Medical workers at Napa’s Providence Queen of the Valley Medical Center are battling burnout and staffing shortages while continuing to care for a constant deluge of COVID-19 patients.
“The stress of this isn’t going away any time soon,” said Leigh Glasgow, an Intensive Care Unit shift lead at the Queen and representative of the California Nurses Association.
As the COVID-19 pandemic has persisted, the shortage of nurses has become a more prominent issue both around California and nationally. And though California now has less COVID-19 transmission than any state in the country, according to the Centers for Disease Control and Prevention, the highly infectious Delta variant of the coronavirus is still sending people to hospitals and filling up ICUs.
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Last month, several Queen of the Valley nurses spoke of their experiences after Amy Herold, Chief Medical Officer at the hospital, gave an overview of the hospital’s operations during a Napa City Council meeting.
Herold said the hospital was short-staffed in every department, which was resulting in exhausted staff and longer wait times for patients.
“Everybody’s very tired,” Herold said at the meeting. “It’s been 18 months in managing crisis mode, and there’s a lot of fatigue in the medical staff.”
The nurses at the meeting gave more details, saying burnout from taking care of COVID-19 patients amid short-staffing was compounded by support experienced nurses needed to give to new or new to ICU staff members.
Kim Butts, a nurse at the Queen, said many experienced medical workers had left the hospital since the winter COVID-19 surge in response to physical and emotional stress they’d endured.
The hospital didn’t have adequate staffing during the winter surge, Butts added, and positions had been filled with brand new or new to Intensive Care Unit nurses. About two-thirds of ICU staff at the time was new to ICUs, she said.
“The simple fact is that there are not nearly enough experienced nurses or nurse educators that the Queen is supporting to support these nurses,” Butts said. “The result is unsafe patient care to our community, my neighbors, our family members, and increased stress on the experienced staff.”
Queen of the Valley chief executive Terry Wooten wrote in a statement that, in light of the most recent COVID-19 surge, the hospital’s caregivers are “running an unexpected extra leg of this marathon.”
Wooten said that, to mitigate the challenges, the hospital is providing competitive sign-on bonuses to job candidates, offering caregiver referral bonuses for nearly every open role, is working with staffing agencies to find temporary nurses and is requesting additional clinical resources from Napa County. Wooten also said Providence is offering recognition bonuses to all caregivers.
"I am eternally thankful to our caregivers for pouring their hearts into our mission of caring for all in need and this is a small token of our appreciation," Wooten wrote.
Glasgow said some issues have improved in the past month, but most issues identified by the nurses at the meeting remain, including the quantity of less experienced nurses.
“I still consistently see that we’re a new (graduate) experience ground,” Glasgow said. “They’ll get a year or so of experience then they’ll move on to other hospitals.”
Glasgow added she didn’t think she could support the less experienced ICU nurses in the way they need to be supported, especially considering the additional workload brought by COVID. She also said that lead nurses have to be aware of what types of patients are coming in so they can be there to explain to newer nurses how to handle specific cases.
“They still need a lot of support,” Glasgow said. “There are a lot of things they don’t know they don’t know.”
And taking care of COVID patients, Glasgow said, is physically and emotionally draining for all the nurses. The patients often require intensive care, and those who die from the virus often live on ventilators for several weeks. Because of the infectiousness of the disease, the hospital isn’t allowing in any visitors.
California is the only state that restricts the number of patients that can be assigned to each nurse. Emergency waivers allowing nurses to work above the nurse to patient ratios were granted by Gov. Gavin Newsom to hospitals last December, but weren’t renewed, and expired Feb. 8. But individual California hospitals can still apply to the state for temporary waivers.
Wooten wrote that the Queen applied for a waiver in August, but hasn't needed to waive the required nurse-to-patient ratios during the current surge, thanks to caregivers pulling together to work extra shifts and the recruitment of traveling nurses and permanent staff.
Glasgow said, however, that it’s often been impossible to staff to state-required ratios during COVID because of the lack of staff.
“Most of our COVID patients should be one-to-one care, one nurse, one patient,” Glasgow said. “However, we simply don’t have the staff.”
Glasgow also said layoffs at the Queen this year — including of emergency department technicians, administrative assistants and engineers — had added to stress for the nurses.
“I have never seen anything like this,” said Leigh Glasgow.” If I had faced this as a new grad I don’t know if I’d still be in nursing. What we have to do and the amount of medication we in the ICU have to give people, in order to breathe with the ventilator to fight against COVID, is unreal.”
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