Posted by Bill Sandweg on 07 March 2022.
It is no secret that nurses are the backbone of the health care system. They are generally caring and compassionate. They are the health care professionals who interact most often with patients in both doctors’ offices and in hospitals. Right now, they are in short supply, especially at hospitals.
There have always been traveling nurses. When hospitals found themselves short staffed due to vacations or other factors, they would hire one or more traveling nurses from a service to fill their temporary vacancies until the regular nurses returned from vacation or until the hospital could hire and train more regular staff. Things are different today, at least in part due to the Covid pandemic. Today, almost all hospitals find themselves woefully short of nursing staff. To fill the gaps in their staffing levels, they are forced to rely on increasing numbers of traveling nurses. This has significant implications for both hospitals and the patients who come there for treatment.
Why are hospitals so short of nursing staff today? As I mentioned above, in part the shortage is due to the Covid pandemic. Nurses are burned out by the demands placed on them by hospitals filled to overflowing with seriously ill patients. According to various news outlets, many hospitals are so full that they are forced to stash patients in hallways while they wait for a room to become available or while they look for a place to transfer the patient. Some hospitals are so crowded that they have been forced to convert cafeterias into ICU’s. The demands of the pandemic with its unrelenting nature, its repeated surges and its high death toll has so depressed many nurses that they have either called it quits completely or opted for a traveling nurse job where they have more control over their schedules.
A second reason for the current shortage of nurses comes down to our old friend money. Nurses complain that they don’t get enough of it. Many nurses resent the fact that the hospitals for which they work take in huge amounts of money and that the hospital executives are highly compensated while nursing salaries have not kept pace with inflation. A recent front page story in the Wall Street Journal quoted a number of nurses blaming the nursing shortage on “greedy hospitals.”
Still another reason for the current nursing shortage is the graying of America. As our population ages, more and more caregivers are necessary, Of course, not all of those seniors find their way to the hospital but, wherever they are, they need nurses and hospitals are losing nurses to these other care giving facilities.
The law of supply and demand now takes over. Hospitals must fill the patient. care shifts that were filled by the nurses who have left them. To do that they turn to services which provide nurses to hospitals for the short term. Because the needs of the hospitals greatly outstrip the supply, the traveling nurses and the companies which provide them are making lots of money. This is of small to no consolation to the loyal nurses who report to work every day and who have not joined the ranks of the traveling nurses.
All of this has a significant impact on patient care in hospitals. Patient care in the modern hospital requires teamwork. Teamwork is difficult to achieve when members of the nursing staff come and go frequently. It is also difficult for traveling nurses to quickly become familiar with the many policies and procedures they are expected to follow at the different hospitals to which they may be sent. There are also unwritten rules and cultures at hospitals of which traveling nurses will not be aware. For example, Dr. Jones wants to be called if his patient’s blood pressure ever gets below a certain level.
Over the years I have had two very tragic cases involving paralysis following surgery where the nurse in question was not a regular member of the post-surgical team and made critical mistakes. In both cases, there were post-surgical changes which occurred during the night and which should have been reported to the surgeon. In both cases, the nurse failed to notify the doctor and he arrived the following morning to find his patient was paralyzed.
We are going to be dealing with the issue of traveling nurses for quite a while into the foreseeable future. It will take a while for supply and demand to balance out and for new nurses to be trained and to come on board. Just hope that in the interim, the legislature doesn’t address the problem the same way it recently addressed the shortage of teachers. Instead of making it more attractive for teachers to stay in the classroom, the legislature reduced the requirements necessary to teach. Problem solved?
The takeaway today is the same as it has been for a long time. Keep your eyes open and pay attention when you are in the hospital. If possible, have an advocate with you to watch out for you when you are not able to watch out for yourself or speak for yourself. Don’t assume the nurse knows what he or she is doing. Make sure medications being passed are actually intended for you and are the correct medications. Politely but firmly insist that the nurse call the doctor if something seems out of the ordinary. Don’t just blindly accept the reassuring statement that everything is fine. Good luck.