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Monday , July 2 , 2012
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Hospitals nurse a critical illness

- Private health care struggles to get staff

A severe scarcity of nursing staff in Calcutta is forcing private health care facilities to compromise on the stipulated patient-nurse ratio, press the pause button on expansion and sometimes turn away patients.

The shortage isn’t new but the demand-supply mismatch has become magnified because of a combination of reasons ranging from a spurt in private facilities to a health care recruitment drive by the Mamata Banerjee government.

“The crisis has deepened over the last four years and is affecting patient care at every level of health care. Hospital authorities have to take various ad hoc measures to cope with the shortage,” said Pradip Tondon, president of the Association of Hospitals of Eastern India.

The 20 or so large private hospitals in town have 7,000-odd beds and barely 8,000 trained nurses to work in shifts. “The minimum requirement is 10,000 nurses,” said Tondon, who heads Belle Vue Clinic.

Health ministry guidelines stipulate a 1:5 nurse-patient ratio for general wards and 1:2 for intensive care units. For patients on ventilator support, the ratio should be 1:1.

Several heads of private health care units Metro spoke to blamed the shortage of skilled nurses for the deterioration of medical services. Worse, some are recruiting poorly trained nurses to make up for the shortfall.

“Recruits not registered with the Indian Nursing Council and without any recognised diploma are given basic training and posted as nurses in the general wards,” said a senior official at Swastha Bhavan.

Retired nurses are being reemployed too.

At Ruby General Hospital, the authorities have been forced to use a three-tier system to tide over the crisis.

“We have general nursing & midwifery graduates along with BSc nurses for patient care. In the second tier, we have deployed health assistants who can’t administer injection or dress wounds but can measure blood pressure. The third tier comprises ward assistants who change bed linen and help in shifting patients,” said Brig (retd) S.B. Purkayastha, the hospital’s CEO.

CMRI has set up a new, 20-bed ICU but is short of nurses to make it fully operational. “We have been using 10 beds since last month. The remaining 10 will get patients once we have more trained nurses,” said Rupak Barua, chief operating officer of the hospital.

Belle Vue Clinic has postponed expansion. “We were to set up another hospital but that will have to wait because of the nurse shortage,” said CEO Tondon.

Some hospitals have been forced to under-utilise their infrastructure. “Our intake is 10 to 15 per cent less because we don’t have enough nurses,” said Probir Bose, director-in-charge of Woodlands Hospital.

Super-speciality departments like neonatology, oncology or nephrology, where patients need special care, are affected the most.

“The gap between demand and supply has increased as there has been expansion in corporate health care facilities but the number of nursing training institutes has not increased proportionately,” said Barua of CMRI.

Bengal has around 15 nursing institutes, against 57 in Kerala and 26 in Karnataka. In Calcutta, finding land to set up one is the biggest challenge. At least 55,000sq ft is required along with a 100-bed hospital to set up a 60-seat institute.

Failure to retain nurses is another problem.

“As there is no lock-in clause, all nurses passing out of a hospital’s own institute can’t be retained. Many of them are lured by lucrative offers abroad,” said a source at Apollo Gleneagles Hospitals.

Government jobs are also taking nurses away from the private sector. At the start of a nursing career in a private hospital, a trained recruit gets Rs 11,000 to Rs 12,000 a month, against Rs 17,000 a month in a government job.

The state government has started recruiting nurses to meet its own shortage. “Around 2,500 posts are vacant and we have already recruited 900 nurses through advertisements,” said health commissioner Dilip Ghosh.