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    Friday, January 27, 2023

    'I leave work wanting to cry': Staffing shortage takes toll on Connecticut health care workers

    Since kindergarten, Sherri Dayton wanted to be a nurse. When she grew up and became one, she figured she'd never do anything else.

    Then came COVID-19 and a multi-year health care crisis and a widespread staffing shortage and a rise in mandatory overtime. Dayton watched as co-workers left the field en masse, whether to become traveling nurses or to work in other industries, such as retail. One nurse she knew quit to drive a truck.

    For the first time, Dayton began to question her future. Today, she continues to work as a nurse at the Plainfield Emergency Care Center, a division of Backus Hospital, prepping for what could be another winter of devastating viral illness — but has also begun pursuing a master's degree that will let her leave the bedside for another health care job.

    "Just seeing where health care has gone, where the profession has gone, it's a broken system right now," said Dayton, who is vice president of health care for AFT Connecticut, a union representing health care workers. "I leave work wanting to cry."

    Health care workers, more than those in perhaps any other industry, have had a difficult few years, full of long hours, stressful shifts and workloads beyond any they'd experienced before, resulting inevitably in frustration and burnout. One survey last year found that nearly one in five health care workers nationally had quit their job since the start of the pandemic, and nearly a third of those who stayed had considered quitting.

    Data from the Bureau of Labor Statistics, meanwhile, shows that the total number of registered nurses nationwide dropped from 2020 to 2021, for the first time in five years.

    Connecticut hasn't been immune to these trends. Health care workers interviewed for this story described long and tiring days on under-staffed floors alongside a revolving door of coworkers. They all know people — of all ages and experience levels — who have given up to do something else.

    "People are getting into the profession and saying, 'This is not what I thought it would be,'" said John Brady, a former registered nurse and AFT Connecticut's vice president. "Which doesn't bode well for the future."

    'You start to lose hope'

    Sonia Brown-Wright, a psychiatric technician, has worked at Hartford HealthCare's Institute of Living in Hartford for more than two decades. In all that time, she says, she has never seen staffing levels as bad as they are currently.

    Brown-Wright says there is rarely enough staff on hand to run the floor, leaving those who are working stretched and tired, working extra shifts with few breaks. Low staffing levels can become a safety issue, she said, such as in one instance when a patient tackled a nurse, seriously injuring her leg, and there was no staff on hand to run and get help.

    "If you don't have enough staff, someone is going to get hurt," said Brown-Wright, who said she has begun looking for other jobs.

    Mandy Richards, chief nursing officer at Hartford HealthCare, acknowledged staffing issues in the system, requiring employees "to be nimble and flexible." Asked about the conditions Brown-Wright described, Richards said Hartford HealthCare values safety highly and has multiple internal channels through which employees can report concerns.

    Connecticut's public hospitals, meanwhile, are facing similar, if not worse, staffing troubles. Solnit Children's Center in Middletown, a state-run psychiatric facility, currently has 97 vacancies, 43 of which are in nursing, according to a spokesperson, and the union there says the building is operating at 48 percent capacity.

    Darnell Ford, a children's services worker at Solnit, says the staffing levels take an emotional, psychological and physical toll on workers there.

    "When you're asking people to do this in a way that there's no end in sight, you start to lose hope," he said. "And in the business of servicing children and their families, that's something you can't afford to lose."

    Among the most frustrating aspects of the staffing shortage, Ford said, is how it affects patients, who then get either inferior treatment or no treatment at all.

    This also gnaws at Dayton, who notes research showing that the presence of more nurses improves patient outcomes.

    "If a nurse can be in that room every hour, she can improve the outcomes of those patients significantly, prevent infections, prevent bedsores, prevent falls," Dayton said. "And when you're not there and these things happen, you get this moral injury, like 'I know I could have prevented that if only I didn't have 15 other things to do.'"

    Marva Thomas-Taylor, a registered nurse at the state-run Connecticut Valley Hospital said nurses there do all they can to ensure patients get exactly the care they always have. But with far fewer of them on the floor than there used to be, that means an increasingly grueling workload.

    "The nurse has to stretch themselves to do twice the work to get things done," she said. "Less trips to the bathroom, so you have to hold it as long as you can, and no breaks."

    Health care workers often describe themselves as conscientious and mission-driven, having entered a difficult field out of a desire to help people. When COVID-19 hit, few complained about the long hours and dangerous conditions.

    But as the pandemic has progressed and conditions have often gotten worse instead of better, some have struggled to maintain the same tireless pace. Now, as experts fear overlapping waves of COVID, flu and RSV, they're braced for another long and difficult winter but fearful of what that might cost.

    "It'll drive people to want to step up and do more, but it will also wear them out quicker," Brady said. "They'll do it, but they'll do it until they break."

    'It's only going to get worse'

    To Ford, the Solnit employee, it sometimes seems that those in charge don't understand how dire the health care staffing crisis truly is.

    "It's disheartening, it's frustrating that a lot of the people who make these decisions don't see what the direct care workers see, don't feel and go through what our nurses, doctors and clinicians go through," he said.

    Amid a national shortage of workers across numerous industries, it hasn't been easy for the state or for private health systems to find the staff the need. Still, Ford said he'd like to see a more aggressive hiring push that would allow Solnit to open the units that are currently closed, perhaps by offering higher wages or more flexible schedules.

    According to the Connecticut Department of Children and Families, which operates Solnit, the department has offered jobs to 33 nursing candidates since July 1 but only seven have accepted a position at the facilitiy. In a statement, DCF commissioner Vannessa Dorantes said safety for patients and employees "remains the priority in all our efforts" and that the department has "focused on targeted recruitment efforts," particularly in nursing.

    Similarly, Richards said Hartford HealthCare has stepped up its hiring and retention efforts, bumping salaries, offering student debt assistance and creating a peer-support program through which nurses can provide each other emotional support.

    Officials at Yale New Haven Health, Connecticut's other largest health system, did not grant an interview about staffing levels.

    In a recent national report, AFT offered a variety of ways to ease the staffing crisis, from bolstering recruitment efforts to strengthening workplace protections to offering programs to support workers' mental health. Brady said he would particularly like to see greater input from workers in staffing plans, as well as state-mandated nurse-to-patient ratios and the elimination of mandatory overtime, which he describes as "a short-term solution that makes a long-term problem worse."

    Dayton also keyed in on mandatory overtime, arguing that forcing employees to do more work only drives them out of the industry.

    "Mandatory overtime is killing the morale in Connecticut," Dayton said. "The hospitals that mandate in Connecticut, they have a really tough time keeping people, and they're cutting off their nose to spite their face."

    For now, Dayton says the situation in her department continues to deteriorate as difficult working conditions drive away nurses — further worsening the situation for the workers (and patients) who remain. Hiring, she says, is like "filling a bucket that has holes in the bottom."

    The situation will likely only get worse moving forward, Dayton said. Whether or not she is still around to see it.

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