Threats to staff safety impact health services

Hubballi: Throughout the day the public announcement system at the Karnataka Medical College and Research Institute (KMCRI) in Hubballi puts out reminders that misbehaving with doctors and medical staff on duty warrants three years of imprisonment and a penalty. Yet, paramedical staff working at the critical care unit, lab technicians, and radiologists say that there is rarely a day that they do not encounter the wrath of patients and attendees.

Being one of the medical lifelines of north Karnataka, the tertiary hospital at Hubballi receives nearly 200 to 250 critical care patients daily. Chaos is a very mild term to describe the situation when an emergency case is brought to the critical care unit, as there are limited beds and human resources. The hospital sees several cases of accidents, poisoning, snake bites and burns.

“We have limited hands and a high inflow of patients to the unit. We attend to the patients depending on the severity of the case. Tending to their relatives and attendants is more challenging,” says Gauramma, one of the permanent nursing staff deputed at the trauma centre. She has put in 28 years of service at the KMCRI. 

“Of late, the situation has worsened. Not a single day passes by without abuse and ridicule being directed to medical staff by patients and their relatives. There have been instances where relatives have assaulted the paramedics,” she says.

For a 2,404-bed hospital, there are only 572 nurses, out of which 191 are permanent, 76 are hired on an ad-hoc basis and 287 are contract workers. Paramedics working at the facility point to apathy of successive governments, which have failed to upgrade facilities and strengthen the availability of human resources.

Take, for example, the X-ray unit at the in-patient department of KMCRI. The 24x7 operating unit, which requires at least five staff for each eight-hour shift, has only two or three per shift. “Even with all the precautionary gear, an X-ray operator can only be exposed to radiation 30 times a day. However, here we attend to between 70 and 90 patients daily,” says Robert Antony, an X-ray imaging officer with two decades of work experience. He says the number of people visiting the hospital has increased by four times in the past ten years, and yet, the human resources at the department have not increased substantially.

Another issue troubling paramedical staff is ‘VIP culture’, where patients often come with a recommendation letter from a political leader. “Any delay in treatment or even in providing wheelchairs means the relatives threaten us with a call to a politician,” says another paramedic staff at the diagnostic lab.

The institute has been investing in new technology to ensure better care for patients. “However, there are not many technically well-versed staff to handle the equipment. The majority of them are hired on a contract basis, and after completing the minimum days of training, they leave for better opportunities in private hospitals. Not all staff get training to operate the machines. This results in the breaking down of the equipment,” says a CT scan operator at the institute.

Eshwar Hasbi, medical superintendent of KMCRI, says unless the public mends their ways, it is difficult for the medical fraternity to provide quality treatment, as expected from a government institute.

“Deploying additional security personnel at the hospital is not the solution. The public has to behave. They have to understand that keeping the premises clean and safe is also their responsibility,” says Hasbi.