PA Hospital Hit for Staff Shortages

By Walter F. Roche Jr.

A state report on a 412-bed Pennsylvania hospital has concluded that staff shortages at the facility have jeopardized patient care and caused serious injuries to at least two patients.
The detailed report on the Wilkes Barre General Hospital comes just months after nurses at the chain owned hospital went on strike.
The report, issued recently by the state Health Department, was the result of a complaint investigation, and followed an on site visit by state surveyors from Sept. 10-14.
The hospital is owned by the Tennessee based Community Health Associates. The for-profit firm last year sold off four of its Pennsylvania properties including the Chestnut Hill Hospital in Philadelphia.
Hospital officials did not respond to requests for comment.
According to the inspection report staffing levels at the Wilkes Barre hospital fell below expected levels for 81 of 148 shifts reviewed. In addition 91 registered nursing positions were unfilled.
It was a lack of staffing, the surveyors concluded, that enabled two suicidal patients, who were supposed to be on constant one-to-one watch, to injure themselves.
One patient, who was not properly monitored, had hidden a razor in his mouth and was discovered with multiple open lacerations on his arms and neck, some requiring sutures.
"The facility failed to prevent self harm of suicidal patients," the report states.
Surveyors found that although a doctor had ordered that the patient have "direct observation at all times" shortly after admission on Aug. 11, no sitter was available.
A little over an hour after admission the patient was found with the lacerations.
The surveyors found that although the hospital had purchased a high tech metal detector, it had been placed in storage because there was insufficient staff to operate it. Instead the patient was checked with a wand that failed to detect the razor.
After the wounds were discovered, the patient, at the request of a staffer, removed the razor from the mouth and handed it to the nurse.
The second patient was admitted on Sept. 13 at 1 a.m. and a doctor also ordered "direct observation at all times." The patient went un-watched and was discovered hypoxic and non-responsive later on the same day. The report states that the patient used gown strings for self strangulation.
The patient was bagged and regained consciousness, surveyors reported.
"Nursing documentation revealed there was no sitter at the bedside due to lack of staffing," the report states.
The facility also was faulted for failing to remove restraints on the same patient on a timely basis or for proper monitoring while the restraints were in place.
A review of the records of four other suicidal patients showed three of the four went without sitters, despite physicians' orders.e
As for staffing in general the inspectors found that the facility failed to provide organized nursing services 24 hours a day.
"The chief nursing officer and assistant chief failed to provide oversight," the report states.
The lack of staffing also was blamed for delays in delivering patient medications in two of three cases reviewed.
A staffer told the inspectors there was insufficient staff to turn patients or care for patients properly.
The staffing was unsafe for patients and staff, one employee reported, adding,"The patients on our unit are very sick and this is not fair to them."
This is the worst they've ever seen it and morale is down, the surveyors related.
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