The surge in COVID-19 cases across the country has brought its health care system to its knees. When many countries faced a shortage of resources like N95 masks and PPE, we got ample time to gird up and replenish. But the Indian government mainly focused on impregnating the supplies and equipment. Facilitating all the goods before the cascade of COVID-19 was a good step, but what about the manpower required to drive the fight against COVID-19?
The pandemic would have been better contained had the Govt. focused on key little things listed below:
- Shortage of Nurses
When the situation worsened, and numbers started rising, we noticed a shortage of nurses with the knowledge and skill required to work in COVID areas. Yesterday, I received a call from the Delhi govt. Health headquarter is asking me to join work in recently established COVID centres. I had to refuse as I am already employed with the country’s biggest fightback centre. There were plenty of shortages and deficiencies at various levels that needed to be addressed before the pandemic. According to the Union health ministry data, there are just 1.7 nurses per 1000 in India. That’s way less than the WHO’s prescribed minimum of 3. Our administrators’ lack of this foresight has exposed the lacunae in our health care system.
- No master rotation policy
As a part of the rapid action plan, wards and ICUs were converted into COVID areas. There was no contingency plan about allotting duties and rotating the staff accordingly to prevent infection and exhaustion. Had there been a plan regarding master rotation policy, allotment of protective equipment and screening of symptomatic individuals, we would have been in a much better position in this battle.
- No quarantine leaves
A few days ago, over 4000 nurses at All India Institute of Medical Sciences, New Delhi, protested for better facilities at the workplace, which included reducing the number of working hours in PPE, providing accommodation and safe commutation during odd hours. If that was the situation in the national capital and a premier institute, imagine the working conditions at the primary health care level. There is no uniform quarantine policy across the country, leading to chaos. What’s the ideal solution? Do we need to rethink whether reducing the working hours will solve the health issues nurses face? Should we demand for less working hours or quarantine leaves? I know it’s a catch-22 situation where one would expect us to stand tall and face the scenario risking our well-being. Every hospital has developed its way of deployment of nurses as per their convenience. A new disease requires new methods of approach; when will we find it?
Suggested approach
• Recruiting unemployed nurses in the COVID centres with proper remuneration and facilities.
• Redeployment of nurses across the states because there are regional differences in the severity of the disease outbreak, as well as in the availability of nurses per 1000 population
• Creating a master rotation policy to safeguard nurses because working relentlessly in COVID areas makes them groggy and unhealthy. They are the backbone of health care.
• Adequate quarantine leaves as per the disease’s incubation period, stipulated by ICMR. This will not only help in reducing the health issues among nurses. Instead, it helps identify the disease’s symptoms and prevent the spread of infection.
Conclusion
In conclusion, Covid-19 is a highly contagious disease, and hospital-acquired virus infection is a huge threat for all health care workers. Nurses, frontline care providers with maximum exposure time, are more vulnerable to infection. We believe appropriate and adjustable hospital protocols and policies will play a vital role in the management. Despite the difficulties, India is in a better position than many developed countries due to the sheer willpower of its dedicated health care staff.
