In a recent report by the Royal Civil Service Commission (RCSC), the medical field in Bhutan has been facing a concerning shortage of healthcare professionals.
The shortage of healthcare professionals is not limited to one hospital, but extends to the Central Regional Referral Hospital in Gelephu and Eastern Regional Referral Hospital in Mongar, in addition to the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH). Specifically, Mongar Hospital is facing a shortage including in its Operation Theatre (OT) section. With four functional OTs and 12 nurses handling three shifts, the recent resignation of 2 nurses has further worsened the situation.
An OT staff expressed that for smooth functioning, the OT requires at least 20 staff members, but currently, there are only 12 nurses. As a result, the existing nurses are forced to work double shifts, losing their designated weekly day off without any compensation for their holiday sacrifice.
The staff member also highlighted the need for specialized training for OT nurses, which takes 2-5 months for senior nurses to guide new recruits, unlike general ward nurses who can begin working after a few weeks of guidance.
Nursing Superintendent Phuntsho Norbu acknowledged the shortage of nurses, admitting that the current numbers do not meet the standard nurse-to-patient ratio of 1:6. Despite the challenges, the staff at Mongar Hospital remain resilient and cooperative, providing support to one another during difficult times. “While the situation is being managed, the consistent trend of one nurse resigning each month could potentially lead to a major issue if not addressed promptly,” he added.
One of the nurses from Mongar Hospital shared that the pressure is felt by those who stay back. She said, “Pay hike is not exciting for the nurses to stay back, as they have already made their minds to go abroad”. She shared that, seeing every 2 nurses visiting Thimphu to do the IELTS exam is discouraging them, as they will be under more pressure than ever before.
Similarly, Gelephu CRRH is dealing with its own set of challenges. Although the facility boasts various medical specialists and adequate nurse-to-patient ratios in different wards, the loss of specialized nurses has been a growing concern.
There are currently 149 nurses at Gelephu CRRH. There is all major specialist in medicine, surgery, pediatrics, obstetrics and gynecology. The patient-to-nurse ratio varies and is never constant, in the general ward, it is usually 1:6 and 1:2 in ICUs, said one of the senior nurses of Gelephu CRRH.
She shared her concern regarding the loss of specialized nurses, she said that the department of OT is already seeing the scarcity of nurses. “Cabin facility will be opening soon, however, we also need the pool, in addition to any services, demands the human resources,” she added.
She acknowledged the less attrition of nurses from Gelephu due to the lack of direct access to consultancies and other facilities, such as IELTS. However, the remaining staff have seen their colleagues leaving and have paved the easier way for them as well.
Meanwhile, another nurse from Gelephu Hospital shared the work pressure faced. While there is an average of 17 to 18 patients in the medical ward, and there will be 2 nurses looking after 18 patients during the night shift. “At times, when a patient expires, it is very challenging for just 2 nurses to handle the situation,” she added.
Despite the difficulties faced by healthcare professionals in Bhutan, the dedication and commitment of the staff have been unwavering. The challenges posed by the current staff shortage highlight the urgent need for measures to retain and attract healthcare personnel.