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State Hospital works on staff shortages

Staff shortages result in high use of overtime leading to exhaustion, low morale, high turnover and increased risk of medical error and incidents, said Rosalie Etherington, superintendent of the North Dakota State Hospital at the Governing Body's...

Staff shortages result in high use of overtime leading to exhaustion, low morale, high turnover and increased risk of medical error and incidents, said Rosalie Etherington, superintendent of the North Dakota State Hospital at the Governing Body’s quarterly meeting Monday.

The good news is that leadership positions may soon be filled, she said. The staff perform well but there is need for constant support and leadership, she said.

“As of Friday night we have three possible applicants for the position of director of nursing,” said Etherington, who is also acting chair of the governing body.

Lyle Grove, human resource director, said in his report that three psychologists and clinical forensic psychologists have been hired over the past year but the search for psychiatrists, nurse practitioners, registered nurses, licensed practical nurses and direct support staff is ongoing.

“The turnover rate over 10 years has increased from 10 to 28 percent,” Grove said.

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Of the 113 employees who left in 2017, he said 64 percent resigned, 20 percent retired, 16 percent were dismissed, 11 percent were “other” and 2 percent died while employed. High turnover rates are similar among psychiatric hospitals across the nation, he said.

North Dakota has fewer people looking for work with a 2.6 percent short-term unemployment rate, he said. Stutsman County has a 2.3 percent unemployment rate, Grove said.

Exit interviews show people are leaving for a wide range of reasons, he said. Higher pay and different job duties, lack of day care, workplace environment, civility, the mentoring process, personal or mental health reasons were all mentioned, he said. Fast turnover does not allow adequate transition of new staff, he said.

The Governing Body approved 10-0 to approve the reappointment of existing medical staff. Pam Sagness, chair, and Shelly Peltier, tribal representative, were not present.

The market is competitive, said Eduardo Yabut, medical director of the State Hospital in his report. Partnerships with medical schools and university health programs make the State Hospital a site for clinical rotations and internships for occupational therapy, nutrition and dietician and have led to applications upon graduation or licensure, he said.

The State Hospital has utilized a travel nurse agency and is talking with an international nursing organization to staff nursing positions that cannot be filled, said Lincoln Coombs, director of quality management and psychology.

“This is something new for us,” Coombs said.

There are inherent and unavoidable safety concerns to all state psychiatric hospitals and workplace safety is now central to a review of policies and practices on the work environment, reporting, accountability and expectations, he said.

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The State Hospital has heard from other members of the Western Psychiatric State Hospital Association and identified consistent difficulties with scheduling practices and workplace safety, he said.

The State Hospital has reduced incidents of violence or trauma from 26 to 17 incidents or 34 percent since the third quarter 2017 by using a behavioral support plan, he said. A trainer will be on site to discuss a client and recovery-centered approach to reducing violence and to minimize the need for seclusion and restraint, he said.

Related Topics: NORTH DAKOTA STATE HOSPITAL
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