Comment: What’s behind the state’s shortage of nurses?

By Kelli Johnson / For The Herald

For years, the story that there is a nursing shortage has cycled its way through media headlines.

How the public defines the nursing shortage is a result of colleges’ inability to educate new nurses at the pace of the growing demand of our communities. For so long, nurses in the profession were able to compensate for this shortage by working overtime with many working closer to 60 hours a week instead of the standard 32 hours. Hospitals business model relied on nurses to work overtime in order to meet the needs of patients, their customers. Will hospitals publicly admit that? No.

What if I told you that there about 40,000 nurses who are licensed in Washington state who are not working in health care? Imagine if they were, could it still be said that there aren’t enough nurses? If there are enough nurses then why did they step away from the profession?

What happens when nurses — in the business of giving the best health care they can to every patient they have — are endangered by hospitals who want to save as much money as they can?

What happens when the hospitals’ business model prioritizes their bottom line at the cost of the health care that nurses are able to provide, costing patients their health, and even their lives? Hospitals have lost millions of dollars in their investments, primarily in the stock market. They don’t want you, the patient, to focus on their investment losses, but prefer you, the constituent, to focus on their losses being a result of reimbursements from insurance companies, the state, and the federal government not matching the cost of health care. Yet, it has been sufficient enough for some hospitals to invest upwards of $8 billion into diversifying their portfolios. It has been sufficient for them to pay the executives millions of dollars. It has been sufficient for them to pay their administrative staff bonuses year after year.

What happens when nurses work for hospitals who are willing to pay temporary travel nurses up to $10,000 a week to risk their lives during the first year of the pandemic but refuse to pay their employed nurses hazard pay and at-risk bonuses while they, too, risk their lives? What happens when their employed nurses find out that hospitals paid their administration staff bonuses during covid even though their lives were never at risk while working from the comfort of their homes behind a computer screen?

What happens when hospitals tell their nurses they have no choice but to care for eight patients instead of the standard four patients, a ratio that is deemed safe for the patient and safe for the nurses? What happens when a patient’s risk of dying in the hospital increases to 30 percent because the nurse is caring for eight patients and not four?

What happens when nurses witness patients wait for hours for food, the bathroom, medication, or just the simple interaction of a nurse being able to comfort their patient while the patient is sick in the hospital? What happens when nurses have to decide between the patient who can’t breathe and the patient who is having chest pain only to risk that one of them dies because there weren’t enough nurses to help both patients at the same time?

What happens when the nurses tell their hospital leaders over and over that this is happening and their response is to be grateful for the staff they do have? To tell nurses to be mindful that their negative attitudes don’t drive more nurses away. What happens when nurses witness patients die in the ER lobby because there simply aren’t enough nurses to stabilize the patients as they come in?

What happens when nurses remember that hospitals are choosing to close their pediatric floor because they couldn’t afford nurses, that it wasn’t in the budget? When nurses remember that beds are closed in the hospital because they couldn’t afford nurses, it wasn’t in the budget. But the hospital could afford to invest in the stock market. They could afford to pay bonuses to employees who provide no direct patient care.

What happens when nurses are no longer able to provide the standard of care they were taught to give, that they are ethically bound to give?

What happens when hospitals work hard every day to normalize nurses giving crisis-level of care to every patient they have? Crisis-level of care that increases the chances of patients dying while they are in the hospital and creates critically unsafe working conditions for nurses.

Nurses can’t hide behind a computer as patients suffer; we experience it first hand and regularly struggle to cope with knowing that you, our patients are suffering. Change is dependent on the hospitals, hospitals that tell us through their actions that they do not prioritize your health and well-being the way we do.

So, we leave. We leave because the depression, the anxiety, the guilt becomes too great to bear.

Nursing is an endangered profession. What action is taken will determine if it becomes extinct.

Kelli Johnson has worked for more than nine years as a nurse, six in emergency rooms.