Work Stuff

Nursing Shortage – Bracing for Impact

Karen

Let’s talk about work –  bae-bee … (referencing this song)

I haven’t talked about work for a while so let’s bring you up-to-date on the madness that is my 40-plus hour work weeks ..

For those of you that don’t know, I’m a (reluctant) medical assistant. I say reluctant because I never, not once, as in, it never crossed my mind, had any desire to work in the medical field. I never had any aspirations to be a nurse or anything else inside the field but it just sort of happened and before long, I found myself eyeball deep in a “career” not-by-choice. If you’re interested in hearing/listening to how I stumbled into the medical field, you can click on these links: Podcast: Being a Medical Assistant – I Got a Promotion! (Sort of) – Accidental Health Care Career

But suffice it to say, I’m here and I’m giving my job 150% of myself. It’s exhausting, challenging and rewarding every day. I don’t see myself doing anything else (I have about ten years until I retire – but don’t quote me on that – you never know what life will throw at you), nor making an effort to be anything more than a medical assistant. (Again, don’t hold me to that).

This past year has been tough, I don’t have to tell you that. We’ve all had challenges but I’ll be honest, it’s been especially challenging for healthcare workers.

I have it easy, honestly. I work in an outpatient clinic for Neurosurgery. There are nine surgeons in my office and though I help wherever and whenever I’m needed, I work primarily for Dr. M. Dr. M’s team consists of him, his PA, his nurse, me and his medical secretary. And if you think that’s a lot of people surrounding one doctor, you would be right, but he needs all of us to handle the work load he alone generates.

He’s not special (though I think he’s pretty special – ha!), all of the doctors in our clinic have the same number of staff. Our jobs, broken down are as follows:

  • Dr. M evaluates patients in clinic and does surgery. (duh)
  • Physician’s Assistant (PA) or Nurse Practitioner (NP) compiles detailed information on patients in clinic and assists with surgeries.
  • Nurse sets up the surgeries and are available to patients after surgery to help manage post-op questions/pain and after care.
  • Medical Assistants (Me) set up his clinics (appointments, making sure patients have images and everything is ready for clinic) and clean up clinics, meaning patients are scheduled for testing and any follow up appointments.
  • Medical Secretaries help answer phones, request images from other facilities, fill out FMLA paperwork, etc.

These duties are simplified, of course, as we all have many other duties that we’re in charge of but you get the gist of what we do and what we’re responsible for.

We are a unique group. We’re not any more special than anyone else but I mean we’re unique in the way we’re set up when compared to other outpatient clinics.

Most clinics only have one nurse and the doctors have their own MA’s. Not very many clinics have both both a nurse and an MA for each doctor. Our clinic started out as an independent clinic from the hospital and that is how the doctors wanted it when they structured their practice. But then the hospital bought the practice and we integrated into the hospital structure and though the hospital wanted our clinic to get rid of the nurses (thereby saving them a ton of money), the doctors said no and kept their nurses.

I’m very thankful for that fact as again, I wouldn’t want to be my doctor’s sole “go to” clinic person and quite frankly, I don’t want that responsibility.

COVID changed the way we see patients. Our doctors never once even entertained the thought of offering Telemedicine visits. But then COVID hit and we were left with the challenge of how are we going to keep seeing patients, thereby keeping everyone employed and generating money for the hospital by continuing to do surgeries if we weren’t allowed to actually SEE anyone?

Enter, telemedicine.

To say it’s been a challenge, and continues to be a challenge, would be sugar coating it. I have grown to hate Telemedicine with a passion. At first, I loved it – I didn’t have to actually deal with patients in-person and it was a challenge. Now, I’m over the challenge and frustration and I’m MORE than ready to go back to in-person visits. But alas, my doctor is not ready for that and he continues to insist on only offering Telemedicine visits. So. I continue to grit my teeth and practice more patience that I ever thought I was capable of and somehow we get through the technical difficulties of Telemedicine.

There have been times, (and continue to be times), I just want to throw my headset down and walk away. Seriously. I can’t tell you the number of times I have allllllmost walked out. Screw this, I can make more money at Hobby Lobby and have a lot less stress. There have been times, (and continue to be times), that I want to throw my laptop through a window, but of course, I haven’t. I have stayed because ultimately I didn’t want to upset and disappoint my team. I’m quite attached to them and I genuinely like them. It’s a good thing too because honestly, and I’m being dead honest here, I would have left a long time ago if I wasn’t so attached to everyone.

We’re now to a point that I’ve gotten pretty good at Telemedicine visits. I have clawed my way through troubleshooting moments and I can pretty much talk a patient through anything. The only line I draw is when a patient tells me they don’t know how to access his/her email. If you don’t know how to access your email, I can’t help you. I’m done. My doctor continues to insist on Telemedicine visits and doesn’t want to see anyone in the office until the vaccine is being widely distributed to the general public. I can respect his decision but it doesn’t mean I have to like it. Luckily, or unluckily, due to the rising cases of the disease and the fact that we’ve had 150 patients with COVID in the hospital and a number of employees out because of being positive for COVID, it hasn’t been a hard sell at this point. However, there will come a time that selling Telemedicine to patients will become harder and harder. I don’t think Telemedicine will ever go away entirely, it’s really handy for patients who live hours away and it saves them a trip to town, but locals will not likely accept it as easily.

But I’ll cross that bridge when I come to it. We’re not there yet.

My nurse and her entire family had COVID. She was out for three weeks. She was very sick for about two weeks of it and too weak to come to work the third week so she worked from home. That was a long three weeks for me and gave me a small taste of how my working life would be different if we didn’t have nurses.

I could handle it. It would take some (major) adjusting, but I could do it. I couldn’t do all of it, obviously, I’m not licensed and do not have the authority to give medical advice when it comes to medications but I could certainly put in meds in a patient’s chart with the PA’s guidance. And I could learn to put in surgery orders. But I wouldn’t have the knowledge to round or visit patients in their rooms nor the knowledge to give medical advice to patients with various medical issues. Not having a nurse could be done but thankfully, we don’t have to deal with that.

But with that said ….

We are about to be down five nurses. F.I.V.E. We currently have nine nurses, one for each surgeon, well, ideally we have nine nurses. We’ve been down two nurses for quite some time. Another one quit (being a clinic nurse is not for the faint of heart), another one is going PRN (which is Latin for “as needed”) to go to nurse practitioner school and another one is retiring.

Big deal, you’re thinking, just hire more nurses.

Sounds easy, doesn’t it? Except the big challenge is – we haven’t had any applications. NOT ONE. And the positions have been posted for MONTHS. In fact, when speaking to the charge nurse on the floor we send our patients to after surgery, she hasn’t had any applications, either.

There are simply no nurses to be had.

I don’t know if this means there is a nursing shortage overall, or if every available nurse out there is being utilized to take care of the influx of COVID patients.

Maybe both.

When speaking to my nurse about this, she poo-poos the notion that there might be a nursing shortage.

According to the American Association of Colleges of Nursing site:

I think a lot of people who thought about going to nursing school has declined in recent years because of the threat of socialized medicine programs (which means less money and more work), the cost of schooling, which has skyrocketed in the past few years alone, and the fact that most people want a quick buck and don’t want to work for it and let’s face it, nursing is HARD.

So yes, I think the nursing shortage is going to be more keenly felt now more than ever – COVID just pushed it down the hill much sooner than anticipated.

Once again, screw you COVID.

All of this to say, we’re coming up on yet another hard curve in the working road. Hopefully, we can take the turn slow enough that we don’t skid off the side and careen down the cliff exploding at the bottom into a fiery ball of skin and bones.

How’s them visuals?

Our clinic is finally fully staffed with medical assistants. There for a while, we were down a few MA’s and we had to all work together to cover each other. But now, it’s the nurses’ turn to be short staffed and we’re going to all have to work together to help them out as much as we can. Each nurse is going to have to consistently cover two doctors and that is going to take a lot of patience and cooperation from us.

It’s so weird, because this situation used to be exactly opposite. We couldn’t find decent MA’s for YEARS. It wasn’t a field that people went into, let alone really knew about. And many people think you have to go to school to become an MA – not true. A lot of places will hire you and train you on the job – at least, it used to be like that. But now that more people are going into the field, employers might be a little more choosy on who they hire and NOT hire someone who hasn’t had any schooling.

Being a medical assistant isn’t hard, but you do have to have a lot of patience, superior multi-tasking, communication, and time management skills, If you’re not very good at juggling several balls in the air at the same time, being a medical assistant is not the job for you. I’m just keeping it real.

So. Once again, our clinic is getting ready to enter a challenging time. It’s rare to have a time period where everything is going great and we’re fully staffed before one domino falls over and before long, we’re scrambling to rebuild the entire thing. But I supposed that is the case for every industry in one form or another.

Anyway. All of this to say, that’s the biggest reason I haven’t posted in a while. I’ve been busy working overtime and filling in for my nurse. But now that my nurse is back, the challenge has shifted and who knows how much I will be needed with the upcoming nursing shortage.

I guess, all we can do is live our lives one day at a time, right?

I can say this for our clinic though, we are a tough crowd. We have been through some CRAZY hard transitions over the years and most of us are still standing. Yes. We’ve lost a few people over the years but the majority of us have stayed.

That says a lot about us, I think.