How an expanding hospital chain ignited its own staffing crisis

Patients lingered for hours on stretchers with serious, time-sensitive problems. Surgeries were delayed. Other patients developed bedsores, open wounds that for fragile patients can be fatal, because they were not repositioned often enough.

“You feel horrible because you know you’re not converting these patients,” said Genesys nurse Jillian Wahlfors. “You know they get their meds late. You don’t have time to listen to them. They’re having accidents, because you can’t get in fast enough to get them to the bathroom.”

Nick Ragone, a spokesman for Ascension, denied that cost-cutting contributed to staff shortages during the pandemic. This claim, he said, “is fundamentally wrong, misleading and demonstrates a lack of understanding of the impact of Covid-19 on the health workforce”. He also said Ascension offers superior care that “has gotten better over time” and that the hospital offers free treatment for many low-income patients.

Unlike some rivals, Ascension avoided layoffs early in the pandemic, and Mr. Ragone said the chain has more patient-related employees than many of its peers. From December 2015 to June 2021, he said, Ascension’s ratio of nursing capacity to its discharged patients has increased by 64 percent, with staffing increases and discharges of about stable

Academics who study hospital staffing warned that the metric makes staffing conditions at Ascension look better than they are. For example, the increase in the number of nurses in the ratio over time reflects at least in part that Ascension has added about 17 hospitals, while the discharge data does not include outpatients, even though nurses spend every more time to attend to them.

Because it is difficult for outsiders to verify this industry-supplied data, hospitals can use it to fulfill their own purposes.

“The complexity and the lack of transparency, all of these things make it impossible to try to figure out exactly what’s going on,” said Linda Aiken, a professor at the University of Pennsylvania School of Nursing who has conducted large staff surveys. from the hospital . . “That’s why we ask the nurses.”

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