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SAN FRANCISCO (AP) – Nerissa Black was already struggling to care for four COVID-19 patients who need constant heart monitoring. But due to the staffing shortage affecting hospitals across California, its caseload recently increased to six people infected with the coronavirus.
Black, a registered nurse in the heart telemetry unit at Henry Mayo Hospital in Valencia, just north of Los Angeles, barely has time for a break or a meal. But what really worries him is not having enough time to devote to each of his patients.
Black said she rarely has time to help patients brush their teeth or use the bathroom because she has to prioritize making sure they get the drugs they need and don’t develop. no bedsores.
“We had more patients falling (in December) compared to last year because we didn’t have enough staff to take care of everyone,” Black said.
Burdened with COVID-19 patients in the country’s most populous state, Black and many other already exhausted nurses are now caring for more patients than is generally allowed by state law after the state has started issuing waivers allowing hospitals to temporarily bypass the patient ratio law – a move they say is pushing them to the brink of burnout and affecting patient care.
California is the only state in the country that by law requires a specific number of nurses for patients in each hospital unit. It requires hospitals to provide one nurse for two intensive care patients and one nurse for four patients in emergency rooms, for example. According to nurses, these ratios have helped reduce errors and protect patient and nurse safety.
Nurses overwhelmed with patients due to the pandemic in other states require ratios prescribed by law. But so far they have failed to get them. In Massachusetts, Pennsylvania and New York, the country’s first pandemic hotspot, nurses have been demanding state-mandated minimum staffing standards for months. Massachusetts voters in 2018 rejected mandatory nurse-to-patient ratios.
In the 10 minutes that Black spends with each person every hour, she must review lab work reports, imaging reports, communicate any abnormalities to the doctor, document her interventions, coordinate with social workers, and in many cases. many cases make arrangements for the hospital chaplain. , she said.
“It’s very busy, the nurses and not just the nurses but the assistants, we are all exhausted. Morale is pretty low, ”she said.
Gov. Gavin Newsom’s Department of Public Health began issuing temporary waivers to the law for the second time in December after another push left hospitals in Southern California and the San Joaquin Farm Valley with which is considered intensive care capacity due to understaffing. The department had ordered all elective and elective surgeries and issued a 90-day blanket patient ratio waiver last spring.
So far, at least 250 of some 400 hospitals in California have been granted 60-day waivers that allow intensive care nurses to take care of three people and emergency room nurses to supervise six patients. The exemptions apply only to intensive care, observation, cardiac monitoring, emergency and surgical units. But Newsom has so far not canceled elective surgeries in the recent outbreak.
Kaiser Permanente, which has 36 hospitals in California, requested waivers in 15 of them to plan for surge needs, spokesman Marc Brown said. He said the health giant avoided asking for more waivers by canceling elective and elective surgeries, paying nurses overtime and working with nurses to move their shifts and location.
“We take the existing ratios seriously,” said Brown.
California Hospital Association spokeswoman Jan Emerson-Shea said hospitals only seek waivers after they have no other choice to care for the patients they have.
“We are literally in the worst crisis of this pandemic yet and we are witnessing a workload that we have not seen to date,” Emerson-Shea said, adding that hospitals were just trying to get through the crisis. . “No one wants our staff to be emotionally and physically exhausted. but we have no choice. People need care. “
California hospitals typically turn to recruiting agencies and travel nurses during the winter season, when hospital admissions increase and medical staff fall ill from the flu. But California is now among the states in the country vying for medical staff, especially nurses trained in critical care.
Stephanie Roberson, director of government relations for the California Nurses Association, criticized hospitals for failing to prepare better by training registered nurses and for not hiring more staff – including mobile nurses – during a fall lull of COVID-19 cases, despite an expected drop in hospitalizations.
“In some of our hospital systems, if they were lucky enough to have travelers, they kicked the travelers out because they told the travelers they weren’t in crisis mode and those travelers went elsewhere because that they had better gigs elsewhere, ”Roberson said.
Black, who has been a nurse for 10 years, said she relied on her husband to look after her family’s needs so that she could rest and sleep as much as possible on her days off. She also saw a therapist to deal with the stress of the job.
She said she was doing everything she could to take care of herself because she was committed to helping her patients. But she describes her working conditions as less secure.
“A lot of people say we signed up and no, we didn’t. I signed up to help take care of people, not to throw myself into the fire, ”Black said.
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Associated Press writer Don Thompson in Sacramento contributed to this story.
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