Nurses: Virus surge creates staffing issues
Hospital says it has strategies to accommodate local influx of virus cases
The California Nurses Association raised concerns about staffing levels at hospitals amid the surge of coronavirus patients and the onset of winter with its customary flu season.
“Employers who did not prepare for this pandemic and did not prepare for our current surge are now telling nurses to hold up the sky, assigning the more patients than they can safely care for at once,” said Stephanie Roberson, the CNA government relations director during a news conference on Wednesday. “… They are just using the pandemic as an excuse to cut corners and quite honestly, check a box on their wish list to make sure that safe staffing limits are watered down, and ultimately wiped off the books for good.”
California Gov. Gavin Newsom announced the state was expediting approval of emergency staffing waivers that allow hospitals to increase the number of patients a nurse is responsible for caring for in a given unit. For intensive care units, a single nurse could go from taking care of two patients to taking care of three. Newsom referred to the move as “stretching resources.”
“These frontline health care workers, these nurses in particular, are just doing heroic work every single day,” Newsom said Monday. “( We’re) asking yet again for a little bit more during these very challenging, challenging next few weeks, months.”
The CNA nurses said the staffing changes could further strain hospital workers and put the health of
both patients and nurses at risk.
“California nurses are adamantly opposed to handing the California hospital industry a gift that will surely increase the number of infections and increase the number of deaths, a gift to reward the hospital industry that has manufactured its own crisis,” said Zenei Cortez, a San Francisco-area nurse who is serving as the president of the CNA union. “From day one of this pandemic, everyone in the country has known that winter was coming, that a monster surge was going to slam us at the start of flu season.”
She said that hospitals had time to prepare, but have not addressed staffing as they should.
Lesley Ester, an RN at St. Joseph Hospital in Eureka and a CNA representative, said staffing locally has been problematic for years. That has only been exacerbated by the pandemic.
“My main worry in Humboldt County is that we’re geographically isolated, we do not have any agency nurses to call in on a shiftby-shift basis,” Ester said Wednesday afternoon. “Our hospital has a history of very thin staffing that already doesn’t meet the full requirements of Title 22.”
Title 22 is a two-decade-old rule that establishes minimum staffing levels for registered nurses and licensed vocational nurses working in hospitals.
Ester added that local hospital nurses have contracted COVID-19, although she did not provide specific numbers of cases.
“We don’t see that we have right now the staff available — not only nurses, but respiratory therapists, nursing aides, etc. — to handle a surge,” said Ester. “We do see that the hospital has a plan to have more beds, they brought in some extra ventilators, … we don’t have the staff.”
She said she is not aware of any nurses at St. Joseph or Redwood Memorial receiving vaccinations
for COVID-19 yet. She expects that to begin today.
Neither St. Joseph Hospital nor Redwood Memorial has requested a staffing waiver, but Dr. Roberta Luskin-Hawk, the chief executive of the hospital said “we recognize that the need could arise in the future.”
Luskin-Hawk, in response to the concerns of nurses about staffing more beds, said some positions can be shifted and more nurses can be hired.
“The strategies we would use include hiring nurses, requesting nurses from temporary agencies and disaster relief organizations, reassigning nurses with advanced skill sets to the ICU and training nurses in more advanced levels of care,” she said. “Team based care in which an expert critical care nurse is paired with recently trained nurse is a way in which to provide more care and maintain safety.”
She added that some services can be curtailed to allow for critical needs.
“In the face of a substantial surge, we can reduce some services and have nurses reassigned to areas of the greatest need,” she said. “For example, nurses whose usual job is to manage patients post-operatively on a ventilator might be asked to work in the ICU. Our clinical education department is prepared to provide training and educational resources to nurses who are taking care of more complex patients.”
What happens if the alternate care site at Redwood Acres needs to open?
“We hope that we never need the Alternate Care Site at Redwood Acres, however, if we do, the patients will be ambulatory and low acuity,” she said. ” This is a setting that would have a different nursing ratio, if opened.”