GLOVERSVILLE – For the second time in the last two weeks, Nathan Littauer Hospital diverted incoming patients to its emergency room to other hospitals from Wednesday evening until Thursday at around 11 a.m.
Fulton County Emergency Management Services Coordinator Steve Santa Maria posted the announcement of the hospital diversion to the Fulton County Emergency Management/Fire Coordinators Office Facebook page at approximately 6 p.m. Wednesday. The post had been shared 498 times, as of Thursday evening.
Nursing staff shortages have contributed to less available hospital beds coinciding with high patient volumes at the time of both diversions.
Geoff Peck, hospital vice president for business development and its media spokesperson, said Fulton County’s public notifications about hospital diversions have “become helpful” as far as explaining how hospital diversions work to the public.
“We didn’t go on diversion for 20 years, we never had the need,” Peck said. “In the last two years, a situation of low staffing and really high acuity [and incidence of illness] has made us go on diversion multiple times. So, the first time or two, I think it was very confusing as to what was happening, but I think the county has educated people a little bit and answered people’s questions.”
Peck described the circumstances of this week’s diversion. He said at 5 p.m. Wednesday the hospital’s Emergency Room Department (ED) was completely full and the hospital was forced to initiate the patient diversion.
“We had people waiting in the lobby to be seen,” Peck said. “Our special care unit was full. Our third floor Med-Surge [medical surgical unit] was full, and we were holding people in the ED, without the capacity to move them to Med-Surge.”
He said, over the past week, the hospital has seen an uptick in patients to the emergency department exhibiting a wide range of illnesses, but also a lot of “respiratory stuff,” as well as patients who’ve deferred care for different ailments over the past two years during the pandemic, causing medical problems to build up.
“We’ve had a really high incidence of [emergency] cases, this week, and I think our highest number was 83 [patients], which is really high for us,” he said. “Not only are we seeing a lot of people in the ED, an above normal number of people, but they’re sicker than usual. We’re admitting more people to the ED, and we’re discharging fewer, and that’s creating kind of a perfect storm.”
Santa Maria said staff shortages are affecting every hospital and ambulance company in the region.
“It’s just an over abundance of patients and not enough beds,” Santa Maria said of Littauer’s patient diversion.
Santa Maria oversees Fulton County’s Ambulance Incentive Plan, which provides a subsidy for ambulance companies operating in the county in exchange for oversight and data, including information about EMS calls as well as staffing levels for the ambulance companies. He said he doesn’t have figures regarding how many hospital beds were in operation at the time of the diversion, but he believes the hospital being short staffed was a factor.
“On my end, it’s more about notifying all of the ambulances that they are going to be diverted, and trying to get the word out to the public to say, ‘Hey, things are crazy up at the hospital,’ and can we try to make sure we’re using the resources correctly,” Santa Maria said. “[Public announcement of the hospital diversion] affects things a little bit. It seems to slow it down. The more the story gets spread and whatnot. It’s kind of similar to what we saw during COVID, nobody wants to go to the hospital, and we have a lot lower call volume, unless somebody is really, really sick. I’m not encouraging people not to call an ambulance if they need to, but some of the call types we see are [cases] that might best be dealt with in an urgent care setting, or primary care physician. We just want to educate the public, so they’re using resources correctly.”
Santa Maria provided the number of ambulance calls in Fulton County over the last several days:
- Monday — 30 calls
- Tuesday — 34 calls
- Wednesday — 29 calls
- Thursday — as of midday, 8 calls
A spokesperson from the New York State Nurses Association said the registered nurse bargaining unit at Nathan Littauer currently has 106 members, which is down from a range of 120 to 130 prior to the pandemic, a NYSNA official said.
Peck said staffing levels do effect the hospital’s patient capacity, but said it was a “pure coincidence” that both of the recent patient diversions occurred on Wednesdays and then lasted until midday Thursday.
“[Bed capacity] does adjust due to staffing, but it is fairly static, so there are not wide swings in the patients we can take based on staffing,” he said. “We were in good shape on our Med-Surge floor, and we were a little bit understaffed in our ED, but we had a full ED.”
As of Jan. 1, 2022, Fulton County had a lower rate of registered professional nurses per 1,000 residents — 12.17 — than its neighboring counties: Montgomery (15.36), Saratoga (17.34), Schenectady (17.59) and Albany (16.9), according to data from the state Education Department.
Peck said a smaller number of registered nurses living in Fulton County is part of the shortage problem, as is the high number of older nurses who retired during the pandemic who aren’t being replaced in the same number by younger nurses. He said Nathan Littauer Hospital recruits for the same nurses as other hospitals throughout the entire region, including part-time traveling nurses that help maintain staffing levels.
“We need more nurses, every organization needs more nurses, but it’s not just nurses; it’s environmental care staff to clean a room after it’s been vacated, it’s dietary staff, it’s all of the hospital operations being affected in every department, not just nurses, “ Peck said. “We have travel staff here. We have for the last several years. We’ve always used travel staff to fill normal gaps — maternity leaves, things like that, extended sicknesses, but over the past two years — during the ‘Great Resignation’ — we’ve had to fill more and more jobs with temporary staff, but temporary staff is hard to find. Every [hospital] system is competing for those temporary workers too.”