Adventist Health/Rideout is experiencing challenges in all areas of staffing, according to Business Development and Community Well-Being Executive Monica Arrowsmith.
Staffing has stabilized from last week with the arrival of staff contracted from the state and several agencies for crisis staffing. There are a total of 103 agency staff working and 75 in orientation.
“Some of the challenge is directly related to the fact that the volume of patients requires more staffing than usual; some is because of staff who are on COVID leaves, whether COVID positive themselves, quarantined or out with children who are quarantined; and the rest is related to usual leaves (maternity, medical, etc.) and turnover,” Arrowsmith said in an email.
There are currently 49 staff members off of work. Of those, 33 are out due to exposure/quarantine or due to a child in quarantine, Arrowsmith said.
Adventist Health/Rideout has not transferred any COVID-19 patients to other hospitals in the last month. The patients that have been transferred are those who need a higher level of care such as those with spine injuries, pelvic fractures or pediatric patients. The hospital has not taken in patients from other hospitals recently, according to Arrowsmith.
She said the hospital has met the nurse-patient ratios required by the state for all patients. The requirement in the intensive care unit is one nurse to two patients or one nurse to one patient.
Arrowsmith said on Tuesday there were 21 COVID-19 patients classified as critical care. Overall, the hospital had 34 critical care patients on Tuesday.
“What I’ve observed is a combination of compassion, grit, skill, professionalism and love,” Arrowsmith said. “It is hard. It is especially hard managing through the many losses. In the past four days, our physicians, nurses, and respiratory therapists (as well as other staff) took care of so many COVID patients, 10 of whom died.”
In a Facebook post on Saturday, Adventist Health/Rideout ICU nurse Amanda Hicks said the local hospital has more sick patients than there are nurses to care for them. She said her and her colleagues work 12 to 16 hour days with maybe one break.
“I do love my job and getting to help those in need but right now we are drowning,” Hicks said in the post. “... This virus is real!! It is killing more people every day. People’s parents, sisters, children. Please take this seriously, and please for the love of everything holy go get vaccinated.”
Jan Emerson-Shea is vice president of external affairs at the California Hospital Association. She said over the past two months the number of daily cases in the state has risen more than 800 percent to nearly 15,000 every day.
“And, models suggest that COVID-19 cases will continue to grow before they begin to taper,” Emerson-Shea said in an email. “Sadly, the majority of COVID patients currently being treated in hospitals remain unvaccinated.”
Emerson-Shea said hospitals across California and throughout the country are facing serious staffing shortages. She said the stress and uncertainty of the past 18 months is leading some to reconsider their career paths.
“There is no question that some hospital workers are choosing to either leave their hospital jobs, retire early, or find a new profession altogether,” Emerson-Shea said. “This is a scary proposition for all of us. Without doctors, nurses and other clinicians, hospitals’ ability to care for anyone in need, 24/7, cannot be accomplished.”
She said hospitals are doing everything in their power to recruit and retain workers by voluntarily providing temporary housing, child care services and subsidies, extended leave, counseling support, wellness programs and enhanced compensation.
“When hospitals face staffing shortfalls (particularly in nursing), they often turn to traveling nurse agencies to provide temporary staffing,” Emerson-Shea said. “Unfortunately, in the midst of this latest surge of the delta variant, California is not the only state drawing from the pool of traveling nurses. So too are a number of other states. Thus, the current availability of traveling nurses also is limited.”
She said the most important thing people can do is get vaccinated.
Registered Nurse and President of National Nurses United Deborah Burger said nursing shortages are a problem created by hospitals that was exacerbated by the pandemic. National Nurses United is the largest organization of registered nurses in the United States. Burger said before the pandemic, it’s been a “race to the bottom” for hospitals to staff as minimally as possible. She said laws in California about the ratio of patients to nurses is a safeguard that is not there in other states.
In the ICU, the ratio must be one nurse to one or two patients. In the rest of the hospital it is one nurse for every four or five patients. In the emergency room it’s one nurse for every four patients, according to Burger.
She said hospitals have also created an unsafe work situation by not having enough people working and not providing enough personal protective equipment.
Burger doesn’t use the phrase “burn out” to describe the toll on nurses but rather “moral distress” or “moral injury.” She said nurses are used to working in a stressful environment but over the last 18 months have not received enough support while working through unprecedented times. Burger said there has also been a rise in violence against healthcare workers both at work and outside of work. She said having adequate staffing would solve some of these issues.
In addition, Burger said hospitals need to do a better job of supporting nursing schools and offering nursing school slots. She said there can sometimes be a four-year wait to get into nursing school and that once a nurse gets through school and gets a job, hospitals “grind them up.”
She said on average one third of all new nurses leave nursing within the first year. Burger said the use of the word “hero” for healthcare workers does not translate to the reality of the workplace.
“They’re not treated like you would a hero,” Burger said.
Health officer calls for public to get vaccinated
Bi-County Health Officer Dr. Phuong Luu addressed the community ahead of the Labor Day weekend in a video posted online on Thursday. She asked the public to be cautious about gatherings over the weekend given the situation at Adventist Health/Rideout.
Luu described the hospital as being overwhelmed with more than 30-40 percent of COVID-19 patients being in the ICU at any one time.
“Maybe don’t go to that crowded concert, don’t go to a very crowded gathering indoors,” Luu said. “Take most of those gatherings outdoors. Limit your interaction with those where you don’t know their vaccination status.”
She reiterated that no vaccine is 100 percent protective and that breakthrough cases are to be expected.
“I’m here to tell you it is still your best bet to prevent hospitalization, to prevent severe disease, prevent you dying of COVID-19, if you get fully vaccinated,” Luu said. “... We have a responsibility as the adults of this community to protect our young ones.”