The department of Anesthesiology at Mongar Regional Referral Hospital (MRRH) not only provides the Anesthesia service, but also looks after Intensive Care Unit and Pain Management Service. It also provide education and research in the field of Anesthesiology in order to improve and provide the highest quality of patient care in accordance with the country’s developing philosophy of Gross National Happiness.
Deliver state of the art Anesthesia services in perioperative care, pain and critical care.
We are dedicated to providing state-of-the art patient care in the areas of preoperative evaluation, intra-operative anesthesia, post-operative care, Intensive care Unit and pain management.
Our Values
To achieve our mission and vision, we will focus on the following pillars of the specialty

  1. Healing: We will deliver the highest quality of perioperative clinical care in the ORs, ICUs and clinics
  2. Caring: We will foster an environment that values professionalism, compassion, teamwork and collaboration. We will emphasize quality, patient safety and continuous performance improvement.
    Currently MRRH does not have a full time anesthesiologist. However, the department is manned by four competent Nurse Anesthetics who looks after all care related to anesthesia
    Currently there is no dermatology unit at MRRH. The cases are managed by medical specialist.
    Dental Department
    The department is the largest in the east. The department consists of 2 dental chairs, x-ray facilities and OPG (Ortho Pentono Gram). Currently the department is manned by 1 oral surgeon, 2 dental surgeons, 3 dental hygienists and 8 dental technicians. Beside routine services, the department also provides comprehensive school health program and dental clinics.
    Different types of services provided are temporary crowning, removable ortho- appliances, root canaling and oral surgeries based on the diagnosis.

Emergency Medicine
Emergency Department was established in the year 2008 after shifting to the new building. Due to acute shortage of clinical staff the unit was not well established. However, the department is gradually expanding both in terms of capacity and the type of services provided over the last few years. At present it occupies a part of the building on the zero level next to diagnostic block, emergency pharmacy department attached. The emergency department is manned by GDMOs, Nurses and support staffs. The number of doctors working in the emergency department depends on the availability of doctors. They work on shift system. At present it has the capacity of 10 beds including 3 for critical patients. Additional beds are added whenever necessary.
Laboratory facilities, ultrasonography and X-ray are accessible 24 hours a day through the emergency department. Emergency department has a minor operation theater for emergency procedures. Monitors and other emergency medical equipment are available in the department. The ambulance services are also managed by the department in co-ordination with the Emergency Medical officer and EMT technician.

Types of Services provided in the Emergency Department.
Emergencies of all nature are first seen in the emergency department. All the patients are triaged on admission (prioritization of patients according to condition of the patients) and serious patients are assessed first. All necessary investigation and management are done and if required respective specialist on call are consulted. In short, it is a multidisciplinary approach to the management of the patients.
Emergency department also provides OPD services from 3 PM till 9AM seven days a week.
Some of the most common diseases that are seen emergencies are:
Acute abdomenal pain.
Peptic Ulcer, Appendicitis and Cholecystities.
Road Traffic Accidents (RTA), Assaults and fall injuries.
ARI including pneumonia
Pregnancy related complications like APH (acute perture hamoerrage) and PIH (pregnancy induced hypertension)
Heart related conditions like IHD (ishaemic heart disease) CCF (congestive cardiac failure) and AMI (acute myocardial infarction)
Acute poisoning both accidental and intentional
Seizure disorders including febrile convulsion in children
Diabetic and hypertensive emergencies
Otolaryngology (ENT)
Currently Mongar Regional Referral Hospital does not have an ENT specialist. The department is manned by 3 ENT technicians who attend to the emergencies. The
Technicians also carry out school health program and other community health activities.

Forensic Medicine
The Forensic Medicine Department in MRRH is manned by a staff nurse who is trained in basic forensic medicines from JDWNRH and is assisted by GDMO whenever necessary. The services are provided as and when necessary and there is no full time staff in taking care of the unit. In Clinical Forensic Medicine, the unit provides medico-legal services to victims of interpersonal violence, sexual violence, and domestic violence as well as work related and road traffic accidents. It is also mandated to provide medical age estimation services to people with unknown or uncertain ages. The unit is also mandated to investigate unnatural deaths in collaboration with Royal Bhutan Police.

General Outpatient

All out patients are seen in the Out Patient Unit (chamber 11) located in the level zero. Every day, specialists provide the service except on surgery days. Patients come from Mongar and other districts as formally or self-referred cases. Facilities in Out Patient Unit include:
• Outpatient CTG
• Colposcopy Service:
Outpatient Colposcopy service is located in the Community Health Department, but provided by the Gynecologists from the Department of Obs & Gye. The OPD unit is supported by Health Assistants working in the RHU.

General OPD is mostly manned by Medical Officers. The Medical officers also managed the evening and night OPD from 3pm to 9am. The following tasks are carried out in the general outpatient department:

  1. To manage the general patients who attend the General OPD and pediatrics OPD of the hospital.
  2. To refer patients to appropriate special OPDs.
  3. Attend to any other duties like VVIP duties and sports duties

The working hours
Time Working Period
9 am to 3 pm Week days
3pm to 9 am Evenings/Night
9 am to 9 pm Sundays and holidays

Gynecology /Obstetrics
The Department provides a wide range of service including primary, secondary and tertiary level obstetric and gynecological services.

To provide women and their babies with excellent care in a friendly environment that promotes best practice.

Being in the Regional Referral Hospital in Bhutan we aim to:
• Provide curative, pro-motive and preventive women’s healthcare service
• Provide range of sub-specialties service in Obs & Gyne to serve as tertiary referral center for women’s health care service in the east.

To provide women and their babies with excellent care in a friendly environment that promotes best practice.
Being in the Regional Referral Hospital in Bhutan we aim to:
• Provide curative, pro-motive and preventive women’s healthcare service
• Provide range of sub-specialties service in Obs & Gyne to serve as tertiary referral center for women’s health care service in the east.

The Birthing center
The birthing center is located in Level I. It has two delivery beds for women to deliver ensuring full privacy and comfort. Since the operation room is converted into delivery room the room does not have attached toilets. The room is fitted with ceiling mounted adjustable lights with accessories like CTG monitor, vital monitor, baby resuscitation set and cupboard with all necessary consumables. Other facilities in the birthing unit include: nursing duty station, staff change room and 3 bedded postnatal room. There are 12 full time nurses providing midwifery care to the mothers. They cover 3 shifts in turns. They are wonderful nursing staff with full dedication and commitment for giving human services.

The Department of Medicine is manned by single medical specialist. The department provides emergency care, inpatient care, outpatient care, Intensive care and specialized care for patients requiring services such as Cardiology, Nephrology, Gastroenterology, Nephrology and Diabetic clinics. Apart from the patients in Medical wards the department is also responsible for providing consultations to various medical consultations to patients admitted in other ward such as Surgery, Orthopedics and Obstetrics and Gynecology ward. The MRRH do not have special department for all medical conditions, thus, all medical cases are managed by one medical specialist. The department is in patient services, outpatient services emergency services, ECG and Echocardiography. A nurse is currently undergoing training on Echocardiography. Beside routine medical consultation, the department also manages all dialysis patients 24 X 7. The Department also manages the diabetes clinics with one nurse attached permanently
Ophthalmology Services

The Orthopedic Unit of MRRH is the apex orthopedic referral center in the east. The department is manned by 1 orthopedic surgeon and 1 orthopedic technician. The department is understaffed at present.
Responsibilities and Functions

  1. Inpatient care services – daily ward rounds
  2. Outpatient Clinic, – 6 days a week.
  3. Routine Operations, – 2 days a week (Tuesdays and Thursdays).
  4. Emergency services, – 24 hours a day.
    Our main services include:
  5. Orthopedic trauma management services, especially fracture care.
  6. Bone and joint infection treatment.
  7. Management of soft tissue injury of the extremities.
  8. Pediatric orthopedic services.
    Elective/corrective orthopedic services managed by the Orthopedic Unit currently include:
  9. Fracture care, both acute and late presenting.
  10. Infections of the bone and joints – acute and chronic, including tuberculosis.
  11. Surgical problems of the spine, including sciatica, trauma and infections.
  12. Bone tumors, both benign and malignant.
  13. Arthritis, tendonitis, generalized aches of major joints – e.g. Hip and knee.
  14. Specific wound management problems, especially burns on the extremities.
  15. Musculoskeletal problems specific to children.
  16. Sports injuries.
  17. Hand injuries.


The essence of pediatrics is to give service to those most deserving of a good life, with the deepest need, and the greatest vulnerability. The department of pediatrics at MRRH celebrates the work that we do every day to provide excellent clinical care to children below the age of twelve. We have 18 inpatient beds in the department including 1 in the Intensive care unit. We also run the general pediatric OPD from Monday to Saturday and provide 24/7 inpatient and emergency services here at the hospital. In addition, we provide consultative services to all categories of health care workers all around the country on a 24/7 basis. We also provide technical guidance to various public health programs of the Ministry of Health. The department has only one pediatrician to run the whole hospital.

The Nursing philosophy resides in managing and giving the highest degree of quality, comprehensive patient and family centered care to the patient to maintain or regain the highest level of wellness and accentuates on the spiritual, physical and emotional needs of a patient rather than only critical care.
The nursing profession, comprising of different category of nurses and constitutes the largest working group in the health care settings. Apart from being a highly responsible and noble profession, this profession demands a lot of time, dedication, patience, sacrifice, love and care for the sick patients
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 professional nursing practice encompasses the nurse, the patient (individual/person), other health care providers, health/well-being/illness, or dying, and the environment of care. 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.
• To provide an environment conducive to healing through the consistent application of the nursing process
• To provide the necessary human, material, financial, and educational resources for optimal patient care
• To provide the highest level of health care utilizing multidisciplinary collaborative approaches which foster maximal patient outcomes
• To assess and improve key functions of the Nursing Department through an ongoing quality improvement program
• To provide patient education using multidisciplinary collaborative approaches which improve outcomes by facilitating patient/family knowledge, encouraging participation in decision making, maximizing care skills and increasing coping abilities
List of nursing staff and the departments
Pharmacy Services
The pharmacy department is responsible for dispensing medications daily for an average population of 250 patients. The department consists of Pharmacist as well as technical and support personnel, who work together, to assure that patients receive the highest quality care possible. The pharmaceutical services are provided from 9 am till 8 pm. At present the department has two Pharmacist and seven pharmacy technicians.
The overall mission of the Pharmacy department is to serve society as profession responsible for appropriate use of medications, devices and services to achieve optimal therapeutic outcome with high quality patient care in an environment of professionalism, respect and effective communication.
The Department of Pharmacy will provide optimal patient care and improve patient outcomes to
Meet or exceed customer expectations. Employees will work together to create an exceptional work environment.
To fulfill above mission, the department has following board objectives:

  1. To provide best patient care services.
  2. To promote rational prescribing and use of medicines.
  3. To ensure all the vitals, essential medicines and medical devices are available throughout the year.
  4. To provide drug information to all the patients and the health personnel.
    Service provide
    Patient Care
    Patient care is the most important responsibility of the department. In line with the Good Dispensing Practices, the technicians provide patient counseling, and ensure that appropriate medicines are prescribed and dispensed appropriately so that patient can get maximum benefit with minimal side effects. This department involves all discipline to provide a functional and accurate method of medication administration, proper storage, packaging, labeling, distribution, disposition, and record keeping of medication, in compliance with the Medicines Act of the Kingdom of Bhutan 2003.
    Drug Information
    The Pharmacist and pharmacy technicians endeavor to provide support for the physicians, nurses, and other departments of the hospital in matters regarding medications, and serve as a resource of drug information to those who prescribe, administer and consume medications.
    Pharmaceutical Management
    The department is responsible for ensuring that all the vital and essential medicines and medical devices are available throughout the year. Further the department supervises the overall use of medicines in the ward and the outpatient.
    Adverse Drug reaction (ADR) monitoring
    The World Health Organization defines Adverse Drug Reaction (ADR) as a reaction to drug, which is noxious and unintended, and which occurs at doses normally used in man for the prophylaxis, diagnosis, or therapy of disease, or for the modification of physiological function. ADR reporting/monitoring is important for post-marketing drug safety surveillance. Pharmacy OPD is identified as Eastern Regional Pharmacovigilance Centre and we do report Adverse drug reaction via VigiFlow, World Health Organization web based to Centre Pharmacovigilance I,e. Drug Regulatory Authority of Bhutan. All the patients can report either to the Prescriber or Pharmacy department if encounter with adverse events. Department do Sensitize patients and healthcare Professional on Adverse Drug reaction and its reporting.
    Promoting Rational Use of Drugs:
    The department is involved in promoting rational use of medicines mostly through educative means.
    The department also conducts prescription survey every day and submits to EMTD at the end of every month.
    OPD Registration
    OPD registration opens at 8.45 AM on all working days and closes by 2.45 PM. Patient has to report to the registration counter and should inform the receptionist about their sickness and which specialties that they want to consult. Based on the patient’s problem the receptionist will issue the OPD card along with registration number. Old cases and new cases are register separately and are directed to visit respective specialists.
    Information counter/ Help desk: the hospital in the process of establishing a help desk where patients and attendants can get information about the doctors, and other services.
    Indoor services
    All indoor facilities are housed in the buildings. The indoor facilities include General In-patient ward in all specialties, Private cabins, Intensive care units (Adults/NICU), Dialysis unit, Indoor physiotherapy and Operation rooms.
    Admission and Discharge of patients in the wards are based on the recommendation of the treating doctors. In patients are provided daily evaluation by the treating specialist, Round the clock nursing services, medicines, dietary advice based on energy consumption and daily calorie requirement and Physiotherapy. Three meals, including seasonal fruits, morning and evening tea are provided every day, special diet are provided for patients who need them as per the advice of the dieticians.
    Patient attendant: Only one attendant is allowed per patient, however if patient is serious and needs more attendant, additional one attendant are allowed on the recommendation of the ward in-charge.
    On admission all patients /attendants are required to read and sign on the admission rules and regulations. Visitors will be allowed during the visiting hours only.
    Private Cabins: Not functional
    Visiting hours
    Appreciating the deep impact that visitors, such as the parents, children, relatives, friends and well-wishers, have on the healing process we have the policy of allowing visitors into the Wards. However, unregulated flow of visitors can seriously hamper not only the provision of services but deny the patients time to relax and recover.
    The security guard appointed by MOH regulates the visitor flow into the Wards in coordination with the nursing in-charges. The visiting hours are as follows:
    Morning…………………………..06.30 AM to 07:30 AM
    Afternoon……………………….. 12.00 PM to 01.00 PM
    Evening…………………………. 05.00 PM to 07.00 PM
    Policy on Personal Belongings
    Patients and visitors are responsible for all their own personal belongings and valuables. MRRH does not accept responsibility for the loss of any personal items, including but not limited to cash, jewelries, clothing, spectacles, dentures, hearing aids, mobile phones, or other personal articles, on our premises. To avoid property loss, we recommend patients to bring only essential items to the hospital, such as a list of medications that they are taking, and simple toiletries. Patient / party will be accountable for any loss or damage to the hospital property. Staff or hospital will not be responsible for any loss or damage of the patient’s belongings or any valuables.

General Administration
Hospital administration comprises of Medical Superintendent, Administrative Officer, Nursing services department, Finance, Technical services departments, ICT, Medical Record Unit, and Maintenance.