Nursing in Bhutan had its beginning in the early 1960s. From basic nursing care and housekeeping roles, Bhutanese nurses have now occupied central place in nursing service, administration and management.

Nursing is a profession of discipline, patience, responsibility, punctuality, commitment and dedication. The job requires a lot of hard work, stamina, alertness of mind, adaptability to follow difficult time schedules, ability to think in crisis, good team spirit etc. Apart from possessing these qualities, the persons willing to take up this as profession, should be calm, pleasant, compassionate, understanding and should have the instinct to help and serve the needy people without getting sentimentally attached.

Purpose of the Nursing Department
The purpose of the Nursing department is to facilitate positive patient health outcomes through the provision of excellent evidenced based nursing care. This is best accomplished in an environment that supports the professional practice and leadership roles of the nurse and provides a caring focus for our patients, our community, our health team colleagues, and ourselves. Incorporated in these beliefs is our commitment to continued improvement and learning.
Philosophy of Nursing
We believe that caring is the core of nursing, is central to guiding nursing practice, and the essence of the nurse-patient relationship. We believe that culture and caring are universal and the most holistic means to conceptualize and understand people.
We believe that Nursing Care delivered at ERRH must be safe, evidenced-based, therapeutic, beneficial, meaningful, and satisfying, utilizing a team approach in partnership with the patient and family.
The provision of nursing care incorporates a holistic approach for the patient and family. The nursing process forms the framework for the implementation and evaluation of care within a collaborative practice model encompassing all health care disciplines.
To provide quality nursing care in collaboration with the community and other health care providers
Our goal is to make nursing profession a reality in providing excellent nursing care to all the clients.

Nursing Services and staff strength:

  1. Nursing Services:

Nursing Department comprises of the following wards and units which cater services ranging from specialized care to general nursing services. Some of the inpatient wards and units are housed together under one Incharge. There are 12 specialties including OT nursing, Dialysis and ER. Nurses also cater OPD nursing services in 13 OPD based units. 

* * MDR-TB ward does not have full time staff. We mobilize staff from a pool of wards/units staff whenever we have MDR-TB patients

There are currently 129 nurses comprising of 18 Clinical Nurses, 100 Staff Nurses and 11 Assistant Nurses working in dialysis, OT and different wards/units.

OPD staff strength:

There are currently 11 nurses, comprising of 2 CNs, 6 SNs and 3 Assistant Nurses working in different OPD based units including nursing administration.

Medical Escort services: Patient referral duty

The purpose of the medical escort is to reach the referred patients safely to higher CENTERS, performing all necessary interventions en-route to referred center. However, there is no separate pool of staff assigned for the purpose. They are assigned from indoor staff whenever we have patients for referral to higher centers. The medical escort can be a Physician, Nurse, or a Paramedic. It is usually the nurses who escort the patient when referred to higher centers but the makeup of the medical escort team and number may vary depending on patient condition and/or disability and the type of transport. 

We have guideline for Medical escort and we follow the same for smooth execution of the tasks.

Some DOs and DON’Ts of medical escort:

  1. Medical escort should know the details of the patient prior to the day/date of referral. He/she shall receive proper handing-taking of patient from the concerned unit staff from where patient is being referred on the day of the referral.
  2. Medical escort should come to the unit to take the patient and the concerned unit staff shall accompany the patient up to the ambulance station on the day of the referral.
  3. Medical escort should be in descent dress with white apron and ERR Hospital Medical Escort  name tag
  4. Contact Health Help Centre (112) for emergency transit if required. Example: one patient dies on the way and the other patient has to be transported to refer center. HHC’s assistance/directives could be sought during road block for transit.
  5. Medical escort must refrain from driving ambulance
  6. Medical escort should take the TRIP SHEET and other necessary equipment (including first aid box) from her/his unit/ward and proper handing-taking of the same should be done upon reaching the work station (unit I/C will inspect the same)
  7. Medical escorts shall always come back in ambulance. He/she shall not be allowed to proceed on any leave during the official escort period (unless it is an emergency situation**).

14. Emergency Medical Response team

EMR team comprises of the following category of staff and nurse is an integral part of any

Medical team

  1. 1 GDMO (whoever is on shift)
  2. 1 nurse from ER (on duty)
  3. 1 Emergency medical responder (EMR)
  4. *1 nurse from pre-identified unit

      * Nurse on duty in the pre-identified unit attend the emergency. Concerned unit I/C shall identify the replacement staff in the ward. Emergency Medical Response Team member roster is prepared for 1 week

15. OPD Screening Services:

 OPD screening service by nurses was started in 2019 mainly to ease the patient queing the OPD consultation chambers and provide easy access to general public who seek these Services, especially CHECKING BLOOD PRESSURE. We do not have full time nurse (permanent staff ) working in this unit.  We deploy two nurses from indoor unit  on rotation basis

Way forward

  1. Cabin services:
    Due to nursing HR shortage, cabin services could be made functional. Plan to make atleast few cabins (4-5) functional with deployment of new staff, if we get adequate staff

2. Separate staff for EYE/ENT and PED/NEONATE with separate incharge
At present all these specialties are housed under one IC with same staff due to some constraints namely HR shortage, structure limitation etc. This issue may ultimately be resolved when department of pediatric is shifted to new MCH

3. Full time staff in OPD screening

4. One stop services
OPD injection, dressing, ECG, minor OT in one station with 2 permanent staff