From the Desk of Editor

Joydeep Das Gupta, PGPM ( 1994), PGHRM, DRTM, DHA, Trained Hospital admin AIIMS 2000 & TQM( 2001) Six Sigma Green Belt 2009. Member – Tech Committee AHPI Delhi.

Author of Book - Hospital administration 2009 , Ex HR & AO UCMS Medical College, Ex CAO KPC Medical college, Project Co-ordinator Regional Cancer Institute of India under NEC Shillong & DAE Mumbai, Head HR & Operation YASHODA Hospital & COO-Medius Group, Ex Chief Director –Allen Medical Inc.

Nurses’s safety while on duty
My tribute to Nurse Aruna R. Shanbaug (1 June 1948 – 18 May 2015)
“42 years Suffering of Nurse Aruna Ramchandra Shanbaug still not streamline safety of Nursing staff while on duty”.

In 1973, while working as a junior nurse at King Edward Memorial Hospital, Parel, Mumbai, Shanbaug was sexually assaulted by a ward boy, Sohanlal Bhartha Walmiki, and remained in a vegetative state for 42 years following the assault Whether we can confirm that each and every nursing station having sufficient security coverage for Nurses on duty. Performance can only be better if nursing staff posted in diffident nursing station under streamlined security coverage.

It is found in most of the healthcare units that due to sudden decrease of patient flow sometime so happen that one Male Patient monitor by one Female Nurse. Such situation occurred any time but Question is what safety parameter established in each units.

If you refer the importance of Nursing administration as mention below hope I can make you all understand how nursing dept is important compare to other dept.

    • Role of Nursing

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      The nursing wing is responsible for providing comprehensive and continuing nursing care to the patients in collaboration with numbers of the other health's care services. Good nursing care is the result of ideal coordination between administrative and clinical planning. The nursing service administration unit is responsible for establishing and maintaining standards and for supervising the work of the nursing care personnel.

      Nursing service provides safe, effective and well planned nursing care for patient as a result of the development of nursing as a science; it has become a highly complex function that demands much training and skill. This department has constant contract with patients and naturally it requires the coordination of all other services for best patient care. Control and coordination will be possible only when there is proper organizational structure and adequate supervision. Activities to be perform led and personnel needed must be grouped in such a way as to achieve smooth functioning lines of authority should be clearly marked and above all everyone should know for what, to whom and for whom the nurse in responsible.

      Since one of the objectives of good nursing service is to provide nursing care economically and safely to utilize each worker at her maximum degree of skill, it is important that provision to be made for in-service training for all categories of personnel. An in-service training program for all employees should serve three purposes:-
      1. Introduction of the new worker to the hospital and the department which she/he is assigned.
      2. On the job training for specific activities she/he has to perform at any given time.
      3. Continuing development for improved services and for greater responsibility according to the worker's interests and potentialities.

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      Maintenance of Records in the Wards

      Medical records and reports are an important means of controlling the nursing service. The ward sister in controlling the nursing service and she is usually responsible for the following types of record maintenance:-

      1. Records relating to the care and treatment of patients.

      a. Admission record.
      b. Discharge summary.
      c. History and physical examination.
      d. Labor record.
      e. Consultation record.
      f. Laboratory and X-ray master sheet.
      g. Anesthesia record.
      h. Operation record.
      i. Progress record.
      j. Doctors order.
      k. Nurses record.
      l. Intake and output record.
      m. TPR charts.
      n. Admission and discharge order, etc.

      2. Maintenance of stock books

      a. Drugs.
      b. Tablets.
      c. Injections.
      d. Linen.
      e. Diet.
      f. Stationery.
      g. Instruments.
      h. Furniture.
      i. Crockery and glassware, etc.

      3. Hospital administrative records

      a. Census report (Admission and discharge register).
      b. Paying wards records.
      c. Permission for surgical operation.
      d. Notification of seriously ill patients.
      e. Emergency operations.
      f. Deaths and discharges.
      g. Medico legal case.
      4. Ward maintenance register
      a. Ward maintenance.
      b. Sanitary.
      c. Pantry.
      d. Equipment, etc.
      5. Attendance registers of working staff in the ward.
      6. Nurse treatment register (day and night report of the condition of patient).

      Equipment for mortuary services in major disasters:-

        • Stainless steel postmortem tables or heavy duty trestle tables covered with plastic sheeting.
        • Wheeled trolleys for transporting bodies within the mortuary.
        • Tarpaulin or plastic sheeting for the floor, if it is not made of concrete.
        • Heavy-duty black plastic sheeting for temporary screens.
        • Refuse bins and bags.
        • Cleaning materials – mops, buckets, cloths, soap, towels.
        • Disinfectant and deodorizer.
        • Protective clothing and heavy-duty rubber gloves.
        • Translucent plastic body bags 0.1 mm thick and labels (if epidemic circumstances).
        • Wall charts to record progress or large poster boards if there are no walls.
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      Intensive Care

      The intensive care unit is for patients in acute stage of illness who are unable to communicate their needs. They require continuous observation and extensive nursing care with personnel specially trained for the job. The aim is to first support life in a crisis, prevent threat to life, and then to eliminate the cause of dysfunction by specialized treatment and extensive nursing care. Therefore, the unit is equipped with life saving equipment, and all necessary life-saving drugs and supplies are immediately available.

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      Intermediate Care

      The intermediate care unit is for patients who are moderately ill including patients transferred from intensive care unit who require moderate amount of nursing care. A large proportion of all hospital patients will be directly admitted to this unit.

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      Self Care

      The self care unit is for those patients who, after the acute phases of illness is over, become ambulant during the period of convalescence, or are admitted for diagnostic procedures and are able to look after themselves. Nursing care required for this category of patients will be minimal.

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      Long-term Care

      The long-term care unit is for patients requiring prolonged nursing care and services not normally available at home, including adjustment to disabilities by physical and rehabilitation therapy.

      The basic of progressive patient care system is the amount and type of nursing care required and the degree of dependence of the patient on others. The design of the nursing unit and facilities to be provided differ from intensive care through intermediate, self and long-term care units. However, it is debatable whether the system results in economy in bed utilization because, if each section is capable of taking only patients of a particular category, bed utilization would get adversely affected due to fluctuations in demand in each category. In conclusion, I bring to your kind notice that without streamlined security system for each and every nursing station we can not expect best performance from nursing team member. Above role & responsibility clearly depict that how nursing team member is important for functioning of hospital service.