The Bhutanese Leading the way.
Under this paper’s observation and as confirmed by multiple sources, the Emergency Department at Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) is experiencing a critical shortage of health workers and patient beds.
Some of the health workers at JDWNRH say the ongoing staff shortage in the Emergency Department is placing pressure on the system, affecting patient care and staff morale.
Among the patients inside the emergency room was an elderly woman whose son, who had been attending to her since admission, described the conditions as overwhelming. “The emergency room is packed. My mother is in a corner with limited space around her,” he said. “The staff are trying their best, but it’s so crowded, it’s hard to watch her in this state, surrounded by so many others who are also in pain.”
A young woman who arrived at the Emergency Ward with a severe migraine said she was initially hesitant to come, fearing she would face the same experience her father did last year. “My father was brought in with intense abdominal pain, and there was nowhere for him to even sit, forget about a bed to lie on,” she said. “He was in so much pain, yet we had to wait.”
She said she felt fortunate that, in her case, she was quickly assessed and prescribed medication in a doctor’s chamber, which spared her from being placed in the ward. “My case was minor, but not everyone’s case is like this,” she said. “It’s worrying to think that this is what emergency care has come to.”
A guardian attending to his relative expressed concern after the patient was placed on a bed along the corridor due to the lack of space in the emergency ward. “It was difficult to see my brother lying there, exposed to constant foot traffic and noise,” he said.
“There was no privacy, and the area was so cramped that even nurses had to squeeze through to attend to other patients. I don’t blame the staff, they’re doing their best, but it’s painful to witness someone you care about being treated in such conditions.” He added that while the doctors were attentive, the environment was far from ideal for someone in need of rest and urgent care.
The Emergency Department at JDWNRH serves over 40,000 patients annually and accommodates approximately 20 to 30 patients daily. However, at times, the number of patients exceeds the available beds, and even reaches the point where it cannot be accommodated in the ward.
Health workers shared that they often have to make difficult decisions on prioritization, which can compromise both the speed and quality of patient treatment.
Compounding the situation, the ward has seen a reduction in support from trainee health workers. Typically, nursing and clinical students assist in the ward as part of their hands-on training. However, last month, many of these students were reassigned to field attachments in other parts of the country.
“While students are not licensed professionals, their presence lightens the load by helping with routine work such as taking vitals and updating charts,” said a health worker. “Since they were assigned to a field attachment last month, the ward had become even more difficult to manage.”
A doctor at JDWNRH expressed concerns that even though health workers are compensated for overtime, this does not fully address the underlying issues of patient care or staff well-being.
“While we appreciate the financial support for working extra hours, it doesn’t make up for the toll it takes on our health, and the quality of care we can provide,” the doctor said. “When we are stretched too thin, it’s not just the patients who suffer, our well-being is compromised as well. Burnout is real, and it’s affecting both patients and healthcare providers.”
The doctor emphasized that the solution lies in addressing the core issue: a shortage of health workers, particularly in the Emergency Ward.
“If we had enough staff, we wouldn’t need to rely on overtime to fill the gaps,” the doctor said. “More health workers would mean less stress, more time for each patient, and better overall care. But without adequate staffing, we’re in a constant cycle of trying to keep up, and that’s no way to provide quality healthcare.”
Adding to the ongoing concerns, one of the retired health workers has taken to social media to share his experience, stated that overwhelming workloads and staff shortages were among the reasons they chose to retire early. He said, “This is exactly why many of us left, we were exhausted, overworked, and felt the system wasn’t improving. It was affecting our health and our ability to care for patients the way we were trained to.”
A nurse working in the emergency ward shared that despite their intention to provide the best possible care and comfort to already sick patients, the lack of space often leaves them with no choice. “We want to ensure our patients are comfortable and treated with dignity, but we simply don’t have the space,” the nurse said. “Sometimes we have to settle them in already crowded rooms, or place their beds in the corridor. It’s not what we want, but we have no other option.”
In response to the growing pressure on JDWNRH’s emergency department, the Ministry of Health has been working on long-term solutions, including the construction of a multidisciplinary hospital.
The new hospital, which is being designed to integrate various medical specialties, aims to reduce the strain on JDWNRH by offering more specialized and focused care to patients across the country. The new facility is expected to ease congestion, improve access to healthcare services, and better address the increasing demand for urgent care in both urban and rural areas.
However, despite the plans for a multidisciplinary hospital in the future, many health workers, patients, and their guardians are not satisfied with the current state of affairs and are calling for immediate or even temporary solutions to alleviate the pressure on JDWNRH’s emergency department.
