KARACHI, May 4: First year students of Civil Hospital Karachi’s (CHK) Nursing School are forced to do night duties, often without the supervision of a staff nurse, soon after their induction. Besides being in gross violation of the Pakistan Nursing Council’s (PNC) rules, this practice puts patients’ lives at risk.
The CHK daily caters to about 3,000 to 4,000 patients in the out-patient department, apart from 800 to 1,000 patients in the emergency section.
But despite being a prime healthcare provider in the public sector, the hospital lacks basic facilities and has been facing a severe shortage of staff for over a decade, as there is a ban on recruitments.
Though there are 262 nurses for the hospital on paper, many have gone on casual and maternity leave, while others have left for training and post-graduate studies. The nurse-to-patient ratio is as high as 1:50 at the hospital.
To bridge this huge gap, trainee nurses are asked to do night duties. Resultantly, the ultimate sufferers are the hapless patients, who have nowhere to report their grievances. It is reported that some first year students had to join night duty as early as the fourth month after joining the school.
“Not only this, we are called for night duties on public holidays. In fact, there are no fixed hours. We can even be called at midnight in a crisis-like situation to perform the duty for a staff nurse who, for some reason, has left early or hasn’t turned up. Night duties are also used as a means for punishment,” a student nurse said.
This practice violates the PNC rules, which clearly state that there should be no night duty in the first year of general nursing training. However, in the second, third and fourth years, students can work at night for only two months, and that too under the supervision of a senior staff/head nurse.
About the risks this practice poses to a patient’s life, a student said that once she gave a higher dose to a patient, which resulted in a sudden rise in his blood pressure.
A doctor had to be called to handle the situation. “Taking care of 50 patients’ lives at night, when you have no clue how to administer even an injection or how to give a specific dose, is too much too ask from us. The seniors are not around and at times we have to take the sweeper’s help for simple medical procedures. The doctors, on the other hand, embarrass us by questioning why we are here in the first place, if we don’t know the basics,” said another trainee.
|The students complained that they are hardly taught anything at the school, and that their entire four-year education depends upon their self-learning at the hospital. “The school lacks competent staff and often, trainee nurses have to perform duties in a specific ward to ask a doctor for a lecture,” they said.
Another major concern is the meagre stipend they receive. According to the PNC rules, the stipend of a student will be according to the revised basic pay scale of a staff nurse, in addition to the prescribed mess and uniform allowances. Going by this rule, the stipend of a trainee nurse should be at least Rs4,500, excluding the uniform allowance and mess charges. However, at CHK Nursing School, students get Rs1,500 as a stipend, and that too, often late.
“Our colleagues at Abbasi Shaheed Hospital and Jinnah Postgraduate Medical Centre Nursing Schools are getting around Rs3,000. But why are we discriminated against? Until last year, Rs500 were cut as mess charges from our stipend,” they observed.
Trainee nurses also complained about the conditions of their hostel and the food they are provided with. “After the girls stopped eating in protest over the quality of food, the administration decided to provide us with food from zakat funds, the same which is prepared for patients. This tasteless food is far better than the unhygienic fare, which often contained insects,” they claimed.
After a turbulent training period of four years, most of these students end up in private clinics and hospitals, due to the ban on recruitment. There have been no fresh appointments and promotion of nurses in the CHK for a long time.
However, Chief Nursing Superintendent, CHK, Nasreen Gill maintained that the school is providing the best facilities to its students. On the stipend issue, she said that an application is pending with the finance department, and as soon it gets approval, the stipend amount will be raised to Rs4,500.
