Nursing Shortage in Houston

Nurses General Nursing


this happened here on teusday. The Hospital is on of the 2 county Hospitals, and it is also the hospital thatn delivers the most babies in the country, as well as one of the MAJOR pedi trauma hospitals here.

June 5, 2001, 11:40PM

LBJ back to normal after 16-hour 'internal disaster'


Copyright 2001 Houston Chronicle

Lyndon B. Johnson Hospital resumed normal operations Tuesday morning after a 16-hour period when it couldn't accept patients for its emergency and intensive-care centers, hospital officials said.

Patients during this period were sent to other hospitals in the area.

The "internal disaster" ended at 7 a.m. after hospital officials brought in temporary nurses to increase the staff in its intensive and emergency-care centers. The hospital began diverting emergency patients about 3 p.m. Monday.

An "internal disaster" signifies a significant problem within a hospital such as interrupted phone service, utility problems or a staffing shortage that may affect the quality of care available at the facility.

Dr. David Persse, director of Houston's emergency medical services, said it's unusual for a hospital to implement an "internal disaster" much less call for one because of a nursing shortage.

"They are so rare that we don't even count them," Persse said. "Not only was LBJ on internal disaster, it was on it for a long period."

Generally, hospitals go into "internal disaster" mode for an hour or two, Persse said. In 1999, he said, Ben Taub Hospital administrators called one after a boiler blew up and four workers suffered minor burns and injuries.

In a prepared statement, hospital district officials said they will make every effort to ensure that appropriate staffing levels are met in the future.

The statement continued, "If the hospital is incapable of providing optimal care, administrators will continue to make operating decisions in the best interests of the patients of our community."

Bryan McLeod, a hospital district spokesman, acknowledged the nursing shortage could cause LBJ to go into "internal disaster" mode again if a similar situation arises.

Hospital officials decided to stop accepting patients after the number of nurses in the emergency-care center dipped from five to four, McLeod said.

Staffing levels differ at hospitals, but at LBJ a fully staffed emergency-care center would have 10 to 12 nurses, and intensive-care would have eight, a hospital spokeswoman said.

McLeod said LBJ now has 12 nurses working in the emergency-care center, seven are temporary nurses. He said the temporary agency is paid about $40 an hour for each nurse.

The chronic nursing shortage effecting Houston is part of an international problem that is plaguing hospitals and nursing homes from London, Texas, to London, England.

Fewer people are willing to go into nursing because of wage and quality of life issues. Hospitals are having trouble keeping nurses, especially those who work in high-stress emergency and intensive care centers.

A recently released University of Pennsylvania study of hospital nurses found widespread concern about the quality of patient care because of staff shortages. More than 43,000 registered nurses in 711 hospitals in five countries participated in the study.

The study reports that burnout levels among nurses are high and a significant number -- at least one in five of all nurses and one in three nurses younger than 30 -- expect to leave their jobs within the next year.

The hospital district has had continuing financial problems. In May, officials cited nursing shortages at Ben Taub as the reason for shutting down a 30-bed unit, one of three medical-surgical wards, and eight beds in its surgical intensive care unit.

McLeod said Ben Taub has been unable to reopen the unit or the beds.

With a deficit of at least 29,000 registered nurses, Texas is in the unenviable position of being in the bottom tier of states in nurse-to-patient ratio.

The Gulf Coast region has a shortage of about 5,600 nurses that is effecting nearly all local hospitals.

P.s. thank god we have 120 hospitals in the houston area to chose from though

[ June 06, 2001: Message edited by: Dplear ]


Thanks for sharing that info. I think it could be the ultimate public awareness strategy.

Much of the reason we have deteriorated to the point we are at now is due to lack of attention given to the problem by the powers that be. That includes the hospitals themselves at one point, the media, the insurance companies, the federal government, and legislators.

It is interesting to go back and trace the progression of "this shortage". Some articles I have read say the shortage of the 80's never really went away. There were studies projecting this shortage in 1992. There was a huge demonstration of nurse in Washington D.C. in 1995 vocalizing loud and clear the problems, that was virtually ignored. I myself went to my Representative over three years ago and was basically given the "thank you and goodbye" response.

Now finally over ten years later we have gotten media attention, the Senate has conducted hearings, nurses are striking all over the nation, and hospitals have to resort to calling "internal disaster".

I see this "internal disaster" both appropriate and attention grabbing.

We need to keep the pressure on our legislators and demand action. We need to pressure them to investigate the part that insurance companies and Medicare reimbursements, have played in the deterioration in our hospitals.

Hospitals need more reimbursement from insurance companies and the federal government to enable them to make the improvements that nurses are finally able to demand due to the shortage.

My Representative, Dennis Kucinich, did a study on the part that pharmaceutical companies have played. That study can be downloaded from the California Nurses

Association website for anyone who is interested. While I found it interesting I feel it is only a piece of the picture. Now lets put the insurance companies in the hotseat and find out exactly how much of their operating cost go into reimbursements.

[ June 06, 2001: Message edited by: PeggyOhio ]

I think it is sad to have to call an internal disaster because of nursing shortages, but I do understand it. I am glad the hospital actually chose to do so instead of attempting to work it so short satffed(although it seems they were majorly shortstaffed anyway)Anyway maybe it got some attention...

This is one of the most even-handed and accurate articles I've seen in a while. It cites the varied and actual reasons for the shortage, instead of blaming nurses themselves or including inflammatory or misleading statements from administrators. I'd like to see more of this kind of media coverage as well. Nice job, Houston Chronicle.

Specializes in Hospice, Critical Care.

I would like to applaud LBJ Hospital for taking such action. It appears that they recognize the work nurses do. In our ICU, we just keep taking in the patients regardless of short staffing. We are told by management "There's nothing we can do."

Last night I had received a patient from PACU, intubated, after big belly surgery (literally--she's 300 pounds) and the family was indignant that she was not admitted to a room ASAP. She had to wait in PACU for several hours until we cleared out a bed in ICU. They say "We passed (in telemetry unit) lots of empty beds in this place!" I took this opportunity to explain the difference between an empty bed and a STAFFED bed. I also took this opportunity to educate the family on the nursing shortage crisis hitting the country.

I take every opportunity to educate the public on the nursing crisis--maybe futile, but I gotta try!

I am going to take a copy of the above article to work with me and will hand it out to any and everyone.

Be careful Zee. Where I work, using the words" Short of Staff" to patients and visitors is considered intimidation.This was told to us by a Pa. State Board person.

I saw where some Houston hositals are going to the agency mentality. They are hiring nurses for short term contracts and paying them bonuses at he end of the contracts, thus bypassing the agencies. Will be interesting to see if other hospitals follow suit and start their own internal agencies.

NAVY NURSE, good old Pa. state board of nursing. Alwaysthere to kick a nurse when she/he is down. Don't ya just love them. Notice to anyone considering working as a nurse in Pa. Go to some other state. Being a nurse here is one step above being an indentured servant. The workmens comp. laws are as anti employee as you can get. Our Governor is a republican who despises labor and loves managment. Wages and benefits are stagment in spite of the shortage.

Specializes in LTC,Hospice/palliative care,acute care.

WHAT?Telling someone you are working short is considered intimidation according to a representative of the Pa BON? If this is their stand then we are really in trouble here in Pa...I don't believe it is very professional or appropriate to actually tell someone that we are short-but I can convey that info very well just the same.And invite the family member or visitor to take their complaint down the hall to the proper office...A few weeks ago I refused to work a double(a school night-I have an 11yr old) and had a co-worker actually ask me "Don't you have any sense of responsibility for our residents-they are like babies"(it is a dementia unit) I told her that I have a "baby" of my own-and that my own family takes precedence over someone elses'"The closest this chick has to a baby is her Labrador....These instances are good examples of the kind of support we get inside our profession...and Lord knows the general public is clueless when it comes to what nurses really do all day...

Hi. I'd like to know how telling the truth about staff shortages is considered intimidation when a large segment of the population already knows via the 24 hour media? I know it's not politically correct, and the potential for liability is there, but if they ask or imply?

I agree that education is the key. As a home health nurse and former hospital nurse, I try as best as possible to educate my patients and families on how to be proactive with their care in the hospital in hopes that it will decrease their stress level as well as the hospital staff stress level.

As other posters pointed out, LBJ is to be commended on it's handling of it's crises. But folks, I really feel we need to have a moment of prayer or silence for the overall problem with health and medical staff shortages. Even though there's always hope, as the old saying goes "we ain't seen nothing yet."

I feel the health/medical staffing crises may eventually dwarf the needs of our defense and educational system in the U.S. Our legislators want to rightly beef up support for our defense. But, it's hard to get educated and defend your country when you're sick and there's barely any staff to help you get well or stable. Good health>good education>solid defense.

Specializes in Hospice, Critical Care.

I didn't say "short of staff" and assured the family that ICU was better staffed (sure, only 3:1!) than regular floor. I told them that's why beds were closed...not that the open beds were short-staffed. I explained the nursing shortage as a NATIONAL problem, not my hospital's specific problem (although, of course it is too). I did not imply that the patients were not getting care, only that that was why beds were CLOSED. I do understand liability issues. I think the Houston article explains it that way too.

Hi. Zee, I feel you gave a very good broad answer to your patients about the shortage. I don't suggest that any of us would blurt out that our unit or hospital is experiencing staffing shortages. What I do suggest is that there is going to be more inquiry by patients and families who use our services about our staffing levels. We need autonomy to judge how direct or indirect we should be with them.

Those in the public who pay attention and who care know there is a growing nursing shortage. What we nurses need to do is to get the word out to these people about their role in staff shortages before they need health or medical services. Then they can help us educate those who are not paying attention or don't care.

Nurses and other health care workers have a responsibility to help patients and families become proactive with their health. The public's increasing codependency on the system due to increasing health care problems is going to lead to bankruptcy of the entire system.

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