By
The Associated Press
TUCSON, Ariz. - Tucson hospitals are so short of nurses they have halted intake for hours while patients wait in emergency rooms - and this during what typically is a slow time of the year.
"It's a huge crisis - huge," said Dr. Len Ditmanson, a Tucson internist who spent all Wednesday afternoon trying to find a bed for a seriously ill AIDS patient.
"I've never seen all the hospitals not accepting patients," Ditmanson said. "And it's not even the winter months (when part-time residents typically swell the demand for hospital space)."
Across the city, hospitals are operating at half to two-thirds of their licensed capacity.
Tucson Medical Center, the city's largest hospital with 609 beds, had sufficient nurses for only 301 beds on Friday.
On Wednesday, University Medical Center was staffing 249 of its 365 beds. On Thursday, St. Joseph's Hospital had enough nurses to staff 181 of its 301 beds.
"It's a crisis, there's no question about it," said Dr. Ken Iserson. On Wednesday, 15 patients were being held in UMC's emergency room until there was sufficient staff to allow moving them to non-emergency beds.
Hospitals in Phoenix reportedly are having a similar problem. Patients have been flown from one city to the other as beds became available.
On Wednesday, for instance, when Sarah Mallard of Phoenix went into premature labor and needed a hospital with a "level three" critical-care nursery, the three in Phoenix all were diverting patients.
Mallard was flown to UMC, where all available medical and surgical beds in use but labor-and-delivery had room for one more patient.
Officials say nurses are scarce because fewer young adults are becoming nurses, instead choosing better-paying and less-stressful careers. Many of those who are available are working "off the register" - taking short-term contract posts, even a day or two at a time, in order to improve their pay and working conditions.
"All of the hospitals are very worried about this (shortage)," said Mary Lou Monahan, chief nursing officer at TMC, explaining that health care personnel meet daily in an attempt to find ways to deal with the situation.
John Duval, chief operating officer at UMC, said hospitals everywhere are recruiting "travelers" - nurses who move around the country as needed.
If it's this bad in September, what's it going to be like in January, when winter visitors and flu typically increase demand?, Ditmanson and others ask.
With flu vaccine in short supply this fall, health officials expect that more people will become more seriously ill than in past winters. That would be likely to further increase demand for hospital care.
"There's going to be a lot of people dying, locally and nationally," Iserson said.
Dr. Cleo Hardin, a pediatrician who specializes in children's hospital care, said this typically is the slowest time of year but that there was only one pediatrics intensive care bed in all of Arizona in the last week of August.
"It's ugly now. It's going to get uglier," Hardin said. "I think we're going to have to be willing to accept (lower) standards of care that haven't been adopted yet in this community (but have been put into use elsewhere already)."
Dr. Jose Santiago, chief medical officer for St. Joseph's and St. Mary's hospitals, said hospitals already "are doing no more than is absolutely necessary" for patients in order to stretch their available nursing resources.
"We can't go much further than we've gone" with that strategy, he said.
Potential patients can help by getting flu and pneumonia shots and by seeing a doctor before an illness becomes acute, the experts said.
And more may have to rely on care at home, authorities say.
"I think we really have to start talking to families about caring for their own," said Fran Roberts, a registered nurse who is vice president of the Arizona Hospital and Healthcare Association.
The only Tucson hospital that has escaped the nursing shortage is Northwest Medical Center, which recently opened a women's hospital, is building a new inpatient wing and is completing expansion of its operating and emergency rooms.
"If a bed becomes vacant, it gets filled right away, either with someone who's waiting in the ER or somebody being admitted for a planned procedure," spokeswoman Jami Eggold said.
