Patient care has to be paramount!

Jul 31, 2016 News

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By Sharmain Grainger

Most doctors and nurses enter their respective professions with the identical aim – making patients better. There are of course those who seek to find out the various reasons for our expiration, such as those in the field of pathology. But we have precious few of our local medical professionals venturing into that area; moreover the majority are tasked with making us better.
But it seems that some of these professionals tasked with helping to improve our health have given new meaning to patient care.
Let’s take a closer look at the Georgetown Public Hospital Corporation (GPHC), Guyana’s premier health care facility.
In the past few weeks it has been featured in the media for reasons that have left me a bit confused. Based on rumoured reports, some of which have been substantiated by the hospital’s Chairman of the Board of Directors, Dr. Carl ‘Max’ Hanoman, there has been a breakdown of communication between doctors and nurses in some sections of the health facility.
This has reportedly resulted in some departments of the hospital being understaffed, and based on what I was told the Accident and Emergency Unit (A&E) is among the most affected.
Now this can never be a good thing, regardless of how it is examined.
The A&E Unit is usually the first stop when people in need of medical attention are rushed to the hospital. There is probably not a single day that that department isn’t overwhelmed.
I am not a medical professional by any stretch of the imagination, but I do believe that common sense would dictate that this department must always have a team of very capable nurses and doctors always ready to cater to the needs of patients. When such a department is deprived of sufficient staffers, that, in my humble opinion, is a recipe for disaster. There is no explaining that away.
Based on the utterances of Dr. Hanoman, the hospital has a shortage of in excess of 200 nurses. This, he informed, has resulted in nurses being shuffled around the hospital to meet nursing needs in other departments.
Because only some nurses are reportedly pressured, many of them absent themselves, further reducing the numbers available to aid in the delivery of health care.
But there is another aspect to this story.
There are allegations that were featured widely in the media that the Director of Nursing Services (a fancy name for Matron) of the hospital is opposed to having nurses of the hospital be dictated to by doctors. I am of the belief that if a doctor is on a particular ward, he or she automatically is the one with the superior authority.
This has essentially hampered attempts to have the hospital move forward with plans to have specialist training for nurses.
With specialist training, it is expected that nurses will dedicate their efforts to a particular department. The argument against this is that nurses should be able to function efficiently in any department should there be a major crisis situation.
Although he sees merit in both arguments, the Board Chairman has recognised that there is a dilemma. He disclosed to the media recently that many of the doctors of the institution have been complaining that they had dedicated many hours training nurses to function in their departments, only to have them moved to other areas, and the training process has to start all over again with new nurses.
The allegations that the Matron has been deliberately slighting the doctors by not favourably responding to their requests for nurses, are currently under investigation. There are reports that the Matron has even been defying the orders of the Chief Executive Officer (ag), Mr. Alan Johnson.
Moreover, it was recommended at the level of the Board that she be sent on administrative leave to facilitate a probe into the allegations.
But I have no major interest in how the hospital deals with its disciplinary measures, my interest, however, is whether this will lead to improved delivery of health care? Will the rift between nurses and doctors end?
The decision to send the Matron off, in fact truly brought to light the depth of the ‘unpleasantries’ between nurses and doctors at the GPHC.
A statement issued by the Guyana Nurses Association spoke of the decision to send the Matron home as a move to merely “appease the doctors.”
The nursing body pointed out too that “sometimes the knowledge displayed by our professional nurses supersedes that of the doctors. When doctors are in training or are employed, most of them are guided by the nurses; from setting an intravenous infusion and simple dressings, to making other pertinent decisions for patients.”
Moreover, the GNA has dared the doctors of the institution to spend time conducting the research to improve their clinical practice, and leave the nurses to do nursing management.
But the disclosures got even more damning when the GNA revealed that “if deaths in other departments are investigated, like those in the Maternity unit, it will shock the nation, as wrong diagnosis and poor management contribute to an alarming number of deaths. Nurses are aware.”
Now it makes no sense that nurses would be fully aware of such a troubling state of affairs and say nothing. Did they even think of reporting their concerns to the Medical Council or at least the CEO?
This suggests to the average layman that they care so little for patients that they would sit idly by and just let them die. As Minister of Public Health, Dr. George Norton, puts it, this speaks of “collusion”.
They are as much to be blamed as the doctors if in fact these disclosures are true.
Why must it take a Matron being sent on administrative leave for disclosures of unacceptable health care to be highlighted?
But I guess the nation can take solace in the fact that both the Minister of Health and the Board Chairman have respectively assured that they will do whatever it takes to fix the shortcomings at the GPHC.

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