BROOKSVILLE — Even before the pandemic, there weren’t enough nurses at HCA Florida Oak Hill Hospital, said veteran nurse Judy Preuss.
Since then, it’s become a crisis.
Her colleagues in the hospital’s medical wards are assigned as many as seven patients, well above recommended nurse-patient ratios. The charge nurse, who is supposed to be free to assist in the ward, is now being assigned patients, too, Preuss said.
It’s a similar story in the intensive care unit, where Preuss has worked for the past 20 years. Nurses should have no more than two patients in their care, according to best practice recommendations. But Preuss and all her colleagues have three, making it almost impossible to help other nurses turn a patient over or to respond to a cardiac arrest. Preuss has no doubt that patient care is suffering.
“Patients are falling more often; dressings don’t get changed after surgery; wound dressings don’t get changed as often as they need to be,” she said.
Preuss was among a group of 25 Oak Hill nurses who rallied outside the Brooksville hospital early Tuesday to protest conditions that they say put the safety of patients at risk and are harmful to medical staff. They are demanding that HCA take immediate steps to hire and recruit more nurses at the hospital.
They held signs saying “Staff up for safe care” and strung together dozens of pink “Assignment Despite Objection” forms that nurses fill out when they are given a patient assignment or patient load they feel is unsafe. The forms are intended to provide a level of legal protection if a nurse’s license is under threat.
Thousands of the forms have been filed with hospital supervisors in recent years, Preuss said.
It’s not just patients who are affected. Nurses routinely miss meal and rest breaks and sometimes go a whole shift without a bathroom break, she said.
In a statement released Tuesday, HCA officials said they have added 78 direct care nurses this year at Oak Hill. They highlighted that the hospital has received awards and accolades commending its quality care, including certification as a primary stroke center from the Joint Commission, an organization that accredits health organizations in the U.S. They also cited the hospital’s accreditation as a comprehensive cancer care center from the American College of Surgeons Commission on Cancer and numerous specialty clinical awards from Healthgrades, a firm that provides information on health care providers.
“We are focused on recruiting, training and promoting our clinical teams to maintain the high-quality care we’re known for,” the statement read.
The health company owns and operates operates 16 hospitals between Citrus and Lee counties in its West Florida Division. HCA runs 182 hospitals and more than 2,200 clinics, surgery centers, free-standing emergency rooms, urgent care centers and physician clinics in 21 states and the United Kingdom, according to its website. The company is publicly traded, reporting almost $15 billion of revenue in the first quarter of 2022.
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California is the only state that has passed laws specifying nurse-patient ratios.
Hiring and retaining nurses has become a major headache for hospitals in Florida and nationwide in recent years, a situation that the pandemic has exacerbated. The shortage has led to more nurses resigning from permanent jobs to take up short-term contract work that can earn them $3,000 or more per week.
A report by the Florida Hospital Association and the Safety Net Hospital Alliance of Florida reported that in 2019 there was a shortfall of approximately 11,500 registered nurses and 5,600 licensed practical nurses.
If current trends continue, the report warned, Florida could be short 59,100 nurses by 2035.
Some Florida hospitals have responded by offering bonuses to new hires worth tens of thousands of dollars, according to a report by Becker’s Hospital Review. Preuss said she would welcome new nurses being hired but that HCA should follow other hospitals that have put a premium on retaining experienced nurses by offering bonuses to remain on staff.