Wages, housing, competition, burnout: Multiple issues contributing to Idaho hospital worker shortages during COVID surge

A slide from Division of Public Health Administrator Elke Shaw-Tulloch’s Aug. 19 presentation to the Idaho Department of Health and Welfare’s Board of Health.

By Melissa Davlin, Idaho Reports

A perfect storm of circumstances is contributing to staffing shortages is hitting Idaho hospitals right now, and a widespread solution isn’t immediately clear.

On Thursday, the Idaho Department of Health and Welfare’s Board of Health heard an update on Idaho’s current COVID-19 wave, which IDHW officials fear will trigger statewide healthcare rationing and cause more than 4,000 new cases per day by mid-October. 

The current surge’s stresses are different from previous waves; Unlike the beginning of the pandemic in spring 2020, hospitals have enough ventilators and personal protective equipment, even as the state is breaking records for COVID patients in ICUs and on ventilators.

The biggest issue is staff, and not just nurses and doctors who care for critically ill patients. Hospitals statewide are struggling to find employees for nutrition and environmental services — in other words, staff members who clean rooms in between patients.

“The hospitals are really feeling this very acutely right now,” said Elke Shaw-Tulloch, administrator for IDHW’s Division of Public Health. 

Shaw-Tulloch said Kootenai Health in Coeur d’Alene had told IDHW they have 500 open positions at the moment; Normally, the hospital operates with about 200 vacancies. Other hospitals are reporting about 40 percent of their environmental services staff positions are vacant.

Three Idaho hospitals have officially requested staffing aid from the federal government. 

“What we’ve been told informally from the federal government is there aren’t really any federal resources to be had,” Shaw-Tulloch said. “There are significant restraints across the whole United States. Everybody is sort of vying for the same previous resources and staffing.”

Board chairman Darrell Kerby, who lives in Bonners Ferry, said hospital staffing issues are compounded by growth and skyrocketing housing prices in north Idaho. 

“Most of north Idaho has been gentrified overnight,” Kerby said, adding that interviewees will accept positions at the region’s hospitals, only to find they can’t afford housing on the proposed salaries. 

Housing shortages are also contributing to the problem in some areas of the state. Board member Wendy Jaquet told Idaho Reports after the meeting that the already-existing Wood River Valley housing crisis was compounded by COVID, when new residents moved to the area from out-of-state and continued to work remotely. Those workers bought up or renting the area’s already limited housing units while not contributing to the local job market.

“There’s no supply. That’s our big issue,” said Jaquet, who served as the Idaho Legislature’s House Minority Leader from 1998 to 2008. “We just have no place for anybody to live.

The result: Nearly every industry in the valley, including the healthcare system, is scrambling to find workers.

“We’ve had this situation before, but we are in crisis here,” said Jaquet.

Board members also briefly discussed whether hospital vaccine requirements would prompt some healthcare workers to quit. 

The majority of hospitals and healthcare providers in the state don’t have a vaccine requirement, with three big exceptions: St. Luke’s Health System, Saint Alphonsus, and Primary Health, all based in the Treasure Valley. 

When the health systems first announced their new vaccination requirement in July, 79 percent of St. Luke’s employees were already vaccinated, while about 3,000 were unvaccinated, said Dr. Jim Souza, chief physician executive for St. Luke’s, during a media call last week. As of last Thursday, about 400 more have chosen to receive the vaccine, and Souza expects that number to rise closer to the September deadline. 

Souza said the hospital doesn’t plan to change its policy, despite those staffing concerns.

But vaccine requirements don’t play into the shortages faced by Kootenai Health or other hospitals across the state. On Monday, Dr. Robert Scoggins, chief of staff for Kootenai Health, confirmed to Idaho Reports that his hospital doesn’t mandate the COVID-19 vaccine as a condition of employment. 

Another factor: Burnout. Healthcare workers are exhausted. 

Earlier this week, Dr. Kenneth Krell of Eastern Idaho Regional Medical Center told Kyle Pfannenstiel of the Post-Register that this surge is particularly disheartening. 

“It feels worse because we at least had the hope when things were flaring (up) in December and through the early spring, that vaccines were going to be the answer,” Krell told Pfannenstiel. “You have to understand that health care workers are discouraged at this point, seeing that we’ve got a solution to this problem that we’ve not fully taken advantage of.”

Vaccines have been widely available in Idaho for months. Unvaccinated Idahoans are 13 times more likely to be hospitalized for COVID-19 than vaccinated Idahoans.

“It’s very disheartening to see the number of patients that we’re seeing now after such a long period of time,” Scoggins told Idaho Reports, adding some critically ill patients and their families still don’t believe they’re sick with COVID, even as they’re being cared for in the ICU. 

“Honestly, this nursing staff is worn out and the physicians taking care of the patients are worn out,” Scoggins said. “It really has been a battle at the hospital to care for these patients. They’re difficult patients to take care of.”

Shaw-Tulloch told the board that the Crisis Standards of Care Advisory Committee is meeting Thursday afternoon to go over the state’s plan, which provides guidelines for how to make difficult decisions on rationing care under emergency situations in which hospitals cannot provide sufficient healthcare to everyone who needs it. 

Idaho Reports is hosting a live special on Idaho’s current hospital crisis next Thursday at 8 pm MT on Idaho Public Television. 

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