How hospitals are dealing with a nursing shortage during the pandemic
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IDAHO FALLS — Recently, a number of medical professionals have come out and said there’s a breaking point with COVID-19, and the community has reached the point.
But if you glance at COVID-19 hospitalizations and intensive care unit bed numbers reported to the Idaho Department of Health and Welfare, Eastern Idaho Public Health or EastIdahoNews.com, you may think hospitals aren’t in dire situations. For example, Eastern Idaho Regional Medical Center saw a dip in COVID-19 hospitalizations from last Tuesday to Thursday, and Idaho Falls Community Hospital had half of its ICU beds full last Thursday.
But Dr. John Miller, the director of IFCH’s intensive care unit, told EastIdahoNews.com a hospital’s true capacity might be different from its number of beds. He said it’s not a question of having physical beds but having the staff to tend to the patients in those beds.
“People think that unless there are lines of collapsing people outside the hospital … trying to get in and they’re falling off at the wayside, they think the hospital is not full,” Miller said. “But in fact, across the country, around the world, there are shortages of nurses … even before the pandemic. … That’s the thing that limits the capacity, is the caregivers.”
‘It’s all about the staffing’
It takes a team to care for one patient, from doctors, nurses, respiratory therapists, the lab department, physical therapists, X-ray technicians and so on, Miller said. COVID-19 has increased hospitals’ caseloads and doubled the work their employees are asked to do.
He said that although many people contract COVID-19 and are fine, some people who get a bad case of the virus require a lot of hospital resources.
EIRMC Spokeswoman Coleen Niemann said because there’s a complex web of support for a single patient, anything that strains that web has a domino effect throughout the facility.
“Every hospital, not just EIRMC, every hospital in America has been saying this,” Niemann said. “It’s been said over and over nationally, as well as locally — it’s all about staffing.”
In the United States, there is a standard ratio of 10.35 registered nurses per 1,000 population, according to a 2020 Idaho Nursing Workforce report. In 2018, Idaho was below the national standard with 9.3 registered nurses per 1,000 population and in 2020, the state was again lower than the national standard with 9.93 registered nurses, or a deficit of 514 registered nurses.
“What we need is the community to step forward with personal responsibility.”
Before COVID-19 even hit, Miller said IFCH had ongoing staffing initiatives, but the demand for nurses is so much higher now with “critically ill patients” and “only so many trained nurses out there.” Niemann also said EIRMC spent a lot of time recruiting nationally for nurses and physicians with special expertise needed to work at the largest medical facility in the region.
Both said that before COVID-19, the nursing shortage was more manageable than it is today. Early on in the pandemic, IFCH had team members who volunteered to go to different parts of the country to help other hospitals who were in greater need at the time than in Idaho, but Miller said there’s a high demand for nurses all over the country now.
The 2020 Idaho Nursing Workforce report states that 64% of hospitals reported using Agency Travel Nurses in 2019-2020. IFCH will receive its first travel nurse — in this case, a nurse from Utah — who will start working at the hospital Wednesday. Another one will come from Tennessee in a few weeks.
“We had resources that we could draw travelers from (pre-COVID),” Niemann said. “But now, every hospital in America is trying to take those same travelers. … We all want the same resource, which is the medical expert.”
Despite the steps that have been taken by the hospitals, Miller and Niemann said the nursing shortage during the pandemic is not the only reason hospital staffing is being affected.
Hospital personnel and their families live in the community and are not exempt from catching the virus, which is part of why community members are being asked to wash their hands, maintain physical distancing and wear a face-covering in public places.
“Although it’s important to know what hospitals have always done to try to build a pipeline of employees, in the end, what we need is the community to step forward with personal responsibility (and) actions that science tells us slows the spread, and therefore, maintains the hospitalizations at a manageable level,” Niemann said.
Local school trying to meet the nursing demand
EIRMC has worked closely with the nursing schools in the region and is providing programs for any EIRMC employee to further a career in healthcare with things such as tuition reimbursements and student loan assistance, Niemann said.
Last year, the College of Eastern Idaho announced two new nursing programs — the Part-Time Registered Nurse Program and LPN (Licensed Practical Nurse) to RN (Registered Nurse) Bridge Program — to help with the staffing issues at hospitals, CEI Assistant Nursing Administrator Jodene Trimble said.
CEI took in 16 students for each program this year and plans to admit more students in the future. But right now, COVID-19 is making it difficult for students to get their clinical placement done. Students must spend 50% of their time doing simulations and the other 50% getting hands-on opportunities in a hospital setting.
But due to COVID-19 and to help with some of these staffing issues, Trimble said the State Board of Nursing has allowed CEI nursing students currently working in healthcare and in good standing with the nursing program to get access to their temporary license 30 days before graduation.
“A lot of our nursing students work in healthcare, like as certified nursing assistants or licensed practical nurses,” Trimble said. “(With the temporary license) they can then work as a registered nurse, or if they’re … in practical nursing school, and they’ve been working as a certified nursing assistant, then they can work as a licensed practical nurse prior to graduation.”
Along with that, Trimble said the State Board of Nursing has allowed CEI to do an apprenticeship program. Students who have completed their first year and have finished fundamentals classes can get an apprenticeship license to use more advanced skills than they could as a CNA.
“We recognize we need to get these nurses out there to practice,” Trimble said. “We’re just trying to do everything we can to get our students into clinical and get them graduated and make sure again that we maintain the integrity of the students that we’re producing.”
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