Nursing Shortage Impacts the Number fo ICU Beds, Hospital Officials Say
As San Diego County's "demand for hospital services" increases with its rising population, hospital administrators are "confronting" the declining number of beds available, but the San Diego Union Tribune reports that determining the "appropriate number" of beds is an "inexact science." Coupled with nursing shortages, the flu season and an increasing number of uninsured patients, many hospitals are diverting ambulances more often -- making the issue of bed capacity "especially pronounced." The Union-Tribune reports that San Diego County has one of the lowest hospital bed-to-population ratios in the country with 2.25 beds for every 1,000 residents. By comparison, New Orleans has the highest ratio in the country with 5.21 beds per 1,000 residents. Hospital executives warn of an "impending crisis" if action is not taken to alleviate the bed shortage soon, but community leaders are "not sure" how to react to such warnings. Karen Gill, president of the League of Women Voters of San Diego County, said, "When (hospital executives) want money, they say there are not enough beds. When a hospital closes, they say there are too many beds."
Hospital administrators say the occupancy rates -- which have remained at 58% since 1994 -- can be "misinterpret[ed]" because they are based on the number of licensed beds a hospital reports to a state. However, many licensed beds "go unstaffed" and "skew the figures," making it appear that the hospitals have more beds available for patients than they actually do. Administrators say that the nursing shortage makes it "impossible" to staff all of the licensed beds at a hospital. Currently about 18% of licensed beds in the county, or 1,100 beds, cannot be used for patient care. The occupancy rate also does not consider the type of beds that a hospital has available. At Sharp Memorial, for example, the "overall" occupancy rate was at 66.6% for the first nine months of 2000. However, the surgical intensive care unit beds had a rate of 83.3% and the medical and coronary care ICU beds had a rate of 80.9%. Hospital executives say that the bed shortage is "greatest" in ICUs. ICU beds must meet "specific standards" and may not be converted from other beds. Standards regarding the availability of natural light, space around the beds and nurse to patient ratios differ for ICU beds, making bed "conversions ... virtually impossible."
To create more intensive care unit beds, hospitals are looking to build more wings with ICU space as they remodel to comply with state seismic requirements. In addition, hospitals are looking at bed and room designs to convert non-ICU beds with "minimal effort." Gary Stephany, the outgoing president of the Healthcare Association of San Diego and Imperial Counties, said, "If you take a look at the population growth, there's no way we're going to have enough beds" (Fong, San Diego Union-Tribune, 2/4).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.