Evolving Crisis Standards of Care and Ongoing Lessons from COVID-19 Proceedings of a Workshop Series (2022) / Chapter Skim
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3 Considerations for Staffing, Effects on the Workforce, and Future Trends
3 Considerations for Staffing, Effects on the Workforce, and Future Trends
Pages 19-32
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From page 19... ...
Staffing shortages and their accompanying challenges have been encountered throughout the pandemic across sectors, making this notion painfully clear. In this chapter, the speakers highlight some of the key staffing challenges encountered throughout the COVID-19 pandemic, discuss specific issues with nurses and emergency medical services (EMS)
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From page 20... ...
Instead, the lines are much more blurred and uncertain. Devereaux noted that even before the pandemic, there were staffing shortages, antiquated hiring and staffing mechanisms, a failure to view nurses as key talent within an organization, scope-of-practice policies lacking flexibility, and unusual payment structures financing the nursing workforce.
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From page 21... ...
In the United States there are roughly one million EMS clinicians working in EMS agencies, said Gamunu Wijetunge, EMS specialist, Office of EMS, National Highway Traffic Safety Administration. In the course of
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From page 22... ...
at HHS, commented that the typical surge staffing model relied on by health care in most disasters has been a source of constraint in the pandemic. He highlighted two main practices within the model, saying often times the workforce just works harder and faster to get through it, thinking it will only last days or weeks, and then if that does not work, they borrow resources from other sources.
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From page 23... ...
Erickson added to the discussion about the lack of team cohesion by explaining that the continuous movement of staff between various clinical settings and between various teams leads to questions of safety.
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From page 24... ...
However, this concept has only been in the civilian world for the last 18 months with constant triaging in health care. Maves believed that the pandemic opened up a window where the health care workforce can be trained in the concept of resource limitation, integrating it into a better appreciation for palliative care.
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From page 25... ...
PROMISING STAFFING STRATEGIES AND FUTURE DIRECTIONS Lisa Rowen, chief nurse executive, University of Maryland Medical System, highlighted key strategies for managing staffing and workforce challenges across three time frames: today (immediate) , short term (1–3 months)
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From page 26... ...
Next, he explained, they had multiple surge missions that affected hospitals, such as through skilled nursing facilities support, alternate care sites, and load balancing across institutions, which was often challenging because of the amount of high-flow oxygen that ambulances needed to carry to support patients during transport. Finally, he reviewed some of their staffing models for this support, which included California's Disaster Medical Assistance Teams, which were highly mobile and flexible, as well as the National Guard, students, and retired personnel.
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From page 27... ...
This imbalance is forcing health care workers into situations where they are regularly engaging in nonfunctional overreaching, which translates to increased burnout and errors. An important part of the conversation that is often left out are the stabilizing influences that can come from the quantity and quality of work, Niven explained, and the influences of cultural support within teams and health care organizations.
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From page 28... ...
Creating organizational support structures that include sick leave, family care plans, caregiver assistance, and allowing a scheduling system that does allow for recovery can significantly help mitigate staff burnout. Discussion on Structural Impediments to Staffing While some have proposed increasing the number of new nurses and graduates as a solution to these challenges, a participant asked if these new recruits are just being put into the same environment that is causing current staff to leave.
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From page 29... ...
Without that, he continued, there will be a loss of manpower and constant turnover and staff churn, which degrades overall workflow and quality. Erskine added that those health care workers will need to adapt to the technology system and system of care, which involves training and electronic learning to bring the person up to speed, and this will take additional time and effort.
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From page 30... ...
Backer concluded that paramedics cannot replace nurses but they complement them quite well in an acute care setting. But once a hospital changes back from crisis and contingency to standard conventional care, then often the regulation exemptions and the territoriality of professional societies and unions returns and brings challenges to the mixed staffing models.
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From page 31... ...
• Acknowledge nurses as talent that must be recruited, developed, and re tained within health care organizations. • Address the perverse payment structures that finance the nursing workforce.
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From page 32... ...
In terms of understanding moral injury and supporting health care workers, Niven highlighted a final gap: there is no data regarding respiratory therapists, EMTs, or other allied health workers. That is something that needs to be understood and measured if solutions are to be found.
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