Our hospitals are at capacity, profit-driven healthcare is to blame

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Our hospitals are packed, but COVID is only part of the problem. The design and management of for-profit hospitals is at the root of the crisis.

Health care systems and hospitals in our region, not to mention the country, are facing a crisis of overcapacity and understaffing. This crisis is not simply the result of the COVID-19 pandemic, but is the very creation of hospital CEOs and leaders.

The results of our full ICUs and busy ERs are delayed and compromised care for all of us. Have you been hit by a car and need an intensive care unit? Hopefully one of the local hospitals has a bed available.

An important aspect of this crisis is the limited physical space in our hospitals and intensive care units. Space in hospitals is always valuable because it is expensive to build, maintain and own. Hospital planners have a financial interest in having the least amount of space needed for work.

Likewise, to save money on empty patient rooms and unused equipment like extra ventilators in storage, a hospital’s goal is to have an intensive care unit with the size and resources needed forever. be at or near full capacity. In the United States, empty intensive care beds, nurses sitting and unused ventilators are all lost revenue.

A similar dynamic played out in the early days of the pandemic when hospitals were caught off guard with tiny or nonexistent stocks of N-95 respirators. Like a manufacturing company or Amazon’s logistics industry, our hospitals make their decisions with financial determinants far above our actual well-being.

In case it’s not clear, it’s the hospital chiefs who oversee this staffing model that has people running out of steam. These are the same leaders who chose not to invest in other resources like N-95 stocks. And finally, these are the same executives who compensate their workers with poor health insurance while keeping wages as low as possible given the job market, etc.

At the same time that our intensive care units are designed to be as small as possible in order to be full all the time, our health systems have been aware of a shortage of nurses for over 20 years. Since the late 1990s, experts have pointed out that not only is there a current shortage of nurses, but that the shortage is only getting worse as the workforce ages and retires.

Ed Young, a reporter for the Atlantic last November, explained the dynamic this way: “Even before COVID-19, many of them struggled to bridge the gap between the lofty ideals of their profession and the realities of its business. . The pandemic has simply pushed them beyond the limits of this compromise. »

Underfunding of nursing programs and low compensation for nursing faculty are major contributors to the staffing shortages hospitals face. Addressing this will require serious public investment in training new nurses and funding strong nursing programs.

But hospitals share much of the blame in the nursing shortage. They fuel the extraordinary rates of nursing burnout that drive so many new nurses out of the workforce as soon as a year after earning a nursing degree. I remember I was a new nurse and it was completely normal for my fellow new graduates to come home every day from work and cry in despair and fear.

While studies often cite a statistic that one in five nurses experience burnout in their first three years of practice, a study from the University of Pennsylvania School of Nursing in Philadelphia reports a rate by 35%!

There is no doubt that COVID-19 can only increase these numbers. It is widely recognized that hospitals are the source of this burnout due to understaffing, excessive hours and failure to provide adequate resources to staff.

This refers to hospitals acting like factories, wanting to staff their staff so that all nurses, and healthcare workers in general, do as much work as possible during their entire shift. Ultimately, the stress of having too many patients to care for while lacking the breaks and support needed to deal with the physical and emotional consequences drives nurses away from the profession.

Of course, COVID-19 has pushed all of that to the limit and brought healthcare workers to the brink of exhaustion and sanity. But the conditions for this crisis to exist and persist were created by those responsible, those who chose to put profits before the health and well-being of our society.

While this includes politicians and billionaires, it also includes the millionaires who run our local hospitals as CEOs, directors of nursing, etc.

Simply getting past this pandemic stage of COVID-19 is not a solution as our healthcare systems will continue to be unsustainable day to day and overwhelmed by the next pandemic or mass casualty event.

We need to revamp our hospitals so that extra intensive care beds or staff are not seen as an unnecessary cost, but a normal part of preparedness. Additionally, we need to fund a massive expansion of nursing schools and faculty to address continuing staffing shortages. Simply put, we must prioritize our health and well-being over profits.

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