Jesse Ramdeo

Se­nior Re­porter

jesse.ramdeo@cnc3.co.tt

Trinidad and To­ba­go Reg­is­tered Nurs­es As­so­ci­a­tion (TTR­NA) pres­i­dent Idi Stu­art has de­fend­ed his de­ci­sion to raise alarm pub­licly about what he de­scribes as a wor­ry­ing nurs­ing short­age at the Er­ic Williams Med­ical Sci­ences Com­plex (EWM­SC) in Mt Hope, in­sist­ing the sit­u­a­tion has reached cri­sis lev­els and is af­fect­ing pa­tient care.

In a state­ment post­ed to the as­so­ci­a­tion's Face­book page on Sat­ur­day, Stu­art said giv­en the sit­u­a­tion, the pub­lic is ad­vised to seek treat­ment for them­selves or rel­a­tives else­where.

"Mul­ti­ple wards have none or on­ly one nurse on du­ty. No con­tin­gency plan in place. No alert lev­el post­ed to in­form pub­lic of the emer­gency sit­u­a­tion. Un­safe ra­tios through­out en­tire hos­pi­tal. Most wards - 17 to 20 pa­tients to 1 RN. Oth­er wards - No staff.

"Se­nior man­age­ment are asleep at home and mak­ing no pro­vi­sion to ad­dress the is­sue and mit­i­gate the life and death sit­u­a­tion for crit­i­cal pa­tients of the in­sti­tu­tion. If you have rel­a­tives there, get them trans­ferred to an­oth­er in­sti­tu­tion AS­AP."

Speak­ing with Guardian Me­dia yes­ter­day, Stu­art said it was re­port­ed to him that nurs­es on du­ty in the last sev­er­al days were not be­ing re­lieved in a time­ly man­ner, un­der­scor­ing a broad­er is­sue plagu­ing the North Cen­tral Re­gion­al Health Au­thor­i­ty (NCRHA).

"One, there has been a dis­con­ti­nu­ity of hir­ings by NCRHA. In fact, a dis­con­tin­u­a­tion of hir­ings across the board by a num­ber of RHAs. They were say­ing they need par­tic­u­lar ap­provals, and they are wait­ing on a par­tic­u­lar gov­ern­ment di­rec­tive to re­in­state hir­ings," he said.

"So, that was one. So, on­ly the hir­ings that were al­ready in train were com­plet­ed, but new hir­ings were placed on hold. Sec­ond­ly, be­cause NCRHA was so short of staff and par­tic­u­lar­ly Er­ic Williams Med­ical Com­plex, which is one of the largest in­sti­tu­tions, health in­sti­tu­tions, they used to re­ly on nurs­ing per­son­nel com­ing from oth­er in­sti­tu­tions to work full, which is re­al­ly ex­tra du­ty, to sup­ple­ment their short­age of staff and I want to re­it­er­ate, NCRHA is one of the worst in terms of staffing com­ple­ments."

Stu­art’s com­ments fol­lowed crit­i­cism from NCRHA chair­man Dr Tim Gopeesingh, who sug­gest­ed he could have re­quest­ed a meet­ing in­stead of air­ing con­cerns on­line.

"He should fa­mil­iarise him­self with what is go­ing on in­side him be­fore open­ing his mouth and writ­ing ir­reg­u­lar non­sense on so­cial me­dia. I think it is un­for­giv­able for him to cre­ate that hys­te­ria in the nurs­ing pro­fes­sion," Gopeesingh said.

Gopeesingh main­tained that ef­forts were made to pre­vent any dis­rup­tions due to the staffing is­sues flagged by Stu­art.

"There were 72 nurs­es ros­tered and 14 en­rolled nurs­ing as­sis­tants and 12 nurs­es did not turn up and three ENAs did not turn up and we made arrange­ments from the pool of nurs­ing per­son­nel to cov­er those pa­tients. So, to in­di­cate to not send your fam­i­lies to EWM­SC is gross­ly ir­re­spons­bile and un­wise."

But Stu­art ar­gued that it is not best prac­tice to ap­proach the chair­man di­rect­ly in­stead of the CEO, a po­si­tion cur­rent­ly va­cant, adding that the ur­gency of the sit­u­a­tion re­quired pub­lic in­ter­ven­tion.

"There's no CEO in place. They would have let go of the pre­vi­ous CEO, Davlin Thomas, and they have an in­ter­im CEO who would deal with the day-to-day run­ning. I re­al­ly don't ex­pect the chair­man of NCRHA to be get­ting in­to the day-to-day man­age­ment of the in­sti­tu­tion be­cause that would pose a sig­nif­i­cant chal­lenge for work­ers and al­so the as­so­ci­a­tion by deal­ing with the chair­man and the board of di­rec­tors. That is re­al­ly a no-no. The board of di­rec­tors are not sup­posed to get in­to the day-to-day run­ning of an or­gan­i­sa­tion. For that, we would want to tread very care­ful­ly be­cause if there's is­sues that need to be ad­dressed with se­nior man­age­ment, who we be­lieve are fail­ing with­in the NCRHA, we have to car­ry those is­sues to the board."

Ac­cord­ing to Stu­art, chron­ic un­der-staffing at the EWM­SC has se­vere­ly strained op­er­a­tions and com­pro­mised pa­tient care.

“On av­er­age, a ward would re­quire 20 to 24 nurs­es to op­er­ate on a dai­ly ba­sis over a pe­ri­od of a month,” he ex­plained.

“How­ev­er, NCRHA, when you watch their ros­ters, they have some­thing like eight to 10 nurs­es—less than half.”

He claimed the au­thor­i­ty had been forced to re­ly heav­i­ly on part-time ex­ter­nal nurs­es to sup­ple­ment the short­fall, but a hir­ing freeze and sub­se­quent re­fusal to ac­cept ex­ter­nal staff deep­ened the cri­sis.

“Pa­tients are pay­ing the ul­ti­mate price,” Stu­art warned. “We have pa­tients dy­ing as we speak that ought not to be dy­ing if they had enough nurs­ing per­son­nel tak­ing care of these pa­tients.”

He added that the pub­lic on­ly be­comes alarmed when deaths oc­cur, prompt­ing calls for ex­ter­nal re­views.

“We can­not con­tin­ue in this vein,” he stressed.

Gopeesingh, how­ev­er, launched a sharp coun­ter­at­tack on Stu­art, ac­cus­ing him of fail­ing to dri­ve im­prove­ments in nurs­ing out­put.

“Mr Stu­art has to tell us what he has been do­ing to get more nurs­es trained in the sys­tem to get nurs­es pass­ing their ex­ams,” he said.

“He has been sit­ting on his hands do­ing ab­solute­ly noth­ing and talk­ing.”

The NCRHA head in­sist­ed his door re­mains open.

“My phone has been open to the gen­er­al pop­u­la­tion of Trinidad and To­ba­go ever since. Every­body knows my tele­phone,” he as­sert­ed.