Patients lying on the floor at the Emergency-Outpatient area, Friday June 24. Photo by Irwin Angiki
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NRH floor-bed problem continues


Patients lying on the floor of the Emergency-Outpatient of National Referral Hospital (NRH) will be an ongoing sight for a long time to come.

This sad reality with our National Referral Hospital (NRH) is caused by a number of factors, which the hospital’s management and the ministry of health (MHMS) currently cannot fix.

Sick patients often find themselves having to spend few days and nights on the floor of the EOD corridors, waiting to be admitted to a ward or be seen by a doctor.

Some patients tell Island Sun over the weekend they have been lying on the floor of EOD for a week, others two to three nights.

For years, sick people seeking help have died along the corridors of the emergency-outpatient department, senior doctors at NRH tell Island Sun.

“I must admit that there are cases over the years where we missed and they died lying along the corridors of the outpatient and outside,” an EOD doctor tells Island Sun on condition of anonymity.

“There are cases who sleep at the corridors, only to be noted they are very sick when they are gasping for their last breath,” the doctor added.

MHMS when sought for comments, referred the paper to their June 14 press statement on overcrowding at NRH, in which the ministry blamed the problem on patient caregivers, which it says has increased following the lifting of covid-19 restrictions.

But, a senior doctor in NRH’s administration, also speaking to the paper on condition of anonymity, disagrees.

“The ministry is diverting attention to blame the people when the factors influencing the problem lie elsewhere, and are issues which MHMS and government do not have funding or the will to pursue their realisation.

“The hospital is in dire need of expansion. But, expansion itself will not solve the problem, as it will eventually catch up after NRH is expanded.

“MHMS should implement policies to help to reduce Non-communicable diseases (NCD).

“NCD now tops the list of admission. The majority of people in admission are NCD patients

“MHMS should decentralise the point of care. Guadalcanal province needs a hospital itself. Honiara City needs a hospital or clinic that runs 24/7.

“All main provincial hospitals need specialist doctors to be posted with support services such as Lab, x-rays etc.

“We need to improve all the points of care, health centres in all the provinces to cater the demand of health services.”

Supporting services at the NRH are vital to how fast the hospital provides medical care to patients, and they also need improving, the EOD doctor says.

“Our paramedics must work 24/7 to help us at the outpatient to make decisions to discharge or to keep or admit.

“For example, a person presented at 8pm with Fever. We want to test for malaria and dengue, we collect the blood samples but have to wait for the next day for the lab to process them.

“The same goes for ultrasounds and X-rays. We have to keep patients overnight just to do those the next day. In the end, we have an overcrowded emergency and outpatient area.

“If those supporting services run 24/7, the service at the emergency and outpatient (EOD) should be flowing and hence reduce the overcrowding.”

The doctor of NRH admin tells Island Sun that another important matter is that of the hospital’s autonomy.

“Hospital needs some autonomy.

“A lot of problems at NRH can be solved easily, but are hindered by protocols and channels established by the system.

“The management level of NRH is powerless to bring about the needed changes to improve services. The ministry, which is basically a third party to these issues, has the power.

“CEO, MS do not have any power to execute decisions because they themselves are powerless.”

Another issue which contributes to overcrowding at the EOD corridor is what is called ‘bed blocking’ at the wards.

A ward doctor tells Island Sun:

“NRH is facing bed block every day. So, most times all patients supposed to be admitted in the wards are kept at the Emergency ward, resulting in over-crowding at the EOD.

“This issue won’t be solved until when we expand the hospital, by increasing the beds in the wards. Right now, there is no space in the wards, hence no more beds can be added.”

Meanwhile, the MHMS press statement on June 14 in response to overcrowding at the hospital states:

“Following lifting of COVID-19 restrictions the NRH has noticed the sudden increase in the number of care givers which has causing inconveniences for doctors and nurses when doing ward round and clinical rounds.

“Therefore, the NRH is advising the public in Honiara to limit the number of family members and relatives coming to the hospital including the number of visitors at a given time.

“According to the last bed census, out of 200 patients, the number of relatives doubled by 400.

“Currently the NRH is on stand down and fully back to normal business with no COVID-19 patients.

“However, this does not mean people can now come in numbers to the hospital.

Given these developments, the hospital will be undertaken certain measures to control this flow and public must accept if they are being turned back from entering the hospital of the wards,” the MHMS statement said.