Editorial: Staff shortage needs better fix

Sunday, Dec. 4, 2005 | 8:33 a.m.

A recent audit that says deficiencies at the Southern Nevada Mental Health Hospital contributed to two patients' deaths and attacks on nurses shows the results of an underfunded, understaffed state mental health care system.

According to a recent report in the Las Vegas Sun, the audit by the Centers for Medicare and Medicaid Services shows a shortage of staff contributed to a litany of problems that, some days, left patients without a physician present.

Only one on-call physician was available to take care of 77 patients during an April weekend when a 28-year-old homeless man hanged himself and died, and a woman died because of complications of a new medicine, the audit reported.

In addition to these deaths, the audit says a lack of staffing contributed to incidents in which nurses were physically attacked by patients and had no one to call for help. Some of these workers suffered broken bones.

The 130-bed hospital also has no dedicated space for therapy sessions, which were scheduled but never conducted. Patients spent their days sitting on benches doing nothing or watching television, the audit says. They were lined up and given medications for which no explanations were offered.

The images trouble Carlos Brandenburg, director of the Nevada Division of Mental Health and Developmental Services. To free up space for therapy immediately, the state is sending 10 patients to a smaller, private facility. And the state is to open a new 150-bed mental health hospital in April.

But those actions won't address the biggest challenge facing the system, which is finding enough qualified psychiatric care nurses. The existing hospital's inpatient facility is 11 nurses short, and its outpatient clinic has 12 vacancies. The new hospital will need 99 nurses.

The 2005 Legislature increased the facility's budget by $12 million this fiscal year and $24 million next year. As a result, pay for Nevada's psychiatric nurses is now competitive with a few Western states but still lags behind California.

Brandenburg said the shortage is a national problem. The state personnel office and the mental health system's nursing manager are diligently contacting universities and posting national advertisements to recruit nurses.

But Nevada competes with $10,000 signing bonuses offered by private hospitals, Brandenburg has said, adding they can't afford to hire a full-time recruiter.

We don't see how they can afford not to hire one.

The mental health care system's desperate situation cries out for more flexibility and creativity in hiring nurses. The Legislature's Interim Finance Committee is to consider increasing funding for nurses. It should include money to hire a professional nursing recruiter.

It is the least we can do for a system that needs more of our attention.