Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: THURSDAY, January 14, 1993 TAG: 9301140269
SECTION: VIRGINIA PAGE: B1 EDITION: NEW RIVER VALLEY
SOURCE: CAROLYN CLICK STAFF WRITER
DATELINE: CATAWBA LENGTH: Long
CATAWBA HOSPITAL FACING STAFF CRISIS
The departure of 10 registered nurses during the past six months forced Catawba Hospital officials Wednesday to temporarily close one floor of the psychiatric facility and relocate 34 elderly patients to other parts of the state institution.Hospital Director Michael Marsh said the third floor of the six-story, 222-bed hospital will remain empty until more staff can be hired. The hospital primarily serves geriatric patients, although 35 beds are reserved for adult acute care.
The move comes as other state mental hospitals report a similar drain of professionals who are leaving for higher-paying jobs at private and federal hospitals.
At stake is not just the retention of experienced nurses. There is a fear among state mental-health officials that an acute staff shortage could lead to questions about patient care and in turn, place the hospitals' accreditation and Medicaid-certification in jeopardy.
"That is what we are most afraid of," said Olivia Garland, assistant commissioner for staff and program development in the Virginia Department of Mental Health and Mental Retardation. "We are afraid if this trend continues what it will mean a year or two from now if we don't have enough nurses."
Marsh said he hopes to reopen the floor as soon as the staff vacancies are filled, but could offer no timetable.
"We wish we could read the tea leaves," he said.
The move Wednesday took about two hours to complete. While some of the patients played bingo in the dining room, Catawba employees pitched in to quickly reorganize the floors and help the patients settle in to their new environment.
Most of the patients were moved to a vacant wing of the fifth floor. The remainder will be filling beds on other units, said Nursing Director Barbara Kolarik.
The move, while disruptive to both patients and staff, is designed to make better use of the personnel who remain, without requiring the huge amounts of overtime that have become almost routine at the facility, Marsh said.
At the same time, Marsh is seeking permission from state officials to offer more lucrative salaries and differential benefits to its nursing staff.
"We really have to stop people from leaving," Marsh said.
That has proven particularly difficult for Catawba officials, who have watched private hospitals and the Salem Veterans Affairs Medical Center lure skilled nurses away with annual salary increases of $4,000 to $6,000.
Dr. William Douglas, the hospital's medical director and a former chief of psychiatry at the Salem VA center, said the push for higher salaries at federal facilities began about five years ago and bore fruit in the past year.
"It just sucked out nurses from here," he said.
Since Aug. 1, Kolarik has lost 10 of the 45 registered nurses on her staff, some to higher wages, more flexible hours or both. The hospital also has lost licensed There is a shortage across our system. Catawba is not the only one. We have had some hospitals that have been in as bad shape. Olivia Garland State mental health official practical nurses and psychiatric aides.
Kolarik needs to fill 11 1/2 vacancies, but has found she is not competitive on entrance salaries or on compensation for older, more experienced nurses.
Because of the state's convoluted step pay scale and the freeze on state workers' pay during the past two years, some of her supervising nurses are making less than their younger, less-seasoned counterparts.
The average salary for registered nurses at Catawba is $31,398, Marsh said.
Del. Vic Thomas, D-Roanoke, said he also planned to introduce legislation at the 1993 General Assembly to upgrade salaries.
"They are in a crisis situation and it's got to be addressed," he said.
Garland, who heads up a task force studying the nursing crisis throughout the state hospital system, said Catawba is not alone in seeking geographic and shift differentials to help close the salary gap.
"Actually there is a shortage across our system," said Garland. "Catawba is not the only one. We have had some hospitals that have been in as bad shape.
"We have been communicating with all of them about their shortages and strategizing for ways to alleviate the problems," he said.
But all the strategy in the world won't replace an infusion of much-needed money into the system. Like other state agencies, the Mental Health Department has endured a series of cutbacks during the past three years and expects little relief until the next two-year budget cycle, in 1994-96.
"It's really hard to do without funding," she said. "When you are competing with facilities that are paying nurses $5,000 and $10,000 more, it's hard to tell an employee, `Stay and be loyal.' "
Garland said state hospitals do have the flexibility to offer higher salaries to nurses - if the employee goes outside the system and receives a bona fide offer from another hospital.
"It's called a competitive offer and we have the ability to give it, but it's not something many employees want to do," she said.
For the short term, Wednesday's reshuffling may affect admissions at Catawba of new geriatric patients, who make up the bulk of the population at the 222-bed hospital.
State officials have offered to help place incoming patients at other facilities, such as Piedmont Geriatric Hospital in Burkeville, which is devoted entirely to aged patients, and Southwestern Virginia Mental Health Institute at Marion.
Memo: shorter version ran in the Metro edition.