EVERETT — This month’s headlines reported rampant nurse burnout, overwhelmed intensive care units and the deployment of the Washington National Guard to hospitals here and across the state.
Through it all, some readers have continued to point to the state’s vaccine mandate as a driving force behind a severe nursing shortage. But officials say the reasons for stretching health systems are more complicated and have been growing for years.
Statewide, hospitals have lost about 2% of their staff to the vaccination mandate, with employees being laid off 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, hospital officials said the loss should not have a significant impact on operations.
In an analysis of 2021 exit surveys, the WSHA found that 7% of RNs leaving their jobs cite the state’s immunization 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 due to burnout.
So what’s behind today’s stretched and strained hospital systems? Here’s what we know.
The burnout of nurses during the pandemic is well documented. At the Providence facility in Everett, officials said, turnover gradually increased in 2021, mirroring national trends, as nurses had to work longer hours and cover more patients.
The so-called “big resignation” has affected countless industries, with and without a mandate.
Everett hospital nurses have described many staff leaving in recent months and particularly during the latest outbreak of infections.
A December poll of unionized healthcare workers in Washington found that 84% of respondents were burnt out and 49% were likely to leave the field in the next few years, mostly due to lack of staff and salary.
Staffing levels at Providence Regional Medical Center, however, remained roughly where they were before the pandemic, although many of those positions were temporary staff filling in gaps. According to hospital officials, the increase in the number of patients, sick employees and other factors mean that the level of staffing is insufficient.
years of preparation
The pandemic has strained hospitals and accelerated turnover, but officials say a healthcare workforce 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 aging and older people need more care.
It creates a “perfect storm,” Providence spokesman Casey Calamusa said.
According to the American Hospital Association, more than half of all nurses were 50 or older. Nearly 30% were 60 or older.
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 the state and national level.”
In the 2019-2020 academic year, 2,600 nursing graduates were educated in Washington. This compares to the 6,100 registered registered nurses who were needed to fill vacancies last year. To fill the void, hospitals rely on contract travel nurses, although about 3,100 registered nurse positions remained open in 2021.
“The math just doesn’t add up,” Briley said.
Problems 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 affecting nursing homes, there is often no place for these people to go.
Of the 600 beds at Providence Regional Medical Center Everett, about 100 represent people who are medically stable and awaiting discharge to lower-level care facilities. The hospital this week called the situation “the main driver of our staffing issues.”
Even though these patients are stable, they still require medical attention from staff.
This month, Inslee announced efforts to ease the burden by increasing nursing home capacity and speeding up legal guardianship proceedings, but Everett hospital officials said there was no simply not enough beds, staff and other resources to solve the problem.
Record COVID hospitalizations
Omicron has pushed the state’s COVID-19 hospitalizations to record highs.
These patients are still largely unvaccinated.
The highly infectious variant has also forced more caregivers into self-isolation after being infected with or exposed to the coronavirus, Providence Chief Medical Officer Dr. Jay Cook said.
Now the hospital is following updated guidelines from the Centers for Disease Control and Prevention that allow some staff to return to work sooner if they contract the virus.
“The risk of an unprecedented staffing shortage,” Calamusa said, “poses a greater threat to patient and caregiver safety than asymptomatic caregivers — wearing all appropriate protective gear, including N95 masks. – providing medical care to those who need our services.