five-Year Plan goals for high-quality healthcare. Results/expected outputs: Enhanced Quality of Care • Significant improvements in the quality of critical care services across Bhutan’s healthcare facilities, leading to better patient outcomes and increased health equity. • Greater awareness and adoption of international best practices in critical care nursing throughout Bhutan's healthcare system, fostering overall health system strengthening. • Creation of a comprehensive repository of lessons learned and effective practices related to diaspora engagement and nursing education, enhancing knowledge management within the health sector. Strengthened Local Capacity • Increased competencies among Bhutanese nurses, resulting in a more skilled, confident nursing workforce capable of delivering advanced ICU care. • Effective mobilization of Bhutanese healthcare professionals, facilitating sustainable healthcare development through knowledge sharing and resource support. • Positive feedback from Bhutanese nurses regarding mentorship experiences, demonstrating enhanced skills, knowledge, and professional growth. • Ongoing engagement in professional development activities by both international nurses and Bhutanese counterparts, fostering a culture of lifelong learning in the nursing profession. Improved Educational Standards • Development and implementation of an enriched curriculum for nursing education that integrates international best practices and addresses current trends in critical care. • Establishment of sustainable training and mentorship programs that ensure continuous professional development for nursing staff, ultimately raising the standard of healthcare delivery in Bhutan.

Competencies and values• Leadership: Knowledge of the leadership development theories, concepts and methodologies; ability to apply them in the design and implementation of the leadership development strategies and programmes; ability to advise leaders on their development needs and related strategies • Operations Management: Ability to effectively plan, organize, and oversee processes into order to convert its resources into the best results in the most efficient manager. • Knowledge sharing and Facilitation: Ability to research and turn information into useful knowledge, relevant for content or responsive to a stated need. • Systems Thinking: to use objective problem analysis and judgement to understand how interrelated elements coexist within an overall process or system, and to consider how altering one element can impact on other parts of the system.

Living conditions and remarksBhutan is a lower middle-income country1, landlocked between China and India, with an estimated population of 770,0002. A Human Development Index of 0.666 (2021)3 places it in the medium human development category, ranked 127 out of 189 countries. Rapid economic growth averaging 7.5 per cent per annum was experienced since the 1980s4. Between 2010 and 2021, the Gross National Income (GNI) per capita increased by 22.3 per cent to USD 11,3005. Poverty rates reduced sharply from 23 per cent in 2007 to 8 per cent in 20176, with 12.4 per cent recorded in 2022.7 Significant gains in human development, poverty reduction and living standards have been guided by Bhutan’s gross national happiness philosophy of balancing economic growth with environmental sustainability, inclusive social progress and cultural vibrancy, underpinned by good governance. Despite the positive momentum, socio-economic vulnerability remains, primarily due to difficult geographical conditions, narrow economic base, dependency on limited international market for trade, and increased emigration of productive population in recent years. Bhutan is a relatively stable and peaceful country. The capital, Thimphu, is located at an elevation of 2,334 meters where the summers are warm, and winters are chilly. The Bhutanese currency Ngultrum is pegged with the Indian Rupees and one USD is equivalent to 82 Ngultrums approximately. In the capital, rented flats range from Nu.7000-17,000 (96 to 250 USD) while furnished apartments cost around 300 to 700 USD. Public transportation including taxis are cheap starting from 0.3 USD to 5 USD. Groceries and other food items would amount to around 300 dollars a month. Bhutan provides free basic health and education and as per Article 9 of the Constitution of Bhutan, access to universal basic health services is free to all individuals living in the country. The country’s national language is Dzongkha but the local populace is comfortable in using English which makes day to day conversations easy. Entitlements of International UN Volunteer include Entry Lump Sum Allowance (USD4,000); Monthly Volunteer Living Allowance (VLA) (USD2,734.93*), Entitlement Travel for UN Volunteer and eligible dependents (Authorized in writing by UNV HQ): Flight tickets (entry on duty & repatriation); Insurance Coverage (Comprehensive health, life, and malicious acts insurance); Annual Leave of 2.5 days per month; Access to UNV’s learning and career development resources; and Exit Lump Sum Allowance (USD225 per month served) payable upon successful completion of the assignment. For further information on the full entitlements, please refer to the Unified Conditions of Service for UN Volunteers (COS) at app.unv.org/explore *VLA will be specified when the Offer of UN Volunteer assignment is issued.