Winter rush: YRMC preps for busy season

Hospital will hire up to 175 extra nurses to deal with patient influx

Preparing for the winter rush never ends. For Yuma Regional Medical Center, it actually starts at the end of the previous season.

And after more than a decade of juggling the many pieces that must come together to make a season successful, the program in place now works like a finetuned orchestra.

In preparation, YRMC hires up to 175 extra nurses each winter, many through a program in which the same nurses come for three, six or nine months.

But it’s not only additional nurses that are needed in the winter. The hospital must also hire extra support staff, from nursing assistants to housekeepers and more. Most of these are locals, so the year-round community benefits as well.

“It’s largely in response to the influx of winter residents. But that’s not the only reason. We also get seasonal migrants and their families,” pointed out John Bowles, administrative director or nursing operations at YRMC. During this past year, the hospital’s daily census was 20 percent higher in the winter than the summer. In other words, YRMC sees an average of 43 patients more per day during the winter months. During the peak month, the hospital averages 80 patients more per day than the summer months.

Instead of depending on a temp agency, YRMC has its own program, with many of the same seasonal staff signing on to return the following winter, said Randal Etzler, chief of human resources officer.

“It’s nice because it’s the same people coming,” Bowles said, adding that even before the staff leaves, the hospital has it set it up so they know who’s coming back next year.

Many of these “veterans” are already invested in the hospital and have established relationships with their co-workers. In turn, “we treat them as core members of our team.”

Although the hospital hires an extra 150 to 175 nurses, how many are ultimately hired depends on many factors. Some nurses sign on for three months, some for six or nine months. Etzler’s department must then fill in the gaps.

Hospital officials follow a formula involving predictive analytics and projections, comparing numbers from the last few years with the normal volume, in deciding how many will be hired.

This method has proven “very successful” the last couple years, Bowles said.

YRMC even has it’s own 84-unit housing complex, owned by the hospital, for winter staff, in the area of 24th Street and Avenue C.

Etzler noted that returning staff often bring back their friends and family with them. And the tendency is to recommend each other.

Why do they come back? “Often they say other organizations don’t treat them as part of the team. They give them a larger workload and the more complex patients,” Bowles said.

At YRMC, the strengths of the nurses are matched to the needs of the patients, he explained.

And of course, there’s the weather. “Most come from cold climates, a lot are Canadian,” Etzler said, pointing out that they appreciate the pleasant weather in Yuma.

To make room for the extra patients in the winter, the hospital opens a 146-bed unit that remains closed for the rest of the year. There’s also another 52-bed unit that hires additional staff which averages 36 patients but can fill up.

The goal is for patient care to be seamless. It takes a lot of behind-the-scenes juggling to ensure that the hospital has all the equipment it needs, that the pharmacy is well stocked and that the other necessary components are in place.

There is a strategy in play with every decision. Each year hospital officials learn something and apply it to the next year. And each year it gets better.

“We’ve had 10 to 15 robust seasons,” Bowles said.

Winter visitors start settling in around October, but many go back home for the holidays and then the Yuma population — and the hospital volume — spikes the first week of January. But February, although the shortest month, traditionally has the peak volume.

During the week, Tuesday, Wednesday and Thursday have the highest volume. But flu season also throws in a curveball.

Throughout it all, hospital officials are on their toes, trying to prevent gridlock, which is when the hospital reaches capacity and there’s no patient movement.

YRMC only has so many beds, so staff tries to get patients back home early in the day so beds will be available. Once gridlock reaches the Emergency Department, it means everything else is full.

To avoid reaching this point, officials and staff are always on the lookout for symptoms of near-capacity vs. reacting once gridlock hits.

“While at capacity, it’s all hands on deck,” Bowles said.

Patient care becomes the priority and all administrative duties are secondary. The objective, Etzler said, is not to get distracted from the hospital’s main mission. With this in mind, non-essential things like meetings are cut down.

In addition, Bowles added, “If we hit maximum load, there’s plenty of help out there. We just need to know.”

This year the hospital will be cross-training the Cath Lab and registered nurses who want to learn to process administrative discharges and transfers. A SWAT team of sorts for these critical situations.

For this year, the hospital plans to work on its communication strategy, making sure that recruiters know the status of the every department weekly or biweekly.

In the meantime, YRMC is already welcoming seasonal staff, helping them through orientation.

“That also has to be staged. We can’t have 175 nurses showing up at the same time,” Etzler said.

In the end, the message these officials want to convey to the public is: “We work very diligently yearround to have the right people here to take care of you,” Bowles said.

“It takes a village. But we’re here for our community and hope to deliver the best quality of care.”