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CARE
DELIVERY
Even $10K+ bonuses
aren't alleviating
'critical' nurse
shortage in Western
Pennsylvania
By Gabrielle Masson
S
ome healthcare leaders are deeming the nurs-
ing shortage in Western Pennsylvania "critical,"
reported the Pittsburgh Tribune-Review.
e shortage is occurring in a region characterized by a
rapidly aging population and shrinking workforce, and
has been further exacerbated by the pandemic.
UPMC and Allegheny Health Network, both based in
Pittsburgh, had more than 2,200 openings for registered
and licensed nurses posted online the week of July 26, ac-
cording to the Tribune-Review. UPMC, the state's largest
employer, is offering recruitment bonuses up to $10,000
for registered nurses, while AHN is offering up to $15,000
for more experienced nurses.
Some personal care homes and assisted living facili-
ties are paying as much as $50 an hour to fill pressing
vacancies for nonlicensed caregivers, said Margie
Zelenak, executive director of the Pennsylvania As-
sisted Living Association. At least two personal care
homes told her they decided to close, with one citing an
inability to hire help.
Since May 2020, employment in nursing homes and
residential facilities across the six-county region has
dropped by 1,100 workers, according to the U.S. Bureau of
Labor Statistics.
"We are having a horrible time hiring to fill positions,"
said John Dickson, president and CEO of Greensburg,
Pa.-based Redstone Presbyterian SeniorCare. Even before
the pandemic, Redstone worked through the Healthcare
Council of Western Pennsylvania to bring in nurses from
the Philippines.
Greensburg-based Excela Health, which operates three
hospitals and multiple outpatient facilities, plans to im-
plement an international contract for nurses this fall, a
spokesperson told the Tribune-Review.
In 2018, AHN recruited 150 registered nurses from
the Philippines and Caribbean islands, which have
similar professional standards. Claire Zangerle, DNP,
MSN, chief nurse executive at AHN, said the program,
which has the nurses come on three-year work visas,
has been a success with a high retention rate. However,
the system is still short about 300 nurses, Dr. Zangerle
told WPXI-TV. n
Hand sanitizer's second act:
What physicians say about
risk of overuse
By Erica Carbajal
A
mid the pandemic, hand sanitizer has become a fixture in
Americans' daily lives, but it's not without risk, two physi-
cians told The Boston Globe.
Overall, the near-ubiquitous nature of hand sanitizer is a good
thing, the physicians said.
"The great benefit is the ease of use, and the demonstrated
efficacy of killing viruses, bacteria, etc.," said Gregory Poland,
MD, infectious diseases physician at Rochester, Minn.-based
Mayo Clinic.
However, there are several risks associated with hand sanitizer
overuse. Below are five possible risks:
1. The vapors of hand sanitizer, when used in excess, may irritate
people with hyperreactive airway disease, Dr. Poland said.
2. The high concentration of alcohol in sanitizer can also damage
the skin's outer layer, said Abigail Waldman, MD, a dermatologist
at Boston-based Brigham and Women's Hospital. The damage
causes dry skin prone to itching and cracking, thereby increasing
the risk of bacterial infections. Healthcare providers accustomed
to frequent use of hand sanitizer compensate with Vaseline and
Aquaphor, Dr. Waldman said.
3. People who regularly use hand sanitizer may develop a resis-
tance to the sanitizer being used, though resistance is more com-
mon with antimicrobial agents, Dr. Waldman said.
4. Hand sanitizers may also disrupt the microbiome. They wipe
out bad bacteria and viruses, but also wipe out good bacteria and
viruses, Dr. Waldman said. "We just don't know what the implica-
tions of that are. More and more, we're realizing that your normal
skin flora actually maybe has some purpose in protecting you."
5. Ethanol and isopropanol are safe and effective sanitizer ingre-
dients, though methanol — a hand sanitizer ingredient used in
many countries — is not. It's banned in the U.S. but allowed in
certain countries that sell the product online, prompting several
FDA warnings last year. Ingesting methanol may lead to blind-
ness and death, according to the CDC, which reported 15 cases
in two states last summer.
Bottom line
"What's clear is that sanitizer is inferior to soap and water, which
allows for a more thorough wash," Dr. Poland said, noting that
hand sanitizer can't penetrate mucus, dirt, blood or other solid
particles. However, when soap and water isn't available, hand
sanitizer is the next best option.
"I think the benefits far outweigh the risks when it's an approved
hand sanitizer, used properly, and soap and water isn't available
or not a feasible option," Dr. Poland told the Globe. n
