Lok Nayak Hospital COVID-19 nursing staff object to order to work for longer shifts

There are signs of trouble between the administration and the nurses at Lok Nayak Hospital in Delhi. The medical director ordered that nurses should be doing 12-hour shifts instead of the current shorter shifts. The nurses have refused to do 12-hour shifts. Instead, they have written to the Delhi government and state health minister Satyendar Jain citing their inability to do so.

Currently, there are three shifts – a six-hour morning shift, then an afternoon shift of six-hours and a 12-hour night shift with two nurses in each shift. “As per guidelines, a staff nurse can wear the personal protective equipment (PPE) only for four hours. This kind of hectic, long COVID-19 duty will lead to continuous exposure for 12 hours. This will affect the staff physically, mentally and psychologically. We strongly oppose the 12-hour duty and request you to withdraw the order,” stated Jeemol Shaji, general secretary of Delhi State Hospitals Nurses’ Union.

“It is impossible to do 12-hours on COVID-19 duty. Once the PPE kit is worn, the staff can’t drink water, urinate or even go to the toilet. The suit is not made of breathable fabric and most of us are sweating inside it,” said a nurse on COVID-19 duty at the hospital.

While issuing the 12-hour shift duty order, medical director JC Passey had not consulted any of the senior nursing staff, said nurses. “He issued a memo to the nursing superintendent regarding the 12-hour shift, so the nursing superintendent was forced to make the 12-hour duty roster. However, the nurses’ union said that the staff should not follow it. Now, confusion reigns. So, in some wards, nurses are following the 12-hour duty roster and in most wards the old three-shift system is being followed,” said a nurse, who did not want to be identified.

Senior doctors said Passey was simply following the orders of the Delhi government. On March 29, 2020, the Delhi government had issued an order stating that the health staff at COVID-19 designated hospitals would work in two shifts of 10 hours (8 am to 6 pm) and 14 hours (6 pm to 8 am). The nurses have questioned why this order was being implemented a month after it was sent.

The COVID-19 nursing staff at All India Institute of Medical Sciences (AIIMS) have four shifts of 6 hours – 2 am to 8 am, 8 am to 2 pm, 2 pm to 8 pm and finally 8 pm to 2 am. AIIMS nurses working in the ward where suspected patients have been admitted are on four-hour shifts.

In their letter to the Delhi government the nurses union have stated that working 12-hour shifts would increase their exposure to Coronavirus and make the staff increasingly susceptible to the virus.

The LN Hospital medical officer-in charge, Dr Basna said that their motive was to expose fewer people to the virus. Moreover, COVID-19 patients don’t need a lot of care, he claimed. “Most patients are stable and so they do not require constant attention. Only nurses and doctors working at the intensive care unit are stressed out,” said Dr Basna.

A number of patients arriving at LN Hospital have co-morbidities, which means in addition to being COVID-19 positive, they would have other ailments too, said a few other medical staff. This would mean that the patients need constant care, unlike what Dr Basna was stating.

When he was reminded that a staffer can wear the PPE suit for only four hours, he said that they would make it three nurses per shift. Senior nurses said that if the 12-hour shift were to be implemented, nine nurses will get exposed every 14 days rather than the six currently.

According to the 12-hour duty roster, when nurses finish their night shift for seven days, they are immediately put on 12 hours morning shift, which means they would end up working 24 hours in a COVID-19 ward. To avoid this, nine people have to be put on the 12-hour shift, said a senior nurse.

At LN Hospital, a medical staffer on COVID-19 duty has to work for 14 days, after which they will be quarantined for 14 days. They the staffer can go home. But, due to mismanagement of staff duty, even before the quarantine period is over, the nurses have been called for duty. The hospital was declared as a COVID-19 dedicated hospital in April.