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Federal regulators find psychiatric patients sleeping in Tampa General hallways

By Lisa Greene, Times Staff Writer
In print: Tuesday, August 26, 2008

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TAMPA — When federal investigators visited Tampa General Hospital to look into how two patients were able to kill themselves within three days, they found other problems, as well.

At least five patients had to sleep in the hallway of the psychiatric unit, regulators said, so they all could be watched by one staffer.

Doing so failed in "providing for privacy and dignity," regulators for the Centers for Medicare and Medicaid Services said in a report that threatens to stop Medicare funding next month unless problems are fixed.

It also raises questions about staffing and management problems at the hospital, said Tampa lawyer Mike Trentalange, who represents the family of one of the dead patients.

"Do you want to have your mother or father sleeping in the hallway?" he said. "It's a teaching hospital … where residents go to learn to do things the right way. This is the example they're setting."

Hospital officials would not comment Monday on Trentalange's comments or say whether the psychiatric unit is understaffed. Trentalange said that if the unit is understaffed, the hospital should raise salaries to attract more nurses and spend more on equipment such as video monitoring.

But other problems the report cites point to staffing problems, mirroring a national shortage of psychiatric nurses and other health care workers.

"There is a genuine shortage of psychiatric nurses," said Nick Croce, executive director of the American Psychiatric Nurses Association. "When psychiatric nurses graduate, they're getting multiple job offers."

"There are nursing shortages everywhere, but it's particularly difficult to recruit psychiatric nurses," said Dr. Anita Everett, who chairs a health care systems committee for the American Psychiatric Association.

There are 2.9-million nurses in the United States, and about 90,000 of those are psychiatric nurses, according to federal labor statistics. That includes not just nurses in such units as Tampa General's, but also those in clinics and doctors' offices.

The problem isn't just nurses, but also psychiatrists, social workers and others in the psychiatric field, said Everett, who is section chief of general and community psychiatry at Johns Hopkins Bayview Medical Center.

"There's a lot of concern about the psychiatric work force aging, and not as many younger people going into the disciplines that would work in an environment like that," she said.

Health care workers say the field can be stressful and dangerous and doesn't pay as much as some other specialties, Everett said.

Trentalange sent a letter Sunday to the State Attorney's Office calling for manslaughter charges against the hospital. But spokeswoman Pam Bondi said that office doesn't do such investigations, and that the case is in the hands of state health regulators.

Such charges are extremely rare. For example, criminal charges were never brought in the case of a pregnant woman who died at South Florida Baptist Hospital after the hospital gave her a medication overdose.

Lisa Greene can be reached at greene@sptimes.com or (813) 226-3322.