For everyone working in a hospital during the darkest days of the Delta surge, one thing was clear.
The capacity crisis was about staff, not stuff.
While access to care during the first COVID surge was affected by the supply shortage, especially PPE, access issues during the summer heading into the fall were driven by the workforce shortage.
“Our system was at the breaking point,” said Becky Hultberg, OAHHS President & CEO.
Fortunately for Oregonians, the system did not break, thanks to incredibly hardworking employees and leadership at the facility and HR level.
“We have gotten pretty creative, I have to say,” said Ginny Williams, CEO of Curry General Hospital in Gold Beach. “We have not stood on the corner and said woe is us, the sky is falling and we’re never going to make it out, but we have really focused on recognition, retention, and recruitment.”
As November began Curry General, a critical access hospital in rural Oregon, had 90 openings. Not all of them were clinical, but one-third of them were: nursing, diagnostic imaging, respiratory therapists, laboratory, and more. “We are struggling like everyone else to maintain safe nursing standards,” Williams said.
Williams said appreciation bonuses of $1000 were helpful, but she also said her team went further. “We needed to bring some normalcy to our staff, so we started an employee recognition drawing. Every day we do a drawing of two $50 gift cards. It’s really a gift of gratitude, thank you for being part of our team.”
When it comes to showing gratitude and getting creative, it’s hard to top the special gesture from Curry General’s management team during Hospital Week.
They washed staff members’ cars.
“We are working toward creating a culture of gratitude and appreciation. And it is through our staff that we will be able to recruit people that want to be here.”
At Good Shepherd Medical Center in Hermiston, staff support has also been a top priority to address the exhaustion the surge brought.
“It’s the burnout from their day to day lives at home, the expectations at work, and everything that comes from society,” said Sara Camden, Director of Critical Care. “The first wave of COVID was ‘I’m a superhero, I can do anything.’ The second wave it felt like I don’t really matter this time, I’m not really that important. They didn’t really feel that valued.”
Good Shepherd has brought in outside resources for support and counseling in addition to the many daily efforts from the team. “There have been plenty of one-on-one discussions in your office, and just shut the door and let people have a moment,” said Janeen Reding, Vice President of Human Resources.
“Some of what I am most proud of is to see the emergence of empathy in the staff,” Reding said. “They could have become disgruntled, but there is a resilience instead. I’m really proud of the staff for that, they have chosen to be even more supportive to each other, given each other some extra grace.”
Of course, the staffing crisis was not confined to rural hospitals. Urban hospitals were affected as well.
Legacy Health’s chief nursing officer said they took an “all hands-on deck approach” to surviving the surge and maintaining high standards of care.
“My job is to make sure we have the right amount of resources to care for our patients,” said Dr. Kecia Kelly, Senior Vice President and Chief Nursing Officer. “That means looking at different models of care and looking at different creative ways of caring for our patients.”
Dr. Kelly said Legacy had operating room nurses working in patient care when scheduled procedures were paused – again -- during the surge. “We needed to make sure we had critical care beds available for our patients that needed that care,” she said. “So when we did a curtailment of our elective surgeries, we had staff available. We actually created an extender, helping hands model.”
Those nurses did whatever was needed, always putting the patient first.
“We never underestimated the power of getting a pitcher of ice or a pillow for a patient,” said Dr. Kelly. “So we used staff in that capacity to help our frontline teams.”
The “all hands-on deck” approach extended to some on the management team. “We had one of our presidents who threw on scrubs and worked as a nurse’s aide,” said Dr. Kelly.
She also spoke of the importance of attending to the emotional and spiritual health of the staff.
“This pandemic has created shock and trauma for many of our teams,” said Dr. Kelly. “We’ve seen this exodus of our nurses and people leaving the health care profession and I want to acknowledge that we know there was burnout that was already happening, and there has been caregiver fatigue.”
Like many hospitals, Curry General has used traveling nurses to get through the surge, but Williams does not see them as a long-term solution. “Thinking of using travelers as a fulltime option, it’s not sustainable,” she said. Aside from the high cost (some travelers in Oregon are being paid up to 700 percent of the regular hourly rate of a state nurse), Williams said that her staff works as a unit, one that is very difficult for travelers to mesh with.
“You have to train them, incorporate them into teams,” said Williams. “It creates an extraordinary burden on the people who are here and are living here and want to be here.”
“To come into a hospital staffed with strangers, it’s absolutely not who we are at least in rural America.”
And while many outside of health care focus on higher pay to attract nurses, Williams said it’s often not about money when it comes to creating a happy and high functioning workplace.
“We can offer more benefits, we can offer more money,” said Williams. “But we’ve really taken the approach, we want to hear from our employees about what’s most important. And it’s funny when you sit down with them, it’s not money, it’s I want to get breaks consistently, I want to get my lunch, I want to have my manager talk to me and not at me. They say it’s the small things that we care about most.”
At Good Shepherd, leaders hear the same thing: more than anything else, employees want to feel valued. They’ve worked hard to make sure staff know they are appreciated because it’s the right thing to do, and because the pandemic has led to a lot of reflection.
“That appreciation is so important,” said Reding.
“People have really reassessed what they want out of their work life, and what they are willing to accept in a work environment. It’s causing us to reevaluate, and that’s not necessarily a bad thing, I think it’s been a long time coming,” said Camden.
Hospital leaders hope the recent capacity and staffing crisis has raised awareness on workforce issues that existed long before COVID hit.
“I just want to express gratitude to our frontline workers. This has been the toughest time in all of our lives. I always want to acknowledge their work and their dedication to the profession,” said Dr. Kelly.
That’s a feeling all of these women share.