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Mon, Aug. 19

But not enough staff to open the doors

PRESCOTT – A national nursing shortage has landed many hospitals, including Yavapai Regional Medical Center, in the emergency-room ward.

In order to keep its nurses and recruit new ones, YRMC is offering carrots such as increased salaries, shift differentials, sign-on bonuses and relocation expenses.

Despite those efforts, members of the community are feeling the staffing crunch.

An elderly woman, who asked that she not be identified by name, checked into the hospital's emergency room on Tuesday with a serious infection.

"I asked them to admit me," she said. "But two or three people told me there was no room."

Instead, the ER staff treated her with intravenous antibiotics, then told her to come back at midnight for another series of IV treatments.

Before the infection started clearing up, she was forced to make 12 separate visits to the hospital, three times a day, over the next four days.

The woman, who lives on the opposite side of town, said that the hospital gave her "a few coupons" for taxis. She also enlisted friends to help her make the appointments because she was "too weak to drive."

She said that she asked to be admitted several times because "the going back and forth was just too much for me. ... I didn't feel well at all."

Instead, the woman said, YRMC staff members offered to transfer her by ambulance to a hospital in Phoenix, "which I thought was ridiculous."

She pointed out that the YRMC staff "did take good care of me, I'm not complaining about that ... but to treat a senior like that is really bad."

So what's going on?

"We're running at capacity in terms of our ability to provide care," explained Mardy Taylor, YRMC's chief nursing officer.

The hospital recently bolstered its total number of beds from 87 to 127; however, Taylor said, "because of the nursing shortage both nationally and locally, we have not been able to open and utilize all those beds."

With approximately 200 registered acute-care nurses – about 70 percent of whom are on the clock at any given time – YRMC can fill only 95 beds.

"That's what we're operating at," Taylor said. "That's our capacity right now based on our staffing and our ability to get staff."

She insisted, however, that the hospital is fully capable of dealing with serious trauma cases – or even multiple trauma cases.

"If a critical patient arrives on our doorstep, we will provide emergency care to stabilize the patient and any further care we can provide here," she said.

If there is no bed available, she added, the hospital may discharge someone early to make room for the new patient, or it may transfer the patient to another hospital.

"As with other hospitals, we will certainly transport patients to the appropriate level of care based on their needs, if we cannot accommodate them here," she said.

In fact, YRMC immediately transfers to Phoenix patients who require open-heart surgery, neurosurgery, serious burn treatment or extensive neonatal care.

In case of a catastrophic incident, Taylor said, YRMC would coordinate with local fire departments to set up triage stations to funnel patients to various hospitals.

In fact, she added, the hospital and the Prescott Fire Department trained together on a mock chemical-spill scenario about two weeks ago.

Despite the hospital's ability to deal with short-term cases (the ER treated an average of 100 patients per day over the holiday weekend), its ability to provide long-term care will continue to suffer until the hospital finds more nurses.

In order to put people in the 30 beds sitting empty in its new wing, YRMC must hire an additional 50 to 70 nurses, Taylor said.

"We have put together a number of initiatives to recruit and retain nursing and patient-care staff, and we are working to get additional staff here at YRMC so that we can open additional beds," she said.

At the end of last month, the hospital raised its starting pay for RNs from $15.17 to $16.08 per hour, which is on par with what Phoenix-area hospitals are paying, Taylor said.

Currently employed acute-care nurses received "at least" a one dollar raise, she added.

But while there is an increased demand for nurses across the country, the number of nurses is steadily decreasing.

Student enrollments in nursing programs have decreased by about 5 percent each year for the past five or six years, Taylor said.

"There are so many opportunities and fields to get into that have developed over the last 20 years," she said.

Furthermore, she added, there are now more nursing jobs that offer better hours in doctors' offices, pharmaceutical and insurance companies.

"I wish I had an answer," she said.

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