As there is no clear end to the pandemic in sight, the biggest unanswered question is what this experience means, and what it will ultimately mean, to those who are always on the front lines ( the nation’s health care workforce) and the patients they serve.
An estimated 1.5 million health care jobs were lost in the first two months of COVID-19 as the country tried to contain the new coronavirus by temporarily closing clinics in U.S. hospitals and limiting non-health services. Struggled for. According to the US Bureau of Labor Statistics, health care employment remains below pre-pandemic levels, with the number of workers down 1.1%, or 176,000, from February 2020.
Yet the need for healthcare workers has never been greater. Staffing shortages are now the nation’s biggest patient safety issue, forcing Americans to endure long wait times for care “even in life-threatening emergencies,” or a non-profit. According to the safety organization ECRI.
In a March letter to the House Energy and Commerce Committee, the American Hospital Association said hospitals faced a “national emergency” of understaffing, pushing the total nursing shortage to 1.1 million by the end of the year. . And it’s not just nurses: professionals from medical lab workers to paramedics are in short supply.
The effects are felt throughout the care process. In some parts of the country, entire hospitals and medical departments have closed amid such shortages, leaving patients without access to critical medical care, including delivery services and hospital care for children.
With fewer doctors working in the field, physicians are taking on more patient responsibility, increasing burnout levels that experts say increase the risk of medical errors and As a result, doctors are at a potential disadvantage. American. According to the New England Journal of Medicine, the number of central line-related bloodstream infections increased 28 percent in the second quarter of 2020 compared to the same period in 2019, while the rate of falls and pressure injuries increased 17 percent. There was an increase of about 42%. % in skilled nursing facilities during the same period
And the tension didn’t end. A February 2022 USA Today and Ipsos survey of more than 1,100 healthcare workers found that nearly a quarter of those surveyed said they would leave the field in the near future because of the pandemic.
Low morale has already translated into departures. Results of a September 2021 survey of 1,000 healthcare workers showed that by February 2020, 18% had left their jobs.
Patients feel the sting in different ways. In January 2022, St. Alphonsus Health System, a primary care provider for a population of more than 1 million in parts of Idaho and Oregon, temporarily expanded weekend operations at three of its health care centers. Decided to close. Urgent care and reduced hours at all 11 of its urgent care clinics for a few weeks after several staff members contracted COVID-19 and had to isolate. Although the situation has since returned to normal there, sudden and temporary staff losses have been common during the pandemic, which has sickened workers in every corner of the healthcare landscape.
Other staff cuts have been more permanent. In April 2022, Memorial Hospital of Carbon County in Rawlins, Wyoming announced that it was ending its labor and delivery services due to staffing issues. Now, the closest facility for expectant parents is an hour and a half away at Evanson Memorial Hospital in Laramie, Wyoming.
“The cost of traveling nurses played a major role in this decision,” Rod Weckerlin, chairman of the MHCC board of directors, said in a news release. Labor and Delivery is a single service line that requires a large number of staff. Unfortunately, as a result of the pandemic, MHCC has lost a large number of nursing staff, forcing them to rely on traveling nurses and operating financial imbalances.
The growing demand for health professionals has also sharply increased labor costs, as hospitals competing for workers must offer higher salary packages. According to a recent report by consulting firm Kaufman Hall, hospital labor costs increased by 37 percent between 2019 and March 2022.
For hospital systems like Northwell Health in New York, the volatile job market has presented immediate and long-term workforce challenges that have evolved with the changing nature of the pandemic.
In early 2021, the focus of the Northville crew changed. It went from handling an influx of critically ill COVID-19 patients to staffing its emergency departments. And inpatient beds in its outpatient settings to treating more mild cases.
With the number of Covid cases rising again at PresTU. Northwell Health Deputy Chief of Staff Matthew Kurth says the health system has to ensure that Focus has been placed. On adequate staffing of testing centers and processing labs.
But even as workers have adapted, many patients are changing the way they access health care. Because of the pandemic, which has created both opportunities and new challenges.
For example, many patients have become accustomed to using digital tools like telehealth to meet their primary care needs. A process that Kurth says will likely continue beyond the pandemic. will remain But while fewer people are being hospitalized for severe COVID-19. More patients are developing serious illnesses. Creating a backlog of cases at numerous facilities across the country. Many of these cases arise from delayed care. People who withhold treatment because of fear of contagion or care restrictions implemented at the height of the epidemic.
“I think the first wave effect was definitely across the spectrum,” says Dr. John D’Angelo, chief of integrated operations at Northwell Health.
A Heavy Burden
Although hospital staffing challenges have changed with each new wave of COVID, one concern remains: the mental and physical burden placed on health care workers.
At Henry Ford Health in Michigan, pandemic-related burnout and stress have prompted some professionals to seek more lucrative jobs by hiring staffing agencies, while others have left the field altogether. What is the choice, he says. John Harrington Davis, vice president of workforce diversity and talent acquisition organization. He estimates there are about 3,000 vacancies in the health system.
“I don’t think there’s any area that I can name that hasn’t had a lot of turnover,” says Harrington-Davis.
Michelle Gaskellhams, Kaiser Permanente’s director of operations for the Southern California and Hawaii markets, says that while the situation in terms of cases and deaths has improved since the early months of COVID-19, there remains an urgent need for hospitals to prepare workers. Trouble should be removed. Experienced since day one.
“As our growth slows, more people are vaccinated, and hospitalizations decrease, many people want to put the pandemic behind them, but the health In the care space, it’s not that simple,” says Gaskill-Hames. “There’s just layers of anxiety, stress and fear. It just doesn’t go away.”
To help workers recover from the trauma caused by the pandemic. The health system launched Rise and Renew, an initiative that provides employee counseling support.
At Mount Sinai Health System in New York. Staff have been offered free 14 individual behavioral health counseling sessions and group workshops since June 2020. When the organization launched its Center for Stress, Resilience and Personal Growth.
According to Jane Maqsood, the health system’s director of human resources, the program. Along with efforts to allow up to 10,000 team members to work remotely. Is part of a broader retention strategy to help workers know what to do. Depending on where they are. Engaging them with support and allowing for maximum flexibility.
Yet even as the country enters a less severe phase of the pandemic. Some experts doubt that enough is being done nationwide to deal with the lingering trauma of working on the front lines during COVID-19.
“My concern is that, even though it’s happening. For a lot of it, I don’t know if the support clinical staff is,” says Dr. Rajneesh Jaiswal, associate chief of emergency. Medicine at NYC Health + Hospitals-Metropolitan in Manhattan. “Health programs that take that into account and allow people to actually use them. I think that’s going to be the next big thing.”
A return to “business as usual” for many hospitals will also mean facing. The same staffing issues that existed before COVID-19, Jaiswal says.
A Coherent Answer
Creative staffing solutions have also emerged from the pandemic. Amid the initial waves of COVID-19, some hospitals addressed workforce gaps by quickly. Redeploying existing staff to help in areas of greatest need. Medical professionals whose services were suspended to prevent. The spread of the virus have started helping their colleagues in caring for COVID-19 patients. Teams of nurses and doctors led by intensive care unit doctors were formed to treat sick patients.
“In some cases, we had doctors working for nurses because there was too much. Of a burden on the nursing teams to really provide consistent bedside care,” says Maqsood.
Similar tactics are being adopted in San Alfonso, for example. To address nursing staff shortages and ideally reduce wait times. The medical center is launching a pilot program that creates nursing care teams composed of registered nurses. Licensed practical nurses and certified nursing assistants. With fewer nurses available to care for patients in the region. The program aims to There are fewer RNs caring for a large group of patients than they traditionally. Do without lowering the quality of care or safety standards.
“It’s a way to expand that care team a little bit,” says David McFadyen, president of St. Alphonsus Regional Medical Center.
At Virginia Mason Franciscan Health in Washington state, virtual care is helping. The centralized mission control center and virtual hospital, which went live in 2019. Provide real-time, system-wide monitoring that helps deploy staff to departments more quickly. Says Nursing Director Diane Aroh. which address capacity issues. While addressing bottlenecks in patient flow and waiting times
“It’s a system that I think we’re going to benefit from in the future,” she says.
The Road Ahead
Whether due to labor costs, illness or burnout, the long-term effects. Of the current shortage of health care staff are likely to be felt long after the pandemic is over.
Across the country, staffing shortages threaten to worsen in what projections have characterized as a growing crisis for years. By 2025, the U.S. is projected to have a shortage of approximately 446,000 home health aides, 95,000 nursing assistants, 98,700 clinical. And laboratory technicians and technicians, and more than 29,000 nurse practitioners.
Meanwhile, the need for health care will only increase as the elderly population continues to grow. According to the Department of Health and Human Services. The number of people age 65 and older is expected. To increase from 54 million in 2019 to more than 80 million by 2040. The prevalence of chronic diseases among youth and children has also increased over time. With more than 40% of school-age children and adolescents having at least one chronic health condition.
While technological and workplace innovations may provide short-term relief. Workforce reductions point to a future in which patients will have to become more active participants. In their own health care to achieve better outcomes.
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