October 1, 2022

 

I can get more beds, bring more beds in. But I have to have staff to take care of a patient in a bed — Troy Clark, president and CEO of the New Mexico Hospital Association

 

 

The collateral damage COVID-19 inflicted upon New Mexico’s hospitals was severe, beyond the roller coaster of new cases, hospitalizations and deaths.

Healthcare workers grew exhausted by continued stress, to the point that some left the field altogether. Hospitals sought outside help, and work shifts changed for those who remained.

Healthcare continues to deal with workforce shortages.

According to data from New Mexico Department of Workforce Solutions, the average number of monthly registered nurse job postings between Fiscal Year 2020 and Fiscal Year 2021 rose considerably. It jumped from an average of 4,507 RN job postings in 2020 to an average of 6,306 RN job postings in 2021, an increase of 33.3 percent.

The highest number of advertised online job postings for registered nurses came in June 2021, which featured 6,931 openings.

Lack of reprieve

Troy Clark, president and CEO of the New Mexico Hospital Association, said there were several ways the pandemic worsened the workforce shortage, a problem the state has dealt with for decades.

Hospital workers were asked to work extra shifts and longer shifts during the winter months, meaning they needed extra time off in the spring and summer months — a time that didn’t offer hospitals any reprieve.

Even after COVID-19 vaccines entered the picture in spring 2021, Clark said New Mexico hospitals were still running at 140-160 percent capacity because there were those delaying care such as surgery because of the pandemic. Some may have required in-patient admission, while others may have required a stay in the intensive care unit.

Even after the delta and omicron waves subsided, the larger hospitals in the Albuquerque area were at 100-130 percent of capacity in March.

“I can get more beds, bring more beds in. But I have to have staff to take care of a patient in a bed,” Clark said.

To get that additional staff, hospitals sought temporary help from outside agencies.

“Nobody foresaw that this would take 24 months to get through… There’s the mental fatigue on top of the physical fatigue,” Clark said.

And because of the high demand for temporary staff work, such as traveler nurses, traveler respiratory therapists and traveler laboratory technicians, Clark said health settings are paying a lot of money — in some cases, two, three or four times more than usual  — to bring them in to help get through the next wave.

“Healthcare workers across the United States have been physically and mentally exhausted by the experience of caring for patients with COVID-19,” Lovelace Health System spokeswoman Whitney Marquez said in an email statement. “A number of other factors have contributed to the drop in workforce, including staff nurses transitioning to traveling nurses, staff retiring and others choosing to enter another field of work. We have been proactive in supporting all our healthcare workers and recognize they are our most valuable asset in caring for our patients and our community.”

Politics also didn’t help

Clark said healthcare workers were viewed as heroes in the early months of COVID-19, until things changed radically.

“Because politicians got involved with vaccine mandates, mask mandates and shutting down businesses… the healthcare workers became a visual reflection of the results of those mandates,” he said.

Healthcare workers have to continue to wear masks in hospitals and enforce that mandate for visitors entering hospitals, which often means they have to contend with people who may not like it. As a result, Clark said they became demonized.

“They’re spit upon, they’re yelled at. The amount of violence against healthcare workers has increased,” Clark said, adding those factors also contributed to early retirements and health workers changing careers.

Education pipelines offer hope

Educational institutions like CNM and UNM Health Sciences formed a partnership last month to help create a direct path to occupations including healthcare. That way, those who may not opt to continue on to college can get the necessary training and certification to prepare themselves for the workforce.

“We both are working hard to get more nursing students graduated and out in the workforce,” said Laura Burton, associate director of business operations at the UNM Health Sciences Rio Rancho campus.

Erin Johnson-Kruft, CNM’s senior director of employer and industry engagement, said those partnerships will help students get exposure to various healthcare careers. If a student can obtain a certificate to become a medical assistant, community health worker or nursing assistant, it gets them right into healthcare so they can garner experience, she said.

“A lot of times, the employers will help fund their continued education. There’s a lot of funding for tuition right now with the opportunity scholarship,” she said. “There is a shortage of nurses in New Mexico and nationally, so we’re all working hard to try and fill those gaps.”

Clark is convinced that programs like the UNM Health Sciences and CNM collaboration can pay dividends down the road because a health worker who grew up in New Mexico and was trained in New Mexico has a tendency to stay in New Mexico more than four times longer than their out-of-state counterparts, which leads to lower turnover and an easier recruitment. He said that’s especially important for rural hospitals where workers may come and go.

Challenges still remain

Work was done in the state legislature to increase nursing school enrollment to help address the workforce over the long term, Clark said. He said it takes schools 12 months to hire extra instructors and get their curriculum set in place for extra clinical rotation spots, then it takes students another two to four years to come out of their training and begin to care for patients. The impact of nursing school training wouldn’t be seen for three to five years, Clark said.

And despite initial interest from students wanting to go into healthcare, Clark said the mistreatment of health workers in recent months led to some having second thoughts about pursuing a career in that sector. Other students didn’t learn as well in remote settings when COVID-19 took them out of their clinical rotations and delayed their graduation, Clark said.

Even so, the interest is still there, he added. And the legislation that was passed, which allows industry to “grow your own” workers, will enable hospitals to work with middle school and high school students to make certain that interest is sustained.