The most recent 12-hour emergency department shift for registered nurse Chris Kish began the same way they all do.
At 6.30 a.m., he enters the ambulance through the back doors while swiping his Oregon Health & Science University badge. Before starting his shift, he takes a moment to gather his thoughts. He then dons a mask, safety goggles, and a stethoscope.
The 32 rooms in the department are typically already occupied. Patients also occupy the stretchers that have been positioned in the hallways most mornings. One of those beds is directly near the emergency room elevator, which is often very busy.
A dozen or more sick persons who have been waiting to be seen or admitted to the hospital for the entire night are already present in the waiting area.
Kish claimed that he frequently “feels this incredible impotence of ‘here we go again'” when he arrives there each morning. Another awful day is already off to a bad start. It will be necessary for us to attempt the impossibility.
As a result of the hospital’s overcrowding, it entails attempting to care for every patient who has spent the previous night or even days in the emergency room while also tending to every new trauma patient that walks through the door.
As the shift drags on, the pressure increases. Although the ambulance drivers are aware that this emergency room is already packed, ambulances still arrive. The majority of these patients cannot be transferred to another hospital.
When hospitals are placed on divert status, paramedics call the hospital “red,” asking ambulances to move less critical patients elsewhere, if possible.
Almost all of the hospitals in the state are currently red, which is not unusual at all, according to Kish.
However, this time, it’s not COVID-19 that’s overrunning Oregon’s hospitals—it’s a shortage of nurses who can handle the volume of patients. Other floors in some cases had beds available, but there weren’t enough nurses to care for the patients. That’s partly because the federal funding that helped hospitals pay for travel nurses to increase their staffing levels is no longer available. And one reason for that is that there are so many patients.
Some of the busiest hospitals in the state have formally lowered their standards of service in response to the overcrowding and asked the state Legislature for emergency funds.
In a letter sent to Gov. Kate Brown in July, the Oregon Association of Hospitals and Health Systems said plainly, “There are not enough health care workers in Oregon.
Theoretically, nurse-to-patient ratios, one of the fundamental requirements for safeguarding patient safety, have not changed. According to Oregon law, those ratios are established by an internal staffing council in each hospital and are exceedingly difficult to change.
In real life, according to some nurses told us, they are caring for more patients at once than their position permits. Kish and two other nurses provided on-the-record interviews, with Kish claiming to speak only for himself. Others choose to remain anonymous out of concern for their jobs.
One OHSU nurse who requested anonymity stated, “My colleagues and I are worried that we or anyone we love would require the hospital right now. “We’re drowning,”
Because they are being required to supervise too many patients at once, nurses who spoke to our news channel for this story expressed concern that it’s only a matter of time before they make a mistake.
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