TikTok video of nurses confronting admin over staffing prompts investigation of New York hospital

Erie County Medical Center in Buffalo, N.Y., faces a state investigation related to its comprehensive emergency psychiatric program after allegations of a 1:53 nurse-patient ratio spread on social media, according to nurse.org.  

The New York State Health Department confirmed the investigation in a statement shared with Becker's.

"The Office of Mental Health and Department of Health are aware of the complaint and are investigating the matter," department spokesperson Monica Pomeroy said in the statement.

According to The Buffalo News and nurse.org, a video posted on TikTok and on a Reddit thread appears to show workers confronting hospital administrators and asking about staffing plans for the week.

The publications report that one woman in the video indicates she has cared for 50 patients during one shift, and workers contend they are dealing with 1:53 ratios and double-digit ratios. 

Erie County Medical Center's comprehensive emergency psychiatric program is the only behavioral health emergency department in the region, according to The Buffalo News.

The newspaper interviewed patients, family members, mental health counselors and mental health advocates, and many described deteriorated conditions amid staffing challenges.

In a statement shared with Becker's, the hospital said that the dynamics it faces "are occurring statewide and nationally with the inability to discharge patients for weeks and months, as well as staffing shortages. These dynamics have been widely reported."

The hospital also said it continues to see high patient volume challenges in its comprehensive psychiatric emergency program because it is unable to discharge patients to state-supported programs, an issue that is "coupled with inadequate Medicaid reimbursements."

"As we work through these community dynamics, we are working with our [state] nursing association union representatives to resolve these challenges, which include filling 12 current open nursing positions," the hospital said.

Additionally, the hospital said it has hired 39 new comprehensive psychiatric emergency program staff year-to-date, and have seven new nurses starting in the unit, "with more nurses soon coming on board; we will temporarily hire travel agency nurses to fill those other vacancies until the remaining nurses complete their orientation and start working in CPEP. Year-to-date our average daily patient census in CPEP is 32."

The hospital also said it has "implemented a plan to communicate with patients and their families both verbally and in writing information concerning CPEP processes at the time of arrival to CPEP and upon admission to CPEP." Other efforts cited by the hospital include providing staff with additional education, which included elements of a model that "incorporates tools for staff to utilize for compassionate communication throughout the CPEP process, and how to assess and provide for all patient needs."

The hospital is also expanding behavioral health services such as partial hospitalization and intensive outpatient programs for patients who don't require emergency care in CPEP. The hospital is also looking to partner with community-based behavioral health providers to care for more patients. The video comes as the New York State Nurses Association is negotiating a new contract for nurses at the hospital. Their last contract expires Dec. 31.

"We continue to be frustrated by management's lack of urgency and lack of a real plan to hire and retain the nurses we need to deliver safe patient care," said Steve Bailey, RN, Western New York regional director of the union, in a statement to The Buffalo News. "As nurses, we are committed to delivering safe, quality care to every patient. At this point, we are sending an SOS to management that we need the nurses and resources to be able to do our best for our patients — and we need them now."  

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