Articles - Negligence
Nurses In Demand :: (11 28, 2005)
Last week's $2.7 million settlement of a lawsuit against Wesley Medical Center put the local spotlight on a nationwide shortage of hospital caregivers.
Billy Higgins sometimes feels his hospital room is closing in on him.
Higgins, who has spent more than 80 days this year at Via Christi Medical Center-St. Francis Campus for cancer treatments, feels better when Rebecca Applebaugh enters the room.
"She'll talk to you more than the doctor does, and that's the truth, too," said Higgins, 72, of his nurse.
Just as Higgins has a regular doctor, he knows Applebaugh will be his attending nurse every time he comes to St Francis.
It's one hospital's attempt to use nursing staff more efficiently, one way to fight a shortage of caregivers.Nursing staff shortages - a looming challenge for hospitals nationwide - came into sharp focus in Wichita last week. Wesley Medical Center agreed to pay $2.7 million to the family of Shirley Keck, which claimed she suffered a paralyzing stroke because of nursing shortages at the hospital.
To families concerned about whether their loved ones will get the care they need, local hospitals say they work hard to find ways to lessen the impact of staffing problems.
"With the nursing shortage a reality, we have to look for changes in the way we deliver care," said Sharon Gonzales, vice president of patient operations at Via Christi. "We want the public to feel safe in our hospitals, and we're working hard to achieve that."
Kay Willis, Wesley's chief nursing officer, said: "Staffing has always been a challenge, and the nursing shortage has been cyclical Our primary goal is to stay prepared."
The problem
The fastest growing population in America is ages 85 and older, and millions of baby boomers are passing age 50.
At the same time, the nursing work force is aging. The number of students graduating from nursing schools is declining.
"Where are the caregivers going to come from?' wonders Wesley President and CEO Carl Fitch. That's a concern not only at Wesley but across the country.
'There's always been talk of this looming nursing shortage, but... recent news and journal reports have really brought things to the forefront," said Hope Ball, spokeswoman for the American Nurses Association, a professional organization that represents 2.6 million registered nurses. Although the shortage is real, some question whether staffing problems are caused instead by hospitals trying to cut costs.
"I think it's a combination," Hall said. "Sometimes you do have a hospital that may have inappropriate staffing or that would rather hire nursing assistants instead of RNs. You do have those situations.
"I'm not sure there's going to be any quick fix."
During Wesley's legal struggle, the hospital fought allegations that it put profits before patients - the same concerns that in recent years have haunted its owner HCA, The Health Care Co.
Formerly HCA-Columbia, the corporation based in Nashville, Tenn., owns more than 200 hospitals in 24 states. While facing charges of fraud for improper billing, it promised to downsize and concentrate on patient care.
Testimony from nurses at Wesley said the Wichita hospital didn't staff units properly because it might eat into profits.
"Everybody is aware it's money oriented," said Joni Herrlngton, a Wesley nurse, in a sworn deposition during the Keck case.
Wesley's Fitch says his hospital puts patient care first.
"This hospital exists to take care of patients who come in our door," Pitch said. "We do the best we can do."
Fitch pointed to Wesley's willingness to close its outpatient Heart Center recently because of a shortage of workers as evidence that the hospital puts patients before profits.
Looking for answers
Hospital administrators know they can't control how many students come through nursing schools, but they have to cope with shortages of available help.
People get sick. They collide in car accidents. And they come through the hospital doors unexpectedly at all hours.
"We can't tell those people to make an appointment for next week. We can't close our doors when we don't have enough people," said Gonzales at Via Christi.
That leaves Wichita hospitals searching for ways to stretch the staff they do have.
Wesley, for example, is trying to relieve nurses of making phone calls or inputting electronic orders, Willis said.
While averaging 20 to 35 vacancies for full-time registered nurses over the past two years, Wesley is concentrating its efforts on recruiting new nurses and keeping those it already has.
That has meant increasing its regular "float pool" - nurses not permanently assigned and available to areas that don't have enough nurses - from zero to more than 40. The hospital also offers bonuses for nurses in critical-shortage areas such as operating rooms and bonuses to employees who refer people to help fill cntical positions.
Beyond that, Wesley is working more closely with nursing schools to help train and recruit nurses.
"The road we're taking is admittedly the long approach, but we basically want to create the best place to work, and we see that as key to recruiting and keeping good people," Willis said. "In that environment, people will do their best work and patients will get the best care."
Via Christi, which couldn't provide vacancy numbers Friday, has taken similar steps. It's also experimenting with the idea of attending nurses - a program that could be one of the first of its kind in the nation.
Applebaugh, the nurse for cancer patient Higgins, is the first attending nurse at the hospital. Holding a master's degree in nursing, she makes rounds with doctors for each of her patients, who she sees from their admission to even after they're released.
"It's wonderful to have someone you can rely on," said Higgjns, a former oil reflnery worker from El Dorado.
The hospital hopes the program will help nurses feel like they have ownership in their patients' care.
"I know his histoiy, and he doesn't have to repeat himself every time he comes in,"Applebaugh said. "It really helps with communication."
The aim is not only to increase efficiency but improve recruitment and retention of nurses. The opportunity lured Applebaugh from her job with an insurance company.
At its St. Joseph campus, Via Christi also is freeing up nurses to concentrate on medical duties with staff called hospitality specialists.
Formerly the housekeeping staff, these employees now perform non-medical tasks once left to nurses. They make sure patients have fresh water, blankets and their meals. They visit the patients every hour and summon nurses when needed.
"Just passing (food) trays on a floor will save nurses 30 minutes," said Karen Gibson, clinical director for the medical-surgery floor at St. Joseph.
The savings translate into more quality time between nurses and patients.
"I'm actually being able to talk to patients now," said Christy Martin, a registered nurse at St. Joseph.
Riverside Health System told The Eagle last month that the hospital's nursing staff was in good shape, after a three-year effort to recruit and retain health care workers.
The hospital uses specially trained volunteers for nonmedical tasks.
Measures of care
As hospitals face staffing challenges, families can play a role in making sure their loved ones get good care.
The key, Willis says, is for patients to speak up about any concerns.
"To any patient I would say, we want you to be as confident as we are that you are going to be surrounded by people who care for you and want to take care of you," she said.
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