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Charo Volunteer Service

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Denki Lhamu


Chharo Volunteer Services
Handbook for Volunteers

January 2011
Sharing is Caring - Share your time and talents to care for others


Hospital volunteer services are a tradition in many countries. Volunteer services are of considerable importance and value to individual patients and hospital staff. Given Bhutan’s young development history there would have been no takers had such a volunteer service been initiated half a decade ago, but now with increasing number of educated house wives and retirees desiring to contribute towards society, the time is ripe for initiating this beneficial service.
Giant oaks from tiny acorns grow and the growth of Chharo, a fledgling volunteer service, will depend on the dedication and commitment of our volunteers. Chharo has great potential to grow to a well organized establishment providing invaluable and humane volunteer services not only to hospitals throughout Bhutan but could also provide out reach services for the needy in their homes.
We welcome you to the Chharo Volunteer Services family.
We are thankful for the commitment you have made by joining our team. Chharo Volunteer Services relies on the dedication of people like you to maintain high standards. We hope you will find your volunteer experience to be enjoyable and rewarding.
Please read this orientation manual carefully. It contains information that will assist you in carrying out your volunteer duties.
All volunteers work free of payment.

Mission of Chharo Volunteer Services (CVS)

Chharo Volunteer Services was initiated by four Thimphu based women, three of whom have nursing background.
The increasing patient load at the Jigmi Dorji National Referral Hospital (JDWNRH) with the ever increasing population of Thimphu city coupled with the chronic shortage of health staff is a dire situation. Frustrations of patients awaiting services and over worked under staffed medical professionals often result in undesirable clashes. Services offered by CVS to the JDWNRH can undoubtedly help to ease the situation. Volunteering to share the work load of the health staff will make the experience of patients visiting the hospital pleasant and satisfying while relieving burden on the health staff. CVS can show by example the need for community members to take active interest and pride in supporting to make our own hospitals better.

The mission of Charo Volunteer Services is to provide excellent support services for health care delivery and imbibe shared social responsibility towards our health services and facilities.
• To provide desirable and needed supplemental services which will contribute to quality of patient care and satisfaction.
• To assist in non-patient care departments by providing clerical or cleaning support through supervision.
• To help create and promote an understanding of the hospital and its services among patients and their family members.
• To raise funds for special needs in the hospital as well as for sustaining Charo Volunteer Services activities.

Core Values of Chharo Volunteers Services

Values are critical to an organization’s culture and its ability to function effectively, therefore, in order to fulfill Chharo’s mission of excellence in rendering our voluntary services to JDWNRH, we have established these values as the foundation of our actions. All CVS volunteers will abide by these core values.
• Accountability:
We accept responsibility for our actions and are answerable to our patients, to one another and to all we serve.
• Compassion:
We provide service with compassion, care and kindness to all patients, their families, and each other.
• Excellence:
We strive for excellence in our given task and perform with dedication and mindful of team work.
• Respect:
We appreciate individual dignity and differences and treat all people with respect

Organization of Chharo Volunteer Services

CVS is managed by a Management Committee composed of the four founding member, two representatives from JDWNRH and two volunteer representative.
The Management Committee meets once a quarter. An annual report is prepared and shared with the hospital administration an all volunteers.

CVS Office
CVS has an operational office at the JDWRN hospital. Volunteer application forms and detailed information on CVS is available at this office.
People interested to join CVS may contact:
Telephone: ___________

CVS Organization

CVS office comprises of four sections ie; human resource, communications, fund raising and accounts.
To aid in the daily function of volunteers, willing and able volunteers will be selected to become supervisors who will be responsible to supervise and monitor volunteers on duty. They will also assist the Head of Human Resource in preparing duty rosters and trouble shoot for substitutes when volunteers are unable to report for duty.
Interested volunteers may offer assistance in any of the four sections outlined above, particularly if they have specific expertise related to the sections.

Work at JDWNRH for Volunteers

CVS volunteers will provide services in the Out Patients Department (OPD) and conduct interactive awareness sessions for patients and their relatives.

Work in OPD
Volunteers work with the JDWNRH Public Relations Office (PRO) staff in the following areas;
• At the information desk to provide information to patients.
• Guide patients to the relevant doctors’ chambers and other departments, in particular the elderly, mothers with young children, patients who are coming from outside of Thimphu and new to the hospital and all others needing help.
• Translate between expatriate doctors and patients.
• Monitor cleanliness in the OPD
Working hours: Monday to Saturday from 9 am to 3 pm.

Public and patients education sessions
Volunteers work in close cooperation with Ward in Charges and other departments to provide interactive education sessions for patients and their relatives.
Main objective of the sessions are to raise awareness of patients and their family members of their responsibilities in helping the hospital to function better. Simple responsibility of being mindful of hospital rules and regulations, correct use of hospital facilities such as toilets, lifts and waste disposal to help the hospital function smoothly.
Working hours: Mondays, Wednesdays, Fridays.
Between 3pm to 5pm. Sessions in conducted in the OPD will be in the morning.
CVS organizes events and sales to raise funds to sustain CVS activities and to fund special cases of need among patients.
• Once a month sale of healthy food and gift items on the hospital premises.
• Annual joint JDWNRH and CVS concert show
• Annual CVS ball at which Volunteer of the Year will be awarded.

Volunteer Guidelines

How to become a volunteer with CVS
• Must be over 16 years of age to be a volunteer
• Must be willing to give a minimum two days a month to do volunteer work.
• All volunteers must meet medical fitness requirement. A health check will be provided by JDWNRH.
• Complete CVS volunteer application form.
• Volunteers must attend mandatory induction training before being assigned duty.
• Volunteers will be provided with a uniform jacket and name tag to wear on duty.
• Volunteers work will be supervised by a senior Volunteer.
• Contact CVS office at JDWNRH for application forms for those wanting to join CVS.

Code of Conduct
Having come on board as a CVS volunteer, in keeping with our core values, all volunteers must take pride in maintaining high standards of work ethics.

General Code of Conduct
• We respect the Confidentiality of personal information, particularly of patients.
• We are Considerate and of fellow volunteers, other co workers at the hospital and more importantly patients who depend on our services.
• We are Competent by doing even the simplest of task with total dedication and mindfulness.
• We are Compassionate and treat all one as we would treat our own.
• We are Punctual as time is of the essence in providing meaningful voluntary services at a hospital.
Specific codes of conduct
• Volunteers must maintain strict confidentiality particularly in relation to patient information.
• Volunteers must not take advantage of hospital volunteer status to cater to their family and friends need for any hospital services while they are on duty.
• While on duty volunteers will not visit their friends and family admitted in the wards, they may do so after getting off duty.
• While on duty volunteers must wear apron with visible name tag that clearly identifies them.
• While on duty volunteers will not chew doma/tobacco or smoke in any area of the hospital.
• While on duty phone calls are kept to the bare minimum.

The need for confidentiality in a hospital cannot be over stressed. Privacy and confidentiality must be maintained at all times. Matters pertaining to a patient are to be discussed only as necessary in a private setting and not in public places such as corridors, waiting areas, lifts or the canteen. Even though medical records of patients may be accessible to volunteers, it must be remembered that only persons providing treatment to the patient have legal right to access the medical records.

Dress Code
All volunteers will be required to wear an official CVS volunteer jacket that is clean, neat and worn at all times while on duty. The jacket along with a name tag will be issued by CVS. Name card must be worn while on duty.

Signing in and out
When you arrive for your duty, sign in on the attendance roster. Report to your hospital departmental supervisor when you arrive and when you leave. Monthly and cumulative totals of hours of volunteer service will be calculated and recorded in data maintained jointly by JDWNRH and CVS.

Hours for Volunteering
Most volunteer organizations in general expect volunteers to work between 12 to 16 hours per month and likewise CVS desire our volunteers to contribute a minimum least 12 hours each month. Volunteers are assigned to work at scheduled times between the hours of 9:00am and 3.00pm in the OPD and between 3.00pm and 5.00pm in other departments.

Volunteers are not permitted to work in areas other than those to which they are assigned except with the permission of CVS supervisor or the hospital department supervisor. If volunteers wish to change their assignment or want to add additional hours, please discuss with CVS supervisor.

If you are unable to report for your scheduled duty due to unforeseen circumstances, you must be report to the CVS supervisor on duty at the earliest so that substitute volunteer can be called. If you are sick, do not report for duty and inform CVS supervisor at the earliest.

Leaving Volunteer Service
When you plan to leave volunteer service, please notify the CVS at the earliest so arrangements may be made to substitute. Please be sure to return your identification badges and jacket on your last day of service. If required, CVS office will be happy to give a letter of reference or other verification of your volunteer service with CVS.

Relationship with Staff
Volunteers will work under the general supervision of a CVS supervisor. The CVS supervisor will be responsible for orienting new volunteers to their work place and point out any special restrictions or precautions and provide on-site supervision. Volunteers must report to assigned supervisor on arrival and departure from duty.
Volunteers must accept supervision gracefully and follow all instructions exactly as they are given. Ask questions if there are any doubts or reservations concerning a staff member's instructions.
Volunteers’ work is only to supplement and enhance health staff functions in order to make each patient's visit or stay at the hospital as pleasant and comfortable as possible. Volunteers should not attempt to provide any form of medical or nursing services to patients. If a patient needs medical or nursing attention, inform the staff of the department at once.
Do not request medical advice, treatment, drugs or supplies from the hospital staff.

Health Screening
All volunteers are required to receive a medical clearance from the hospital.
CVS will arrange medical check up for volunteer recruits. (Detail of health check tests are to be provided by Dr Ngawang)

Infection Control

All CVS volunteers must cooperate in controlling the spread of infection. Procedures for the control of infection are designed to minimize the spread of infection from:
• Patient to patients
• Patients to volunteers
• Volunteers to patients
Hand washing
One of the most important things you can do to minimize the spread of infection is to practice good hand washing technique.
Wash your hands:
• When you report to your assigned area of volunteer service and when you leave
• Before and after breaks and meals
• After you use the restroom
• After any personal contact with patients
• After you handle any materials (linens, food trays, etc.) used by patients
• When hands are visibly soiled
When washing your hands:
• Wet hands with water apply soap to the palm of the hands, rub hands vigorously to work up a full lather, with particular attention to areas in between fingers and under the nails for 10-15 seconds.
• Rinse hands and dry thoroughly.
Hand Hygiene Instructions for Volunteers in Patient Care Areas
Volunteers who select assignments that involve direct patient contact must adhere to the additional hand hygiene requirements as follows:
• Finger nails are to be neatly trimmed and maintained short.
• Artificial nails and chipped nail polish is not permitted.
• Chunky and fancy finger rings and bangles should not be worn while on duty.
Isolation Area of the Hospital
It is important that volunteers recognize isolation areas and do not enter isolation rooms unless one has received explicit instructions and permission from the nurse.
Certain areas of the Hospital should not be entered without special precautions. These areas include the Operating Room, the Recovery Room, Labour & Delivery, and the intensive care units (ICU's). The precautions might include wearing an isolation gown, scrubs, or other protective clothing. Please take care to recognize these areas and be sure to comply fully with the precautions.
Gloves, Masks, and Gowns
At times and in certain areas of the hospital, you may be required to wear disposable gloves, masks and/or gowns. These items are to be used only once and disposed of properly. If you have any questions about the proper use or disposal of these items, please ask the nurse on duty.
Blood borne Pathogens
Blood borne pathogens are transmitted through body fluids, primarily blood and semen, although all body fluids and tissues should be regarded as potentially infectious. The most common modes of transmission are sexual contact, needle sharing, and to a lesser degree, infusion of contaminated blood products. These organisms are not transmitted by casual contact, touching or shaking hands, eating foods prepared by an infected person, telephones, toilets, or other surfaces. To eliminate the risk of infection, under no circumstances should a volunteer handle any item that may contain blood and/or body fluids or handle needles.

• Do not report for volunteer service if you are sick, especially if you have a fever, diarrhea, or a skin infection.
• Do not eat or drink in a patient's room or from a patient's tray.
• Do not enter an isolation room unless you first check with the nurse.
• Do not attempt to clean up spilled specimens.
• Do not handle injection needles.
• Do not touch any item that may be contaminated with blood and/or body fluids.
If you have any doubts about your safety or about procedures for infection control, please talk to your CVS supervisor who will put you in touch with the JDWNRH Infection Control in Charge for detailed information.

Other Safety Hazards
Various areas in the Hospital contain hazardous biological, chemical and radiological hazards. As a volunteer, you will not be assigned to areas or functions in which you may be exposed to these hazards.
Every injury sustained by a volunteer while on duty the must be reported immediately to the CVS supervisor. All injuries must be evaluated and documented as soon as possible.
If volunteer gets injured or become ill while on duty, CVS supervisor must be notify at once. If treatment is necessary, volunteer will be accompanied by the CVS supervisor or the JDWNRH focal person and relevant doctor consulted.
Accidents of any sort - spill a specimen, damage of hospital property or equipment, cause an injury to a patient must be reported. Volunteer must not attempt to correct the situation on her/his own. Notify immediately your supervisor and the head of the department in which the accident took place.
Notify your departmental and CVS supervisor at once if you witness an accident or unusual incident at the hospital or if you observe any safety or health hazard.
Volunteers should not accept money or gifts from patients or their families.
Use of Telephones
Hospital telephones are to be used only for Hospital Business. Please do not use the Hospital telephones for personal calls.
Dr Ngawang may provide details of JDWNRH evacuation procedure for fire emergency
Wheelchair Safety
When using a wheelchair to transport a patient to a destination in the hospital you must:
• Place the wheelchair close to the patient
• Always lock the wheels before the patient gets into or off the chair
• Be sure the footrests are up
• Stand close to patient as he/she ambulates
When transporting patients make sure the patient is facing forward. When going into elevator pull the patient backwards into the elevator; always advise the patient you are doing this. Pay attention to the patient; avoid long conversations with friends and other staff while you wheel a pateint.
What Volunteers Cannot Do
As a volunteer at JDWNRH, you must not;
• Give medications of any kind to patients
• Transport medications
• Handle controlled substances (What these substance are will be told during induction training)
• Take telephone treatment messages or orders from physicians
• Transcribe physician's orders
• Make entries in a patient's chart
• Empty bedpans
• Discard needles
• Give bed baths
• Raise or lower a bed without the nurse's permission
• Lift a patient or change a patient's position in bed
• Give food or drink to a patient without the nurse's permission
• Feed patients without the nurse's permission
• Escort patients on stretchers alone
• Escort patients who are on IV medications alone
• Escort critically ill patients alone
• Enter an isolation room without the nurse's permission
• Care for patients in isolation rooms without the nurse’s permission
• Attempt to give any form of medical or nursing care
• Attempt to perform any duty you have not been taught to do

In Closing

This hand book is intended to help CVS volunteers to work well at the JDWNRH and while performing their duty to ensure safety of patients and themselves. Further, it is hoped that the contents of this booklet will stimulate thoughts, questions and suggestions about specific issues or concerns to improve services that of both CVS volunteers as well as that of JDWNRH.

CVS appreciates the services contributed by all our volunteers. Your involvement is vital in enhancing social responsibility towards improving our health services and facilities. Volunteers are important in maintaining a crucial link between the hospital and the community at large.

Tashi Delek and thank you for your participation - may the generous giving of your time in service for others bring you peace and fulfillment.

In the words of His Holiness the Dalai Lam;
“It is very difficult to achieve peace and harmony through competition and hatred, so the practice of kindness is very important and valuable in human society. Here we don’t need a deeper philosophy, we don’t need monasteries, temples, images, gods and so on – we can simply practice kindness. Simply try to become a good human being; by a good human being, I mean a warm-hearted person. To think of other people – complete selflessness is impossible but to be unselfish and more concerned about other people – that is the real Dharma or Religion.”



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