‘Painful to watch patients gasp for air’
"They groan and cry out just to get some oxygen. Most of them can do nothing but wait for a patient to get better and be released from the hospital, freeing up a bed. Watching the patients gasping and struggling to breathe is painful. Unfortunately, we can do nothing but watch them suffer."
This is how Dulal Hossain, a senior staff nurse at Rajshahi Medical College Hospital (RMCH), described the hospital's grim scenario. The quiver in his voice was evident over phone.
While Covid-19 patients keep surging, beds with oxygen supply are becoming scarce at RMCH, officials said.
Critical patients who are coming to the hospital with low oxygen saturation levels have no other option but to wait for an empty bed, they said.
Dulal, who has been stationed at the Covid-19 unit, detailed the situation when The Daily Star interviewed him on Monday afternoon.
"It hurts to see a Covid-19 patient waiting for a bed," Dulal said while sharing his experiences at the workstation in the unit's ward 29 and 30.
The wards where Dulal works have 48 beds. The hospital's entire Covid-19 unit was treating 291 patients till yesterday, 20 more than its bed capacity of 271.
The Covid-19 unit's 271 beds were supported by the hospital's central oxygen supply line. However, authorities could manage only 55 nasal cannulas to ensure high-flow oxygen, and 18 ventilators at RMCH's intensive care unit (ICU).
RMCH is one of the country's major hospitals, and the number of deaths and infected patients skyrocketed since May 24.
Yesterday, at least 12 patients died; seven of them were Covid-19 positive, and the rest were suspected of being infected, raising the death toll to 271, since May 24.
For the 48 beds at Dulal's wards, there are only 17 nasal cannulas.
"None of the nasal cannulas at his wards remain idle," he said. "Most patients come in critical condition, needing high-flow oxygen."
After getting his degrees from Bangladesh Nursing and Midwifery Council in 2011, Dulal served at different private hospitals, before becoming a government senior staff nurse at RMCH in 2016.
During a visit to the Covid-19 unit on Monday, this correspondent noticed many patients were put on oxygen using cylinders. Some of them and their attendants said patients suffer during the brief period when cylinders become empty and get swapped with new ones every two hours.
Dulal said most patients had to influence doctors, hospital officials and local government representatives to get a bed.
On Sunday, this correspondent saw a woman from Chapainawabganj gasping, sitting on a veranda near the Covid-19 unit. Her attendants said she was denied admission, as patients more critical than her were in plenty.
She was, however, admitted to the unit later that day, when journalists drew the hospital authority's attention.
Dulal has been serving Covid-19 patients since RMCH authority opened the Covid-19 unit in March last year.
"We could serve patients well in the beginning, when they came in low numbers," he said.
But the situation changed in the last week of May, when numbers started soaring.
"Initially, most patients were coming from only Chapainawabganj," he informed. "A week later, we started receiving patients from Godagari and Tanore upazilas of Rajshahi."
"Currently, patients from different areas of Rajshahi city are predominantly filling beds," Dulal said.
"Patients come with oxygen saturation level between 70 and 80 percent, and we have to work hard to treat them. Many don't feel better even with high-flow oxygen, so doctors send them to the ICU," he continued.
"The moment a patient is released after getting well, attendants of more than three patients continue to lobby for securing the bed for their patients. This competition is increasing daily," he shared.
Dulal said the best moments at his workstation is when he sees patients getting well. "It happens between 8:30am and 1:30pm, when specialised doctors go around the wards and release patients who they consider to have gotten better."
"When they get well and prepare to return home to join their family, we feel overjoyed," he said.
Dulal and his colleagues used to work for six hours at a stretch, wearing personal protective equipment (PPE), alternating among themselves every 15 days.
"It's difficult working for six hours in PPE, but we forget the trouble after observing patients suffering from breathing issues," he shared.
Dulal said the most troublesome job for him was returning home after a day's duty. "My fear is that I might spread the virus among my family. I've been living alone in a room at my home -- separated from family members -- for more than a year. How long can you remain away from your family?"
Dulal said initially, hospital authorities had arranged a hostel for nurses to spend two weeks after ending 15 days of work, but there is no such provision now.
"When I complete my duties, I take a bath before returning home. But the fear hangs over my head," he said.
Scenes from the Covid-19 wards haunt him sometimes. "I get nightmares," he added.
No measure was taken for the staff's mental health. They were not even given special training for dealing with Covid-19 patients.
"We learned everything during our duties. We feared our job before, but now, those fears have been buried under our responsibilities," Dulal said.
Contacted, RMCH Director Brig Gen Shamim Yazdani acknowledged the struggle to provide beds and oxygen.
They will add 32 more beds at the Covid-19 unit soon to overcome the mounting pressure, and have also stored some 450 oxygen cylinders for emergency situations, he informed.
He said they already started using the cylinders for 22 additional patients at the unit.
"Central oxygen is connected with beds only, but there are more patients than beds," the director said.
They would also hold discussions over staff's mental health, he added.