U.S. Sen. Jeff Merkley heard an earful from Oregon nurses about a range of issues, some long standing and others arising from the coronavirus pandemic.
But for the Oregon Democrat, that's nothing new.
His wife, Mary Sorteberg, is a nurse. Her recent experience has been in hospice care and short-stay surgery.
Jana Bitton, director of the Oregon Center for Nursing, said what Merkley heard during a virtual forum was a sampling of what nurses around Oregon discuss during weekly conference calls sponsored by the center based at the University of Portland.
"As you are getting feedback from your wife, we are getting feedback from a myriad of people from all over the state about the different experiences they have had," Bitton said.
But there were common themes:
• Job stress, and not just affecting nurses in direct contact with COVID-19 patients. According to a survey released in October by the American Nurses Foundation, 42% of the 9,500 nurses who took part said they have experienced stressful, disturbing or traumatic events as a result of the pandemic. "It does not matter whether you are in emergency care or longterm care, or even if you are in nursing education," Bitton said. "There are a lot of nurses exposed to some traumatic events."
• Staffing shortages when nurses decide to take less stressful work or leave the profession — some shortages more severe than others, depending on geography — and a lack of nurses to take their place. In the same national survey, close to half who said they were considering quitting in six months cited work negatively affecting their health and well-being (48%) as a top reason followed by insufficient staffing (41%).
Misty Richards is a critical care nurse at Kaiser Sunnyside Medical Center in Clackamas, and also vice president of the Oregon Federation of Nurses and Health Professionals, Local 5017 of the American Federation of Teachers. The union, which represents more than 5,500 members in Oregon and southwest Washington, and others reached a tentative agreement with Kaiser that averted a potentially far-reaching strike.
"I believe nurses do not need more resiliency training," she said. "We need help.
"When you let a person die alone, when you crack the ribs of a 90-year-old person in pieces like glass, a bubble bath isn't going to fix that. A cup of tea and a good book will not fix that."
Lack of instructors
• A shortage of instructors who can train nurses, even as more students seek to enroll in nursing programs. Merkley said many find they can earn more working as nurses, rather than teaching. He said that a decade ago, when Congress was writing what became the Affordable Care Act in 2010, he and others wrestled with how the federal government could help increase the numbers. But he said the government simply carved out more money for nursing in specific sectors, such as care for military veterans and in rural areas.
"All we are doing is having them compete for the same nurses," he said. "I feel frustrated about that."
Merkley said he has boosted pending annual appropriations for the Labor and Health and Human Services departments by $16.5 million for nursing workforce development. The Senate version awaits approval. He also is a chief sponsor of legislation that would boost nurse training during "public health events," such as pandemics. The bill proposes $1 billion; the Build Back Better budget resolution for President Joe Biden's social priorities contains $500 million for such training.
• Nurses caring for patients who are on average sicker. Richards said she has seen patients who five years ago would have been placed in intensive care or progressive care units — and patients now in those units who would have been dead earlier.
"We are trying to take care of patients who are very sick and normally would transition to a higher level of care, but there is not access to that right now," said Nicole Bennett, director of the Willamette Health and Wellness Center in Monmouth, which specializes in behavioral health. "We've had to adjust how we support our providers and give them the space and time to manage through that."
Merkley also heard from nurses at Legacy Emanuel Medical Center in Portland, Asante Rogue Regional Medical Center in Medford, and St. Charles Medical Center in Bend.
After the virtual forum, the Oregon Employment Department confirmed that overall employment in nursing and residential care has dropped by 4,600 between the start of the pandemic in February 2020 and October 2021. For hospitals, the number dropped by 1,000, although for ambulatory services such as physicians, it went up by 2,900.
Department economist Gail Krumenauer told reporters on Dec. 1 that these are continuations of longterm trends that preceded the pandemic. She said the downturn in nursing and residential care can be explained not only by burnout, but people seeking alternatives to nursing homes and other institutional care.
Merkley said several nurses have told him privately about their frustrations with people who fill up hospitals largely because the patients declined to get vaccinated against the coronavirus. "They are preventing sick people from getting surgeries," he said.
Merkley, who was born in Myrtle Creek and lived in Southern Oregon before his family moved to East Portland, said he understands how some rural residents resent government mandates. But he also said that vaccine mandates have made public health a reality in this country.
"It has become a cultural divide," he said. "What bothers me is that I feel we had a national emergency, there should have been no differences between the parties, or between left and right, and that if we get the technology, we all have to unite as if it we were fighting a war against a foreign enemy. It shows you how powerful now the existing divisions are."
NOTE: Adds information from the Oregon Employment Department about declines in nursing and residential care employment.