Baja California Life and death in the pandemic tragically revealed the shortage in many hospitals, and perhaps the entire healthcare industry, of trained nurses. The problem was so acute that many nurses could earn two and three times their normal pay, if they were willing to travel to some of these hot spots. Training nurses doesn’t happen overnight obviously, so the shortage will persist. Tragically, this story is not a simple as hospitals overwhelmed by the pandemic. Once again, in too many cases, it is a story of hospitals, including tax-exempt nonprofit hospitals putting profits before people. This sordid, predatory tale was only too clearly revealed in a recent report in the New York Times.
The report focused on the giant nonprofit hospital chain, Ascension, one of America’s largest. The chain has $18 billion in cash reserves. They have 139 hospitals and 2600 sites of care in 19 states, mainly in the Midwest and South. “By 2010, Ascension’s $15 billion in revenue rivaled that of companies like General Mills and Gap.” Its tax-exempt status allows the chain to avoid more than $1 billion in federal, state, and local taxes, ostensibly because they provide charity care. How did it get so rich and huge, beside exploiting the tax breaks? At one level, as one of its executives explained, “Their whole approach to finances was right out of the Wall Street playbook.” The playbook included larding on overhead charges for central services to their individual hospitals, so bad in the case of Providence Hospital in Washington that served largely a poor client base, that the chain had to void $130 million in so-called debt when forced by the local district attorney. At the other level, they got there before the pandemic through staff reductions, including nurses that they touted as a model to the rest of the healthcare industry as having saved the chain half-a-billion bucks.
What was the impact of this kind of staffing hatchet job? As the Times looked at two hospitals where they could access information from unionized nursing staffs, it was clear that the inevitable result was poor care, long waits, and worse. Ascension was caught with its pants down in the pandemic and patients paid for it with whole departments and emergency rooms forced to close because of lack of staff. Required staffing ratios, including by the labor contracts, went out the window. Nurses that remained had twice the normal, accepted patient load, and some hospitals tried to institute mandatory 16-hour shifts. Ascension also employed robots to monitor patients in some facilities, except in cases where there was a suicide risk. Nurses called the robots “sitters on a stick”, because they were essential a mounted camera connected to a remote-control room for response.
One nurse, closing this story, cautioned that “someone is going to die if this continues” referring to the staffing and money-saving shortages. The truth is that people have already died because of this profit mongering in sheep’s clothing. We just don’t know their names.