DOVER — Some have left the field, others elected to retire early and there’s even more who are on the sidelines for a week or two waiting to be cleared from quarantine or isolation.
For whatever the reason, Delaware’s hospitals need help as they deal with staffing shortages which are occurring at one of the most inopportune times. The state just experienced its highest hospitalization rates, both overall and for COVID-19, of the pandemic.
Hospitals have been over capacity statewide for the last six-plus weeks. Some days they’ve been at over 120% of capacity.
“The pandemic has been an unforgiving onslaught over the last few years,” said Wayne Smith, president and CEO of the Delaware Healthcare Association. “There’s just more patients than the system was designed to accommodate.”
“It is difficult for hospital employees to bear that day in and day out and for it to not have an effect,” Mr. Smith added.
“We’ve had early retirements, we’ve had people leave the field. I do want to stress that most hospital employees have stayed on and they’ve been doing heroic and valiant work. But there’s certainly been a reduction in the workforce and that becomes a cycle that puts additional strain on the employees that remain.”
Assistance is coming in a couple of forms.
DHA put out a call last week for volunteers willing to commit to two or more shifts per week at a local hospital to help fill clinical and non-clinical support roles in an effort to alleviate staffing challenges. A sign-up sheet is available online.
Mr. Smith said DHA has already received interest from about 500 volunteers whose part-time shifts will be equivalent to 100 to 150 full-time employees. Hospitals in all three counties need more than that but the initial response has been motivating, Mr. Smith said.
“Hospitals need help, hospitals are in crisis,” he said. “We’re counting on the historic response of Americans in time of crisis to step forward to pitch in. I think it speaks to the goodness and community sense and spirit of most of our fellow travelers of Delaware. It’s reaffirming to see people stepping forward in a crisis and saying, ‘I’m here. I’m ready to help. Put me in where I can best be used.’”
DHA is looking for volunteers who may have prior health care experience, such as recent retirees and local nursing students. It also is hoping to attract volunteers from the general public who may be able to fill non-clinical support roles like assisting with patient registration, answering phones, cleaning rooms, working in the cafeteria or delivering supplies.
Mr. Smith said current shortages are such that clinicians are needing to fill these logistical roles, taking time away that they should be spending with their patients.
“We’ll take all comers,” he said “Of course people with clinical experience are very much sought after. But now you have a lot of clinicians doing things that usually logistical people would be doing, for example maybe carrying food to patients’ rooms. You don’t want a nurse doing that. That’s where volunteers can really help out. That frees up clinicians to spend time with their patients, where they should be spending their time.”
The Delaware National Guard has also been deployed to area hospitals.
Approximately 150 Guard members finished training to become certified nursing assistants last week. The Guard has also been performing support roles at hospitals and some walk-in clinics during Delaware’s state of emergency order.
TidalHealth Nanticoke has 18 Guardsmen working in its hospital while Beebe Healthcare has onboarded 22 National Guard troops the last two weeks
“That helps not just our team members but also our patients,” said Dr. Bill Chasanov, Beebe’s chief population health officer.
Addressing the shortage
Local hospitals are taking several steps, some using American Rescue Plan Act funding, to attract new employees and retain their current ones in the wake of the shortage.
Bayhealth recently created part-time weekend positions for qualified applicants with benefits, including paid time off, sick time, medical coverage and a 401(k)-retirement plan. It is also offering relocation assistance.
The health system said this new program will help retain valuable staff and could boost its workforce by about 13% by creating more flexibility for health care workers who need more time to care for their families but still offering them the security of benefits often only afforded to full-time workers.
Open qualified positions for this program include nursing (LPNs and RNs), respiratory therapy, lab, radiology and diagnostic imaging.
“We understand these are tough times for working parents and the like, especially health care workers who have no choice when it comes to their calling to take care of our communities,” said Shana Ross, Bayhealth vice president of human resources and chief diversity officer. “We want them to know we are there for them. We are proud to offer flexible scheduling, including part-time clinical weekend positions coupled with the security of generous benefits packages and competitive incentives.”
Additionally all qualified applicants will be entered to win a three-day, all-expense-paid trip for two to Nassau, Bahamas, which includes round-trip car service to and from Philadelphia International Airport, airfare and two nights luxury accommodations.
Bayhealth is also offering up to $30,000 in student loan repayment for a three-year commitment to employment. Qualified positions for student loan repayment include nursing (LPNs and RNs), respiratory therapy, patient care technician/phlebotomist, diagnostic imaging technician or clinical medical assistant.
TidalHealth and Beebe are both working with local academic institutions to improve the health care worker pipeline in Sussex County. TidalHealth is offering to pay for training and certifications as well as providing scholarships to nursing school while Beebe runs its own certified nursing assistant program and has its Margaret H. Rollins School of Nursing.
Beebe’s human resources department has been active in the community to identify areas to find new colleagues. Dr. Chasanov said Beebe’s latest job fair attracted more than 100 individuals — one of the highest totals they have seen in recent years.
Downstate hospitals have also been establishing their own residency programs, with the hope most doctors will remain in the area after they complete their residency. Bebee’s inaugural class for family medicine and internal medicine will arrive in July 2023 while Bayhealth began its family medicine and internal medicine residency programs this past year. A Bayhealth third program, general surgery residency, will welcome its first residents this July.
Bayhealth is also looking to add another residency program for emergency physicians. It expects to have a total of 109 residents graduating from the four programs.
However the effect of the residency programs won’t be felt for several years down the road.
“For the long term there’s some bright spots with the residency programs that are being stood up,” Mr. Smith said. “Particularly Downstate, that will augment the very strong systems upstate and their residency programs and education programs. But training and education is a long-term solution for a long-term problem. The immediate need is for people, both to retain them and bring them in.”
For those current employees, hospitals have offered mental health services and other various programs to support their workers dealing with the stress of the pandemic and prevent burnout.
“The behavioral health side of this for everyone, including our team, is definitely a focus everyday in conversation and action,” TidalHealth CEO Dr. Steve Leonard said. “We have people rounding every day checking in on not just physical, but the mental health of our team. It’s definitely a challenging time. The community continues to support our team but as an industry across the country, there are significant labor challenges impacting health care at this point.”
“There are all sorts of counseling programs and resources being deployed to make sure everyone on the patient side of care has the opportunity to talk about their experiences,” Mr. Smith said. “They can decompress, receive counseling and receive the type of support that is necessary during these extended, trying times.”
Hospitals are also now able to have their employees return to work sooner after they test positive for COVID-19, per updated guidelines from the U.S. Centers for Disease Control and Prevention specifically for health care workers.
Dr. Chasanov said Beebe is following the conventional approach, which provides two options. The first is the infected person is out for 10 days before they can come back if they are feeling well. The second option is if a worker is feeling better around days five and six, they can undergo testing and come back to work after day seven if they test negative.
“It’s definitely helpful,” Dr. Chasanov said. “We are following those guidelines, seeing how people feel and testing. People are coming back earlier so we are optimistic that will help get folks back.”
Other hospitals have been following Crisis Standards of Care protocols since Jan. 10, including TidalHealth, Bayhealth, ChristianaCare and Trinity Health Mid-Atlantic-Saint Francis. Crisis Standards of Care extend availability of resources and staffing to handle the influx of volume. Beebe is the only Delaware hospital not in Crisis Standards of Care but it did postpone all non-emergent surgeries as of Jan. 13.
It’s unknown how long these hospitals will operate under Crisis Standards of Care. The situation has improved with Delaware down to 555 COVID-19 hospitalizations after setting a record of 759 on Jan. 12.
But the current total is still above last winter’s peak of 474.
“It’s an amazing effort but at the end of the day, we’re people taking care of people and the team is tired,” Dr. Leonard said. “Everybody wants to push through this surge. There’s absolutely a sense of fatigue. But as all good teams do, they’re coming together to find a way to get it done.”