The neonatal intensive care unit (NICU) at the government-run Vani Vilas Hospital that handles extremely premature babies and babies with congenital birth defect — which require round-the-clock care — has a severe shortage of nurses.
The 45-bed unit is manned by 22 nurses, working in three shifts, whereas each shift requires 22 nurses to maintain the standard ratio of 1:2. Currently, the ratio of nurses to children is a whopping 1:7, which paediatricians point out is a situation that can affect critical care.
“Such a ratio is unheard of anywhere else,” acknowledged R. Premalatha, head of paediatrics, Vani Vilas Hospital. “Many a time, two nurses are absent ... so there will be just five taking care of 45 beds,” she added.
Dr. Premalatha added that the process for appointment of nurses to Vani Vilas Hospital had been going on for the past six months. At present 22 nurses, most working on contract, work in three shifts at the hospital.
“For cases where ventilator support is required, there should be one nurse to each bed to monitor the newborn,” said Raghuramaiah K.N., consultant paediatrician, Jayanagar General Hospital. A 2010 study by the Postgraduate Institute of Medical Education and Research, Chandigarh, published in the Nursing and Midwifery Research Journal, concluded that one nurse can provide nursing care to maximum two ventilated neonates and one nurse can provide nursing care to three non-ventilated neonates, in an NICU set up in a hospital like PGIMER.
Other child care government-run hospitals fare better, though they fall short of the internationally accepted nurse patient ratio in NICUs of 1:1. Naveen Benkappa, medical superintendent, Indira Gandhi Institute of Child Health, Bengaluru, said, “Since 1:1 ratio may be difficult to achieve in India, at least 1:2 is recommended. Having a ratio higher than 1:4 definitely compromises care.”
The IGICH and the K.C. General Hospital have a ratio of 1:3 while the 15-bed NICU At Bowring and Lady Curzon Hospital has a nurse-patient ration of 1: 2.15.