At Montefiore Medical Center in the Bronx, psychiatric units are “usually at capacity,” according to a resident doctor. Offline for more than 2 weeksthe psychiatric ward is “almost full” with patients every day, according to a nurse.
That was before Mayor Eric Adams last week announced measures To make it easier for emergency responders to unwittingly bring people with serious mental illness to the hospital.
Psychiatric nurses and medical residents who spoke with THE CITY say the number of nurses and other workers needed will not exist in emergency rooms that are already struggling to staff in the COVID era. .
“I do not think so [Adams] He talks about what is currently going on in these units, how we struggle every day to help individuals in need of mental health, who are emotionally disturbed and who are brought in for anxiety. I have the lens I need to see how the ER is overloaded in people with depression, suicidal tendencies,” said Irving, a psychiatric nurse practitioner at New York-Presbyterian Brooklyn Methodist Hospital in Park Slope. Campbell said.
“We look at it every day, and every day we struggle to decide where to put these patients,” Campbell said in an interview last week.
Adams’ surprise announcement put a spotlight on staffing shortages as union contracts expire at some major local hospitals and nurses demand better wages and working conditions.Montefiore Nurses at the hospital, Mount Sinai Hospital, and the New York-Presbyterian Hospital System are negotiating or preparing to negotiate new collective bargaining agreements. Contracts covering residents and interns in the city’s 11 public hospital systems expired last year.
Many hospital staff nurses have left the profession or have taken up more favorable positions as private practice nurses. travel nursea trend intensified by the stress of COVID treatment.
If the ward is understaffed by nurses, other staff, including physicians, must perform additional tasks such as assessing intake, changing sheets and toilet bowls, inserting intravenous fluids, and transporting patients. means
It is a uniquely difficult situation in New York because of the sheer number of patients, said Dr. Ashley Britten, regional representative of the Interns and Residents Committee-SEIU, the union representing residents and interns.
Britten, the union’s former national representative, said New York stands out among other regions in its staffing problems. Eliminate the shortage of nurses.
“There are too many residents. There seems to be a shortage of nursing assistants and nurses,” she said.
Sorry, we are fully booked
State Department of Mental Health spokesperson James Plastiras told THE CITY that as of September, about 415 of the city’s total of 2,640 psychiatric beds, or about 16%, were unavailable. More than 1,000 psychiatric beds statewide transitioned to COVID care at the height of the pandemic and are slowly returning, Gotham Gazette recently reported.
Beds can go offline for a variety of reasons beyond staffing shortages, including construction, Plastiras said.
“OMH continues to work with hospitals to bring offline psychiatric beds back online, and we expect more than 200 beds in New York City to come back online in the coming months,” he said in a statement.
Psychiatric nurses and residents who spoke with THE CITY expressed concern about meeting the needs of more people with serious mental illness with the current staffing.
According to nurses and doctors, when a new patient comes in to be observed, a nurse or nursing assistant is usually off the floor to monitor it, keeping critical staff off the floor and away from nursing duties, and allowing other staff to slack off. and accept more patients.
“We need more beds, we need more staffing,” said Ali Boma, a mental health nurse at Interface Medical Center in Brooklyn.
If a psychiatric unit or ward is full, your doctor may request a transfer to another hospital in the area through EMS. However, conversions to psychiatric beds in the Bronx, where Britten works, are regularly denied due to the ward-wide capacity being reached.
About EMS, she told THE CITY: And you’re like, “Well, why not?” And they say: ‘Because all the other hospitals in the district are also requesting diversion.'”
The same is true of Bellevue Hospital in Manhattan. The facility features the largest inpatient psychiatric unit of any hospital in the city.
Dr. Michael Zingman, psychiatric resident at Bellevue Hospital, said:
About a dozen specialties ranging from emergency medicine to cardiology last Wednesday before an oversight committee hearing held by City Councilman Mercedes Narcisse (D-Brooklyn), chairman of the hospital board. Twenty nurses testified about understaffing in the city’s public and private hospitals. .
Nurses and union leaders said chronic shortages were pushing professionals to breaking point.
There are also shortages after workplace injuries and illnesses tripled between 2019 and 2020 for nurses across the state, according to the federal government. Bureau of Labor Statistics — This figure is largely due to exposure to COVID-19 and the long and painful shift during the surge in cases.
“New York’s main problem isn’t that there aren’t enough nurses to meet demand. There are thousands of nurses in New York who just don’t want hospital jobs,” said Maimonides. Nancy Hagans, a registered nurse, testified. She is a medical center and an elected president of the New York State Nurses Association.
Hagans also notes that many discharged nurses become traveling nurses, independent contractors who travel from hospital to hospital for months at a time and earn two to three times the income of staff nurses. I also mentioned becoming
“The most pressing problem is chronic staffing shortages. Hospitals are trying to save a few bucks in labor costs by ignoring contractual staffing ratios,” she added. “When there are not enough nurses and the patient quota is too heavy, patients suffer and nurses become exhausted and start looking for new jobs.”
While intensive care units generally have staffing ratios that cap the number of patients a nurse can handle per shift, the same is true in other hospital departments, especially emergency departments, because patients cannot be turned away. Not applicable.
Craig Burke, a nurse at Flushing Hospital, testified before the council last week that emergency department nurses “should be assigned to at most six patients. Nurses should take care of 15 or more.” This is unacceptable.”
https://www.thecity.nyc/2022/12/6/23497402/nurses-question-adams-plan-mentally-ill-involuntary-commit-staff-shortage Nurse gives poor prognosis to Adams’ psychological plan citing staff shortage