EVEN before the drama over the death of a pregnant nurse on February 4 started, the All India Institute of Medical Sciences (AIIMS) had been witnessing a silent tussle between two important wings — nurses and resident doctors. While battlelines are now clearly drawn between the two sides over the suspension of five resident doctors accused of negligence, the two wings have been at loggerheads for the last six months over another issue — who will draw blood samples of patients. The issue cropped up in August last year, when the Resident Doctors’ Association (RDA) unilaterally decided that no resident doctor would draw blood samples. Sources confirmed that the proposal was given a green signal by the medical superintendent. However, the nurses’ union opposed the decision and the resident doctors went back to drawing the samples. The RDA argued that drawing blood samples has resulted in “increased work load” and “decreased time, which should be spent on developing skills for good patient management”. Sources said it is not just the drawing of blood but a contentious “bar code” clause that led to the tussle. After blood is drawn, and once doctors request the various tests to be conducted by the laboratory, a bar code is generated. An order entry is filled online and the bar code is used as the reference number. “The AIIMS resident doctors’ manual mentions that the blood sampling will be done by them. Our work is only to provide the vial. The nurses are also responsible for labelling. After computerisation, they want us to fill the order entry which generates the bar code. If we miss an entry or enter the column twice, we are accountable for the lapses. It is not our job to generate the bar codes,” a source in the nurses’ union said. Meanwhile, an RDA official said the tussle is not with the nurses’ union and that the administration should appoint phlebotomists (people trained to draw blood) and data entry operators. “Doctors have lot more duties and concerns while working in the wards and should be free from such clerical work, so they can provide better patient care and management. Residency is all about attaining skills but unfortunately it is mostly spent in drawing blood samples,” the RDA said it its letter to the medical superintendent. “AIIMS has made a compulsory rule to use computers to generate barcodes, write consultations and see reports of patients. They have provided systems but have not assigned anyone to do this computer-based work. Work that initially required only a few minutes now takes hours. We hope you kindly employ trained data entry operators for managing the labelling,” the letter said.
