JENSEN LA VENDE

Se­nior Re­porter

jensen.lavende@guardian.co.tt

The cur­rent nurse-to-pa­tient ra­tio of one nurse to as many as six pa­tients at the St James Med­ical Com­plex is in keep­ing with in­ter­na­tion­al best prac­tice and will be en­forced by nurs­ing staff as part of in­dus­tri­al ac­tion from next week.

Dur­ing a Face­book Live on Tues­day, Trinidad and To­ba­go Na­tion­al Nurs­ing As­so­ci­a­tion (TTNNA) pres­i­dent Idi Stu­art called on nurs­es not to care for more than six pa­tients at a time. He said the mea­sure will take ef­fect from April 28, co­in­cid­ing with the Gov­ern­ment’s first an­niver­sary.

“On April 28, the one-year an­niver­sary of the cur­rent Gov­ern­ment, we are go­ing to en­sure it is ac­ti­vat­ed. We want to make sure every­one is cog­nisant of all the re­quire­ments at hand, and we are go­ing to pub­lish the ra­tios,” Stu­art said.

He not­ed that the ra­tio ap­plies to hos­pi­tals, as there is no es­tab­lished in­ter­na­tion­al bench­mark for health cen­tres and dis­trict health vis­i­tors.

Doc­tors at the St James Med­ical Com­plex yes­ter­day told Guardian Me­dia that there are typ­i­cal­ly six to sev­en nurs­es on du­ty dai­ly, with a max­i­mum pa­tient ca­pac­i­ty of ap­prox­i­mate­ly 28.

Stu­art added that based on his in­for­ma­tion, on­ly St James cur­rent­ly op­er­ates at such a ra­tio, while oth­er in­sti­tu­tions make do with lim­it­ed re­sources.

Os­ei Daniel, who spoke with Guardian Me­dia at St James af­ter his son was trans­ferred from the Port-of-Spain Gen­er­al Hos­pi­tal (PoS­GH), re­ferred to the lat­ter in­sti­tu­tion as “Port of Pain.” He said he no­ticed a sig­nif­i­cant dif­fer­ence in care be­tween the two in­sti­tu­tions.

“It re­al chaot­ic in Port-of-Spain (Gen­er­al Hos­pi­tal). Very chaot­ic. Com­pared to my ex­pe­ri­ence in St James, it is much calmer. St James is much bet­ter. In Port-of-Spain, there are no beds, peo­ple in the cor­ri­dors. It is frus­trat­ing just be­ing there,” he said.

Daniel called on the Gov­ern­ment to “han­dle” the nurs­es, adding that he was sur­prised to learn they are not paid over­time rates, un­like oth­er cat­e­gories of work­ers.

While Daniel praised con­di­tions at St James, an­oth­er pa­tient who spent three nights at the PoS­GH de­scribed her ex­pe­ri­ence as large­ly pos­i­tive, though not with­out room for im­prove­ment.

The woman, who asked not to be iden­ti­fied, said she ob­served a ra­tio of ap­prox­i­mate­ly one nurse to six pa­tients. She sug­gest­ed that cus­tomer ser­vice train­ing could fur­ther im­prove pa­tient care.

“There could be a lit­tle more train­ing, but if there is a lot of frus­tra­tion with­in the or­gan­i­sa­tion, that al­so needs to be ad­dressed for staff to func­tion ef­fec­tive­ly. Over­all, I was well tak­en care of,” she said.

Stu­art warned that any se­nior nurse or nurs­ing man­ag­er who at­tempts to com­pel sub­or­di­nates to care for more than six pa­tients will be is­sued a pre-ac­tion pro­to­col let­ter. He al­so ad­vised nurs­ing man­agers to ob­tain writ­ten di­rec­tives from their su­pe­ri­ors if in­struct­ed to ex­ceed the ra­tio.

He ac­knowl­edged that while nurs­es are typ­i­cal­ly trained to care for four pa­tients, the pro­posed ra­tio rep­re­sents a com­pro­mise.

“Nurs­es will find it very dif­fi­cult, giv­en the na­ture of the pro­fes­sion, to strict­ly ad­here to the in­ter­na­tion­al­ly ac­cept­ed bench­marks. We know this is best prac­tice and the on­ly way to en­sure qual­i­ty pa­tient care, but nurs­es are in­her­ent­ly dri­ven to pro­vide to­tal care and may strug­gle to im­ple­ment lim­its,” he said.

“We want to en­sure that pa­tients who have suf­fered over the years do not con­tin­ue to suf­fer be­cause of in­ad­e­quate nurs­ing num­bers.”

Calls to chair­men of the North Cen­tral and North West Re­gion­al Health Au­thor­i­ties, Dr Tim Gopeesingh and Ma­jor An­tho­ny Blake, re­spec­tive­ly, went unan­swered.

When con­tact­ed, South West Re­gion­al Health Au­thor­i­ty chair­man Anil Go­sine ad­vised that Health Min­is­ter Lack­ram Bo­doe be con­tact­ed. Calls and mes­sages sent to Bo­doe since Tues­day re­gard­ing the pro­posed ac­tion have gone unan­swered.

Al­so con­tact­ed, To­ba­go House of As­sem­bly Health Sec­re­tary Dr Faith Breb­nor said the planned ac­tion will not af­fect To­ba­go, as fa­cil­i­ties there al­ready op­er­ate with­in in­ter­na­tion­al stan­dards.

“The ac­tions tak­en by the TTNNA do not ap­ply to To­ba­go, as these are in re­sponse to con­di­tions iden­ti­fied specif­i­cal­ly in Trinidad. Cur­rent­ly, the TRHA av­er­ages a nurse-to-pa­tient ra­tio of 1:5 to 1:7, and we con­tin­ue to re­cruit nurs­es to main­tain prop­er work­ing stan­dards,” she said in a What­sApp re­sponse.