Reducing Regulations May Ramp Up Nebraska's Nursing Pipeline

While we may never know how many lives healthcare workers saved the past two years, for many nurses and doctors, they can’t forget the ones who died in their care.

“In health care, we’re trained to just do and get things done and move on and cure people, and when you can’t do that as a healthcare provider, I think that’s somewhat of a tough pill to swallow for staff,” Caleb Poore said.

Poore is the Chief Financial Officer at Callaway Hospital, tucked into the tiny town of Callaway in central Nebraska.

Even though he oversees the hospital's finances, he jumped into patient care when staffing levels ran thin and they were running out of time to transfer their patients to bigger hospitals.

“There have been instances in the past where we ran into some pretty long wait times – calling across state lines to place certain individuals, which presents many issues across the board, especially for the family members of that individual, trying to understand why it’s taking so long for their loved one to be transferred to a tertiary facility,” Poore said.

“That’s always a challenge for our staff to deal with.”

Callaway was one of many small hospitals that proposed trading patients with bigger hospitals. Poore said more patients could be saved if smaller hospitals were able to send a severely sick patient to a larger hospital and in return, smaller hospitals could take in lower level patients.

The answer, more often than not, was no.

If bigger hospitals were to try to help in these dire situations, they may be violating the Emergency Medical Treatment and Labor Act, which requires hospitals to care for patients if they have the capacity.

Ivan Mitchell, of nearby Great Plains Health in North Platte, said finding solutions to those issues will help when another surge comes – as well as using federal pandemic money to expand the programs that can pump more healthcare workers into the state.

“The only nursing program in this [part] of the state is Mid-Plains Community College. They produce about 32 [nurses] a year, and so they don't even meet the needs for for us," Mitchell said.

"There are a lot of issues with regulation and red tape that actually keeps them from expanding.”

Mitchell said training institutions also have outdated operations that haven’t modernized along with how patients are treated today, which slows down the pipeline too.

“Ten years ago, if someone got their knee replaced, they would stay in the hospital for a week. And today, a lot of times they'll actually get discharged the same day they have surgery," Mitchell said.

"We have our curriculum for nurses set up the way we practice medicine 40 years ago. They need to kind of get with the times and actually honor clinical credit for the way that we practice today."

The hospital CEO also would like to take in overseas healthcare workers who used to travel more to Nebraska on visas. And then there’s the price-gouging practices of traveling nurse agencies, which hurt hospitals and nursing centers.

Mitchell said plenty of people want to be nurses, so the field should look at an overhaul in how it accepts, trains and teaches the next generation that will care for us.

“It's a good career. It pays well. It's a rewarding career. There's a lot of ‘why’ behind what you do. But you need to have the numbers to care for the patients because what it's doing is just – it's burning out the current ones,” Mitchell said.

Leah Wescoat, Great Plains Health’s Director of Case Management, agreed.

Wescoat, who is a registered nurse, said healthcare workers showed up when hospitals and nursing centers were overflowing with patients, and it wasn’t necessarily because of overtime pay.

“If we recruit people just for the payment, then we aren't going to have that heart and soul in the job," Wescoat said.

"You aren't going to have the great outcomes in nursing – [nurses] sticking with that profession for that long-term if that's not what their passion is for. That is my concern of when we just look at wages for nurses – is that it probably won't be the best outcome many years down the road if we're just in it for the money.”

Wescoat said, even with the pay hikes, she understands why many are jumping out of the field, considering the political divisiveness, vaccination conspiracies and overall decline in treatment from patients.

However, she said she’s going to stick it out – like many of her coworkers – while the industry creates permanent solutions.

"My heart is in nursing, and I don't ever feel like it can go anywhere else, because that's what drove me for that job," Wescoat said.

This is the final story in our healthcare staffing series that looks at the impacts a short staff is having on Nebraska’s healthcare system, its workers and the Nebraskans needing care. The first two parts of this series looked at how staffing shortfalls led to hospitals denying hundreds of people care and the strain still felt in nursing care centers.