The Bhutanese Leading the way.
Eight applications to leave comes every two weeks
Recently only 11 people applied for 17 nursing vacancies
The medical field has experienced a total of 183 voluntary resignations from January to 25 May 2023, of which the highest number is among nurses, with 98 nurses resigning of which 66 were regular staff and 32 were on contract. There are also 26 nurses on Extra Ordinary Leave. The numbers are only expected to shoot up in the coming months.
These growing resignations when translated into the field is leading to tremendous burden on the remaining nurses which is impacting quality patient care as nurses do a lot of the heavy lifting in healthcare.
The nursing department of JDWNRH receives about eight applications every two weeks which are mainly for Extra Ordinary Leave (EOL) since their visa is already granted, but if EOL is not given on time then they resort to resigning.
Nursing Superintendent, Chimi Lhamo, of JDWNRH shared her concerns regarding the growing trend of healthcare professionals seeking opportunities abroad. She highlighted the challenges faced by the institution, stating that the recent trend of going abroad is ever more, and there is no restriction for those going on EOL.
She said that the department had recently advertised nursing vacancies, but only limited applicants came forward to apply, indicating a shortage of interested candidates. “We recently announced the vacancy for 17 Nurses, and there were hardly 11 applicants who applied for the post,” she said.
Highlighting the issue of contract nurses, she shared that in March this year, 32 contract nurses were recruited from various colleges, including Arura, RTC, FNPH, and India.
However, some of these contract nurses worked for one to two months and resigned since there is no restriction for contract nurses.
Another reason is that contract nurses have already applied for the visa and they are working until they get the confirmation of the visa grant and right after their visa grant, they resign and leave.
She said that there will be a compromise in the quality of patient care as most of the nurses have been appointed with multi-responsibilities. However, there have been no incidents recorded so far.
Currently, there are 409 nurses in the In-patient Department (IPD) and 50 nurses in the Out-patient Department (OPD) in JDWNRH.
The 409 nurses are divided among 30 departments.
The X-Ray department claims to have an adequate number of doctors while nurses from the Maternity ward are not enough.
A nurse shared that the nurse-to-patient ratio was 1:6 before, but due to the increasing number of EOL, the ratio now is 1:16, resulting in an acute shortage of staff.
She emphasized the challenging working conditions, stating that nurses are required to work tirelessly without any Sundays off, no days off, or fixed working hours. Sick leave is granted only in severe cases, and at times, nurses are compelled to report for duty even when unwell due to staff shortages.
Speaking about the situation, the nurse said, it compromises patient care, and they cannot provide the necessary hourly monitoring. It also impacts the family time, as there is only one day off in a week which is uncertain due to emergencies.
Another nurse from the ward stressed on the impact of demands on their personal lives, stating that they are unable to spend quality time with their families and are rarely granted holidays.
She also stated, “All the nurses leaving may not be a significant issue, but the leaving of experienced nurses who have undergone numerous trainings and gained expertise in the field is a significant loss for the healthcare system”.
Similarly, another nurse shared views regarding the heavy workload and additional responsibilities that nurses have to undertake. He emphasized that they are primarily meant for patient care but are associated with various other tasks such as attending workshops, working on projects and research, and documentation.
In fact, documentation alone for new recruits can take up to half an hour. Moreover, tasks related to infection control and Neonatal Quality Improvement (NQI) are often left unfinished due to the lack of time during duty, becoming a part of the homework.
He further highlighted the effect of increased workload on patient care. Previously, each nurse would be assigned to each cubicle which has multiple beds, ensuring adequate attention to patients. However, the current situation requires each nurse to look after 2 cubicles while managing additional responsibilities, ultimately compromising the quality of patient care.
He said there is an urgent need to address the shortage of nursing staff and improve working conditions to ensure quality patient care and enhance the well-being of healthcare professionals.
Many nurses feel that major measures are necessary to address the shortage of nurses and lessen the burden on them and also to ensure that the patients receive quality care. The matter must be sorted out to the earliest for ensuring a sustainable and efficient healthcare system for Bhutanese.
