The New York hospital staffing crisis is fueled by Omicron – exacerbated by employee turnover

A nurse working in the emergency department of the Brooklyn College Hospital Medical Center in Brooklyn said there were many close calls lately. At one point, they were short of hospital staff, and after removing the device that helped him, BPAP, they found that the patient was “pulseless” in the hospital bed, so the nurses covered it. Said that he entered some of the unassigned facilities. breath.

“We caught him in time,” said the nurse, who started CPR. “We intubated him and everything, but there must have been staff there.”

Brookdale employees recently said there was a recent night shift with four to five nurses covering the entire emergency department.

“Patients will die,” they said. “That is my greatest fear.”

Currently, hospital staff in five provinces are suffering from a shortage of staff in New York City. Health officials predict a few weeks ago. At a press conference Thursday, Dr. Mitchell Katz, President and CEO of NYC Health + Hospitals, a public system of 11 hospitals in the city, said: “There is nothing about becoming a nurse or doctor who immunizes you with Omicron.”

Some hospitals have dealt with the very high absenteeism of staff who have caught the virus themselves, even after the recommended quarantine period has been reduced from 10 to 5 days. in the meantime, City data show COVID-related hospitalizations are increasing. And the hospital reports that COVID patients have not arrived as dangerous as in the spring of 2020 (Some are recognized for other reasons and happen to be positive on the test In the case of viruses), they are no longer the only priority. Unlike the first wave, many people are now coming in for non-COVID related care.

According to LaRay Brown, CEO of OneBrooklyn, a total of 356 employees (about 7% of employees) fell ill on Thursday in Brooklyn and Interface, both part of the One Brooklyn Health System. She said it was an improvement from the previous day.

But the current shortage of staff is not just due to people calling for illness. Brookdale nurse and four others at the City Hospital, who spoke with WNYC / Gothamist, said they had lost their colleagues for months. In some cases, those colleagues retired and in others they took advantage of better employment opportunities, including temporary employment and travel nursing jobs. Pay a much higher fee More than a full-time position — the fee the city hospital is currently paying to hire temporary workers to fill the gap.

“When I look around, it’s scary to think,’Wow, no one is here,'” said Kelly Cabrera, a nurse in the emergency room at Jacobi Hospital in Bronx. Knowledge with them. “Similarly, everyone here is a brand new or just-beginning traveler.”

Another Jacobi employee said many colleagues have retired in recent months, contributing to staffing issues. However, Stephanie Guzman, a spokesman for Jacobi’s NYC Health + Hospitals, denied that was the problem. “I’ve never heard of many employees leaving hospitals and systems, and I’m sure they won’t cause any further tension during the Omicron surge,” she said.

The higher costs required by temporary and travel nurse agencies can place certain burdens on safety net hospitals such as Brookdale, which primarily serve low-income patients. More volatile finances Than hospitals with a large number of middle class and wealthy patients with private insurance.

Brown in One Brooklyn confirmed that her health care system lost staff during a pandemic. She said she was willing to pay a “premium price” to hire temporary workers. This means she may have to cut corners elsewhere. “We have other vendors for equipment and fixtures that we may not be able to pay or may have to pay months late,” Brown said.

To meet the staffing needs of Omicron’s surge, Mayor Eric Adams announced this week that he will send $ 111 million to NYC Health + Hospitals and the city’s health department. He also said the city will add $ 33 million to the COVID-19 Hospital Loan Fund, which is operated through a partnership with Goldman Sachs, and will provide a total of $ 45 million in loans to safetynet hospitals outside the public system. rice field. For one Brooklyn health system.

“This plan will ensure that front-line healthcare heroes have the resources they need to deal with staff shortages and continue to provide the highest quality care for everyone passing through the door,” Adams said. Stated in a statement regarding the offer.

Mr Brown said he was grateful that the mayor had admitted a private safety net hospital in the city “in the neighborhood, which continues to be unbalancedly affected by COVID.” But she said she had to think twice about borrowing money given the financial constraints of One Brooklyn.

Temporary workers cause controversy among full-time staff

While the flexible workforce has become a reliable strategy for responding to the COVID surge, increasing reliance on temporary workers has also created resentment among some full-time staff. An intensive care nurse at Lenox Hill Hospital in the Upper East Side asked not to be named for fear of retaliation, but was underestimated because he did not receive hazard pay during the pandemic. Said he felt.

“You can imagine how you feel when you are asked to stop the self-care and vacation you earned to join and work in a stressful situation,” said the nurse. “In addition, I try to come to the unit temporarily and do three times the rewards, because many of them are incapable of doing everything we train. . “

For example, if the nurse has no experience with the type of unit assigned to it, the nurse may not be familiar with the specific medical device used there or how to troubleshoot problems. Full-time hospital staff who spoke to WNYC / Gothamist stated that these nurses have a learning curve to familiarize themselves with the nuances of how a particular hospital operates, even with relevant experience. rice field.

Sean Petty, a nurse in Jacobi’s pediatric emergency room, said the medical center had been hit by a “brain drain” in recent months. He said temporary workers could not replace the experience and expertise of those who left when they were available, especially in specialized areas such as pediatric medicine.

According to Petty, staffing issues began to occur before Omicron arrived in the city in November. The pediatric emergency room was almost empty in the spring of 2020 during a pandemic in New York, but the volume increased as the city was unblocked and the children returned to school. It was expected. “What went wrong,” Petty said. “It happened at the same time that hospital staffing became more and more vulnerable.”

NYC Health + Hospitals acknowledges an overall shortage in the current wave of COVID, but agency spokesman Guzman said the pediatric emergency department of the health system is not a prominent problem area. rice field. “I’ve never heard of a lot of tension on the front lines when it comes to pediatric ED,” says Guzman. “In general, we have not experienced the national experience of other hospital systems with a surge in pediatric cases of COVID.”

Overall, New York State has seen a dramatic increase in the number of inpatient children who are positive for COVID-19 in recent weeks. There were 365 patients under the age of 19 who were hospitalized on January 4. Up from 21 Just a month ago. In Jacobi, 39 patients of that age group who were COVID-19 positive were hospitalized during the week from December 29th to January 5th. State data..

Some pediatric patients with Jacobi suffer from other symptoms that can be exacerbated by COVID-19, such as asthma and a respiratory illness called croup, Petty said. Anyway, he said the staffing of his unit was the worst he’s seen in the hospital for 14 years, and in his view it has real consequences. Petty said there is not always enough staff to triage when patients come in. That is, patients are viewed in order of arrival and may wait 2-3 hours before being evaluated.

“If the person has dyspnea, or if the child has a more serious illness, we don’t know unless parents get our attention,” he says. I did.

The future of healthcare professionals

The New York State Nurses Association said that vacancies were increasing in some hospitals during the pandemic. Called by the administrator Do more to hire and retain full-time employees.

“At least in the short term [the rise of temp and travel nursing] Dr. Jan Moor, director of the SUNY Albany Center for Health and Labor Research, said:

By 2030, a shortage of nurses was predicted in parts of the country, as many baby boomers were scheduled to retire in the last decade, even before the pandemic. New York was supposed to be in the black, but it’s unclear how the pandemic will affect that outlook.

“Smoke must be pandemic and clear in order to really understand if we are seeing some long-term trends,” Moore said.

As of June 2021, state health care workers overall decreased by 3% from pre-pandemic levels. According to the governor’s office.. It exacerbates the long-standing staffing challenges faced by certain sectors such as nursing homes. “There are just not enough health care workers in hospitals, care facilities, ambulances, and loved ones’ homes,” Governor Kathy Hokul said in a speech by Governor Wednesday.

She promised to invest $ 10 billion over multiple years to strengthen her healthcare professionals. This includes incentives such as higher wages and bonuses to maintain your position over the long term.

Meanwhile, hospital workers said they were suffering from the destabilization that the pandemic caused in the workforce. “I feel like all of this is collapsing everywhere, and I don’t know how sustainable this is,” said Jacobi’s Cabrera.