Updated March 17, 2022 - 7:08 am
For critical care nurse Emily Johnson, working long hours during the pandemic has meant delaying plans to get a master’s degree and missing time at home with three children under the age of 3, two of them foster kids.
“My kids are growing up without me,” said Johnson, 33, who works in the burn center at University Medical Center in central Las Vegas.
Despite plummeting COVID-19 cases and hospitalizations, Johnson and other UMC nurses say they aren’t getting a reprieve. After eliminating incentive pay for overtime last month, the hospital is now reimposing a requirement that nurses work mandatory overtime.
Beginning next week, nurses will be required to work an extra 12-hour shift per week, said Elizabeth Bolhouse, a nurse in the pediatric intensive care unit and chief nursing steward for the union. The Service Employees International Union represents UMC’s 1,400 nurses and certified nursing assistants.
The move comes after the hospital in late February ended incentive pay that had risen to a high of $100 per hour for overtime. UMC paid an overtime bonus at several points during the pandemic, including during the omicron surge that is now receding.
Nurses question why the crisis incentive pay is being eliminated if weekly overtime is needed.
“We’re so tired. We’ve been doing this for so long,” Johnson said about the heavy workload, as she stood with dozens of co-workers outside UMC’s Delta Point building last week. The nurses were waiting for an update from union representatives on talks with UMC’s administration.
UMC representative Scott Kerbs said that other local hospitals also have ended incentive pay, and that the hospital’s plan to add shifts is intended as a short-term, precautionary measure.
“As a taxpayer-funded nonprofit hospital, UMC has a unique responsibility to maintain a high level of fiscal responsibility,” Kerbs said in an email.
‘Surprised and saddened’
In a March 7 memo to the nursing staff, chief nursing officer Deb Fox said she was “surprised and saddened” by the actions of some nurses when the incentive pay was eliminated.
Some nurses who had signed up for extra shifts with the promise of the incentive pay called off of work when the bonus ended, UMC nurses said.
“It was apparent that the incentive crisis pay was no longer being valued as a short-term way of recognizing those going above and beyond, but rather an expectation of entitlement,” the memo states.
The memo infuriated some nurses, and the fury only grew when a popular nurse advocate known as “Nurse Erica” made fun of it in a TikTok video.
Assigning the blame for the staffing shortage to nurses has lowered morale, nurses said.
“I love working at UMC,” Bolhouse said. “I’ve been there 22 years.” But she said she’s at the lowest point in her career. “It feels like my nursing division is sinking.”
A UMC ICU nurse said she’s at her lowest point of the pandemic, after feeling highly valued when the crisis was at its worst. To help out co-workers, she willingly picked up extra shifts at times when there was no incentive pay. But now she needs to recharge, and may need a co-worker to pick up a shift for her.
“UMC, stop telling me I’m a bad nurse for not working extra shifts,” said the nurse, who spoke on the condition of anonymity to avoid reprisal. “Stop making nurses look like money-hungry jerks.”
Return to normal
UMC’s Kerbs said that eliminating incentive pay comes as COVID-19 hospitalizations drop and operations return to normal.
“While these incentives represented a significant expense for Southern Nevada’s only public hospital, UMC’s world-class nurses truly deserved this additional pay during the most challenging time in our hospital’s 90-year history,” Kerbs wrote in an email.
As of Tuesday, the hospital had 16 hospitalized COVID-19 patients, a significant decline from the nearly 170 daily patients the hospital recorded at the peak of the omicron surge.
UMC maintains the highest nurse-to-patient ratio in the state, he said, and the extra shifts are needed to maintain that ratio.
To limit the need for overtime, UMC continues to use traveling nurses to bolster staffing, he said. Since January, UMC has hired 41 nurses, a trend the hospital expects to continue.
Severe staffing shortages, especially for nurses, have been experienced at hospitals across Southern Nevada.
The Nevada Hospital Association on Wednesday said that hospital staffing has improved from “crisis” to “warning” levels, a significantly improved situation that still requires mitigation measures.
At Sunrise Hospital and Medical Center, incentive pay for working overtime was reduced last month from $50 per hour to $10 per hour, said one nurse in the medical-surgical unit, who spoke on the condition of anonymity for fear of reprisal.
The nurse said the change has led to fewer nurses working overtime, which has worsened the ratio of nurses to patients. As a result, it’s taking longer for nurses to respond to call buttons, which has led to patients falling, according to the nurse.
“I don’t want to pick up overtime when I’m going to have eight or nine patients,” instead of the norm of six, the nurse said, which is “too exhausting” and increases the risk of error.
In a statement, Sunrise Hospital said, “As all hospitals across the country grapple with staffing in the middle of a national nursing shortage and the pandemic, we support our Sunrise Care Team by leading aggressive and creative nurse recruitment initiatives and contracting travelers to provide additional support and relief for our nurses.”
The hospital said it is not relying on mandatory overtime.
Shortage preceded pandemic
The nursing shortage preceded COVID-19, authorities say.
The retirements of baby boomers, nurses transitioning from bedside care to become nurse-practitioners, and the need for more nurses to care for an aging population already had caused a shortage before the COVID-19 pandemic, said Brian Oxhorn, dean of the College of Nursing at Roseman University of Health Sciences in Southern Nevada.
When the pandemic hit, “You can’t just ramp up your supply as the demand increases,” Oxhorn said. “It’s going to take time to get the nurses into the workforce.”
To become a nurse requires first obtaining a two- or four-year degree and then months of on-the-job training, he said.
Desperate for nurses to care for COVID-19 patients, hospitals turned to using traveling nurses who cross the country to work in hotspots, and who can command five times the salaries of staff nurses, Oxhorn said. Hospitals also began to offer incentive pay for overtime to retain nurses.
“That’s not a model that’s sustainable,” he said, noting that the situation will worsen as hospitals lose federal pandemic relief funding. “You can’t keep paying those prices and stay in operation.”
But there are no easy answers, he said, as nurses are understandably burned out. “I feel for both sides,” Oxhorn said.