EVERETT — This month, headlines reported rampant nurse burnout, overwhelmed ICUs and the Washington National Guard’s deployment to hospitals here and across the state.
Through it all, some readers continued to point to the state’s vaccine mandate as a driving force behind a dire shortage in nurses. But officials say the reasons behind stretched health care systems are more complicated, and have been mounting for years.
Statewide, hospitals lost about 2% of staff to the vaccine mandate, with employees either getting fired or leaving on their own, according to the Washington State Hospital Association.
Everett fared better. Providence Regional Medical Center lost 1% of its more than 5,000 employees due to the mandate. In the fall, officials at the hospital reported the loss was not expected to significantly impact operations.
In an analysis of 2021 exit surveys, WSHA found 7% of registered nurses leaving their posts cited the state vaccine mandate as a factor. More often, nurses said they were leaving for a spouse’s job, to become a better-paid travel nurse, to retire or because of burnout.
So what’s behind today’s stretched and strained hospital systems? Here’s what we know.
Exhaustion
Burnout among nurses during the pandemic has been well documented. At Providence’s Everett facility, officials said, turnover gradually increased in 2021, a reflection of national trends as nurses were expected to work longer hours and cover more patients.
The so-called “great resignation” has impacted countless industries, with and without mandates.
Nurses at the Everett hospital have described many employees leaving in the past few months and especially during the most recent surge in infections.
A December poll of Washington unionized health care workers found 84% of respondents were burnt out and 49% were likely to leave the field in the next few years, mostly due to short-staffing and pay.
Providence Regional Medical Center’s staffing levels, however, remained about where they were pre-pandemic, although many of those positions were temporary staff filling in gaps. According to hospital officials, increased patient loads, sick employees and other factors mean that the staffing level is inadequate.
Years in the making
The pandemic strained hospitals and accelerated turnover, but officials say a health care staffing crisis has been brewing for years.
In an email to The Daily Herald, Providence cited an aging workforce and not enough training slots for new nurses, in schools and in residency programs. Patient demographics are also trending older, and the elderly require more care.
It makes for a “perfect storm,” Providence spokesperson Casey Calamusa said.
According to the American Hospital Association, more than half of all nurses were 50 or older. Nearly 30% were age 60 or up.
The WSHA is now pushing the Legislature to expand nursing programs, pay educators more, fund simulation labs and make it easier for nurses to repay loans.
The group’s vice president, Taya Briley, described health care education as “chronically underfunded at both the state and national level.”
In the 2019-20 academic year, 2,600 nursing grads were turned out across Washington. That’s compared to 6,100 licensed registered nurses who were needed to fill vacancies last year. To fill the gap, hospitals have been relying on contracted travel nurses, although about 3,100 registered nursing positions remained open in 2021.
“The math just does not add up,” Briley said.
Issues with long-term care
Across the state, patients ready to be discharged to long-term care facilities are stuck in hospitals. With staffing issues also plaguing nursing homes, there’s often no place for these people to go.
Of the 600 beds at Providence Regional Medical Center Everett, about 100 represent people medically stable and waiting to be discharged to lower-level care settings. The hospital this week called the situation “the primary driver of our staffing challenges.”
Even though these patients are stable, they still require medical attention from staff.
This month, Inslee announced efforts to alleviate the burden by expanding capacity in nursing homes and speeding up legal guardian proceedings, but Everett hospital officials said there simply aren’t enough beds, staff and other resources to solve the problem.
Record COVID hospitalizations
Omicron pushed the state’s COVID-19 hospitalizations to record levels.
Those patients are still largely unvaccinated.
The highly infectious variant also forced more caregivers into isolation after being infected by or exposed to the coronavirus, Providence Chief Medical Officer Dr. Jay Cook said.
Now, the hospital is following updated Centers for Disease Control and Prevention guidance that allows some staff to return to work faster if they contract the virus.
“The risk from an unprecedented staff shortage,” Calamusa said, “poses a greater threat to patient and caregiver safety than asymptomatic caregivers — wearing all appropriate protective equipment, including N95 masks — providing medical care to those who need our services.”
Claudia Yaw: 425-339-3449; claudia.yaw@heraldnet.com. Twitter: @yawclaudia.
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