Noida: In the district hospital already stretched thin, it took a video of a security guard, untrained in medicine, filling syringes from ampoules for a nurse too overwhelmed to lay bare just how threadbare the hospital’s workforce has become.Officials were quick to distance themselves from what had happened. The guard’s role, they said, could not be justified and was plainly illegal, a violation of the basic line between medical and non-medical staff. Yet, even as they moved to suspend the two, hospital data show that around 4,000 outpatient department (OPD) patients and 300 inpatients are handled daily at the district hospital by just 45 doctors and roughly 100 staff nurses. To adequately serve such a patient load, the hospital needs at least 100 more staff nurses and 50 more doctors across various wards, officials said.The shortage forces nurses to juggle multiple responsibilities simultaneously, compounding the pressure of an already heavy patient load. “At one given moment, a nurse takes care of multiple different things. On one hand, she checks a reading of a post-operative patient’s blood pressure, fields questions from family members, gives injections to other patients, records readings and manages various essential work. It is very tiring and humanly impossible at times. There is an urgent need to recruit more staff nurses,” said a nurse at Noida district hospital.Indian Public Health Standards (IPHS) and Indian Nursing Council (INC) recommend a nurse-to-patient ratio of 1:6 in general hospital wards. The district hospital’s current staffing falls well short of this benchmark.The staff crunch also extends patient waiting times, with patients often waiting one to two hours before being attended to, particularly during peak OPD hours. Officials said the situation is not confined to the district hospital, with community health centres (CHCs) and other govt facilities across the district reporting similar shortages among doctors, paramedical staff and support workers.Jewar CHC is functioning with just five doctors and six paramedical staff, roughly half its sanctioned strength, and has no general surgeon, physician, orthopaedic specialist or eye specialist. Bisrakh CHC, which caters to around 800 patients daily, operates with five doctors and four nurses, and also conducts 150 to 200 deliveries every month.Bhangel CHC, which sees over 700 patients daily, has nine doctors, seven nurses and three ward boys. The CHC has no sweeper. “If there is no sweeper and only two or three ward boys, how will the CHC run? Especially in cases where patients are seriously injured and bleeding, or post-delivery, the beds and wards need to be cleaned properly before another patient can be shifted there. However, there are no such facilities here. The condition is very shabby,” a senior doctor at Bhangel CHC told TOI.Staffing norms at these CHCs are still based on 2012 patient-load estimates, officials said, even as daily footfall at some centres has climbed from 150 to 800 patients over the years, creating a widening mismatch between sanctioned manpower and actual demand.The manpower crisis at the district hospital was compounded after the recruitment of 15 staff nurses and two lab technicians came under a cloud recently over alleged violations of National Health Mission (NHM) rules that restrict district-level appointments to these posts after May 2023. Most of the staffers stopped reporting to work from Monday after the CMO halted their salaries. With no alternative arrangements made so far to fill the posts, the existing staff have been forced to absorb the additional workload.Chief medical officer Madan Mohan Mani Tripathi told TOI that the recruitment of the 17 outsourced staff nurses had happened internally at the local level and was not authorised. “An investigation is going on into the matter. Meanwhile, a detailed report has been sought from all the hospitals on their staffing requirements, and it will be sent to the state health department soon,” Tripathi said.The district hospital’s chief medical superintendent (CMS) said the facility would seek additional manpower from the state health department to address the shortfall.
