For Elisa Moylan, chief nursing officer for Mee Memorial Hospital in King City, scheduling nurses is a precarious balancing act. The hospital has always depended on traveling nurses to fill gaps but since Covid-19 struck, traveling nurses are harder to come by. A year ago the agency fee for a traveling nurse was around $85 an hour. Today that fee is over $200 an hour, depending on nursing specialties. For a small, rural hospital that’s not part of a larger health care system that can absorb such costs, that’s a hefty price to pay.
They do pay the steep fees when absolutely necessary for the positions Mee Memorial needs most, like operating room nurses. So Moylan finds other places to cut, like using nursing management staff to fill in.
“We always have some challenges, however the challenges are now just escalated. Accelerated would be the word, because of the need all over the country,” she says. “Travel nurses are harder and harder to get. Fewer of them want to work because of the consistent stressful work. Many are burned out. One of the agencies told us they have 50-percent fewer nurses than they did a year ago.”
Monterey County’s hospital, Natividad in Salinas, is reporting a large number of staff vacancies for all staffing, not just nursing, at nearly double the normal rate, according to Janine Bouyea, assistant administrator. For nursing they are using traveling nurses, “but our contractor is unable to fill all of our requests.”
The current need for specialty nurses is the greatest in operating rooms, intensive care units and labor and delivery rooms in nearly every hospital. At Community Hospital of the Monterey Peninsula, the ICU and labor and delivery are the greatest needs. “We currently have enough nurses to treat our patients, but pandemic-related burnout is a real concern and we are constantly recruiting to fill vacancies,” spokesperson Monica Sciuto writes by email. “Our open positions are slightly higher than normal due to Covid-19, retirements and the high cost of housing in the area.”
Salinas Valley Memorial Hospital staffing is steady at the moment, says Pete Delgado, president and CEO of the SVMH system. He says they’ve worked proactively throughout the pandemic to keep staff morale high. “They are the tip of the spear and we have to take care of them,” Delgado says. That SVMH earned Magnet status from the American Nurses Credentialing Center in May – a recognition of following rigorous standards of nursing excellence that few hospitals achieve – helps it attract talented nurses on a continual basis, he adds. Some traveling nurses after spending time there decide to stay in permanent positions.
Recently all four hospitals in the county issued a joint statement that they expect all of their employees – not just nurses – to be vaccinated against Covid-19 by Oct. 1, which could mean losing some who refuse. Those with verified exemptions will be tested twice a week. CHOMP employees not vaccinated and without exemptions could face termination. (More than 92 percent are vaccinated.)
At SVMH, staff who refuse will not be permitted to work inside the hospital. (The staff is 91-percent vaccinated and all new hires must be vaccinated.) Administrators did not express concern that any loss of employees would put more strain on staffing than already exists.