Health care leaders in New Mexico painted a dark picture Monday of hospitals and nursing staffs in crisis as the coronavirus pandemic plunders on.
The New Mexico Hospital Association and various hospital representatives told the Legislature’s Health and Human Services Committee the pandemic has worsened weaknesses in the state’s already fragile health care system. They need workforce help for the short term and solutions over the long run, such as money to help colleges produce more nurses, they said.
They described both big-picture institutional crises and appalling behavior at a personal level. Tim Johnsen, a registered nurse and senior vice president with Presbyterian Healthcare Services, said early in the pandemic, nurses were cheered publicly as heroes, food arrived at hospitals for them and banners flew.
Now, Johnsen said, because of political or philosophical differences over how to deal with the pandemic, some people sneer, spit, kick and punch at nurses.
“Our nurses are the most fragile I’ve ever seen in my career,” said Johnsen.
Johnsen said his daughter is an intensive care nurse at Presbyterian’s Albuquerque hospital, where seven COVID-19 patients died in one day last week. Johnsen said his daughter tried to collect herself in a restroom that day, emerged with a stricken look on her face, then was embraced by another staffer as both coped with the intensity of their jobs.
“The hero banners are long gone,” Johnsen said.
Johnsen and others also described an environment in which New Mexico hospitals are paddling hard against a river of sickness and staff shortages.
“No one has seen the deaths that we’ve seen,” Sandoval Regional Medical Center CEO Jamie Silva-Steele said of the pandemic. Her hospital is part of University of New Mexico Health.
The presenters to the committee said more than 450 hospital beds statewide are unavailable because of staffing problems. And seven hospitals in the state have officially declared they are under “crisis standards of care,” which means treatment must be prioritized and directed to those who need it most.
Many hospitals have had to use expensive agencies that coordinate traveling nurses, who are far more costly than regular hospital staffers. And at least 30 hospitals in the state have seen one or more of their nurses leave for more lucrative traveling nurse jobs.
New Mexico Hospital Association CEO Troy Clark described a system in which nurses are now in such demand that bizarre things are happening.
Clark said he believed it was true that in some cases, New Mexico nurses are going, for instance, from Las Cruces to Alamogordo and others from Alamogordo to Las Cruces — and receiving the traveling nurse pay.
Because of the demand for traveling nurses, they now cost $150 to $220 an hour, up from $70 to $80 before the pandemic, Clark said. The group’s presentation showed a slide that indicated about 12 percent of the hospital nurses working in New Mexico now are under the oversight of traveling nurse agencies.
In July and August alone, they said, New Mexico hospitals spent $36 million in extra staff costs to fill holes in their workforce. Hospitals and nursing groups requested an allocation of $15 million a year to bolster class sizes in nursing schools in close to 20 colleges and universities around the state.
Linda Siegle, a lobbyist for New Mexico nursing groups, said the $15 million allocation annually is in Gov. Michelle Lujan Grisham’s proposed budget and the Legislative Finance Committee’s budget.
“That’s a very good sign,” Siegle said before the hearing.
New Mexico hospitals are especially challenged, the presenters said, because the patient mix here relies so heavily on Medicaid and Medicare. Those government-supported programs for low-income and elderly patients reimburse hospitals at a lower level than commercial insurance, they said.
In 2020, 80 percent of New Mexico’s hospital patients were supported by Medicaid or Medicare, compared to 34 percent nationwide. Further, with the economic slowdown caused by COVID-19, more New Mexico residents — 55,000 of them — have joined Medicaid rolls, the presenters’ slideshow said.
Clark said a University of New Mexico study found the state needs more than 6,000 additional nurses. Silva-Steele said about 1,600 students are admitted to New Mexico nursing schools annually and 1,100 pass the nursing board test.
“So, we’re far from where we need to be,” she said.
The group said that even with $367 million in federal aid this year, New Mexico hospitals have suffered a $274 million loss.
Christina Campos, CEO of Guadalupe County Hospital in Santa Rosa, said her hospital is in stable condition. But the rural nature of the state puts increasing pressure on hospitals to provide primary care as well as more urgent treatment.
“Rural hospitals are incredibly frail,” she said.
Clark said the state has had a nursing shortage for more than 20 years. But the combination of current conditions, he said, makes the crisis worse than ever.