Hawaii’s most understaffed hospital also needs more beds

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HILO (HawaiiNewsNow) – Hilo Medical Center officials say the facility is in desperate need of more beds and frontline caregivers because the number of people in the community has grown too large for the hospital.

According to the Hawaii Healthcare Association, Hilo Medical Center is the most understaffed hospital in the state.

Hospital officials confirm that the facility has been overcapacity and understaffed for more than a year. Nurses say these issues have a direct impact on patient care.

Earlier this month, hospital officials invited Hawaii News Now to see first-hand what’s going on in Hilo’s emergency room, intensive care unit and in the progressive care unit. of the hospital.

On a recent weekday around 10:30 a.m., ER staff raced against time to prepare for a patient suspected of having a stroke.

On the public address system, the hospital broadcast: “Activation of the stroke team in the emergency department”.

The woman was rushed out of the ambulance and immediately taken for a brain scan.

“It’s a bleed,” a nurse announced to a room crowded with medics standing by.

A caregiver yells, “Start Cleviprex.”

When someone has a stroke, the minutes determine if a person will walk again, talk again, and if they will ever see their family again.

“She shook my hand a bit,” said one of the many nurses standing at the patient’s bedside.

At times like this, observation is key.

Seconds later, another caregiver called a doctor: “I think she’s convulsing.

But the reality is that there are times when caregivers are far apart. And in this business, you don’t always get a second chance.

“Unfortunately, we are missing things,” said Ashley Mae, a registered nurse in the intensive care unit at Hilo Medical Center.

“It’s the fact that we’re so full. We can’t care for all of our patients and it hurts because we just don’t have room for them.

These days they come from everywhere.

“We have outgrown our hospital”

In addition to caring for communities along the 80-mile stretch from Honokaa to Kau, the Hilo Medical Center has become the catch-all for patients that smaller hospitals on the Big Island aren’t equipped to handle.

It doesn’t stop there.

People are sometimes flown into Hilo from other parts of the state.

“We don’t just need more staff,” Mae said. “We have outgrown our hospital.”

For more than a year, the 166-bed establishment has not only been full, it has been overcapacity by up to 30%.

This means that there are days when staff have had to find additional space for up to 50 people.

“It’s not fun for the patients,” said Hilo Medical Center emergency room registered nurse Tyler Sumner. “In the emergency room, it’s very common to see someone waiting more than six hours.”

Hallways that were once empty are now cluttered with stretchers. The sick are constantly moved.

“Out of 28 (ER) beds, sometimes 24 (patients) are waiting for upstairs beds,” Sumner said. “So you’re playing with four pieces.”

This is because patients take longer to come out.

Officials say that while some are well enough to be discharged, understaffing at many long-term care facilities on the island means they have to stay put – until there is a place to go.

Another issue is that many of those admitted are sicker than pre-pandemic patients, which lengthens recovery times.

The problems have created backlogs in just about every department.

“We’re so congested,” said Caitee McCallister, a registered nurse in Hilo Medical Center’s Progressive Care Unit. “When we walk in – in the morning. We see a whole list of patients waiting for us.

In the intensive care unit, there are only 11 beds.

“Usually we’re full,” Mae said.

Faced with a serious labor crisis

Some patients are so ill that they require the full time attention of one nurse, sometimes two.

But severe staffing shortages have dispersed those caregivers.

“Our patients unfortunately suffered because of this,” Mae said.

The workforce crisis has hit Hilo Medical Center particularly hard.

Currently, nearly a quarter of the hospital’s 335 registered nurses are travelers arriving from the mainland by air. And even that is not enough.

“I know last week I worked five days,” Mae said.

It’s a 60-hour work week.

She says some 12-hour shifts are so chaotic they leave carers in shock.

“We all sit down at the end of the day and breathe a sigh of relief that we made it,” Mae said. “And that our patients got away with it.”

It’s a cycle that too often puts people’s lives at risk.

“When we can’t give our patients the attention they need, we blame ourselves. (Thinking) oh, if I could have been there for this – I could have done this,” Mae said.

Patients who should have had more time.

There are plans to expand Hilo Medical Center for the first time in nearly 40 years. But the hospital’s bed expansion project has not yet started.

The facility is currently seeking more than $50 million in funding from the state legislature.

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