Employee Management
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Vaccine Second Shot, Boosters Kick in Protective Effect
A study of healthcare and other frontline workers with COVID-19 showed a history of two or three mRNA vaccine doses significantly reduced the severity of illness. Workers who received two or three doses of vaccine reported less fever and chills, less need for medical care, and lower viral load than in the non-vaccinated cohort.
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Ethical Approaches to Address Nursing Workloads, Staffing Shortages
Ethicists can perform an invaluable role by working closely with senior management and medical staff leaders to develop collaborative initiatives to acknowledge the problem’s magnitude and engage nursing representatives in developing creative solutions.
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ED Violence Pushes Out Top Employees
While multiple factors can figure into an emergency provider’s decision to leave his or her profession, receiving threats or winding up as assault victims while on the job easily can be the final straw. Those who work in the ED say the violence in this setting is only growing worse.
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Inexperienced Nurses Placed in Unsafe Roles Due to Staffing Shortages
Because of staff shortages, inexperienced nurses are placed in roles that may be unsafe for patients — and for the nurses themselves.
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Beware Venting About Staffing Problems
Emergency providers should follow proper channels for making such complaints. There may be a patient safety organization to which staff are directed to submit complaints, or the hospital could view the situation as a human resources issue.
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EMTALA Concerns if Patient Harm Is Linked to Staffing Shortage
It is important for administrators to understand an individual emergency physician or facility can be held liable under EMTALA, even if no one is hurt.
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Documenting Understaffing Could Sound Like Blame-Shifting to a Jury
Jurors are going to expect everyone in the ED is working together for the patient’s benefit. If the emergency physician has valid safety concerns, the medical record is not the place to voice those. Patient safety committees or the peer review process are better options, and generally are not discoverable during malpractice litigation.
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Travel Programs, Flexible Work Options Shore Up Retention, Recruitment
Two nurse leaders explain how their healthcare systems incentivized nurses to take some extra shifts without placing undue burdens or giving the appearance outsiders are invading to take someone's job.
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Avoid Disaster by Properly Preparing New Nurses
Ideally, new graduates should not practice in an ED without first undergoing an intense preceptorship overseen by experienced nurses, followed by undergoing proper precept with a seasoned professional. Even if the hospital is not held specifically at fault for a failure to prepare new graduates, the lack of training can be the cause of a negligent act that leads to a lawsuit.
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Operational Countermeasures Help EDs Navigate Staffing Challenges
A possible solution involves moving care to the front end of the visit. Depending on the size of the department and acuity level, this might involve putting a physician or an advanced practice clinician out front, supported by a nurse, a tech, a phlebotomist, and a transporter. The goal of this approach is to ensure patients receive everything they would need if they were able to be in a room.