Centre-run ESIC Hospital in Delhi functions as Covid-19 facility with one-third staff

The central government-run ESIC Hospital in Okhla, which was again converted into a Covid-19 facility in April first week is facing a severe staff shortage with less than 80 nursing officers working in three shifts to care for more than 250 patients, including those in intensive care units. There are fewer than 50 support staff working with the nurses to help patients.

As per a government order in 2019, the sanctioned staff strength for this hospital was 213, but most of the posts have been lying vacant for more than a year. In addition to this, the Delhi government had on April 26, 2021, ordered Covid Hospitals to augment all levels of staff by 25% either through on contract or through an outsourced agency. There are currently 110 nursing officers employed at ESIC-Okhla and 35 senior nursing staff who do not handle patient care. Of these 145 nursing staffers, 35- 40 nurses have tested positive for Covid-19.

However, the hospital has not begun recruitment either for nurses or the support staff even though several letters have been written by the ESIC Nurses Association (Delhi/Noida), the latest letter being on May 2, 2021. Prior to this, a letter was sent in April and before than in 2020.

“Before the hospital was designated a Covid-19 hospital in 2021, there was staff shortage. Despite repeated reminders health workers were not hired. After it became a Covid-19 hospital, the shortage became acute. We have 12 ICU beds and according to norms we are supposed to have 1:1 nurse-patient ratio in the care unit, but we have only 10 nurses working 3 shifts. It is exhausting and we will all burn out,” said a senior member of the association.

In the absence of relatives to look after the patients, all duties fall on nurses and the support staff. “Earlier, relatives would assist us. We did not have to rush to every patient all the time. Now, from the time a patient wakes up, a nurse has to be around, but we do not have so many staff members. All the nurses in the hospital are over-worked and the management turns a blind eye. We cannot continue this way. The patient and the healthcare worker suffer,” rued another healthcare worker in the hospital.

According to nursing staff guidelines, there must be a 1:1 nurse-patient ratio for each shift in every critical care unit. But now, it is 1:4 in the intensive care unit for each shift. In the general wards, the ratio is supposed to be 1:6, but there are three or sometimes 4 nurses for 35 patients in each shift, making it 1:9. In special wards, where severe COVID-19 patients are admitted, guidelines state that the ratio must be 1:5, but at ESIC Hospital, it is again 1:9.

A paper published in the Pondicherry Journal of Nursing on the ‘Efficient Utilisation of Nursing Manpower during Covid-19 pandemic’ by Rajarajeswari Kuppuswamy and Suresh K Sharma, states that the nurse-to-patient ratio in Covid-19 ICUs should be 1:1 if the patient is on ventilators and 1:3, if the patients are not on ventilators. In isolation wards, the ratio should be 1:5. However, none of these are followed at the ESIC Hospital.

“In a Covid-19 ward, the oxygen levels of most patients are low, and they will need continuous monitoring as relatives are not allowed in the ward. Every patient is sick and there is no respite for us,” said a nurse on Covid-19 duty at the hospital. The person did not want to be identified.

The Medical Superintendent of the Hospital Dr Deepika Govil refused to comment on the issue. “I am sorry I cannot comment on the issue or the recruitment. We are a central government institution, so I am not authorised to speak on the matter,” said Govil.

Currently, all the 250 beds in the hospital are full. On May 3, Delhi recorded 18,043 cases of the 61,045 tests conducted. The positivity rate was 29.56%. The country recorded 3,57,316 cases on Sunday, May 3.