At 1 pm on a Friday, Sujatha* is snappy and heavy-eyed after a 12-hour shift at Niloufer Hospital, where she works as a staff nurse. She is tired and wants to return home to catch a snooze before her next shift, which starts in 10 hours. But, it is not that easy.
“I have been standing for over six hours, now I have to travel for another one hour in a bus,” says the 28-year-old nurse with the paediatric emergency ward.
Sujatha is among the 147 nurses who keep Niloufer Hospital running. As the department head at the hospital put it, “The nurses are the crucial link between a doctor and quality healthcare.”
The hospital’s rolls show there is a requirement of 249 staff nurses, but they have only 147 nurses currently working there. On an average, the hospital, which has a 950-bed capacity, receives 1,200 patients on a daily basis; between June and August, these numbers go up to 1,800.
To increase the bench strength of staff nurses, the hospital must increase their bed strength in proportion. The hospital administration has sent requests to the state government to add 500 beds to cater to the visiting patients, but there has been little or no response.
According to the department head, the nurses are rotated based on requirements. “There will be fewer nurses in the general ward, as most of them are assigned to the ICUs and emergency wards where they are most needed,” said the doctor, adding, “The present numbers are just not enough. As a stopgap arrangement, we have students who fill in; however, there are duties that only a nurse can perform.”
The Indian Nursing Council prescribes that a 1:6 ratio (one nurse for six patients) is to be maintained in general wards and 1:1 (one nurse for one patient) in ICUs. At Niloufer, though, the ratio is skewed.
Talking to TNM, staff nurse Sushma* said, “I take care of over 30 to 50 patients and even 80 patients on some days. It depends on which ward I am working in.”
She adds, “Nurses stationed in ICUs and emergency wards focus on fewer children as they need more attention. For general wards, however, the hospital diverts fewer nurses, so a nurse ends up handling more work.”
Cases challenging the hiring of nurses for Niloufer and other state-run residential educational institutions (a total of 533) are caught in a legal battle at the Hyderabad High Court since 2017.
Unhappy with the state government’s decision to award an extra 30 marks to contract workers, petitioners approached the court, which then put a stay on the appointments made by the Telangana State Public Service Commission (TSPSC) in 2017.
Admitting the staff storage, Murali Krishna, superintendent, Niloufer Hospital, said, “We never say no to anyone knocking our hospital doors despite the shortage of staff. A lot of people visit Niloufer as it is a tertiary care hospital. People come from districts across Telangana and even from neighbouring states. We hope to increase the number of beds by 500. But again, the number of people visiting the hospital will increase proportionally. And then, we are back to the same problem of overcapacity. There is a need to strengthen the periphery hospitals to bring down the number of people visiting Niloufer.”
“It’s not an easy job,” said Sunitha*, a staff nurse who was also on her way out after her shift.
“Sometimes I have to prioritise whom to give attention to. It may be taking the temperature of a child or changing the IV bottle or giving an injection; but I cannot give attention to everyone who is under my care. Most of the cases are complicated and have to be handled carefully. If anything happens to the child, the relatives will blame the doctors and nurses; no one will care to understand the conditions under which we work,” she added.
*Name changed