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IOWA CITY — University of Iowa Health Care leaders have notified employees that nurses in the coming weeks will face “some of the most challenging” staffing to date — warning that nurses in some units at times will have to take on five patients at once.
“The first two weeks of October present the most staffing challenges,” a UIHC leader warned employees last week, according to an email provided to The Gazette. “But the challenges will continue for the adult inpatient staffing through mid-November. I have already received some feedback and suggestions from staff on how to have staff safely care for five patients.”
Some UIHC nurses report the “increase in nurse-patient ratios” is out of line, and they’ve coordinated a protest over it outside the hospital for Thursday.
“We refuse to let our hospital administrators make poor decisions that affect our quality of care because they couldn't plan well and prepare properly,” according to a Facebook event page for the protest encouraging staff, patients, family and managers to “bring the cowbell, noisemakers, signs, ALL of it!”
The protest is planned from 11 a.m. to 1 p.m. Thursday along Hawkins Drive outside Parking Ramp 3.
“Increasing nurse-patient ratios is NOT the answer,” according to the event page. “You can't have quality and safety as a priority when you stretch your nurses so thin they go home crying!!”
In response to The Gazette’s questions on nurse shortages and whether UIHC is upping nurse-patient ratios, officials did not say whether five patients per nurse was an increase and, if so, by how much. UI Health Care did provide a statement characterizing any staffing changes as optional.
“Hospital staffing needs can change quickly based on the number of patients and their level of acuity (severity of illness),” according to the statement. “When more staff are needed, existing staff have the option to pick up additional shifts or hours for additional pay.”
UIHC “is committed — and always will be — to providing safe, high-quality care,” the statement said. “This means having a team of staff who care for patients in a safe, supportive work environment.”
Among strategies UIHC has employed to manage ongoing nursing shortages is use of travel nurses — who come for several months at a time and are compensated through contracts the university signs with temporary nursing agencies. Those nurses typically are paid more than staff nurses.
In response to questions about whether its travel nurse contracts are changing or whether its travel nurse staffing is or has shifted in any way, UIHC officials said, “travel nurse contracts has stayed consistent at UI Health Care.”
“The number of travel nurses who accept those roles may vary from month to month. Traveler rates vary based on supply and demand and prevailing market rates, and we continue to pay contractual rates that are competitive in the market.”
Out of the university’s 866 inpatient beds, 805 were being used Wednesday, putting it at 93 percent full.
The UI job website, among other health care openings, lists 380 open “nursing” positions, including 144 full-time posts and 236 part-time jobs across the campus — from labor and deliver to adult psychiatry and from nurse management positions to nursing assistants.
In the Friday email warning of staffing needs amid shortages, a UIHC unit leader said, “We are open to all suggestions on how to staff during these challenges.”
“You can expect to see leadership on the floor more often to try and mediate some of the holes while balancing what we need to accomplish in the office,” the email said. “I know this is really hard to hear for all of us, and I understand the feelings of being frustrated and nervous for what the future is going to bring. I do hope we can all come together to help get through this as a team.”
In a statement, UI Hospitals and Clinics Interim Chief Executive Officer Kim Hunter reiterated, “We are committed to providing safe, high-quality care that Iowans trust us to deliver while also striving to support the health and well-being of our employees.”
“In health care, staffing is flexible and we safely match resources with constantly changing patient care needs,” she said. “We are grateful for our nursing and care teams who come together to support one another as they care for our patients and their families.”
New buildings, leadership
UIHC is nearing the end of its search for a new Vice President of Medical Affairs of UI Health Care and dean of its Carver College of Medicine, after outgoing Brooks Jackson in February announced plans to step down and join the UI faculty as a researcher.
Jackson committed to stay on until his successor starts, and a nationwide search recently brought four finalists to campus — a pool that included two women and two men, two who identify as racial minorities, coming from institutions across the country, including Chicago, Dartmouth in New Hampshire and the University of North Carolina.
UI President Barbara Wilson hasn’t announced a final selection.
Once that person is in place, the university will start on replacing hospitals and clinics CEO Suresh Gunasekaran, who left in February to lead the University of California San Francisco Academic Health System.
Turnover atop UIHC comes as the enterprise moves forward with a new $525.6 million hospital campus in North Liberty; a $95 million expansion of its inpatient tower; and a $24.6 million emergency room expansion, among other projects.
The campus additionally has aired plans to spend $620.9 million over the next five years on a new inpatient tower on the main UIHC campus and $212 million on a new “modern health care research facility.”
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