Lack of regulations to employ skilled nurses in hospitals leads to preventable deaths
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Intensive care unit is one of the most important departments in any hospital, where patients are admitted in the most vulnerable time in their entire life, and even the meanest of error contribute its own part towards singificant morbidity or death some where down the line. For a person who is unaware of these implications, its difficult to correlate and find an association between the cause(error) and effect( morbidity or death or increased cost etc).
It is an undeniable fact that most of the crimes, errors and negligences are grossly under reported in our country due to various reasons, hence its difficult to find any preventable mishaps inside a hospital, caused by untrained nurses, because usually these things are not reported, there are no known unbiased channels to report.
Except very few exceptionally good and dedicated hospitals, most of the private hospitals employ fresh passed out nurses in ICU for the many reasons
1. Fresh passed out nurses are available for a very cheap salary
2. They are lured into getting 'experience certificate' from the 'Intensive Care Department' so that they can ask for a better salary while applying for the next job
3. They can be easily fired at the earliest sign of trouble
4. The preventable nursing errors and the ill effects caused to the patients are not displayed to the public or any quality indicator audits- so there is no risk to the reputation of the hospital
Though these unsafe practises cant be changed over night, we need to start the change somewhere.
Undeniably, ICU and Emergency Departments are not the places where Human resource departments enact their business strategies, to maximise the profits, to cut corners, by just saving few thousands more that an experienced nurse might deserve. The importance of patient safety, though well maintained on the paper works, is entirely different in reality.
Currently we are fortunate to have NABH( National Accreditation Board for Hospitals) an independent body to ascertain the quality of hospitals across the country, and NABH can bring about an immense and rapid change just by revising their policy.
Hence I request you to urge the NABH directors to make it mandatory for all the hospitals to
1. Employ only nurses with atleast 3 years of clinical experience in Intensive Care Units and High Dependency Units, after proper skills assessment
2. Atleast 50% of nurses in Emergency departments should have atleast 3 years of experience
3. Every Hospital should display their quality indicators on their website
4. NABH should make it mandatory for all hospitals to obtain Nursing Excellence Certificate, atleast for critical departments like ICU, Emergency Department, Operation Theatres, Post operative wards.
Though these things in no way give patient safety assurance, atleast we shall urge the policy makers to begin some where and the next step shall be to make it mandatory for all hospitals to get 'Nursing Excellence Certificate', an added accreditation provided by NABH.
Lets not forget the 'unpublished/ under reported fact' that unskilled and unregulated nursing leads to preventable errors, preventable deaths which are easy to hide. Lets do justice to our profession.
Thank NABH in advance for making this important change, which would save lots of lives in our country.
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