The National Capital Delhi’s first COVID-only facility Lok Nayak Hospital has been facing a shortage of at least 350 nurses and doctors. The staff have written several letters to the administration. Currently, there are vacancies for approximately 80 doctors and 275 nurses.
There is a shortage of at least 30 doctors in the medicine department and 50 in anaesthesiology. Thr staff have written at least five times from the beginning of May to both the hospital administration and the state health department regarding the issue. There are currently 650 junior and senior resident doctors in the hospital.
In the nursing department, there are 89 posts vacant for nursing officers. Additionally, at present 150 senior nursing officer posts, 22 assistant nursing superintendent posts, one each of deputy nursing superintendent and nursing superintendent posts are yet to be filled. There are currently 1,318 nurses, including senior nursing staff, in the hospital and there are 2,053 authorised beds.
In the latest letter to the LN Hospital director, the residents of the medicine block have stated that there are nine residents posted in the new block consisting of three floors. This translates into three residents per floor. Each floor has 60 patients. “With increasing number of sick patients being admitted daily to the new medical block, instead of increasing the number of clinical residents, their number has been decreasing. This is unhealthy for the working residents and also hampering the care of the sick patients,” states the letter.
The doctors have requested the hospital for a total of 18 residents for every 12 hours. Along with the doctors, they also want a residents’ duty roster to be made to ‘ensure that best possible care is given to all patients timely’.
The residents from the anaesthesiology department too have been writing letters. “We are worried because the hospital has decided to begin intensive care units in various wards of the hospital, and it cannot be manned by the current strength. In all these ICUs, specialised staff is required. We do not have enough. All the residents from other departments are being pooled in because there is a shortage. Earlier, one doctor would take care of three ICU patients, now we have monitor 12 critical patients at a time and that too wearing protective personal equipment. This is not good for the patients themselves, leave aside doctors,” said a doctor working in one of the ICUs in the hospital. The doctor did not want to be identified.
“A large number of our junior residents have been sent off to district hospitals. There, they are not a part of the medical team handling COVID-19 patients. Several of them have been entrusted with documentation work. They have taken away the manpower from the largest COVID-19 hospital in the national capital,” said Dr Keshave Singh, general secretary of the Residents’ Doctors Association.
The nurses are worried too. “We do not have enough staff. There are almost 450 nurses working in the first batch and when they go into quarantine after their 15-day duty, the next batch takes charge. But this constant duty schedule has taken its toll on the staff members. In between, several nurses have also tested positive. Then, the staff management goes haywire. We try to allocate duty based on the health of the nurses. Those who are pregnant or have underlying health conditions are not stationed in wards where there are severe COVID-19 cases,” explained Jeemol Shaji, general secretary of the LNH Nurses Union. Nurses were last recruited in 2014 and exams for these held in 2012. It has been six years since new nurses have joined the hospital.
In the ICUs, there are severe shortages of nurses too. According to nursing staff guidelines, there must be a 1:1 nurse-patient ratio for each shift in every critical care unit. But now, it is 1:4 in the intensive care unit for each shift. In the general wards, the ratio is supposed to be 1:6, but in the medicine ward of the hospital, there are three nurses for 30 patients in each shift, making it 1:10. Medicine ward is where the moderate to severe COVID-19 patients are admitted. In special wards, guidelines state that the ratio must be 1:5, but at Lok Nayak Hospital, it is again 1:10. “According to the staff inspection unit guidelines, the hospital will require at least 500 additional nurses, not including senior nurses. Currently there are 1,111 nurses working in two shifts. The others are senior nurses and a few others are on leave. The hospital is unlikely to recruit nurses according to guidelines,” underscored Shaji.
Additionally, the stress of working and staying away from their families is taking its toll. “After the 15-day duty period, nurses stay at the same hotel until their COVID-19 test result comes back. Only then can they go home. Within a few days of going home, they are back at work. So, in a month, a person ends up staying hardly for a week at home. This causes a lot of problems for them at home. If the staff shortage is filled, then there can be three batches. This will allow the nurses to rest and be with their family too for more than 10 days a month.
Currently there are more than 600 patients admitted at the hospital. On July 4, Delhi recorded 2,505 COVID-19 cases taking the total to 97,200 cases in the capital. The COVID-19 death toll in the capital stands at 3,004, of which 55 were registered on July 4.