EDITOR’S NOTE: Each quarter, the NNBW publishes a special “B2B Industry Focus” edition that centers on a certain industry. The fourth quarter’s B2B Industry Focus is on healthcare. This is the first in a five-part series of stories on that topic; the other parts are below. Look for the remaining stories later this week at nnbw.com, and look to the Wednesday, Oct. 20, print edition for the full lineup.
Northern Nevada hospital leaders say the latest surges in COVID-19 are adding to fatigue and burnout, especially among nursing staff. But this time, exhaustion is heightened by something new: frustration that so many people have refused to get vaccinated. In Washoe County, the Delta variant swelled COVID-19 infections to averages of more than 400 a day in early September, levels last seen pre-vaccine, according to the county health district (though, the number of cases was on the downturn as of month’s end). As of early October, meanwhile, Washoe County had a vaccination rate of about 64%. “The fact that we have a vaccine and we’re going through another surge here in our community has put a whole other level of caregiver fatigue on our nursing workforce,” said Katie Grimm, chief nursing officer at Northern Nevada Medical Center in Sparks. “The majority of the people we are seeing are unvaccinated, and they are younger, and they are losing their lives.” The emotional distress, Grimm said, is causing some nurses to retire early or “leave the profession altogether.” Others are leaving the region to take travel assignments that are “paying extremely well right now.” Fueled by intense demand — and paid for in part with federal emergency funding to hospitals — travel-nurse pay has skyrocketed. In December 2019, the average gross weekly wages for a travel nurse were $1,600, according to data from Vivian Health, a healthcare recruiting agency. A year later, the average pay was more than $3,500 a week. After declining from a winter peak, pay has risen again as the Delta variant rages on. Average weekly gross wages for a travel nurse in the U.S. rose to $2,597 in early August, the highest rate since February, per Vivian Health. As a result of Northern Nevada nurses leaving the profession or the region for lucrative travel jobs, the number of staffed hospital beds within Washoe County is shrinking dramatically, medical officials say. ‘PEOPLE ARE JUST WORN OUT’ In the past few months alone, the county’s total staffed hospital beds contracted from about 1,700 to roughly 1,300, said Tiffany Coury, CEO of Saint Mary’s Health Network, citing data from the Nevada Hospital Association. Further, staffed intensive care unit (ICU) beds in the county have dropped from 233 to 166, she noted. “That is evidence of how much staff we have leaving the industry,” Coury said. “When the first surge came on, there was this sense of duty that I think every healthcare professional had. And then the second wave came and there was a fatigue that had set in of ‘can you believe we’re in this same situation again?’ And now going into the third (surge), people are just worn out. “I know that there’s a sense in the medical community that we wish people would reconsider their position on vaccinations,” she continued. “Because it’s one way that our providers can really help someone who will inevitably get exposed somewhere to the virus.” Nursing shortages have long plagued hospitals in Northern Nevada and beyond. But in the year and a half since COVID hit the U.S., the pandemic has stretched the nation’s nurses like never before, testing their skills and stamina as desperately ill patients with a poorly understood illness overwhelm emergency rooms. “It was not ideal before the pandemic, and the pandemic exacerbated that,” Michelle Miller, vice president and chief human resources officer at Carson Tahoe Health, said of the nursing shortages. “Rightfully so, they’re exhausted. Despite that being where they want to be, and it tugs at their heartstrings, there are a lot of people who are seriously reconsidering or have already made decisions to leave healthcare.” ‘SICK OF SEEING PEOPLE DIE’ As the highly contagious Delta variant continues to grip Northern Nevada, bedside nurses, doctors, and other hospital workers are fatigued “beyond comprehension,” said Dr. Tony Slonim, CEO of Renown Health. “They’re sick of seeing people die,” Slonim continued. “They’re emotionally drained. And every day, I can only imagine, is difficult to get back on that horse and come back to work when you know you’re going to face more of the same.” What’s more, the explosion in pay for traveling nurses has made it tough on hospitals short on nursing staff and still recovering from pandemic-related revenue shortfalls, he said. “If you take the financial challenges of your organizations, in large part, they’re related to the excess expenses we have related to travel nursing,” Slonim said. To help meet the demand at NNMC, Grimm said the Sparks-based hospital has hired some traveling nurses, but they are “difficult to find” since the pandemic altered the labor market. “The biggest thing for us is to focus on retention, and to do everything within our knowledge and power to address resiliency and stress and provide support,” said Grimm, noting the hospital has employee assistance services that provide emotional support and counseling. However, many of the region’s hospital leaders fear the exodus will accelerate as the pandemic drags on and burnout intensifies. Compounding the nationwide problem: a third of the nation’s nurses were born during the baby boom years, with 640,000 nearing retirement, according to data from the National Sample Survey of Registered Nurses. And increasing the nation’s nursing workforce is no easy task. The U.S. is producing about 170,000 nurses a year, but 80,000 qualified applicants were rejected in 2019 because of a lack of teaching staff, according to the American Association of Colleges of Nursing.
Unitek College in Reno, which opened in June 2020, has clinical simulation labs for students pursuing a career as a nurse or medical assistant. Photo: Kaleb M. Roedel / NNBW
‘DROP IN THE BUCKET’ One nursing school new to Reno is trying to help bridge the gap in Northern Nevada. Unitek College opened its Reno campus in June 2020, months into the first wave of the pandemic, at 5250 S. Virginia St. Janis Paulson, Unitek College CEO, said that expanding to Reno was not on the organization’s initial roadmap. That changed a few years ago when the college’s leadership discovered the nursing shortages hampering Northern Nevada. “We did some studies on the shortages and realized, we had to come, we have to put a campus here,” Paulson said. Since June 2020, Unitek College has seen about 210 students enroll in its three programs, which includes registered nursing, practical nursing and medical assisting, said Marilyn Lim-Carreon, campus director at Unitek College in Reno. She added that the Reno campus has a goal of eventually growing its enrollment to as many as 400 students at a time. “The sites (hospitals) that we are partnered with want to hire our students,” said Lim-Carreon, noting the college is partnered with almost all of the region’s hospitals. “We had a career fair and during it students that haven’t even graduated yet were being offered positions. That’s how exciting it’s been for our students. They get to pick where to work.” Still, Unitek College knows the number of nurses and medical assistants it can develop is “just a drop in the bucket” compared to what the region needs to address the workforce shortage. “Adding 100 students is 100 more than you had before, but it’s still way short of where you need to be,” Paulson said. Growing its student pool is not all Unitek College is focused on. The institution is working to hire experienced faculty for its Reno campus and six other facilities across California, as well as its online programs. The pandemic, though, has made hiring faculty a challenge, too. “The natural progression is to go from bedside (nurse) into teaching,” Paulson said. “And what happened was they stayed bedside longer because there was such a need and such a shortage. And they got a point of exhaustion and wanting to really take downtime completely. Or we’ve seen where they say, ‘I can’t leave right now, I can’t go into teaching yet.’ “If there’s a shortage of nurses, it’s because there’s a shortage of education. And if there’s a shortage of nurses, there’s also going to be a shortage of faculty.”