KUALA LUMPUR, Nov 21 — Ranau Hospital will receive more medical officers (MOs), said the Sabah state health department (JKNS), following complaints from doctors about working 48 to 72 hours continuously during on-call.
In a letter to CodeBlue last Monday, an MO at Ranau Hospital wrote that the district hospital, located at the foot of Mount Kinabalu, was severely short-staffed with only 10 MOs running the entire hospital, following recent transfers and multiple no-shows among doctors posted there.
Initially, Ranau Hospital operated with approximately 20 MOs that the doctor said was just sufficient to cover four inpatient wards (male, female, paediatrics, and obstetrics & gynaecology); the outpatient department; the operation theatre (emergency cases – Emergency LSCS); the forensics department; and the emergency department.
“As a result, our on-call system has deteriorated into an unsustainable and unsafe pattern. Instead of the already exhausting EOD (every other day) calls, we are now routinely doing back-to-back on-calls, remaining on duty for 48 to 72 hours continuously, followed by only about 15 hours of rest before resuming another 48- to 72-hour call.
“This workload is beyond any safe or reasonable limit,” said the MO, who requested anonymity.
In response to the doctor’s letter to CodeBlue, JKNS said it has verified the staffing constraints, adding that Ranau Hospital currently has 13 MOs, with a temporary reduction expected due to scheduled movements.
“The Ministry of Health (MOH) acknowledges that this has placed pressure on several service areas,” said JKNS in a statement to CodeBlue on Tuesday.
JKNS added that over the last week, it mobilised five MOs to assist Ranau Hospital. In addition, six newly appointed contract MOs are scheduled to report for duty next Monday. Ranau Hospital has been earmarked as one of the priority placements.
“Duty rosters are being realigned to safeguard staff wellbeing,” said JKNS.
“MOH does not permit prolonged continuous working hours. JKNS has been instructed to reorganise duty rosters and optimise workload distribution to ensure compliance with safe working hour practices.”
The anonymous MO who wrote to CodeBlue said the extreme on-call hours of two to three days’ length were compromising patient safety.
“Staff health is deteriorating. Several colleagues have fallen ill due to exhaustion; one is currently admitted with pneumonia but had continued working previously because there were simply not enough officers to cover the shifts. Some of us have gone over six weeks without a single off day, including weekends,” said the doctor.
“Our outpatient clinic services have also been severely affected. At present, we are unable to operate the clinic because our limited manpower cannot be further redistributed to staff it safely.
“Consequently, patients are being diverted to the emergency department, where we must simultaneously attend to unstable cases while tracing and updating specialists for stable patients who should have been seen in the clinic. Many other patients are left without proper access to care, having to reschedule their appointments on a daily basis in hopes of being accommodated.”
JKNS said in response that Ranau Hospital’s outpatient workflow is being adjusted.
“Due to the staffing limitations, the hospital had implemented internal patient quota measures. With recent manpower mobilisation and upcoming postings, outpatient scheduling and patient flow are being reorganised to improve access and reduce congestion at the emergency department.”
According to JKNS, a new hospital director has been appointed at Ranau Hospital to “enhance coordination, communication, and day-to-day management”.
“MOH’s medical development division will continue to provide oversight and support during this period,” it said. “Patient care and staff wellbeing remain MOH’s priority.”
