EVERETT — Providence Regional Medical Center is in dire straits after its emergency department was overwhelmed this week.
The Everett hospital opened a command center Monday and funneled staff and resources from other departments to handle an inundation of patients.
Chief Executive Darren Redick said the emergency department generally has a “handful” of patients waiting for beds elsewhere in the hospital. On Monday, there were about 70.
Days before, the hospital paused admissions to its pediatric unit due to a lack of nurses.
Providence nurse Kelli Johnson said it’s been the worst week she’s ever seen in the emergency department, with patient-to-nurse ratios tripling in some instances.
“We’re watching the collapse of health care,” she told The Daily Herald. “I’ve come in at 4:30 in the morning watching doctors cry to other doctors about how terribly unsafe it is, and how they’re watching their patients tank.”
Redick said the situation is a product of ongoing nurse burnout, COVID hospitalizations and about 100 patients waiting to be discharged to less acute care facilities. Providence’s two Everett campuses are trying to hire “well over 250 nurses,” Redick said.
“I would characterize it as a continuation of what we’ve seen throughout the pandemic. I think part of the challenge is time,” he said. “The same is continuing over a longer period of time, which is creating more burnout and challenges for our workforce.”
Surgeries are being paused, Redick said, but that’s nothing new.
“Just to be frank, we’ve had our surgical procedure leaders, physicians and nurse leaders and support teams meeting pretty much daily since last August to review surgical cases,” he said. “On and off since last fall we’ve been canceling cases, delaying cases, rescheduling cases as a matter of routine.”
The issue is statewide, though regional hospitals like Providence are being hit hardest, according to state officials.
“Hospitals and emergency departments are reporting significant stress,” Dr. Tao Sheng Kwan-Gett, the state’s chief science officer, told reporters Wednesday.
Meanwhile, emergency departments are bracing for a busy summer, when injuries tend to increase.
“We are particularly concerned about the upcoming holiday weekend, which tends to be a busy one for emergency department visits,” said Beth Zborowski, with the Washington State Hospital Association.
The state’s deputy secretary for emergency preparedness and response, Nate Weed, encouraged residents to attend professional fireworks displays this weekend, instead of lighting off their own, and to take extra precautions if swimming or boating in open waters.
Providence hospital will re-evaluate its situation Friday, Redick said, and try to get emergency department capacity back to normal levels in preparation for the weekend.
Redick said the main issue is “having enough nurses available in the pipeline.”
But many nurses say otherwise. Frustration is mounting after the state Legislature failed to pass a bill setting minimum hospital staffing levels. The proposal was backed by exhausted nurses who cited dangerous conditions for workers and patients. Hospital executives argued the bill wouldn’t bulk up the talent pool, which they said was the root issue of staffing problems.
“Health care workers told the Legislature that without having (staffing standards), this is what’s going to happen,” said Kendra Valdez, UFCW 3000 staff director. “And we’re seeing the result of that.”
She said higher wages and bonuses would incentivize workers to pick up more shifts, remain in the field, or take a job at the hospital in the first place.
“There are solutions, and I think if hospitals talked to the nurses and workers, they’d hear the solutions,” she said. “The problem is there’s nothing holding them to that right now.”
A lack of incoming nurses is “half the story,” one telemetry nurse, who asked to remain anonymous, told The Herald. She said nurses stopped taking overtime shifts around April when they were no longer offered a bonus to do so.
“They’re not offering more money,” she said. “They’re not offering incentive for people to come in other than just saying ‘pretty please.’”
Johnson said her colleagues are scared they’ll be so stretched thin that patients will get hurt, and they’ll lose their license.
“Your answer to the staffing problem is, ‘There’s not enough nurses to go around.’ Well, I call (expletive),” Johnson said. “It’s a money issue. The easiest way for them to reduce that loss of of income (during the pandemic) is by cutting staff.”
In a statement to The Herald, Providence spokesperson Casey Calamusa said there are no quick fixes.
“Hospitals in Washington state are competing in a national market for both permanent and temporary staff,” he wrote, adding that money for more nursing education slots and clinical placements would help.
The hospital is trying to rely less on travel nurses, temporary and high-paid positions that weary health care workers flocked to during the pandemic. Meanwhile, inflation and supply chain issues mean hospitals like Providence “have suffered staggering operating losses.”
“Yet the for-profit insurers, pharmaceutical companies, medical device companies and staffing agencies have logged record-breaking profits throughout the pandemic,” Calamusa wrote.