HT Spotlight: Chaotic and unhygienic, GMCH-32 in dire need of attention
There’s an urgent need to improve doctor-patients ratio here; critically sick patients can be seen lying outside the toilets in stinking conditionspunjab Updated: Mar 17, 2018 11:38 IST
The condition of the Emergency at the Government Medical College and Hospital (GMCH), Sector 32, is “bad” according to the chairperson, emergency services, and “very bad” according to medical superintendent. Yet, nothing much is being done to improve its condition.
A visit to the emergency of GMCH-32 — city’s tertiary care hospital — reveals that it is one of the most disorganised, unhygienic and chaotic hospital when compared to other government hospitals.
Since its inception in 1996-97, the number of beds have remained the same. 12 in medicine, 7 in surgery, 6 in orthopaedics, 21 in gynaecology, 14 in paediatrics means mere 60 beds.
With only 60 beds in the Emergency, GMCH-32 caters to patients from Chandigarh, Punjab, Haryana, Himachal Pradesh and other states. At any given point, there are at least 350 patients admitted in the emergency, yet the administration has not improved the infrastructure.
20 resident doctors for more than 300 patients
Further, there are hardly four resident doctors. One senior resident and two-three junior resident doctors in each department. It means, there are roughly 20 resident doctors to look after over 300 patients in the emergency.
Consultants are on call during the night and during the day time, they only pay visits.
“On Thursday, 350 patients were examined at the emergency, out of which 50 were medico-legal cases. During epidemic, the number increases to 500 also,” said Dr Harish Dasari, chairperson, Emergency services, GMCH-32.
In 2017, over 1.33 lakh patients were examined at the Emergency, out of which over 99,000 were new, over 36,000 were revisits and over 18,000 were medico-legal cases.
The hospital’s emergency does not have a triage system. There is only one emergency medical officer at the entrance whose main focus is to deal with medico-legal cases and she refers all other patients to different departments after a quick examination.
Ideally, there should be a triage system, wherein a doctor assess patients’ severity of injury or illness within a short time, assign priorities, and transfer each patient to the appropriate place for treatment.
“The triage system has not come up yet. We set up triage during disaster situations like at the time of Ram Rahim verdict and other such incidents,” said Dr Dasari.
All at sea here
Enter the Emergency and you will find patients lying everywhere on trolleys, not neatly organised, though. There is no place for attendants to sit, they are either sitting on the floor or spend the day by standing next to a trolley.
Enter ward number 21, medicine emergency and it’s all chaotic here. Trolleys are placed in a haphazard manner, one patient is lying in one corner and another one is on the other side. There is no symmetry, when compared with Hall A of Post Graduate Institute of Medical Education and Research (PGIMER), which has less space, more trolleys but is far better organised.
Inside ward number 21, there is an Intensive Care Unit (ICU) just next to gents’ toilet and the area stinks. Not only this, critically sick patients can be seen lying outside the toilets in stinking conditions.
Similar is the situation in other wards. The hygiene is quite poor in the emergency; you can see rats running around and the floors are filthy.
The Emergency was constructed for a particular number of patients but the patient load has increased manifold. This is leading to delay in treatment, sub-optimal treatment and chances of error increases.
Harrowing time for patients, kin
Sher Singh, husband of Karamjeet from Hallomajra, said, “My wife is diabetic and after she developed some complication in her foot. We rushed her to GMCH-32. The doctors cut her thumb on February 21. Then after five to six days, they cut her foot. This week they said there is a need to cut her leg.”
Afraid, he took her wife to PGIMER emergency. “I brought her to PGIMER. There doctors said that so far there is no need to cut her leg. They will conduct ultrasound and decide the course of treatment. There they conducted no tests,” said Sher Singh. “The condition is quite bad in GMCH-32 Emergency. They could not even control my wife’s rising blood sugar levels, which PGI doctors controlled in a day. I will never visit that hospital,” he said.
Deshraj Saini, a labourer in a steel factory from Jagadhri, is having a tough time at the Emergency. He brought his 23-year-old son, a TB patient, here on Thursday evening but no one is looking after him. “Last evening, doctors saw his X-ray and prescribed medicine but there is no relief from pain. Since morning, no doctor has examined him and he is writhing in pain. I do not know what to do.”
Being a TB patient, he wasn’t kept in a separate ward but with other critically ill patients.
Karan, son of Shammi Devi, shares, “I have to make 10-15 rounds and then a nurse or doctor examines my mother. The patient care is quite bad here.”
But there are some who are satisfied with the treatment. Jaswinder Kaur, wife of Sapinder Singh, said, “I brought my husband to the Emergency three days ago and he is being looked after by the doctors. Since morning, one doctor and nurse has seen him.”
Two other attendants voiced satisfaction with the treatment provided inside the Emergency.
‘May give session to docs, nurses on how to behave with patients’
Dr Ravi Gupta, medical superitendent, GMCH-32, said, “At any given point of time one or two complaints are registered with the hospital administration by the patients or their attendants against the staff. Last week, three complaints were registered. The common complaint is that either the treatment is delayed or improper treatment was given. We investigate every complaint and majority of times they are incorrect.”
“We may start orientation session for doctors and nurses wherein they are informed how to behave with patients and their attendants. Ideally, Medical Council of India (MCI) should introduce some non-medical subjects to improve communication skills of the doctors,” he said.
Medical superintendent on:
Overcrowding is a major problem. The Emergency was constructed for a particular number of patients but the patient load has increased manifold. This is leading to delay in treatment, sub-optimal treatment and chances of error increases. The solution is that the other state governments should have same level of health care so that at least routine cases are not send to city hospitals.
Emergency medical officer is a generalist, who sends all the patients to different departments — surgery, medicine, orthopaedics, where the residents of respective specialities are managing patients. Many a times, a patient referred by EMO can be treated by EMO itself, in this way there would be less pressure on the departments. The solution is the development of department of emergency medicine, with round-the-clock availability of residents of emergency medical officer who will stabilise or treat many patients and send them back from entrance itself.