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Opinion: North Hawaii Community Hospital nurse’s concerns for safe patient workloads

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Like many of the nurses at North Hawaii Community Hospital, I’ve worked hard and dedicated my career to improve my knowledge and skill for my specialty area of nursing. I’ve been a Certified Obstetrical nurse for 14 years. I have loved working at NHCH for seven years. I enjoy associating with the highly skilled and experienced people I work with. We are a family, and we work together for the best interests of our patients. 

The nurses at NHCH work there because they choose to. Some people even commute 1–1.5 hours to and from work because of their desire to be part of our facility. It is a great hospital, but it is facing great challenges.

Working at the Family Birthing Unit gives me the ability to provide wholistic family care that isn’t always possible at a larger medical center, where high volumes of patients create more specialized units that separate the phases of childbirth into distinct phases of care. The opportunity to work closely with midwives is also only offered on this island at NHCH.  

But being a rural facility also has extra challenges. One challenge is obtaining and keeping qualified personnel. Due to our low staffing ratios, inexperienced nurses are not usually hired at NHCH; most departments require at least two years of experience.  The challenge of a very small recruitment pool on this island creates added stress to our chronic problem of staffing shortages.

NHCH has decided that instead of enticing highly qualified nurse to work here by increasing wages to a more competitive level with Queens Hospital and other Hawaii facilities, they will mandate nurses work extra shifts to fill the scheduling shortages. They also feel that all nurses, no matter the specialty unit they work, can be used to float throughout the hospital to other units. 

While the nurses at NHCH are willing to help and support each other, we are concerned about the patient safety risk that this process creates. I believe that all patients deserve to be cared for by specialty nurses in whatever department they may be receiving care. The nurses at NHCH care about patient safety and Safe Patient Workloads.

Queens Health System has invested an untold amount of money into the infrastructure and technology upgrades for NHCH. It is beautiful facility with modern equipment, and it will soon have a much-needed new Emergency Department. But QHS has chosen to trim expenditures in a truly priceless and unquantifiable measurement: the human factor of healing and health, the one person who truly does make all the difference in patient care, the nurse at the bedside.

Heather Yost RNC
Kamuela, Hawaii

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