Delhi’s RML Hospital short of 108 doctors, 328 nurses as it fights Covid fear & fatigue

184 healthcare workers associated with RML Hospital have tested Covid positive so far. Meanwhile, overworked doctors point out their casual leaves have been cancelled.

File image of Ram Manohar Lohia Hospital in New Delhi | Twitter | @ANI

New Delhi: Delhi resident Raghuvir Singh had something of an ordeal last month when he tried to get his 15-year-old daughter admitted to Ram Manohar Lohia (RML) Hospital after she complained of chest pain and breathing problems. 

The teenager had tested positive for coronavirus three weeks earlier, on 6 June, but Singh said doctors at the hospital prescribed some medicines and asked the family of three to go into home quarantine.

“We came to RML after visiting Hindu Rao Hospital and GTB Hospital. We had been referred to RML from there (GTB),” he told ThePrint. The family was finally forced to take the teenager back to GTB, where she was admitted and subsequently recovered.

Singh is not alone in facing a hard time at RML, a central government hospital that, according to its spokesperson, was the first in the country to start screening people coming back from abroad, and the first in the capital to start Covid-19 treatment in March.  

A severe staff crunch has left the hospital struggling, by its own admission, as it seeks to attend to both Covid and non-Covid patients.

Minakshi Bhardwaj, the medical superintendent of the hospital, said the facility is in dire need of doctors. Despite launching a search for doctors, they are struggling to draw a positive response, she added.

“We have 72 positions for senior resident doctors open and despite advertising only 10 walked in for an interview,” she said.

Stretched hospital, tired doctors

RML hospital has 162 dedicated beds for Covid-19 patients, including ICU facilities, with the rest of its 1,200 beds set aside for non-Covid patients. Additionally, the hospital has 85 beds for suspected Covid and severe acute respiratory infection (SARI) patients.

It has 953 doctors and 1,195 nurses, of whom 183 doctors and 246 nurses have been assigned Covid duty on a rotational basis. The hospital, authorities said, needs 1,061 doctors and 1,523 nurses to run at full capacity, but is currently short by 108 doctors and 328 nurses.

Speaking about the lacklustre response to its job ads, medical superintendent Bhardwaj blamed the “fear of catching Covid-19”. 

So far, 184 healthcare workers have tested positive and three have died.

The fear has also taken a toll on contractual staff serving such roles as security. Speaking to ThePrint, a guard said he had caught Covid-19 and recovered. While he decided to report back to work after recovery, he claimed many of his colleagues had gone back home in light of the pandemic. 

“After recovering, I decided to come back on duty instead of going back to my village. Every day, we hear about some or the other guard testing positive. We can’t help it, our work is such,” he added.

Bhardwaj corroborated this account. “We are facing a shortage of contractual staff. Most of them don’t want to work here fearing Covid,” she said.

For doctors, the staff crunch has manifested in tiredness, and complaints of being overworked abound. “The first pool of residents is on their second or third rotational duty in the Covid wards. Many doctors who got infected also came back to work in the Covid ward after recovery,” said a resident doctor.

Doctors say their shifts are officially eight hours long, but often stretch longer. Those on Covid duty work for 14 days and are sent into quarantine for the next 14.

All casual leaves for doctors, the aforementioned doctor said, have been cancelled and no one has taken leave over the past three to four months. “It is mentally and physically exhausting,” she added.  

The existing batch of resident doctors, she said, is eagerly waiting for the latest pool of junior residents to join the team later this month so that the workload comes down.

Turning back patients 

The shortage of staff is just one of the challenges for the hospital as it battles a pandemic that shows no signs of receding. Often, doctors say, they are forced to turn back patients because they don’t have vacant beds.

“We conduct 300-400 tests a day. We have a high number of Covid patients coming to the hospital but, due to the limited number of beds, we refer them to other dedicated Covid hospitals like AIIMS and Safdarjung,” said a hospital spokesperson. 

New patients, the spokesperson added, are only accepted when a patient is discharged.

The resident doctor quoted above said the hospital was “running at full capacity”. “Before Covid, patients were able to share beds during emergencies, but owing to the pandemic patients cannot share beds. Under ministry guidelines, if our beds are full, we have to transfer Covid patients to designated Covid hospitals.” 

Non-Covid patients feel ignored

The staff crunch at the hospital is not being felt in the Covid ward alone. Patients arriving at the hospital for other ailments and reasons say they have trouble reaching doctors and getting help on time.

Shagufta Khan told ThePrint that she had to wait hours before her five-year-old nephew, who had a head injury and broken bones from an accident, was attended by doctors. “It’s been 12 hours and the doctors have only conducted a CT scan. No doctor has come for consultation so far,” she said last week.

Bablesh Kumar, a 23-year-old, was at the hospital for treatment of a spinal injury he sustained four years ago — the injury left him unable to walk or move his legs, and he has to undergo regular treatments for it. 

On 19 June, he was discharged from the hospital after a young girl in his ward tested positive for Covid-19. “I understand that the hospital has discharged my entire ward and asked us to quarantine for our safety… The doctors are overworked and troubled because of Covid 19, pending cases like ours do not see a solution.”

Explaining the daily struggles of the job, a resident doctor said, “We have not started elective surgeries but we are still taking cases in emergency and OPD… Previously, we had only one block dedicated to Covid but now we have increased it to three blocks due to the large influx of patients.” 

Medical superintendent Bhardwaj said the hospital is tending to 2,500-3,000 non-Covid cases per day. “While these numbers are low compared to non-Covid months, during the lockdown, the number of patients had come down to as low as 300-350,” she added. “Keeping that and the pandemic in mind, this is a big number.”