‘A disconnect in Tallahassee’: Medical facilities struggle with ‘staggering’ staff shortages

From the Tallahassee Democrat

The current labor shortage is also gripping the health care industry. Just ask Quentin Bryant.

Bryant is a 25-year-old respiratory care student at the Ghazvini Center for Health Care Education at Tallahassee Community College.

He’s in a one-year, five-semester program that graduates students who often work in Tallahassee’s local hospitals, Tallahassee Memorial HealthCare and Capital Regional Health Care.

There’s one longtime reality that he hears in whispers: Too many jobs and not enough people to fill them; a decade-spanning trend that, in combination with the pandemic, is beginning to show its consequences.

“You can see it,” he said, giving a perspective through his time in a TMH clinical. “People are exhausted and it’s something that I think is made worse by the stress of COVID.”

The Greater Tallahassee Chamber of Commerce conducted a survey of 15 local hospitals, physician practices and other medical providers and found that there are currently 874 openings for certified medical assistants, nursing assistants, registered nurses, licensed practical nurses and patient care technicians.

Another 1,054 openings are projected over the next year, meaning a total of almost 2,000 jobs will need to be filled during that period for just those providers alone, the report said.

“This is a crisis,” said Terrie Ard, president and COO of Moore and an executive board member heading up the Chamber’s talent committee. “Looking at the raw data, it’s staggering.”

Ard said some of the leading factors are the capacity of education programs, an aging population, an aging health care workforce and an increase in chronic disease beyond COVID.

“We’re desperate for staff,” said Tom Harrison with Tallahassee Primary Care, which has about 12 to 15 different locations. “We’ve got one office in danger of having to shut down.”

Harrison agreed with Ard and said this has been an ongoing problem rooted in a shortage of talent development.

“I think there’s just a disconnect in Tallahassee,” he added. “People see health care as doctors and RNs but there’s an awful lot of large health care organizations out there, not just hospitals that are desperate for staff.”

Burnout and musical chairs

TMH, one of the participants in the chamber survey, is not “unusually short staffed,” said Steve Hayes, the hospital’s chief human resources officer.

However, because of a surge of inpatients, the hospital adjusted its staff planning, sometimes requiring nurses to return to the bedside – a musical chairs arrangement that aims to halt impacts from potential shortages.

“The staff shortage and surplus was once very predictable,” he said. “I think with compounding factors, it’s become less so. We luckily have a lot of highly qualified nurses that volunteer to fill in roles when needed.”

One of the “compounding factors” Hayes mentioned was burnout: TMH’s medical staff, especially in the COVID unit, are dealing with an influx of very sick patients.

In a Facebook post directed at COVID deniers, TMH nurse CJ Payne wrote, “Come talk to a patient with me as I beg and plead for them to not give up even though they are exhausted and don’t know if they can do it anymore…

“Come hold the patient’s hand while they take their last breath, knowing their children, grandchildren, and spouses will no longer have a vital part of their family anymore.”

Hayes said, because of COVID, he has seen some staff retire when they might have stayed longer.

“It is a difficult job,” he said. “It requires a lot of protective equipment and the intensity of that work with individual patients is very high.”

Plugging the ‘skills gap’

The solution, he and other experts agreed, is in education.

In direct response to the chamber survey, Tallahassee Community College and Lively Technical College developed accelerated programs to bridge the “skills gap,” which describes a mismatch between people’s training and workforce opportunities.

Kimberly Moore, who leads workforce development for TCC, said she is focused on improving the Ghazvini Learning Center’s offerings as well the college’s new Clinical Medical Assistant program that trains and prepares students in just 90 days.

Typically, she said, a medical assistant program takes one year to complete.

The new program will teach foundational knowledge in medical terminology, basic pharmacology, nutrition, anatomy, physiology and more that applies to a clinical medical assistant role.

The goal of the program is to get students, upon graduation and a passing grade on the  national certification exam, into medical assistant jobs.

Partnering with Florida State University, over 40 FSU students, who are pursuing degrees, applied to the program so they can get short-term certification and start working before graduation.

“It was in direct response to the shortage,” Moore said about the medical assistant program. “We need a direct stream of talent and that’s where education comes in.”

Beating the ‘brain drain’

FSU College of Medicine has nine residency programs around the state with about 150 students spread throughout, according to Dean John Fogarty. It was the first medical school founded amid an early 2000s push for new medical schools in the Sunshine State because of a medical labor shortage and an aging population.

Residencies are a key component to addressing medical staffing shortages, he said, because 90% of students plant roots within 100 miles of their residency program.

Meaning that without enough residency programs in Florida or Tallahassee, graduates will relocate and likely work out-of-state, leaving Florida health care facilities short staffed.

Over the last 10-15 years, FSU’s medical school graduated 17 classes, and over half have completed their residency programs; however, only 60 of the about 1,600 graduates are practicing in the Tallahassee area.

Additionally, anywhere between 60%-65% of students go out of state for residency programs. It’s a problem the school is looking to address by improving its current programs at TMH, Sarasota Memorial and Lee Health in Fort Myers, to name a few, as well as increasing its total number of programs.

“I think we are contributing and producing the workforce that Florida needs,” he said. “But there is clearly more to be done.”

Nationally, the same trend appears.

According to a 2020 report by the Association of American Medical Colleges, the United States will face a shortage of between 54,100 and 139,000 physicians by 2033.

The report cites America’s aging population as a key reason for the shortage. The report says that the over-65 population is expected to grow by 45% in the next 13 years or so, while the national population is slated to increase by only a little more than 10%.

Additionally, the annual Nursing Solutions, Inc. National Health Care Retention & RN Staffing Report, which covers 226 facilities across 37 states, projected another large shortage.

“Although the industry has been resilient throughout the pandemic and surge, COVID has definitely amplified and stressed the labor market and shortage,” the report’s preface said. “While supply varies geographically; on a national level, a major crisis is evident and deteriorating.”

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