Tag: chain

Sen. Tim Kaine visits a lot of health care facilities, but said during a visit to Mary Washington Hospital on Monday that he saw and heard things there that were new to him—including a detailed look at one situation that’s made the nationwide labor shortage even worse.

The Democratic senator has been holding roundtable meetings across Virginia to discuss a bill, signed into law by the president, that will help those who take care of the medical needs of others get the mental health services they need. It’s named after Dr. Lorna Breen, a Charlottesville native who contracted COVID-19 early in the pandemic, then died by suicide while working on the front lines.

Kaine also wanted to hear feedback from Mary Washington Healthcare officials about other aspects of COVID and its long-term impact—and doctors, nurses and department heads gathered around the conference table provided an earful.

“January and February were really hard” in terms of dealing with the omicron surge in the middle of a labor shortage, said Kathy Wall, chief human resources officer. But what’s on the horizon may be even worse, she said.

“I don’t think we’ve even experienced the impact of the workforce (shortage) yet, and it’s coming,” she said. “Right now, today, we have hundreds of open positions and we don’t have candidates. A lot of them have gone to travel where they’re paying triple of what we would normally pay a nurse, and so that’s very hard to compete.”

That got the senator’s attention. When someone first mentioned “travel agencies,” Kaine admitted he was thinking more about booking trips than nursing contracts.

“I want to understand this,” he said.

Wall and Eileen Dohmann, chief nursing officer, were happy to fill him in.

Before the pandemic, the idea of “travel nurses” appealed to a small segment of the nursing population, Dohmann said. Those with at least two years of experience would take 13-week assignments and be paid more because they were working out of their area or state.

Pre-COVID, nurses at MWHC were making $35 to $45 an hour, while a travel nurse made about $50 to $65 an hour, she said. Nurses would work three 12-hour shifts, then travel home, where they’d spend the rest of their week.

Before March 2020, Mary Washington Hospital probably had “30 to 40 travel nurses in our facility,” Dohmann said, “meaning we had exhausted any kind of hiring we could do and we would bring in travel nurses, the most expensive nurses for us at any point in time.”

When the pandemic began, the travel agency with whom MWHC had a contract pledged to be there with staff when the hospitals needed them. Then, they sent along their rates, which had gone up 30% before the Fredericksburg area had its first COVID patient, she said.

MWHC officials learned that was just the tip of the iceberg. Rates continued to go up and by fall 2021, the health care system was paying $160 to $175 an hour for a travel nurse, Dohmann said. As a result, many nurses quit their hospital jobs to become travel nurses. While there already was a nursing shortage, it became even worse when the travel pay created more resignations and vacancies.

And the term “travel nurse” became a misnomer, because nurses weren’t going to assignments across the country. They were working in Culpeper, Richmond or Northern Virginia.

Dohmann said she couldn’t fault a person for making the choice to become a travel nurse and use the extra money to pay off student loans or credit cards. But she also knows that the nurses haven’t been the full beneficiaries of the rate increases. They might be getting $100 of the $175 hourly rate being charged.

It’s the travel agencies that have “benefited greatly,” she said.

Dr. Mike McDermott, CEO of the health care system, said the agencies “are taking advantage of the situation. I don’t think it’s in the best interest of the health of our nation.” He equated the situation to price gouging by gas companies during an oil shortage.

Kaine said after the roundtable that he knew traveling nurses could “make a lot of money,” but was surprised to hear how “it kind of turns everything topsy-turvy amidst all the other challenges.” He planned to take the information back to his staff to see what could be done.

The senator said he appreciated hearing about programs such as MWHC’s partnership with Germanna Community College. Through an initiative called “Earn While You Learn,” nursing students at the college are paid as nursing assistants at Mary Washington as they work with trained nurses to get more clinical experience.

The cost of their salaries is divided between MWHC and Germanna, Dohmann said. In addition, a hospital nurse also takes on a supervisory role with the students and is paid for the dual duties.

Dohmann asked Kaine for his help, both to examine the rates of travel nurses and to create more slots for nursing students.

“This partnership really works,” she said about the Germanna program. “If you can help us make it easier for students to get into schools of nursing, we’re prepared to make changes on how we train them, but it really does come from those kind of academic–clinical partnerships.”

Dr. Christopher Newman, chief medical officer, also explained ongoing issues with the supply chain. Problems began early on in the pandemic, particularly with personal protective equipment, but they’ve continued with other items.

The pandemic “sort of shined a light on a broader problem that I would put in a national security risk category,” Newman said, “when we look at the lack of redundancy in our health care supply chain and amount of medication and lifesaving things that are manufactured solely in China or places that may not be great political partners down the road.”

He said foreign countries “could turn off the pipeline of cardiac medication or IV fluids,” noting that supply chain problems aren’t limited to auto parts.

“Every week we have another crisis with the supply chain and unlike other things, where you wait eight months to get your car, some of these are critical, lifesaving things,” Newman said.

Kaine said he’s trying to address some of those issues, including making sure health care workers get the mental health support they need during what Newman called “moral distress and burnout.” Kaine said the nation might broaden its definition of items that are considered national security—and made in America—to include health care supplies, or manufacture them in the Americas where there are free trade agreements.

In addition to the heavy discussions on pandemic-related fallout, Kaine also toured the hospital’s care coordination hub, which looked like an air-traffic control center. On 10 monitors, workers could see the flow of patients in both Mary Washington Hospital and Stafford Hospital as people moved along from one department to another.

“I go to a lot of hospitals but I’ve never seen this in any hospital,” Kaine said. “This looks like the emergency operations center that I had when I was governor. Or, I’m on the armed services committee and I go to bases everywhere in the world, there’s usually something like this.”

The senator asked how common the hubs are in hospitals.

“This will become the new standard, but we’re probably on the early side of it,” Newman said.