The nursing shortage in Utah just took a turn for the worse with the Army Reserve's activation of the 328th General Hospital at Fort Douglas Monday.
The state will also have a shorter supply of doctors because of the activation of the second Salt Lake-area military hospital.The unit's 700 members are spread out from St. George to Pocatello to Colorado, and include doctors, nurses, pharmacists, therapists of all sorts, administrators and other support personnel - the makings of a full-service, 1,000-bed, tertiary-care hospital.
Utah hospitals began implementing contingency plans to compensate for the shortages.
Linda Jo "GI Joe" Nielson, director of nursing at Mountain View Hospital in Payson, is "honored to be called up and honored to serve my country in this way.
"There is probably not a better general hospital and people to start a general hospital than the 328th," Nielson said. In addition to Nielson, five doctors from Mountain View are being activated.
The Veterans Administration Hospital will lose 33 employees to the latest call-up, said spokesman Warren Longley. That may affect patient referrals from surrounding states.
Hospitals will deal with staff shortages by doing what University Hospital plans to do: adjust shifts, call in extra people, have staff work extra hours and increase recruiting efforts.
Dr. Robert Jones, chief of medical services at the Utah State Prison, is a lieutenant colonel with the 328th and began interviewing his potential replacements Monday afternoon, just hours after the activation was officially announced.
Prison officials have spent several months preparing for the possibility that Jones might be called away because of Operation Desert Shield. "(Corrections Director Gary) DeLand asked for my recommendations on replacements. We've spent months working on it," he said.
A total of three members of the prison's medical staff are members of the 328th and will be leaving their jobs for the 180-day call-up. "Prisoners are the only Americans who are guaranteed access to medical services under the Constitution," he said, pointing out the correction's department's need to be prepared with replacements.
Jones said he has also been impressed with the signs of support because of the activation - both from his neighbors who have offered to help take care of the needs his wife and six children will have while he is away; and from other area doctors who have offered to fill in with the prison's medical needs. Calls from the other doctors started coming in long before the activation was announced but long after rumors of the activation began circulating in the medical community.
Jones said he has also been warning the patients in his private practice for three months that he might be leaving temporarily.
Jones went through medical school on a military scholarship and spent 10 years after that in the Navy. Some other doctors in the 328th have similar military-sponsored educations and active-duty service backgrounds, he said.
Intermountain Health Care spokesman John Taylor said that the organization has lost 127 doctors, nurses and suppport personnel to the call-ups. Many of the people are specialists, potentionally leaving IHC in a tough situation, Taylor said.
John Dwan, director of community relations for the University of Utah Hospital, said 27 nurses, six doctors and a number of technicians and administrative personnel are being called up as part of the 328th. The number of nurses at the U. expected to be called up may climb as high as 50, Dwan said.
"It will have a serious impact on hospital operation, primarily in the nursing situation," he said. "We in no way will let personnel problems affect the quality of care, but it is going to cause some problems for the health-care community in the state."
Nathan Dwight Williams, an emergency room doctor at Mountain View Hospital in Payson, is one of the 60 doctors in the unit.
"We've known for some time (a call-up) was likely," he said. "You're never ready to go. That is something that you just accept and you interrupt things in mid-cycle."
Williams hopes the unit will not be split up.
"If we're split up, that would probably work to the disadvantage of the cohesiveness and morale of the unit," he said. "We hope we all stay together, but the Army does what it wants to do."
This weekend, unit members got a pretty big hint they might be activated when they were called to participate in a "prepared overseas movement," an exercise in getting all paperwork and other details in line prior to being deployed.
Faced with spending Christmas away from their families, some members of the unit, like Mark Meadows, a public relations spokesman at St. Mark's Hospital, will celebrate the holiday with their families this week. Ten to 12 staff members at St. Mark's are being activated.
The call-up creates not only personal hardships but also practical hardships for the medical personnel involved - particularly doctors who will close up their practices for the three to six months they'll be gone. That includes laying off office staff.
The call-ups will also deal a double whammy to at least one physician - Dr. Earl Duke who has obstetrics/ gynecology practice in Logan. When Duke was called to active duty as commander of the 144th Evacuation hospital, he said his partner planned to cover the practice until Duke returned. But the partner is on the staff of the 328th General Hospital, which has now been activated also.
Dr. Robert Frampton, a family practitioner in Spanish Fork, said trying to close up a practice on short notice is "really hard to do."
"You have a lot of people that depend on you, babies to be delivered, people in the hospital - I've got four people in hospital right now," Frampton said. "It's hard to get everything organized as quick as we are leaving."
Most doctors will lose about 50 percent of their income, while the expenses of a practice - such as malpractice insurance, office rental, etc. - will continue, Frampton said.
"I kind of thought when they took one hospital unit from Utah they might not take another," Frampton said. "I had hoped the reserve would stay home and take care of the women and children, but we'll go where we're needed."
Marshall Willis, chief of staff at American Fork Hospital, which is sending one nurse and three doctors, said "We're proud of our physicians who are serving in the reserves and although we will miss them terribly, we would like to assure the community that area doctors are willing to help fulfill the medical needs of the community during their absence."
328th General Hospital call-up
Number: 700 Army Reserve doctors and nurses.
Capability: The unit is capable of staffing a 1,000-bed hospital. Army Reserve officials have not specified how many members are doctors and nurses.
Effect on local hospitals: Puts strain on services because it is the second military hospital from Salt Lake City to be called into service for Operation Desert Shield. The first unit to be called up, the Utah Army National Guard 144th Evacuation Hospital, had 425 members.
Departure: Ordered to report to Fort Douglas Thursday. Will leave for Fort Carson, Colo., Monday.
Final destination: Several members of the 328th said they expect their duty assignment will be in Germany. It is also possible that the hospital staff will be split up and sent to several different locations.
Other facts: The call-up roughly doubles the number of Utah's Reserve and Guard troops involved in Desert Shield. Numbers of Utahns involved in Desert Shield is estimated at 3,700.
History: The 328th was reorganized and assigned to Fort Douglas in 1947 after World War II. During that war, the hospital, known then as U.S. Army Base Hospital No. 35, was assigned to New Guinea in 1944 and 1945. In 1918 during World War I, the hospital was sent to France.