The Hindu : Kerala / Thiruvananthapuram News : Staff shortage hits MCH functioning

Online edition of India's National Newspaper
Wednesday, May 31, 2006

Kerala

Kerala - Thiruvananthapuram

Staff shortage hits MCH functioning

C. Maya

Surgeries are being held up; uncertainty over trauma care unit

Thiruvananthapuram: Acute shortage of anaesthesiologists, nurses and paramedical staff is playing havoc with the day-to-day functioning of Medical College Hospital (MCH). Staff shortage has always been a perennial feature in MCH, but with the authorities eager to make the trauma care unit functional, this shortage of staff could turn out to be a major hurdle.

Shortage of anaesthesiologists has put surgeries in many departments on the hold. Even though April and May are the months when a large number of elective surgeries are performed, currently there is a long waiting list for surgeries at MCH, including cancer surgeries. Postgraduate medical students, who form a chunk of the working hands in MCH, are currently having exams and this has hit the Anaesthesiology Department the hardest.

"There are several vacancies in the department at present, including the unauthorised absence of a few. Even though we desperately require more hands, post creation has not been happening. No PSC list has been put up to advertise vacancies. Even though we suggested that anaesthesiologists be appointed on contract basis, qualified hands are going to private sector where the pay is much more attractive," says a senior doctor.

Operation tables allotted to each of the surgical specialities - Orthopaedics, General Surgery, Neurosurgery, Gastroenterology, Urology, Plastic Surgery - have been cut by at least 20 per cent now as there are not enough anaesthesiologists to handle the high volume of surgeries. Surgical departments are peeved at this cut in their surgery tables, but Anaesthesiology Department has expressed its helplessness.

Doctors also point out that fresh graduates and postgraduates in the Anaesthesiology Department are not interested in sticking on at MCH because the pay packet is poor.

"There are no incentives here and for a non-practising speciality like ours, the private sector offers a lot of opportunities," a medical student says.

Shortage of anaesthesiologists aside, patient care and day-to-day functioning of the hospital has been suffering because of the acute shortage of nursing assistants and attenders.

MCH is still managing with the staff pattern of nurses fixed in 1961 in the patient-nurse ratio of 1:6, when it had 500-odd beds. Today, the hospital's bed-strength has gone up to 1,588, it has 25 wards, 11 intensive care units, several speciality departments. Patient load has gone up several fold, with at least 1,000 patients visiting various outpatient clinics alone daily. The existing patient-nurse ratio is 1:150 in some wards.

At present, it is the shortage of lower level staff - upper attenders, nursing assistants, first grade and second grade attenders - who are responsible for cleaning activities, waste management, shifting of patients to wards etc, that has been creating problems for the hospital administration. There are 39 vacancies of upper attenders, 88 vacancies of nursing assistants and about 103 vacancies of first grade attenders at present.

Though there are about 193 sanctioned posts of Grade II employees, for the past five years the MCH has been having people appointed on temporary basis for short periods of time by either the Hospital Development Society or the District Medical Officer.

"There is constant displacement of staff as most of them leave just when they are getting familiarised with the work. Because of the general staff shortage, the Grade II sometimes have to be assigned other tasks also and this affects cleaning activities," points out a hospital staff.

Many advanced facilities that were added on in recent times at the MCH, such as the modern surgical ICU, are remaining under-utilised because there are not enough nurses to manage these facilities.

About 42 persons - 25 nurses and 17 paramedics - were appointed on daily wages when the Major Operation Theatre A was renovated, with additional operating tables. Only a few of them have been coming regularly because they are paid only Rs. 140 a day.

The authorities are under much pressure to open the trauma care unit now. But unless new posts are created at all levels, the system will not run, it is pointed out.

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