Interim Guideline for Technicians and Nurses on patient management

Posted on: August 22nd, 2013      Author: tshewang

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Ref: MoH/BMHC/09/2013/  497                                                                                                                                                                                            August 9th, 2013       


Sub: Interim Guideline for Technicians and Nurses on patient management


Considering the important roles that the medical technicians and nurses play in patient management in different health centres in the country and also to facilitate service to the patients, Bhutan Medical and Health Council is pleased to issue the following Interim guidelines for nurses and technicians in patient management. This is issued as per the decision of the 12th Executive Committee meeting of the Council held on 1st August 2013;


Guideline for Technicians

  1. They are permitted to examine, diagnose and treat patients within their knowledge and expertise in their own area of specialty only. (Eg-ENT technicians to deal with ENT patients, Ophthalmology technicians to manage only ophthalmology patients, etc.)
  2. They should refer all patients to the specialist if they are not confident of the diagnosis or management protocols;
  3. They shall not be allowed to manage general OPD patients in other specialities;
  4. Technicians shall not be put on first call emergency duties;
  5. Patients referred to the specialist from other health centres should not be attended by technicians;


Guideline for nursing professionals

  1. Provide emergency management to admitted patients whenever necessary;
  2. Attend and provide treatment to any emergency patients coming to the ward at night;
  3. Inform the on call doctor after initial management of patients;
  4. Follow instructions of the doctors accordingly;
  5. Permitted to prescribe medicines and provide treatment as per the guidelines and protocols issued by different programs of the ministry of health.


This guideline is provided as an interim measures till the Council draws up proper Scope of practice for nurses and technicians;

All concerned are directed to follow the guidelines with immediate effect.






Medical Director, JDWNRH

All Superintendents

All CMOs

All DHOs

Nursing Superintendent, JDWNRH

Head of Departments, EYE, ENT, Orthopaedic, Physiotherapy, Anaesthesiology, JDWNRH



  1. PS to Honourable Lyonpo,MoH, President of BMHC for appraisal
  2. Secretary, MoH, Vice-president, BMHC for kind information
  3. DG,DoPH, MoH for kind information
  4. DG, DMS,MoH for kind information
  5. CHRO, MoH for kind information
  6. Office Copy