Hospital busier than ever, staff facing burnout

McCOOK, Neb. — In case it has not been apparent, Community Hospital, like all hospitals in the United States, has been challenged by the state of healthcare in the nation, according to Troy Bruntz, President & CEO. “I would say that in my 18 years we have never been busier for this long of a period of time. We are short-staffed and our staff is tired and facing burnout.”

For months, Community Hospital has had days where it was at maximum census for the amount of staff on hand. The hospital is a 25-bed critical access facility, but only ideally only fills patient rooms according to the staff ratio available to work that day. There have been many days that all patient rooms were full, and much extra staff needed to come in on days off to care for these patients, Bruntz said.

There are many reasons for the higher patient load and staff shortages. Yes, there have been more patients in the hospital in 2021 and now 2022 than ever before, but the surge is not necessarily from COVID-19. Some patients have COVID, according to hospital nursing leaders but many do not. However, COVID compounds the issue as a patient sick with it requires one-on-one care by a nurse, lab tech, or respiratory therapist, who has to don and doff protective gear every time they enter the room. It takes more resources, staff included, to care for these patients.

Some staff are sick as well; absent with COVID and other respiratory illnesses. An exposure to COVID can keep a healthcare worker at home – reducing staff even more.

Community Hospital has a very low turnover rate, yet, there have been several positions open at the hospital for months, compounding the shortage. Some are nursing positions and others require staff with specific medical training. With more baby boomers retiring and fewer individuals in the younger age groups to fill those positions, a shortage of workers has developed. Nationwide, there has been a shortage of healthcare workers for years, and the last two years have made this most dire.

In the past when a hospital had a staff shortage – especially for nurses - traveling nurses from other areas and states were brought in until the shortage could be reduced with long-term hiring. Most traveling nurses have all been spoken for during this nationwide crisis, and those who have not are much too expensive for rural hospital budgets.

These reasons and many more have created challenges for hospitals wanting to provide excellent patient care, according to Molly Herzberg, Vice President Patient Care Services & CNO.

“Our patients are very sick and they need to be hospitalized,” she said. “What we are seeing are staffing shortages related to caring for so many inpatients at once. Also, we are seeing our emergency department being two to three times busier. We are no different than the other hospitals in our region, our state and the nation.”

“We just want the public to know they may have to wait to be seen in the ER,” she said. Also, they may have been waiting and someone else comes in who may be more emergent (sicker) and may be seen before them even though they were already waiting.”

Julie Wilhelmson, RN, Director of ER & Outpatient Services, agrees. “There could be long waits in the ER,” she said, not only to be seen but also to find a hospital bed if one is needed. “If Community Hospital cannot care for the patient either due to the level of care the patient needs or because a bed is not available, we have had several patients waiting hours in the emergency room,” she said. Some have waited while nurses make call after call to other hospitals locally, in the region, and even to hospitals in other states to find a bed for the patient. It is not unusual for a nurse to call 15-30 times for one patient. Patients have been transported from Community Hospital to Wyoming, Colorado and South Dakota. This means that in these cases, the very closest hospital that could take a patient was 500-600 miles away.

Wilhelmson encouraged readers, “Please do not delay using the emergency department, or calling 911 for life-threatening emergencies, such as severe shortness of breath, chest pain, stroke symptoms, traumatic injuries, or uncontrolled bleeding. Visit the clinics, walk-ins, and urgent cares for other non-emergencies, such as cold symptoms, allergies, and minor illnesses,” she added.

“And please do not come to the emergency room to simply be tested for COVID.” She explained that pharmacies have over-the-counter testing kits for COVID. “People can also be tested in a clinic. It is best if the emergency department can dedicate their efforts towards patients needing emergency care,” she said.

Both nurses explained that recently they had to make the difficult decision to postpone some elective surgeries and scheduled OB procedures because there was not enough staff and open beds to care for patients on the patient wing following the surgeries and procedures. “We have had to reschedule cases several different times in the last month related to no bed availability,” Herzberg said. “We do always try to leave a bed open for laboring patients and trauma patients,” she added.

To help with staffing, employees from other departments have been asked to help with care on the patient wing. “These are scenarios we currently are facing. By no means do we want to send the message not to come to the hospital for services,” Herzberg concluded. “But they may have to wait and these are the reasons why.”

The public can help by staying home if they are sick, to not spread COVID to others, and by following the new quarantine guidelines,” Wilhelmson said.  “Vaccination is strongly encouraged because it can lessen the severity of the virus and help to keep people out of the hospital,” she added. “Bruntz added that the current Nebraska stat is for every one vaccinated COVID positive patient in the hospital, nine hospitalized patients with COVID have not been vaccinated.

All three hospital leaders ask the public to be patient with healthcare workers. “The healthcare system is at a crisis,” Bruntz said. “At one point, we were the heroes. Now we are really struggling and worn out and don’t know if the public really knows or understands.”