Providence Regional Medical Center Everett in Washington state is responding to local leaders' and outside the emergency department (ED) earlier this month.
Several days after the patient reportedly died in the ED waiting area, the Snohomish County Council and Everett City Council , expressing "disappointment" and "concerns" with the "handling of the staffing crisis amongst nurses."
Although the letter did not reference the patient death, it outlined more than a dozen issues that had been brought to local leaders' attention, including a worsening of nurse understaffing that is said to be contributing to burnout and decreased quality of care, as well as the fear of patient harm or the loss of licensing if mistakes are made.
In the letter, local leaders also detailed a number of proposed actions the hospital can take to mitigate the situation, such as meeting with nurses to hear their concerns and ideas to improve care, advocating for funding or regulatory changes in state law that may help address understaffing, and starting at the top when savings need to be made so the focus can be on competitive wages and benefits for nurses.
In response, a spokesperson for Providence said in an email to that to the Snohomish County Council and Everett City Council on November 18.
"The letter provides a thorough account of the challenges facing healthcare across the country, as well as their local impacts," the spokesperson said. "Our leadership has continued to meet with members of the councils over the last week and they have had collaborative and supportive discussions."
Specifically, the letter noted that, similar to other healthcare facilities across the country, Providence Everett has been greatly affected by the pandemic.
"Providence Everett was the first hospital in the nation with a confirmed case of COVID-19," the letter stated. "In addition to being at the center of the pandemic, more patients are coming in with more advanced diseases, hospitals' finances have been devastated by inflation and stagnant reimbursement rates, and healthcare staff are leaving the workforce nationwide."
The letter said the hospital plans to address recruitment and retention and has an eye on new and innovative care models. For instance, in response to the nursing shortage, the hospital will augment care teams with other clinical roles to support care, such as Nursing Assistants Certified (NACs) and nursing students hired as Nurse Techs.
The letter further noted that the hospital welcomes local leaders' "collaboration and support" going forward.
With regard to the recent patient death, the Providence spokesperson said in an email that the patient was in a bed when they died, and not in the ED lobby.
"In alignment with national best practices, we have processes and protocols in place to rapidly assess patients when they come to the emergency department and to guide their ongoing care and evaluation," the spokesperson said. "If a patient has a medical emergency in the emergency department, our specialized teams respond and initiate all appropriate resuscitation methods."
The spokesperson added that the hospital has initiated a review of the event and the relevant processes.
Kristy Carrington, RN, MBA, interim chief executive at parent health system Providence Swedish North Puget Sound, said the following in a statement: "We are deeply saddened by this incident and our deepest sympathies are with the patient's family and loved ones. We are providing counseling support for the patient's family, our nurses, caregivers and physicians."