Flu worsens problems of ERs turn patients away because of nurse shortage

Posted: Wednesday, November 28, 2001

ANCHORAGE (AP) -- A shortage of critical care nurses is causing Anchorage hospitals to divert ambulances from emergency rooms, forcing paramedics to look elsewhere, according to doctors and paramedics.

The problem was first noticed in 1998 but got noticeably worse this month with an outbreak of influenza that overwhelmed emergency departments, doctors and hospital officials said.

Providence Alaska Medical Center experienced eight periods -- lasting from hours to days -- this month in which ambulances were diverted. As of Tuesday afternoon the total diversion time was a record 277 hours, said hospital spokeswoman Karina Jennings.

At Alaska Regional Hospital, the November numbers are even more striking: 11 diversion periods totalling 380 1/2 hours, said spokeswoman Kjerstin Lastufka.

No one could cite any lapse in patient care because of the diversions, but ''it's a layer of confusion that shouldn't be there,'' said Kurt Sorensen, a paramedic battalion chief with the Anchorage Fire Department.

At one point, when Providence and Alaska Regional were diverting ambulances, a paramedic called both hospitals to see if they could accept a patient with a history of heart problems. Neither could, and the heart patient was taken to Alaska Native Medical Center, which doesn't have heart catheterization services, Sorensen said.

The topic came up Tuesday at the monthly meeting of the mayor's emergency medical service board, a policy group that includes doctors, nurses, paramedics and others.

The group is looking to fine-tune what happens when all three hospitals notify the city's dispatch center that they are diverting ambulances at the same time. Doctors said they believe that has happened several times this month, the Anchorage Daily News reported.

Already a protocol kicks in that says if all of the hospitals try to divert ambulances, then none of them can do so, to ensure patients get care somewhere. Patients may get immediate treatment, but then stack up in emergency rooms while waiting for a hospital bed to open up.

The city is working on a policy to give dispatchers more control to direct ambulances so that they all don't end up at the same overloaded hospital, said Soren Threadgill, deputy fire chief for emergency medical services.

The main reason for the diversions is a nationwide shortage of critical care nurses in the hospital, not a crunch in emergency departments, Anchorage hospital officials said.

Hospitals use temporary, traveling nurses to help fill the gaps, but it has been difficult recently to attract them. Alaska Regional has 20 such nurses, including three in critical care, and is looking to hire more. The problem is luring them in the winter, especially as Christmas nears, Lastufka said.



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