With an influx in hospitalizations in Hawaii due to the surge in COVID-19 cases, health care officials have put out an urgent call for more nurses to assist.
Hospitals are already short-staffed, said Daniel Ross, president of the Hawaii Nurses Association OPEIU Local 50 that represents approximately 4,000 members across the state. “It’s only going to get worse as time goes on,” he said.
Health care officials in the private, public and nonprofit sectors are collaborating on a multipronged initiative to bring more nurses in to the state to address the increasing caseload caused by the ongoing novel coronavirus outbreak.
Within the past week, the Healthcare Association of Hawaii, the Hawaii State Center for Nursing and the state and federally authorized Hawaii Healthcare Emergency Management Coalition launched a recruiting campaign aimed at experienced nurses as well as recent nursing graduates.
The state has waived licensing requirements under an emergency proclamation signed by Gov. David Ige to allow recent graduates to provide assistance in supporting roles such as screening and administrative work to free up experienced and qualified nurses to focus on COVID-19 patients.
The Healthcare Association is a nonprofit trade organization that serves Hawaii’s hospitals, skilled-nursing facilities and assisted-living facilities, home-care companies and hospices.
Laura Reichhardt, director of the Hawaii State Center for Nursing, said it has received a vast response from available nurses and new graduates. “We need their support and work immediately,” she said.
Hilton Raethel, president and chief executive officer of the Healthcare Association of Hawaii, said it also activated the Hawaii Medical Reserve Corps in collaboration with the Hawaii Healthcare Emergency Management Coalition. Volunteers with the medical reserve corps, however, are available to help only for a few days at a time.
Additionally, officials are contacting staffing agencies across the country to bring in “travel nurses” for short-term employment. The initiative presents a challenge because the nurses are in great demand throughout the U.S.
“Everybody is competing for travel nurses right now,” said Mimi Harris, vice president of patient care and chief nursing officer at The Queen’s Health Systems.
The Queen’s Medical Center alone is seeking an additional 40 to 60 nurses to care for patients in the areas of critical care, telemetry, medical/surgical units, emergency room and inpatient dialysis.
Salaries are higher for a travel nurse compared to a staff nurse. Raethel said a nurse who resides in Hawaii could earn $3,000 a week at $75 an hour, compared to a traveling nurse, who may earn $4,800 a week at $120 an hour. The pay for traveling nurses is higher to cover travel and lodging expenses.
Another initiative is seeking help from the federal government. Health care officials are currently preparing documents to seek federal assistance to bring 140 nurses and 12 respiratory therapists from the mainland. Raethel indicated Hawaii would first need to demonstrate that the state has exhausted all other efforts to acquire more nurses before tapping into federal resources.
“We’re doing all the preparation now to put (in) a timely request,” said Judy Kern, program manager of the Office of Public Health Preparedness at the Hawaii Department of Health.
The Health Department would submit the request to the Hawaii Emergency Management Agency, which, if warranted, would then send the request on to the federal government.
Raethel said the Healthcare Association of Hawaii is meeting daily with state health officials and federal partners to keep them apprised of the COVID-19 infection rate.
The search for more nurses and respiratory therapists comes at a crucial time when daily new coronavirus case counts have remained in the triple digits for nearly a month.
As of Friday, approximately 270 patients afflicted with COVID-19 were hospitalized at medical facilities throughout the state, according to Raethel. Of that figure, an estimated 90 are hospitalized at The Queen’s Medical Center at Punchbowl and about a dozen are at Queen’s-West Oahu.
Officials say there is a sufficient number of beds — more than 3,000 statewide — to accommodate the surge in hospitalizations. However, on any given day, hospitals have a staff capacity to cover only 2,000 of those beds.
Raethel noted hospitals were operating at full 100% staff capacity as of Aug. 21, which was the average capacity last year.
As of Friday, hospitals were operating at 106% staff capacity, with 111 more patients needing care than the previous week. “That means we have to find staff to take care of 111 more patients than what we normally take care of,” Raethel said.
So the dilemma is not the number of beds available but the staff needed to care for ill patients. “What we don’t have is staff,” he added.
Caring for patients with COVID-19 requires meticulous, time-consuming precautions and procedures when using personal protective equipment to prevent self-contamination.
Ross said an unspecified number of nurses who are in quarantine because they tested positive for COVID-19 has contributed to the staffing shortage.
Though he suspects most of the nurses who contracted the virus were infected while out in the community, Ross said, “I guarantee that there some acquired at work.” And even with proper personal protective equipment, there is still a risk of contracting the infectious disease.
In addition to the 270 COVID-19 patients currently being treated at Hawaii’s hospitals, nurses still need to take care of other patients with critical needs, such as individuals who suffered a heart attack or stroke.
Ross said initiatives to bring in more nurses should have been done awhile ago. “We need help,” he said.
He suggested to hospitals that they hire nurses who are currently working as a nurse aide or unit secretary because there were no available nursing jobs at the time they completed schooling. They could be hired as temporary registered nurses for a six-month period that could potentially turn into a permanent position based on their job performance, Ross said.
He said the hospitals told him they would look into it.
Health care leaders say bringing in more nurses is vital not only to care for patients but also to provide relief for the dedicated nurses who have been working long hours since the outbreak began.
Carl Hinson, director of workforce development at Hawaii Pacific Health, the parent company of the Kapiolani Medical Center for Women and Children, Pali Momi Medical Center, Straub Medical Center and Wilcox Health on Kauai, said he has started to look into enlisting travel nurses because staff is working at a “sustained high level.”
Travel nurses would give staff nurses time to recharge. “There are so many heroes across the health care industry. People every day are going to work and knowing that disease is out there,” Hinson said. “It’s just incredible to watch these teams do what they do every day.”