Hospital down to 158 nurses

The number of nurses at the Commonwealth Health Center has dropped from 167 in previous months to 158, according to a report submitted to the Commonwealth Healthcare Corp. board yesterday.
The same report adds that due to attrition, the hospital currently has 42 vacant nursing posts. It also revealed recurring challenges at the nursing department including, among others, difficulty in filling hard-to-fill positions.

In his report to the board, hospital services director Jesse Tudela disclosed that one of the major challenges CHC is facing is recruitment, hiring, and retention of experienced nurses for all in-patient and outpatient nursing units.

He said there is a lack of experienced and qualified nurses on island.

“Nursing experiences in specialty areas—in ICU, NICU, OR, and L&D—are hard to find unless recruitment and hiring from abroad is implemented. The base salary of staff nurses is also unattractive for potential nurse applicants from the U.S. mainland, making it more difficult to fill the 42 vacancies budgeted for CHC,” said Tudela.

He said the 42 vacant nursing slots are for 36 staff nurses, two nurse supervisors, two licensed practical nurses, and two nursing assistants.

Saipan Tribune learned that the 158 nurses CHC currently has include six nurse supervisors, 10 head nurses, 99 staff registered nurses, 21 LPNs, and 22 nursing assistants.

This nursing shortage is contributing to excessive overtime costs. Tudela said it is a challenge to reduce overtime hours when nursing coverage is scarce.

Also contributing to excessive overtimes is the increased number of patients in the medical surgical unit and the additional nursing services needed to cover the primary care access program, or PCAP, at ER after working hours of the Family Care Clinic.

“A major challenge is eliminating salary disparity among nurses. The proposal is to give all nurses salary adjustments based on years of experience and degree obtained, which will include their housing benefits to their base salary, therefore eliminating the expenses of CHCC,” states Tudela’s report.

He said that majority of the nursing staff support this proposal and are just waiting for the good news.

Another challenge the report cites is auditing of nursing practices through revision of policies and procedures. To date, it was learned, each unit is still revising their respective nursing unit policy and procedures.

The director of nursing post became vacant in December last year with the departure of Leticia Reyes. It was reported yesterday that finding a qualified nurse with education and experience to fill this post remains difficult.

Tudela said the hospital also lacks nurses to cover services for the Department of Corrections. Currently, staff nurses from various units are being assigned to cover DOC, which adds to the overtime cost. The plan is to identify vacant positions in other units to be used for permanent staffing at DOC.

Despite challenges, notable achievements were made

Tudela reported that at one point, CHC had only 130 nurses due to the mass exodus of its nursing staff, majority of whom left because of uncertainties with their job and non-renewal of housing benefits. At the time, the cost to the hospital was over 2,500 hours of accrued overtime.

Tudela said that bringing the workforce up to 158 is quite an achievement.

“The ongoing plans to cross-train nurses in other units to reduce OT is being done to diversify staff nurses’ skills and to attempt to reduce overtime hours. However, the cross-training is moving at a snail’s pace due to staff nurse shortage to cover units,” the report states.

Another accomplishment, Tudela said, is the electronic health record system. The nurses appreciate and recognize the importance of using technology, he added.

The hiring of a nurse continuing educator, or CE, is another accomplishment, improving nursing practice skills and preventing medication errors.

The installation of a swipe card lock system for the medication room is also an accomplishment, ensuring the safe storage of stock medications in wards.