NCRHA denies ‘chronic nurse shortage’ at Mt Hope hospital

- File photo/Angelo Marcelle

The North Central Regional Health Authority (NCRHA) says “unexpected absenteeism” is the only reason wards at the Eric Williams Medical Science Complex (EWMSC) in Mt Hope were left with one registered nurse (RN) on the weekend.

The TT Registered Nurses Association, in a social media post on November 2, alleged there was "severe staff shortage” at the EWMSC.

It added this was a “chronic” issue facing the EWMSC, and was being made worse by a reduction and restriction of the extra duty pool by NCRHA management.

It said a hiring freeze coupled with the redirecting of all new hiring through the central government campaign was also contributing to the problem.

TTRNA warned nurses to not work alone and advised them to go to the nursing manager’s office and await a second RN to be assigned to their ward before starting work.

It emphasised three RNs should be assigned per ward and added while two RNs were “by no means” adequate to provide safe nursing care, that was the minimum it was willing to accept.

The association added nurses should not move from their ward if management tries to reassign them from a ward that only has two nurses.

In a defiant response, the NCRHA, in a media release, described the TTRNA’s allegations that a staffing issue existed as “reckless, inaccurate and misleading,” but admitted there was a staff shortage on November 1.

“On that date, four wards operated with one registered nurse each instead of two, due solely to unexpected absenteeism.”

NCRHA said all other wards at the hospital maintained a “satisfactory” nurse-to-patient ratio.

It did not provide the ratio but said it was “fully consistent with the authority’s established operational and clinical standards.”

In another social media post on November 3, the TTRNA responded to the NCRHA release, saying the authority "admits that nurses were forced to work alone, but does not see how patient care of safety could have been comprised because of this."

It said the NCRHA "finds no issue with one nurse to 24 patients."

While international standards vary depending on the type of ward and the country, hospitals in Singapore, Australia, the US and the UK cite a ratio of one nurse to four or five patients as acceptable with a 1:8 ratio the absolute safe minimum.

Studies published on the US National Library of Medicine’s website noted staffing ratios in low/middle-income countries (LMICs) might be as low as one nurse caring for over 25 patients.

Other studies warned however inadequate staffing ratios lead to higher rates of in-hospital deaths, infections, falls, missed care, and adverse events.

NCRHA, though, said it was “false, irresponsible, and unacceptable” to suggest that patient care or safety was in any way compromised and added the delivery of safe, professional, and compassionate care remains its highest priority.

“Patients and their families can have full confidence that every NCRHA institution continues to provide high-quality, efficient, and cost-effective health care, delivered by teams of committed doctors, nurses, and support staff who work diligently every day in service of the nation.”

Former education minister Dr Tim Gopeesingh was appointed NCRHA chairman in August to lead a new board of directors.

The authority said under the new board it “has intensified its efforts to strengthen service delivery, enhance staff support, and improve patient outcomes across all facilities.”

With all 893 nursing positions filled, it said recruitment efforts were also increased but vacancies remain after an insufficient number of suitable candidates were found.

“The authority has advertised 345 vacancies for enrolled nursing assistants to further support frontline nursing services. However, despite this proactive effort, only 34 qualified applicants were successfully interviewed and are now being appointed to their respective positions.”

The authority added it “stands ready to continue engaging constructively with all stakeholders, including the TTRNA, in the shared mission of strengthening the national health system and safeguarding the highest standards of patient care.”

Calls to both Gopeesingh and TTRNA president Idi Stuart went unanswered.

Stuart posted to social media on November 3 that he was at Mt Hope "to see the great staffing levels at EWMSC."