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
&
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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
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CHAMBER
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CHURCH
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Florence Church of Christ
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DENTURIST
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524 Laurel Street
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ESTATE SALES
Cindy Wobbe Estate Sales
498 Hwy. 101
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EVENT CENTER
Florence Events Center
715 Quince Street
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FINANCIAL SERVICES
Florence Area Chamber of Commerce
290 Hwy 101
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541-997-3128
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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.
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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-
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Oregon Pacific Bank
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FUNERAL CHAPEL
Burns’s Riverside Chapel
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Florence, Oregon 97439
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Dunes Memorial Chapel
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GARBAGE & RECYCLING
County Transfer & Recycling
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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
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West Coast Real Estate Services, Inc.
1870 Hwy. 126, Suite A
Florence, Oregon 97439
541-997-SOLD (7653)
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REC. VEHICLES SERV. & REPAIR
Florence RV & Automotive Specialists
4390 Hwy 101
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RESTAURANT
1285 Restobar
1285 Bay St, Florence, Oregon 97439
(541) 902-8338
RETIREMENT LIVING
The Shorewood
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SEAFOOD
Krab Kettle
270 Hwy 101
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SEPTIC SERVICE
Wally’s Septic Tank Pumping Inc.
541-997-8885
TIRES
Les Schwab Tire Center
4325 Highway 101
Florence, Oregon, 97439
(541) 997-7178