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About The Siuslaw news. (Florence, Lane County, Or.) 1960-current | View Entire Issue (July 31, 2019)
SIUSLAW NEWS | WEDNESDAY, JULY 31, 2019 | 7A on the staffing problems, where everything is lined up and it’s going to become un- safe. … I think Peace Health understands patient safety is important. So once we shared some of that narrative with leadership, it’s not been a dif- ficult process to get the im- proved.” In the past few years, Peace Harbor has doubled its labor and increased staffing mod- els. It has added a clinical educator position who keeps staff trained and up-to-date, doubled labor and delivery staffing and recently made a full-time charge nurse posi- tion in the emergency depart- ment. “I would also say that add- ing the charge nurse position in our ER around the clock is providing more resources for our patients and our oth- er nurses to rely on to help elevate some clinical deci- sion making that needs to be made,” Hawkins said. “It frees them up to do more direct pa- tient care. The charge nurse can help arrange for trans- fers, help to make sure we’re getting results back from our labs, radiology and critical patients.” Hawkins also stated that the hospital has been work- ing on competitive benefits and wages, along with newer equipment for staff — “Like a Nexus unit for medication dispensing is more effective and allows them to spend more time with the patient instead of gathering meds. We have just deployed nine new airflow beds to help pressure increase. And our team is get- ting a new patient monitoring system in January or Febru- ary. And the reason I say that is, when you’re trying to get a model in place to recruit and retain, you want to be able to have competitive wages and benefits. You want to be able to get them a decent work en- vironment, have good staffing plans where they feel safe and they can take care of their pa- tients, and not ask them to work too much overtime be- cause they have families that need to be taken care of.” Peace Harbor has also worked on decreasing read- missions through programs such as Mobile Integrated Healthcare (MIH) and Home Healthcare. Robin Allen, director of clinical services, said, “I think the communication with the MIH provider is that they MEDICAL from page 1A But keeping nurses like Davidson in Florence can be a challenge. From housing issues to overall provider and nursing shortages in the in- dustry, staffing rural hospitals can be a challenge. This was of particular concern a few years ago, as Peace Harbor’s wait times stretched into hours, and sometimes days. Since then, the hospital has worked on creating more positions, increasing employee benefits and nurturing innovation in the system. “The way we see it now, I think we’re close to the po- sitions that we need to fill,” Peace Harbor Chief Adminis- trative Officer Jason Hawkins said. “If we can keep them filled, we’re in better shape than we have been in a long time. I can’t speak to years and years gone by, but speaking to the other nurses in times gone by, they’ve commented that it’s getting better.” Peace Harbor’s struggles with employee retention be- came public debate in 2016 and 2017, when several care providers and one general surgeon left the community at the same time, followed by a protracted contract ne- gotiation between the Ore- gon Nurses Association and PeaceHealth. “I would say that it was kind of a baseline model that didn’t have a lot of redundan- cy built in,” Hawkins said. The issue was not that the medical center did not have positions filled, but that they did not have enough posi- tions to cover sudden staff shortages, such as someone calling in sick, taking a leave of absence or moving to an- other city. The hospital was constantly trying to cover for these normal shortages. “There’s enough turnover in healthcare that we want to build in redundancy that will take care of these issues 99 percent of the time,” Haw- kins said. “Ideally, 100 per- cent of the time, but there are always those situations and circumstances that we are challenged with. It could be a flu epidemic that could affect our employees. Our rules are that if you were to get the flu, they’re not supposed to come to work until they’re fever free for 24 hours. But if the flu hits five or six nurses in a unit?” It can cripple the unit. “You get to a tipping point, based & shoppe play buy stay work really closely with home health, so the patients that are being discharged don’t fall be- tween the cracks. They make sure that MIH gets out there to make that connection, then follow up with home health. It’s a really great system. They’re great partners.” The changes have ultimate- ly helped bring down patient wait times. “I think what you’re see- ing is our ‘left without being seen’ rates in the ER are going down,” Hawkins said. “Pa- tients that are coming and having to wait are finding they can stay and be seen in around 15-20 minutes. We don’t get it right all the time, but we are getting better at it. I’m also seeing us providing better care when they’re here. Our readmission rates are de- clining as well. Our length of care in acute care is declining in certain diagnosis. We’re getting meds to them faster the first half day. We’re taking care of them and they’re being discharged and getting them home sooner. And they’re not bouncing back. We’re not pushing them out the door too quick. So we’re seeing those readmission rates go down too.” But there are still occa- sional issues. As the hospital works promote within to fill newly created positions, an occasion “perfect storm” can occur that leaves staff short. “We still have challeng- es with that,” Hawkins said. “We’re still working where those baseline models are still fragile.” One example is a recent shortage in Peace Harbor’s Intensive Care Unit (ICU), which has led to some pa- tients being transferred to other facilities. “Normally we have a cen- sus of 2 to 3 patients in our ICU,” Hawkins said, with the possibility of up to four pa- tients at any given time. However, two of the charge nurses on the regular med- ical floor were promoted, which the hospital believed they could cover. Then the unexpected resignation of one nurse, followed by an- other who had to take leave for personal reasons, left the hospital short on staff in the Medical-Surgical unit. To cover that unit, they had to look at other units they could temporarily cut back on until new nurses were hired. They turned to the ICU, cutting Support By Supporting ART ALLIANCE AUTOMOTIVE Hoberg’s Complete Auto Repair 345 Hwy. 101 Florence, Oregon 97439 541-997-2413 Petersen Auto Detailing Florence, Oregon, 97439 541-999-6078 CHAMBER CHARITABLE GIVING Salvation Army - Western Lane County PO Box 1041 Florence Or 97439 1-800-481-3280 CHURCH Cross Road Assembly of God 1380 10th St Florence, Oregon 97439 541-997-3533 Florence Church of Christ 1833 Tamarack St. Florence, Oregon 97439 541-997-3133 DENTURIST Denture Services 524 Laurel Street Florence, Oregon 97439 541-997-6054 ESTATE SALES Cindy Wobbe Estate Sales 498 Hwy. 101 Florence OR 97439 541-999-0126 www.CindyWobbeEstates.com EVENT CENTER Florence Events Center 715 Quince Street Florence, Oregon 97439 541-997-1994 FINANCIAL SERVICES Florence Area Chamber of Commerce 290 Hwy 101 Florence, Oregon 97439 541-997-3128 www.florencechamber.com erage. People who come here really want to be here, and that’s a really neat thing.” But finding people can be difficult. First, there is a na- tional shortage of healthcare workers, both in providers and nurses. “I think we’ve been able to influence a lot of those things, with the exception of work- force housing. That, I think, is important to share,” Hawkins said. “Florence is a beauti- ful place. As a caregiver, you want to work either urban or rural. And then you make that decision, and decide where you want to work that’s a smaller community. I think Florence is a great solution for that, and I believe in that. But the housing component for rural communities is pretty challenging. We’re always, as a team, trying to find housing for new caregivers and there’s some great stories. Recently, one of our caregivers helped out another caregiver and their family who was recently hired.” Allen explained, “They were living in a hotel for two weeks. We were able to find them a place to live, but it was very difficult for them to, on their own, find a place.” Another problem is the overall lack of employment in the area. While a nurse can be employed at the hospital, their spouse may have diffi- culty finding steady work. “Sometimes in rural areas, it’s the spouse. One spouse is a nurse, the other is a school teacher. That might work out nice. We’ve had people apply where the spouse is an electrical engineer, or a ma- rine biologist. Some of those jobs are nearby, but not right here. Sometimes those are challenges for us,” Hawkins said. “It’s an imperfect system that we’re trying to make the best of. I think if a healthcare worker wants to work some- where rural in a great com- munity, I think Florence is a great spot. I really do.” Davidson pointed out that the benefits of working as a nurse in a rural area can out- weigh those in working in a metropolitan area. “I feel like the one-on-one patient care really helps be- cause you get to know your patient better than most hos- pitals. With bigger hospitals, I always hear seasoned nurs- es say that it’s hard to get the one-on-one patient care that they see here. And that keeps a lot of nurses here, the chance to get to know your patients better. I couldn’t imagine be- ing busy, busy, busy and not having the chance to really sit down and say, ‘How are you?’ and get to know not only what’s going on in the hospital, but what’s going on outside of the hospital. “I feel like that’s a good rea- son why nurses want to stay here. I feel the more nurses we have come in, the more nurses we’ll have stay and the staffing issue won’t be in ex- istence.” By mid-August, Hawkins expects the Medical Surgical Unit to be fully staffed again and the ICU can go back to normal levels, though those levels are expected to change as the community grows. “We’re a reflection of the community,” Hawkins said. “As the community needs change, I think that as more Baby Boomers come in who will need services, our need for primary care providers and our need for additional lab and radiology will in- crease, and we’ll continue to grow. And we’ll keep an eye on that. It’s a gradual growth.” For more information, visit www.peacehealth.org. Let me Showcase your property. Jan Jagoe Broker 541 999-0879 89310 Levage Dr – Enjoy this 3 bdrm, 2 bath home with vaulted ceilings, separate living and family rooms, and sunroom to the large back- yard. Kitchen with cook island, double oven and pantry. Master bath has custom shower and heat- ed fl oors. $359,000. #2901-18621943 1749 Highway 101 • 541-997-1200 Your Community Keep it local. Florence Regional Arts Alliance 120 Maple Street Florence, Oregon 97439 541-999-0859 back on the census of pa- tients that would be allowed. Instead of having up to four patients, they limited it to just one patient at a time. “We couldn’t guarantee that we would have two RNs in there 24/7,” Hawkins ex- plained. “We definitely felt comfortable we could have one. Rather than put any of our patients in jeopardy with not enough staff, we’re limit- ing our census.” But by limiting the ICU to just one patient, Peace Harbor had to transfer additional pa- tients to other facilities, such as RiverBend. This is being done by the Western Lane Ambulance District, which in turn has to approve overtime for its ambulance staff to be able to make the transfers. “We’ve moved people about half a dozen times,” Hawkins said, pointing out that trans- ferring people from a 21-bed facility is not entirely uncom- mon. “In my time here, we’ve bumped up at that ceiling maybe one time, usually flu season. But then, the entire region was full. Sometimes you can’t find a bed any- where.” The ICU shortage at Peace Harbor is not the norm and is expected to be alleviated within the next few weeks. “It takes us two to four weeks to bring in a traveler,” Hawkins said, referring to nurses who travel to differ- ent cities to fill in positions that are temporarily vacant. “They have to do background checks, get a license some- times. And get acclimated through our systems. It’s re- ally unfair to our patients to kind of drop in a nurse who doesn’t know our processes and protocols. That’s unsafe too. … It happens across the industry. You might find a 500-bed hospital that may say they’re full. But when you look at it, a particular unit may be closed down entirely because there’s just not enough staff. We don’t particularly do that here. It’s happened a couple of times, you get close, and then you get covered. We try and get travelers from other parts of the Oregon network. Un- fortunately, we had to make this decision in this case.” As for hiring a more per- manent employee, the process can take longer, anywhere from four to 12 weeks. “That’s just the reality of it,” Hawkins said. “Our turnover is a little less than the state av- Edward Jones-Andy Baber, AAMS Financial Advisor 1010 Highway 101 541-997-8755 Oregon Pacific Bank 1355 Highway 101 Florence, Oregon 97439 541-997-7121 www.opbc.com FUNERAL CHAPEL Burns’s Riverside Chapel 2765 Kingwood St. Florence, Oregon 97439 541-997-3416 Dunes Memorial Chapel 2300 Frontage Road Reedsport, Oregon 97467 541-271-2822 GARBAGE & RECYCLING County Transfer & Recycling 85040 Hwy. 101 Florence, Oregon 97439 541-997-8233 HEATING/SHEET METAL Florence Heating & Sheet Metal 1645 Kingwood St 541-997-2422 Local Businesses HUMANE SOCIETY Oregon Coast Humane Society 541-997-4277 Shelter 2840 Rhododendron Dr. Thrift Store 1193 Bay St. INSURANCE Abel Insurance Agency 875 Hwy 101 Florence, OR 97439 541-997-3466 www.abelinsuranceagency.com NEWSPAPERS Siuslaw News 148 Maple Street Florence, Oregon 97439 541-997-3441 www.thesiuslawnews.com PEST CONTROL Swanson’s Pest Management 1550 15th St #14 Florence, Oregon 97439 541-997-4027 PET GROOMING/BOARDING Aloha Pet Grooming 1751 12th Street Florence, Oregon 97439 541-997-2726 REAL ESTATE Coldwell Banker Coast Real Estate Lynnette Wikstrom, Broker 100 Hwy 101 Florence, Oregon 97439 541-999-0786 West Coast Real Estate Services, Inc. 1870 Hwy. 126, Suite A Florence, Oregon 97439 541-997-SOLD (7653) www.shoppelocal.biz REC. 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