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Nurses, staffing are not the problems

August 15, 2004|by Mary Towe

This is in response to the op-ed piece by Bob Rollins in the Sunday, Aug. 1 issue of The Herald-Mail. I appreciate Rollins' writing to present what he sees as a staffing issue at the current Washington County Hospital site.

What Rollins sees as a staffing concern, I see as patient safety and quality of care issues - not because we are understaffed, but rather because of the age and condition of the hospital. Let me explain further.

Sometimes, we do have to go on red or yellow alerts. A red alert means that monitored beds for critically ill patients are not available. It happens most often because all the beds are filled, not because we are short-staffed.

In our new facility, the critical-care beds will be co-located and increase from the 43 we have currently to 54. Thus, we will be better able to care for critically ill patients by using our resources more effectively.

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A yellow alert indicates that our emergency department has reached its capacity to care for patients. It was built in 1983 to serve about 42,000 patients each year. In 1997, the emergency department was renovated to serve about 47,000 patients per year.

We have outgrown this last renovation. In our last fiscal year, the emergency department served 66,832 patients. In the new facility, we will about double the size of the emergency department to 58 beds. It will include seven beds just for children and an eight-bed rapid diagnostic center.

Currently, our rapid diagnostic center is set apart from the emergency department due to the structure of the hospital, spreading nursing resources over multiple, segregated areas. In the new facility, it will be within the emergency department. So we will have the benefit of being able to care for our patients more efficiently.

Our hospital is exceptional in that we do not face the same level of nursing shortages as most other hospitals. In fact, our nurse vacancy rate for the last two years is only 2.5 percent, which is far below the Maryland state average of 12.9 percent.

And our turnover rate for nurses is only 6.5 percent, again well below the Maryland state average of 12 percent. If Rollins counted 20 nursing positions as open, that is only three percent of our 550 registered nurse positions - an enviable percentage in any health-care setting.

The commitment of our professional nursing staff to the highest quality of care is responsible, in large part, for the enviable vacancy and turnover rates. Nurses are our most precious resource, not the "problem" referred to in the letter. These dedicated professionals deserve to give care in a facility that enhances - not taxes - their ability to maintain a high standard of patient safety.

Nurses at all levels of the organization are involved in the planning of the new facility. At any one time, there have been many different committees involved in planning the new facility, most with nursing representatives. Nurses also had the opportunity to evaluate a mock patient room in the new facility to assess its functionality for patient care.

The new facility will have many benefits for our staff and patients. Individual patient rooms will be located around a triangular nursing station, making the distance nurses have to travel to the bedside much shorter than the long bowling alleys they currently run.

Also, related departments will be located adjacent to each other. This will make response time to a critical patient easier for staff like anesthesia services, for example. Currently if they have an emergency call, they may have to run to the post-anesthesia care unit on the second floor, to outpatient surgery on the first floor, to the operating room on the second floor or to the emergency department on the first floor. The challenge of providing optimal care to these patients will be a thing of the past in the new hospital.

We have had several renovations to the hospital since we moved here in 1912. In our present building, there are two patients to each room, making it difficult to provide treatment in a confidential setting.

Often there are family members visiting patients, who vie for space with nurses and other health-care providers. In the replacement hospital, the new patient rooms will be about the same size as the current semiprivate rooms. But they will be laid out much differently. There will be a dedicated space for caregivers to work with the patient, giving them the elbow room they need to provide care in a safe and efficient manner. There will also be dedicated space for families and visitors. In fact, there will be a pullout bed for a family member to stay with a loved-one round-the-clock.

One of the advantages to building a new facility is that we can more easily recruit nurses who want to work in a state-of-the-art hospital with the newest technology.

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