Carolina Nursing Crisis

Written by Kristen Snyder

There’s an alarm coming from a patient’s monitor, and another one coming from the patient  down the hall. Two minutes later, there’s a dozen call lights flickering at the nurse’s station.  Nurses rush to answer each call, but there aren’t enough nurses…and perhaps there never will  be. 

Alarm fatigue sets in and each beep becomes indistinguishable.  

“Staffing on every level has been short and it affects care. Care is delayed, things are missed, the  hospital is not as clean as it should be, so it’s a breakdown of the whole system,” Huns Brown  registered nurse explained. 

When Covid-19 spread across the United States, nurses stood at the frontlines backed by public  support. Yet, with the decrease in Covid cases, the public has moved on to another cause. But,  for nurses, the fight is not yet over.  

Hospitals are still oversaturated with patients as nurses attempt to provide adequate patient care  despite their physical and emotional fatigue. For some nurses, the profession has simply become  too much. They take their scrubs off, throw them in the corner, and never put them back on  again. 

But for the nurses that stayed, the patients keep coming and hospitals expect them to keep  admissions high to sustain the hospital’s profits.  

Brown is a nurse at Mission Hospital in Asheville, N.C. Mission is the only fully equipped  hospital in Asheville, making it the primary hospital in the entire area. According to Brown, the  hospital used to hold a high standard of care. But, when the Hospital Corporation of America  bought out the hospital, the primary focus became profits. 

Current staffing shortages lower the standard of care, yet the hospital administration continues to  push high admission rates… even if it means putting nursing licenses on the line. 

“I’ve had some days where it was just too much, you just want to give up,” Brown explained. 

Although Brown is on a better unit now, he recalled days he was so overcome with patients he  simply couldn’t keep up. 

“From the top down they’re pushing you get them out, get them in…and they’re trying to empty  those beds and refill those beds as quick as they can. There’s been days where I had 12 patients  in one day between discharges and admits.” Brown said. 

There were many days Brown feared that he would miss something crucial, leading to the loss of  a patient and consequently, his license. So, he fought back. He became one of the founding  members of the nursing union, National Nurses United at Mission Hospital. For Brown and other 

nurses in the union, this was a substantial achievement because North Carolina refuses to support  unions as a right-to-work state. 

The union at Mission has fought for increased staffing and benefits to encourage recruitment and  retention. They have made large improvements in security to defend staff. But there is still much  work to be done. With only 40% of nurses in the union, Brown is not sure that there will be  enough members to truly influence the HCA to make the necessary improvements. 

Mission Hospital is one of many hospitals in North Carolina struggling to keep nurses on staff.  As the problem crosses county lines, the North Carolina General Assembly has begun to look  further into increasing recruitment and retention rates among nurses. But many nurses believe the  problem extends further than just staff shortages. 

“I’m not really sure if the public understands what nurses do, or how they’re educated, what a  person goes through to become a nurse,” Mike Frazier said. 

Frazier is a retired U.S. Army Col. and a nurse at Duke University Hospital. For Frazier, helping  people is God’s calling for him. His faith and ability to work under pressure allow him to move  forward each day, yet he believes that much of the public does not recognize the incredible  amount of work that goes into taking care of each patient. 

“40% of what a nurse does has to do with medication administration…it’s just not passing pills,”  Frazier explained. 

Nursing requires skill and expertise. From the second they enter the room, nurses are monitoring  vital signs, analyzing how patients are reacting to medication, and think about what the patient  will need next. 

“If you should look at T.V. and Media, does it show nurses making critical life and death  decisions? What’s portrayed in the media are the delivery of meals or giving of baths, and I don’t  discount the importance of nutrition and showing the caring side of nursing…but we are much  more than that,” Professor Peggy Wilmoth explained. 

Wilmoth is a professor at the School of Nursing at UNC-Chapel Hill and has served as the  Associate Dean for Academic Affairs. She is a retired Army Maj. Gen. seeking to inspire the  next generation of nurses. 

“We do need to educate more nurses. But, we also are losing a lot that are in the workforce  because they feel undervalued, underappreciated, they’re burnt out, the workplace isn’t a healthy  environment… patients and families are often impatient and treat nurses like waitresses and  nurses often engage in bullying behaviors toward each other.” Wilmoth said. 

Nursing is more than just a job, it’s a profession. It is the combination of what Zane Robinson  Wolf calls the sacred and the profane. But between the two worlds, the staffing crisis spreads.  Beyond North Carolina, hospitals around the globe are losing more nurses than they have the  ability to replace.

Leslie Surace is a registered nurse and shift leader at Novant Hospital in Matthews, N.C. After  Covid-19, she began to see a substantial increase in nurses abandoning their units. 

“It is hard work; you can’t be a pansy to be a nurse. You have to be very nice and kind but you  also have to really work under pressure, because it’s really severe,” Surace noted. 

Surace is part of the leadership staff at Novant. But with experienced staff leaving, she is left  with a lack of leadership to guide nurses that are new to the hospital. While she has learned to  balance the workload, she still bares the emotional pressure of sustaining two kids and patients  that constantly need her. 

“Sometimes you have to come out, take a breath, put on a fake face and go into the next room  and say ‘hi,’” Surace said. 

Surace recalled a young patient that had been diagnosed with a brain tumor. Her parents  cemented themselves to her bedside, never leaving her for a second. Surace saw the desperation  in the family’s faces, holding onto anything that might keep them rooted to a reality where their  daughter made it through another day. 

Surace knew the girl was in pain. She couldn’t stand to watch the young woman in such agony,  so through tears and a choked voice she told the family it was time to administer pain  medication. 

Their daughter passed the next morning. 

Surace drove home to her daughters after the end of her shift. She wouldn’t burden her family  with the long night and loss that edged its way into her heart. Instead, she sat in her car for an  extra moment to compartmentalize the faces of the parents watching their child close her eyes for  the last time. 

Nursing is emotionally and physically exhausting. And there aren’t many individuals that seek  out a life of such dedicated service. 

“Somebody asked me once why I was a nurse and I said, ‘because I can.’ Not everybody can do  that, but I can. Not everybody, even after being trained, can save someone’s life. I can,” Surace  said.

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