Hawaii’s most understaffed hospital in dire need of more beds too

Hospital leaders confirm the facility has been over capacity and understaffed for more than a year.
Published: Aug. 31, 2022 at 6:17 PM HST|Updated: Sep. 2, 2022 at 6:07 AM HST
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HILO (HawaiiNewsNow) - Officials at Hilo Medical Center say the facility is in dire need of more beds and frontline caregivers as the number of people in the community has outgrown the hospital.

According to the Healthcare Association of Hawaii, Hilo Medical Center is the most short-handed hospital in the state.

Hospital leaders confirm the facility has been over capacity and understaffed for more than a year. Nurses say those issues are directly impacting patient care.

Earlier this month, hospital officials invited Hawaii News Now to get first-hand look at what’s happening within Hilo’s emergency room, the intensive care unit and in the hospital’s progressive care unit.

On a recent weekday at around 10:30 a.m., ER staff raced against the clock to prepare for a patient suspected of having a stroke.

Over the PA system, the hospital broadcast: “Stroke team activation in the emergency department.”

The woman was rushed out of the ambulance and immediately taken for a brain scan.

“It’s a bleed,” a nurse announced to a room crowded with caregivers who are standing by.

A caregiver shouts, “Start the Cleviprex.”

When someone has a stoke, minutes determine if a person will walk again, if they’ll ever speak again and if they’ll ever see ever their family again.

“She did squeeze my hand a little bit,” said one of the many nurses standing at the patient’s bedside.

In moments like this, observation is critical.

Seconds later, another caregiver called out to a doctor, “I think she’s seizing.”

But the reality is — there are times caregivers are pulled away. And in this line of work, you don’t always get a second chance.

“Unfortunately, things are getting missed,” said Ashley Mae, Hilo Medical Center Intensive Care Unit registered nurse.

“It’s the fact that we’re so full. We cannot care for all of our patients and it hurts because we just don’t have room for them anymore.”

Nowadays, they’re coming from all over.

‘We’ve outgrown our hospital’

On top of caring for communities along the 80-mile stretch from Honokaa down to Kau, Hilo Medical Center has become the catchall for patients the Big Island’s smaller hospitals aren’t equipped to handle.

It doesn’t stop there.

People are sometimes flown into Hilo from other parts of the state too.

“We need not only more staff,” Mae said. “We’ve outgrown our hospital.”

For more than a year, the 166-bed facility hasn’t just been full — it’s been over capacity by as much as 30%.

That means there are days where staff has had to find extra space for as many as 50 people.

“It’s not fun for the patients,” said Tyler Sumner, Hilo Medical Center Emergency Room registered nurse. ”In the emergency room, it’s very common to see someone waiting six-plus hours.”

The once empty hallways are now crowded with gurneys. The sick are constantly shuffled around.

“Out of 28 (emergency room) beds, sometimes 24 (patients) are waiting for beds upstairs,” Sumner said. “So you’re playing with four rooms.”

That’s because it’s taking longer for patients to be discharged.

Officials say even though some are well enough to be released, staffing shortages at many of the island’s long-term care facilities means they have to stay put — until there’s a place for them to go.

Another issue is a lot of the people being admitted are sicker than patients prior to the pandemic — making recovery times longer.

The problems have created backlogs in just about every department.

“We’re just so congested,” said Caitee McCallister, registered nurse in Hilo Medical Center’s Progressive Care Unit. “When we come in - in the morning. We’re seeing a whole list of patients waiting for us.”

Over in the Intensive Care Unit, there are just 11 beds.

“Usually we are full,” said Mae.

Grappling with a severe workforce crisis

Some patients are so ill, they require the full-time attention of a nurse — sometimes two.

But severe staffing shortages have these caregivers spread thin.

“Our patients have unfortunately suffered because of that,” Mae said.

The workforce crisis has hit Hilo Medical Center particularly hard.

Right now, nearly a quarter of the hospital’s 335 registered nurses are travelers who are flown in from the mainland. And even that’s not enough.

“I know last week I worked five days,” said Mae.

That’s a 60-hour work week.

She says some 12-hour shifts are so chaotic it’s leaving caregivers shell-shocked.

“We all just sit back at the end of the day and breathe a sigh of relief that we made it through,” said Mae. “And that our patients made it through.”

It’s a cycle that too often is putting people’s lives in jeopardy.

“When we can’t give our patients the attention that they need, we beat ourselves up. (Thinking) oh, if I could have been there for this — I could have done this,” Mae said.

Patients who should have had more time.

There is a plan to expand Hilo Medical Center for the first time in nearly 40 years. But the hospital’s Bed Expansion Project isn’t a go just yet.

The facility is currently seeking upwards of $50 million in funding from the state Legislature.