ICU Crisis Threatens Healthcare Services in Bhutan

In a stark challenge to Bhutan’s healthcare infrastructure, the Intensive Care Units (ICUs) at major hospitals, including the Jigme Dorji Wangchuck National Referral Hospital in Thimphu, are grappling with severe staff shortages that threaten patient care quality.

The departure of the sole ICU specialist at Jigme Dorji Wangchuck National Referral Hospital due to extraordinary leave has exacerbated an already precarious situation. Currently, the ICU is managed by a team of regular doctors, attached medical doctors, and volunteers, with hopes pinned on a competent female doctor to fill the intensivist role. Despite these efforts, concerns linger over the unit’s operational efficiency and service standards in the absence of adequate staffing.

“The shortage of ICU staff is a significant challenge,” acknowledged Pema Dorji, the ICU in-charge at the national referral hospital. “Our nurses are compelled to work extra shifts due to the shortfall. Ideally, we should maintain a 1:1 nurse-to-patient ratio according to international standards, but currently, we manage with ratios of 1:2 or 1:3.”

The situation is mirrored at regional referral hospitals in Gelephu and Mongar, where resignations have crippled ICU operations. Gelephu, originally equipped with a capacity for 10 ICU beds, now utilizes only five due to resource constraints. Mongar faces similar challenges, managing with significantly reduced nursing staff and lacking dedicated ICU doctors.

The attrition of healthcare professionals, as highlighted in the Ministry of Health’s 2023 Attrition Report, reveals an average annual attrition rate of 4 percent since 2018. Bhutan currently faces shortages of 69 specialists, 103 doctors, and 824 nurses, severely impacting healthcare delivery across the country.

Low salaries compared to international standards emerge as a primary reason for the mass exodus of healthcare professionals. “Our salaries do not compete with those offered to expatriate doctors,” lamented a doctor from a district hospital, emphasizing the financial disparities that drive many to seek opportunities abroad.

Nurses, too, cite low pay, heavy workloads, and inadequate training as key factors influencing their decisions to leave. The demanding nature of their work, often without appropriate compensation for additional duties, further exacerbates dissatisfaction among healthcare providers.

As Bhutan struggles to retain and attract healthcare professionals, the Ministry of Health faces mounting pressure to address systemic challenges. Initiatives to enhance salaries, improve working conditions, and expand training opportunities are urgently needed to bolster the resilience of the healthcare system.

With the crisis in ICU staffing casting a long shadow over healthcare services, stakeholders must collaborate to implement sustainable solutions that safeguard patient care and support the dedicated healthcare workforce of Bhutan.

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