The Bhutanese Leading the way.
The Annual Incident Report Analysis of the JDWNRH deserves appreciation because a hospital cannot improve if it first refuses to acknowledge its own shortcomings.
The report paints a picture of a hospital under immense strain. Patients absconding, aggression against staff, fights between patients, self-harm attempts, verbal abuse, and even a knife-wielding individual entering the Emergency Department remind us that healthcare today is not just about medicine. It is also about security, mental health, and managing increasingly complex human situations.
At the same time, the report also documents incidents that directly affect patient safety. Surgical gauze left behind after delivery, a wrong procedure on the wrong patient, questions over informed consent, and the unattended death of a homeless patient are serious failures. While the hospital says these cases have been investigated and corrective measures taken, they cannot simply be brushed aside as isolated incidents. Every patient who enters a hospital has the right to expect safe and competent care.
However, accountability must be accompanied by context. Bhutan’s national referral hospital deals with overwhelming patient loads, staff shortages, overcrowding, and increasing numbers of psychiatric and drug-related cases. Healthcare workers are expected to remain calm and compassionate even while being verbally abused, threatened, intimidated by influential names, or even physically assaulted. No doctor or nurse should have to fear going to work.
Protecting staff and protecting patients are not competing objectives. They are inseparable. A frightened, exhausted, or demoralized workforce cannot consistently deliver the quality of care that patients deserve. Likewise, patients who feel unheard, confused, or neglected are more likely to become frustrated in an already stressful environment.
The recommendations in the report, from strengthening psychiatric security and improving reporting systems to de-escalation training and stricter clinical protocols, require resources, leadership, and regular follow-up.
Public healthcare is ultimately built on trust. That trust depends on patients believing they will be treated safely and fairly, and healthcare workers believing they will be protected while serving the public. Strengthening one without the other is impossible.
“To do what nobody else will do… is to be a nurse.” – Rawsi Williams
