'No end in sight' for critical staff shortages at Northland hospitals
Community Memorial Hospital in Cloquet has been feeling the trickle-down impacts of nurse shortages at hospitals across the state. In the Northland, there are more job openings for nurses than there
Health care systems across the state and region continue to struggle under the bed shortage in hospitals and intensive care units. Charles Kendall, a family medicine doctor and head of the COVID-19 Task Force at Community Memorial Hospital in Cloquet, said in his opinion, the conditions in the hospital are the worst they’ve been since the beginning of the pandemic, with "no end in sight."
While CMH does still see COVID patients in the hospital, Kendall said the patient volumes are nowhere near what they saw in November and December 2020. Instead, the problem lies in the fact that there are no open beds to be found anywhere in Minnesota or its surrounding states.
"There are no ICU beds anywhere in this region, including the surrounding states, and there has not been for six weeks at least,” he said.
Rural and community hospitals like CMH regularly need to transfer patients to larger hospital systems with specialized physicians, but they’ve been forced to board patients in their small hospital because there are no available staffed beds to take the patients who need specialized care.
“That is the key thing that has changed, and why, from my standpoint, the last two months we’re at the worst point ever in this pandemic because of that,” Kendall said. "When we’re transferring people out, it’s because they need that higher level of care and that’s where it has really been tough for us: to not be able to get these people out.”
Instead, physicians and nurses are consulting specialists over the phone to ensure patients get the best care they can, but Kendall said the conditions are not ideal in the slightest.
CMH has 18 hospital beds and four ICU beds, but CMH Director of Inpatient Services Melissa Seibert said there are six open positions for nurses that prevent the hospital from being able to fill all the beds. The number of beds left open depends on the day and its staffing capabilities, she said. Lately, CMH has been forced to keep patients in the emergency room until an inpatient hospital bed opens up, which then creates long wait times for new patients to be admitted to the emergency room.
“That’s the No. 1 reason things are as bad as they are right now in the hospital world — just not enough nurses, especially in intensive care units, to take care of the patients — COVID or not," Kendall said. "It was already that way two months ago, and then the COVID numbers are up again.”
According to the Minnesota Department of Employment and Economic Development's job vacancy survey, there were 2,195 vacancies in health care support occupations in Northeastern Minnesota in the second quarter of 2021. In 2020 there were 754 vacancies and in 2019 there were 386. Health care practitioners and technical occupations had 1,292 vacancies in the second quarter of 2021, compared to 467 in 2020 and 600 in 2019. The occupations had the second- and third-highest number of vacancies in the region, after food preparation and serving-related occupations, which had 2,521 job vacancies.
Statewide, DEED reported 17,169 job vacancies in health care support occupations in the second quarter of 2021, and 13,859 vacancies in health care practitioners and technical occupations.
Employment trends tracked by Northspan's Northforce program showed job postings in the health and wellness category started rising significantly in early 2021, reaching all-time highs in June and November. Health and wellness job posting totals rose by 15% from 2019 to 2020, and another 44% from 2020 to 2021. The average number of job postings in the field this year were approximately double what was seen by Northforce in 2019.
In addition, Northforce reported a decrease in candidate interest in the health and wellness field. Candidate sign-ups for the field decreased about 10% from 2019 to 2020, and have decreased 32% from 2020 to 2021. Average minimum and maximum hourly wages and average minimum annual salaries have remained steady through the pandemic, according to Northforce job posts. Average maximum annual salaries have increased by about $6,000 from 2019 to 2021.
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Kendall and Seibert said CMH has been lucky to not have had any nurses quit, but they have lost a few nurses due to retirement or moving away. Other hospitals, like St. Luke's in Duluth, have told the News Tribune they've had many nurses quit due to burnout from long, difficult hours working in the pandemic, as well as to pursue travel nurse jobs and to retire.
Nine chief executive officers from Minnesota health care systems, including Essentia Health in Duluth, released a plea on Dec. 13 for the public to take precautions against the spread of COVID, including getting vaccinated, to try to keep COVID patients out of critically understaffed hospitals.
"Our emergency departments are overfilled, and we have patients in every bed in our hospitals," the health care CEOs wrote. "This pandemic has strained our operations and demoralized many people on our teams. Care in our hospitals is safe but our ability to provide it is threatened. At any time you or a loved one might need our support. Heart attacks. Car accidents. Cancer. Stroke. Appendicitis. Now, an ominous question looms: Will you be able to get care from your local community hospital without delay? Today, that’s uncertain."
The appeal, which published last week in newspapers across the state and on social media pages, was also signed by CEOs from North Memorial Health, Mayo Clinic, Fairview Health Services, CentraCare, Hennepin Healthcare, Children's Minnesota, Allina Health and HealthPartners.
Kendall said rural hospitals work together to take in patients when others are at capacity. CMH has seen patients who overflowed from Fairview Range Medical Center in Hibbing and Essentia Health-St. Mary's Hospital in Superior.
“The hospitals have helped each other out when they can, but I’ve got to say lately we’ve not been able to do that when requested because we don’t have the space or the staffing,” Kendall said.
Seibert said she anxiously awaits the end of the semester at area nursing programs, including Fond du Lac Tribal and Community College and the College of St. Scholastica, hoping newly licensed nurses will come work in Cloquet.
CMH employees have been required to receive a COVID vaccine or an exemption due to federal regulations. Kendall said the health care system has reported 100% compliance with the mandate.