Schneider Hospital Campaign Slowly Reversing Post-Hurricane Staff Exodus

Schneider Hospital staff stand by as a prospective applicant fills in paperwork.

Schneider Regional Medical Center opened its doors on Wednesday for its Open House and Career Day, an event that’s part of a larger campaign to augment its staffing numbers decimated by the 2017 hurricanes.

On Wednesday, Schneider Hospital’s lobby saw a bigger crowd than usual, with hospital upper management and human resources staff walking around to address potential questions from job seekers. One corner of the lobby became a makeshift radio studio manned by Addie Ottley, who interviewed Schneider executives in turn. Tables with application forms and sign-in sheets greeted attendees who quickly received attention from staff on standby.

“This is specifically designed to address the job issues…it’s designed to be able to reach out to various specialties in the medical field, primarily registered nurses, medical technologists for our laboratory, and necessary therapists,” said Schneider CEO Bernard Wheatley.

Wednesday’s job fair was part of the hospital’s strategy to attract fresh hospital staff to St. Thomas. Its human resources division also launched ads in healthcare magazines across the nation and used events like Wheatley’s presentation at the famed Becker’s Hospital in Chicago to let mainland practitioners know of the vacancies on the island.

“When it comes to recruiting to the islands, it’s always a unique situation, because individuals have to make that deciding effort that ‘we’re going to move to an island,’” said Human Resources Director Rolda Mason. “Inasmuch as we’re getting a lot of traction from that, the final decision, the proof is in the pudding.”

Along with a salary increase instituted in July — an additional $12,000 a year for nurses — and the launch of a referral program, the hospital hopes to address the severe staffing shortage that directly resulted from the hurricanes; it lost a total of 175 employees, 44 of them registered nurses.

Mason said Schneider’s focus currently lies in hiring much-needed clinical staff, not necessarily getting the numbers back to pre-hurricane levels.

“We’re seeking to employ 40 to 50 nurses right now,” said Mason. “That doesn’t include CRNAs, certified nurse midwives and things of that nature…we’re climbing back to sort of where we were pre-storm in terms of services, so we want to make sure we have the right staffing.”

In addition to nurses, the hospital also needs medical doctors specializing in internal medicine, anesthesiology and interventional cardiology. Luis Amaro, chief medical officer at Schneider, said that of roughly 120 credentialed medical providers at the hospital, about 50 are physicians and only about 25 are on staff.

“We have some severe shortages. Right now, we don’t have a gastroenterologist on staff and we’re looking forward to get that back in,” said Amaro. “It’s very promising that as we turn over the year, we’ll be able to fill in a lot of these positions.”

Getting clinical staff to come onboard as permanent employees would help the hospital avoid hiring costly locum tenens, transient doctors who help out in critical areas like the emergency department. In contrast, helping doctors relocate to St. Thomas and paying them a fixed fee would drastically cut those costs.

The short tenures of locum tenens providers also deprives patients of continuity, said Wheatley, if they are seeing different doctors.

“They come in for short periods, three weeks, sometimes two weeks, and then they leave,” said Wheatley. “It would be greatly advantageous to have permanent doctors here. That’s the key.”

According to Wheatley, the hospital is also balancing out the number of traveling nurses compared with permanent nursing staff. From roughly 30 traveling nurses prior to the storm, Schneider now has only about six, a reduction that also helps cut down costs and provides more continuity in patient care.

While there remains a critical need for nurses, the reduced number of hospital beds — currently, 21 adult beds — due to hurricane damage is alleviating the high ratio of patients to nurses, a situation that can become fertile ground for medical errors if left unchecked, according to Wheatley. Yet Schneider Hospital is also seeing an uptick in emergency room activity, which means the hospital will soon need to expand its bed capacity.

The staffing shortage also exacerbates the problem with long emergency room wait times, although Wheatley attributes the problem mainly on the reduced patient beds and the increase in “boarders,” patients treated at the hospital that their families or the nursing home would not claim. With not enough beds, emergency room patients bottleneck in the ER, choking the ER’s ability to function smoothly and putting additional strain on a staff already stretched thin.

More than a year after the storms, Wheatley said they have been able to recover only about 35 employees of the 175 they lost. The chief executive, however, said that due to their energetic hiring efforts, the staffing situation is “incrementally moving in the right direction,”

“I’m a very aggressive thinker,” said Wheatley. “I’m hoping in 12 months from now, we’re at a point where we don’t have any traveling nurses, and we’re able to meet all the criteria for patient ratios and we don’t have any outliers that would produce concerns from a regulatory standpoint.”

Wheatley said that the hospital is fully accredited by both the Joint Commission and the Centers for Medicare and Medicaid Services. In regards to St. Thomas residents continuing concerns about the hospital’s ability to provide quality care, Wheatley said Schneider Hospital has no conditional level issues with the regulatory bodies that make sure they are indeed providing quality healthcare to the community.

As for the decision to rebuild or repair the hospital, Wheatley said the executive staff’s position is to repair the original structure instead of building a new hospital from scratch. According to Wheatley, the hospital has enough space to allow the repairs to be done in phases, a strategy that would also introduce less disruption to the hospital’s operations.

Assessors have determined that the hospital’s hurricane-related damage represents 47 percent of the total structure, according to Wheatley, just below that 51 percent threshold that would trigger a rebuild funded fully by the federal government.The final word on that, however, lies with the Federal Emergency Management Agency, the Army Corps of Engineers, and the Virgin Islands government, said Wheatley.