In The News

National nursing organizations endorse release of policy statement: Dissemination of Non-scientific and Misleading COVID-19 Information by Nursesr

November 19, 2021

National nursing organizations endorse release of policy statement: Dissemination of Non-scientific & misleading COVID-19 by nurses. Misinformation is defined as distorted facts, inaccurate or misleading information not grounded in peer-reviewed scientific literature and counter to information being disseminated by the Centers for Disease Control (CDC) and the Food and Drug Administration (FDA).

 

State of Colorado Reactivates Staffing Shortage Fusion Center

The Colorado Unified Coordination Center (UCC) announced the reactivation of the Staffing Shortage Fusion Center (SSFC). Organizations that can ask for assistance include residential care facilities, hospitals, correctional facilities and other licensed care settings.

The fusion center only accepts staffing requests for assistance directly related to COVID-19 in which staff shortages are impacting patient care. Requests are submitted via a designated intake form and limited to short term assistance to bridge a gap, but are not intended to be a long term staffing solution. 

The fusion center was originally activated from November 2020 to March 2021 to support staffing shortages.  During that time it filled 4,850 shifts with 160 supplemental staff in 58 facilities statewide. Between April 1 and September 30, CDPHE has continued to provide staffing resources for residential care facilities, filling 994 shifts in 31 unique facilities.

The fusion center is led by the Colorado Division of Homeland Security and Emergency Management (DHSEM) through the UCC. The SSFC includes representation from:

  • Colorado Department of Public Safety

  • Colorado Division of Homeland Security and Emergency Management 

  • Colorado Department of Public Health and Environment

  • Colorado Residential Care Strike Team

  • Colorado Hospital Association

  • Colorado Department of Corrections

  • Colorado National Guard 

  • Colorado Department of Healthcare Policy and Financing 

  • Colorado Department of Human Services

Continue to stay up to date by visiting covid19.colorado.gov.

 

Where Is My Nurse?

October 27, 2021

For the last 19 months, while Colorado struggles through the SARS-CoV2 (Severe Acute Respiratory Syndrome Coronavirus 2), or COVID-19 pandemic, Colorado nurses have been saving lives and advancing community health under perpetual under-staffing and under-valuing.   Chronic understaffing is driving burnout and nurses in Colorado need a change.

 The COVID-19 has made clear the weak links in our health care system.  For example, over the last several decades, trends in cost management and the application of  “lean” production principles have led to significant reductions in staff numbers and staff time to provide for the essential care needs of patients. 

The State of Colorado and the news media regularly point out that how many hospital beds are available.  A hospital bed without a nurse, respiratory therapist, physician, environmental services, laboratory, dietary services, is just furniture. “Beds” are necessary, but not sufficient, for adequate care of sick individuals seeking comfort, relief, and healing; an adequate nursing and healthcare workforce is also necessary.

COVID-19 is forcing Colorado health care leaders to rethink how we invest in patient care for today, and importantly for the long term.  The most acute workforce needs are currently in hospital emergency departments and intensive care units where many patient lives are at high risk.  Significant nurse staffing shortages are also being experienced in long-term care, public and private schools, correctional care, home care, hospice care, and public health care clinics. 

Nationally there is a severe shortage of nurses.  In Colorado, there are approximately 64,000 licensed RNs in the state with the largest group being in the age group of 30-39 years of age.  We also know that schools of nursing are recording record numbers of interested candidates and graduates, despite faculty shortages.  Colorado Nurses Association suspects that many RNs are choosing not to work due to unsafe working conditions in many facilities. As has been reported throughout the country, we know of many Colorado RNs who have chosen to do relief nursing through “travel nurse agencies” that have significant increases in salary and benefits, often including housing.

Despite nurses consistently demonstrating their individual and collective resilience over the course of this pandemic, the following stories from Colorado front line clinical RNs and health care workers reinforce the impact of work environments on them personally: 

  • “We had 8 traveler nurses until yesterday, all left and now I work with 5 new graduates instead of experienced RNs”;
  • “I’ve personally seen my workload triple…and my benefits have been cut”;
  • “No time to provide routine daily cares such as showers”;
  • “RNs are taking care of COVID positive and COVID negative patients at the same time”;
  • “Nursing has become dangerous for patients and dangerous for staff with patient and family violence”;
  • “What used to be 1 RN to 1 Patient care for critical ill patients in the Intensive Care Unit receiving continuous renal replacement therapy (CRRT) and external blood oxygenation (ECMO- extracorporeal membrane oxygenation) are now 2 and 3 patients to 1 RN and are often staffed by people who have not been trained on the equipment or monitoring needs of these patients”;
  • “We had two traumas in the ED at the same time – there was no staff in one room for a patient with a gun-shot wound to the chest with no pulse, while one nurse was doing aggressive blood replacement was being provided in the 2nd trauma room; simultaneously a patient in another room was crawling out into the hall looking for help”;
  • “ We have 2-3 staff for 23 seriously mentally ill, unstable patients, who often become violent when frustrated with chaos of the unit”; and,
  • “We can’t provide the standard of care necessary due to critical staffing shortages; we are overwhelmed, exhausted, frustrated and leaving the profession”.

This is not a picture of health care workers being weak, resistant to change, or, reluctant to be a team player. In fact, healthcare workers surviving current work environments repeatedly speak about the power of their professional teammates and the importance of every person on the team being critical to their ability to come back every day.

Attempting to understand why nursing care is not better funded relates to the reality that nursing is by definition labor intensive and labor costs are a significant percentage of healthcare delivery system expenses. Arguments against funding safe staffing levels are often based on disingenuous reports of unaffordability despite the fact that Colorado hospitals received upwards of $1 billion dollars in COVID relief funds in the first four months of 2020.  Pre-pandemic, many of Colorado’s major metropolitan hospitals reported higher than national average profits and one major hospital system in Colorado actually reported more profitability in 2020 than in 2019.

Colorado Nurses Association stands with the many known and unknown, seen and unseen, health care workers in need of evidenced- based, safe work environments.  We are advocating for environments that are safe for staff and safe for each of us as Coloradans as potential patients.

What can be done?

First and foremost, every Coloradan can help by getting the COVID-19 vaccine. Vaccines are safe and effective in reducing hospitalizations and further demands on an already stressed system.

The State must commit to regulatory oversight of valid, reliable, and publicly available staffing data that can be studied, trended and acted upon as needed. Accountability and transparency is essential. This data can also provide real-time situational awareness of the strains on the healthcare system as well as trends over time to better allocate resources.  There is strong evidence available confirming that a 10% increase in RN staffing in hospitals is associated with an 11% decrease in patient deaths and complications such as pressure ulcers (bedsores), falls, and infections. Public transparency of staffing data can assure Coloradans of safe care. Complications cost lives and money.

Antiquated payment systems that lump nursing care costs into the “bed costs” both hide and limit the costs association with adequate nursing care.  At a state level, we can ask for regular reporting of nursing salaries and percentages of salary costs attributed to clinical care as compared to administrative, as one example. 

Human resource policies must be adapted to reflect the flexibility and diverse needs of a workforce that is predominantly female who most often serve as chief operations officer of their own home and family. Retention efforts must be emphasized as much as recruitment.  Career ladders acknowledging the clinical leadership required at the bedside or front lines (school nurses as example) can serve to avoid salary caps.  Assuring a safe transition to practice for all new graduates is essential, such as funding for nurse residency programs, to assure a long term workforce.

Patient care staffing discussions in health care are nothing new. Those of us inside the industry have spent careers defending one side or the other of importance of staffing or defending profits over assuring safe patient care.  Patients are in facilities because they cannot be cared for in an outpatient setting or at home.  Colorado health care leaders must reconsider how we invest in the physical safety and emotional support of our health care workforce in everyday work-place settings. If not, the problems will only get worse.

For More Information Contact: [email protected]

 

Did You Know: Nurse Faculty Loan Repayment Program

October 17, 2021

Colorado Nurses Association is sharing details related to State-based loan repayment incentives for RNs pursuing nurse faculty positions.  CNA leaders worked for many years to be certain that nurse faculty be recognized as part of Colorado health professionals loan programs.

The next application time-frame is July 2022.  Begin to plan for a future in academics now.

For more information please see the Colorado Department of Public Health & Environment webpage: Nurse Faculty Loan Repayment Program.

 

Colorado Nurses Association Supports Denver Pandemic Fund Ballot Ordinance 300

The ability to study and plan for evidenced based pandemic preparedness and response has the potential to dramatically improve the safety of community members and the health care workforce. 

 
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