Becker's Hospital Review

77 FINANCE CMO / CARE DELIVERY Tenure gaps growing in hospitals By Kelly Gooch A s hospitals in the U.S. are grappling with nursing shortages, they are not only facing fewer nurses, but they are also facing a widening skills gap as experienced nurses leave the field, MedPage Today reported Sept. 15. e Institute of Medicine warned about a shortage of experienced nurses in 2011 in a re- port on e Future of Nursing, initiated by the Robert Wood Johnson Foundation, and recom- mended that 80 percent of nurses should have at least a bachelor's degree in nursing by 2020 to meet future U.S. healthcare needs as well as improve care quality. Additionally, according to the American Nurses Association, more than 500,000 sea- soned registered nurses anticipate retiring by 2022, and the U.S. Bureau of Labor Statistics projects more than 1 million new registered nurs- es are needed for expansion and replacement of experienced nurses. Nursing shortages are not new. However, hos- pitals have said the COVID-19 pandemic and the wave fueled by the delta variant have exacer- bated the problem, leading to some retirements earlier than planned and more nurses consider- ing leaving earlier amid stress and challenging working conditions. And the pace of new nurses is not keeping up with the number retiring, according to Shawna Butler, RN, a nurse economist based in Texas. "e pipeline of new nurses doesn't keep pace with retirement — and with so much of the ex- perience retiring from the workforce, much of the operational, safety, clinical, and institutional knowledge, history and wisdom is lost," she told MedPage Today. Beth Wathen, MSN, RN, president of the Amer- ican Association of Critical-Care Nurses, told the publication new nurses are also leaving the bedside sooner, with some staying at the bed- side only a couple years. During the pandemic, hospitals have taken various measures to address shortages and at- tract and retain nurses, such as halting elective surgeries, offering sign-on bonuses and other incentives, bringing in travel nurses, and solic- iting federal help. Potential solutions for the fu- ture, cited in MedPage Today, include things like improving training opportunities. n Heart patient dies after being turned down from 43 ICUs amid COVID-19 surge By Erica Carbajal A 73-year-old patient from Alabama died Sept. 1 after dozens of hos- pitals in three nearby states did not have an intensive care unit bed available for the patient, The Washington Post reported Sept. 12. The patient, Ray DeMonia, was treated for a stroke in April. In late August, he began experiencing heart problems and was taken to Cullman (Ala.) Regional Medical Center. Jennifer Malone, a spokesperson for the hospital, confirmed to the Post that Mr. DeMonia was a patient in their care, adding that "the level of care he required was not available at Cullman Regional." The hospital contacted 43 other hospitals in three states, all of which did not have a specialized cardiac ICU bed available, his family told the Post. Mr. DeMonia was eventually transferred to Rush Foundation Hospital in Meridian, Miss., about 200 miles away and died Sept. 1. "When patients are transported to other facilities to receive care that they need, that's becoming increasingly more difficult because all hospitals are ex- periencing an increased lack of bed space," Ms. Malone told the Post. The news comes as Alabama grapples with "a real crisis" with its ICU bed capacity amid COVID-19 surges, Scott Harris, MD, head of the state's health department, said during a Sept. 10 news conference. There were nearly 2,800 people hospitalized with COVID-19 in Alabama as of Sept.12, including 768 people in ICUs, according to data from the Post. There were about 60 more ICU patients than there were open beds in the state the week of Sept. 6, Dr. Harris said. n New York health system halts maternity care after staff resign over vaccine mandate By Alia Paavola L ewis County Health System, a single hospital system in Lowville, N.Y., closed its maternity unit in September due to staffing challenges wors- ened by the number of workers unwilling to get the COVID-19 vaccine, NNY360.com reported Sept. 10. Gerald Cayer, CEO of the health system, said the maternity department will be closed until they can find enough vaccinated nurses to reopen it, according to the publication. At the time of publication, the hospital has not reopened the unit. Mr. Cayer said Sept. 10 that seven of the 30 people who have resigned due to New York's vaccine mandate worked in the maternity ward, and seven ad- ditional workers in the unit did not indicate whether they would get their first vaccine by Sept. 27, the deadline set by the state for healthcare workers to get their first dose. The health system said it may also scale back medical services in five oth- er departments if more employees resign over the vaccine mandate. As of Sept. 10, there were 165 of about 650 employees who were unvaccinated. "It just is a crazy time," Mr. Cayer said, according to NNY360.com. "It's not just LCHS-centric. Rural hospitals everywhere are really trying to figure out how we're going to make it work." n

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