Two Confluence Health nurses describe some of the systemic issues they’ve been facing as new Omicron subvariant Arrive at hospitals nationwide.
When Sara Morgan Bergenholtz started at Washington Central Hospital five years ago, she considered Confluence Health the “gold standard” for nurse-to-patient ratios.
“There is a sense of community within the facility and a belief that we are really working to improve our community,” Bergenholtz said.
The ratio of nurses to patients depends on the patient’s acuity or level of care required. Depending on which unit the nurse is assigned to, each nurse can only see a certain number of patients per day.
Bergenholtz said medical oncology nurses treated a maximum of five day staff and six night staff patients compared with last year’s four day staff patients and five night staff patients.
“Currently, in our staffing, nurses are seeing seven patients at times,” Bergenholtz said. “That puts us in contingency at the pre-crisis staffing level.”
Paul Stamilio, who has been a nurse for more than 10 years, said he moved from North Carolina to Washington because of the state’s high medical standards.
It wasn’t until the pandemic hit that the two nurses saw a major cultural shift in the workplace, with stress, burnout, and strained resources further exacerbating staffing issues at Confluence and hospitals across the country.
In the wake of the COVID-19 outbreak, several nurses decided to resign early or retire, leaving Confluence Health’s remaining nurses to fill the gaps, Stamilio said.
According to the U.S. Bureau of Labor Statistics, there are 3.1 million registered nurse positions nationwide, and an estimated 203,200 registered nurse vacancies will be added each year through 2031 as nurses retire or leave the workforce.
Based on COVID-19 impact assessment poll According to a survey by the American Nurses Foundation and the American Nurses Association, 52 percent of nurses are considering leaving their jobs because of understaffing, work that negatively impacts health and well-being, and an inability to provide quality care. 60% of acute care nurses report feeling burnt out and 75% report feeling stressed, frustrated and exhausted.
“When we go to work, we’re short on money, it’s a bad day, and people die unnecessarily,” Bergenholtz said. “That’s why people leave.”
Last year, both Stamilio and Bergenholtz were transferred to the ER department. Since then, both nurses have said it is rare for either of them to take a full lunch break.
rear HB 1155 Signed into law, breaks became mandatory, and a full day was scheduled for each nurse, shifting responsibility from the nurses to the administration.
Although the law is set to go into effect in 2020, Bergenholtz said the break schedule has not been enforced for some time, and it is common for nurses to forego their lunch break due to the volume of patients.
In response to low staffing levels, several hospitals began hiring travel nurses for vacancies. However, many nurses leave the travel nurse position due to higher salaries and flexible schedules offered by travel nurse agencies.
generally, the average annual salary for a travel nurse is $103,695.It’s becoming such a lucrative business that the American Healthcare Association ask The federal COVID-19 response team stepped in.
“A system that works well doesn’t need to pay $5,000 a week to care for an unsafe number of patients in an ICU in Texas,” Bergenholtz said.
According to Bergenholtz, due to a lack of travel nurses, Confluence Health had to close one of their step-down wards, which is a unit for cardiac patients.
She also shared that during a recent contract negotiation with the Washington State Nurses Association (WSNA), Confluence Health agreed to hire a break nurse who would serve as a nurse while the other nurses were on break for a one-year trial.
However, Bergenholtz said she has not seen plans for this.
Stamilio attributes the lack of state funding of rural health care systems to another hurdle, with Confluence Health getting most of its funding from private insurance rather than Medicare and Medicaid reimbursements.
Funding is often strangled if hospitals take patients who are typically more difficult to discharge.
Bergenholtz noted that most of the patients they found difficult to discharge were those with advanced dementia who inevitably struggled with healthcare due to a lack of available rooms in long-term care facilities.
“Unfortunately, when [a facility] Deciding that someone is too much work for them, they functionally expel them by sending them to the emergency room and refusing to take them back,” Bergenholtz said.
There are currently two bills in the 2023 state legislative session that address some of the issues nurses face.
SB 5236 is a bill that proposes to establish minimum staffing standards in hospitals, requires hospital staffing committees to develop staffing plans that address mandatory overtime, lunch and break breaks, and Provide law enforcement.
The bill is similar to 2022 Legislative Session, a similar requirement is made.Washington State Hospital Association Objects two bills From last year to this year billpointing out that this would negatively impact patient visits.
The second bill is SB 5103which proposes paying hospital bills for hard-to-discharge Medicaid patients who are in the hospital waiting to be discharged to a long-term care facility or return to the community.
“Whatever you wish for health care, the fact is we live in a for-profit system, and if the legislature doesn’t take that seriously and care about the most vulnerable in our communities, the problem will continue to get worse,” Bergenholtz concluded.
Confluence Health declined to comment.